Inspection on 06/02/06 for White Ash Brook Nursing Home

This inspection was carried out on 6th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

White Ash Brook Nursing Home 01/12/08

White Ash Brook Nursing Home 12/06/08

White Ash Brook Nursing Home 04/12/07

White Ash Brook Nursing Home 07/06/07

White Ash Brook Nursing Home 19/06/06

White Ash Brook Nursing Home 26/08/05

White Ash Brook Nursing Home 02/11/04

White Ash Brook Nursing Home 01/06/04

White Ash Brook Nursing Home 16/09/03

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE White Ash Brook Nursing Home White Ash Brook Nursing Home Thwaites Road Oswaldtwistle Accrington Lancashire BB5 4QR Lead Inspector Mrs Susan Hargreaves Unannounced Inspection 10:00 9th February & 2 March 2006 nd X10029.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People and Care Homes for Adults 18 – 65*. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service White Ash Brook Nursing Home Address Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) White Ash Brook Nursing Home Thwaites Road Oswaldtwistle Accrington Lancashire BB5 4QR 01254 394163 01254 872152 whiteash@zen.co.uk www.mimosahealthcare.com Mimosa Health Care Limited Mrs Janet Elizabeth Briggs Care Home 53 Category(ies) of Dementia - over 65 years of age (25), Mental registration, with number disorder, excluding learning disability or of places dementia (1), Old age, not falling within any other category (27), Physical disability (8) White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Within the overall total of 53 a maximum of 27 service users requiring nursing care who fall into the category of OP Within the total of 53 places there can be a maximum of 20 service users requiring personal care who fall into the category of OP Within the total of 53 places there can be a maximum of 25 service users requiring nursing care who fall into the category of DE(E) Within the overall total of 53 a maximum of 8 service users requiring nursing care who fall into the category of PD Within the overal total of 53 a maximum of 1 named service user who falls into the category of MD. When the named service user reaches the age of 65 years or no longer resides at the home an application to vary the registration and revert back to the original must be made. 23rd August 2005 Date of last inspection Brief Description of the Service: White Ash Brook is a purpose built home registered to provide 24 hour nursing and personal care for up to 53 people. The home has two separate units. Foxhill, which offers personal and nursing care for both older and younger adults and Stanhill, which offers care to older people suffering from dementia. Accommodation is provided in single en-suite rooms located on the ground floor. Communal lounges and dining rooms are also on the ground floor. The gardens are easily accessible to all residents. There is a car park for visitors and staff. The home is situated in the small town of Oswaldtwistle close to local amenities. White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two days. One additional visit has been made since the last unannounced inspection. This was to investigate a complaint about staff getting residents up early. Details of the complaint and the investigation are available from CSCI. This issue was monitored again at this inspection. A tour of the premises took place and staff files and care records were inspected. At the time of this inspection fifty-two residents were living at the home. Members of staff on duty, residents and visitors were spoken to. Discussions also took place with the business manager and nursing staff about issues raised during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Prospective residents should be given as much information as possible about a care home. This must include confirmation in writing their care needs can be met. Care plans for some residents need to contain more information to ensure that their care needs are fully met. Risk assessments should clearly identify the level of risk. Where a risk has been identified a care plan, which gives clear guidance about how the risk is addressed must be developed. Detailed records about the care and condition of a pressure sore must be kept. Residents must receive the help they need with personal hygiene. When a resident asks to be taken to the toilet assistance must be given promptly. The daily routine must be reviewed to ensure that vulnerable residents are not getting up as early as 6.00am against their wishes. Involving residents and White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 6 their relatives in care planning will ensure that information about a preferred daily routine is obtained. It was evident from the number of residents up and dressed at 7.00am that the daily routine was institutional and did not necessarily meet the needs and preferences of vulnerable residents. One of the requirements made in response to a complaint about this issue in October 2005 has not been addressed. In order to ensure the residents have a comfortable and homely place to live the lounge on the Stanhill unit must be redecorated and the torn cushions repaired or replaced. The radiator in the Foxhill ‘link lounge’ must be repaired. In order to provide effective care for all residents 50 of care assistants must have an NVQ level 2 in care. Recruitment procedures must be thorough to ensure residents are protected from abuse. A POVA/CRB check must be obtained for all new staff before they start working at the home. To promote the health and safety of residents and staff correct moving and handling techniques must always be used. All members of staff who have not received up to date training in moving and handling must do so. