Care Home: Heathland Court

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What the care home does well Feedback through surveys and discussion with individuals was positive about the overall service. Comments from people who use the service included; "I am very happy here", "I like living here", "the atmosphere is very nice", "I wouldn`t want to go anywhere else" and "I am perfectly happy here". Staff have developed good relationships with the people using the service. Individuals told us they felt "well looked after". Comment on the staff included; "staff are very good indeed, I am very satisfied", "staff are very good, very nice and interested in you", "they are very good, they make you feel happy", "staff are excellent" and "staff are fantastic, always enough around and they come when you need them". The food provided is of a very good quality and the `lite bite` menu means that people who use the service can get hot or cold snacks at any time in the evening or through the night. People told us "I enjoy my food, it`s plentiful and tasteful", "the food is very good", "If anything there is too much" and "I enjoy my food, there is always something else if I don`t like one thing I can have something else". The complaints procedure is well advertised. Everyone we spoke to or who completed surveys were aware of how to make a complaint and who they should speak to if they were not happy with anything.I would like pictures of the staff on the wall What has improved since the last inspection? Staff have worked to provide a more relaxed atmosphere at mealtimes. Staff from all departments in the home are involved at lunchtime which allows staff more time to support people who might need assistance with their meal. At the time of this visit a major refurbishment of the home was taking place which should provide improvements in the environment. Care plans have improved with generally more information on how the needs of individuals will be met. Staff were seen to be more careful with cleaning fluids which we found to be stored safely. Staff are taking part in distance learning which should provide them with a better understanding of the experience of living with dementia and how to support them. What the care home could do better: Senior staff should carry out more checks on the care planning and medication records to make sure they are up to date and in line with good practice. Care plans could be more person centred. Where the freedom of movement of any person is restricted this decision must be taken as part of a multidisciplinary review with the person concerned and their representative. This will ensure that the rights of individuals are protected. Staff must also make sure that they acknowledge and respect the choices individuals make and take advice should these choices not be in line with medical advice. Consideration should be given to providing the daily menu in a pictorial form for those people who may have some difficulty with reading the printed version. Consideration should be given to key staff being provided with training on engaging people with dementia in meaningful daily living activities. In future a full employment history must be sought for each new member of staff. This will further safeguard people who use the service as gaps in employment can then be seen and explained. CARE HOMES FOR OLDER PEOPLE Heathland Court 56 Parkside Wimbledon London SW19 5NJ Lead Inspector Liz O`Reilly Key Unannounced Inspection 3rd January 2008 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Heathland Court DS0000019098.V358554.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. Heathland Court DS0000019098.V358554.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heathland Court Address 56 Parkside Wimbledon London SW19 5NJ 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) 020 8944 9488 020 8944 1820 www.bupa.com BUPA Care Homes (AKW) Ltd Mrs Avril Jones Care Home 82 Category(ies) of Old age, not falling within any other category registration, with number (45), Physical disability over 65 years of age of places (37) Heathland Court DS0000019098.V358554.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home can admit up to 3 named service users under the age of 65 years for respite care within the Nursing and Residential Units. 21st November 2006 Date of last inspection Brief Description of the Service: Heathland Court provides nursing and residential care for up to 82 people. Accommodation is provided over five floors, with the nursing units on the lower floors of the home. There is a passenger lift to all floors. The home is run by BUPA and is located in a residential area of Wimbledon, within a short walking distance of the Common. The fees range from £900 to £1150 per week, based on the amount of care and support needed by each person. Heathland Court DS0000019098.V358554.