Care Home: Albany House

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What the care home does well This is a family type of home where all the staff get to know the residents well. All staff work as a team to ensure residents needs are met for example the cook will answer the phone, greet people who call at the front door and still find time to ask the residents what they would like to eat. The Home regularly plans trips out to the coast, the local museum or just a tea away from the home. They also have regular entertainment in the home and therapists visit to give one to one time with residents. The home have a very good relationship with the local GP practice and has received letters of praise on the way they manage the health care needs of the residents. What has improved since the last inspection? Since the last inspection the homes registration has changed to allow the home to care for people with dementia. With this beginning to happen staff are receiving training on this subject. The home has added name frames and recognition pictures to each residents bedroom door to aid orientation. All residents now have a photograph in the office that ensures the right care/medication is offered to the right resident. What the care home could do better: The environment is in need of improvement. The home cannot offer the quality dementia care that residents deserve in areas that are small and sometimes dark. The dining room is too small for all residents to sit in which restricts the choice of where people would like to eat and the corridors leading to resident`s bedrooms are dark and poorly lit with no natural light. Now the home is offering care for people with dementia this needs to be evidenced in a person centred approach showing how each person is offered choice in a way that the person understands. The staffing levels need to be increased to meet the growing needs of the residents ensuring those needs are met appropriately. CARE HOMES FOR OLDER PEOPLE Albany House 43 Bridge Street Fakenham Norfolk NR21 9AX Lead Inspector Ruth Hannent Unannounced Inspection 3rd October 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Albany House DS0000066421.V352431.R01.S.doc Version 5.2 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. Albany House DS0000066421.V352431.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Albany House Address 43 Bridge Street Fakenham Norfolk NR21 9AX 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) 01328 863753 01328 863861 mail@albanyhouse.info Woodspring Care Ltd. vacant post Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (16) of places Albany House DS0000066421.V352431.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th September 2006 Brief Description of the Service: Albany House is a care home providing personal care and accommodation for up to 20 older people. The home is owned by Ms D Hannent and Mr T Armitage. The home is located in the market town of Fakenham, close to shops, pubs, the post office and other local amenities, including transport. Albany House is an adapted family home on three floors and facilities include 16 single and 2 shared occupancy bedrooms. The home has 3 lounges, including a smokers lounge, a dining room and conservatory. Assisted bathing facilities are located on each floor. A shaft lift provides easy access to all parts of the home. The conservatory overlooks the gardens and a main thoroughfare to the town centre, allowing service users to watch activity outside. Off-road parking is available. Fees £325 - £360 per week. Albany House DS0000066421.V352431.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of Albany House. It took place over a period of six hours and was assisted by the Manager. In total 17 residents were living there on the day out of a possible 20 places available. Throughout the inspection observations of care practise was seen, residents, staff and relatives were spoken to and a tour of the building took place. Prior to the inspection the Manager had returned to the Commission a completed Annual Quality Assurance Assessment (AQAA) and this document has been used to assist the completing of this report. Throughout the day records were seen that include pre admission assessments, care plans, risk assessments, staff personnel files, rota’s, staff training, medication administration records and quality assurance questionnaires. A meal was taken with the residents where information about the day to day life at Albany House was discussed. What the service does well: This is a family type of home where all the staff get to know the residents well. All staff work as a team to ensure residents needs are met for example the cook will answer the phone, greet people who call at the front door and still find time to ask the residents what they would like to eat. The Home regularly plans trips out to the coast, the local museum or just a tea away from the home. They also have regular entertainment in the home and therapists visit to give one to one time with residents. The home have a very good relationship with the local GP practice and has received letters of praise on the way they manage the health care needs of the residents. Albany House DS0000066421.V352431.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: 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. The summary of this inspection report can be made available in other formats on request. Albany House DS0000066421.V352431.R01.S.doc Version 5.2 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 Albany House DS0000066421.V352431.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are assessed to ensure the home offers a suitable service that will meet their needs. The home does need to update the information shared with residents. EVIDENCE: The potential residents who may wish to live at Albany House are assessed fully prior to being offered a place to ensure the service provided can meet the needs of the person. A recent couple had arrived at Albany House and the completed assessments were seen during this inspection. The two were both observed throughout the day and matched the information that had been written at the time of the assessment. Albany House DS0000066421.V352431.R01.S.doc Version 5.2 Page 9 The information held within the home that is offered to residents such as the service users guide is now out of date. With the development of the service the content needs to be reviewed to ensure all the information is current and available for all residents. (Recommendation) Albany House DS0000066421.V352431.