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Inspection on 17/02/09 for Alexander Family Nursing Home

Also see our care home review for Alexander Family Nursing Home for more information

This inspection was carried out on 17th February 2009.

CSCI 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.

CARE HOME ADULTS 18-65 Alexander Family Nursing Home Oakhurst 1 Parker Close Carshalton Surrey SM5 3HF Lead Inspector Alison Ford Unannounced Inspection 17 and 25 February 2009 10:00 th th Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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. Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alexander Family Nursing Home Address Oakhurst 1 Parker Close Carshalton Surrey SM5 3HF 020 8669 1111 020 8669 7070 denise.deroyparker@btinternet.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) Mrs Denise Deroy Parker Lee Nah Woodman Care Home 18 Category(ies) of Learning disability (0), Physical disability (0), registration, with number Terminally ill (0) of places Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A variation has been granted to allow service users currently residing in the home who are over the age of 65 to be accommodated until such time that the home is no longer able to meet their needs or their placement ceases. A maximum of four service users over the age of 65 may be accommodated in specified rooms on the lower ground floor. 27th March 2008 2. Date of last inspection Brief Description of the Service: Alexander Family Home is an attractive chalet style residence in Carshalton, designed and adapted by the proprietor, originally to suit the needs of a relative. As it was a private home it has retained a very comfortable and homely atmosphere. Now registered as a care home it provides accommodation for up to eighteen residents, with nursing needs, who may also have physical or learning disabilities. The home is situated close to the centre of town and is well served by public transport links. Accommodation is provided over two floors and consists of five double and eight single bedrooms all with en-suite facilities and there are also assisted baths on each floor. A large dining room is adjacent to the kitchen and there is a lounge on each floor, one of which opens onto the garden. The proprietor of the home is very involved in its running and she and her team are committed to providing a high standard of care within a family type environment. At the time of this inspection weekly fees ranged from £550-£1300. These are agreed according to the needs and dependency of the residents and would be discussed prior to admission. There may also be some extra charges payable for items such as toiletries, some activities and services such as hairdressing. These too would be explained prior to admission. A copy of the homes Statement of Purpose, Service User Guide and the latest inspection report can be obtained from them. Inspection reports can also be downloaded from The Commission for Social Care Inspection website at www.csci.org.uk . Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1star. This means the people who use this service experience adequate quality outcomes. This report follows two visits to this service. The first was unannounced however, the homes manager was not available. Therefore, although several standards were assessed, with help from the trained nurse on duty, a return visit was undertaken one week later. When writing this report, consideration has also been given to other information gathered throughout the year such as, records of incidents and accidents, complaints and other documentation required to be kept by the home as evidence of its commitment to the health and safety of the people who use the service. We have also spoken with residents, and members of staff. Prior to the visit the homes Registered Provider had submitted an Annual Quality Assurance Assessment (AQAA). This is a document in which they tell us about the home, how well they consider they meet the needs of the people living there and their plans for the future. This home is registered with The Commission for Social Care Inspection to provide care for adults age 18-65 although a previous variation was in place to allow older people who were already living there to remain. On the days of this inspection there were 12 residents living in the home although one was in hospital. On the second day there was also a lady who attends regularly, just for the day. Usually one trained nurse is on duty with three care staff, supported by a cook, domestic and maintenance staff. However, on the first day, staff sickness had reduced the number of carers to two in the morning. During the inspection a tour of the premises was undertaken; a sample of care plans were assessed, documentation relating to health and safety was seen and several of the residents and members of staff were spoken with. Menus were seen and the lunchtime meal was served during the visits. There have not been any complaints about this service since the last inspection. Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Since we last visited the home a new Registered Manager has been appointed, Mrs Lee-Nah Woodman. She is a registered nurse with additional management qualifications and has previously worked in the home for some years. At our last visit we asked for care plans to contain more information about residents past lives and achievements. This information helps staff to understand about the people that they are caring for and also to provide activities that will interest them. This is now beginning to be done. We could also see that pre-admission assessments are more detailed to help staff understand the potential problems and concerns that residents may face when they come to live in the home. Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 7 A questionnaire has now been sent out to the relatives of those who live in the home asking about their views of the service. All of the feedback that we saw was very positive. There is an ongoing redecoration and refurbishment plan, which ensures that the home remains a pleasant place for people to live in. A new shower and toilet has recently been installed in one of the bedrooms and the kitchen is currently being replaced. What they could do better: 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. The summary of this inspection report can be made available in other formats on request. Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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 people who use this service have an assessment, undertaken by a senior nurse, to make sure that their healthcare needs can be met and they are able to get information, which helps them to decide if the home will suit them. EVIDENCE: A copy of the Service User Guide is hanging outside each resident’s room with other information including a copy of the latest inspection report. This now contains all of the information that is required to ensure that residents understand about the services that will be provided for them. Potential residents or their representatives would be able to read this booklet when they visited the home. Four people have been admitted to the home since our last inspection visit. We could see that they are now having a more detailed assessment undertaken to make sure that the home will be suitable for them. If they were able, they would be encouraged to visit to see if they like it however, they are often to frail for that to take place. Relatives and representatives would be encouraged to participate in the admission process. All admissions are subject to a trial period of four weeks. Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 10 Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. People who use this service have an individual care plan outlining the care and support that they need. There is some evidence that this has been compiled with input from them and that they are being encouraged to make choices in their lives, as much as their disabilities allow. EVIDENCE: Each resident has an individual care plan and four of these were seen at this inspection. We found that nursing care needs are appropriately documented and reviewed on a regular basis. However, the information is organised in quite a fragmented way. Daily progress notes are in one file, care plans in another and other files contain information relating to bodyweight, dressings etc. In this home there are quite a small number of residents and staff know them very well but for anyone unfamiliar with the home it would be difficult to find the information that they needed to support people as they preferred. Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 12 It could also mean that resident’s problems are viewed in isolation rather than looking at their overall health needs. There is evidence to show that some people are involved in decision making such as day-to-day activities and meals that they like. For others this is limited because of their very complex care needs. The home has recognised that they need to encourage staff to work with the residents to help them maximise as much of their independence as they are able. They intend to address this through the key worker system where staff will be encouraged to talk to residents and identify their wishes. Some of the residents do have access to an independent advocacy service. It is recommended that this could be increased especially for the younger residents in the home. The Registered Provider has control over some money kept on behalf of residents. Records are kept and we looked at three of them. They were accurate and easy to understand and they are audited regularly. The Registered Provider is an appointee for one resident. . Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. A limited range of activities is arranged for residents in this home. Some of them are able to maintain their links with the local community and visitors are always welcome. A well-balanced and varied diet is provided to ensure that resident’s nutritional needs are met. EVIDENCE: Although some of the residents living in this home are under 65years old they are unable to work due to their limited capabilities. The range of activities that is offered to interest and stimulate them is very limited as the home is, once again, without a designated activities organiser. Care staff do try and engage in various pastimes and are sometimes able to take residents out of the home. One resident is able to go out in his own road quality wheelchair when the weather is fine. Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 14 Visitors are always welcome into the home and could meet with people in private if they wish or sit in one of the large and pleasant lounges. Staff interaction with residents is good. Many of them have been working at the home for some time and they enjoy a good relationship with them. The fact that so many residents sit together in the lounge, and eat their meals seated around a large table also helps to promote the family atmosphere in this home. All residents have locks on their bedroom doors however; none have elected to use them. All those people that were spoken with agree that the food served within the home is of a very high standard and the menus are varied. The chef has a good relationship with the residents and spends time talking to them about their preferences. He will always provide an alternative meal choice if it is wanted and extra snacks and drinks are always available. He has recognised the preferences of those who prefer more ethnic dishes and provides rice, noodles and vegetarian dishes for them. The registered provider frequently joins residents for lunch, which is served at a large table to promote a congenial and homely setting. The kitchen area was observed to be very clean and tidy however a recent environmental health visit highlighted the need for units and equipment to be replaced. A new kitchen is now in the process of being installed. Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. People who use this service know that staff will support them with their healthcare needs in a sensitive manner. Procedures are in place for the safe ordering, and disposal of medication however some errors were noted in administration procedures. EVIDENCE: Personal support is provided to residents in private and those who were able to talk to us they say that they are able to choose when they get up and go to bed. All rooms have en-suite facilities and there are hoists and other aids in use within the home in order to help residents move safely. Advice is sought from other members of the multidisciplinary healthcare team, such as physiotherapists, and the Tissue Viability Nurse as needed. Residents in this home are all highly dependent and have nursing needs, which they would be unable to manage themselves even if supported. Four care plans were seen at this visit. These showed that where residents need help and Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 16 support this has been identified along with the ways that they will be addressed. Regular reviews take place to make sure that any changes are noted and care plans are amended accordingly. The home has introduced a monitored dosage system since the last inspection and records of medication storage and administration were seen We did see some errors in the recording process. Where medication had not been administered there was not always an indication of why it had not. Topical preparations did not always identify which part of the body they should be applied to. Prescribed dressings had not been signed for. Trained nurses administer medication in this home and they are reminded of their responsibilities with regard to the administration of medication. At the time of the inspection, one resident was taking responsibility for her own medication. A risk assessment had been completed for this and she displayed knowledge of the drugs, their purpose and how they should be taken. However, the drugs were being dispensed, by nursing staff, into a compliance aid that she was then keeping in her handbag. Concerns were raised about the possible risk to other residents and the Registered Provider agreed to provide a lockable facility for the medication, in her bedroom. We also reminded the homes manager that there must be a risk assessment in place regarding the practice of dispensing medication into the compliance aid. Since this visit we have been informed that the resident has said that she would be happier if the home took control of her medication. While this may be the most appropriate course of action, residents should be encouraged to retain their independence in relation to their medication if it is safe for them to do so. Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. There is a complaints procedure in place; any concerns are dealt with appropriately. EVIDENCE: There is a clear and appropriate complaints policy which all residents and their families have access to although it is only produced in a standard format. The complaints book is now kept in the entrance hall and was seen. The Commission has not received any complaints about the service since the last inspection. Staff were able to demonstrate an awareness of issues around adult abuse and whistle blowing and have all received relevant training. No new members of staff are employed until all of the necessary checks have been made. This ensures that people are protected from those who have been judged as being unsuitable to work with vulnerable adults. People who live in the home are generally not able to manage their own finances. The Registered Provider is an appointee for one resident also keeps some money on behalf of other people. We were able to see the records of these and they were well organised and accurate. They are audited regularly. It has been recommended that staff should attend training sessions concerned with The Mental Capacity Act and Deprivation of Liberty Safeguards, in order to gain a greater understanding of these issues. Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 18 Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. People who use this service live in a home, which is clean comfortable and well maintained with specialist adaptations, to ensure that their needs are met. EVIDENCE: The home is an attractive chalet style house that has been designed and adapted to suit the needs of the residents and is in keeping with its surroundings. The owner has tried to ensure that the home remains comfortable and homely with the appearance of a family home rather than a nursing home. Bedrooms are very spacious and three separate sitting areas provide an above average amount of communal space with access for residents requiring wheelchairs. Residents all benefit from en-suite facilities and there are two assisted baths. There is an ongoing redecoration and refurbishment programme, which ensures that the home is well maintained and comfortable. Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 20 A passenger lift ensures that all areas of the home are accessible for people who may have limited mobility. This means that those with bedrooms downstairs could sit in the upstairs lounge and everyone can get down to the garden. On the day of the inspection the home was warm, fresh and clean. It was completely free from malodour. Laundry and sluice facilities are sited in the ground floor away from areas used by residents. CCTV cameras have been installed at entrances and also in communal areas in the home. We have been told that this is for the protection of people in the home and does not intrude on their privacy. There is a code of practice for its use in place. Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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 people who use this service can be generally be confident that staff will be available in sufficient numbers and have the necessary skills and expertise to meet their needs. EVIDENCE: We looked at rotas, which showed that there are always trained nurses and care staff on duty in sufficient numbers to meet resident’s needs. They are supported by a cook and domestic staff. Feedback forms that we saw praised the skills and capabilities of the staff most of whom have worked in the home for some time and know the residents well. Many of the staff have completed an NVQ level 2 qualification while others are progressing to level 3. Courses are being planned for the forthcoming year although we were told that these are purchased through the local authority and there are often problems with them being cancelled at short notice or being oversubscribed. Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 22 Mandatory training such as Moving and Handling and abuse awareness has been completed. Each staff member has an individual folder and ongoing supervision identifies any further training needs. The manager is also in the process of compiling a training needs analysis, which will make it easy to see who has attended various sessions. We are assured that no new member of staff is employed without the necessary checks being carried out. However, we looked the staff files of 4 new staff members and they were not all complete in as much as some references were missing. All staff files must contain all of the information required by Schedule 2 of The Care Homes Regulations. Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. People who use this service can be sure that there is an intention to run the home in their best interests. A quality assurance monitoring system is being introduced to measure how well they consider that the service delivers care to the people who live there. EVIDENCE: This home now has a Registered Manager, Lee-Nah Woodman, a trained nurse who has worked in the home for some years. She is already in possession of an NVQ level 4 award in management. She is supported by the Registered Provider, Mrs Denise DeRoy-Parker who still takes an active role in the running of the home. Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 24 Pervious inspections highlighted the need to introduce a quality assurance system to evaluate how well the home meets its aims and objectives. A questionnaire has now been distributed to the relatives of those people who live in the home. We saw the replies that have been received. All of them were very positive and complimentary about the home and the staff. There remains a need to ensure that those people actually living in the home and experiencing life there share these views. It is acknowledged that most of the residents would find it difficult to complete the forms themselves and we are told that their views will sought by care staff who are going to talk to them as a part of key working sessions. We would recommend that consideration should be given to increasing input from independent advocates to facilitate this process. The Registered Provider and manager have demonstrated a commitment to the health and safety of residents. Equipment and services are all properly maintained. A fire risk assessment has now been produced which has been approved by the Fire Safety Officer and signage has been improved. There are regular fire drills carried out in the home, including at night, and there is a designated person in charge of fire procedures. Accidents and incidents, which affect the welfare of residents, are all properly recorded and notifications are sent to The Commission. Following a recent environmental health officer’s visit a new kitchen is in the process of being installed, in line with current best practice guidelines. Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X X 3 X Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 26 NO 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 YA20 Regulation 13(2) Requirement Timescale for action 10/03/09 2 YA20 13(2) 3 YA20 13(2) 4 YA34 19(1)(b) Records must indicate any reason why residents did not take their medication as it was prescribed. Where topical creams are 10/03/09 prescribed, the administration records must state where they should be applied to ensure that they are being used as ordered. Where dressings are prescribed 10/03/09 the record sheets must be signed to show that they are being used. Staff files must contain all of the 10/03/09 information required by Schedule 2 to provide evidence of the homes recruitment procedures. 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 YA14 Good Practice Recommendations It is recommended that the range of activities available to DS0000019070.V374242.R01.S.doc Version 5.2 Page 27 Alexander Family Nursing Home 2 YA23 3 YA39 residents should be increased in order to offer them more interest and stimulation. It is recommended that staff training should include information regarding The Mental Capacity Act and The Deprivation of Liberty Safeguards, to help ensure the protection of the people who live in the home. It is recommended that consideration should be given to increasing the opportunity for residents to access the services of independent advocates in order to gain their views of life in the home. Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Alexander Family Nursing Home DS0000019070.V374242.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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