Inspection on 13/06/05 for Woodmead

This inspection was carried out on 13th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Woodmead 06/01/09

Woodmead 27/06/08

Woodmead 25/09/06

Woodmead 01/02/06

Woodmead 02/12/04

Woodmead 29/09/04

Woodmead 30/01/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Woodmead 35 Portway Warminster Wiltshire BA12 8QQ Lead Inspector Roy Gregory Unnounced 13th June 2005 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 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 D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Woodmead Address 35 Portway, Warminster, Wiltshire, BA12 8QQ Telephone number Fax number Email 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 manager.woodmead@osjctwilts.co.uk The Orders of St John Care Trust Colin Newman Care Home 48 Category(ies) of 10 DE(E) Dementia - over 651 LD(E) Learning registration, with number dis - over 6548 OP Old Age4 PD(E) Physical disof places over 65 Woodmead D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 No more than forty eight service users with old age at any one time2 No more than ten service users with Dementia, over 65 years of age at any one time3.No more than four service users with a Physical Disability, over 65 years of age at any one time.4.No more than one service user with a Learnining Disability, over 65 years of age at any one time. Date of last inspection 2nd December 2004 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. There have been two major refurbishments to the building since its opening, to meet fire safety and registration requirements. All accommodation is in single rooms on the ground and first floor, a passenger lift being provided between the floors. 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 D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 9:00 a.m. and 5:35 p.m. on Monday 13th June 2005. The inspector spoke at length with seven residents, including sharing lunch in the dining room with four of them. The manager, Colin Newman, was available throughout the day and made documentation available as necessary. Additionally there were conversations with care and housekeeping staff, and the inspector was able to sit in on a care handover meeting. The inspector selected a number of care plans to compare observations and descriptions of care with written records. Other records consulted included those relevant to recruitment, staffing and health and safety. Most of the building was visited, including a number of individual rooms and the garden. What the service does well: What has improved since the last inspection? What they could do better: Care plans continue to retain some elements that do not reflect current need, indicating a need for greater attention to evaluation in review of plans. They are also largely geared to physical needs, and it is recommended that when an activities co-ordinator has been recruited, that person should be directly involved in care planning. Some worn curtains need to be replaced, and although cleaning and hygiene standards were in the main very high, there Woodmead D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 Page 6 were some shortfalls in cleaning. A monthly audit of cleaning standards and of related environmental factors, to identify concerns such as broken down floor seals and rusted toilet frames, would help to identify and rectify risks to hygiene at an early stage. Residents identified too few opportunities for consultation, and minutes of residents’ meetings showed these did not take place often or with any consistent agenda. Near the dining room, there is scope for considerable improvement to the toilet provided there, and to the corridor connecting one wing to the rest of the home. At meal times, residents would like a range of sauces and condiments to be made available. 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 D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Woodmead D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 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 standard(s) 1, 3, 4 & 5 (n.b. key Standard 6 is not relevant to Woodmead as Intermediate Care is not provided) There is a clear admissions procedure in place, backed by good information provision. Residents’ needs are assessed prior to placement. Assessments are comprehensive and detailed, enabling residents and their supporters to have confidence in the home’s appropriateness to meet their needs. EVIDENCE: Residents spoken to considered the home to be meeting their needs that had been assessed at the time of admission. The Trust policy is to use the comprehensive “long term needs assessment” from their standard careplanning documentation as an assessment overview, together with a dependency profile and mental functioning assessment. This combination helps assess prospective residents in line with the registration categories of the home, and was seen to pave the way for commencement of a care plan prior to a person’s actual admission. Where residents were placed with the aid of the local authority, community care assessments confirmed on what basis a need for residential care had been identified. The inspector saw the brochure that is made available to all enquirers about prospective admission. Mr Newman said that a copy of the contract, together Woodmead D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 Page 9 with residents’ handbook, are provided ahead of an admission date, giving time for prospective residents and their families to study these before going ahead. Initially admission is for a one-month’s trial period, which is regarded as integral to the assessment process. In practice, many residents admitted permanently have experience of the home through prior use of the day centre, respite care in the home, or both, so that both they and home staff are in a strong