CARE HOMES FOR OLDER PEOPLE
Adelaide Nursing And Residential Care Home 35 West Street Bexleyheath Kent DA7 4RE Lead Inspector
Maria Kinson Unannounced 22 April 2005 07:25am 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. Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION
Name of service Adelaide Nursing And Residential Care Home Address 35 West Street Bexleyheath Kent DA7 4RE 020 8304 3303 020 8301 0133 Adelaide@schealthcare.co.uk Southern Cross Health Care Ltd 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) Mr M I Gurib Care Home 76 Category(ies) of Dementia (42) registration, with number Old age, not falling within any other category of places (34) Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION
Conditions of registration: Includes one bed for the nursing care of people under 65 years with dementia. Date of last inspection 06.11.04 Brief Description of the Service: The Adelaide Care Centre is a purpose built nursing and residential care home. It was first registered in July 1997 and was then purchased by Southern Cross Healthcare in September 1998. The home is situated in a side road off Bexleyheath Broadway near the railway station, bus services and the shopping centre. There is car parking space on the site. The home is registered for a total of 76 places, with different categories of registration. The home has two floors divided into four separate units providing care for the different categories of service users. On the ground floor, there are 20 general nursing beds and 14 beds for conventional residential care. On the first floor, there are 25 nursing beds and 17 beds for residential care, all for older people with dementia. All of the bedrooms in the home have en-suite facilities. The laundry is sited in a separate building to the side of the home. At the rear of the building there is an enclosed garden. Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Two inspectors carried out an unannounced inspection at Adelaide Care Centre on Friday 22nd April 2005 between 07.25am and 17.25pm. The majority of the time was spent on the first floor nursing unit for people with dementia, a brief tour of the two units on the ground floor was also carried out during the latter part of the inspection. Care, medication, training and recruitment records were examined. The inspectors listened to the handover from night to day staff and observed staff communicating with residents, assisting residents with meals and drinks and repositioning residents who had difficulty moving. Four members of staff, six residents and one relative were spoken with on the first floor nursing unit. Thirty comment cards were distributed to residents, relatives, general practitioners, health care professionals and care managers who had contact with the home. Twelve questionnaires were returned to the commission. What the service does well:
Good systems were in place to ensure that medicines were handled and administered in a safe manner. The new manager had established good working relationships with residents, relatives and staff. The manager visits all of the units regularly and spends time talking and obtaining feedback from residents and staff. The home has a comprehensive complaints procedure. Complaints and concerns were investigated thoroughly and responded to promptly. Good information about the home was provided for prospective service users and staff carried out a thorough assessment of residents needs prior to admission. The home and garden were maintained to a satisfactory standard and further improvements were planned. Domestic staff worked hard to keep the home clean and tidy and action had been taken to improve the standard of cleanliness in the main kitchen. The menu was varied and most of the residents were satisfied with the quality and choice of food provided in the home. The residents and relatives that responded to the questionnaire sent out by the commission were mostly satisfied with the overall care provided in the home. The following comments were made about the staff and manager. “ I like living here and I am very grateful to the staff because they care and treat me very
Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 Page 6 well” and “I have always found the management and staff approachable, helpful, kind and caring”. Access to health care services was good and appropriate equipment was available to staff to reduce the risk of cross infection. Health care professionals that responded to the questionnaire sent out by the commission were mostly satisfied with the care provided in the home and indicated that “staff are always friendly and helpful” and “there is a consistently stable and happy atmosphere on the general and EMI residential units”. What has improved since the last inspection? What they could do better:
Staff should use bedrails cautiously and not without careful consideration of the risks. Use of bedrails should be reviewed regularly and rails should be removed from resident’s beds if they are no longer in use. Some of the call bell leads on the first floor nursing unit were not accessible to residents in bed. Staff must ensure that lifting equipment is used appropriately. The previous requirement to provide specialist dementia training for all staff on the first floor nursing unit had not taken place. All of the staff working on the units for people with dementia should receive dementia training. Induction training was taking place but should be reviewed and updated to comply with National Training Organisation specification. Further work is required to ensure that the homes supervision procedure is implemented consistently throughout the home. Staff sometimes made choices for residents with dementia who could have made decisions for themselves with support. This was particularly apparent at
Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 Page 7 mealtimes and was reinforced by one resident who when asked if he choose his meals said no “We are just given it”. Staff were aware of the action that they should take if they witnessed or were told that a resident had been abused, but were not always familiar with the homes whistle blowing procedure. Overall the home was maintained to a satisfactory standard but some areas such as the kitchens on the nursing units and the ground floor dining room carpet should be replaced. The undersides of the dining tables on the first floor nursing unit were dirty. The Registered Manager must ensure that tables are cleaned regularly. Documentation was good overall but staff must ensure that all of the relevant paperwork is completed, dated and signed. Staff on the dementia units should ensure that the social history sheet is completed with residents or their relatives if they wish to provide more individualised care. Senior staff must ensure that the commission are informed about serious accidents that occur in the home. The new manager was taking action to ensure that existing staff files included all of the necessary documentation. Two written references must be obtained prior to allowing staff to work in the home and staff that are allowed to work prior to receipt of a full police check must work under supervision. A record of staff interviews should be maintained. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 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 Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 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 and 4. (Standard 6 does not apply to this home). Comprehensive information about the home was provided for prospective residents. The information provided assists residents to make an informed decision about whether they wish to move into the home. Staff assessed prospective residents prior to admission to ensure that the home was able to meet the individual’s health and welfare needs. Some staff require additional training to meet the needs of people with dementia. EVIDENCE: The home had recently updated its Statement of Purpose and Service Users Guide. Both documents included detailed information about the facilities and services provided in the home. The Manager was asked to consider providing a little more detail about the range of needs the home is intended to meet when the Statement of Purpose is next reviewed. Four sets of records were examined on the first floor nursing unit. A comprehensive assessment of the residents needs and any known risks was
Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 Page 10 undertaken and recorded prior to making a decision about whether the home could meet the person’s needs. One of the relatives praised the manager and staff for supporting his request to have his relative reassessed following a change in circumstances. This home has two units that provide specialist care for people with dementia. Discussion with staff and examination of staff training records indicated that the previous requirement to provide specialist dementia training for staff had not been addressed. Some staff had little knowledge of the different types and effects of dementia and could not explain why residents may become agitated or aggressive. Communication between staff and residents with dementia was variable, some staff communicated effectively and had established good relationships with residents whilst other staff interacted infrequently even when they were providing one to one care such as assisting a resident to eat. See requirement 1. Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10. Staff had access to sufficient information to meet resident’s health needs but did not always obtain adequate information about individual’s social background and history. This could make care feel impersonal. EVIDENCE: Four care plans were examined on the first floor unit for people with dementia. All of the service users had an up to date care plan, but plans were very similar in appearance and there was little evidence that staff had considered residents individual needs. Care plans were reviewed regularly and some relatives had agreed and signed the care plan. Some of the assessment sheets such as the social history sheet were not completed and other records were not signed or dated. See recommendation 5. Wound care documentation was good with body charts, photographs and wound evaluation sheets used to supplement the care plan. Staff assessed resident’s health care needs and paid particular attention to issues known to affect older people such the risk of falls, pressure sores and
Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 Page 12 malnutrition. Local General Practitioners visit the home regularly and other specialists were contacted by staff when necessary. There was evidence in resident’s files of the involvement of a Chiropodist, Dentist, Dietician and Tissue Viability Nurse. The management of medication was assessed on the first floor nursing unit and was found to be good. Four medication administration charts were examined. Accurate records were maintained of medication received, administered and disposed of in the home. No gaps or discrepancies were noted and the medication remaining in the pack corresponded with the medication listed on the administration chart. Storage facilities were good. Staff were observed assisting residents thoughout the day. Residents were dressed appropriately and action was taken to maintain resident’s privacy and dignity. Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 Page 13 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) 13, 14 and 15 This home provides a good variety and choice of food to meet resident’s nutritional needs. Residents with dementia were not always given an opportunity to choose the food that they were given. This could lead to feelings of poor self esteem and worth. EVIDENCE: Relatives were satisfied with the visiting arrangements and indicated that they were able to visit their family member in private and were made welcome by staff. Some of the residents told the inspectors that they were able to choose their clothing and said they were able to go to bed and get up when they were ready. The menu indicated that residents were provided with a good choice and variety of foods at each meal. Discussions with residents and information obtained from the comment cards that were distributed indicated that the majority of residents were satisfied with the quality and choice of food provided in the home. Good supplies of fresh fruit and vegetables were stored in the kitchen and staff were able to prepare snacks for residents between meals.
Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 Page 14 The dining room on the first floor nursing unit was rather crowded and noisy during the lunch period. Staff should consider how they could make meals a more relaxing and enjoyable experience for the residents on this unit. Observation of lunch indicated that residents on the first floor nursing unit were not offered a choice of food and did not have access to condiments. One resident was asked whether he choose the food that he was given to eat. The resident replied, “No, we are just given it”. Residents were assisted to eat where necessary. See recommendation 1. Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18. The home has a comprehensive complaints and adult protection procedure in place for responding to complaints or allegations of abuse. EVIDENCE: The homes complaints procedure was prominently displayed in the reception area. The procedure includes a timescale for responding to concerns and contact details for the commission. Since the last inspection the commission had received two anonymous complaints about access to the home, care issues and cleanliness in the kitchen. The manager and the local environmental health department investigated the complaints. The concerns raised could not be substantiated but action was taken by the manager to monitor care and to ensure that other professionals had adequate information about the layout and access to the home. Complaints were acknowledged promptly and thoroughly investigated by the manager. Staff had received abuse training during induction and vocational training sessions. Staff understood the need to report poor or abusive practice but were not familiar with the companies whistle blowing procedure. The Registered Manager agreed to discuss the procedure at the next staff meeting. Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 Page 16 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) and 26. 19, 20, 22, 24 The home was mostly clean and tidy. Some of the furniture and fittings must be replaced to ensure that the home remains a homely and comfortable place for residents to live. Some concerns were identified with some of the equipment fitted or used in the home. Failure to address these issues could put residents safety at risk. EVIDENCE: The home was mostly clean, tidy and odour free. The only exception to this was the underside of the dining tables on the first floor nursing unit, which were dusty and had food residue down the legs. A sign above the visitors’ book explained the need for good infection control practices and alcohol hand gel was provided for visitors use. Adequate equipment was provided for staff that were caring for residents with infections and the protocol for minimising the risk of cross infection was displayed in the relevant rooms. Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 Page 17 The building was maintained to a satisfactory standard but some of the carpets and furniture was looking a little tired. The work surface in the small kitchen on the general nursing unit was worn and damp and the carpets in the main dining area and room 53 were stained. Some of the chairs in the lounge did not have cushions or covers because they were being washed. Since the last inspection the carpet in the small lounge and in two of the bedrooms on the first floor nursing unit had been replaced and the dining room redecorated. The main kitchen had been deep cleaned and action taken to ensure that food was stored appropriately. The flooring in the main kitchen had been patched in the recent past but was now starting to come loose around the edges near the food trolleys. See requirement 2. Some of the resident’s bedrooms included furniture and personal items from their homes. Adding items such as photographs, pictures and ornaments made the rooms appear more homely and helped residents with dementia to recognise their personal space. All of the residents had access to a variety of communal areas such as lounges, dining rooms and a paved garden at the rear of the property. The garden provides a pleasant quiet area for residents to sit during the warmer weather and was maintained to a high standard. Assisted showers and baths were provided on each of the units and all of the rooms had an en suite toilet and washbasin. Additional toilets were positioned close to the lounges and dining rooms. A variety of aids to assist residents to remain independent or to provide assistance for staff were provided on each unit. The leads for the call bell, in the bedrooms on the first floor-nursing unit, were too short for residents in bed to reach. This appears to have occurred because the beds were repositioned. Prompt action must be taken to address this issue. Staff were observed transferring residents from a wheelchair into a more comfortable chair. A standing aid was used for this purpose. Some of the residents that were transferred did not appear to be weight bearing and may require a full body hoist. The Registered Manager agreed to discuss this issue with the homes moving and handling trainer and arrange for all of the residents on the first floor unit to be reassessed if necessary. Risk assessments were undertaken prior to using bedrails and resident’s relatives were consulted about the use of this equipment where possible. The risk assessment form indicated that if the resident could climb over the side, bedrails should not be used. Despite this guidance bedrails were sometimes placed on residents beds who were capable of climbing over the sides or who were known to be restless. See requirement 3 and 4. Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 Page 18 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, 29, 30. The arrangements for recruiting new staff was mostly satisfactory but some staff were appointed prior to adequate documentation being received. This could place residents at risk of harm. Access to training was good but dementia training must be provided to ensure that staff have adequate skills to communicate effectively with residents with dementia. EVIDENCE: The mix and number of staff on duty on the first floor unit were satisfactory and the off duty roster indicated that action had been taken to ensure that the home complied with the staffing notice. The manager had reviewed the files of staff employed prior to his appointment and was taking action to ensure that all of the documentation listed in the Care Homes Regulations was obtained from existing staff. Four staff files were examined and overall recruitment procedures were mostly good. However two staff members had been employed using a criminal records bureau disclosure from a previous employer and two written references were not always obtained prior to allowing the staff member to work in the home. There was no record of one of the staff members being interviewed. See recommendation 2 and requirement 5.
Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 Page 19 All of the staff files examined included a signed copy of the induction training programme. The programme does not comply with National Training Organisation specification. See recommendation 3. A record of the training undertaken by each member of staff was also recorded and kept in their personnel file for reference. All of the staff had completed relevant training sessions but there was no evidence that the previous requirement to provide dementia training for staff on the first floor nursing unit had taken place. Specialist training and increased supervision is required to ensure that all staff utilise appropriate communication skills and can interpret messages communicated through behaviour. See page 10 ‘Choice of Home’ and requirement 1. Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 Page 20 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, 32, 36 and 37. This home is managed by a competent manager who is committed to improving standards of care and supporting staff. EVIDENCE: The manager’s application for registration was assessed and agreed by the commission in January 2005. The manager has undertaken a significant amount of work since his appointment in October 2004 to familiarise himself with the home, residents and staff. Regular team meetings were being held on each of the units and staff on the first floor nursing unit reported improved team working and relations. Staff said that the manager kept them informed
Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 Page 21 about significant issues and made a point of visiting all of the units each day to monitor care and support staff. A supervision matrix had been devised and senior staff were beginning to arrange dates for sessions with staff. Further work is required to ensure that the procedure is fully implemented in a consistent manner throughout the home. See recommendation 4. Record keeping was good and the manager kept the commission informed of significant events that occurred in the home. The only exception to this was a serious accident, which was recorded in the daily care notes and on a separate form but was not reported to commission under regulation 37. See requirement 6. Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 Page 22 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 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 x 13 3 14 2 15 3
COMPLAINTS AND PROTECTION 2 3 x 2 x 3 x 2 STAFFING Standard No Score 27 3 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x x 2 2 x Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 Page 23 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 4 & 30 Regulation 12 & 18 Requirement The Registered Person must provide specialist dementia training for staff that work on the first floor nursing unit. This training must include communication skills. (Previous timescale of 01.02.05 not met ) The Registered Person must replace the worn kitchen worktop in the kitchen on the ground floor nursing unit, reseal or replace the flooring in the main kitchen and replace or remove the stains from the carpets in the ground floor dining room and room 53. Adequate cushions and covers must be provided for all of the chairs on the first floor nursing unit. The Registered Person must ensure that staff are aware of the risks associated with the use of bedrails and use this equipment appropriately. The Registered Person must arrange for the call bell leads to be extended so that residents can access the bell when they are in bed. The Registered Person must ensure that two written Timescale for action 01 August 2005 2. 19 23 01 September 2005 3. 22 13 14 July 2005 4. 22 13 & 23(n) 01 July 2005 5. 29 19 01 July 2005
Page 24 Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 6. 37 37 references are obtained prior to staff commencing work in the home. This must include one reference from the last period of employment that involved work with vulnerable adults of not less than three months duration. Staff that commence work in the home prior to receipt of a full CRB disclosure must work under the supervision of a appropriately qualified and experienced member of staff. The Registered Person must advise the commission in writing of all of the events listed under regulation 37 of the Care Homes Regulations 2001. 01 July 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. 1. 2. 3. 4. 5. Refer to Standard 14 29 30 36 7 & 37 Good Practice Recommendations The Registered Person should ensure that the service users on the first floor nursing unit are offered a choice of food. The Registered Person should ensure that a record is maintained of staff interviews. The Registered Person should ensure that any induction and training undertaken by staff is to TOPSS standards. The Registered Person should ensure that care staff receive formal supervision at least six times a year. The Registered Person should audit care documentation regularly to ensure that records are signed, dated and completed in full. Adelaide Nursing And Residential Care Home G51S6752AdelaideV214387 22.04.05 Stage 4.doc Version 1.20 Page 25 Commission for Social Care Inspection River House 1 Maidstone Road Sidcup Kent, DA14 5RH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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