CARE HOMES FOR OLDER PEOPLE
Abbeycrest Nursing Home Essex Way, Kennylands Road, Sonning Common, Reading Berkshire RG4 9RG Lead Inspector
Delia Styles Unannounced 19 July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Abbeycrest Nursing Home H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Abbeycrest Nursing Home Address Essex Way, Kennylands Road, Sonning Common, Reading, Berkshire, RG4 9RG Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01189 724414 abbeycrest01@hotmail.com Abbeycrest (Reading) Ltd - Eric Jennings Mrs Lesley Wright Care Home with Nursing 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Abbeycrest Nursing Home H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 15 November 2004 Brief Description of the Service: Abbeycrest is situated on the outskirts 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 easy reach of a local bus service, village shops, library and doctors surgery. 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 kitchen on the ground floor. Residents accommodation is provided in 14 single and 5 shared (double) rooms. The rooms are equipped with a washbasin. There are 3 bathrooms one on the ground floor, two on the first - and three separate toilets. A small passenger lift and stairs serve the first floor. The home is set in a large plot of ground, laid to grass with a large mature tree and garden seat overlooking a stretch of common land and public footpath beyond, at the rear of the building. A paved patio area and flower beds with garden benches are reached via a fire exit door. There is gravelled parking space for cars and flower beds at the front approach to the building. Abbeycrest Nursing Home H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and was undertaken by 2 inspectors and lasted for 6 hours. The inspectors spoke to the registered manager and 3 staff members and most of the residents. The home’s premises were toured and a sample of residents’ care records and staff records were inspected. Three additional unannounced visits have been made since the last inspection of the home as part of an investigation into 2 complaints received by the Commission. Also, a NHS senior nurse from Oxfordshire and a care manager from Berkshire visited the home over 2 days to review all the residents’ care needs and a report with some recommendations was given to the Home’s manager. The home’s owner, Mr Jennings, and registered manager, Ms Wright, met with the inspector and a Regulation Manager from CSCI to discuss the complaints and were required to submit an action plan to the Commission showing what they will do to improve or change some practices in the home that were found to be unsatisfactory. What the service does well: What has improved since the last inspection?
New dining chairs and tables have been purchased for the dining room and first floor sitting room. Individual rooms have been redecorated and recarpeted. The home’s manager, and another registered nurse have worked to develop the opportunity for care staff to undertake National Vocational Qualification (NVQ) training and have started the process of having regular ‘supervision’ meetings with staff. Supervision for all staff is good practice as it gives individual employees the chance to have time set aside with their manager or a senior staff member to discuss their work, progress and any concerns. One staff member has successfully completed an ‘adaptation’ course so that she can apply to be registered with the Nursing and Midwifery Council to practice as a nurse in this country. The staff member enjoys working in the
Abbeycrest Nursing Home H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 Page 6 home and hopes to continue working at Abbeycrest, which will increase the number of registered nurses employed by the home. A carer now has additional responsibility for organising activities with residents once a week, which she and they are enthusiastic about. What they could do better:
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 acknowledges 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 has been rejected to date. The most recent amended application was under consideration by the planners at the time of writing this report. 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 (even in the event of the planning permission being granted). The home was first registered in 1988 and, though it met the registration criteria at that time, much of the building is not suitable for more heavily dependent service users. Following this inspection the inspectors made a requirement in respect of room doors being wedged/propped open. This is poor practice because it puts residents at risk of injury from smoke or flames in the event of fire: closed doors will slow down the spread of fire and give longer protection time for residents while waiting for rescue. This requirement has been made at previous inspections and further failure by the home to stop this practice, may result in the Commission taking enforcement action. The recruitment records for staff were incomplete and must be improved to show that the manager and home’s owner always follow a thorough and consistent process for checking references and interviewing all new employees. The employer must be able to show that he has taken all reasonable precautions to protect vulnerable older residents from potential harm by only employing people who have satisfactory references, skills and experience, police checks and who are legally available to work in the UK. The home’s system for checking individual resident’s risk of falls or accidents should be kept up to date and included in their care records. The protective surfaces of disability equipment (bath hoists, for example) should be regularly checked and where damaged, be replaced or re-sealed, to reduce the risk of injury to residents’ and staff, and the spread of infection. The home burns domestic waste in a container at the rear of the home; this was seen to be closely located to combustible materials. This practice should be discontinued because of the risk of fire and injury to workers, residents and staff and pollution affecting neighbouring properties.