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by two regulation inspectors on 3rd January 2008. We had the opportunity to speak with twenty people who use the service, four of the staff and the registered manager. We provided surveys for people who use the service, a sample of relatives and staff. The registered manager has completed an assessment of the service for the CSCI. Judgements made in this report are based on information from all of the above sources along with observations made on the day of the visit to the service. We found that people who use this service are provided with Good outcomes from this service. What the service does well: Feedback through surveys and discussion with individuals was positive about the overall service. Comments from people who use the service included; “I am very happy here”, “I like living here”, “the atmosphere is very nice”, “I wouldn’t want to go anywhere else” and “I am perfectly happy here”. Staff have developed good relationships with the people using the service. Individuals told us they felt “well looked after”. Comment on the staff included; “staff are very good indeed, I am very satisfied”, “staff are very good, very nice and interested in you”, “they are very good, they make you feel happy”, “staff are excellent” and “staff are fantastic, always enough around and they come when you need them”. The food provided is of a very good quality and the ‘lite bite’ menu means that people who use the service can get hot or cold snacks at any time in the evening or through the night. People told us “I enjoy my food, it’s plentiful and tasteful”, “the food is very good”, “If anything there is too much” and “I enjoy my food, there is always something else if I don’t like one thing I can have something else”. The complaints procedure is well advertised. Everyone we spoke to or who completed surveys were aware of how to make a complaint and who they should speak to if they were not happy with anything. I would like pictures of the staff on the wall What has improved since the last inspection? Heathland Court DS0000019098.V358554.R01.S.doc Version 5.2 Page 6 Staff have worked to provide a more relaxed atmosphere at mealtimes. Staff from all departments in the home are involved at lunchtime which allows staff more time to support people who might need assistance with their meal. At the time of this visit a major refurbishment of the home was taking place which should provide improvements in the environment. Care plans have improved with generally more information on how the needs of individuals will be met. Staff were seen to be more careful with cleaning fluids which we found to be stored safely. Staff are taking part in distance learning which should provide them with a better understanding of the experience of living with dementia and how to support them. 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. Heathland Court DS0000019098.V358554.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 Heathland Court DS0000019098.V358554.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): 1, 3 & 5 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People are provided with good information on what they can expect from the service. Assessments are carried out before anyone is admitted to ensure that the needs of each individual can be met. Care needs to be taken to make sure that the information provided is carried forward into the care plans. EVIDENCE: All of the people who use the service who completed a survey confirmed that they had enough information on the home before they moved in. This assisted them in deciding this was the right place for them. Two people told us that members of their family chose the home for them and one person said they had visited the service before deciding on moving in. Heathland Court DS0000019098.V358554.R01.S.doc Version 5.2 Page 9 We found assessments had been carried out before admission and this information was, in the majority of cases seen, being used to compile an initial care plan. This ensures the needs of individuals can be met and provides staff with information before the person arrives. We did find in one instance not all assessed needs had been included in the care planning. Staff need to take care to follow through the assessment with information on how individual needs will be met. Heathland Court DS0000019098.V358554.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 & 10 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Staff are continuing to make improvements in care planning towards a more person centred approach. Further improvements could still be made in this area. Staff have received appropriate training on the management of medication. However the recording of medication needs to be more closely monitored. Staff respect the privacy and dignity of individuals. EVIDENCE: We looked at a sample of files and found each person was supplied with a care plan. Improvements have been made in the care planning with, in a number of instances, good information on the personal preferences of individuals, guidance on how to provide support and directions for staff on providing comfort for the person. We found good information on communicating with individuals and supporting people in a sensitive manner. Heathland Court DS0000019098.V358554.R01.S.doc Version 5.2 Page 11 However this was not consistent across the sample. In one instance needs noted in the assessment had not been addressed in the care plan. Staff need to make sure that they follow through from assessment with actions and information. In one instance the outcome from the assessment indicated that staff should find out the likes and dislikes of the person. We found no evidence that this had been carried out other than the person liked wine. However staff had added to the review that this was ‘not acceptable’ as the person was not eating well. Staff need to take care to ensure that the wishes of individuals are not ignored or judged. Should the wishes of the person using the service appear to clash with medical advice this needs to be discussed with the individual and if needed other health care professionals and