Inspection on 11/10/05 for Abbeycrest Nursing Home

This inspection was carried out on 11th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Abbeycrest Nursing Home 28/06/07

Abbeycrest Nursing Home 09/05/06

Abbeycrest Nursing Home 19/07/05

Abbeycrest Nursing Home 15/11/04

Abbeycrest Nursing Home 18/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Abbeycrest Nursing Home Essex Way Sonning Common Reading Berkshire RG4 9RG Lead Inspector Delia Styles Announced Inspection 11th October 2005 09:30 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 Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 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. Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Abbeycrest Nursing Home Address Essex Way Sonning Common Reading Berkshire RG4 9RG 0118 9724414 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) Abbeycrest (Reading) Limited Mrs Lesley Jacqueline Wright Care Home 24 Category(ies) of Learning disability (2), Old age, not falling registration, with number within any other category (24) of places Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. On admission persons should be aged 60 years and over. The total number of persons accommodated must not exceed 24 The above LD category relates to two named individuals and CSCI will need to review any changes to the above 19th July 2005 Date of last inspection Brief Description of the Service: Abbeycrest is situated at the edge of Sonning Common village, near Reading. It provides accommodation and care for a maximum of 24 older people who require general nursing care. The building was originally a school and was converted for use as a residential care home in the 1980s. It is within reach of a local bus service, village shops, a library and the doctors’ surgery. Residents’ accommodation is provided in 14 single and 5 shared (double) rooms. All rooms are equipped with a washbasin. There are 3 bathrooms one on the ground floor and 2 on the first floor – and 3 separate lavatories. A small passenger lift and stairs serve the first floor. A dining room and sitting room on the ground floor and a combined sitting and dining area on the first floor provide the communal rooms. There is a very small room used as a laundry on the first floor and a kitchen on the ground floor. The home is set in a large plot of ground laid to grass, with a large mature tree, and overlooks a stretch of common land and public right of way across the fields at the rear. A paved patio area with garden seating is accessed from a fire exit door. There is a gravelled parking area for cars at the front of the home. Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection undertaken by two inspectors and lasted six hours. The inspectors toured the premises, talked with residents, staff and a visitor. Financial records, residents’ care records and maintenance records were examined. Comment cards were received from 2 relatives/visitors, a Health and Social Care Professional and a General Practitioner: their views about the care home are reflected in the report. As part of an investigation undertaken into a complaint received about the home in April 2005, the registered manager and the proprietor met with a regulation manager and the lead inspector for the home. They agreed to undertake an audit of the premises and risk assessments, and submit a written report of the findings to the Commission. The proprietor confirmed in a letter to the Commission having undertaken a premises check on 26th September that ‘to the best of our knowledge and belief the Home is fit for the purpose and meets the Regulations with the exception of those noted by CSCI.’ The facilities and the layout of the home do not meet many of the current National Minimum Standards for Care Homes for Older People. The proprietor has acknowledged this and has submitted numerous plans to South Oxfordshire District Council to build a new care home on the site of the present home. The first application was made in 1988 and each scheme and/or amendment has been rejected to date. The most recent amended application had been withdrawn on the advice of the Planning Officer and a new submission has to be made in November 2005. The home was first registered as a care home in 1988 and, though it met the registration criteria at that time, much of the building is not suitable for more heavily dependent residents. The outcome of previous inspections by the Commission demonstrates that there are aspects of the home’s environment that must be improved or new provision made. The inspectors would like to thank the home manager, proprietor, staff and residents for their time and comments during the inspection. What the service does well: The home is clean, tidy and there are no unpleasant odours. Comment cards received stated that the manager and senior staff communicate well with doctors and other visiting health and social care professionals, so that Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 Page 6 residents’ health needs are met. Relatives and visitors comments were very positive about the ‘family atmosphere’ of the home and the ‘excellent nursing care’. The staff are friendly and the home is ‘warm and welcoming’. Staff spoken with said that they enjoyed working with their colleagues – ‘it is a good staff team’; ‘the staff group are great to work with’. Two residents spoken with confirmed that the ‘staff are wonderful’ and are ‘really helpful’. Residents said that the standard of meals and choice of food are very good. What has improved since the last inspection? What they could do better: The care plans are well set out but there were some important things missed out in the sample seen, so that staff may not have all the