CARE HOMES FOR OLDER PEOPLE
Willowbank Nursing Home Pasturegate Burnley Lancashire BB11 4DE Lead Inspector
Mrs Marie Matthews Key Unannounced Inspection 09:30 19TH June 2006 X10015.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 Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 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. 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. Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Willowbank Nursing Home Address Pasturegate Burnley Lancashire BB11 4DE 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) 01282 455426 01282 455345 Sage Care Homes (Willowbank) Limited Mrs Anne Wareing Care Home 53 Category(ies) of Dementia (6), Dementia - over 65 years of age registration, with number (47), Mental disorder, excluding learning of places disability or dementia (6), Mental Disorder, excluding learning disability or dementia - over 65 years of age (47) Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home is registered for a maximum of 53 service users to include: Up to 35 service users who require nursing care. Up to 47 service users who fall into the category of MD(E) Up to 47 service users who fall into the category of DE(E) Up to 6 service users who fall into the category of MD Up to 6 service users who fall into the category of DE 1st November 2005 Date of last inspection Brief Description of the Service: Willowbank is registered to provide both nursing and personal care for fiftythree residents with either a dementia or mental health problem. The home is a detached two storey building with a purpose built extension set in 1.5 acres of garden, with attractive lawns, flower beds and patio areas. Willowbank has 29 single and 12 shared bedrooms, a number of comfortable lounge and dining room areas and two conservatories. The home is set in a quiet, pleasant residential area approximately a mile from Burnley town centre. There are shops, a post office, public houses and a convenient bus route near by. Information about the services that the home offers is provided in the form of a service user guide and is available to existing and prospective residents and their relatives. A summary of the most recent inspection report is available within the service user guide. The fees from April 2006 range from £355.50 to £459.00. Additional charges are made for hairdressing and toiletries. Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection was conducted at Willowbank on 19th June 2006. The inspection involved looking at records, talking to staff, two visitors and five residents, a tour of the premises and generally looking at what was happening in the home. Information was also obtained from survey forms received from eight relatives. This inspection looked at things that should have been done since the last visit and a number of areas that affect resident’s lives. There were forty-seven people living in the home on the day of the inspection. What the service does well:
The home always made sure that people were given enough information about their rights and about the home and the services on offer before they were admitted to the home. This enabled people to make an informed choice about whether the home could meet their needs. Residents were always assessed properly to make sure that staff could look after them properly; this was confirmed in writing before they were admitted to the home. Records supported that generally resident’s medication was managed safely and that residents were having their medication regularly reviewed to ensure it was suitable and appropriate for them. Staff treated people well and responded appropriately to residents and their visitors. Contact with relatives and the local community was maintained where possible and relatives confirmed they were made to feel welcome. Two relatives said they were able to visit in any area of the home and could see their relative in private if they wished. Residents were given a choice in many aspects including mealtimes, routines, activities and choice of clothing. Other residents were unable to make choices and relied on staff to make the right choice for them. The home provided varied activities to meet resident’s social and recreational needs. Staff had filled in a daily programme this showed exercising to music,
Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 6 ball games, dancing, singing, nails and hand massage, watching the recent England games, watching old time films, craft activities, quizzes, dominoes and a recent garden party. Residents were offered a variety and choice of meals that met their tastes and choices. The meals were served hot and attractively presented and the menu was changed in consultation with residents and from cooks awareness of residents likes and dislikes. Staff were seen giving support to those residents that needed assistance. The home had a clear complaints system and people knew how to complain and were happy their concerns would be responded to. One resident said ‘staff are very kind to me and would try to help me if I was worried’. The residents were protected by the clear policies and procedures regarding abuse; the procedures together with training given to staff would protect residents from harm. Clear records of resident’s finances were kept and showed that their finances were safeguarded. Rotas were clear and showed a good skill mix of staff. Ten relatives felt there were always sufficient staff on duty and one resident said there is always someone around to help. Staff said we all work as a team. Staff were appropriately trained to help them to meet the needs of the residents who lived in the home. One relative said I am very happy with the level of care offered at the home. There are some truly wonderful and highly dedicated members of staff another said ‘nice staff and its a lovely place. One resident said the staff are very kind to me another said they are a grand bunch. What has improved since the last inspection?