recorded. Care plans were being reviewed every month, which ensures that the changing needs of individuals are monitored. Consideration should be given to the purpose of and the way in which reviews are being carried out for people who are ‘wandering’. The reviews or evaluations we saw focused on negative aspects and did not assess why someone may be walking around or how staff might engage these individuals. The service has good contacts with other health care professionals. People who use the service can keep their own GP or be registered with the visiting GP practice. Arrangements are in place for dental, optical and chiropody services to be provided in the home on a regular basis. Individuals can make their own arrangements for these services should they wish. A private physiotherapist can be arranged through the home. People who use the service told us that they could see the doctor when they wanted and that they usually received the care and support they needed. We found staff keep good records relating to the health of people who use the service. Wound care management records were well maintained. We found medication stored safely. Staff have completed training on the management of medication. The majority of medication records were found to be up to date and accurate. However on one unit staff had not signed the medication administration sheet in at least five instances. Staff need to take care to add any medication they already have to the number or amount received. This will allow an accurate audit of medication to be carried out. We observed staff supporting people in a sensitive manner taking into consideration the privacy and dignity of people who use the service. People who use the service told us that staff were “kind”, “polite”, “patient” and “there when I need them”. Heathland Court DS0000019098.V358554.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The service offers a wide range of activities for people who use the service. Consultation on the menu takes place on a regular basis and improvements have been made around meal times. A good variety of food is on offer throughout the day and night. EVIDENCE: All of the people we spoke to gave positive comments about the food provided. These comments included; “the food is very good”, “the food is decent”, “they feed me very well”, “if anything there is too much” and “I can always have something else if I don’t like it”. In surveys four people told us they ‘always’ liked the meals and five people said they ‘usually’ liked the meals. We saw improvements in meal times since the last inspection. Staff from all departments were involved at meal times which allows more time for supporting people who need assistance with their meals and therefore provides a more relaxed atmosphere. We observed staff assisting people with their food in a discreet and sensitive manner. The home manager was taking her meal with people who use the service on the ground floor. Heathland Court DS0000019098.V358554.R01.S.doc Version 5.2 Page 13 The menu offers a good variety of food and alternatives are available at each meal time. The menu is on display in dining rooms. Consideration should be given to providing the menu in a more easily accessible format for those residents who may have difficulty with a written format. Breakfast is served from seven to ten thirty each morning taking into consideration the varying times individuals like to get up. All meals can be taken in the dining room, in the persons own room or in the conservatory. Records show that the food provided is regularly discussed at meetings with people who use the service and their representatives. Visitors can join with their friends or relatives in a meal for a small charge. Coffee is available in the ground floor lounge throughout the day so that people can help themselves. The ‘lite bite’ menu is on display in the dining rooms and provides a wide variety of snacks hot and cold which is available throughout the evening and night. Eight people who returned surveys said that there were ‘usually’ activities which they could take part in and one person said there ‘always’ were activities which suited them. Comments from people we spoke to included; “there is enough going on, trips and such”, “I like to play table tennis”, “I enjoy the lovely garden in the summer”, “the concerts are very good”, “there are lots of games” and “ I like going to the Windmill café”. One person felt that there was “not enough going on”. Care needs to be taken to make sure that any choices people make are respected and acknowledged. Staff felt that one area which could be improved was the provision of activities for people with dementia. Consideration should be give to key staff being provided with training on engaging people with dementia in meaningful daily activity. The home usually employs two activity assistants but one person had recently resigned. A timetable of events is posted on each floor. The activities available include a walking club, which staff informed us was very popular, arts and crafts, baking, gardening, trips out, visits to the local Windmill café, discussion groups, films shopping, music and movement and visits from the ‘pat dog’ service. Concerts are arranged on a regular basis. A large group of Japanese students had recently visited the service and had provided demonstrations on wearing a kimono, the tea ceremony and origami. Visitors are welcome to visit at any time and people who use the service told us that their family and friends visited them. Heathland Court DS0000019098.V358554.R01.S.doc Version 5.2 Page 14 Arrangements can be made for people to receive visits from local religious centres. One person who uses the service told us they received holy communion twice a week. Heathland Court DS0000019098.V358554.