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care of residents is met with some improvement in the formats used required. Some staff need to be aware of how they address a resident. Albany House DS0000066421.V352431.R01.S.doc Version 5.2 Page 11 EVIDENCE: Two care plans for residents were looked at. Each document has information that is relevant for the person but within each folder there is some paperwork that is done with a scoring system that is not easy to understand and does not make each part of the care plan personalised for the individual resident. The care plans are for staff to follow and also a document that can be shared and understood by residents and relatives when building and reviewing the care plan. It should be a tool that is relevant for that person and is easily understood, therefore the development of care plans needs to be considered to make it a much easier to use working document. (Recommendation) The home has a growing number of people who have developed dementia. The care plans and the delivery of care for these residents does not appear any different than those who do not have dementia and also need to be developed into a more user friendly, person centred care document. (Requirement) The health care needs of each resident is monitored closely with good support from the local GP practice. The Annual Quality Assurance Assessment (AQAA) talks of the relationship with the practise and a letter written by the GP, complimenting the staff team on the management of medication and health care needs within the home was seen on the day of the inspection. Residents are weighed regularly and any concerns are reported to the GP who will involve dieticians when necessary. The residents can be referred by the GP to any medical specialist with the Manager giving a good example of how a recent concern had been referred on and a specialist had visited the home. The Home has also been working with the district nurses and the continence advisor to ensure the right continence aids are available for individuals. The medication held within the home is in a locked cupboard in the office. On inspection it was noted how neat and tidy the cupboard was with details on how all unused or unwanted medication is returned. The home also has a system of returning the odd tablet in a sealed plastic pocket with a label placed over the seal that is seen as good practise. The medication administration records are in place with medication administered signed for by trained staff except for the applications of creams that staff are forgetting to sign for, which the Manager explained is a problem. Other ways of managing this was discussed and is now to be implemented (Recommendation). The Home has also recently received a letter of commendation from the GP on the recent audit carried out on medication stating that the Manager can show the letter to the Inspector. (Seen) Albany House DS0000066421.V352431.R01.S.doc Version 5.2 Page 12 Throughout the day resident’s dignity and privacy was noted. The staff do need to think about how they address residents as on quite a few occasions ‘darling’ was used rather than the persons name. Choices, offered to each resident was heard throughout the day such as ‘would you like to sit in this chair’ and ‘would you like a hot or cold drink’. All doors were closed when care was offered and all doors were knocked upon before someone entered. Albany House DS0000066421.V352431.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home does provide some suitable daily life and social activities but needs to look at the needs of residents with dementia in more detail. Albany House DS0000066421.V352431.R01.S.doc Version 5.2 Page 14 EVIDENCE: The home does have an activities person who has 12 hours per week allocated to this task. Noted on the wall in the entrance was all the outing photographs of places visited this year. One gentleman spoke of the entertainment that visits the home regularly and on the day of this inspection a therapist arrived to offer aromatherapy to residents on a one to one basis. The gentleman spoken to told of the changes of need of lots of the residents and how they now have to have more security in the home but that was OK as ‘I have my own back door key and I can come and go as I like’. The home does cater for the occupation and stimulation of those residents who can say what they would like. It was more difficult to identify what support, choice and relevant stimulation was available for residents who have dementia as noted throughout the day was residents just sitting with nothing to occupy or stimulate them other than the day to day tasks that were happening around them. As the home now has a registration that includes people with dementia then more ideas on how to occupy these residents needs to be in place. (Recommendation). Relatives do came and go as they wish with many signatures seen in the visitors book with at least seven different people arriving on the day of the inspection. (Staff were overheard greeting them and offering a drink). No comment cards had been returned to the Commission before this inspection but last years inspection comments received stated that visitors were made to feel welcome. A meal was taken with the residents with a choice of lamb casserole or corn beef on offer. The residents spoken to all said the food was good and they could always have a choice. Residents weights are monitored carefully and the amount of food eaten is recorded when concerns are shown. The home does offer soft or liquidized food. (Noted was a meal offered to a person who now manages her meal with her fingers and the encouragement offered with suitable items on her plate that could be picked up.) The home unfortunately does not have suitable dining facilities and a few residents have to eat in the same chair in the same lounge as they spend the rest of the day. Ideally, with the developing needs of this home, the new building should have two dining areas that are large enough to seat all 20 residents plus some staff who may be needed to assist a resident. Concern was shared with the Manager on the safety of residents if they needed moving from the very small dining room quickly as a number of them were pushed in very close together. (Recommendation) Albany House DS0000066421.V352431.