The detail in the resident’s care plans had improved, included information from the initial assessment and generally showed what action staff needed to take to meet resident’s needs. Residents and their relatives had been involved in planning and agreeing their care. Staff had been given specialised dementia training to help them to meet the needs of residents in the home. The home had a planned programme of redecoration and replacement and of major changes to the building. The appearance of the home was slowly improving but needed further work, particularly in communal areas and bedrooms, to provide a comfortable, safe and homely environment for residents to live in. One relative said the home has a good feel about it.
Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 7 Staff had been supported through one to one supervision sessions to ensure they had the skills to look after residents in their care. The home had improved the way it consulted people about whether their needs were being met. A resident and relatives survey had been done and results of this were seen on the notice boards. Meetings with residents and their relatives were to be held three times a year and staff meetings were held regularly; staff said they were able to contribute. What they could do better: 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. Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 1, 2, 3 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home provided current and future residents and their representatives with information that enabled them to make an informed choice about admission to the home. Resident’s needs had been assessed before admission and staff had been provided with specialist training to ensure they could look after residents properly. EVIDENCE: Information about the home was clear, detailed the services on offer and was given to residents and their families. Service users views and a copy of the latest inspection report were not yet included in the service user guide. The last inspection report was seen on the notice board. Assessments of needs had been done before new residents were admitted to the home to make sure the home could look after them properly. The home confirmed in writing whether they could meet people’s needs.
Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 10 The home had provided a number of staff with specialised dementia training to help them to care for the residents in the home. Other staff were due to attend this training. Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The care plans had improved. They had been developed from the assessment information, generally detailed the action to be taken by staff to meet resident’s needs and showed that residents and their relatives had been involved in the development or reviews. The medication systems were under review but policies and procedures needed to reflect current practice to provide clear guidance for staff to prevent residents being put at risk. Staff treated people with respect and maintained their rights to privacy and dignity. EVIDENCE: Three care plans were looked at. The standard of care planning had improved. The care plans had been developed from assessment information and were generally detailed and organised. A range of risk assessments were in place and any risk identified had generated a care plan that clearly showed staff what action needed to be taken. The care plan of a recently admitted resident did not fully detail the care needed to be given by staff to meet their needs and this was discussed with senior staff. There was evidence that residents or
Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 12 their relatives had been consulted about their plans and reviews had taken place regularly. Eight relatives said they were involved and kept up to date. One resident had bed rails in place, this had been risk assessed in detail but there was no evidence this had been discussed with relatives or included in a plan of care. Pressure sore risk assessments had been done and when needed a wound care assessment was in place. There were records to support that residents had access to healthcare support from other health professionals to ensure their needs were met. The home was gradually introducing a new system of medication. Records for both systems were looked at and were clear and accurate. Policies and procedures needed to be reviewed as a matter of urgency as these did not reflect current practice and did not clearly guide staff to safely manage medication and could put residents at risk. Qualified staff dealt with all aspects of resident’s medication although two senior care staff were doing a safe handling of medication course. Controlled drugs were checked at random and records were accurate. The medication administration charts were clear; however handwritten directions were not always supported by a second signature and PRN protocols were not written. There was evidence that residents medication had been reviewed either form a visit by the GP or requested by the home. Staff were seen treating people well and responding appropriately to residents and their visitors. Two relatives said they were able to visit in any area of the home and could see their relative in private if they wished. Staff were seen knocking on doors and respecting resident’s privacy. Screening was available in shared rooms although most of them were being used as singles rooms as there were plans to convert shared rooms into en suite singles. The architect was visiting on the day of the inspection. Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home provided varied activities to meet resident’s social and recreational needs. Residents were offered a variety and choice of meals that met their tastes and choices. EVIDENCE: From observation, looking at records and talking to people it was clear that residents were given a choice of many aspects including mealtimes, routines, activities and choice of clothing. Other residents were unable to make choices and relied on staff to make the right choice for them. There was a record of all activities that had taken place and of the residents who had joined in. Staff had filled in a daily programme this showed exercising to music, ball games, dancing, singing, nails and hand massage, watching the recent England games, watching old time films, craft activities, quizzes, dominoes and a recent garden party. Trips out were local to the theatre and shopping. Two residents said they had had a ‘great time’ at the garden party and another said she had enjoyed meeting the Mayor. Information about the date and weather were displayed on boards around the home and the names of staff on duty were soon to be included.
Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 14 Contact with relatives and the local community was maintained where possible and relatives confirmed they were made to feel welcome. Records showed that residents were supported to manage their own money, able to make decisions about their care or appropriate decisions were taken on their behalf. A number of residents had access to an advocate to support them or to act on their behalf. The menu was displayed in the home. Residents were given a choice of meal and a record of this was kept. The meals were served hot and attractively presented although liquidized meals should be separated into portions. The menu was changed in consultation with residents and from cooks awareness of residents likes and dislikes. Staff were seen giving support to those residents that needed assistance. The dining areas were bright and a number of new tables had been purchased and others were to be provided. It was noted that tablecloths were not in use and this was discussed with the manager as a way of improving the dining experience for residents. Plans to re site and enlarge the kitchen were in progress. Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home had a clear complaints system and people knew how to complain and were happy their concerns would be responded to. The residents were protected by the clear policies and procedures regarding abuse and staff awareness of what action to take if abuse was suspected. EVIDENCE: The home had a clear complaints system. Six out of eight relatives had said they were aware of how to complain. Two visitors said they were aware of whom to complain to and that concerns would be dealt with. Three residents said they would speak to staff if they were unhappy. One resident said ‘staff are very kind to me and would try to help me if I was worried’. The procedures to guide staff in responding to any reports of abuse were clear; the procedures together with training given to staff would protect residents from harm. Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 16 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 the following standard(s): 19, 24 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The home had a planned programme of redecoration and replacement and of major changes to the building. The appearance of the home was slowly improving but needed further work, particularly in communal areas and bedrooms, to provide a comfortable, safe and homely environment for residents to live in. EVIDENCE: During a tour of the home the registered manager explained all the changes to the building planned and underway to improve facilities for residents. The architect was visiting on the day of the inspection and a new programme of maintenance and renewals would be provided. Work completed since the last inspection included replacement of windows to the conservatories and bungalow areas, two doors blocked in and fire doors replaced following advice from the fire services. Two bedrooms had been totally refurbished, a training room and quiet area for meeting with visitors
Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 17 were now available. Some dining tables and beds had been replaced and some areas of the home had been redecorated. Communal areas were bright although carpets were in need of replacement in some lounge and dining areas. The gardens were attractive, tidy and accessible to residents although the patio area to the rear of the home was inaccessible and unsafe for use by residents. The registered manager said there were plans to make this into a secure and safe area for residents to sit in. There were some areas, particularly resident’s bedrooms, which still looked ‘shabby’; furniture and paintwork was damaged, doorways were scuffed and carpets were in need of replacement. There were a number of odours in some of the rooms where carpets were in need of replacement and the manager was aware of this. Replacement and refurbishment was detailed in the programme of planned improvement but this had been reviewed and there had been some ‘slippage’ in the timescales in favour of major structural changes to the home. It was clear that money was being invested in the home but there needed to be clear timescales to ensure resident’s rooms were comfortable and homely. One relative said the home has a good feel about it. Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 18 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 consider all the above are 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, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The procedures for staff recruitment had not been followed and could put residents at risk of being cared for by unsuitable people. Resident’s needs were met by a well trained and competent group of staff and this had improved quality of life for the residents. EVIDENCE: Rotas were clear and showed a good skill mix of staff. Staff felt that staffing levels were sufficient and the rotas showed that any shortfalls had been filled with volunteers from the staff list or as a last resort with agency staff to ensure a continuation of care for residents. Ten relatives felt there were always sufficient staff on duty and one resident said there is always someone around to help. Staff said we all work as a team. Information from records and discussions with staff showed that staff were appropriately trained. Staff were able to confirm that they had received induction and update training to help them to meet the needs of the residents who lived in the home. A training plan was available to support the need for training and further development of staff. Two recruitment files were looked at. Not all checks, to make sure staff were suitable to work in the home, were in place prior to employment. Neither file contained a Criminal Records Bureau and Protection of Vulnerable Adults first
Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 19 checks, one file included only one reference. The registered manager said there had been a continuing problem with the people who provided these checks and the Commission for Social Care Inspection had brought this to the attention of the registered provider in a letter last year for action. However a safe recruitment procedure had not been followed and this could have placed residents at risk. It was recommended that all staff should have a clear photograph on file as a means of identification. One relative said I am very happy with the level of care offered at the home. There are some truly wonderful and highly dedicated members of staff another said ‘nice staff and its a lovely place One resident said the staff are very kind to me another said they are a grand bunch. Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 20 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 31, 33, 35 and 38 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, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The systems for consultation with residents, visitors and staff have improved with evidence that the home had responded to any issues raised. Staff were supervised in their work to make sure they were able to meet the residents needs. Records required by regulation and for the protection of residents were maintained. EVIDENCE: Mrs Anne Wareing is the registered manager of Willowbank. She is a registered nurse with experience in care and management. Mrs Anne Wareing is working to obtain the Registered Managers Award. There is evidence to support further development of her skills and knowledge.
Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 21 Staff were very positive about the changes that the registered manager had initiated and said ‘we are kept up to date’ and ‘are involved’. Meetings with residents and their relatives were to be held three times a year and staff meetings were held regularly; staff said they were able to contribute. A resident and relatives survey had been done and results of this were seen on the notice boards. The home had achieved Investors In People award; this is a quality assurance award accredited by an outside body and demonstrates a commitment to staff training and development. A business plan was available with short and long term goals for improving the home. Records of resident’s personal allowances were looked at. Records were clear and easily audited and showed that the home safeguarded resident’s finances; however it was recommended that a second signature be maintained for all transactions. The administrator said residents were encouraged to manage their own money with help if needed. Records and discussions with staff confirmed that care staff were supervised in their work to make sure they were able to meet the residents needs. The registered manager said the supervision form would be reviewed to include more involvement from staff. The registered provider visited the home regularly to monitor the day to day running of the home and a record of visits had been made. The registered manager had notified the Commission of any incidents under Regulation 37. Policies and procedures needed to be reviewed to ensure staff had clear, safe and accurate instructions and guidance. Records showed that servicing and test certificates were kept up to date and that people’s health, safety and welfare was maintained. Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 22 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X 2 X 2 STAFFING Standard No Score 27 3 28 2 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 3 Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 15 Requirement Care plans set out in detail the action to be taken by staff to ensure resident’s health, personal and social needs are met. The registered person must review medication policies and procedures in line with the Royal Pharmaceutical Society guidelines. Timescale 20/12/05 not met. The registered person must ensure residents are provided with a comfortable, safe and homely environment to live in. The registered person must keep the home free from offensive odours. The registered manager must ensure all required checks are obtained prior to staff working in the home. Timescale for action 31/07/06 2. OP9 13 24/07/06 3. OP19 23 31/07/06 4. 5. OP26 OP29 16 19 31/07/06 10/07/06 Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 Page 24 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. 2. 3. 4. 5. 6. 7. Refer to Standard OP1 OP7 OP9 OP9 OP15 OP15 OP24 Good Practice Recommendations Resident’s views of the home and a copy of the most recent inspection report need to be included in the service user guide. The use of bed rails should be discussed with residents or relatives and consent for use should be obtained. The criteria for PRN medication should be clearly defined and recorded. The registered person should ensure transcribing of medicines is witnessed The use of tablecloths at mealtimes should be considered Liquidized food should be served in separate portions. The registered person should ensure that an audit of furniture be completed and if service users had not been provided with the standard furnishings the reason for this should be documented in the care files. The registered person should ensure that 50 care staff have the NVQ level 2 in care, or equivalent. Staff files should contain a clear photograph as a means of identification. Policies and procedures should be reviewed. Two signatures should be obtained when dealing with resident’s personal allowance. 8. 9. 10. 11. OP28 OP29 OP33 OP35 Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 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 Willowbank Nursing Home DS0000022471.V287746.R01.S.doc Version 5.1 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. 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!