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 & 18 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use the service and others involved with the home understand how to make a complaint and have been supplied with information on what will happen if a complaint is made. People who use the service are safeguarded from abuse. Further safeguards need to be in place should any restrictions on the freedom of movement of individuals be implemented. EVIDENCE: Everyone we spoke to who was using the service and all of those surveyed knew how to make a complaint and who to speak to about any concerns they may have. All of the staff surveyed told us they knew what to do if someone came to them with a complaint or concern. Staff we spoke to were also aware of what to do. The manager keeps a record of any complaint along with actions taken and outcomes. At the time of this inspection one complaint was being investigated. Staff are provided with training on safeguarding adults which provides them with information on recognising abuse and how it should be reported. This training also ensures that staff are aware of their individual responsibilities in reporting any allegation or concern they may have. Heathland Court DS0000019098.V358554.R01.S.doc Version 5.2 Page 16 We found that in one instance where someone was described as ‘wandering’ instructions for staff included locking all outside doors. We found no assessment in place regarding this restriction of an individual’s freedom of movement. Where a persons rights are being restricted an assessment, involving the individual concerned where at all possible, their representative and any other professionals such as the care manager, GP or consultant, needs to be carried out, recorded and regularly reviewed. Heathland Court DS0000019098.V358554.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 & 26 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. At the time of this inspection the service was in the middle of a major refurbishment programme. The home is well maintained and all areas were clean, well lit and fresh. EVIDENCE: We found the environment to be well maintained. Furnishings and fittings are of a good quality. Since the last inspection new carpeting has been fitted to the ground floor corridor and new chairs have been purchased. A major refurbishment was taking place which involved individuals moving rooms. This had been discussed with them at meetings and individually. Although this type of activity has the potential to cause major upset to people who use the service staff have worked well to make the move as smooth as Heathland Court DS0000019098.V358554.R01.S.doc Version 5.2 Page 18 possible. At no time did anyone raise concerns with the inspectors about this issue. Everyone we spoke to felt the home was kept clean and fresh. Six people in surveys said the home was ‘always’ clean and fresh with two people stating ‘usually’. Comments about the environment included “the accommodation is lovely”, “I have a lovely room, very comfortable” and “I don’t think I could ask for better”. Heathland Court DS0000019098.V358554.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 & 30 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. There are generally enough staff available to meet the needs of individuals. The recruitment procedures assist in safeguarding people who use the service. Staff are provided with good opportunities to take part in training to increase their skills and knowledge. EVIDENCE: Of those people who use the service who were returned surveys eight said there were ‘always’ staff available when needed and three people said ‘usually’ staff were available. One person told us they felt there were not always enough staff available between five and seven in the evening. Others said; “there are always enough staff around”, “you just have to ring and they are there straight away”. We observed enough staff on duty to meet the needs of the people using the service. All of the staff surveyed felt there were enough staff on each shift. Two staff members felt they would like more time to sit down with people who use the service on a one to one basis. When asked if staff listen and act on what you say all of those surveyed said ‘yes’. One person qualified this with adding that ‘sometimes then it is forgotten’. Another person felt that some staff, although very nice, did not always understand what was being asked of them and so tended to walk away Heathland Court DS0000019098.V358554.R01.S.doc Version 5.2 Page 20 without answering their question. This is something which should be addressed by the service manager. One person felt that an improvement for them would be a board with the photographs and names of staff on each floor. This is something which could be put to other people who use the service for consideration. Comments made by people who use the service on the approach of staff were for the majority very good. Comments made included; “they are very good to you here”, “they are good and polite”, “they are very good indeed, I am very satisfied”, “staff are excellent”. One person felt that some staff were “not so good”. Staff are provided with good opportunities for training. A senior member