position to assess suitability of the home to meet their needs. Woodmead D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 Page 10 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 standard(s) 7, 8, 10 & 11 Care plans direct care and receive regular review, but insufficient evaluation. Residents’ health needs are met. Manual handling and pressure area risk assessments are in place. Residents value provisions made for their privacy, including in relation to arrangements for terminal care. EVIDENCE: Care plans were specific in guiding care provision, with additions and changes showing they were maintained as active documents. They were heavily geared towards the meeting of physical and health-related needs, but within those, there was plentiful evidence of staff having ascertained the preferences of individuals as regards how care was to be delivered. Residents had signed care plans, and many recalled having done so. Documentation showed reviews of care plans took place regularly, but there was little in the way of evaluation; for example, guidance in one plan was reviewed a number of times as still indicated, whereas it was plain the aspect of care concerned had related to a period of acute illness in the past. A behavioural issue for one service user was carried forward from review to review, without supporting evidence that there remained any cause for concern and thus for raised staff awareness. This ran the risk of a resident being treated with unnecessary caution. Residents were being weighed regularly. It was evident that any possible indicators of ill health were quickly observed and responded to. A doctor’s Woodmead D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 Page 11 appointment was made for a resident, for whom appropriate arrangements were then made to enable attendance at the surgery. Pressure area risk assessments were in place and translated into care plans where indicated. Manual handling assessments were also done for all residents, although an aspect about their completion was drawn to the manager’s attention. Tracking of referrals to, and liaison with, health professionals was excellent in the care records, and there were instances of such professionals, for example a GP and a physiotherapist, having made their own entries in the home’s record. Residents themselves had confidence in the home’s staff to understand and work with health matters. The inspector heard many expressions of appreciation of staff attitudes, and observed instances of respect for privacy. One resident was in receipt of terminal care. Facilities for their comfort and that of their visitors were in place. There were good records of the person’s expressed wishes. There was additional help with the person’s needs from a person from the local hospice. Another resident told the inspector of their wish to die at Woodmead, and their expectation of what that would mean in terms of respectful personal care. Woodmead D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 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 standard(s) 12 - 15 Residents can exercise a range of choice and self-determination, but this could be enhanced at mealtimes. Contacts with the wider community are supported, whilst the home is actively addressing how to supplement activities currently available. EVIDENCE: Two care workers in particular have sustained a pattern of external trips most months, and some internal activities. In addition, residents are notified of daily events in the day care area of the home, which they are welcome to join subject to space. The inspector heard from residents and staff alike about regular very popular singalongs in one of the sitting rooms in the evenings, the home having the benefit of a pianist among the resident group. Nevertheless, one quite active resident said “most days are the same”, and care plans have not drawn on assessment knowledge to identify physical or social stimulation needs. The home was seeking to appoint a part-time activities co-ordinator, an initiative of the provider Trust, which could be expected to make an impact in helping identify needs and ways to meet them. There was agreement by residents that visitors enjoy ready access to the home, seeing residents in private rooms or communal areas as they choose. Residents considered they could exercise choice about how they use time, for example about getting up, going to bed, use of communal or own rooms at any time. Meals could be taken in bedrooms, although many residents regarded going to the dining room for lunch as an important social point in the day. Woodmead D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 Page 13 The inspector was advised of a choice of meal for lunch, with salad as a third alternative that could be provided. However, at table a resident was disappointed that a request for a salad could not be provided. Later, Mr Newman was also disappointed to learn of this departure from apparently normal standards of service. The residents with whom the inspector shared lunch, and others during the day, considered meals to be usually of a high standard. On this occasion, considering one of the choices was chicken and chips, it was surprising not to have vinegar on the table, neither was there an offer of sauces, which several residents would have liked. Some felt there was too little consultation with residents in the home, and particularly about food, and minutes showed resident meetings to be rare. By contrast, however, the Trust does require catering staff to conduct regular food satisfaction surveys with differing small groups of residents. There was written evidence these were carried out weekly and, as well as generating a great deal of positive feedback, had produced a number of ideas that had been enacted, for example, the reintroduction of cooked breakfasts one day a