Inspection on 02/09/05 for Acorn Hill Nursing Home

This inspection was carried out on 2nd September 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Acorn Hill Nursing Home 10/06/09

Acorn Hill Nursing Home 10/07/08

Acorn Hill Nursing Home 21/09/07

Acorn Hill Nursing Home 12/04/07

Acorn Hill Nursing Home 12/04/06

Acorn Hill Nursing Home 15/04/05

Acorn Hill Nursing Home 02/09/04

Acorn Hill Nursing Home 28/01/04

Similar services:

Trevayler Residential Care Home

St Marys Nursing Home

Thornham Grove

Cheaney Court Care Home

Thistle Hill Hall

Chater Lodge

Conifer Lodge

Tixover Care Home

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

CARE HOMES FOR OLDER PEOPLE Crown Hills Nursing Home Rowlatts Hill Road Leicester Leicestershire LE5 4UH Lead Inspector Mrs Janet Browning Unannounced 2 September 2005 09:00am nd 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. Crown Hills Nursing Home C51 C01 S1897 Crown Hills Nursing Home V238748 020905 Stage 2.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Crown Hills Nursing Home Address Rowlatts Hill Road Leicester LE5 4UH 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) 0116 276060 0116 2761428 GB Care Ltd Mrs Maria Anne Read Care Home (CRH) 49 Category(ies) of Dementia - over 65 years of age (DE(E)) 49 registration, with number both, Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (MD(E)) 49 both, Learning disability over 65 years of age (LD(E)). Crown Hills Nursing Home C51 C01 S1897 Crown Hills Nursing Home V238748 020905 Stage 2.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: To be able to admit the named person of category LD named variation number V8757 dated 11/06/04. To be able to admit the named person category DE as identified in variation application No. V7975 dated 2 June 2004 for periods of respite care. To be able to admit named person of category MD/PD named in variation application number V12445 dated 28/09/04 for a limited period from 12/11/04 until the final date 10/12/04. To be able to admit the named person of category MD named in variation application number V21395 dated 16/6/05 for a limited period from 20/6/05 until date 07/7/05 Date of last inspection 15/04/05 Brief Description of the Service: Crown Hills Nursing and Residential Home is a care home offering accommodation for up to forty nine older people. The home is registered to admit older people with dementia and/or mental disorders. The home is located in a residential area to the east of Leicester. It is easily accessed by road using the outer ring road. The centre of Leicester is approximately fifteen minutes away by car and there are adequate car parking spaces. A bus service is available from outside the home with more frequent bus services available near to the home. The buses Number 54 and Number 16 supply a service passing every ten minutes. The building itself is a purpose built modern property offering accommodation on three levels. The majority of rooms available are situated on the ground and first floors. The home is equipped with a slow moving lift. There is a large garden to the rear of the property with a lawned area, established plants and trees and a patio area with seating. All areas of the home and outside areas are accessible for people with mobility impairments. Crown Hills Nursing Home C51 C01 S1897 Crown Hills Nursing Home V238748 020905 Stage 2.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on the 2nd September 2005. The inspection commenced at 9.00am and finished at 5.00pm. When undertaking inspections, the Commission for Social Care Inspection (CSCI) focuses on the outcomes for clients living in a home. To support this, four residents living at Crown Hills were ‘case tracked’. This means that the care records of four clients were checked; the clients themselves were spoken with where possible, as well as two members of staff supporting their care. Due to the category of residents residing in the home, the inspector was not able to speak with any of the residents case tracked but the opportunity was taken to speak with one resident who was able and one relative visiting the home at the time of the inspection and to examine some of the home’s documentation was also examined. The recommendations and requirements arising from this inspection are a direct result of case tracking and other observations made by the inspector during and after the inspection. What the service does well: What has improved since the last inspection? The home has improved the assessment process and the care plans for wound care are now of a very good quality and following recommended clinical guidelines. Qualified staff are given extra time to enable them to be able to review documentation. The reviewing and improving of care plans is an ongoing project. Shift patterns have been maintained to ensure residents are more adequately supervised during meal times and the morning medication is more efficient. Crown Hills Nursing Home C51 C01 S1897 Crown Hills Nursing Home V238748 020905 Stage 2.doc Version 1.40 Page 6 Creams are being stored more efficiently in the medication room. The fridge temperatures are being monitored correctly. Accident records are more detailed and are audited by the manager and risk assessed. The monitoring of fire precautions in the home is being performed regularly. Formal supervision of staff has been commenced. What they could do better: The Statement of Purpose could be reviewed to include all the information regarding all the services the home provides. Although some care plans have been improved, the home needs to ensure that all care plans being used set out in detail the action to be taken