CARE HOMES FOR OLDER PEOPLE
Willow Gardens St Edmonds Road Bootle Liverpool L20 7AJ Lead Inspector
Julie Garrity Unannounced 21st April 2005 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 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. 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. Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Willow Gardens Address St Edmonds Road Bootle Liverpool Merseyside L20 7AJ 0151 922 4324 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) European Wellcare Homes Limited Mrs Elizabeth Mumford Care Home 46 Category(ies) of OP Old Age (37) registration, with number of places PD Physical Disability 19 - 60 years (9) Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Service users to include up to 37 OP(N). Sliding scale of staff agreed by CSCI to be adhered to at all times, as agreed on 2/2/04. 2 named female out of category service users, under pensionable age. The variation applies to the named service users only, should they leave the home the variation will cease to apply. Not accommodated in the Willow View Unit. 1 named female out of category service user, under pensionable age to receive respite care. The Commission to be notified if the circumstances for the service user change. Not accommodated in Willow View Unit. The service should employ a suitable qualified and experienced manager who is registered with the CSCI Service users in the Willow View Unit to include up to 9PD(N) The age range between service users in the Willow View Unit should be no more than 25 years at any one time. 1 named service user accommodated in the Willow View Unit outside the 25 year age range restriction. This condition to cease when the service user leaves Willow View Unit. 1 place within Willow View Unit for a service user between the age of 18 and 64 years. Date of last inspection 2/6/04 Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 5 Brief Description of the Service: Willow Court is situated in Bootle area of Liverpool. There is a shopping centre near to the home and public transport system within easy access. The home is a purpose built care home, which provides nursing care. The home is built on 2 floors. There are two Lounges a large lounge on the ground floor and a smaller lounge on the first floor with a separate smoking area. Dining facilities are provided in two separate areas. The home provides care to 37 older persons and 9 younger disabled adults. All rooms are single rooms with 14 rooms providing en-suite facilities and 32 rooms without en-suite facillities. Willow Court has gardens to the rear and sides of the home that provide space for service users to sit outside in good weather. The gardens are easily accessible from the large ground floor lounge.The home is privately owned and the company has a variety of other homes within the UK, providing care for a number of service users with a wide range of differing needs. The manager has been working in Aldercourt for several years and had previously worked within Willow Court prior to her taking over the role of manager. Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 6 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 9.30 am. The duration of the inspection was 7 ½ hours. The manager Mrs Liz Mumford represented Willow gardens throughout the inspection and all areas of the inspection and findings were discussed with Mrs Mumford before the inspector left Willow Gardens. Discussion took place with six residents separately, two relatives, one visitor to the Home, seven members of staff and the manager. The inspector left resident and relative questionnaires and received a total of 14 responses to the questionnaires. A variety of records in the Home were viewed and a tour around the Home was undertaken. What the service does well:
There is a lot confidence expressed by the residents in the staff team and their ability to support their needs. New residents felt that the Homes atmosphere was very welcoming and staff had a kind and caring attitude. Relatives are encouraged to become involved in the care of the residents within the Home. Staff are regularly involved in the discussion at the start of each new shift, which details any changes in residents and any particular events that need planning for this maintains good levels of communication and a good team working approach. Staff are able to detail a good depth of knowledge in the individual personalities and needs of the residents in the Home. There is a stable staff team with very few staff leaving and very few new staff. This helps with the residents always knowing the majority of staff and having very few new faces to get to know. The majority of residents stated that they liked the food and that there was plenty of choice available for them. They also enjoyed the trips out that they had been on and they all had enjoyed a recent entertainer in the Home. The Home arranges parties for special events and were planning a party for a residents birthday. The Home is well presented, clean and tidy, residents and families stated that they enjoyed the light airy feeling to the Home and the efforts that the staff had made to make it more Homely. They were particularly pleased with the staffs support for them to individualise their bedrooms. The Home has developed a new unit specifically for younger persons and a number of staff have requested to work on this unit. The majority of the residents have complex needs and initial training has been implemented to assist the staff in fully understanding and meet the needs of the residents who live on the unit.
Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 7 One resident detailed the support that they had received when they were recently admitted to the Home. They felt that the staff had made extraordinary efforts to make their admittance comfortable and as stress free as possible. What has improved since the last inspection? What they could do better:
Although much work has been undertaken in staff training, the specific needs of more complex needs to be completed, this includes challenging behaviour, epilepsy and special diets for the catering staff. A variety of risk assessments are in place, however these need to be further expanded to included medications in particular where family members support residents and residents who smoke. Care plans continue to develop appropriately and those plans available on Willow View contain far more information regarding resident’s social needs than those generally available within the rest of the Home. Staff still have a tendency to detail residents medical issues and although expansion of social needs is evident this imbalance is awaiting further development. Of a matter of urgency is the routines for administration of medication a number of areas and inappropriate handling of medicines was noted and it is imperative that staff responsible for the administration of medications address this as a priority.
Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 8 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. Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 10 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Residents receive a full and proper assessment prior to admission and this information is discussed with the residents on the day of admission. This has lead to new residents feeling assured that the Home can meet their needs and many of the current residents expressed the view that useful information is available for them to review at their leisure. EVIDENCE: A senior nurse assesses all new residents before they move into the Home (Willow Gardens), or its younger adults unit (Willow View). One resident and their family told of the arrangements that had been undertaken by the manager to assess and meet their needs before they came to live in the Home. This had included a day’s visit to the Home and an introduction to the staff to make sure that there was a familiar face. The manager discussed plans to further increase the welcome into the Home, such as fresh flowers in the resident’s rooms upon arrival. All of the assessments viewed detailed a record that clearly identified a variety of needs of the residents. Throughout the Home there is a variety of useful information available such as the Service Users Guide, which details amongst other areas how the Home is
Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 11 run and who is in charge of the Home. There is information on care planning, making a complaint and Health and Safety arrangements. Staff on duty were spoken with were able to discuss and understand a variety of complex needs of the residents. Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 12 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. 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 feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 There continues to be progress made within care plans the care plans available on Willow View are of better quality than those available within the Home in general. The care plans mostly detail the health, personal and social care needs of individual residents but would benefit from a reduction of repeating care actions from one individual to another and specific changes of residents needs reflected clearly in the care plans rather than being the common knowledge of the staff. The Home meets Health care needs as appropriate and has recently further developed the monitoring of wounds and dressings. This should indicate to staff if resident’s wounds are healing properly. There is little progress in appropriately handling resident’s medications. This includes poor documentation, storage, monitoring of medications and appropriate risk assessments. This places the residents at risk. EVIDENCE: All residents have an individual plan of care. Plans can be generalised and medically based, the plans on Willow View have a lot of relevant information on social needs of residents that is not available elsewhere in the Home.
Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 13 Additionally they clearly describe the care needs of residents from the resident’s point of view. One resident had a plan for meeting hygiene needs that was photo-copied from another resident with the name changed and did not include information specific to the resident. Staff do up date the plans regularly but do not always reflect the changes in residents needs or in the actions to be taken by the staff. Staff had extensive knowledge regarding the residents that was not in the care plans. One resident has a special mattress in place, the need for which was assessed in their plan, however the plan asks for a different mattress to be used. On review the mattress in place was the correct one and the plan was therefore not accurate. Staff detailed issues with the behaviour of one resident, although briefly mentioned in the residents plan, there was no specific actions to be taken by the staff in order to protect themselves or others from any challenging behaviour. Observation of daily records describes any important events that occur for individual residents. One resident explained that it was difficult to access dentistry and optician services. This was due to transportation issues. The manager has tried to arrange for opticians and dentist to visit the Home but had found that both services were reluctant to visit the Home and it was not always possible for residents to access local dental surgeries or opticians, due access of buildings and transportation. The Home keeps clear and concise records of all health care visits and the staff in the Home provide escorts to and from hospital. There has been an improvement in the way that the staff manages wounds such as pressure ulcers (bedsores), a record of the wound is made and the wounds are checked at regular intervals and any changes to the wound recorded. Nursing staff give out medication. The storage of medications was neat, tidy and well organised. The recording of medications was not always appropriate with doses of medications omitted with no clear explanation as to why they were not given. Eye drops were undated upon opening and this meant that staff were unable to decide if the eye drops had expired and could no\longer be used. Eye drops and insulin were stored at temperatures not in accordance with the manufactures instructions. Records of medications administrated did not match the amount still available. One resident had 10 tablets more available that the records indicated. Where medication stated one or two tablets staff were not detailing how many tablets they had actually given. One relative detailed that the residents medication is frequently left with her to administrate. Discussion with the staff and manager detailed that this is due to the relative wishing to be involved in the care process and the staff had accommodated this. It is commendable that staff feel the need to fully include relatives in residents care, however there was no assessment of the risks involved in this process and as such this practice and the examples detailed above results in staff giving out medications unsafely. Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 14 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. 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 maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14, 15 Social activities are managed appropriately. There is a variety of choice available for the residents. The activities co-ordinator intends to be in the home for longer periods of time and the individual choice available for activities. Residents explained that they were given plenty of choice in meals, however the menus were not created with the residents and this has limited their control over the meals available. EVIDENCE: Residents and relatives in the Home that were spoken with commented positively on the food that was provided. They felt that there was sufficient choice and information available to enable them to decide what they would like to eat. The cook will make light snacks if the main meal of the day does not have any appeal. The menus viewed were not decided on by the residents. The cook detailed that he must work round the set menu and make alterations taking into account the residents likes and dislikes. This can be difficult as this then means that the menus do not always explain to the residents the meals that are on offer. To overcome this the cook makes sure that each resident is asked on a daily basis what he or she would like to eat each day from the choices that he has made available. The cook intends that he will speak to each of the residents over the next few weeks in order that changes to the menus will reflect the resident’s choices.
Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 15 There is a member of staff whose job it is to develop activities for the Home. Residents detailed that there was a variety of activities that they could be involved in if they wished. There are two mini buses available to enable day trips out. One resident stated that transport could be difficult to access as only one of the buses was suitable for the wheelchair that they used. As Willow View unit has younger residents the activities co-ordinator intends to increase the activities into this unit and to expand the activities available for the residents living there. Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 16 Complaints and Protection
The intended outcomes for Standards 16 - 18 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’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 The Home takes appropriate steps to reducing potential abuse and has staff who would feel confident in reporting any concerns to the appropriate people. EVIDENCE: Staff spoken with made clear that they had read the policy on the protection of residents from abuse. Additionally they had received training both from the Home on induction and within the training qualifications they were doing. They felt confident that they would be able to recognise and report appropriately any concerns regarding potential abuse. Relatives and residents were sure that issues of this nature would not be tolerated by the Home and that management would act appropriately to protect the residents and staff. Two residents detailed that they felt that some of the members of staff spoke abruptly to them at times. Although the information was not specific and a little confusing it was detailed to the manager who said she would address these concerns both with the residents and the staff. Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 17 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 26 The environment is well managed and kept appropriately clean. Sufficient equipment is available for the staff to use in the reducing the spread of infection and ensuring that good hygiene levels are maintained. The Home was odour free and there was an enough cleaning staff available to maintain the cleanliness of the Home. EVIDENCE: Observation of the environment including the laundry and kitchen showed that the Home makes appropriate arrangements to maintain a pleasant and hygienic environment. All bathrooms had sufficient soap and paper towels to ensure that residents and staff can maintain good hygiene levels and prevent the spread of infection. Equipment such as plastic aprons and gloves were available for staff to use. This was particularly evident for a resident who has additional needs regarding the prevention of the spread of infection. All areas of the Home have an appropriate cleaning schedule in place and staff complete this as they go about their duties. Residents and relatives discussed
Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 18 that they were very happy with the levels of cleanliness in the Home. They felt that there was plenty of cleaning staff available to keep the Home clean. Care staff will also assist in keeping the Home clean. The manager monitors the environment to make sure that any repairs are undertaken and all areas are clean and tidy. Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 19 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 The majority of residents and relatives believe that there is sufficient numbers of staff available to meet the needs of the residents. As there is no a formal means to determine residents needs and to guarantee that staff availability suitable the manager can not be demonstrate that the Home can at all times appropriately support residents needs. There are a number of training areas that need further development. The Home has recognised this and put into place a training programme to provide the training needed. The majority of relatives and residents expressed that they feel safe, relatives explained that they were confident that staff had the right skills to care for the residents. The occasion in which placement student escorted a resident to an appointment without a member of the homes staff must be prevented from reoccurring. This event placed both the resident and placement student at risk. EVIDENCE: The residents and the staff voiced that in their opinion there was sufficient staff available in the Home to meet the residents needs. One relative and one resident felt that on occasions there was not sufficient staff within the Home. Contracts between the Home and Social Services for Willow View residents state the amount of staff time that should be provided for each resident the Home meets this. The manager relies exclusive on the opinion of the staff, residents and the relatives. The residents living within the younger adults unit have variety of complex needs. The staff have not been fully trained to meet all of these, examples include dealing with challenging behaviour and epilepsy. The staff detailed that they felt that they would benefit from a further expansion of these skills. The manager explained that extensive training of a number of staff had been undertaken and the Home intended to further
Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 20 expand these areas. Observation of a staff training plan had a number of different training course detailed and who was to attend. The Home had a work placement student in the Home. On the day of inspection she had inappropriately escorted a resident to a hospital appointment without a member of the permanent staff and was solely responsible for the resident. Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 21 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. 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 the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 38 An independent review of quality has been undertaken that included the resident’s point of view. This has resulted in the Home identifying and addressing areas for development and increasing its ability to run the Home in the best interests of the residents. Health and Safety within the Home is in need of further development. Mandatory training for staff in areas of health and safety is undertaken and regularly up date. However there is a need to improve risk assessments within the Home in particular for residents that smoke and arrangements for keeping fire doors open need to be up dated. The areas identified, potentially place residents, staff and visitors to the Home at risk. EVIDENCE: The Home has recently taken part in an independent assessment of quality. This was done to build on strengths and to identify and address any areas of weaknesses. The Home accomplished a good grade of four stars from a five
Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 22 star scheme. Staff felt that this recognised their hard work and relatives and residents had a sense of pride in this achievement. A company known as RDB, which is a nationally recognised company, undertook the quality assessment. The areas for further improvement included care of residents clothing, resident’s general routines and delivery of the service regarding food. The Home has recognised these areas and has taken action to address these, such as ensuring that residents clothing is appropriately named, that residents meetings have minutes available for all and that a hot trolley is purchased for food delivery to residents not in the main dinning room. Residents are invited to residents meetings and supported to express their opinion. A number of questionnaires were returned to the inspector, the majority of the residents did not wish to be involved in the running of the Home and expressed their confidence in the manager to address all their needs. Staff receive Health and Safety training such as moving and handling when they start in the Home and this is updated regularly. One resident smokes within their bedroom, a risk assessment observed does not fully explore the risks involved within this activity. One relative detailed that the call system to let the staff know assistance was needed was not working in their relative’s bedroom and had not done so far a considerable time. This was addressed on the day of inspection. On the day of inspection four residents struggled to open the door in the main lounge. One of the residents said the inspector that staff usually propped the door open with the large wooden candlestick behind the door. A number food of items in the kitchen had not been appropriately labelled with an expiry date. This was a requirement on the previous report. A recent change in the cook has resulted in the lapse of appropriate labelling of food items. Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 23 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3
COMPLAINTS AND PROTECTION x x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x 3 x x x x 2 Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 24 No 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 OP 9 Regulation 13 (2) Requirement All medications must be stored as per manufactures instructions and given as prescribed by the GP. Staff must full recorded all medications administarted. All food items must be labelled with an expiry date. All identified risks must have apropriate risk assessments in place that clearly detail, what the risk is and actions to be taken to reduce the risk. Appropiate means to keep the fire door to the main lounge on the ground floor open must be put into place ther Home. The manager must ensure that call system buzzers are in full working order at all times. All food items must be labelled with the expiry date. Outstanding from previous report. Timescale for action 21/05/05 2. 3. OP 26 OP 38 16 (2) (i) 13 (3) 21/05/05 21/05/05 4. OP 38 23 (4) (i) 21/05/05 5. 6. OP 38 OP38 23 (2) (c) 16 (2) (j) 21/05/05 21/05/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 25 No. 1. 2. Refer to Standard OP 1 OP 7 Good Practice Recommendations Different formates should be for residents information such as the Statement of purpose and Service Users Guide. An expansion of the good practice regarding more personal centered care palnning on Willow View unit, should be considered for the Home as a whole. Staff should be supported to move away from medically based care plans and base plans on the clear needs of residents. The manager should formalise the monitoring of residents needs in order to clearly monitor that there is always staff to meet the identified dependency needs of the residents. The manager should ensure that the training needs discussed in the inspection are undertaken within the training programme developed by the Home and further training needs are identified and planned for. 3. 4. OP 27 OP 30 Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection 2nd Floor Burlington House Crosby Road North Waterloo L22 0LG 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 Willow Gardens F03 F53 S59852 Willow Gardens V225034 210405 Stage 4.doc Version 1.30 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