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Older People) 2 (Adults 18-65) Following pre-admission assessment prospective residents did not receive confirmation in writing that their needs could be met at the home. EVIDENCE: Admission procedures were found to be thorough at the last inspection. However, the manager was advised to confirm in writing to prospective residents that their care needs could be met at the home. This requirement has not been met. White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service Users, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9 (Older People) 6, 19 and 20 (Adults 18-65) Care plans did not contain detailed information relating to all aspects of healthcare. This meant there was the potential for some healthcare needs not to be fully met. Medication was administered correctly promoting good health. EVIDENCE: The individual care plans of seven residents were inspected, five from Stanhill and two from Foxhill. These plans identified the care needs of each resident and explained how these needs were met. Appropriate risk assessments had been carried out. However, the falls risk assessment for one resident and the White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 10 risk assessment relating to bed rails for another resident did not clearly identify the level of risk. One resident was assessed as having a high of developing pressure sores and of falling. Care plans giving information about the action being taken to address these risks was not in place. Another care plan provided insufficient information about the care and condition of a pressure sore. Care plans were reviewed monthly but there was no evidence to suggest that residents or their relatives were involved in this process. Residents were registered with a GP and had access to other healthcare professionals. Although all the residents asked said the staff were very nice one resident said she wasn’t getting the help she needed with personal hygiene. Another resident said, “I have to wait a long time when I want to go to the toilet.” Medication was stored correctly in a locked trolley and cupboards inside a locked utility room, one in each unit of the home. Records relating to the management of medication were in place. A contract with a licensed waste carrier ensured all unused medication was disposed of safely. White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service Users have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 and 15 The daily routine was institutional and did not consider the preferences of vulnerable residents who were unable to express a choice. The meals were wholesome and menus were varied. EVIDENCE: On arrival at the home, 7.00am, six residents were sitting at dining tables in the Foxhill unit. Several residents were sitting in wheelchairs without cushions. The nurse said there was a lack of cushions for wheelchairs. However, on the second day of the inspection cushions were in use with the wheelchairs. White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 12 On the Stanhill unit fifteen residents were up and dressed at 7.00am. Most of these residents were unable to make an informed choice. A member of staff explained that they started the bed change at 6.00am and residents were washed and dressed if they had been incontinent. She also explained that one resident had been assisted to get up for pressure relief. This resident was sitting in a wheelchair without a cushion. The care plan for this resident identified a high risk of developing pressure sores but did not state she had to get up at 6.00am for pressure relief. Members of staff continued to get residents up and by 8.00am virtually all the residents on the Stanhill unit were up and ready for breakfast. One resident said, “I get up when they get me up.” Another resident said, “It’s noisy at 7 o’clock because everyone is getting up.” One of the requirements made in October 2005 following the investigation of a complaint relating to this issue has not been addressed. All except one of the residents asked said the food was good. One resident said, “The food is very good.” The meal served at lunchtime was wholesome and nicely presented. Members of staff were observed patiently helping residents with feeding. Lunch was unhurried allowing residents time to chat and enjoy their meal. Although a choice of menu was not offered at lunchtime alternatives to the set meal were readily available. White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service Users feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Complaints were taken seriously and investigated. Appropriate policies and procedures were in place to ensure the protection of residents at the home EVIDENCE: A copy of the complaints procedure was displayed in the home. One complaint has been made to the home since the last inspection. Detailed records of this complaint and the action taken were seen. The Commission investigated a complaint in October 2005. Policies and procedures relating to the protection of vulnerable adults were in place. This issue was discussed with two members of staff. They were aware of the procedure and said they would report any concerns immediately. White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 25 The home was clean, comfortable and well maintained. This meant that residents had a homely place to live. EVIDENCE: At the time of the inspection the home was clean and tidy. This provided a safe and homely environment for the residents. However, the lounge on the Stanhill unit was in need of redecoration because in several areas wallpaper was peeling off the walls. The cushions on a settee and matching chair were torn and needed replacing. To maintain and improve the home redecoration White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 15 and refurbishment was ongoing. One bedroom had been redecorated since the last inspection and new carpets had been ordered for two bedrooms. A new carpet had been fitted on the corridor of the Stanhill unit. The gardens were well kept and accessible to all residents. Residents were encouraged to personalise their rooms with ornaments photographs etc. The radiator in the ‘links lounge’ on the Foxhill unit was broken. A portable heater had been placed in this room. This was very hot and would cause a serious injury if a resident fell against it. The handyman repositioned this heater and put a chair in front of it. This radiator had been repaired before the second day of the inspection. Arrangements had been made for the heating system to be serviced. White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 29 Staffing levels had improved by the second day of the inspection and were appropriate to meet the needs of the residents. Recruitment procedures were not always thorough. Less than 50 of care assistants had achieved NVQ qualifications. EVIDENCE: At the time of the inspection staffing levels were not appropriate for the needs of the residents. Absence levels were of serious concern and several members of staff said they often worked short staffed and consequently morale was low. Each unit had a designated laundry assistant. However, these members of staff were included in the number of care assistants on duty effectively reducing the number of care staff by one on each unit every day. One member of staff explained that a resident had asked if she could have a bath but because of staffing levels this had not been possible for two