Care Home: The Laurels

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What has improved since the last inspection? Since the last inspection, liquid soap and paper towels had been made available throughout the home to reduced the risk of cross contamination. Staff training had improved and now included infection control and adult safeguarding training. The record of finances being kept for one of the people living in the home had improved and was easy to understand. The recruitment procedure had improved but further improvements needed to be made (see below). What the care home could do better: The main areas for improvement related to the home`s records. People`s files needed to show that there was consistent recording that people`s identified needs were met and that records were kept up to date. The inclusion of people`s social needs in their care plans and daily records of how each person spent their day would demonstrate person centred care. An up to date record of all medicines for each person needed to be provided. Staff recruitment files needed to include identity documentation and dates of employment. Relevant correspondence, contracts and evidence of interview would also demonstrate a robust recruitment procedure.The LaurelsDS0000008021.V374969.R01.S.docVersion 5.2Page 7Improvements could be made to the home`s quality assurance monitoring system by providing written records to demonstrate that checks and audits had been carried out. Key inspection report CARE HOMES FOR OLDER PEOPLE The Laurels High Street Norton Doncaster South Yorkshire DN6 9EU Lead Inspector Christine Rolt Key Unannounced Inspection 16th April 2009 09:45 DS0000008021.V374969.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Laurels Address High Street Norton Doncaster South Yorkshire DN6 9EU 01302 709691 01302 708409 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) Mr Kenneth Swales Mrs Deborah Swales, Mr Andre Swales Mrs Anne Godwin Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th April 2007 Brief Description of the Service: The Laurels Care Home is in the centre of the village of Norton, which lies to the north of Doncaster. It provides accommodation and care for up to 30 older persons. The home is an attractive stone built, two-storey building in well-maintained gardens. There is a large car park to the side of the home. The manager’s office and communal areas are on the ground floor. Bedrooms are on the ground floor and first floor. A passenger lift and stairs provide access. All bedrooms are single occupancy and some have en-suite lavatories. Aids and adaptations are provided for easy accessibility throughout the home and the garden areas. A conservatory reception area forms a link between this home and its sister home, The Laurels Nursing Home, which is registered to provide nursing care for 20 people. Each home is registered and inspected separately. The homes have strong links with the local community. The fees ranged from £420.14 to £430 per week. Additional charges were made for hairdressing, private chiropody, newspapers and personal toiletries (the home provided standard toiletries). The manager supplied this information during the site visit on 16th April 2009. The statement of purpose, the service user guide and the most recent inspection report were available in the manager’s office and copies were to be made available in the main reception. The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations – but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This was a key inspection and comprised information already received from or about the home and a site visit. The site visit was from 9:45 am to 6:00 pm. The registered manager had completed an Annual Quality Assurance Assessment (AQAA). This document gave her the opportunity to say what the home did well, what had improved and what they were working on to improve. Various aspects of the service were then checked during the site visit. Care practices were observed, a sample of records was examined, a partial inspection of the building was carried out and service provision was discussed with the manager. The majority of people living at the home were seen throughout the day, and several were asked for their opinions of various aspects of the home and the care received. A visitor and a health professional were also asked for their opinions. The care provided for three people was checked against their records to determine if their individual needs were being met. All opinions and comments were considered for inclusion in this report. The inspector wishes to thank the people who live in the home, visitors, staff, the registered manager and Mr. K. Swales, one of the owners, for their assistance and co-operation. What the service does well: The home was welcoming and homely and people said that they liked living there. It was clean, well furnished and well maintained. The owners were on site most days and were well known to people living in the home and their visitors. People praised the staff for their care and considered that all staff were good. The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 6 The dining facilities were good and showed that people were treated as individuals. People said the meals were good and that their preferences were taken into consideration. When people were asked to sum up their feelings about the home they said, “Quite content really”, “Very pleasant” “Good” “Better than some. and “Very attentive staff and the food’s good” Pretty well run” What has improved since the last inspection? What they could do better: The main areas for improvement related to the home’s records. People’s files needed to show that there was consistent recording that people’s identified needs were met and that records were kept up to date. The inclusion of people’s social needs in their care plans and daily records of how each person spent their day would demonstrate person centred care. An up to date record of all medicines for each person needed to be provided. Staff recruitment files needed to include identity documentation and dates of employment. Relevant correspondence, contracts and evidence of interview would also demonstrate a robust recruitment procedure. The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 7 Improvements could be made to the home’s quality assurance monitoring system by providing written records to demonstrate that checks and audits had been carried out. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service had full assessments of their needs. EVIDENCE: This home does not provide intermediate care therefore Standard 6 was not applicable. People said that this home was chosen because it had a good reputation and was convenient for families to visit. “Heard it was good” The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 10 The manager said that all people living in the home had copies of the service user guide and the statement of purpose. Copies were also kept in the office along with the latest inspection report. The manager said that copies of these would be made available in the main reception area. The files for three people were checked to determine if their needs had been assessed. Files provided some good information of people’s needs and wishes. Information of health needs was particularly good. There was no information to state that the person had been informed in writing that the home could meet their assessed needs. This was discussed with the manager during the site visit. The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were treated with respect. Medication recording procedures needed amendment. Care and health needs were met but care planning and recording could improve to ensure that social needs were met thus providing person centred care. EVIDENCE: People living in the home looked well cared for, clean and appropriately dressed. They said that they received the care and support they needed and were treated with respect and dignity. Staff were observed treating people with respect and kindness, and interactions were good. People said they were happy living in the home. “They do look after me” “Bring me a cup of tea in bed in the morning” The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 12 Three care plans were checked in detail. Care plans provided good details of people’s physical and health needs but did not include how the person’s social needs, as identified in their assessments, were to be met. Daily records provided some good information, but at times irrelevant information was also recorded. An example of this was daily information that a person had “eaten well” yet there was no assessed dietary needs and the person could dine independently. There was no consistent information in care planning or daily records or charts of how each person spent their day, which would have helped show person centred planning. Other information that needed to be recorded was missing. An example of this was bathing records, which were left blank or completed sporadically. Inventories of people’s belongings were also left blank. Information on one file stated that a urine sample was clear but there was no other information on file of the reason for the test and the manager could not throw any light on this. Improvements in record keeping were discussed with the manager. Files contained risk assessments. Accidents were recorded and monthly analyses were produced to identify any common themes and determine the action that needed to be taken. The manager was advised to introduce 72-hour monitoring charts as a good practice measure. These forms record the close monitoring of people who’ve had accidents or falls where no injuries are apparent at the time of falls and ensure that injuries are quickly noted. Files contained good information of health care professional involvement in the home and during the day of the visit, a GP, a community psychiatric nurse and a physiotherapy assistant were visiting. People were supported to look after their own medications within a risk management framework. The medication was stored securely in a room with hand washing facilities, liquid soap, paper towels and gloves. The medication trolley was secured to the wall. There were no gaps in the Medication Administration Record (MAR) charts. Medication in the Monitored Dosage System (MDS) tallied with the MAR charts. Medication receipt was not entered onto the MAR chart but all medications were entered into a book. However, this did not provide a running record for medications, particularly where medication was not in the MDS e.g. packets and bottles of ‘as and when’ medications for pain relief or short-term courses of antibiotics. Because these medications were not being carried forward and totalled onto new MAR charts there was no up to date record of stock control. The manager said that she would do this within 24 hours. The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 13 A record of staff signatures was kept. This is good practice. People’s files contained information of their medications and the reasons for them being prescribed, which is good practice. Medication that required refrigeration was kept in a domestic refrigerator in the medication room. Staff snacks were also in the refrigerator and these were removed. The refrigerator seal was damaged. The refrigerator temperature was not being monitored daily to ensure that medication was kept at the correct temperature. The manager was advised to obtain a copy of the Royal Pharmaceutical Society guide The Handling of Medicines in Social Care to remind staff of the procedures for dealing with medication. People living in the home considered that their privacy was respected. All bedrooms were fitted with locks and people had keys for their bedroom doors and their lockable facilities. The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 14 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were generally satisfied with their lifestyles in the home. EVIDENCE: On the day of the site visit, a communion service was being held in the home. A person who lived in the home said that this occurred every month. There was no activity programme displayed. People who were spoken to said that some activities did take place but they would like more. They said