week, and greater availability of cheese and biscuits. Woodmead D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 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 standard(s) 16 - 18 Complaints receive appropriate investigation and action. Civic rights are recognised and protected. Staff have training to be alert to potential instances of abuse, and concerns about the security of residents lead to appropriate action being taken. EVIDENCE: There is good guidance to residents and staff by way of the provider Trust’s complaints procedures. Residents said variously that they would raise any concern with any member of staff, or with the most senior person on duty at any time, and were confident that they would receive attention. Complaints of any magnitude are logged for the manager to address in a consistent fashion. Five had been received since the previous inspection, each being upheld and leading to corrective action. One had been referred to a higher level in the provider Trust. Service users had been enabled to vote in the recent general election, if they wished, by organisation of postal votes by the administrator, or in person with transport provided by relatives or candidates’ representatives. One service user had recent experience of assistance provided by use of an advocacy service, and the staff group had received training input about that service. Visitors’ entry to and exit from the home are monitored by staff, although there was some laxity in use of the visitors’ book. Residents chose whether or not to use room keys. There have been some instances of theft and alleged theft of monies in the home. The Police have been consulted about these and the Commission notified on each occasion. Residents have been offered advice, and safe keeping of valuables and monies is provided on request, with proper safeguards. All staff have been issued with “No Secrets” guidance to local Woodmead D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 Page 15 inter-agency procedures for responding to suspicion of elder abuse, and related training is provided. Woodmead D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 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 standard(s) 19, 20, 21 & 26 Arrangements are in place to ensure the home is maintained to a safe, modern standard, although decorative upkeep lags behind. Residents benefit from a range of attractive communal space, inside and out. In the absence of en suite provision, there are adequate toilet and bathroom facilities. Good procedures are in place to promote hygiene, but a few areas would benefit from greater attention to detail. EVIDENCE: The provider Trust oversees the provision and operation of a range of service and maintenance contracts, with an emphasis on safety. Mr Newman described the regular inspection visits of a property manager. Following rewiring work last year, including the installation of much improved lighting in bedrooms and communal areas, the home’s handyman has drawn up a priority list for making good many resultant shortfalls in décor, such as where lights and switches have been removed. This work is inevitably a slow process and it is regrettable that much of it was not provided for as part of the refurbishment scheme, as too many rooms looked neglected. There were also old, worn curtains in some of the bedrooms. All rooms have wash hand basins. Woodmead D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 Page 17 The upstairs corridors were badly in need of redecoration, but Mr Newman showed that this had been provided for, together with new carpeting, in the current year’s budget. He agreed the observation that the linking corridor from one wing of the home to the dining room and rest of the home, passing the kitchen, had always had a non-homely, utilitarian feel, and would benefit from imaginative attention. Residents’ access to the garden and patio had been improved by a ramp from some French doors. Residents appreciated this, and also the range of sitting areas and rooms available, where good quality furniture was provided, creating opportunities for reading, conversation or being quiet. There was also a brightly decorated hairdressing room. Standards of cleanliness around the home were mainly good, but downstairs toilets and bathrooms were in need of better high level and concealed area cleaning. In one toilet the floor covering needed re-sealing to the wall to give full infection control protection. Housekeeping staff expressed knowledge about hygiene procedures, and motivation to uphold good standards. The home was beginning use of a laundry person, and the kitchen had been provided with its own washing machine, both measures allowing for greater control over laundry processes. Sluice rooms were clean and well organised, and commode liners were numbered to ensure they were always returned to the same rooms. Whilst on this occasion residents did not comment unfavourably on toilet provision, the manager and staff said there continued to be pressure of use on the one toilet close to the dining room. Since this toilet presented as oldfashioned and in need of refurbishment, it seemed to the inspector it could be divided into two cubicles, thereby improving provision and quality at the same time. Woodmead D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 - 30 Staffing is sufficient to meet both the care needs of residents, and the domestic needs of the home. Care leaders take responsibility for liaison with outside professionals, which results in delivery of care in accordance with identified priorities and professional guidance. The process of staff recruitment ensures that all the checks and references necessary to protect service users are in place. There is good provision for training of staff. EVIDENCE: Rotas worked and planned showed that the home maintained staffing