Inspection on 20/10/08 for Woodcross Mental Nursing Home (Highfields)

This inspection was carried out on 20th October 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Woodcross Mental Nursing Home... 19/11/07

Woodcross Mental Nursing Home... 21/07/06

Woodcross Mental Nursing Home... 06/03/06

Woodcross Mental Nursing Home... 26/09/05

Woodcross Mental Nursing Home... 24/01/05

Woodcross Mental Nursing Home... 06/12/04

Woodcross Mental Nursing Home... 02/02/04

Similar services:

The Lodge Nursing Home

Bracken House

Sunnycroft

Field Farm House

Edgeview Nursing Home

Church Terrace Nursing & Residential Home

The Forbury

The Maples

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Woodcross Mental Nursing Home (Highfields) 23 Reeves Street Bloxwich Walsall West Midlands WS3 2DQ     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mandy Beck     Date: 2 0 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Woodcross Mental Nursing Home (Highfields) 23 Reeves Street Bloxwich Walsall West Midlands WS3 2DQ 01922497394 01922497395 woodcross@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Roger Low Type of registration: Number of places registered: Southern Cross Healthcare Centres Limited care home 44 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 44 The registered person may provide the following category of service only: Care Home with Nursing (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia (MD) 44 Date of last inspection Brief description of the care home Woodcross Nursing Home is registered to accommodate 44 adults with enduring mental health issues and associated conditions. A small number of people have a physical disability, although this is not their primary need. The home is a purpose built two-storey building. On the ground floor there are three lounge areas, one being a smoking room. There is a large dining area with a serving hatch to the kitchen. The Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 44 Brief description of the care home home has toilets and bathrooms situated throughout. There are two sluice areas and professional laundry facilities. The home has single and shared bedrooms, none of which have en-suite facilities. There is an enclosed garden at the side of the home, with a patio ara and barbeque facilities. The home has a minibus for use by people who use the service. The home is located near the centre of Bloxwich with local bus services, shops and other amenities close by. The Service User Guide did not reflect information relating to the fees in the home as required. The reader may wish to approach the care provider for up to date details of the fees payable. Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced visit to the home, they were given no prior notice. One inspector and an expert by experience completed this inspection. An expert by experience is a person who, because of their shared experience of using service, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. We looked at all the information that we have received, or asked for, since the last key inspection. This included, Care Homes for Adults (18-65 years) Page 6 of 31 The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Information we have about how the service has managed any complaints. What the service has told us about this that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. Relevant information from other organisations. We also spent time talking to the people who use the service and to the staff who support them. We looked at the care of four people who use this service in depth. This is part of our case tracking process and helps us make judgements about the homes abilities to meet peoples needs. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 31 Care Homes for Adults (18-65 years) Page 9 of 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who choose to use this service can feel confident their needs will be assessed in full prior to their admission. Evidence: We looked at the care of four people in depth as part of our case tracking process. When we looked at the assessment details of one person we found the homes own assessment had not been completed in full. For example the front of the daily living assessment had been completed but the reverse sheet was blank and had not been filled in. The home had however taken steps to obtain copies of the care managers assessment and the Care Programme Approach (CPA) the information in these sets of documents did provide enough information for staff to be able to plan care with people. The assessment details in the other three files we looked at were complete and again formed the basis for planning effective care for those people. Care Homes for Adults (18-65 years) Page 11 of 31 Care Homes for Adults (18-65 years) Page 12 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service can expect to be included in planning their own care and the service will manage risks to people appropriately. Evidence: Since our last inspection the home has maintained its approach to care planning and managing risk for people. We saw that care plans and risk assessments were more person centred in their approach and did give an overall picture of peoples needs. People we spoke to said they were involved in the planning of their own care and felt that the staff supported them when they needed it. We also spoke to staff who told us we do talk to residents so that we know what they want when we look at the care plans. Risk assessments are reviewed regularly but the home must make sure that they are a current reflection of peoples changing needs. We saw risk assessments in place for reducing the risk of falls, pressure sore development, malnutrition and road safety. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: There were also risk assessments from the Care Programme Approach that manages peoples specific risks associated with their mental health problems. Care Homes for Adults (18-65 years) Page 14 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service will be encouraged to take part in activities and to lead an active life. Evidence: We saw that people are encouraged to attend colleges and attend day centres if they choose to do so. One person told us he would like to try going back to college again. This was reported back to the manager who told us he would look into this for the person. The manager also told us that more work has been done to encourage people to take part in activities outside the home. We spoke to people about how they felt the home supported them they told us they felt staff understood their needs and helped them with activity. People told us they were particularly fond of the art groups and cooking in the occupational therapy room. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: Other people said that they had the choice about participation in activity but preferred to stay in their room. People also told us they enjoyed the line dancing that takes place once a week. At the time of this inspection the home had been decorated for Halloween and people were planning a Halloween party. People can choose where they want to eat their meals, the majority of people choose to have their meals in the dining room. People told us the food is good and there is alot of choice. Food is freshly prepared on the premises and the home is able to meet specialist dietary requirements when necessary. Care Homes for Adults (18-65 years) Page 16 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to the healthcare services they need but more attention could be given to the changing needs of people. Evidence: We looked at the care plans and health records of four people using the service. Each person has their own individual care plans that generally details their care needs. People gave us a mixed response when we asked if they had been involved in the planning of their own care. They said I havent seen my care plans I dont know what they are, another person said yes I have my own nurse I can talk to about my care and I think the staff have tried hard to understand my needs and have supported me as I settle in. Care plans are generally an accurate reflection of the care that people are receiving. We found that some improvements could be made to them. For instance, one care plan referred to staff having to monitor relapse but there was no explanation of what form that relapse may take for that individual. If there is no explanation it would be difficult for staff to know when a relapse was occurring. In another persons daily Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: records we saw that they had needed specific short term care following a hospital admission. We found no care plan to show how the home had addressed this. The manager told us he would have expected to see a care plan in the persons file to address this. We could see that peoples healthcare was kept under review in most cases. People have access to their own doctor and the home is visited by a psychiatrist on a two weekly basis to monitor peoples mental health and well being. The home completes risk assessments so that those people most at risk can be identified and a risk management plan can be done. In one persons case we found that staff had not kept the risk assessment up to date and it did not reflect changes in the persons current physical health. We saw that this person had experienced four falls within a three week period. They had also experienced unexplained weight loss over a period of four months. We could not find any evidence to show us the home had taken any action to address this. We asked the manager if the information would have been recorded anywhere else, he told us no it should all be in the file. The manager must make sure that staff are completing risk assessments accurately and taking appropriate action where problems are highlighted. We looked at other care plans for people including those for challenging behaviour. We found that the care plan was clearly written and gave staff suitable guidance particularly if restraint should be necessary. The medication systems in the home are good and do safeguard peoples well being. The person we spoke to was able to give a good account of how the home orders, stores and administers medication on behalf of the people living there. We have made some recommendations to further improve practice. We have asked that all handwritten entries onto the Medication Administration Record (MAR) are signed by two members of staff. This will reduce the risk of errors being made. We have also asked for the home to produce care plans for the use of as required medication. This should happen so that all staff are clear about the circumstances under which this type of medication can be administered. The home must also make sure that requests on MAR sheets, such as when absolutely necessary are not accepted as an instruction for administration of peoples medication. Care Homes for Adults (18-65 years) Page 18 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service can be sure their concerns will be listened to and acted upon. Staff have the knowledge and skills to protect vulnerable people living in this home. Evidence: The service has not received any complaints since our last inspection. People who responded to our surveys told us, they were aware of who to speak to if they were unhappy about anything and they felt confident about making complaints is they needed. One person who spoke to our expert by experience said that they felt the home wouldnt take action if they were unhappy about something and that staff generally do not listen to what people have to say. We have informed the manager of these comments and have asked him to take action by making sure that all people are aware of the complaints procedure and that peoples view will be taken seriously and acted upon. The home includes a copy of the complaints policy and procedure inside the Service User Guide that each person has their own copy of. People are protected from harm whilst living here. Staff have received training in safeguarding vulnerable adults and were clear about what to do if an allegation or incident were made known to them. Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: The service must make sure that when it is recruiting new staff it carries out the required safety checks against the Protection of Vulnerable Adults list (PoVA) and Criminal Records Bureau disclosure (CRB). These checks will help stop unsuitable people from working with vulnerable adults. This did not happen in all the new workers files that we saw. The home has a member of staff who is trained to deliver training in non violent physical crisis interventions. He plans to provide training for all staff in this area so that they will be more aware of the strategies available to them when diffusing difficult situations. There are no other methods of restraint in use at the home at this time. Care Homes for Adults (18-65 years) Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well maintained home that is clean and comfortable. Evidence: We were shown around the home by the staff and the some of the people who live there. The home is comfortable and a safe environment for people to live. People told us they liked living at Woodcross. They said my room is the best the staff have helped me decorate it. We saw some peoples bedrooms and they had been personalised to reflect individuals own tastes. The expert by experience reported the following The entranceway to the home was light and pleasant. The corridors and communal areas of the home were fragranced by pot pourri, which I found overwhelming after a while. I was given a tour of the home, and in some places the corridors and stairs had a slight odour of urine. I saw one persons bedroom, which was very basically furnished. There are ample communal areas for people to make use of. The large lounge by the dining room appears to be a popular place for people to meet and socialise. The home provides smoking facilities for people both indoors and outside in the garden. The occupational therapy room provides space for people to cook their own meals and to Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: take part in activity should they choose to do so. There is a games/recreational room with pool table, sofas and televisions for people to enjoy. we did note that the televisions in this room are not in full working order and should be repaired so that people can enjoy watching them. The home has a large patio area with plenty of seating and tables for people to use. People are encouraged to do their own cleaning wherever possible, there are laundry facilities in the home to support people doing this. Staff have access to protective clothing such as gloves and aprons, there is also hand gel and hand wash for people to use. These measures will help reduce the risk of cross infection in the home. Care Homes for Adults (18-65 years) Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service are supported by staff in sufficient numbers to meet their needs. Staff receive regular training to keep their knowledge and skills up to date with current best practice. Improvements in recruitment procedures will give vulnerable people extra protection from unsuitable workers. Evidence: The home said in their AQAA the rota in the home is managed to ensure that there are always sufficient staff. We looked at the duty rotas which did appear to show that staffing levels within the home are sufficient to meet the needs of the people living there. We saw that the rota is not always kept up to date with the hours that staff are working. For example, the deputy managers hours were not recorded at all on the rota. The home must make sure that it keeps accurate rotas and of the hours that care staff are working. The home also told us in their AQAA that they operate a robust recruitment procedure to ensure that all staff have the right experience, qualifications and personal qualities to provide a high standard of care. Personnel files are complete and are audited on a monthly basis. We looked at the staff recruitment files of four new workers, we found that improvements are needed if people using this service are to be safeguarded. The home must make sure that people who begin working in the home with only a Protection of Vulnerable Adults (PoVAfirst) check in place, are Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: supervised whilst working by an experienced member of the staff team. This should continue until the return of a satisfactory Criminal Records Bureau (CRB) disclosure. The manager must risk assess this situation and take action to put the appropriate safeguards in place to protect people living in the home. The home has arrangements in place for staff induction and training. We spoke to some staff during this inspection who confirmed that training takes place regularly. They told us we are always put up for training, I cant remember the last training I did but it is regular. The home has its own moving and handling trainer who is responsible for making sure that staffs knowledge of moving and handling is up to date. The manager also showed us the training schedule for the rest of the home. We saw that there are some gaps in training and some training that is due for refresher training. There are systems in place to address this. Once completed this will mean that staff have the knowledge and skills to meet the needs of the people living in the home. Care Homes for Adults (18-65 years) Page 24 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed well. There are systems in place to make sure the service runs in the best interests of the people living there. Improvements are needed to reduce the risks to the health safety of people. Evidence: The service now has a registered manager, Mr Roger Low was approved by the commission as fit to manage the home in July 