Inspection on 04/07/06 for Alexandra Nursing Home

This inspection was carried out on 4th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Alexandra Nursing Home 23/06/08

Alexandra Nursing Home 16/01/08

Alexandra Nursing Home 05/07/07

Alexandra Nursing Home 06/12/05

Alexandra Nursing Home 11/03/05

Alexandra Nursing Home 19/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Alexandra Nursing Home 370 Wilsthorpe Road Long Eaton Nottingham NG10 4AA Lead Inspector Jo Wright Key Unannounced Inspection 4th July 2006 08:45 X10015.doc Version 1.40 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 Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 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 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. Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Alexandra Nursing Home Address 370 Wilsthorpe Road Long Eaton Nottingham NG10 4AA 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) 0115 946 2150 0115 946 2094 BUPA Care Homes (BNH) Limited Vacant Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 1 PD place. On a named basis for the person named in the notice of proposal letter. The home to accommodate named individual for the period of stay at the Home in the category (PD). 6th December 2005 Date of last inspection Brief Description of the Service: The Alexandra Nursing Home is a purpose built care home registered for 40 Residents. The home is registered to provide care for people with nursing and personal care needs. The home provides a modern and pleasant environment for residents and the accommodation is provided across two floors. There is a passenger lift and staircase access to the first floor facilities. The home has two spacious lounge/dining areas, one with access to an octagonal sun lounge/conservatory. There is a landscaped garden to the rear of premises, which is accessible to residents. The majority of bedrooms are single occupancy, with three double bedrooms provided for residents wishing to share. All bedrooms are equipped with ensuite facilities. All bedrooms are also fitted with TV points, smoke detection equipment and thermostatically controlled radiators. The home has provision of separate assisted bath/shower facilities. There is a call system, which operates in all areas of the home. The home also has a dedicated hairdressing salon. Relatives and visitors can call to visit residents at any time. Information about the service is provided through the Statement of Purpose and Service User Guide, both of which were made available to residents. Information included on the pre-inspection questionnaire received on 12/05/06 stated that the fees for the home were £507 to £607 per week, and that this information was also included on the contracts and terms and conditions. Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection, carried out by one inspector, and lasted 8 ½ hours. A review of the evidence available prior to site visit was undertaken, for example, the pre inspection questionnaire, resident surveys (6 surveys received) and notification of incidents, and used to identify areas to be examined during the site visit. The information available was used to identify those residents whose care was to be cased tracked. Records such as care plans (as part of the case tracking process, which is used to help determine how the home meets the needs of individual residents) were examined in depth during this inspection. Time was spent taking with residents and staff on duty and observing the daily routine. A small selection of bedrooms was viewed during this visit. Other records such as medication records and staff files were also examined. The manager was on duty during this visit and the findings of this site visit were discussed with her. What the service does well: Alexandra Nursing Home provides a comfortable and safe environment for the people who use the service. Residents and families were encouraged to personalise their rooms with their own possessions. The staff team are committed to providing a good standard of care for residents, and are supported to do this through a structured induction and training opportunities, although additional staff still need to achieve the required level of training. Residents’ care was planned, and staff generally have clear guidance to follow to enable them to meet individual residents needs. Management and staff recognise the importance of providing opportunities for the people living in the home to join in with activities and entertainment. Social events and activities were organised and provided variety and social stimulation for the majority of residents. Residents were offered a choice and variety of meals, and provided with a pleasant dining area in which to take their meals. Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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. Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 Page 7 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 Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 Page 8 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 the following standard(s): 3 and 4 (Standard 6 is not applicable in this home) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission procedures ensured that residents were assessed prior to admission, and the assessments provided staff with sufficient information to fully identify individuals’ needs and plan care. EVIDENCE: Residents were adequately informed about the facilities and services provide at the home through the information pack provided in each room. The manager reported that since the last inspection, the statement of purpose had been amended to include details of physical environment. Information provided in the resident surveys indicated that 3 out of the 4 respondents (and whose admission to the home has been planned) had received enough information to decide if the home was the right place for them to live. The file of three residents were looked at in detail during this site visit. The files were in the process of being updated, and organised into sections for ease of reference. Case tracking confirmed that a structured admission process was Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 Page 9 completed for all prospective residents. The documentation included section to be completed that provided reassurances that residents needs could be met at the home. However, these sections had not been completed on the preadmission assessment seen during this site visit. The manager had visited prospective residents prior to admission, and carried out an initial assessment of their care needs. The information in this assessment was then used to develop the plans of care. Information provided by other professionals invovled in the residents care was also available in the files. Residents spoken with indicated that they felt cared for and that the home was able to meet their needs. The staff training programme provided staff with the necessary skills and experience to meet the needs of the residents. Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care of residents was planned and given in a way that respected individuality and privacy. The the administration of medication needs to improve in order to ensure that residents receive the medication that they are prescribed. EVIDENCE: Residents spoken with were generally positive about living at the home. Residents commented that the staff team were good, and they felt able to request assistance when they required it. No issues around privacy and dignity were raised, and staff were observed routinely knocking on bedroom and bathroom doors, and speaking with residents in a respectful and polite manner. The manager reported that residents/relatives had been asked if they wished to have privacy locks fitted to their bedrooms doors, and locks would be fitted where requested. The files of three residents were looked at in detail during this inspection. Although care plans generally provided staff with sufficient information to meet Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 Page 11 residents needs, the amount of information about individual abilities and preferences and involvement in planning their care varied. Some care plans clearly demonstrated that the resident had been involved in the the planning, and directed staff to meet care needs that the resident was unable to meet themselves. Other care plans lacked this level of detail and were more medically orientated, and less specific in detail. Additional information about residents’ abilities and needs was gathered through risk assessments. The required risk assessments were in place, but care plans had not always been developed where a risk was identified, for example, risk of falling. Monthly reviews of care were not always taking place, and residents were not always involved in these. The files supported that attention was paid to individual’s health care needs and access to other health care professionals facilitated as required. Residents spoken with and information gathered from the resident surveys also confirmed this to be the case. A reivew of the medication records was undertaken during this site visit. Administration of medication was the responsibiltiy of the qualified staff. A number of discrepancies were found on one the medication records, which did not support the residents were receiving medication as prescribed. These were brought to the attention of the manager, as there is a potential for staff to be unsure whether the medication has been given or not. The record had been signed to indicate that the medication had been given, when it had not, as too many tablets remained in the blister pack. It was also noted that during the morning medication round, the medication trolley had been left open, with medication packs on tables round the trolley, in the dining room, whilst the qualified nurse left to room to take medication to a resident in their room. Although there was another qualified nurse in the dining room assisting a resident, this member of staff did not have a clear, unrestricted veiw of the trolley and medication. Storage of medication was satisfactory. Handwritten entries were checked and signed by two members of staff. Systems were in place to check medication on receipt into the home and on destruction. Systems were in place for planning and caring for residents during the end stages of their lives. The home using the Liverpool Care Pathways to plan and deliver palliative and end of life care. Ongoing training was being provided for staff. The manager reported that this system has been used recently and had assisted in the delivery of care. Any deaths that occurred in the home were being reported as required. Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A range of suitable activities was being provided, which met the leisure and recreational interests of the majority of residents. The meals were good offering both choice and variety. EVIDENCE: Efforts had been made to provide a structured social and recreational programme for people living in the home. Dedicated staff time was provided for activities each weekday. Time was spent talking with the activity coordinator during this site visit. This member of staff organises activities mainly for small groups of residents, although one to one time was also provided. The activity co-ordinator commented that it was difficult to engage residents, relatives or staff in activities or fund raising events. This was discussed at length with the activity co-ordinator and the manager, and ideas put forward for how to further develop the acivity programme, links with the community and the involvement of relatives. On the day of the site visit, residents were observed joing in with a quiz during the morning, and attending a clothes sale in the afternoon. Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 Page 13 Very little information was recorded in the files about indiviudal residents social interests and hobbies or life history. However, it was clear when talking with the activity co-ordinator that this information had been obtained. This information needs to be available to all staff, so that they have a complete picture of the resident, not just their personal and health care needs. Disucssion took place about facilitating a more active approach towards maintaining links with community groups, rather than expecting residents to do this for themselves. Information gathered from the resident surveys indicated that acivities were usually organised, but one person commented that activities were never organised. This person spent much of their time in their room, and commented that although the activity co-ordinator had spend some time with this person recently, this was an exception. Efforts should be made to provide social interaction and stimulation for all residents, regardless of their needs and abilities. Visitors spoken with commented that they were welcome in the home at any time, and kept informed about their relative. Although generally satsified with the care and services provided at the home, they did express concerns about the recent changes in staff, as a number of long standing members of staff had moved on. The manager acknowledged this, but indicated that the staff had been replaced, although it took time for new staff to get to know the residents. Information in the files supported that residents, whenever possible, made choices about their lives and were encouraged to retain their independence for as long as possible. This was observed during the inspection, by people choosing to stay in their rooms, rather than sitting in the communal areas. Menus were varied and offered a choice of meals. There was sufficient dining space for residents, and dining tables were well presented with tablecloths, placemats, napkins, cultery, condiments, glasses and jugs of water/juice. The lunch time meal was served in an relaxed manner, and staff support was provided as required for those residents who required assistance. Residents spoken with were satisfied with the meals provided, although the information provided in the residents surveys contracted this, as half of the residents (3 out of 6) commented that they only sometimes liked the meals. Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A satisfactory complaints procedure was in place with some evidence that people felt that their views were listened to and acted up. Staff had a good knowledge and understanding of adult protection issues which protects residents from harm. EVIDENCE: Residents spoken with commented that they felt listened to and able to speak to the staff and the manager if they were not happy about anything to do with their care. Information gathered from the resident surveys generally supported these comments. The complaints procedure was available to all residents and relatives and included in the Serivce User Guide, which had been made available to all residents. Staff spoken with aware of the complaints procedure and were able to describe how they would deal with any complaint that they received. The manager has dealt with six complaints since the last insepction and these have been resolved to the satisfaction of the complainant. Residents were protected from potential harm through staff knowledge and training, and the written policies and procedures. The required polcies and procedures were in place, and staff spoken with had a good understanding of these procedures and confirmed that they had attended safe guarding vulnerable adults training. The manager reported that staff attended training on the protection of vulnerable adults. There were plans for two members of senior staff to attend the local authority training course, to become in house trainers for the protection of vulneable adults. Following the recommendation Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 Page 15 made in the last inspection report, the manager has obtained copies of the Public Interest Disclosure Act 1998 and the Department of Health guidance No Secrets. Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 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 the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of the environment was acceptable and provided residents with a homely place to live. Inappropriate storage in bathrooms placed residents, visitors and staff at potential risk. EVIDENCE: The home was clean, tidy and free from odour at the time of this site visit, and this was generally supported by comments from residents. Domestic hours were sufficient to keep the home clean and tidy. All areas of the home were reasonably maintained and decorated, although there were some difficulties with ongoing maintenance. The home has been without a maintenance person for a number of months, and although systems were in place for major work to be attended to, some areas, such as high level cleaning in communal areas, and the garden area, require attention. The garden area was poorly maintained, and although residents were able to access this area, the only level/ramped access was via the main entrance to the home, and the majority Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 Page 17 of residents would require assistance from staff to access the garden in this way. Residents were observed making good use of the communal areas available to them, although the first floor lounge area was not in use. The conservatory areas were also too hot for residents to sit in at the time of this site visit. The rooms of the residents whose care was case tracked showed individuals had been able to personalise their rooms, and they were satisfactorily clean and well presented. Aids and adaptations were provided and satisfactory to meet the needs of the resident group. All equipment had been maintained within the specified timescales. The temperature of hot water was controlled and these temperatures checked on a regular basis. One bathroom was being used as a storeroom, which places residents and staff at risk as this area did not have the appropriate fire precautions in place, and also reduces the bathing facilities available to residents. The manager was asked to prioritise removing these items to an appropriate storage area. It addition, a suitable privacy lock needs to be fitted to this bathroom door. Residents spoken with were positive about the laundry service provided at the home. The laundry area was well organised and staff commented that personal laundry arriving at the laundry in the morning is usually returned to residents the same day. Laundry staff confirmed that they had received appropriate training on the chemicals/products that they use. Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The availability of staff during busy periods was not always sufficient to promptly meet the needs of the residents. The staff team were not fully trained to ensure that they were competent to fulfil their roles. EVIDENCE: Comments in surveys suggested that generally residents felt that they usually received care support when they needed it, although several residents commented that depending on the time of day, staff do not respond promptly to the call bell, and people have to wait. This was observed during the site visit, especially during the morning period. This means that the service is not always able to respond to the individual needs of people using it. A relative spoken with expressed concerns about the number of staff on duty, and commented that on the day of the site visit, the afteroon drinks were late being offered, and that their relative was still in the dining room when they arrived, and usually they would have already been taken through to the lounge area. Staff spoken with also felt that they were able to provide a better level of care when there were six care staff on as opposed to five. Care staff also reported that qualified staff were too busy with their own work, such as administration of medicatin and record keeping, to be able to assist in the delivery of care, other than on an occasional basis. The manager reported that an increase in staffing levels was planned, due to the increase in occupancy. Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 Page 19 Residents living at the home were not supported by a competent and trained staff team, as the home has not achieved the 50 target of care staff trained to NVQ Level 2 or equivalent. Only 5 out of 18 care staff have achieved this level of training. The manager reported that she waiting for a start date for staff to start this training. Staff confirmed that they were offered a range of training opportunities, and kept up to date with the mandatory training. New staff worked through an induction training, that provided them with the necessary skills and knowledge to deliver the care that the home offers to provide. Staff confirmed that they were offered opportunities to develop their skills and knowledge, and all staff were provided with three paid training days a year. There has been a relatively high turnover of staff since the last inspection in December 2005, and 11 members of staff have left their employment (1 retirement and 1 redundancy) The manager reported that these staff have been replaced, although additional staff were being recruited. Residents were protected from potential risk through robust recruitment and selection procedures. A review of staff files showed that the required documentation had been obtained. Although criminal record bureau checks had not been received for those staff whose files were looked at, confirmation had been received that they were not on the Protection of Vulnerable Adults list. Staff awaiting criminal record bureau checks were always supervised by other staff. Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was generally well managed, and regularly seeks the views of residents, in order to improve the quality of the service provided. EVIDENCE: The manager has been in post since September 2005, and has recently submitted an application for registration to the Commission. The manager has many years experience as a qualfiied nurse, and has previous experience in the role of deputy manager. The manager reported that she was currently studying towards the Registered Managers Award. A representative of the company visits the home on a monthly basis, to carry out the monthly audit of the conduct of the home. These reports were available in the home and were also forwarded to the local area office. Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 Page 21 Residents, relatives and staff commented that the manager was approachable and that they were able to discuss any issues with her as they arose. A recent relatives meeting had been held, to assist open and two way communication betweeen the manager and the relatives. Quality assurance systems were in place, and the company and the manager were committed to improving the quality of care and services provided at the home. A resident satisafaction survey was carried out in early 2006. The results from this survey had been compared to those from the previous survey in 2005, and the information made available to residents and relatives in the Statement of Purpose. The manager also has responsibility for carrying out monthly audits and reporting the information, for incidents such as complaints, and accidents. Systems were in place for safeguarding residents money. However, the records avaiable, which were not the most up to date, indicated that a number of residents had a negative balance, which implied that other residents monies was being used. The printed information available for inspection was several months out of date, although the electronic record was kept up to date. This was discussed with the manager, and was in part, due to the recent change in administrator. Staff were up to date with the majority of the mandatory training. All staff had completed moving and hanlding and fire safety training. Food hygiene training was provided through a distance learning package, and all staff were working through training package on nutrition. On completion of this training, staff would begin a training programme on infection control. Staff also complete a brief introductary booklet on infection control and moving and handling as part of their induction to the home. Only two members of staff hold a current first aid certificate, although qualified nurses are on duty at all times in the home. Accidents records were viewed as part of the case tracking process. The files supported that accidents were recorded in the daily logs and separate accident forms were also completed. All accidents forms were reviewed by the manager and signed off when the appropriate action had been taken. Information provided in the pre-inspection questionnaire supported equipment had been serviced/maintained within the specified timescales. The lift was being serviced on the day of the site visit. Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 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. 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 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 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 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? No 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 2 3 Standard OP9 OP9 OP21 Regulation 13(2) 13(2) 13(4)(2) & 23(4) 18(1)(a) Requirement Timescale for action 31/08/06 4 OP28 Residents must receive their medication as prescribed. The medication trolley must not 31/07/06 be left open and medication inadequately supervised. The items stored in the 31/08/06 bathroom must be removed to a storage area fitted with adequate fire precautions 50 of care staff must be 30/09/06 enrolled on courses to train towards NVQ Level 2 or equivalent. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP7 OP7 Good Practice Recommendations Action to be taken by staff should be recorded in specific and measurable terms in the care plans. Care plans should be drawn up with the involvement of the resident, include details of their abilities, needs and preferences, be recorded in a style accessible to the DS0000002132.V293567.R01.S.doc Version 5.1 Page 24 Alexandra Nursing Home 3 4 5 6 7 8 9 10 OP7 OP12 OP21 OP20 OP20 OP27 OP35 OP35 resident, and agreed and signed by the resident whenever capable and/or representative (if any). Care plans should be reviewed and evaluated on a monthly basis with the resident and/or representative. Information about individual residents social interests, hobbies and life history should be readily available to all staff. An appropriate privacy lock should be fitted to all bathroom doors. (Outstanding requirement from inspection report dated 06/12/05) The garden area should be tidied up and made presentable. Consideration should be given to providing a ramped access to the garden area from the main ground floor lounge. The staffing levels during busy periods should be reviewed to ensure that sufficient staff are available to attend to residents needs promptly. Money from one person’s personal allowance should not be used for another person. Up to date records for residents personal allowances should be available at all times. Alexandra Nursing Home DS0000002132.V293567.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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