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are listened to and acted upon. Staff do need to have their knowledge updated by being trained regularly on the protection of vulnerable adults. EVIDENCE: The home has had a few complaints that were more like concerns. These letters were seen, and noted was the immediate response of the Manager to actively deal with the problem and no further repercussions have occurred. There is a complaints procedure displayed in the entrance hall and one family member spoken to on the day felt she would be able to talk to the Manager at any time if she was at all concerned. Albany House DS0000066421.V352431.R01.S.doc Version 5.2 Page 16 The home does have a whistle blowing policy, which on talking to one staff member was understood. The Manager has recently written in some more details into the policy ensuring that anyone having to report a concern will be protected and confidentiality retained. The Manager had sent in to the Commission with the AQAA a copy of the training planner for the year. It was noted that the protection of vulnerable adults training was not planned. This must be in place. (Requirement). All staff are CRB checked before working unsupervised. Albany House DS0000066421.V352431.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24, 25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The building environment is becoming less suitable for the kind of clientele the home cares for. Albany House DS0000066421.V352431.R01.S.doc Version 5.2 Page 18 EVIDENCE: A tour of the building took place and one of the improvements noticed was the names on the door that were easy to read for residents, enabling them to identify their rooms. The main lounge has also been decorated and some new furniture has been purchased. The grounds are tidy and the home is clean. Unfortunately the home refurbishment has, to date, not started and the home is in great need of improving to make the environment suitable for the needs of the residents. More equipment is being used on a daily basis as the needs of resident’s increases. More people are needing assistance with aids and wheelchairs to get around and the general areas are too small for this to be done in comfort. On the day of the inspection a wheelchair, zimmer frame and hoist were all trying to be used at the same time in a very limited space. Many of the rooms are too small and one lady trying to move in the dining room was struggling to get around other walking aids. As mentioned on a previous report the lighting (low wattage bulbs) and lack of natural light in some corridors is unsuitable and with the bedroom doors painted in a dark colour the visibility for some residents would be reduced quite considerably. (Requirement) It was also noted that curtains are unhooked from curtain tracking making it difficult to draw the curtains and in one bedroom the sink is so small that it would be impossible for anyone to have a proper wash. (Recommendations). On the day of the visit the home had only one washing machine functioning and a backlog of washing was waiting. With the only domestic already having completed her shift, it meant care staff were having to leave residents to do the laundry. There was one bag awaiting a sluice wash and a number of sheets and personal laundry all left waiting for the one machine. The fault of the other needs to be attended to as soon as possible to ensure good infection control practise is in place. (Recommendation) The walkway to the laundry is unsafe at night with very little lighting and is not within hearing distance if anyone calls out. There is a call bell system in the laundry to attract staff’s attention but this would not alert staff if someone had fallen. (In the building you would hear a bump or hear someone calling out). (Recommendation) Albany House DS0000066421.V352431.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels need to increase with staff who are skilled to care for people with dementia. Some areas of training need to happen, ensuring all staff are competent. EVIDENCE: The only staff on duty until lunchtime was the Manager and two carers. With the growing needs of the residents (some requiring two staff members) this is not suitable. Comments from relatives on the homes quality surveys also show the lack of staffing is a concern. The Manager is recommended to not be included on the rota and the home needs enough competent staff to cover all care duties. It was noted that more staff came on duty for the lunchtime period to assist with meals, which is good practise. With the cook answering the door and taking phone calls as well as preparing meals. (Not hygienic) The domestic staff member trying to clean the whole house and do all the laundry. Two care staff delivering care to 17 residents while the Manager is trying to do all jobs is not adequate and the health and welfare of residents could be at risk. The staffing for the home needs to be increased. (Requirement). Albany House DS0000066421.V352431.R01.S.doc Version 5.2 Page 20 The staff are encouraged and the home has or has staff in the process of achieving the NVQ qualification. One has level 3, two have level 2 and four are half way through achieving theirs. Two recruitment files were looked and both hold relevant references, application form and medical form. The latest person to commence work has been taken on while her CRB is being processed. The Manager has not had the POVAfirst check returned and this person should not have started without this check being available. The Manager was to chase this report up immediately. (Requirement). The Manager has a copy of all the training either taken place or planned over the next few months. A record is kept of who attends and certificates are held on the personnel file. Staff spoken to say they have the opportunity to train on a regular basis and seen were the booked dates with a reputable trainer for all the planned events. The Home has not had any POVA training for some time and with a number of new staff recently recruited this training is essential. (Requirement) Albany House DS0000066421.V352431.