2008. Mr Low has the necessary skill and qualifications to run the home. He is aware of the need to keep up to date with practice and continuous development of management skills. And has responsibility for reviewing home policies and procedures and making sure they are kept up to date with current best practice. The quality assurance systems in place involve the manager conducting over 16 audits a month. These audits include care planning, medication, home environment and accidents. They help the manager determine if improvements could be made to the service the home is providing. People living at the home are also invited to comment Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: about the service through regular residents meetings. As part of the homes self assessment they also completed the AQAA, the information contained in the AQAA gave us a reasonable picture of the service. There was also some evidence to support some of the comments made but more would have been useful to illustrate what the service has done in the last year or how it is planning to improve. The homes health and safety systems are satisfactory but we found some improvements that need to be made to safeguard the people living in the home. We looked at the hot water temperatures and found in some instances they were too hot and could pose a scald risk to people. We have asked the home to address this promptly. We also noted when we checked the fire records for the home that bulbs were missing from the emergency lighting. They had not been replaced since they were reported as defective in February 2008. We have asked that the home take prompt action to rectify this. All other maintenance records were up to date. Staff have a rolling programme of health and safety training provided by the home. This will make sure that their knowledge of current best practice is kept up to date. We also noted as part of our case tracking process that incidents/accidents had occurred that we were not notified of. For instance one person had been involved in a physical assault, the other person has sustained a fracture. We would expect homes to notify us under Regulation 37 of the Care Homes Regulations 2001 of these occurrences. We have recommended the manager obtain a copy of our guidance about notifications from our website. Care Homes for Adults (18-65 years) Page 26 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 13 The home must be able to demonstrate that it has taken appropriate action to meet peoples needs in relation to unexplained weight loss. This will make sure that peoples well being is addressed. 31/12/2008 2 20 13 The manager must make sure that when people are prescribed medication on an as required basis there must be a maximum frequency for administration recorded on the MAR sheet. This must be done so that staff are very clear about the amount and the frequency with which as required medication should be administered. 31/12/2008 3 20 13 People who are prescribed medication on an as required basis must have a clear care plan that tells 31/12/2008 Care Homes for Adults (18-65 years) Page 28 of 31 staff when this type of medication should be administered. Staff should also be recording the effectiveness of the medication following administration. This should be done so that people are only given this type of medication when they need it. 4 34 19 The manager must make sure that when new workers are permitted to start work at the home without a satisfactory CRB, the situation is suitably risk assessed and the new worker is supervised by an experienced member of staff. This will help reduce the risk to the people using this service until such time the new workers CRB is received. 5 42 13 The manager must make 31/10/2008 sure that the excessively high hot water temperatures are addressed. This specifically refers to bedrooms 17,19,20. This must be done to reduce the risk of scalds and burns to the people who use the service. 6 42 37 The manager must make sure that the commission is notified of deaths, illness and other events in the care 31/12/2008 31/10/2008 Care Homes for Adults (18-65 years) Page 29 of 31 home as outlined in regulation 37. . Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 The home should make sure that it completes its own assessment of peoples needs in full. This will help staff to plan care with people if assessments have been comprehensively completed. The manager must make sure that when staff complete risk assessments for people they are an accurate reflection of peoples needs. Two staff should sign the medication administration record when they are completing a handwritten entry. This will reduce the margin for error and protect peoples well being. The manager should make sure that all people using the service are aware of and understand the complaints procedure. People should feel that their views will be listened to and acted upon by the home. Consideration should be given to replacing the televisions that are not in full working order in the recreation room. This should be done so that people can enjoy watching the television without interference. The manager should make sure that all staff working hours are recorded on the duty rota and whether the hours were actually worked. This should include both the deputy manager and managers hours. The home must make sure that when recruiting people whose last period of employment was in a care position a reference relating to that period of employment is obtained. The manager should take prompt action to replace the broken window at the front of the home. This will improve the lighting and security for people living in the home. The manager should make appropriate arrangements for the replacement of the bulbs in the emergency lighting system as highlighted by the homes own maintenance support. 2 19 3 20 4 22 5 24 6 33 7 34 8 42 9 42 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 31 of 31 - 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!