that staff were very busy and did not have time to provide activities. The manager said that an activity co-ordinator was being employed and would commence at the end of April. Staff were observed and heard to offer choices. People said that they could spend their day as they liked and some people chose to spend time in their rooms. Care plans provided information of people’s preferred rising and retiring times, hobbies and interests and food likes and dislikes. People who visited the home said that they were made welcome. The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 15 People living in the home said that they were satisfied with the meals. A menu board informed people of the breakfast choices and the lunchtime meal. There was no choice shown for lunch and the manager added this to the menu board. Staff said that they asked people what they would like for each meal. A person living in the home said that choices were available except at lunchtime. The dining room was pleasant, clean and tidy. Tables were set with tablecloths, place mats, condiments, sugar, table napkins or aprons dependent on need. Cutlery and crockery was suitable to meet people’s individual needs. Fresh daffodils were also displayed on most tables. The lunchtime meal looked and smelled appetising. Gravy boats were available for those capable of using them. Staff provided discreet help where needed. Special diets such as diabetic and soft diets were available. The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 16 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People felt they were listened to and protected. EVIDENCE: The manager said the complaints procedure was included in the service user guide and also on the policy and procedures file. This was seen during the site visit. She was advised to display a copy to ensure that people coming into the home were aware of the procedure. The manager was also advised to update the procedure with the new Commission’s name. There were no complaints. People said that they were satisfied with the home and had no complaints but knew who to see if they had any concerns. “… has never complained.” “Would see Anne (manager)” “Never had need, but would see staff or Ken (owner)” The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 17 Staff had undertaken in house adult protection training and further external training was being supplied on a rolling rota basis. There were no allegations of abuse. The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 18 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People lived in a clean, pleasant and hygienic environment that had aids and adaptations to meet people’s needs EVIDENCE: The home was pleasant and clean and there were no offensive odours. People said that the home was always clean. Furnishings and furniture were in good condition. Bedrooms had been personalised by their occupants and were clean and tidy with good quality furniture. Bedrooms had door keys and there were lockable facilities with keys. The beds were against the wall in the three rooms that were checked. The manager said that the occupants of these bedrooms were The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 19 capable of getting in and out of bed without assistance therefore the risks of injury to people in these rooms and staff were minimal. However, risk assessments need to be carried out to confirm this and kept up to date as people’s needs changed. Bedroom windows had no restrictors and the manager needs to determine the level of risk and take action where necessary. Throughout the home there were chairs and other furniture down the corridors. Some chairs were useful and would enable people to rest when walking down the corridors but some could be removed. The manager needs to monitor this to ensure it does not cause obstructions. There were sufficient bathing facilities including an adapted bath and a shower room. The manager said that people preferred to have a bath. However, the shower room could be improved by fitting hooks for clothing and towels and shelves or baskets for toiletries. The lampshade was also missing. Hand washing facilities had liquid soap and paper towels to reduce the risk of cross contamination. Aids and adaptations were fitted throughout the home. The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 20 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were cared for by a well trained and dedicated staff team. Record keeping of staff files could improve. EVIDENCE: There were three members of staff on each shift and extra staff were brought in at busy times of the day. People considered that staff were caring and helpful and treated them with respect and dignity. “Staff are good” “All very good” The manager said that the home had many long serving members of staff. This provided stability within the home. She also said that the level of sickness had reduced since the owners introduced an incentive scheme. Records showed that staff received induction training to a recognised standard. Information in the AQAA stated that 70 of staff had achieved NVQ in care and the manager confirmed this during the site visit. The training matrix and The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 21 training list showed that staff undertook skills training suitable to meet the needs of people living in the home. The recruitment files for three members of staff were checked. Application forms, criminal record bureau disclosures, POVAFirst checks and references were available. However, there were no identity documents in two of the files and none of the three files contained contracts or other information to verify date of employment. Information of interview sessions would have been useful to confirm that interviews had taken place. Improvements to the recruitment procedure were discussed with the manager. The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 22 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager promoted the welfare of people at the home, and it was run in their best interest. EVIDENCE: The registered manager was qualified and experienced. She had completed