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Inspection on 22/04/09 for Ainsworth Nursing Home

Also see our care home review for Ainsworth Nursing Home for more information

This inspection was carried out on 22nd April 2009.

CQC found this care home to be providing an Adequate service.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What has improved since the last inspection?

The home has had a period of stability, which has enabled them to make a number of improvements needed so that people living at the home receive a good service. This has included the development of care plans so that staff are clearly directed in how residents wish to be supported. Further training and development has been arranged for staff ensuring they have the knowledge and skills needs to carry out their roles. The home was clean, warm and tidy. Some further redecoration had been carried out with on going work identified. Once completed this will enhance the appearance of the home providing a better standard of accommodation for residents. One resident spoken with said that the acting manager was `a good manager who has worked wonders`. They added there have been `a lot of changes for the better`.

What the care home could do better:

To ensure that the residents are kept safe, staff must make sure that a detailed risk assessment is in place for any person needing bedrails. The provider must ensure that checks are carried out on a regular basis with regards to fire safety and water temperatures ensuring the safety of people at the home. Action identified on the recent gas safety certificate must also been addressed ensuring the system is safe and people are not at risk of harm. The provider is asked to expand on the information provided within the monthly visit reports so that this demonstrates they are monitoring all areas of the service provided as well as seeking feedback from both staff and people living at the home. Information gathered as part of the quality monitoring should be used to inform the homes annual development plan. A copy of this should be sent to relevant stakeholder and the commission. The Provider must ensure that the full certificate of registration is displayed within the home.Ainsworth Nursing HomeDS0000017312.V375087.R01.S.docVersion 5.2Page 8

Key inspection report CARE HOMES FOR OLDER PEOPLE Ainsworth Nursing Home Knowsley Road Ainsworth Bolton Lancashire BL2 5PT Lead Inspector Lucy Burgess Key Inspection 22nd April 2009 09:30 DS0000017312.V375087.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ainsworth Nursing Home Address Knowsley Road Ainsworth Bolton Lancashire BL2 5PT 0161 797 4175 0161 797 2168 d.subbiah@btconnect.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ainsworth Nursing Home Ltd Manager post vacant Care Home 37 Category(ies) of Dementia - over 65 years of age (6), Mental registration, with number disorder, excluding learning disability or of places dementia (7), Mental Disorder, excluding learning disability or dementia - over 65 years of age (3), Old age, not falling within any other category (19), Physical disability (2) Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 37 service users, to include: Up to 19 service users in the category of OP; Up to 2 service users in the category of PD (Physical Disabilities under 65 years of age); Up to 6 service users in the category of DE(E) (Dementia over 65 years of age); Up to 7 service users in the category of MD (Mental Disorder under 65 years of age); Up to 3 service users in the category of MD (E) (Mental Disorder over 65 years of age). The service should employ a suitably experienced and qualified manager who is registered with the Commission for Social Care Inspection. It has been agreed with the registered persons that Ainsworth Nursing Home will work towards the following categories to ensure three specific areas of care provision at the Home, to improve the quality of care provided by the service, without disruption to existing service users: Up to 19 service users in the category of OP Up to 2 service users in the category of PD (Physical Disabilities under 65 years of age); Up to 10 service users in the category of DE(E) (Dementia over 65 years of age); Up to 6 service users in the category of MD (Mental Disorder under 65 years of age). From 3rd July 2008 there shall be no further admissions of service users to Ainsworth Nursing Home without the prior written agreement with the Commission for Social Care Inspection. 2. 3. 4. Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 5 Date of last inspection 16th October 2008 Brief Description of the Service: Ainsworth Nursing Home is a care home providing nursing and residential care for older people including older people with mental health and dementia needs. The building is a large, converted former hospital. It is detached and set within its own extensive grounds, with lawned areas and mature trees and shrubs. It is situated at the end of a private access road, in a semi-rural location within the Ainsworth area of Bury. The current fee for this service ranges from £369 to £508 per week dependent on the level of need and funding arrangements. Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was a key inspection carried out by 2 inspectors, which included a site visit and took place over one day, for a period of 7½ hours. The service did not know that the inspectors were going to visit. During the inspection care and medication records were looked at as well as information about the staff and health and safety including how the home and the equipment were kept safe. The inspectors also looked around the building. As part of the inspection process the provider’s are asked to complete a selfassessment survey information document (Annual Quality Assurance Assessment). This had been completed prior to our last visit and returned to us. Time was also spent time speaking with residents and a visiting health professional and as well as observing practice. Comments have been added to the report. In July 2008 we imposed conditions to restrict any further placements at the home without prior permission from the commission. Regular visits have been made by us and the local authorities to monitor the standard of care provided and look at the improvements being made at the home. Application is now being made to remove this condition so that further placements can be made. Discussion and feedback was held with the acting manager and Provider. What the service does well: The staff team has now remained stable for sometime. This provides residents with consistency and continuity in the care that they receive. The residents’ care plans contain a lot of important information about what they need help with, and how they are to be cared for. We also spoke with a visiting health care professional. They expressed that the standard of care and attention provided to the resident they had visited was very good, that staff had been attentive and that issues in relation to dignity had been addressed. Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: To ensure that the residents are kept safe, staff must make sure that a detailed risk assessment is in place for any person needing bedrails. The provider must ensure that checks are carried out on a regular basis with regards to fire safety and water temperatures ensuring the safety of people at the home. Action identified on the recent gas safety certificate must also been addressed ensuring the system is safe and people are not at risk of harm. The provider is asked to expand on the information provided within the monthly visit reports so that this demonstrates they are monitoring all areas of the service provided as well as seeking feedback from both staff and people living at the home. Information gathered as part of the quality monitoring should be used to inform the homes annual development plan. A copy of this should be sent to relevant stakeholder and the commission. The Provider must ensure that the full certificate of registration is displayed within the home. Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 8 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The provider is to ensure that all future placements at the home are only agreed once a comprehensive assessment has been completed ensuring the prospective residents needs can be fully met. EVIDENCE: As stated at the beginning of the report no new admissions have been made at the home due to a condition imposed by us restricting new admissions. This was made due to concerns held by us and the funding authorities about the standard of care provided. Progress has been made in a number of areas, which has improved the service provided. The provider has made application to us to remove the condition so that further placements can now be made. The providers were asked to supply us with supporting evidence as part of the application. This has been complied with. Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care plans show what care needs the residents have and care practices ensure that their needs are met in a caring and dignified way. EVIDENCE: Individual resident care records, (called care plans) were in place for each resident. The care plans of 2 of the residents were looked at. They had enough information in them to show how the care needs of the residents were to be met. The staff looked at whether or not there was any risk in relation to the residents developing pressure sores, any risk of falling and also if they were at risk due to problems with their food and fluid intake. They also looked at and they wrote down, how any resident was to be assisted with being moved around and by how many members of staff and what equipment, if any, was to be used to assist in safe moving and handling. Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 12 We saw that both of these residents needed bed rails to keep them from falling out of bed. There was however no detailed risk assessment to show if it was safe to have them on the bed. Sometimes bedrails are not the safest way to care for a resident as they could climb over them and sustain a greater injury than if they had rolled out of bed. Other checks also need to be done to make sure that the bedrails are fitted correctly. The care plans were checked regularly by the staff so that any change in the residents’ condition could be identified and action taken if necessary. We saw however that staff did not write any information down when the risk assessments were reviewed to see if there had been any change. They only wrote the date that they had checked them. It is important to write down the findings of the review as this gives a clear record of the residents’ condition and any current risk on a specific date. We saw that residents were weighed regularly and their weight was recorded in their