of 5 care staff on morning shifts (i.e. to 2:00 or 3:00 pm), and 4 in the evenings. The figures include a care leader, much of whose time by day can be taken up with administrative tasks away from direct care. However, all care leaders are on shift together once a week to allow them to communicate fully and to complete some of those tasks without affecting resident care time. It was clear from talking with care leaders, and observing handover, that they retain a very full knowledge of the residents and their current needs. At night there are three waking staff. It had been necessary recently to cover a few night shifts with agency staff, but recruitment of night carers was underway. There had as yet been no applicants for the newly created activities co-ordinator post. A laundry person had been appointed, which could be expected to make more carer and housekeeper time available to the immediate needs of residents. During inspection, call bells were answered promptly, and residents said they had no concerns about staff availability. With regard to recruitment of new staff, the required checks were being correctly observed by the home and Trust, thus promoting the safety of residents. Staff, including non-care staff, were engaged in a number of training Woodmead D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 Page 19 events, including dementia workshops and abuse awareness, and there was good evidence of completed and planned training that was related to identified residents’ needs. It was shown how rotas aimed to include a mix of more and less experienced staff. Eight out of 36 staff had achieved NVQ in care to level 2 or 3, with a further 13 enrolled on the training. Woodmead D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36 & 38 Staff project an attitude of shared endeavour under trusted leadership, whilst residents express confidence in the staff and management. The provider Trust has put a quality assurance system in place, within which the home has achieved to a high standard, but consultation with residents is erratic. Health & safety of residents and staff is well provided for, subject to risk management of an identified hazard. EVIDENCE: Mr Newman has been manager of Woodmead for several years, during which period he has also spent periods as “caretaker” manager for other homes in the Trust. He said he would be completing the Registered Managers Award in July 2005. Together with his team of care leaders, he has developed a sense of shared purpose and values among the staff group as a whole, and is well known to all the resident group. Minutes showed that meetings for different groups of staff had taken place periodically. However, organised consultation with residents was less well developed. The Trust’s chosen quality assurance Woodmead D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 Page 21 scheme does not readily engage residents’ perspectives. Mr Newman said a staff member would be attending a course on establishing a newsletter, whilst appointment of an activities co-ordinator may help in the facilitation of residents’ meetings or other devices for feedback. There was evidence of regular supervision sessions for staff with care leaders. Those records looked at in detail showed an emphasis on meeting key work needs of residents, and sharing and monitoring of issues specific to individual members of staff. One care leader has delegated responsibility for health & safety matters. Her risk assessments and other documentation, including an action plan, were of high quality. It was clear that when shortfalls had been identified by any staff member, they had received prompt attention to minimise risk to residents and staff. A hazard pointed out by the inspector was a flight of concrete steps from the patio that would benefit from warning signs or other measures to protect residents. Woodmead D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 3 3 x x x x 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 2 x x 3 x 2 Woodmead D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation 15 (2)(b,c,d) 24 (3) 13 (4)(a,c) Requirement Care plans must reflect current needs and show that any changes are the result of evaluation. Develop consistent recorded means of consultation with residents. Assess and reduce the risks posed by the identified steps in the garden. Timescale for action 1st August 2005 1st September 2005 1st August 2005 2. 3. 4. 5. 33 38 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 7 7, 12 Good Practice Recommendations Manual handling risk assessments should show the number of staff required to perform assessed tasks. When appointed, the activities co-ordinator should be allowed discrete time for assessment and development of social and physical stimulation needs of individual residents, within the care planning and review process. There should be a choice of sauces and condiments readily available at meal times. Consider ways to speed up the making good of shortfalls in D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 Page 24 3. 4. 15 19 Woodmead 5. 6. 7. 8. 19 21 19 26 decor. Consider ways to brighten up the link coridor next to the kitchen. Consider how to improve the toilet located near the dining room, including the posibility of increasing provision at this location. Worn out curtains in residents rooms should be identified and replaced. Devise and implement a monthly audit of the environment to ensure the meeting of recognised infection control standards. Woodmead D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 Page 25 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire SN15 2BB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Woodmead D51_S28300_WOODMEAD_v209266_130605stage4.doc Version 1.40 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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