Abbeycrest Nursing Home H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 Page 7 The home’s records of formal supervision sessions with care staff should be improved. The home’s system for conducting interviews of prospective employees should be improved, by having two interviewers and both making written records of their opinions of the prospective employee’s suitability to work in the home. 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 H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Abbeycrest Nursing Home H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 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 standard(s) 3 & 5 The process for assessing prospective residents is satisfactory and they, and relatives and friends can visit the home to assess the facilities and suitability of the home before they move into it. EVIDENCE: Residents’ care records included assessment information from care managers and from interviews with the residents and family prior to their admission that had been undertaken by the manager or a senior nurse from the home. A review of the care needs of residents undertaken by a nurse from Oxfordshire Primary Care Trusts and a care manager from Berkshire confirmed that the assessment of residents’ needs by the home’s staff was accurate. Abbeycrest Nursing Home H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 & 8 The care planning system is satisfactory and provides staff with the information they need to give the appropriate care to residents. The health needs of residents are met with evidence of regular medical reviews and arrangements for residents to attend hospital outpatient clinics for assessment and hospital treatment when needed. EVIDENCE: A sample of care plans was reviewed and showed evidence of regular review and updating, with the exception of the risk assessments (for example, the use of bed rails if someone is at risk of rolling out of bed; or at risk of accidental injury from falls). Risk assessments should be regularly reviewed and updated as people’s conditions and abilities change. The action to be taken by staff to reduce any specific risk to residents should also be written down in the care plan. An NHS nurse and a care manager looked at the care plans and compared them with their assessment of residents’ needs and concluded that the written records were satisfactory, but recommended the use of a specific assessment of residents’ nutritional needs, to see whether they were at particular risk from malnutrition. This method of assessment is being encouraged by dieticians throughout Oxfordshire’s hospitals, residential care homes and for people receiving care from their GP and community nurses at home.
Abbeycrest Nursing Home H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 Residents are encouraged to maintain contact with family and friends and are assisted to exercise choice over their day. Activities are in place but are restricted to one day a week. Residents receive a varied diet in less than congenial surroundings. EVIDENCE: Residents and a relative spoken with during an earlier evening unannounced visit made by inspectors, and during this inspection, confirmed that the home suited their needs and that visitors were made welcome. One visitor said that they liked the fact that the home was small and nearby, so that they could come and see their relative frequently. The home was busy preparing for a barbecue for all relatives, friends and residents, which was to be held later in the week. Currently there is one day designated to activities and residents spoken to looked forward to their “Wednesday Social Club”. The carer is enthusiastic and would like to further promote these activities. In the morning she asks the residents what they would like to do and organises groups of activities as well as individual sessions for those who do not wish to engage in group sessions. The inspector discussed the home’s food arrangements with the cook and she explained the dietary arrangements and choices available. Residents spoken
Abbeycrest Nursing Home H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 Page 12 to confirmed that they enjoyed their meals and were able to have an alternative meal if required. Lunch is served either in the main dining room, the upstairs lounge area or if preferred in the resident’s own room. Despite the purchase of matching new dining tables and chairs since the last inspection, the dining room remains cold in appearance and due to the difficulties staff had in assisting the residents to the dining room, it was a rather drawn out process and not the social occasion it could be. Residents who prefer to eat their meals in their rooms, do so. Staff were seen helping those residents less able to feed themselves Abbeycrest Nursing Home H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 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 standard(s) Standards not assessed on this occasion. EVIDENCE: Abbeycrest Nursing Home H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 23, 24, 25 & 26 The home does not meet the current National Minimum Standards for Care Homes for Older People in a number of environmental aspects. Limited improvements have been made to the décor and dining room furnishings of the home: the facilities do not provide a pleasing environment to live in. If planning permission for the proposed new care home is not granted, and building commenced within the next 12 months, the Commission will require a prioritised and phased plan for improving facilities to be agreed and implemented by the proprietor. EVIDENCE: Outside, the inspectors noted improvements made since the last inspection, in that broken paving to the front of the home had been repaired, and the grass to the rear of the home had been cut in readiness for the summer barbeque. At earlier visits to the home in April and May, the inspectors had found evidence that the call bell system had been faulty and there were several rooms on the first floor where residents had frequently been unable to ring for
