Inspection on 06/01/06 for Woodland Court Nursing Home

This inspection was carried out on 6th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Woodland Court Nursing Home 29/10/08

Woodland Court Nursing Home 06/12/07

Woodland Court Nursing Home 03/05/07

Woodland Court Nursing Home 25/05/06

Woodland Court Nursing Home 22/10/05

Woodland Court Nursing Home 14/12/04

Woodland Court Nursing Home 26/05/04

Woodland Court Nursing Home 15/01/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Woodland Court Nursing Home 56 Marldon Road Shiphay Torquay Devon TQ2 7EJ Lead Inspector Rachel Proctor Unannounced Inspection 6th January 2006 10:30 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 Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Woodland Court Nursing Home Address 56 Marldon Road Shiphay Torquay Devon TQ2 7EJ 01803 613162 01803 615192 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) Woodland Healthcare Ltd Mr John Robert Lyle Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (3), Physical disability (39), Physical disability of places over 65 years of age (39) Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Registered for max OP 3 Registered for max PD 39 Registered for max PD (E) 39 service users over the age of 65 Date of last inspection 22nd October 2005 Brief Description of the Service: Woodland Court has been a nursing home for just over 14 years. The home is part of a group of homes providing personal and nursing care. It is sited in a residential area on the outskirts of Torquay with easy access to the Torbay ring road, which is half a mile away. This home provides personal and general nursing care to people over the age of retirement. It is registered to care for up to 39 people mainly in single room accommodation. There are 25 single rooms all with en-suite facilities and 7 double rooms, mostly with en-suite facilities. The present configuration has four of the double rooms used, as singles therefore there are 29 singles and 3 double rooms. The home has a shaft lift, centrally located, making access between the ground and first floor easy for the less able bodied Service Users. There is one large lounge with dining space on the ground floor at the rear of the building. The terrace immediately outside the lounge that looks over the garden that has disabled and wheel chair access. The home has recently been redecoration throughout the communal areas and some bedroom areas, which included fitting good quality carpets in the communal areas and passageways. Some of the bedrooms have also been re-carpeted as part of the homes redecoration program. Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission For Social Care Inspection has introduced key standards to be inspected over each inspection year. Therefore, unless it is felt necessary by the inspector, some standards will not be inspected. To obtain a full picture of the home it is recommended that previous reports also be taken into consideration. The inspection took place 6 January 2006 between 10:30 a.m. and 5 p.m. Regulation Manager Mrs Lesley Brown accompanied the inspector until 1 p.m. A further inspection visit was carried out on 2nd March 06 between 10:00 am and 4:00 p.m. on this occasion the Tissue Viability Nurse Specialist Mrs Helen Orchard accompanied the inspector from 10:00 am – 01.00 p.m. Six service users, four staff and two visitors were spoken to during the inspection visits. A tour of the home was completed and six service users plans of care were reviewed as part of case tracking processes on both inspection days. The inspection was conducted over two days to follow up on immediate requirements made in relation to the way the service users health care is recorded and managed. What the service does well: What has improved since the last inspection? What they could do better: Requirements set at the last inspection for medication has still not been fully met. The prescribed wound care products used do not always tally with the wound care products in use for the service users. The manager must ensure that staff have clear guidance relating to wound care management, which ensure consistency with the products used and the way staff evaluate wound healing. Residents who have been identified as at risk of falling must have a plan of care in place to guide staff how to reduce the risk. Although the service users assessments reflect their care needs, care planning is not consistently provided to reflect this. Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 Page 6 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. Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 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 Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 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): 3, Although a comprehensive assessment process continues to be used, the care planning in place does not completely reflect the service users assessed needs. This could put the service users at risk of not receiving all the care they need. EVIDENCE: An initial assessment was completed in all six service users plans of care seen during the inspection. However care plans did not reflect all the care needs identified in this assessment. This had improved on the second visit although there were still some omissions in two of the six services users plans. Copies of care plans provided through the care management arrangements were available with the service user plans of care. Hospital discharge summaries were provided for those service users admitted from hospital. In one instance the care plan for the individual service user developed by the home did not reflect the care planning put in place by the hospital team the day before admission. More information that clearly covered the service users physical heath care needs had been added since the first visit. However their identified emotional care needs and pain control management had not been included. Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 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, The failure to consistently provide care planning that reflects the assessed health care needs of the service users may put them at risk of not receiving the health care they require. The lack of consistency between prescribed wound dressings and the wound dressing used may slow the healing process. EVIDENCE: All six service users plans of care viewed during the inspection had been reviewed monthly or sooner if the service users needs have changed. However one service user who was having difficulty coming to terms with their illness did not have a plan of care to reflect their emotional care needs despite this being identified in the care needs assessment. Emotional care needs had still not been included in this service users plan at the second visit. Although three of the service users asked said staff had talked to them about their care needs this was not been reflected in the care plans available. The care plan did not set out detailed action, which needs to be taken by the care staff to ensure that all aspects of health, personal and social care needs of the service user and met. More information had been included in all six service users plans at the second visit. These reflected the actions staff should take to address the service users health care needs. Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 Page 10 One service users risk assessment that indicated there had a high risk of pressure sore development did not have a plan of care to prevent pressure sore development. A wound care plan had been put in place at the second visit. This service user was also identified as having a moderate risk of falls. No plan of care to reduce the risk of falling had been put in place. A plan of care to reduce the risk of falling had not been completed at the second visit. A record of an accident indicated that the service user was still at risk. One service user who required regular wound care dressings did not have a wound care plan in place. The nurse in charge advised that the district nurse was attending to these dressings. At the second visit the district nurse care plans were available in the service users room. The Tissue Viability Nurse Specialist acknowledged that the wound care planning had improved since the recorded information on the 6th January. However they still lacked consistency in the way evaluation was recorded and the wound care products used for individual service users. Another service user who had wound care, catheter care, pain control and emotional support recorded as part of the care needs assessment did not have a plan of care in place to address these individual care needs. Pain control management and emotional support care planning had not been included in this service users plan of care at the second visit. The manager advised that the wound had healed and she had not been complaining of pain and he did not feel she had emotional care needs. When the inspector spoke to this service user they reported that they had been experiencing pain although not as bad as it was. This service user seemed withdrawn. Two service users identified, as very high risk of pressure sore development did not have the recommended pressure relief mattress in place. The nurse in charge advised that the service users had memory foam mattresses. When the inspector checked the manufacturers recommended specifications they stated they were suitable up to high dependency where there were no pressure sores. One service users who had high risk factors for pressure sore development didn’t have a suitable pressure relief mattress or cushion. The Tissue Viability Nurse Specialist advised that given the risk factors for this service user they should have a high dependence pressure relief mattress to prevent pressure sores. When the manager was questioned about the type of pressure relief this service user was using he advised that the service user had refused a high dependency airflow mattress because they felt uncomfortable with the alternating pressure. No record of this was recorded in the service users plan of care. One service user who had lost a significant amount of weight since their admission did not have a plan of caring place to address this. Nutritional risk assessments had been completed at the second visit. One resident the inspector spoke to in their room was positioned on the side facing the door. The bed table was positioned behind them, this had a lukewarm coffee and Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 Page 11 other drinks, which the service user advised, and they were unable to reach. When asked the service user said sometimes staff forget to position their drinks where they can be easily reached. One service user asked at the second visit stated that staff were helpful and always made sure their drinks were made to their liking. At the first inspection visit one service user’s room entered had a tube of flamazine cream prescribed in October 05, which had been opened. The date the tube was opened had not been recorded. The information recorded on the tube stated to be discarded seven days after opening if not used. The service user also had four types of emollient cream in their room. At the first inspection visit another resident had sachets of dextrose gel in their room prescribed in March 2004, which expired September 2005. They also had Bethidine spray prescribed September 2005, Actisorb dressing prescribed February 2005, Inadine dressings and ketoprofin gel 25 prescribed August 2004. Another resident had four different types of wound dressing in their room. No out of date medication or creams were seen in service users rooms at the second visit. However one service user whose dressings had been changed still had the previously prescribed dressing in their room. This could cause possible confusion with the appropriate dressing to use. The record of medication given to the service users have been recorded and signed daily by the staff giving the medication. The controlled drug book had been completed as expected. However dressings being used for wound care by two service users were not the same as those prescribed on the medication record sheet. On one occasion a wound care plan review recorded that a different dressing was used because the prescribed dressing wasnt available. At the second visit the prescribed dressing were not the same as the dressings being used for two service users. Different dressing had still been used when the dressing in use had run out. It would be difficult to ensure the appropriate dressing are ordered in a timely way if the service users medication MARS sheet did not have the current dressings recorded. Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 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 It was difficult to see how the service users are given opportunity for stimulation through leisure and recreational activities. Without this the service users could be at risk of boredom or social isolation. EVIDENCE: Activities were not being provided for the service users, on either day of the inspection visits. Three service users commented, Staff dont have the time to talk to them. Another service user advised that bingo regularly takes place on a Monday and that they werent aware of any other activities being provided. The nurse in charge advised that there is usually on the list of activities to be provided for the month displayed in the reception area of the home. However this list was not available at either inspection day. Visitors were coming and going throughout the inspection. Staff were seen spending time talking to visitors/family that visited when they asked questions. One visitor spoken to during the inspection said they felt sometimes their friend was isolated in the room and staff dont appear to have the time to stay and talk. The staff spoken to on the second day of the inspection said they were finding it difficult to complete all their work since the staffing numbers had been reduced. The manager advised that as the occupancy levels were lower the staffing levels had been reduced. The inspector noted that several service users required assistance or prompting to eat their food; some of these Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 Page 13 had chosen to stay in their bedrooms or were too ill to leave their bedrooms. At least eight service users required two carers to attend to their care needs. Some of the service users spoken to during the inspection stated that they had chosen to stay in their own rooms and preferred not to go down to the lounge. One service user stated that they were worried about going to the lounge in case staff didnt have the time to return them to their room when the felt tired. After lunch on the second day three service users were taken to rest in their rooms. Individual service users rooms entered had been personalised with items of their choice. A system is in place to establish the service users personal likes, dislikes and whats important to them. However where this was recorded for one service user it was difficult to establish that these were taken into account when care support is given. Five service users spoken to said the meals had improved. One commented that the chef had spent time with them discussing the type of food they liked and how they wanted it prepared. Staff were giving drinks to the service users throughout the inspection on both days. One complaint received by the commission was critical of the way food was presented to the service users in their own rooms. They had stated that food is not always covered when it is taken to the service users rooms. During the inspection food had been covered while it was being transported. Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 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, The comments received by service users that staff are too busy to talk to them may mean that they feel unable to express their concerns freely. EVIDENCE: The commission has received three complaints since the last inspection all remain outstanding. The manager advised that head office is in the process of reviewing two these. These complaints related to the way health care is managed. Copies of these complaints and the actions taken so far were provided for inspection. One complaint had been received in February after the first inspection visit. The complaints procedure was available for the service users and staff. The service user asked said they knew who to talk to if they had any concerns. The inspector was unable to check for staff records of training for adult protection and provision of criminal records checks at the first visit on 6.01.06. However the registered nurse in charge advised that adult protection is part of the mandatory training provided in-house for all staff. At the second visit a copy of the adult protection workbook was provided. The inspector was advised that all staff have or were working with this. The manager advised that a training matrix, which identified staff training, is kept, enabling him to keep staff up dated with their mandatory training, which included adult protection. Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 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): 21, 26, The service users have a fresh, clean environment to live in, which protects them from infection and provides a pleasant place to live. EVIDENCE: The bathrooms and toilets are clearly marked; they are close to service user bedrooms and communal areas. All but one of the service users bedrooms has en suite facilities. There are two disinfecting sluices, one on each floor. Two of the service user rooms had older style commodes in them; these did not have covers on them. This was still the case at the second inspection. One service user had covered the commode with a newspaper. The home was fresh and clean in all areas during the inspection, all the service users and visitors asked said the home is always fresh and clean and well presented. The domestic staff were working to clean rooms and communal areas during the inspection. Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 Page 16 All the service users had clean clothes, which had been press. The laundry person spoken to during the inspection said they liked to ensure that the service users had clothes that look nice. The service users spoken to comment that their clothes were looked after and always pressed beautifully. Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 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 It was difficult to prove that the current staffing levels were fully meeting the current service users needs. EVIDENCE: The checklist of staff appraisals indicated that all staff had received an appraisal by November 2005. However the inspector was made aware of one staff member who had reportedly said they had never had an appraisal and this concern them. The inspector was not told the name of the staff member. The nurse in charge confirmed that statutory training for fire drill, manual handling and health and safety are due in January. A list of staff to attend this is displayed in the treatment room. The home currently has 20 service users. The duty rota indicated that there was always a registered nurse on duty supported by health care assistants. The rota confirmed that more staff are available for the morning shift, which the nurse in charge confirmed was the busiest time. However at the second visit staff spoken to state