by staff to meet residents’ needs. Risk assessments are still not being performed on residents with identified risks as soon as they enter the home and they are not being reviewed monthly. Some risk assessments need more detail and care plans are not generated form the risk identified in any assessment. Residents and/or their family and friends are not routinely being involved with the residents’ care records. Not all care records are maintained as per good record keeping guidelines. The health and welfare of residents is potentially being put at risk due to some poor care practices in relation to pressure area care and urinary catheter care, which the home were instructed to address immediately. Some aspects of the home’s medication procedure still have the potential of putting residents at risk of harm. Communication with community health professionals could be improved. Residents’ preferences in regard to what they want to wear to protect clothing whilst eating were not being sought or recorded. Activities preferences were also not recorded nor when or which resident had taken part in an activity. The indications were that the hours allocated for activities did not appear adequate to meet the needs and capabilities of the residents. Staff were still unsure of what the correct reporting procedures were for suspicions of adult abuse. Some aspects of the home and some residents’ rooms appeared worn and in need of re-decoration in places and some aspects of the home were in need of repair to protect residents form risk of harm. Some residents’ rooms were untidy due to inefficient storage of unused bed linen. Whilst there was lots of equipment evident, the home should consult with outside agencies as to the appropriateness of some equipment and furniture being used. Crown Hills Nursing Home C51 C01 S1897 Crown Hills Nursing Home V238748 020905 Stage 2.doc Version 1.40 Page 7 Quality assurance systems in place do not include either resident feedback or the views of family/friends or outside agencies. The manager does not always have time to monitor staff due to the need to complete paperwork. Moving and handling procedures in the home could put residents at risk of harm. The home was instructed to address this issue immediately. 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. Crown Hills Nursing Home C51 C01 S1897 Crown Hills Nursing Home V238748 020905 Stage 2.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 Crown Hills Nursing Home C51 C01 S1897 Crown Hills Nursing Home V238748 020905 Stage 2.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) 1, 3, 4 and 6 Generally the assessment process is adequate to assure residents and/or their representatives that the home can meet their needs. EVIDENCE: The home has a Statement of Purpose which states the home’s aims for providing care for people with dementia care and mental health needs, but it does not state how the home can meet the needs of people who’s primary need is dementia care but who also have physical needs. Then home performs a detailed assessment process prior to admitting a person into the home so that the home can be sure that all the resident’s needs could be met. The assessment process currently used is a new development in the home and is performed by qualified nurses. The home specialises in providing services for people with mental health and dementia care needs, but some residents also have physical needs. The nurses have a mixture of registered mental health and general qualifications to meet both mental and physical needs. Crown Hills Nursing Home C51 C01 S1897 Crown Hills Nursing Home V238748 020905 Stage 2.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, 9 and 10 The home procedures for maintaining residents’ health and welfare are varied and could put residents’ health at risk. EVIDENCE: The home produces care plans from the assessed needs, which, on the whole, are now being reviewed monthly. Most of the evaluations show the reader the effectiveness of the care being provided via the care plans. However, one resident who had been admitted eight days ago, still did not have any risk assessments or care plans in place, despite the pre-admission assessment identifying that a hoist was required for moving and handling. Also residents did not have adequate detail of the correct techniques to be used for moving and handling or had conflicting care plans in place. Established residents did have risk assessments in place but not always in adequate detail or have care plans developed from these assessments. They were not always reviewed regularly. Again care records varied with some having very good details of residents’ likes and dislikes and some only having scant detail. There has been some improvements in care plans but care plans varied from being good for the mental health aspect of care and wound care to poor for the physical needs of the resident. There was evidence of poor practice in relation to catheter care from documentation, talking with visiting healthcare Crown Hills Nursing Home C51 C01 S1897 Crown Hills Nursing Home V238748 020905 Stage 2.doc Version 1.40 Page 11 professionals and from direct observation, all of which puts residents’ health at risk. One resident was observed still having a night bag on which was wrapped around her leg and hanging without any attachment to the leg. It was evident from talking with staff that they were not aware of when to change leg bags and there was evidence in a resident’s notes of incorrect procedures regarding the care of catheters and the resident having frequent urine infections. Doctors or community nurses were not being called as soon as a problem