Inspection on 22/09/05 for Winsford Grange Care Home

This inspection was carried out on 22nd September 2005.

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

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

Other inspections for this house

Winsford Grange Care Home 27/10/08

Winsford Grange Care Home 15/04/08

Winsford Grange Care Home 10/04/07

Winsford Grange Care Home 29/06/06

Winsford Grange Care Home 27/04/05

Winsford Grange Care Home 14/10/04

Winsford Grange Care Home 17/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Winsford Grange Care Home Station Road Bypass Winsford Cheshire CW7 3NG Lead Inspector Denis Coffey Announced Inspection 22nd September 2005 09:00 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 Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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. Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Winsford Grange Care Home Address Station Road Bypass Winsford Cheshire CW7 3NG 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) 01606 861771 01606 861705 Community Integrated Care Mark Laight Care Home 60 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (30), Old age, not falling within any other of places category (30), Physical disability (1) Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 60 service users to include: * Up to 30 service users in the category of OP (old age not falling within any other category * Up to 30 service users in the category of DE(E) (dementia over the age of 65) * Up to 3 service users age 60 years upwards in the categories of PD or DE * One named service user under the age of 65 in the category of PD The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance which may be issued through the Commission for Social Care Inspection 27th April 2005 2. 3. Date of last inspection Brief Description of the Service: Winsford Grange is a purpose built facility. It comprises of two units: one for elderly frail service users and one for the elderly mentally infirm service users. Each unit has two wings of 15 beds each. Dickens and Austen are the wings accommodating the elderly frail service users, and Bronte and Chaucer the wings accommodating the elderly mentally infirm service users. The home is a single storey building with good access for wheelchairs. Bedroom accommodation comprises of 38 single and one double room. There are no ensuite toilet or bathroom facilities. There are private enclosed gardens. The home provides good car parking facilities, and is located on a local bus route, and is close to rail services. Registered nurses are on duty at the home at all times in accordance with statutory requirements. Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 7 hours; during which time a tour of the premises took place, and staff care records were inspected. Denis Coffey, Regulatory Inspector visited Bronte and Chaucer Units. Helena Dennett, Regulatory Inspector visited Dickens and Austin Units. The inspectors spoke with 8 of the residents and six members of staff. Two sets of visitors were present at the time of inspection, all of who commented favourably on the standard of care provided. Of the eight requirements identified at the last inspection, five remain unmet, and these have been identified in the requirements section of the report. What the service does well: What has improved since the last inspection? What they could do better: Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 6 The care records of the residents need improving by plans of care being devised for the management of all of their identified needs/problems. The management of medicines was identified as needing to improve at the last inspection, and was found to still require this at this inspection. Particular attention is needed to the recording of medicines administered to the residents, and the ordering of medicines to ensure that there are enough stocks of these available at the home. The recruitment procedure needs to ensure that two satisfactory references are obtained for all prospective employees prior to them commencing employment. The agreed staffing levels for the number of trained nurses on duty during the day needs to be adhered to ensure that there are sufficient trained nurses available to meet the health and welfare needs of the residents at all times. 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. Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 7 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 Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 8 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): 2&3 Residents are assessed and given information to make sure that they know their needs can be met at the home and what their rights and responsibilities are whilst living there. EVIDENCE: An examination of the records of three residents showed that an appropriate person had assessed them before they moved into the home. Evidence was also seen of residents being issued with a written statement that identified the terms and conditions of residency at the home. The home does not provide intermediate care therefore Standard 6 does not apply. Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 9 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 & 10 The care records of some residents were incomplete therefore it was not possible to see from these that all the care needs of the residents were being met. There were problems with the medicines that could result in residents not receiving their medicines as prescribed. Residents’ privacy is maintained at all times. EVIDENCE: The care records of five residents were examined at this inspection, and the following observations made;The care plans for one resident were dated September 2003. One of the problems the resident suffered from was insulin dependent diabetes. There was no plan of care in place addressing this problem. Therefore it was difficult to determine how staff was meeting this need. A plan of care was in place for the personal hygiene needs of the resident, but this did not include the bathing needs of the resident, e.g. how they would be assisted into and out of the bath; this is particularly relevant for this resident as they have a physical disability that prevents them from getting into and out of a bath unaided. A Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 10 moving and handling assessment was documented that demonstrated that the resident required assistance. An assessment for the residents skin showed that they were at risk of developing a pressure sore, but there was no plan of care in place detailing how this problem was to be managed. The second set of care records examined were for a resident whose records showed that they had lost over two stone in weight within the past twelve months. The resident’s plans of care had not been amended to reflect this. The resident had been identified through an assessment that they were at risk of developing a pressure sore, but a plan of care was not in place for this. Bed rails were fitted to the resident’s bed, but a risk assessment was not in place for the safe use of these. When reviewing this resident’s Medicine Administration Record sheets it was noted that they were receiving a ‘controlled drug’ for the relief of pain. The reason for this was not identified in the resident’s care records. The third set of records was for a resident who is an insulin dependent diabetic, a plan of care was not in place for this problem. A range of care plans was in place for the resident that had been evaluated on a regular basis. However, some of these care plans had been in place for twelve months. The fourth set of records contained a moving and handling assessment, falls risk assessment, an assessment for the safe use of bed rails, and an assessment of the resident’s skin condition. Daily records relating to the resident’s health and welfare were detailed and informative, and evidence was seen of a dietician being involved in the care of the resident. However, there were no plans of care in place for this resident who had moved into the home in August 2005 and so may be at risk from their needs not been met in full by all staff. The fifth set of records seen was for a resident who also suffers from diabetes, but a plan of care was not in place for the management of this problem. A range of care plans was in place that had last been evaluated in May this year. Care plans should be evaluated monthly to make sure that they are up to date and accurate and still provide information for staff to enable them meet the needs of residents. Assessments were recorded for moving and handling, the safe use of bed rails, falls, skin condition, and nutrition. In August this year the resident was diagnosed as having MRSA and at risk of developing a pressure sore on their toes. Records were seen of the infection control nurse based at the local hospital being consulted regarding this, however a plan of care was not in place for the management of this problem so the resident may be at risk of their needs not being met. A physiotherapist had been involved in this resident’s care and identified a number of exercises staff should do with the residents. When questioned one care assistant involved in the care of the resident displayed a good awareness of the exercises prescribed for the resident by the physiotherapist. Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 11 During the course of the inspection one of the inspectors visited the lounge on Austin Unit where they observed a china hand bell on a table beside one of the residents in the room. The inspector rang this bell and after 5 minutes rang the bell again as there had been no response from the staff. A member of staff responded after the second ring who said that they would not have heard this unless they were in close proximity to the lounge. This problem of residents being unable to summon assistance in a satisfactory manner was identified at the last inspection of the home, and now needs to be addressed The arrangement for medicines was inspected at this inspection. Records were seen of the residents’ Medicine Administration Record (MAR) sheets being audited, and of staff signatures for those staff responsible for the administration of medicines. Some of the MAR sheets were extremely difficult to read, as the administration instructions on these were noticeably faint. Changes had been made in writing to the original prescribing instructions on some of the MAR sheets that had not been signed by the person making the alterations. The MAR sheet of one resident stated that their eye drops had been out of stock since the 16th September 2005. These drops are required to be given on a regular basis and a further supply of these should have been obtained. Some medicines were prescribed on an as required basis the doses of which were variable, however the actual dose of medicine administered was not always recorded, as they should have been. It was also observed on one resident’s MAR sheet that a record was made of their medicine not being supplied, but staff had signed that the medicine had been administered. When asked how they obtained the monthly supply of medicines staff said that they request these from the residents’ doctor who then prescribes them, after which the prescriptions are delivered to the supplying chemist. All prescriptions for the residents’ should when completed be returned to the home before being sent to the chemist to enable the staff to verify that what has been requested has been prescribed. Residents’ spoken with were positive in their comments about the care they receive. Comments were made such as, ‘staff are better than ok they are excellent’, ‘feels like home’, and ‘the food is good’. Staff were observed to maintain the residents’ privacy when attending to their personal care, and to address the residents appropriately. On Dickens Unit at lunchtime all of the residents were given blue plastic aprons to wear over their clothes. These appeared undignified, and should a resident spill food on them the food would slide down the apron onto