care notes. We saw that staff wrote in the care plans when the residents had received visits from health care professionals, such as dentists, opticians, district nurses and chiropodists. One resident spoken with said that the acting manager was ‘a good manager who has worked wonders’. They added there have been ‘a lot of changes for the better’. We also spoke with a visiting health care professional. They expressed that the standard of care and attention provided to the resident they had visited was very good, that staff had been attentive and that issues in relation to dignity had been addressed. We looked at the system for managing the medicines. On the last inspection we only looked at the medicine system on the dementia unit. A safe system was in place, so on this inspection we concentrated on the general side. The medicine trolley is kept in the manager’s office and secured to the wall when not in use. The stocks of medicines are kept in a locked room on the dementia unit. The qualified nurses are the only people allowed to have responsibility for managing the medicines. Overall a safe system was in place. Medicines and Controlled drugs were stored securely and recorded accurately. We saw however that the following needed putting right: • Some handwritten instructions for medicines (transcriptions) were not checked and countersigned. Signing and checking transcriptions reduces the risk of drug errors. • Staff had handwritten a prescription that was incomplete. It did not state how much of the medicine was to be given and how often. Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 13 • • A resident was prescribed painkillers 1or 2 as required. Staff made sure that the resident received them when needed, however they did not record just how many were given. The ordering of medicines was not in accordance with best practice. Staff were keeping a copy of what they had ordered from the GP but were not receiving the prescription back from the GP to check it. It was being collected by the pharmacy. Staff should check what has actually been prescribed by the GP. The staff spoke to the residents in a quiet and respectful way. The residents looked well dressed, clean and comfortable. There were overriding safety locks on bathrooms and toilets and we saw staff knock on bedroom and toilet doors and waiting where possible for an answer, before they went in. Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Routines are flexible and afford residents the opportunity to follow a lifestyle of their own choosing. EVIDENCE: Routines within the home are flexible. Residents are able to spend time in the communal areas or within the privacy of their own rooms. Information about resident’s routines and preferences is recorded within their care files. The activities organiser works at the home for 3 days of the week. Changes have been made to the programme providing a more informal arrangement. Residents are asked what they would prefer to take part in rather than their being a planned activity. This may include; outdoor games, massage, music, crafts, exercise, memory lane and 1-2-1. Evidence of crafts being done, pictures and cards displayed within the home. A large television has also been purchased for the conservatory. Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 15 Residents spoken with appear relaxed and happy. One person said that they were being supported to an appointment the following day and would be stopping off at a café before returning to the home. Another resident spoken with had just returned from a trip to the local post office. We also look at arrangements with regards to meals. The dining room has now been moved to the large conservatory, which means that residents need to move around the building. This encourages them to mobilise offering further opportunities to exercise. Tables had been nicely set with tablecloths, napkins and cruets. Residents have the main meal at lunchtime and the lighter meal in the evening. We looked at the menus. The residents have a choice of meal at breakfast, lunch and tea. Hot and cold drinks were served throughout the day and during mealtimes. We looked at the food stocks in the kitchen and food stores. Dry, fresh and frozen food stocks were plentiful. In one of the stores it was found that mould continues to develop in one of the storage areas. This should be explored and alternative arrangements made for food items. Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Suitable arrangements are in place to ensure residents are listened to and that the appropriate action would be taken to ensure their safety and protection. EVIDENCE: Since our last visit the home has continued to make improvements. There have been no further complaints or protection issues. The acting manager has amended the complaints procedure, which is easy to read and clearly advises people of the timescales for response and relevant contact numbers. Arrangements have also been made for staff to receive training in the local authority safeguarding procedure. Information provided showed that the majority of staff have completed training in this area. However arrangements were being made for these and a number of other staff to complete a refresher so that they are familiar with the current policy and procedure. The acting manager has also completed the course along with training in deprivation of liberty and mental capacity. Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. On-going redecoration and refurbishment is being undertaken to ensure residents are provided with comfortable, well maintained accommodation in which to live. EVIDENCE: Certain areas of the home were looked at to see what further improvements had been made. Work had been carried out with redecoration to some bedrooms, which had enhanced their appearance. The large lounge/dining room had been rearranged with the dining room now being in the conservatory. This encourages residents to move around the Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 18 building. Those people who enjoy spending their time in the conservatory have been provided with a small sitting area where they are able to watch television. The acting manager is aware that further work needs to be completed to bring the environment up to a good standard and explained that as funds become available they would continue with the redecoration and refurbishments. Hygiene standards within the home were good. The home was clean and tidy with no malodour. Staff hand washing is provided as well as protective clothing, which staff were observed wearing throughout the day. Designated staff are in place and take responsibility for carrying out the laundry and domestic tasks. Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient staff are provided throughout the day. Staff are appropriately recruited and are offered on-going training and development to ensure that they are able to meet the needs of residents. EVIDENCE: At present there are only 18 residents at the home. Staffing levels were good and provided sufficient numbers to support the needs of people. During our visit there was the acting manager, 2 nurses, 4 carers, an activity worker, 2 domestics, the cook and a kitchen assistant on duty. At present the team comprises of the manager, deputy manager, 7 nurses, 16 care staff, 2 cooks, 2 kitchen assistants, 2 laundry staff, 3 domestic staff and an activities coordinator. No new staff have been employed therefore recruitment files were not looked at. This standard was met following our last visit. We were advised that the homes handyman had left the home. Recruitment had taken place and the acting manager was to appoint a new worker. Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 20 Information was provided with regards to staff training. At present the acting manager is accessing courses via Bury training Partnership and through an Open Learning provider. Open learning courses have been planned for a few staff members, these include palliative care, equality and diversity, health and safety and dementia care. The manager is aware that some staff still need to complete relevant training and is making the necessary arrangements as dates become available. Further training needs have been identified including person centred planning, first aid, food hygiene, dementia risk assessments and moving and handling. On-going training and development will ensure that staff have the necessary knowledge and skills needed to carry out their roles. NVQ training is also provided. Of the current 16 carers 2 have level 3, 8 have level 2 and 3 are working towards level 2. Ancillary staff have also been on NVQ courses in the relevant areas of work. Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has had a period of stability, which has enabled them to make a number of improvements. This should be continued so that people living at the home receive a good quality service. EVIDENCE: The acting manager has been in post since September 2008. Due to unforeseen circumstances there has been a delay in the acting manager submitting her application to register with us. We were advised that this is now near completion and would be submitted at the earliest opportunity. Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 22 It was noted that on-going improvements have been made at the home. This has been detailed throughout the report. The provider has now made application to us to have the imposed condition removed so that placements can be made at the home. Information requested by us has been supplied so that we can assess whether people being placed at the home would be safe and well cared for. The provider was advised that this is now being dealt with by our registration team who would contact them in due course. It was noted that the full registration certificate was not displayed within the home detailing the current conditions of registration. The Provider must ensure that this is addressed. The acting manager has introduced internal auditing systems so that she can monitor the quality of service provided on a weekly, monthly and annual basis. Areas include, care plan review, medication, staff absence and training and health and safety. Audits are recorded and evidenced where action had been identified and followed up with the relevant action taken. Team meeting, staff supervisions and periodic meetings with residents and their relatives are also held. Feedback surveys had been distributed to relatives however the response had been quite low. Information gathered as part of the quality monitoring should be used to inform the homes annual development plan. A copy of this should be shared with relevant stakeholders and the commission. The provider has also carried out monthly monitoring visits in line with regulation 26. Copies of these reports are held at