days. Examination of the duty rota on the second day of the inspection confirmed that the staffing levels had improved the laundry assistants were no longer included in the number of care assistants on duty. Although absence levels White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 17 due to sickness and annual leave continued to be a problem shifts were being adequately covered. It was evident from discussion with members of staff that training was encouraged. Ten care assistants had an NVQ level 2 in care and two had level 3 (31 ). Three care assistants were working towards NVQ level 2. The files of seven members of staff appointed since the last inspection were examined. Six of these files indicated that all the required pre-employment checks to ensure protection of the residents had been completed. It was evident from the other file that this member of staff had started working at the home before a POVA or CRB check had been obtained. White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 and 38 The home has an experienced and competent manager. Residents were encouraged to express their views about the care and services provided at the home. Not all members of staff had received up to date training in moving and handling. EVIDENCE: White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 19 The registered manager is an experienced nurse she has an NVQ level 4 in management and has completed training in dementia care. The home has achieved the nationally accredited Investors in People award. Resident’s meetings were held twice a year. An annual business plan to help monitor the quality of the service and improve outcomes for residents was available. The manager regularly audited all aspects relating to the care of residents and the management of the home. At the time of the inspection two members of staff were observed using an inappropriate moving and handling technique to transfer a resident into a wheelchair. Two members of staff said they had not received any moving and handling training for three years. White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 2 3 X 4 X 5 X 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 1 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 ENVIRONMENT Standard No Score 19 2 20 X 21 X 22 X 23 X 24 X 25 2 26 X STAFFING Standard No Score 27 1 28 2 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 X 33 3 34 X 35 X 36 X 37 X 38 2 White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 21 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP2 Regulation 14(1)(d) Timescale for action The registered person shall not 09/02/06 provide accommodation to a service user at the care home unless, so far as it shall have been practicable to do so – (d) the registered person has confirmed in writing to the service user that having regard to the assessment the care home is suitable for the purpose of meeting the service user’s needs in respect of his health and welfare. Timescale of 30/09/05 not met The registered person shall – 28/04/06 (c) where appropriate and, unless it is impracticable to carry out such consultation, after consultation with the service user or a representative of his, revise the service user’s plan; and (d) notify the service user of any such revision. The registered person shall 28/04/06 ensure that the care home is conducted so as - (a) to promote and make proper provision for the health and welfare of service users; (b) to DS0000022481.V269770.R01.S.doc Version 5.0 Page 22 Requirement 2 OP7 15(2)(c)(d) 3 OP8 12(1)(a) (b) White Ash Brook Nursing Home 4 OP8 17(1)(a) Sch 3(n) make proper provision for the care and, where appropriate, treatment, education and supervision of service users. When a risk assessment states that a resident is at risk of developing pressure sores and falling care plans must be in place to address these risks. The registered person shall (a) maintain in respect of each service user a record which includes the information, documents and other records specified in schedule 3 relating to the service user; (n) a record of incidence of pressure sores and the treatment provided to the service user. The registered person shall ensure that the care home is conducted so as – (b) to make proper provision for the care and, where appropriate, treatment, education and supervision of service users. Residents must receive the help required with personal hygiene. 24/03/06 5 OP8 12(1)(b) 09/02/06 6 OP14 12(3) The registered person shall, for the purpose of providing care to service users, and making proper provision for their health and welfare, so far as practicable ascertain and take into account their wishes and feelings. The reasons for getting residents up before 8.00am must be clearly documented in their care plan. Timescale of 25/11/05 not met 28/04/06 7 OP19 23(2)(d) The registered person shall having regard to the number DS0000022481.V269770.R01.S.doc 28/04/06 White Ash Brook Nursing Home Version 5.0 Page 23 and needs of the service users ensure that – (d) all parts of the home are kept clean and reasonably decorated. Stanhill lounge must be redecorated and the torn cushions repaired or replaced. 8 OP28 18(1)(c)(i)(ii) The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users – (c) ensure that the persons employed by the registered person to work at the care home receive – (i) training appropriate to the work they are to perform; and (ii) suitable assistance, including time off, for the purpose of obtaining further qualifications appropriate to such work. 50 of care assistants must have an NVQ level 2 or be working towards this by the date given. 19(1)(b) Schedule 2 28/04/06 9 OP29 10 OP38 13(5) The registered person shall not 09/02/06 employ a person to work at the care home unless (b) he has obtained in respect of that person the information and documents specified in (i) paragraphs 1 to 7 of schedule 2 A POVA/CRB check must be obtained before a new member of staff starts working at the home. The registered person shall 28/04/06 make suitable arrangements to provide a safe system for moving and handling service users. All members of staff must receive training in moving and DS0000022481.V269770.R01.S.doc Version 5.0 Page 24 White Ash Brook Nursing Home handling. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations Risk assessments relating to falls and bed rails should clearly identify the level of risk. White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI. White Ash Brook Nursing Home DS0000022481.V269770.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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