CARE HOMES FOR OLDER PEOPLE
Windsor Court 34 Bodorgan Road Bournemouth Dorset BH2 6NJ Lead Inspector
Trevor Julian Unannounced Inspection 12th February 2008 12:30 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 Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 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. Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Windsor Court Address 34 Bodorgan Road Bournemouth Dorset BH2 6NJ 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) 01202 554637 01202 297554 info@win-court.co.uk www.win-court.co.uk Lyndale Healthcare Limited Application in progress Care Home 58 Category(ies) of Old age, not falling within any other category registration, with number (58) of places Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The registered person may provide the following category of service only: Care home with Nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Old age, not falling within any other category (Code OP) The maximum number of service users who can be accommodated is 58. 31st October 2007 Date of last inspection Brief Description of the Service: Windsor Court is located in a quiet tree-lined road in a residential area some three quarters of a mile from Bournemouth town centre with all the facilities that can be expected in a large town, e.g. banks, post office, shops, library and places of worship. Getting to the town centre requires negotiating a steep hill as does accessing public transport, although the nearest bus stop is within 200 yards of the home. Windsor Court was originally a grand gentlemens residence before being converted to a hotel and still retains many of the features and appearance of a building that was used for that purpose, although it is now registered as a care home, providing personal and nursing care for up to 58 older people. The home has a wheelchair accessible entrance area with a small lounge adjacent to the generous hallway. Further communal areas, comprising the spacious dining room, TV and quiet lounges are all located on the ground floor and furnished much as if the premises was still a hotel. All rooms have high ceilings and big windows. There is a secluded garden at the rear of the home that is mainly laid to lawn, surrounded by mature trees and a large car parking area at the front for visitors. Windsor Court is owned by Lyndale Healthcare Ltd, a family business. Management has been given over to BML Healthcare Ltd. Residents accommodation is located on the lower ground, ground, first and second floors of the home with access between floors via a wide staircase, passenger or stair lifts. Aids and equipment are available for residents who may have disabilities. The home is centrally heated throughout. All of the fifty eight bedrooms are for single occupancy, with fifty-three having their own enWindsor Court DS0000032192.V358875.R01.S.doc Version 5.2 Page 5 suite WC. The remaining five comprise two pairs of bedrooms, with each pair sharing the en-suite facilities and one room that has an en-suite WC and wash hand basin. Windsor Court provides 24-hour personal care, all meals, laundry and domestic services. Residents are encouraged to participate in a range of activities organised in the home. A monthly inter-denominational religious service takes place in the home. In June 2007 fees for the home, as confirmed to the Commission for Social Care Inspection (CSCI) range from £442 - £700 per week. Additional charges include hairdressing, chiropody, dry cleaning, toiletries and newspapers. The Office of Fair Trading has published a report highlighting important issues for many older people when choosing a care home, e.g., contracts and information about fees and services. The CSCI has responded to this report and further information can be obtained from the following website: http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_people_ choosing a care home .aspx A copy of the home’s inspection report will be made available to anyone wishing to read it upon request to the manager. Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 Page 6 SUMMARY
This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 star. This means the people who use this service experience, poor quality outcomes.
The unannounced inspection was started on the 12th February 2008 and was completed on the following day. Trevor Julian, Chris Gould, Regulation Inspectors and Christine Main, pharmacy inspector, carried out the inspection. A total of 28 hours was spent on site. This was the third key inspection completed during the inspection year. The purpose of the visit was to monitor progress made with statutory requirements made previously and to measure the home’s performance against the key minimum standards. Information was gathered from discussion with the residents, manager, staff and representatives from the management company, observation, inspection of records and a tour of the premises. We also considered information from an Adult Protection investigation concluded in January 2008 and other information received since the last inspection. Mrs Griffin took up her post as permanent manager in November 2007. What the service does well:
The residents continued to be generally positive about the home. Two people were overheard saying. “I think the place is run as well as any other, it is good enough for anyone. Why do they need to come and inspect again; they should go away.” The home has good facilities for medicines storage and uses a monitored dosage system with most Medicine Administration Record (MAR) charts printed by the pharmacy to safeguard people. The residents praised the laundry service and all areas of the home were clean and free of malodours. BML had been active in ensuring the staff employed were suitable for their role although it was found that the organisation’s application form did not request a full employment history. The home’s complaint procedure was on display in the hallway giving residents and visitors information on how to raise concerns and to contact BML Healthcare and the Commission. There had been improvement to the fabric of the building and the new rooms all exceeded 12mï.
Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 Page 7 The owners have completed remedial work identified from the fire risk assessment. What has improved since the last inspection? What they could do better:
Although there had been some progress made with the outstanding requirements and recommendations there was still work required before they are fully met. The care plans were being completely re written by the manager this was creating problems as the old system was still being used during the changeover. There were examples that the staff were not clear about how care needs were to be met. As the manager was completing all the care plans
Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 Page 8 there was no internal auditing. There was no evidence on several files to show that residents, or their representative, had been involved and agreed their care plans. Some bedrails were being used without a written assessment. In the case of one file there were significant nursing care needs missing. The medication policy needs updating to give staff clear instructions to follow and the home needs an effective quality assurance system for medication to ensure that staff follow correct procedures for administering, recording and storing people’s medication to safeguard their wellbeing, and that unsafe equipment for blood testing is not used to protect residents and staff from infection. Care plans should include how people’s medication needs will be met, including the use of when required medicines. During the tour of the premises, it was found that a fire door was held open by a wedge this seriously compromised the home’s fire precaution. The home had a complaints register although there had been no recent entries. Complaints and concerns can be used to demonstrate the home’s response to issues raised by people living in the home. 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. The summary of this inspection report can be made available in other formats on request. Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home’s pre-admission assessment considered relevant topics to ensure that the identified needs could be met, however these should be agreed with the prospective resident. EVIDENCE: The records for two recent admissions were examined both showed that the assessments had been completed in advance of placement. They also showed that the manager had considered the relevant topics. None of the assessments had been signed by the resident, or their representative, so it could not be shown that they agreed the assessment or that it was an accurate reflection of their needs. When a new resident’s notes were checked there were discrepancies between the assessment and actual needs. The home did not offer intermediate care.
Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Care planning systems were not consistent and placed residents at risk as the care tasks were not readily identified. Medication needed further improvements in order to ensure safe administration. EVIDENCE: The manager was introducing a completely revised system of care planning and recording, this had resulted in two systems working in parallel. There was evidence that the staff were confused about the new system and there was a risk of duplication. The new system was being completed by the manager and there was no evidence that the records were being audited. BML stated that they were going to introduce further management support to enable auditing to take place. We looked at four care plans, two contained incorrect information about the needs of the individuals, and there were no dates on some areas. There was
Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 Page 12 evidence that care reviews were carried out some, not all, were signed by the resident, where one person had signed the care plan the care plan gave wrong information about an aspect of personal care, when discussed with staff it was clear that the task was not completed as described. In the case of a recent admission the care plan and the pre-admission assessment information did not adequately describe the person’s medical and physical needs. The commission was also advised by a relative that at a recent review the home could not locate care records for the resident. This matter had been referred to BML Healthcare to investigate under their complaints procedure. There was evidence of appropriate referrals to community health services and support from community nursing teams. Several residents commented that the staff called for GP visits as required and this was recorded on the files seen. The files contained various assessments including nutritional and safe moving and handling. Some of the nutritional assessments contained contradictory information; in some cases, people were having pureed food while food records showed they were eating biscuits and sandwiches and sweets, which could increase the risk of choking. One new resident was provided with bedrails although there was no assessment in place. Three residents looked after some or all of their own medicines and one risk assessment seen had been reviewed. The medication policy did not include procedures for checking and recording receipt of a new resident’s medication; ordering repeat medicines; a household medicines list to give staff clear guidance to follow. The manager said that she assesses the competence of all new trained nurses to administer medicines before they are given responsibility for this. We checked 6 people’s Medicine Administration Record (MAR) charts with the medicines in stock to see if they were given as prescribed, recorded and stored correctly. Most medicines are provided in monitored dosage blister packs and amounts remaining indicated that they were given as prescribed. Others are supplied in packets or bottles and some of the amounts in stock did not agree with the records indicating errors in administration or recording or possibly use of the wrong person’s medicine. Sometimes nurses did not record the dose given when a choice was prescribed so that the person’s response could be monitored. Records of applying people’s creams had improved. There was no information on 2 people’s MAR charts of whether they were allergic to medicines or not to protect them from being given medicines they are sensitive to, and one had recently had a reaction to medication. The manager had devised, but not yet implemented, a form to give staff clear information on the administration of “when required” medicines. There was little or no information about medication in people’s care plans. Following the inspection we received information about a resident who was not having her medication early enough in the morning for her wellbeing. Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 Page 13 The amounts of medicines requiring special storage and recording agreed with the recorded balances and the fixing of one cupboard had been improved to comply with legal requirements. Nurses had recorded fridge temperatures outside the correct range without taking any action putting medicines at risk of deterioration. The dates of opening eye drops were recorded so that they could be replaced when expired to reduce the risk of infection. There were again unapproved lancing devices in stock that nurses said they were using for blood testing putting people at risk of infection. The manager disposed of the stock straight away as GPs had previously told them that it was no longer necessary to test people with diabetes currently in the home in this way. Residents said they were treated well in the home. The inspectors observed staff interaction with the residents and noted a good rapport. Staff were seen knocking bedroom doors and waiting before entering. In discussion with some of the residents they said they were disturbed at night by a member of staff entering their rooms at regular intervals during the night to check on them, they found the process intrusive and unnecessary. Mrs Griffin said that staff have to check each resident at the start and end of their shift, Mrs Griffin said she would speak to the night staff to ensure that they do not routinely disturb all residents. Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Peoples lives had been improved by being offered increased choice and will be further enhanced by the development of person-centred activities. EVIDENCE: The home organised quizzes, exercise sessions, team scrabble, entertainers and there was a visiting library service. The home had appointed an activity organiser who was due to start shortly, this was to enable the activities offered to be broadened and it was hoped that they would be arranging trips out. One person contacted the commission to say that their relative’s care plan stated that she was supported by staff taking her out for walks in the area around the home, however this had not been kept up. Care plans included limited information on social needs. In the case of a new resident she advised the inspectors that she really enjoyed listening to classical music however the TV was left switched on. Mrs Griffin arranged for a radio to be provided and it was in place for the second day of the inspection. Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 Page 15 There was a timetable in the hallway giving details of the planned weekly programme. Several residents commented that there was very little to do in the home. Residents said that visitors were made welcome and could visit at any time. They were also clear that they had reasonable levels of choice about their daily lives, one person was heard telling another resident that, “… the home was good enough for anyone”. Since that last inspection there had been further changes to the kitchen staff, at the time of the visit, an agency chef had regularly covered shifts. He had information on dietary needs of the residents. The breakfast mealtime had been moved to 09:00 in the dining room. Residents generally felt this was an improvement, one resident said she took her breakfast at 10:30 at her own preference. Food records showed the variety of food offered and the choices made by the residents however, the records did not show all meals and there were no clear entries for the people on pureed diets. Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s systems allowed people to safely raise concerns. Adult protection training programme for staff should ensure that potential abuse cases can be correctly addressed. EVIDENCE: People said they were able to raise concerns with the staff. There was a copy of the complaints procedure in the hallway accessible to residents and visitors, it included information on how to contact BML and the Commission. Information was also included in the service users guide. There was a complaint file to record of concerns and compliments received in the home. There had been no recent entries. The home should record concerns to monitor for trends and to demonstrate a proactive approach to issues raised. Most staff were trained in adult protection procedures by the local authority. In discussion with two members of staff both were clear on their responsibilities to respond to allegations or signs of abuse. Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides generally a good standard of accommodation but some areas are still to be renovated. The residents’ benefit from living in a clean and comfortable home. EVIDENCE: The building work had been completed improving the general standard of accommodation however some of the rooms in the older part of the building would benefit from refurbishment. Many of the original rooms included ensuite fitted with conventional baths, most were not suitable for use by the occupant, and some had significant lime scale stains. Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 Page 18 Since the last inspection, the owners have confirmed that all bedrooms above the ground floor had restricted openings. We found this to be the case in the rooms visited. In the new extension, heating is provided underfloor. In the original building, there were still unguarded radiators, it was suggested that to confirm that the risk was appropriately managed, regular checks of surface temperature should be recorded. During the tour of the premises it was found that a bedroom door was fitted with a “doorguard” device to hold the door open and it was also wedged open, seriously compromising fire safety precautions. The home was clean and there were no malodours. The laundry was located on the lower ground floor in the old part of the building. The laundry was well equipped with commercial washers and dryers. Bed linen was sent out to a commercial laundry service and the staff monitor the quality of the items returned. Staff had been trained in managing infection control. There had been problems with the heating system in some areas of the home these had been addressed by the time of the visit. Staff were able to access gloves and aprons as needed and there were soap dispensers and paper towels available in the communal bathrooms and toilets. Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home maintains reasonable staffing levels although there has been a high turnover of staff and some new staff lack experience. EVIDENCE: Mrs Griffin was working to improve the experience of the senior care workers to help them work effectively and to take initiative in their role. The home was had a good staffing ratio, however there had been a large turnover of staff and many of those employed lacked experience. The staff files for four staff were examined; the files were well laid out and easy to audit. The files showed that new staff were only taken on once employment checks and references had been obtained. The application form asked for employment history for the last 10 years however, changes to the legislation now require employers to obtain a full employment history, together with a satisfactory written explanation of any gaps in employment. The files contained information on training completed and a training programme was being developed. Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 Page 20 Residents said that they were concerned about the continual staff changes and repeated that they continued to be upset that the carers they had known for a long time were leaving. Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The homes management has now been stabilised. Further time is needed to ensure that the service is operated in the best interests of the residents. EVIDENCE: As stated previously Mrs Griffin had been in post since November 2007 and had provided some continuity to the management of the home, however with an inexperienced staff team it was difficult for her to delegate and take on the management tasks. This was discussed with BML Healthcare and the owners during the visit and they were going to increase the management support in the home. Several members of staff and residents said the manager was approachable and helpful. There had been a residents meeting allowing people
Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 Page 22 to give their views. An annual quality assurance survey was planned for later in the year. There was evidence that staff supervision was programmed and being carried out. Residents’ finances were not considered at this inspection there had been no issues previously identified. There had been improvements to the health and safety systems. The action identified in the fire risk assess had been addressed and the local Fire Authority had inspected the premises in July 07. Routine tests and inspections were up to date. As stated previously fire safety was being compromised by the wedging open of fire doors. Accident reports were correctly stored and gave a clear audit trail. The manager was auditing the reports to check for trends. Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X X X X 3 Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 Page 24 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 12(1)(4) and 15(1) Requirement It is a requirement that all aspects of each resident’ s health, personal and social care needs must be recorded, including any psychological, social, cultural and religious needs. Care plans must make clear how these needs are to be met. This requirement had a previous timescale 01/07/07, 31/08/07, 30/09/07, 31/01/08 Medicines must be stored at the correct temperature to maintain their effectiveness. There must be clear directions for how and when any ‘when required’ medicines are to be given so that staff know how to meet residents’ healthcare needs. This requirement had a previous timescale 31/12/07 3. OP9 13(2) The medication policy must be updated so that staff have clear procedures to follow on all
DS0000032192.V358875.R01.S.doc Timescale for action 30/04/08 2. OP9 13(2) 30/04/08 30/04/08 Windsor Court Version 5.2 Page 25 aspects of the handling of medication in the home. This requirement had a previous timescale 31/12/07 4. OP9 13(2) There must be a robust audit trail that is monitored to ensure that medication is given as prescribed and accurately recorded. Details of any medicine sensitivity or ‘none known’ must be recorded on or with the MAR chart to protect residents from receiving medicines they are allergic to. The registered provider must ensure that fire precautions are not compromised by the use of unapproved wedges. The registered person must ensure that a full employment history is obtained for new staff together with a satisfactory written explanation of any gaps. 30/04/08 5. OP19 23(4) 30/04/08 6. OP29 19(1) 30/04/08 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 OP3 Good Practice Recommendations The registered person should ensure that a pre admission assessment is completed ensuring all needs can be met. The assessment should include evidence of the resident’s involvement. Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 Page 26 2. OP9 Care plans must include relevant information about people’s medication needs to enable staff to meet their healthcare needs. The maximum and minimum temperature (normal range 2-8oC) of the refrigerator used to store medicines should be monitored and recorded daily when in use. Care plans for people with diabetes should include details of monitoring required, the person’s usual levels and when and what action to take if levels are outside their usual range. 3. OP9 4. OP12 It is recommended that, where possible, further information about each resident’s background, social history, previous hobbies and interests etc. is recorded, to ensure that the activities on offer at Windsor Court will be meeting the individual needs, preferences and expectations of residents. The food records should contain sufficient detail to determine that individuals have satisfactory diets. Checks should be completed to ensure that radiators are adequately assessed to ensure the risks to residents and staff are minimised. It is recommended that a minimum of 50 of care staff achieve NVQ level 2 training. The registered person should ensure that the Quality Assurance survey seeks the views of all stakeholders. 5 5. OP15 OP25 6. OP28 7. OP33 Windsor Court DS0000032192.V358875.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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