Abbeycrest Nursing Home H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 Page 15 staff help. The call bell system was working satisfactorily on the day of the inspection. The home was clean and smelled fresh throughout The armchairs in the communal lounges are of a domestic nature and are old and many look shabby. Much of the furniture has been donated or belongs to current residents. A sideboard in the first floor sitting room has a missing door; old chests of drawers with missing handles are used to store continence products for residents; domestic-style wardrobes are in the corridors and used by staff to keep their personal belongings and change of clothing/uniforms. The worn and damaged appearance of furniture, though it does not pose a risk to residents, does not create a pleasing domestic environment for residents to live in. A bath hoist frame was seen to have a flaking and damaged surface. This should be re-sealed or replaced so that the surface can be properly cleaned to prevent damage to residents’ skin and the transfer of infection. Residents themselves told the inspectors that they liked their rooms and were satisfied with the way in which they could make them homely with their own ornaments and pictures. Abbeycrest Nursing Home H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 Page 16 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30 The home provides sufficient numbers of staff to provide a satisfactory standard of care to residents. Since the last inspection in November 2004 the standard of vetting and recruitment practices has not significantly improved. There were still gaps in the staff files showing that appropriate checks and references are not consistently being carried out and potentially leaving residents at risk. The home is providing opportunities for care staff to undertake National Vocational Qualifications (NVQ) and all new staff to complete induction training. EVIDENCE: The inspectors looked at the staff files. Staff references were provided on the home’s own questionnaire, and were not all signed with the name of the referee or showing what relationship they had with the prospective employee – for example, whether they had employed the person providing the reference. There is a potential for false references to be presented and accepted. The references must be authenticated to show that the home has taken reasonable steps to make sure only suitably trained and competent people are employed to work with vulnerable residents. There was no evidence that a care support worker on placement for 2 weeks in the home through a Healthcare agency had had a satisfactory police check. The manager must ensure that all staff working in the home have been appropriately screened and should have written confirmation from any agency or organisation that wish to place staff in the home.
Abbeycrest Nursing Home H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 Page 17 It is good practice to check that professional references are provided and can be checked as accurate references for the applicant, by phoning the referee. The manager said that she does this, but there was no written record of this. It is good practice for two people to conduct the interviews for new staff, and to have an agreed list of questions and topics, with a written record of the interviewers’ assessment of the candidate’s suitability for the work offered. There was no record of interviews, no job description or letter of appointment in the staff members’ files. Staff files showed that new staff had read health and safety information and other policy documents for the home. Induction ‘checklists’ for new staff were in their files, showing that they had received fire safety training, moving and handling instruction and had been shown how to help residents with basic personal care tasks. However, several of the induction training records were incomplete and/or had not been signed by the nurse supervising the carer’s practice. The manager, and another registered nurse, undertakes the training and supervision of staff in the home. Six of the current care staff had achieved NVQ Level 2 in care and one staff member has NVQ Level 3. The home’s manager is an NVQ assessor. The home has been approved as a suitable workplace for overseas nurses to undertake ‘adaptation’ courses. One staff member has successfully completed an ‘adaptation’ course and was awaiting registration with the Nursing and Midwifery Council to enable her to work as a registered nurse in the home. Another nurse had just started her adaptation course. This will boost the number of registered nursing staff available to work in the home. Abbeycrest Nursing Home H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 &38 The arrangements for regular formal supervision of care staff have now been put in place but are not as frequent as they should be. The management of health and safety aspects of care in the home overall is satisfactory, given the problems caused by the age and design of the building. However, staff fail to consistently demonstrate good fire safety practice potentially putting residents and themselves at risk. EVIDENCE: Staff files showed that several staff had not had the opportunity for ‘supervision’ – a time set aside to discuss their individual work and training needs with a senior staff member. Other files showed that staff had had only one period of supervision to date this year. It is good practice, and important for staff, to have the regular opportunity to discuss their individual progress and any concerns about their work and for written records to be held of these discussions, which should take place at least 6 times a year. Abbeycrest Nursing Home H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 