was identified. Care plans did not have sufficient detail to guide staff. The home was instructed to address this situation immediately. The care plans for wound care for the pressure sores were of a high quality and following best practice. However, there was evidence of the action detailed in the notes not being followed. A resident, who was under the care of the community nursing service, developed a pressure sore, which was not reported to the community nurses for two days, with the nurses in the home treating the sore. The resident was now under the care of the nurses in the home. The pressure area care for this resident was not being followed as per the care plan or as per best practice. The resident had a large sore to the sacrum and had not had his position altered for over four hours. The documentation for another resident with a large pressure sore showed that she had not had her position altered over night for over fourteen hours. The home was required to address these issues immediately. A nurse was observed administrating medication during the inspection. Examinations of drug charts indicated that medication appeared to be given correctly, but it was noticed that not all medication was being administered legally. For example, residents prescribed Lactulose for constipation, were having it administered from one bottle with one resident’s name on it. This is not legal practice and is unsafe as administration directions can be printed on labels specific to a particular person. Details of for what behaviour “as required” sedation should be given was still not being recorded in care records or documented in residents’ records when it had been given and why it was given. This was a requirement at the last inspection. Staff were observed treating residents with dignity and respect at all times. Staff explained to residents what they were going to be doing and dealt with challenging behaviour sensitively and calmly. Residents were seen wearing plastic aprons to cover clothes at meal times when cloth aprons were available. There was no indication as to whether residents chose this. Crown Hills Nursing Home C51 C01 S1897 Crown Hills Nursing Home V238748 020905 Stage 2.doc Version 1.40 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 standard(s) 12 The home’s activities programme is limited and does not always meet all residents’ capabilities. EVIDENCE: The activities organiser was on annual leave during the inspection and the home had not arranged cover so residents could continued to receive a programme of events. During the inspection, the only activity available for residents was the television or sitting in the garden. The organiser works two hours a day Monday to Friday, which limits the amount of activities that can be provided. The categories of residents in the home are that many have cognitive impairment. The organiser does not keep records and there is no record of residents’ preferences or capabilities for activities. There was no evidence that the specialised needs of residents were being met. The registered manager demonstrated a list of activities, but this was informally written and not available for residents or relatives. This showed that the residents who are able, go on trips out such as on boat trips, but without documentation it was difficult to see who had attended. The registered manager stated that she did not want the organiser to spend time away from the residents writing records. The time allocated of two hours a day, five days a week for over forty residents was discussed. Crown Hills Nursing Home C51 C01 S1897 Crown Hills Nursing Home V238748 020905 Stage 2.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) 18 Staff awareness of correct procedures for adult protection is inadequate to ensure residents are protected from risk of harm. EVIDENCE: On discussions with staff, the indications are that staff are still not fully aware of what constitutes abuse or when to report it. One senior staff member stated that she would report residents being forced to go to bed only if it kept re-occurring. The registered manager reported that a recent referral for investigation under adult protection was deemed inappropriate by staff and that they couldn’t understand why it needed to be reported. The registered manager demonstrated that she is fully aware of the correct adult protection procedures and understood the importance that the all staff should be aware of this procedure, especially senior staff. There is a detailed document for staff to read regarding adult protection. The need for training for staff was discussed as this standard had deteriorated since the last inspection Crown Hills Nursing Home C51 C01 S1897 Crown Hills Nursing Home V238748 020905 Stage 2.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, 22 and 24 The premises and residents’ rooms are not always maintained to promote residents’ safety or comfort. Generally equipment in the home meets residents’ needs. EVIDENCE: On walking around the home, by the afternoon, the home was clean and tidy. One domestic was away that day. Individual rooms seen were suitable for the residents and residents’ own possessions were evident. However, the home and rooms looked worn and shabby in places. The registered manager stated that there was a programme of decorating in place. One toilet upstairs had broken tiles on the floor and hole in the wall. One room seen during case tracking at the end of the inspection had still not had the bed made and another shared room, which the residents had MRSA, had stains on the walls. Bed linen and pillows piled high on the chair next to the resident’s bed. Both