unprotected clothing or the floor. An alternative to these aprons should be sought that promotes the dignity of the residents at meal times. See Requirement 1 See Requirement 2 See Requirement 3 See Requirement 4 See Requirement 5 Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 12 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 & 15 Social activities are well organised, providing a range of interests for people living at the home. Residents’ are enabled to exercise choice, giving them a degree of control over their lives. Visitors can come into the home at any reasonable time. EVIDENCE: A list of the current week’s activities was on display that included such activities as skittles, a quiz, a church service, film show and karaoke. The home organised a recent garden fete that raised £539, and staff said that other similar fund raising events are held during the year. The proceeds from these are used to buy Christmas presents for the residents. The home has an open visiting policy and residents confirmed that they could see their visitors in private if they so wish. Visitors spoken with during the inspection said that they are made to feel welcome at visiting times and that they were happy with the care their relative was receiving. Comment cards were received from the relatives of nine of the residents, all of who stated their satisfaction with the care delivered to their family member. In conversation with the inspector, residents said that they are able to exercise choice and control over their lives within the limitations of their condition. Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 13 They said that they choose when they go to bed and get up, what they wear, and what they eat. Lunch on the day of inspection was gammon and pineapple, minced beef and tomato or assorted salads. A choice of chips, mashed or jacket potatoes was available. A dessert of fruit pie and cream or strawberry gateau was served. Yogurts and ice cream were also available on a daily basis as further alternatives to the desserts offered. Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 14 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 & 18 Information is available to residents and visitors informing them of how to make a complaint and who to make it to. The home’s policies and procedures in relation to adult protection are available at the home for staff to ensure that residents are protected from abuse, harm and poor practice. EVIDENCE: There had been one recorded complaint being received at the home since the last inspection. The family of a resident had made the complaint, but the details of the complaint were not available at the home. The acting manager said that a manager at the company’s head office had appointed an investigating officer, and that this person had met with the family. However, a record of this meeting was not at the home. A letter of response was seen that was sent to the person making the complaint that addressed a number of issues, but as the relevant information was not at the home it was not possible to ascertain if this response had addressed all of the issues raised. Staff spoken with were aware of the home’s adult protection and whistle blowing policies. See Recommendation 1 Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 15 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 & 26 Although the front of the home is kept in good repair the road to the back of the home is in a poor condition and could be a risk to residents or relatives. The home provides a standard of accommodation for people living at the home that is safe and comfortable. The home is kept clean and tidy and so is comfortable for the residents. EVIDENCE: Seven of the double bedrooms present at the last inspection have been converted into fourteen single rooms, all of which have been equipped with wash hand basins. The arrangements for the general maintenance of the building have changed since the last inspection. Previously a maintenance person was employed solely for the home, but the new arrangements are that the home shares this person with another home, and routinely have the person’s services for three days each week. The company have a contract with an independent firm that provides twenty-four hour cover for work outside the scope of the company’s maintenance person. At the last inspection it was noted that the road leading to the back of the home was in a state of disrepair Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 16 and a requirement was made for this to be attended to. The necessary work to this road remains outstanding, but the acting manager said that the company are awaiting quotes for the cost of the necessary repair work, and in the meantime, access to the home by residents, visitors and staff has been stopped. All areas of the home were visited at this inspection and found to be clean, tidy and free from unpleasant smells. The home has its own laundry facilities on sight where all of the residents’ clothing is washed and ironed. When laundered, all clothing is returned to the residents’ bedroom and put away. See Requirement 6 Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 17 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 & 30 The appropriate skill mix of staff are not always on duty to meet the needs of the residents, so residents could be placed at risk. The home’s recruitment procedures were not thorough enough to ensure that residents are supported and protected. EVIDENCE: A review of the staffing rotas showed that there were regular occasions when there was only one trained nurse on duty during the day covering both Dickens and Austin Units. When asked about this the acting manager said that some trained nurses had requested to work nights, and had as yet not been replaced. This has led to trained staff shortages on days, and more trained staff than recommended at times on nights. An immediate requirement was made that the agreed staffing levels at the home be complied with in relation to the number of trained nurses on duty