of the staff team works as the training coordinator. All of the staff surveyed and spoken to felt they had a good induction when they first started working in the service. Everyone also felt they were provided with relevant training for their work. A rolling programme of training is in place. The training programme for January included; fire awareness, safeguarding adults, challenging behaviour, health and safety and customer care. Staff are provided with dementia care training through a distance learning course. We found staff files to be well maintained. Checks, including Criminal Records Bureau checks and references are carried out before anyone starts working in the home. This assists in safeguarding people who use the service. In future a full employment history should be obtained for each person applying for work. Heathland Court DS0000019098.V358554.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 & 38 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The home is well run. People who use the service have regular opportunities to give their opinions on the way the service is run. Staff ensure the health and safety of people who use the service and visitors through regular checks on the environment and equipment. More care needs to be taken in monitoring records relating to medication and care planning. EVIDENCE: The registered manager has considerable experience and knowledge of running a care service. The manager is a qualified nurse and has also completed the Heathland Court DS0000019098.V358554.R01.S.doc Version 5.2 Page 22 Registered Manager Award. People who use the service told us that the manager was “always available”, “very approachable” and “we see her every day”. All of the staff spoken to and who completed surveys told us they felt well supported by the manager. The organisation has a comprehensive consultation process as part of their quality monitoring and assurance systems. Surveys are sent out to people who live in the home, staff, relatives and other professionals on a regular basis. When the result of surveys are collated a report is sent to the manager who is then required to produce an action plan. The results of surveys are also discussed at a meeting with people who use the service. A monthly audit of the home is carried out by the regional manager. There are also regular meetings for people who use the service where they can discuss day to day issues about the operation of the home. At the last meeting discussion took place on the food provided and the changes to the environment. Senior staff need to carry out more frequent checks on medication and care planning to make sure that staff are keeping records up to date in line with good practice and the organisations’ own procedures. Good records of the regular health and safety checks are kept. A record of all accidents is kept and reviewed by the manager. Heathland Court DS0000019098.V358554.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 3 X 2 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 4 Heathland Court DS0000019098.V358554.R01.S.doc Version 5.2 Page 24 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 OP9 Regulation 13(2) In order to ensure the health and welfare of people who use the service staff must keep accurate records of medication held in the home. The medication administration sheets must be kept up to date. 2. OP14 12(2)(3) To make sure that people who use the service are supported to make their own decisions about their health and welfare staff must take note of choices made by individuals. Where these choices are not in line with medical advice this must be discussed with the person and other professionals. 3. OP18 12(2)(3) (4) 10/03/08 Staff must ensure that the rights of people who use the service are respected. In any instance where the freedom of movement of any DS0000019098.V358554.R01.S.doc Version 5.2 Page 25 Requirement Timescale for action 10/03/08 10/03/08 Heathland Court person is restricted a multidisciplinary assessment must be carried out involving the person concerned and their representative. This assessment must be regularly reviewed and recorded. 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. Refer to Standard OP7 Good Practice Recommendations The home should look at ways to make the care plans more person centred and better reflect the individual’s life and preferences. The plan in place should direct the care to be person orientated and less task based. Information gathered at the assessment should be included in the care planning to make sure that people receive the support they need. 2. OP7 Staff should consider the purpose of care planning reviews and make sure that instructions such as monitoring or seeking preferences are carried out and remain relevant. Consideration should be given to staff being provided with training on engaging people with dementia in activities. Menus should be presented in user friendly formats such as pictures or large print. Large whiteboards could also be used to present information and any changes. In future a full employment history needs to be sought for any staff employed. Systems should be developed to ensure that senior staff check care planning and medication documents on a regular basis. 3. .4 OP12 OP15 5. 6. OP29 OP33 Heathland Court DS0000019098.V358554.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Heathland Court DS0000019098.V358554.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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