information to care for the residents in the best way to meet their care needs. The care plans should set out in enough detail, stating what actions the staff need to take to help the residents. There should be evidence that the care plans have been updated and rewritten if the resident’s condition has changed or the care given does not appear to be effective. There should be more opportunities for residents to be involved in a variety of social and recreational pastimes. Their personal choices about what activities and hobbies they enjoy should be included in their care plans and to what extent these have been met by the home. There have been limited improvements made to the staff records. The staff recruitment and training records should contain evidence of appropriate references, work history and a signed record of interview. There should be evidence of satisfactory police checks for all staff or visiting professionals who provide services for residents to demonstrate that the home has taken all necessary steps to protect residents from people who are unsuitable to care for them. Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 Page 7 The system of record keeping of residents’ monies held on their behalf personal expenditure for additional services and purchases - should be improved so that residents and their representatives are able to easily identify their current balance. The temperature of the hot water at some hand basins was too hot, so that there is a potential risk of scald injuries to vulnerable residents. The hot water temperature should be checked more regularly and prompt action taken to adjust it to within the recommended safe range. Items of worn furniture and bed linen should be replaced. 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. Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 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 Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 There was evidence that there is a satisfactory process to ensure that residents’ care needs are assessed before they are admitted. EVIDENCE: The manager has worked at the home for many years and is careful to make sure that only those residents whose care needs can be met by the home are admitted, given the limitations of some of the home’s facilities such as the size and layout of some rooms. Residents’ care records showed evidence of an assessment process and reports from care managers and other professionals that had contributed to information about the individual’s care needs before their admission to the home. Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 The system of care planning in place is clear and consistent overall, though some additional detail and updating is needed to ensure that the plans always provide up to date information about residents’ current care needs and how staff are to meet those needs. The health needs of residents are satisfactorily met with evidence of good multi disciplinary working taking place on a regular basis. The systems for the administration and storage of medication are good with clear arrangements in place to ensure residents’ medication needs are met. Personal support to residents is offered in a respectful way by staff. The layout of the rooms and standard of the facilities in the home is such that staff need to be particularly mindful to promote and protect residents’ privacy and dignity when assisting them with personal care. EVIDENCE: A small sample of residents’ care plans was looked at. The care records are well organised and show evidence of regular review. The care plans for a new resident had a good account of their social care needs, likes and dislikes. Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 Page 11 The nutritional risk assessment method recommended for use at the last inspection is going to be used in the home. The manager has gathered the information needed for staff to start to use the Malnutrition Universal Screening Tool (M.U.S.T) to assess all residents on admission and regularly thereafter to check whether resident’s diet is adequate or whether they are at risk of being malnourished. There were significant omissions from the care plans for two residents in the sample seen. For example, one resident became very distressed and was heard calling out repetitively and very loudly in the lounge during the afternoon of the inspection. The manager and staff explained that this person had these outbursts periodically and that medical and specialist nursing advice had been sought about how to best calm and reassure the resident. However, the person’s care plans did not include information about their psychological care or what kind of interventions by staff might help relieve their anxiety. The care plans should be sufficiently detailed to guide staff about the care needed to meet residents’ assessed needs and care records should show whether the actions taken were effective in practice. The storage areas and medicine administration records (MAR) were examined. The home has a well-organised system for the ordering, storage and administration of medicines. Each resident’s medication is kept in individual boxes in a locked medicine trolley. There is separate secure storage for Controlled Drugs and a fridge for medicines that need cold storage conditions. Staff were observed to speak kindly and respectfully to residents. They were sensitive to residents’ need for privacy and knocked on their bedroom doors before entering. At lunchtime, staff assisted those residents who needed help to eat their meals in an unhurried and discreet way. Two residents spoken with said that the ‘staff are wonderful’ and ‘really helpful’. The shared bedrooms have mobile curtain screens to provide some measure of privacy for residents sharing. The small size of the assisted bathrooms and toilets makes it difficult for staff to transfer residents in and out of wheelchairs and onto bath hoists or toilets with ease. Residents have to be transported on bath hoist chairs through the lounges and narrow corridors to the bathrooms. Staff spoken to confirmed they received instruction during induction with regard to resident’s privacy and dignity and were able to provide examples of best practice. Comment cards received showed that relatives and visitors felt that residents’ privacy is respected, and that they can visit residents in the privacy of their rooms if they so wish. Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 Residents are limited in having opportunities to exercise choice in relation to social activities. EVIDENCE: On the day of the inspection there were no activities being provided for the residents. The only day that activities are planned is a Wednesday and this is really enjoyed by the residents. Thought could be given to extending the hours of the activities coordinator to enable her to extend the time she spends with the residents. The inspector spent some time with the care assistant whose role changes on a Wednesday to that of the coordinator and found that they were busy preparing for Halloween and the more able residents were making masks in readiness for a Halloween party. Care is taken to try and include as many residents as possible on the Wednesday and the coordinator tries to spend time with each resident in the limited time she has. A comment card received from a health professional stated ‘a new social co-ordinator is doing well at entertaining residents’. Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 There is a clear complaints procedure with some evidence that residents and their representatives feel that their views are listened to and acted upon. Since the last inspection the system for vetting and recruitment of new staff has shown some improvement. The former induction and practical supervision of some new care staff did not consistently ensure that their communication skills and care practices safely met residents’ needs. EVIDENCE: The procedure for making a complaint can be found in a folder at the entrance to the home. One relative spoken to on the day of the inspection confirmed that communications with the staff and the manager were good. It was also confirmed that any areas of concern would be addressed promptly. The relative told the inspector that he was very happy with the care his mother received. The manager confirmed that she has received no complaints about the care or facilities provided. The CSCI received two formal complaints about the home in February and April 2005. The first complaint related to the poor condition of the facilities in the home, specifically the state of décor and furnishings in the room shown to the relative of a prospective service user. The complaint was upheld. The second complaint involved allegations of poor training standards and care practices of some staff, inadequate communication skills of staff, staff Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 Page 14 shortages, financial irregularities and theft, and poor standard of facilities and equipment. The complainant’s concerns related their observations during a period of approximately 18 months before December 2004. A multi-agency investigation of the concerns was undertaken, involving CSCI, police, NHS nurse advisor and Social Services Care managers. CSCI inspectors undertook additional unannounced inspections, talking to residents and visitors, and examined a range of the home’s records. The allegations of thefts from residents were not substantiated. Examination of the home’s procedures for purchasing clothing and toiletries on behalf of residents showed some evidence that best practice was not always followed, and the manager and owner have since changed the system for purchasing and invoicing for additional charges made to residents. Allegations of poor practice could not be substantiated. However, the manager and home owner acknowledged that the poor communication and language skills of some former members of staff may have contributed to misunderstanding about care instructions that resulted in occasional instances of poor care practice. Allegations about lack of resources and poor standard of the home’s environment were upheld. The home owner, and manager undertook to complete an audit of the home’s equipment and accommodation and to provide a copy to the CSCI. Irregularities in staff recruitment, induction, training and supervision records were found by the inspectors and these issues are being addressed through the inspection process undertaken in July and October. Allegations about poor training, induction and supervision of care staff were therefore partially substantiated. Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21 & 26 Abbeycrest does not meet the spatial environmental standards but it was clean and reasonably fresh smelling on the day of the inspection. The standard of the furnishing and fittings in the home is poor overall, with limited evidence of improvement being made through maintenance or future planning for the current building. The home does not present as a suitably equipped environment for care of elderly disabled residents. EVIDENCE: Cleaning was underway throughout the inspection and everywhere was clean, tidy and reasonably pleasant smelling. The building is old and this is reflected in many areas, but the domestic team had worked really hard to maintain standards. The inspectors tested the hot water temperature at 9 taps and four were higher than the safe acceptable temperature of ‘close to’ 43°C. The high temperatures were recorded in the toilet and bathroom in corridor one on the ground floor, and at hand basins in a separate toilet on the first floor and a resident’s room. Bath water temperatures were within the safe range. Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 Page 16 However, there is a potential for vulnerable residents to scald themselves if the water temperature is not controlled effectively. The water temperatures at all taps accessible to residents should be checked and adjusted more frequently. The rooms do not have en-suite facilities. The lavatories are not easy for disabled residents to use without staff assistance, because the toilets are positioned close to a room wall and at a slight angle (though there are wall bars and frames around the toilets). Residents have commodes in their rooms. The inspectors looked in the linen cupboards and found towels and bed linen were in a poor condition, with frayed towels and worn, faded sheets. A bed in an unoccupied shared room was noted to have a worn and damaged headboard, a torn plastic mattress cover, and stained pillows, some without protective covers. One professional visitor’s comment card summed up the poor impression given by the appearance of the home and equipment: ‘the fabric of the home is tatty and unsatisfactory: sinks and washing facilities are rudimentary. Flooring seems uneven.’ Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 The records of the home’s recruitment procedures do not demonstrate a consistent and robust system, so that there is a potential for vulnerable residents to be at risk from staff who have not been adequately screened prior to their employment. EVIDENCE: Three staff files were inspected and it is clear that the manager is endeavouring to improve the standards of recruitment. However, it is essential that prospective employees have a clear work history and that any gaps in previous employment are queried and the reasons given by the applicant documented. A brief record of the recruitment interview should be kept. It might be helpful to implement a front sheet checklist to ensure all the necessary checks have been completed and that the home meets the requirements under Schedule 2 of the Care Homes Regulations 2001. There was no evidence that police checks had been undertaken for people who provide regular professional services for residents in the home such as hairdressers and podiatrists. All staff who have ‘unsupervised contact’ with vulnerable adults in the care home must have a Criminal Records Bureau (CRB) check. The manager said she was unaware of this requirement and would ensure the necessary checks were undertaken. Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 There needs to be a more rigorous and systematic way of accounting and record keeping in respect of the personal funds of residents held on their behalf by the home. Regular formal supervision of staff is taking place with records appropriately made and stored. The system in place for recording routine maintenance and safety of equipment checks, health and safety issues and risk assessments is not well organised and should be improved, to demonstrate that the safety and welfare of residents and staff are promoted and protected. EVIDENCE: The registered manager has worked in the care home for many years and has extensive experience in care of older people. She is a registered nurse and has undertaken the Registered Manager’s Award (National Vocational Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 Page 19 Qualifications NVQ 4). There were positive comments from visiting professionals about her abilities - ‘the matron is very good - has good feel for the patients’. However, the inspectors are concerned about the manager’s initial lack of awareness and delay in ensuring the implementation of the vetting and recruitment processes for all new staff. The manager should make sure that she is fully conversant with the Care Standards Act 2000, Care Homes Regulations 2001 and current CRB requirements in relation to her role in ensuring the fitness of all workers coming into the care home. There is only one bank account for the home for all financial income and outgoings, including fees and residents’ individual records of monies spent. Relatives manage the financial affairs of the residents who lack the capacity to do so independently. The money of individual service users is pooled into the company bank account; no interest is accrued the proprietor told the inspector. The inspectors saw the records of transactions and expenditure made on behalf of residents: these were itemised e.g. for hairdressing and chiropody. A small petty cash ‘float’ is kept for immediate purchases required by residents. It was said that relatives could have photocopies of these records on request. Petty cash receipts are kept in bulk and there is no clear tracking system that would enable a resident or their relative to establish the precise expenditure for small personal purchases made on behalf of the resident and then invoiced to them as additional charges. When a resident dies, according to the owner, any outstanding monies in their account are returned to relatives or representative. However, there was no clear evidence of this in the records for deceased residents. Evidence was seen of the bank statements alongside an envelope of receipts. The home’s owner said that his accountant audits the home’s accounts annually. The proprietor’s daughter works part-time to maintain the accounts and financial records for the business and deals with invoicing and staff salaries. There was evidence of appropriate insurance cover for the business and legal liabilities to employees and service users. The business plan for the establishment involves the submission of draft building plans for a new care home and ‘close care’ apartments to the local planning department, and if approved, construction of the proposed development in 2006/7. Re-submission of plans is due by the end of November 2005. Formal supervision of staff now takes place on a regular basis and the supervision is recorded and kept on staff files. This ensures that all areas of practice are regularly monitored and staff supported through any difficulties. Two members of staff interviewed confirmed that supervision now takes place on a regular basis and checking the staff files further evidenced this. There is now a supervision agreement in place and a specific proforma for supervisors to follow. Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 Page 20 The records for the routine maintenance and servicing of equipment were seen but were poorly organised, so that it was difficult to establish whether all the records were up to date and, where service engineers had recommended action to repair or upgrade equipment, it was not evident whether their recommendations had been implemented. The proprietor and manager should identify the roles and responsibilities for routine maintenance and repairs and maintain a clear record to demonstrate a systematic and thorough approach to health and safety issues in the home. The bathroom in corridor one was also extremely cluttered with hoists and a variety of equipment. The bath hoist frame (first floor bathroom) that was noted to have a peeling and damaged surface at the last inspection had been partially made good, but the underside of the frame was still damaged. The surfaces of shared equipment should be properly sealed so that they can be cleaned effectively and do not pose a risk of skin damage to residents. The home has no sluice disinfector machine for the effective cleaning and disinfection of commode inserts. The proprietor said that there is no room in the current building to install one. It was not clear what procedure is used for disinfection of commodes and urinals. A written ‘day routine’ task list for care staff stated that ‘commode pots are soaked weekly’. The home should have a detailed written guidance for staff about the type of disinfection solution and dilution to be used, with safeguards for staff and residents to reduce the risk of accidental injury from splashes, ingestion or contamination from cleaning chemicals. Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 Page 21 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 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 Score X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X 2 X X X X 3 STAFFING Standard No Score 27 X 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 2 3 X 2 Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations Ensure that care plans are sufficiently detailed and regularly updated to show the actions that staff should take to meet the residents’ assessed needs. Evaluation of care given should also be included in the care records. * Increase the opportunities for social and recreational times for residents by increasing the hours for a designated activities co-ordinator and involving all care staff routinely in the organised and informal activities in the home. * Residents’ preferred daily routines, hobbies and pastimes should be included in their care plans; and evaluation of their psychosocial care. * Replace worn and damaged items of bed linen and towels. * Replace the damaged bed head identified during inspection. * Replace damaged protective pillow and mattress covers. DS0000027139.V252757.R01.S.doc Version 5.0 Page 23 2 OP12 3 OP24 Abbeycrest Nursing Home 4 OP25 5 OP29 6 OP31 7 OP35 8 OP38 Ensure that the hot water temperature is checked at all outlets accessible to vulnerable residents with sufficient regularity to identify any faulty controls and to take prompt action to ensure it is consistently maintained at or close to the safe recommended maximum. * Review staff records and provide a tracking system to show that they contain evidence of a thorough and consistent recruitment process. * Two staff should interview prospective new employees and keep a record of the interview schedule and responses. * CRB checks must be undertaken for workers who carry out work in the home and have unsupervised contact with residents. The manager should ensure that she is familiar with her responsibilities and accountability in relation to current CRB requirements and the assessment of fitness of workers under the terms of the Care Standards Act and Regulations. The home’s records of residents’ personal allowance accounts should be improved to show accurately the amounts deposited and withdrawn in respect of each individual. Written verification of the refunding of outstanding balances should be given. * The home manager and proprietor should clarify staff roles for health & safety issues and maintenance and repairs and their individual responsibilities for ensuring that systematic up to date records are maintained and easily accessed. * There should be a detailed written procedure for staff for the cleaning and chemical disinfection of commodes and soiled equipment. This should identify appropriate and effective methods of disinfection, and should include measures to safeguard staff and residents from risk of accident, contamination or cross-infection. * The surface of the damaged bath hoist frame should be repaired. Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Abbeycrest Nursing Home DS0000027139.V252757.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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