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Management of the home is carried out competently with quality issues addressed and health and safety concerns addressed EVIDENCE: The Manager has just completed her Registered Managers Award and is now undertaking NVQ 4 in care. She has been in post for approximately a year and was the Deputy Manager prior to that. Throughout conversations it was clear the competence of this person shows she is a suitable person to manage the home but is yet to complete her application to become the Registered Manager that needs to be done as soon as possible. (Recommendation) Albany House DS0000066421.V352431.R01.S.doc Version 5.2 Page 22 The home has recently sent out questionnaires to all relatives and stakeholders and had a good number of returns (seen). The information received has been collated and a report written on the issues arising and how they are going to be addressed. This information was then shared via a newsletter to all parties and is a successful way of assessing quality. The residents have money for personal bits and pieces held in the safe. The procedures on receiving residents money in is written very clearly in the policy, but unfortunately is not always followed by all staff. Receipts are issued when money is paid in and the money is in the safe but the form with signatures of two staff and the person depositing the money is not always completed that ensures a safe management procedure is taking place. The Manager has good records of supervision that is taking place approximately every 6 weeks (seen). Staff also talked about these sessions in a positive manner. The staff are also monitored on performance and will have extra one to one meetings if there is any performance concerns. The Manager gave good examples of how these sessions take place and the benefit of them to the service offered to the residents. The Manager is ensuring that the health and safety of all residents and staff is promoted and protected with regular training on all statutory topics. All dates for this training was seen and a list was sent with the AQAA prior to the inspection. The home is maintained by the Proprietor and contractors cover the main servicing and large repairs. Small repairs need to be carried out such as light bulb replacements, fire door alarm problem on the top landing and the trip switch problem in the laundry to keep maintenance jobs up to date and ensure all areas are safe. The Manager has not been reporting any deaths to the Commission and one accident in the home resulting in a broken hip had not been received but a copy was seen during this inspection. (Requirement). The home has a good recording procedure for accidents and the Manager recently collated the information which identified a pattern of falls for one lady with the result that the GP changed this person’s medication and the falls have reduced greatly. (Records seen.) All staff have been receiving the in house induction and have now started Skills for Care induction. Albany House DS0000066421.V352431.R01.S.doc Version 5.2 Page 23 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 2 3 x x 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 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 2 x x x x 2 2 2 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 2 3 x 2 Albany House DS0000066421.V352431.R01.S.doc Version 5.2 Page 24 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. 1 Standard OP7 Regulation 15.1 Requirement The home must ensure that residents care plans are written and shared with the resident and/or representative in a format that is person centred and understandable for the people involved. The staff must receive the skills to understand how to ensure residents are protected from abuse The lighting in some corridors needs to be improved to ensure residents are free from any unnecessary risk. The home must have at all times suitably qualified, competent and experienced staff in numbers that are appropriate for the needs of the residents. The Manager must ensure the POVA register is checked while waiting for the returned CRB before allowing staff to work in the home. Timescale for action 01/12/07 2 OP18 OP30 13.6 01/01/08 3 OP25 23.2p 13.4c 18.1a 01/01/08 4 OP27 01/12/07 5 OP29 19.1b Sch. 2 (7) 01/11/07 Albany House DS0000066421.V352431.R01.S.doc Version 5.2 Page 25 6 OP38 37 The manager must notify the Commission of any deaths, serious injury or other events that may adversely affect the well being of the resident. 01/11/07 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 Refer to Standard OP2 OP9 OP12 OP15 Good Practice Recommendations The home needs to update the information written in the Service Users guide. The home should hold record charts for the administration of creams in the relevant residents bedroom to ensure the documents are completed on each application. The home needs to look at ways of occupying residents who have dementia that is suitable for the individual. The home needs to think of ways to offer residents meals that is not in the very cramped dining area by the lift. (Could one of the lounges swap with the existing dining room?). The curtain tracking needs to be improved to prevent the curtains from derailing and sinks in bedrooms need to be bigger than a small cloakroom sink. The home should have two washing machines that function at all times to prevent the backlog of washing. It is advisable to rethink the times of day laundry is carried out and only in an emergency should night staff have to go to the laundry. The home should now have a Registered Manager in post. 5 6 7 8 OP24 OP26 OP26 OP31 Albany House DS0000066421.V352431.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Albany House DS0000066421.V352431.R01.S.doc Version 5.2 Page 27 - 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. 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