Page 19 The inspectors noted that two first floor room doors were wedged/propped open. Room doors must not be wedged or propped open: in the event of a fire, residents’ and staff safety would be compromised because the correct function of closed fire resistant doors i.e. to slow the spread of smoke and flames, would be lost. The presence of door wedges on window ledges and behind corridor doors indicates that staff use them routinely to hold doors open. Where resident’s personal preference is to have their room door open, or there is a nursing or medical need for staff to have ready access to the person, the fire officer’s advice should be sought and a suitable automatic door closer device fitted. This requirement was also made following the May inspection of the home, with a compliance date of June 1st 2004 and November 2004, with a compliance date of 30th November 2004. Continued failure to comply with this requirement may result in enforcement action being taken. To the rear of the home, adjacent to a lean-to workshop, the inspectors noted that rubbish was being burned, unattended, in a large open metal container. The remains of paper, cardboard and other combustibles in the container showed that rubbish is routinely burned outside the home. There was a propylene gas container on the ground and paint pots in the shed nearby, the surrounding long grass was dry and there was a strong breeze. There was the potential for the fire to spread to the adjoining buildings and put residents and staff at risk. Refuse should not be burned on site – it is a fire risk, environmental pollutant and an annoyance to neighbouring residents. The Inspector of Health and Safety inspected the home in April 2004 and found that the ‘facilities at the home were far from ideal and are giving rise to an increase in the risk of cross infection amongst residents and staff’. The laundry room is extremely small and is located on the first floor, directly above the manager’s office. Water stains from previous leakage from the washing machine were evident on the ceiling of the office and around the ceiling electric light fittings. The Health and Safety Officer had recommended that procedures should be laid down for the handling of soiled laundry. The laundry room is so small that there is insufficient room for correct separation of soiled and clean laundry. The home has no disinfecting sluice machine for the effective cleaning of used commode inserts and other items contaminated by body fluids. A system is in place to ensure that the clean, numbered commode inserts are replaced in the same rooms after use. This situation remains unchanged from previous inspection reports. The Health and Safety Inspector, in her report for April 2004, pointed out the need for a separate rest room for the use of staff: ‘it should be large enough and have sufficient chairs and tables for the number of employees likely to use them at any one time’. Staff use the residents’ dining room for their meal and rest breaks and to write up residents’ care records. The Commission recognises the difficulty in identifying additional space within the current accommodation. However, it would be possible for a new laundry facility and
Abbeycrest Nursing Home H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 Page 20 staff room to be provided in an external (temporary) building to address this need. Abbeycrest Nursing Home H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 1 2 2 x 2 2 2 2 STAFFING Standard No Score 27 3 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x 2 x 1 Abbeycrest Nursing Home H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 Page 22 YES 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 29 Regulation 19; Schedule 2 23 Requirement References and CRB checks for all workers employed in the home must be authenticated and evidence held by the home to that effect. Room doors must not be wedged or propped open. The fire officer’s advice must be sought regarding the fitting of appropriate automatic door closers (linked into the fire alarm system, or acoustically activated by the fire alarm) to doors where a residents care need or preference is to have the room door kept open. Provide at least one sluice disinfector in a suitable space with room for staff handwashing/cleaning and clinical waste disposal bin. Timescale for action September 9th 2005 and ongoing September 9th 2005 and ongoing. 2. 38 3. 26 23 November 30th 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations
H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 Page 23 Abbeycrest Nursing Home 1. 8 Implement the Malnutrition Universal Screening Tool (MUST) to assess residents risk from malnutrition and document action taken where risk is identified. Risk assessments should be reviewed and updated regularly and records maintained in residents care files. Repair or replace the sideboard in the first floor lounge. Reseal or replace bath hoist frame, to provide a smooth surface. Undertake an audit of all furniture and repair or replace damaged and worn items. Review staff records and provide a tracking system to show that they contain evidence of a thorough recruitment process. Two staff should interview prospective new employees and keep a record of the interview questions and responses. Ensure that all care staff receive formal supervision at least 6 times a year and that adequate records of supervision sessions are kept. Discontinue the practice of burning domestic refuse on site: paper and cardboard waste should be sent for recycling. Ensure that all combustible materials are safely stored according to guidance given by HSE. 2. 3. 4. 5. 20 21 24 29 6. 7. 8. 36 38 38 Abbeycrest Nursing Home H57-H08 S27139 Abbeycrest V239328 190705 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 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
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