residents were asleep in bed. Crown Hills Nursing Home C51 C01 S1897 Crown Hills Nursing Home V238748 020905 Stage 2.doc Version 1.40 Page 15 One resident was able to have their own key to the room, which gave the resident a feeling of security. The garden was well maintained and secure with a locked external gate, and residents were seen wandering around the garden on a sunny day. External fire doors were alarmed to alert staff if residents had left through these doors. The indications are that the home meets fire regulations and keeps regular checks such as on fire alarms and escape routes. One resident was observed sitting in the first floor lounge, continually slipping down in the recliner chair and looked very uncomfortable. The registered manager stated that the relative insisted that this chair was used when another chair was more appropriate. A discussion took place regarding the resident’s safety and comfort and for consultation with other agencies and professionals and advocacy services. During the inspection, the home received a delivery of manually adjustable beds for caring for residents in need of nursing care. Only two types of slings are available, one for residents with good upper body strength and one that required staff to lift residents to place underneath them to use the hoist. Moving and handling belts were used for residents who were able to take weight through their lower limbs. Crown Hills Nursing Home C51 C01 S1897 Crown Hills Nursing Home V238748 020905 Stage 2.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 and 30 The numbers of staff on duty ensures that residents’ needs should be met, and generally, staff receive training to enable them to meet residents’ needs. EVIDENCE: The staff rota indicated that staffing levels are over that recommended by the Department of Health Residential Forum guidance. The registered manager has rearranged shift patterns to ensure activities of peak activity are adequately covered such as meal times and medication. The manager is also looking at ways to ensure that junior staff are supervised whilst providing care. The indications are that there are adequate numbers of qualified nurses to meet residents’ nursing needs. Nurses now have extra time to complete care records and provide staff supervision. Over 50 of staff have completed NVQ 2 and twelve more members of staff are enrolled to start the NVQ course this year. One staff member training record indicated that the induction, which is supposed to be taken over twelve weeks, had been completed in one day. The manager was not aware of this. Staff had received training on items such as nutritional awareness, moving and handling, food hygiene, with many more training planned for the future. Crown Hills Nursing Home C51 C01 S1897 Crown Hills Nursing Home V238748 020905 Stage 2.doc Version 1.40 Page 17 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) 31, 33, 37 and 38 Generally quality assurance is improving, but some working practices in the home do not promote the health, safety and welfare of residents in the home. EVIDENCE: The registered manager has just completed NVQ 4 management course and is going to be taking further modules in management. One of the deputy managers has commenced the NVQ 4 management course. Working practices in the home regarding moving and handling gave cause for concern. For example, two carers were observed lifting a resident under the armpits to apply a hoist sling underneath. This puts residents and carers at risk of harm. Staff have received training on moving and handling. The door to a sluice room upstairs was unlocked with chemical liquid used in the sluice machine accessible to residents. The registered manager dealt with this straight away and a new lock was fitted. Crown Hills Nursing Home C51 C01 S1897 Crown Hills Nursing Home V238748 020905 Stage 2.doc Version 1.40 Page 18 The use of bed rails had risk assessments but not as per best practice guidelines. The manager has developed good systems for some auditing including medication, care records and accident records. The home holds regular staff meetings and minutes are taken. The home does not hold regular residents and/or relatives meetings due to the category of residents and finding it difficult to get relatives to attend. Regular questionnaires for relatives have been tried but the home did not receive a response. Discussions were held regarding the home trying different formats to obtain external views about the home. The indications were that the manager was not always aware of the working practices being performed by the care staff despite receiving training and did not spend a lot of time monitoring staff on the home floors. The manager stated that she did not always have time due to paperwork. The home does not have an administrator. Accident records are well maintained and the manager keeps good records on maintaining the effective working of the home. Where the home varies is in the record keeping of residents’ care records. Some are of a good standard and some have many aspects missing or are not signed or dated. Residents and/or their relatives/representatives are not involved in the personal records. Records are stored safely to maintain confidentiality. Carers receive drills in fire evacuation and records were kept of checks on systems to maintain safety e.g. water temperatures. Care staff receive training in infection control. Many of the home’s residents are vulnerable and some are at risk of wandering off the premises. The home is secure and residents, although free to wander, the indications are that they would be unable to leave the building without staff