that they were having difficulty completing all their work. They expressed concern that they did not have time to talk to the service users and complete their work. The manager confirmed that staffing levels had been reduced to reflect the lower occupancy levels. However he did comment that due to the fluctuating dependency of the service users some days were busier than others. It was difficult to see how the ratio of care staff to residents was linked to the assessed needs of the residents. The manager did not provide a written assessment of dependency ratings for the service users, which could have informed his decisions on staffing levels. The duty Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 Page 18 rota provided showed that the registered nurses did not hand over between shifts on days. One registered nurse works three twelve hour days and the manger worked four twelve hour days. The manager did not appear to have any supernumerary time allocated. When the manager and the registered nurse on duty were asked how they ensured information was passed on from day to day they advised they keep in contact by phone, use a communication book and the registered nurses on night duty. The majority of the registered nurses appeared to be employed as bank Staff on night duty, working shifts as required. The nurse in charge advised that the health care assistants employed are being put forward to complete NVQ training if they dont already have this. Insufficient information was available during the inspection to confirm whether the recommendation that staff have received adult protection training had been met. The inspector was provided with the adult protection work book that staff use. The manager confirmed that all staff had either completed this or were working towards completion. He also advised that training sessions for adult protection were provided following the completion of the workbook. At the last inspection the manager confirmed that all staff employed had had a CRB check completed. However as at the last inspection copies or evidence that the CRB checks for staff had been completed were not available for inspection. Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 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): 31,37 From the records available it was difficult to evidence that the service users care is being managed in a way that ensures their care needs are met. EVIDENCE: The manager is the first level registered nurse who has experience of caring for older people. He is responsible for no more than one registered establishment. It was difficult to establish whether the manager and other senior staff were familiar with best practice for wound care management. No record of wound management training for the registered nurses was available in the home. The manager had not explored any wound care training for the staff since the last inspection on 06,01.06. The wound care management care plans for four residents were incomplete and did not follow best practice guidelines. Although wound care planning had improved at the second visit, wound care evaluation still lacked consistency. Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 Page 20 There are clear lines of accountability within the home and within the external management of the Woodland Health care group. The manager has completed The Commissions fit person process and has been registered as manager by the Commission. Not all records were inspected on this occasion. However the service users plans of care did not contain all the information to ensure that their complex health care needs would be met. The records of wound care plans did not demonstrate how wound healing was being achieved. The medication records sheets for prescribed wound care dressings were different from the wound care dressings being used for two service users. Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 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 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 X X 3 X X X X 3 STAFFING Standard No Score 27 2 28 1 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X X 2 X Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 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 2 3 Standard OP3 OP7 OP8 Regulation 17(1) Schedule 3 17(1) Schedule 3 17(1) Schedule 3 Requirement Service users care plans must reflect their assessed need Service users care plans must reflect their assessed need. Health-care plans must reflect the health-care needs of the service user and include psychological support, catheter care nutritional support and wound care. Policies and procedures for wound care management and pressure sore prevention must be in place to guide staff. Wound care planning must be consistent and reflect clear evaluation of wound healing. Medication which is past its expiry date were no longer required by the service users must be disposed of in line with good practice procedures. (Carried forward from the last inspection) The prescribed wound care dressing must be the same as DS0000028762.V262415.R01.S.doc Timescale for action 02/03/06 02/03/06 02/03/06 4 OP8 18(1)(c) 14(1)(a) 02/08/06 5 OP9 13(2) 02/03/06 6 OP9 13(2) 02/03/06 Woodland Court Nursing Home Version 5.1 Page 23 7 OP37 17(1) Schedule 3 the wound care dressings being used for the service users. Records required to be 02/03/06 maintained for the management of the service users care must be up to date and accurate RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 6 7 8 Refer to Standard OP12 OP14 OP16 OP27 OP18 OP28 OP29 OP31 Good Practice Recommendations The service users should be given for access variety of activities commensurate with their abilities The service users should be given an opportunity to participate in activities of their choice. The manager should ensure that the service users feel able to express their concerns to staff The number of staff on duty should be decided by the care needs and dependency of the service users The manager should continue to provide training updates to include vulnerable adult training for all grades of staff The training staff receive should ensure that the service users are in safe hands at all times All the information listed in schedule 4 should be available in staff files The manager should ensure that staff receive training for wound care management Woodland Court Nursing Home DS0000028762.V262415.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. 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