NVQ 4 in management and care and had achieved the Registered Managers Award. She kept up to date with current practice. The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 23 The home held a yearly meeting with people living families, and handed out questionnaires at these people’s level of satisfaction with the home. The results were then collated and action taken to improve in the home and their meetings to determine manager said that the the service. The manager said that she carried out checks within the home but there were no records to verify that regular monitoring had taken place. Advice was given on how the quality assurance system could be improved by keeping records of checks carried out on the environment, observation of work practices and audits of systems and procedures within the home. An example of this would be recording any checks of care plans and medication to ensure that up to date records were kept and discrepancies were dealt with immediately (see section on Health and Personal Care). One of the owners dealt with money held on behalf of people living in this home and the sister home. According to one of the owners, none of the three people who were tracked had their money looked after by the home and in fact there was only one person in this home had their finances looked after. This person’s financial record was checked against money held for them and this tallied. Advice was given on regular auditing by a person who does not have day-to-day charge of finance to ensure good practice. The manager provided a training matrix that included mandatory health and safety training (i.e. moving and handling, infection control, basic food hygiene, emergency first aid and fire awareness). The manager agreed that care staff helped people with their meals and provided snacks if required when the catering staff were not available but the training record showed that none of the care staff had undertaken a food hygiene course. The manager said that food hygiene was now included in the infection control training that all staff were undertaking. Mandatory health and safety training was updated regularly, which is good practice. Fire drills and instructions were held regularly. The manager was advised to provide more specific information of staff response times. A fire drill matrix was also advised to ensure that all staff took part in fire drills at regular intervals. The manager had difficulty in locating certificates to verify that systems and equipment had been serviced and maintained within the required timescales. These were held by one of the owners who was not available during this inspection. Another owner located the annual gas contract to verify that systems were maintained. It was recommended that all servicing and maintenance certificates be kept in one file in the manager’s office for easy access. The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 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 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 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 2 X 3 X X 3 The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 25 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 OP3 Regulation 14 Requirement People must be informed in writing that the home can meet their assessed needs Daily records must show that people’s identified needs have been met. The refrigerator containing medication should be checked daily and the temperature recorded. The RPSGB publication The Handling of Medicines in Social Care would remind staff of the procedures for dealing with medication. People living in the home should be made aware that there is an alternative to the lunchtime meal and this information should be displayed on the menu board to remind them and give them time to consider the options. Monitor the amount of furniture in corridors to ensure that it does not cause obstruction The provision of hooks, shelves and a lampshade in the shower room would help improve this bathing facility. DS0000008021.V374969.R01.S.doc Timescale for action 11/06/09 2 OP7 15 11/06/09 3 OP7 17 11/06/09 4 OP9 13 11/06/09 5 OP9 13 11/06/09 6 OP19 13 11/06/09 7 OP29 17 11/06/09 The Laurels Version 5.2 Page 26 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 OP7 OP8 Good Practice Recommendations To provide person centred care, people’s leisure activities should be included in their care plans Consider the introduction of 72 hour monitoring sheets to closely monitor people who have had accidents or falls where there is no apparent injury at the time. The refrigerator containing medication should be checked daily and the temperature recorded. The RPSGB publication The Handling of Medicines in Social Care would remind staff of the procedures for dealing with medication. People living in the home should be made aware that there is an alternative to the lunchtime meal and this information should be displayed on the menu board to remind them and give them time to consider the options. Monitor the amount of furniture in corridors to ensure that it does not cause obstruction The provision of hooks, shelves and a lampshade in the shower room would help improve this bathing facility. Consider extending the quality assurance system to include checks of the environment, audits of systems and procedures and observations of work practice and ensure that records are kept to verify the actions taken. Personal finances held on behalf of people living in the home should be audited at regular intervals by a person who is not in day to day Recording the actual time taken to respond to fire drills would help show if timings could be improved. The use of a fire drills matrix would highlight staff who had not undertaken this training. It is recommended that certificates of servicing and maintenance be kept in a file in the manager’s office for easy access. 3 4 OP9 OP9 5 OP15 6 7 8 OP19 OP19 OP33 9 OP35 10 OP38 11 OP38 The Laurels DS0000008021.V374969.R01.S.doc Version 5.2 Page 27 Care Quality Commission Yorkshire and Humberside St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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