the home and have been forwarded to us. The provider is asked to expand on this information to evidence further that they are clearly monitoring the service as well as liaising with both residents and members of the staff team showing that their views are being sought and considered when developing areas within the home. The system for the safekeeping of residents’ money was safe. Individual records are made of any money left in an account for the residents and any money spent on their behalf. Receipts are kept for any purchases made. We saw records of regular staff supervision meetings in 3 of the staff files that we looked at. Regular staff supervision ensures that staff are provided with clear direction and support. The staff have mainly 1-1 sessions with the manager whereby they can discuss their practice, their training needs and anything else that might be important to ensure the safety and wellbeing of both the residents and the people who work in the home. A random check was carried out in relation health and safety and checks carried out at the home. We found that since the handyman left in March no Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 23 further checks had been made with regards to fire safety and water temperature. Temperature readings were found to be low varying between 36°c and 41°C. The provider must ensure that water temperatures are regulated to 43°C for safety and comfort of residents. Fire safety checks must also been carried out on a regular basis so that residents are kept safe. It is also suggested that a fire drill is undertaken, as the last one was held in June 2008. This will ensure that all staff including those who commenced their employment since that date are aware of the procedure to follow. Safety certificates were also seen for servicing carried out within the home. This included the electric circuits, small appliances, hoists, emergency lighting, fire alarm and equipment and call bells. A recent check had also been carried out with regards to gas safety. Action had been identified. The provider must ensure that this is addressed. The fire officer had also carried out a visit to the home in January 2009. Further information had been requested with regards to a fire evacuation plan. This has been addressed. Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 3 X 2 Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 13(4) Requirement Staff must make sure that any risk to the health and safety of the residents is identified and action to reduce or stop any identified hazard is then taken. Therefore a detailed risk assessment for the use of bedrails must be in place. To ensure the safety and wellbeing of the residents, staff must make sure that a handwritten prescription is accurate. They must make sure that they write down how much of the medicine is to be given and how often. Action identified on the gas safety certificate must be addressed making sure the system is safe and people are not at risk. (Previous requirement of last inspection with timescale of 30/12/08 not complied with) Water temperatures must be regulated and maintained at DS0000017312.V375087.R01.S.doc Timescale for action 30/05/09 2 OP9 13(2) 30/05/09 3. OP38 13(4)23 30/05/09 4. OP38 13(4) 30/05/09 Ainsworth Nursing Home Version 5.2 Page 26 43°C for the safety and comfort of people living at the home. (Previous requirement of last inspection with timescale of 30/12/08 not complied with) Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations Staff should write down the findings of their assessment of any risks and not just write the date. It is important to write down the findings of the assessment as this gives a clear record of the residents’ condition and any current risk, on a specific date. To ensure the accuracy of a handwritten transcription and therefore ensuring the safety of the resident, it should be checked with another member of staff, signed and countersigned. To make sure that there is an accurate record of what has been given and therefore ensuring the safety and wellbeing of the residents staff should record how many tablets have been given. Staff should receive the prescription back from the GP so that they can check what has actually been prescribed by the GP. On-going redecoration and refurbishment must be completed to ensure that the home is of a good standard providing comfortable well maintained accommodation for people to live. OP33 Information gathered as part of the quality monitoring should be used to inform the homes annual development plan. A copy of this should be sent to relevant stakeholder and the commission. Information detailed in the regulation 26 reports should be expanded upon to evidence that the providers are reviewing the service delivery taking into consideration the views of residents and staff. A fire drill should be carried out so that all staff are DS0000017312.V375087.R01.S.doc Version 5.2 Page 28 2 OP9 3 OP9 4 OP9 5 6 7 OP33 8 OP38 Ainsworth Nursing Home familiar with the procedure to follow should an incident arise ensuring people are kept safe. Ainsworth Nursing Home DS0000017312.V375087.R01.S.doc Version 5.2 Page 29 Care Quality Commission North West Region City Gate Gallowgate Newcastle Upon Tyne NE1 4PA Telephone: 03000 616161 Fax No 03000 616171 Email: enquiries.northwest@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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