being aware. Staff now receive formal supervision. This has just commenced with nurses supervising care staff and the manager supervising the nurses. Crown Hills Nursing Home C51 C01 S1897 Crown Hills Nursing Home V238748 020905 Stage 2.doc Version 1.40 Page 19 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 3 x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 x COMPLAINTS AND PROTECTION 2 x x 3 x 3 x x STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 3 x 2 x x 3 3 1 Crown Hills Nursing Home C51 C01 S1897 Crown Hills Nursing Home V238748 020905 Stage 2.doc Version 1.40 Page 20 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 7.2 Regulation 15 (1) Requirement The home must ensure that all care plans set out in detail the action which needs to be taken by care staff to ensure that all aspects of health, personal and social care of the resident are met. (Previous timescale 15/04/05) The home must ensure that risk assessments are performed on all new residents entering the home and care plans generated from any identified risk. (Previous timescale 15/04/05) The home must ensure that doctors or community nurses advice is sought as soon as a problem is identified. The home must ensure that residents health is promoted and maintained in relation to care of urinary catheters. This must be in line with best practice. The home must ensure that the treatment and pevention of pressure sores is followed as per care plans and in line with best practice. The home must ensure that medications are administered Timescale for action 14/10/05 2. 7.3 13 (4) 14/10/05 3. 8.1 13 (1) (b) 14/10/05 4. 8.1 12 (1) Immediate 5. 8.1 12 (1) Immediate 6. 9.4 13 (2) 14/10/05 Page 21 Crown Hills Nursing Home C51 C01 S1897 Crown Hills Nursing Home V238748 020905 Stage 2.doc Version 1.40 7. 9.4 13 (2) 8. 18.2 13 (6) 9. 19.1 13 (4) 10. 38.2 13 (5) only to those residents to which they have been prescribed. Bulk administration of medication must only occur if authorised by the GP. The home must ensure that guidance on the use of PRN medications is provided in care plans and that the use of PRN medications are documented in residents records. This is especially pertinent in the use of sedation. (Previous timescale 15/04/05) The home must ensure that all staff are trained in the correct procedures in reporting abuse in line with Department of Health No Secrets guidance. (Previous timescale 15/04/05) The home must ensure that all areas of the home are free from unnecessary risks to residents. The upstairs toilet must have the broken floor tiles replaced. The home must ensure that arrangements are made for the safe moving and handling of residents including the appropriate equipment, detailed care plans and staff training. (Previous timescale 15/04/05) 14/10/05 14/10/05 14/10/05 Immediate. 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 1.2 7.4 Good Practice Recommendations It is strongly recommended that the homes Statement of Purpose includes all the services the home provides and all the needs catered for. It is strongly recommended that all risk assessments are reviewed monthly, updated to reflect any change in need and actioned. C51 C01 S1897 Crown Hills Nursing Home V238748 020905 Stage 2.doc Version 1.40 Page 22 Crown Hills Nursing Home 3. 4. 5. 6. 7. 8. 9. 10. 7.6 8.1 10.1 12.1 12.3 12.3 19.1 22.1 11. 12. 13. 14. 15. 22.4 24.1 33.3 33.6 33.7 16. 17. 37.1 38.1 It is strongly recommended that all care plans are drawn up with the involvement of the resident and/or relative/representative. It is recommended that the home builds up good communication links with community nursing services. It is recommended that residents wear appropriate covering at mealtimes that respects their dignity and is of their choosing. It is strongly recommended that the home provides adequate activities having regard to the number and needs of all residents, which suits their needs and preferences. It is recommended that the interests of residents are recorded. It is strongly recommended that particular consideration is given to activities for people with dementia and other cognitive impairment. It is recommended that a programme of re-decorating and maintenance takes place in all aspects fo the home. It is strongly recommended that the home ensures that the appropriate chairs are used to meet residents needs and that consultation takes place with other agencies.e.g Occupational therapists, social services. It is strongly recommended that the home consults with external agencies regarding the types of slings to use with hoists to meet all residents needs. It is recommended that residents rooms are kept tidy. It is strongly recommended that the registered manager monitors the quality of care and working practices being provided by the care staff. It is recommended that the home devises ways of obtaining feedback from residents regarding the services the home provides. It is recommended that the home devises ways of obtaining views of residents family and friends and stakeholders in the community on how the home is achieving goals for residents. It is srongly recommended that residents personal records are kept updated and accurate and in line with NMC guidelines for good record keeping. It is srongly recommended that the risk assessments for the use of bed rails is as per best practice guidelines. Crown Hills Nursing Home C51 C01 S1897 Crown Hills Nursing Home V238748 020905 Stage 2.doc Version 1.40 Page 23 Commission for Social Care Inspection The Pavilions 5 Smith Way, Grove Park Enderby, Leicestershire LE19 1SX 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. 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