during the day. Nine of the care staff employed at the home have achieved an NVQ level 2 in care, which means that 23 of the care staff employed have this qualification. The acting manager was reminded that a minimum of 50 of care staff should have an NVQ level 2 (or equivalent) by the end of 2005. Records were not available to confirm that all staff have received their statutory moving and handling training within the past twelve months. The personnel records of one recently appointed employee were examined. Two references had been obtained for this person one of which stated that the Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 18 referee had no knowledge of the person’s strengths or weaknesses, and the second referee referred to areas of identified weaknesses. The acting manager was advised of the need to seek at least one further reference for this employee. An interview assessment was seen in this person’s records along with a copy of their contract that detailed the number of weekly hours to be worked and their holiday entitlement. Evidence was seen of a satisfactory enhanced Criminal Records Bureau disclosure being obtained for this person. Staff training records showed that the following training has been provided; basic food hygiene, infection control, adult protection, health and safety awareness and coaching skills. Further training in infection control, care planning, continence and the management of pain has been planned for. See See See See Requirement 7 Requirement 8 Requirement 9 Recommendation 2 Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 19 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 & 38 The current management arrangements at the home do not ensure that the needs of the residents are being fully met. EVIDENCE: The registered manager has been on a secondment to another home owned by the company. This secondment was for an initial three-month period last March, and is still ongoing. A management representative of the company was present at the home throughout the course of this inspection who was informed that the Commission would require the registered manager to return to the home in light of the findings of this inspection. Records were seen of unannounced monthly inspections taking place at the home by a representative of the company. The records from these visits Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 20 showed that staff and residents had been spoken with, a tour of the premises had been made, and equipment checked. The fire alarm and emergency lighting systems were recorded as being tested weekly. Certificates were seen of the cold water supply being disinfected in August 2005, and of the central heating system also being serviced in August 2005. A total of forty-seven staff were recorded as receiving fire safety awareness training this year, and the acting manager said that all staff employed at the home will have received this training by the end of the year. As stated previously, records were not available to demonstrate that all of the staff at the home have receive training in safe moving and handling techniques this year. A requirement was made at the last inspection that all staff must receive this training. This requirement remains outstanding. See Requirement 8 See Requirement 10 Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 21 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 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 1 28 2 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 Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 22 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 Timescale for action 28/11/05 2 OP38 13 3 OP8 13 4 OP9 13 A written plan must be implemented that identifies how all of the residents needs with respect to their health and welfare are going to be met. This requirement remains outstanding from the last inspection. Appropriate risk assessments 28/11/05 must be carried out and documented for all residents who have bed rails fitted to their beds. A satisfactory system whereby 28/11/05 residents can summon assistance must be provided in all areas of the home used by residents. This requirement remains outstanding from the last inspection. Suitable arrangements must be 28/11/05 made for the recording, and safe administration of medicines at the home. This requirement remains outstanding from the last inspection. Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 23 5 OP10 12 6 OP19 23 7 OP27 18 8 OP38 13 9 OP29 19 10 OP31 9 Arrangements must be made for a suitable alternative to the blue plastic aprons currently being used to protect the residents’ clothing at mealtimes. The service road leading to the rear of the premises must be attended to, to make it safe for anyone accessing this road. Ensure that at al times suitably qualified nursing staff are working at the care home in such numbers as are appropriate for the health and welfare of the residents. All staff employed at the home must receive training from an approved instructor on the safe moving and handling of residents. This requirement remains outstanding from the last inspection. Two satisfactory references must be obtained for all prospective employees prior to their commencement of employment at the home. The registered manager must resume his post at the home unless it is proposed that an alternative person be put forward for this post. 28/11/05 28/11/05 25/09/05 28/11/05 28/11/05 28/11/05 Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 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 Refer to Standard OP16 OP30 Good Practice Recommendations Arrangements should be made for all information concerning complaints received about the home to be kept at the home. Arrangements should be made for 50 of the care staff employed at the home to achieve an NVQ level 2 (or equivalent) in care. Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Winsford Grange Care Home DS0000018743.V249588.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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