CARE HOMES FOR OLDER PEOPLE
Woodmead 35 Portway Warminster Wiltshire BA12 8QQ Lead Inspector
Roy Gregory Unannounced Inspection 09:00 1 February 2006
st 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 Woodmead DS0000028300.V275238.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. Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Woodmead Address 35 Portway Warminster Wiltshire BA12 8QQ 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) 01985 213477 The Orders Of St John Care Trust Mr Colin Newman Care Home 48 Category(ies) of Dementia - over 65 years of age (10), Learning registration, with number disability over 65 years of age (1), Old age, not of places falling within any other category (48), Physical disability over 65 years of age (4) Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 5. No more than forty eight service users with old age at any one time No more than ten service users with Dementia, over 65 years of age at any one time No more than four service users with a Physical Disability, over 65 years of age at any one time. No more than one service user with a Learning Disability , over 65 years of age at any one time. One named service user under the age of 65 years. Date of last inspection 13th June 2005 Brief Description of the Service: Woodmead was originally owned and managed by the Local Authority; it was the first purpose-built care home for elderly persons in Wiltshire, having opened in 1962, since when there have been a number of refurbishments to the building. All accommodation is in single rooms of varying sizes, none with en-suite, on the ground and first floor. The floors are linked by passenger lift. On the ground floor are a choice of sitting rooms and a dining room, which overlook an attractive enclosed garden with patio. The home became part of the Orders of St John Care Trust in 1999. Two respite care beds are available and there is an integral day care service. The home is situated on a main road close to the centre of the market town of Warminster, with easy access to shops, parks and the community hospital. There is ample street parking and bus stops are available close to the entrance. The town also has a rail station. Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by Roy Gregory between 9:00 a.m. and 5:20 p.m. on Wednesday 1st February 2006. The inspector spoke with a number of residents, including one who had been admitted two days previously. Lunch was taken with five residents. The manager, Colin Newman, was available during the afternoon, whilst there were conversations with other staff including the activities co-ordinator, the administrator, laundress and two care leaders. The inspector selected a number of care plans to compare observations of care, and residents’ perceptions, with written records. Other records consulted included those relevant to residents’ monies, staffing and fire precautions. All of the building was visited and some individual rooms were seen with the consent of their occupants. The inspector had the benefit of a “pre inspection questionnaire” provided by the manager, but no “comment cards” have been received from residents or relatives. What the service does well:
21 of the applicable 37 National Minimum Standards were considered at this inspection, and all but two were considered to be met. The inspector observed much natural, friendly contact between all staff and residents. More than one resident spoke of excellent staff, for example: “we’ve all got different needs and staff recognise that, they’re wonderful”; another also spoke of “a variety of needs in the home, people get individual attention”. All residents spoken to were complimentary of meals in the home. The inspector experienced lunchtime in the dining room as a pleasant social occasion; the meal itself was of high quality, and was served in an efficient and friendly manner. Where some personal assistance was necessary it was given discretely. One resident spoke of opting in and out of activities. He particularly liked trips out, including holidays that had been organised from the home. Care plans sampled appeared to reflect well the individuals to whom they related, with a wide spread of issues identified, and good evaluations of how these were met, leading to revisions of the plans. Daily care notes were objective, demonstrating adherence to care plans. There was also good recording of liaison with GPs and other health professionals, with evidence of active follow-up of plans agreed with them. A situation of potential risk had been shared with the Commission, the community mental health team and a relative, leading to a risk assessment and scrupulous recording of observations and actions by care staff. By the time of inspection the matter had been resolved satisfactorily. It was an illustration of the home’s openness to outside Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 6 agencies, and ability to put planned actions into effect, whilst preserving dignity and self-determination for the resident. Provision for pressure area care was very good. There was an assessment of risk for each resident, and guidance obtained from a district nurse to assist such assessments was prominent in the care office. Where an individual was assessed as at high risk of developing pressure damage, a care plan was in place to minimise the risk. Care and storage of medicines were good and there were no problems identified with routine recording of their administration or disposal. What has improved since the last inspection? What they could do better:
A start had been made on redecoration of upstairs corridors, which presented extremely poorly, but this was an unrealistic undertaking for an in-house worker who also has day-to-day maintenance tasks. The handy person could not honestly envisage reaching a point where all the communal areas would present well together, and Mr Newman agreed to pursue with the Trust the need to engage contractors for this work. The time taken to appoint an activities co-ordinator had made available funding for additional care staff support to residents during the busy part of evening shifts. It is recommended that the resultant level of staff cover should be maintained, because the minimum level of four staff at those times is a very stretched operating level for 48 residents. It is also recommended the benefits of the activities co-ordinator post be consolidated by enlargement of the role, which at present is only 20 hours per week. A further improvement to
Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 7 activities provision would be better dissemination of information about activities to the resident group; some were less aware than others of precisely what was available or who was in the co-ordinator role. The organisation of medications practice in the home, and back-up from the supplying pharmacist, were very good. However, in the very few instances of self-administration by residents, a care plan for this would ensure that the individual’s competency and wish to continue were reviewed regularly. Equally, for those medicines prescribed “as needed”, a care plan would confirm how the need is to be established at the point of administration, making the system safer when implemented by new or temporary staff, for example. One resident considered staff could make more checks on those residents who choose to spend most time in their rooms, rather than in communal rooms. Observation suggested this was not an issue in all parts of the home, but may be relevant to the “annexe”. 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. Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4 & 5 (key standard 6 does not apply to Woodmead) Residents’ needs are assessed prior to placement. Assessments and reassessments are comprehensive and detailed, enabling residents and their supporters to have confidence in the home’s appropriateness to meet their needs. EVIDENCE: A new resident had been admitted two days preceding the inspection. He said he had visited the home and had made a positive choice of Woodmead over other options. He was clear about the reasons behind his admission to residential care and the needs he saw the home as meeting. His family had been involved in his admission. Assessment information gathered by a care leader was comprehensive and signed and dated by her. This formed a good basis on which care plans could be developed. At the beginning of the inspection day, the manager Mr Newman was on a hospital visit to re-assess a resident whose needs had changed. He was able to confirm that the home could continue to meet their needs, and had made arrangements for re-admission from hospital the following day. There was evidence that the senior team were skilled at judging when individuals’ nursing
Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 10 needs exceeded the level at which they could be appropriately met by the home in liaison with community nursing services, leading to referrals for nursing needs assessments or transfers to hospital by GPs. Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Care plans are comprehensive and highly individualised, enabling health and social needs to be identified, addressed and reviewed. Medication practice is soundly based. Residents are involved in the care planning process, which enhances provision for respecting privacy. EVIDENCE: Care plans sampled appeared to reflect well the individuals to whom they related, with a wide spread of issues identified, and good evaluations of how these were met, leading to revisions of the plans. Care leaders said care staff used care plans very much as working documents, and that they were often used as a focus of supervision sessions. Daily care notes were objective and drew attention to any new inserts in a resident’s care plans. There was also good recording of liaison with GPs and other health professionals, with evidence of active follow-up of plans agreed with them. By contrast, “long term needs assessments”, commenced as pre-admission documents to inform working care plans, seemed to receive somewhat cursory reviews. Care leaders agreed that many residents may like to participate with their key workers in occasionally reviewing these assessments. Most shortterm plans were signed by residents or their representatives. Some of these
Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 12 highlighted the resident’s right to self-determination. One, for example, recognised the resident’s preference for privacy other than at meal times, and the person concerned had signed agreement to plans about how to carry out night time checks, and how to facilitate their access to the gardens. Provision for pressure area care was very good. There was an assessment of risk for each resident, and guidance obtained from a district nurse to assist such assessments was prominent in the care office. Where an individual was assessed as at high risk of developing pressure damage, a care plan was in place to minimise the risk. One of the care leaders had designated responsibility for maintaining checks on competency of those care staff involved in administration of medicines. In addition, this aspect of care figured in staff supervision, and there were also meetings expressly about medication issues. The home received good support from the supplying pharmacy; for example, they provided printed inserts within their monitored dosage system to draw attention to those items that could not be supplied in the usual blister packs. Following a question about recording that had arisen in the inspection, the care leader was able to raise it with the pharmacy, enabling a solution to be decided that brought more clarity. Care and storage of medicines were good and there were no problems identified with routine recording of their administration or disposal. It could be seen that “as needed” medications were not routinely given, thus that their use was in line with prescribers’ intentions. However, it would be helpful for there to be a care plan to show clearly whether the decision to use an “as needed” drug was to be based on the resident’s decision, or carer’s observations, at the time; equally, in the few cases of self-administration of medicines, a care plan for this would ensure that the resident’s competency and wish to continue were reviewed regularly. The use of prescribed topical creams was recorded in individual rooms. Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 15 Care and thought have been put to identifying and seeking to meet residents’ individual social and activity needs. Meals served are of high quality. EVIDENCE: An activities co-ordinator had been recruited since previous inspection. This person was formerly one of the care staff, and thus had a good pre-existing knowledge of the resident group and of the roles of other staff. She presented as highly motivated and imaginative and it could be seen that the creation of the role has enhanced the home’s good record of providing events and activities. The co-ordinator works flexibly, i.e. at evenings or weekends where this facilitates delivery of the programme she devises. There was a daily record of activities carried out, through which key workers or others could readily track how far individual residents were engaged. Some families were said to have been very helpful in supplying additional background information to help identify what individuals may respond to. Care staff sustained a weekly programme of activities when the activities co-ordinator was not on duty. Staff generally would welcome any further development of this area of care, as the co-ordinator’s post is as yet only part time. A resident thought the role had made an impact, having benefited from support to go out more. Records showed the greater emphasis on meeting social needs, which was reflected in care plans, had included one-to-one
Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 14 support to accessing facilities such as the library and park, as well as group activities such as games and exercise sessions. One resident spoke of opting in and out of activities. He particularly liked trips out, including holidays that had been organised from the home. Some of the staff group have been happy to provide support to such activities in their own time. Residents appreciated such commitment and mentioned staff being prepared to do shopping for them. The activities co-ordinator was liaising with the day care co-ordinator about activity provision geared to the needs of those with dementia. For all residents, activities information was posted on a notice board in the dining room. This was not easily legible, nor well displayed, and it would benefit residents if there were more consideration of how to make them aware of opportunities being offered. The activities co-ordinator said she would be attending a course about newsletter production. The inspector joined a table of residents for the midday meal, which was a roast with vegetables. Mint sauce was provided at table for self-selection. There were alternative meals offered, and a choice of sweets. The meal itself was of high quality, and was served in an efficient and friendly manner. Where some personal assistance was necessary it was given discretely. All residents spoken to were complimentary of meals in the home; mention was made by more than one, of a meal that stood out as unsatisfactory because it had been prepared by a stand-in chef. Descriptions by residents of a variety of breakfasts and teas showed there was considerable choice available, and that a nutritious diet was available throughout the day. Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 15 Complaints and Protection
The intended outcomes for Standards 16 – 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Complaints receive prompt attention with recorded outcomes. Safety of residents is viewed in a broad way and is promoted by sharing concerns and solutions with outside professionals. EVIDENCE: Six complaints had been recorded within the provider’s complaints system since the previous inspection, from both residents and relatives. These concerned diverse issues about food, baths and the environment, with no pattern revealed. The inspector was party to a discussion between the manager and a recently admitted resident, at the latter’s request, about restrictions on the individual’s ability to go unaccompanied outside the home. The manager referred to documentation received from other agencies and the need to balance the home’s responsibilities with the individual’s choices. It was agreed to share the issue with a relative, which in turn led to an agreed and recorded outcome. A situation of potential self-harm by a resident had been shared with the Commission, the community mental health team and a relative, leading to a risk assessment and scrupulous recording of observations and actions by care staff. By the time of inspection the matter had been resolved satisfactorily. It was an illustration of the home’s openness to outside agencies, and ability to put planned actions into effect. Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 16 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 & 26 The home benefits from ongoing maintenance but redecoration of a large corridor area has become a priority need to enhance quality of life in that area. The home is kept clean to a high standard. Shortfalls in heating and lighting when identified are addressed. EVIDENCE: The home’s handy person had continued a programme of making good and redecorating in bedrooms. A start had been made on redecoration of upstairs corridors, which presented extremely poorly, but this was an unrealistic undertaking for an in-house worker who also has day-to-day maintenance tasks. The handy person could not honestly envisage reaching a point where all the communal areas would present well together, and Mr Newman agreed to pursue with the Trust the need to engage contractors for this work. Funding had been agreed to create more toilet provision near the dining room, as recommended in the previous inspection report, and delivery of new dining furniture and carpets was imminent. Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 17 Standards of cleaning around the home were good everywhere, including difficult to reach areas that were not uniformly kept to a good standard at the previous inspection. Residents spoke of having their rooms cleaned usually in their absence, and were satisfied with the outcomes. The inspector informed Mr Newman of an anonymous observation made to the Commission of lapsed standards in one part of the home in September 2005. Mr Newman was aware of some slippage then, when the housekeeping team was not up to strength. A care leader was due to deliver some infection control training the day following this inspection. Sluices were well organised and clean. Mr Newman said there were plans to replace all commodes. Bathrooms, toilets and shower room all presented well, with good levels of cleaning around hoist and toilet seats and frames. The laundry was very well organised, processes being described by the dedicated worker. A resident showed a supplementary heater that had been installed in their room after complaints that the room was not warm enough. Their care plan included guidance to staff to ensure the regular but safe use of the heater. The resident was satisfied with the outcome of having raised the issue. Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 & 30 A stable and well-trained staff team may sometimes be limited in its ability to meet care needs by pressure of a low staff to resident ratio. EVIDENCE: The home has the benefit of a stable and committed staff team. Rotas showed maintenance of a minimum care staffing level of five in the morning and four in the evening, with the evening shift often enhanced to five care staff by use of a 6-10 p.m. shift. Mr Newman said this had been so successful he was hoping to make it permanent, as the current resident group included many who responded to activities provision in the evenings. A ratio of four staff to the needs of 48 resident places would clearly limit the service that can be provided to individuals. The activities co-ordinator post is supernumerary to the care team, but care leaders are included within it and their duties by day can take them away from a direct care role. More than one resident spoke of excellent staff, for example: “we’ve all got different needs and staff recognise that, they’re wonderful”; another also spoke of “a variety of needs in the home, people get individual attention”. Whereas another felt there could be more regular checks on those that choose to stay more in their rooms rather than using the sitting rooms. A handover between staff shifts was thorough, helped by use of a daily book of delegated duties. The inspector observed much natural, friendly contact between all staff and residents.
Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 19 The care leaders had undertaken a new dementia care training package developed by the provider trust in association with the Alzheimer’s Society. It was intended that all care staff will eventually have benefited from this. Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35, 36 and 38. There is a positive management culture that extends through the care leader tier and includes regular supervision of staff. Routine health and safety matters receive appropriate attention, with prompt responses to any identified issues. Residents can take advantage of provision for safekeeping of monies, with appropriate safeguards. EVIDENCE: Mr Newman has long experience of managing Woodmead and other residential homes, and had recently been awarded the registered managers award. Residents and staff alike appreciate his open and caring style of management. Formal supervision of staff by care leaders (and of them by Mr Newman) was being sustained about 8-weekly, and night staff were now fully included in this. Once a week all three care leaders were on duty together, to enable attention to their administrative tasks, such as managing the staff rota. Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 21 A new administrator had been in post just three weeks but had quickly adjusted to the expectations of the post. She was able to demonstrate the system in place for managing safekeeping of residents’ monies and their access to this. All records were double-signed. Mr Newman confirmed that at weekends, care leaders have access to a float to maintain availability of cash for residents, this is then reconciled with the office safekeeping on Mondays. Residents or their families are asked about how they wish the home to be involved in any finance affairs at the time of admission. Fire precautions records were all up to date and in good order. A step hazard was identified for signage to reduce the risk that a resident might not see it. A similar concern identified in the garden at the previous inspection had been addressed quickly and imaginatively. Two fire doors were scheduled for attention to make them safer. Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X 3 3 STAFFING Standard No Score 27 2 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X X X 3 3 X 3 Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. 7. Refer to Standard OP7 OP9 OP12 OP12 OP19 OP27 OP28 Good Practice Recommendations Ensure “long term needs assessments” receive satisfactory review, involving the resident concerned where possible. There should be a care plan in respect of any medication prescribed “p.r.n.” or self-administered. Review the number of Activities Co-ordinator hours available to residents. Improve how activities information is made available to residents. Prioritise redecoration of the upstairs corridors. Seek to retain the additional staffing hours that have been made available on evening shifts. Apply signage to the identified trip hazard. Woodmead DS0000028300.V275238.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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