Inspection on 20/08/07 for Amberwood Nursing Home

This inspection was carried out on 20th August 2007.

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

The inspector 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

Amberwood Nursing Home 22/08/08

Amberwood Nursing Home 14/11/06

Amberwood Nursing Home 09/05/06

Amberwood Nursing Home 19/01/06

Amberwood Nursing Home 25/07/05

Amberwood Nursing Home 25/01/05

Amberwood Nursing Home 06/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Amberwood Nursing Home 231 Exeter Road Exmouth Devon EX8 3ED Lead Inspector Stephen Spratling Key Unannounced Inspection 11:00 20th August 2007 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 Amberwood Nursing Home DS0000026696.V333818.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 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. Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Amberwood Nursing Home Address 231 Exeter Road Exmouth Devon EX8 3ED 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) 01395 263540 01395 263540 amberwood@btconnect.com Alextour Limited Mr Robert Henry Gunn Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Notice of Proposal to Grant Registration for staffing/environmental conditions of registration issued 13 May 1997 The Manager must successfully complete the Registered Managers Award by December 2006. 9th May 2006 Date of last inspection Brief Description of the Service: Amberwood is a detached house standing in well-tended gardens situated on the main road to Exmouth and is on a main bus route. It provides care and accommodation for 24 older people with nursing needs. The home has level access to the front of the house and from the lounge and dining room into the garden at the rear of the building. Information received from the home indicates that the current fees range from £480-£620 depending on the size of room and the level of care needed. Services not included in this fee are chiropody, hairdressing and continence pads. Inspection reports are available on request from the care home. Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In preparing for this inspection we sent questionnaires, asking about the quality of this service, to forty seven people. Completed forms were returned by five people who live at the home, one by staff and six by health care professionals who have contact with people who live at this care home. This inspection site visit was made unannounced 20th August 2007 when we spent five and half-hours in the home. A second visit was made to the home on 22nd August 2007, by appointment, when we spent a further four hours. There were seventeen people resident at the home and at the time of the inspection site visit and we spoke with nine of them. We also spoke with the acting manager, the service administrator and three members of care staff. We looked around all the shared areas of the home and at sixteen people’s private rooms. Read the care records for three people living at the home and looked at some other records kept by the home. What the service does well: The home does thorough assessments of peoples needs and expectations before they move in. This helps to make sure that if they are offered accommodation at the home and they decide to move in that they can be cared for properly. People are invited to contribute to the development of care plans written to describe how they should be supported. The plans produced are useful to staff helping them to provide people with the care they want and need consistently. People living at the home told us that staff treat them with respect and that they are free to spend time where and with whom they choose. Visitors to the home are helped to feel welcome. People living at the home and visiting health professionals tell us that staff work effectively to help people stay well and that staff ensure they receive the health care they need. Medications are safely managed. The home is comfortably furnished, kept clean and properly maintained. The ideas, concerns and complaints of people living at the home are taken seriously and acted upon. The improved management of this service has identified many of the improvements needed and is acting to make those improvements. Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 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. Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 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 Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People thinking of moving to this home can be confident that if they are offered a place, the thorough assessment arrangements will help make sure they can be cared for properly and in a way that meets their individual expectations. EVIDENCE: We looked at the care records for two people who had moved to the home since the last inspection in May 2007. Both contained detailed pre-admission assessments, which were dated as having been completed before they had been admitted. The records contained relevant information about these people’s medical and personal histories. The assessments identified the needs and preferences of the people concerned, for example whether they prefer to spend time in company or alone, their usual routines such as bed times and food likes and dislikes. Both assessment contained reference to information Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 Page 9 provided by the person they concerned and health professionals involved in their care. Both of these recently admitted people told the inspector that staff had visited them from the home before they decided to move in. They confirmed that these visits provided them with opportunity to discuss their needs and expectations and to hear what the home could offer them. Both people said that the preadmission information they had received had turned out to be accurate and were pleased with the service they had received since moving to the home. This care home does not provide an ‘intermediate care’ service. Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at this home can be confident that they will receive the health care they need and their medications safely. They will be properly supported to manage their personal care and will be treated with respect. EVIDENCE: We read the care plans written for three people. All three reflected the needs and preferences identified through the homes assessments. They clearly identified the need/issue, the goal of the plan and provided clear description of what staff should do to achieve the goal. For example one persons care plan identified their difficulty in moving themselves in bed, set a goal that they are comfortable and their skin remains undamaged, then went on to provide description of how staff should assist this person to move in bed including what equipment they should use to do this. Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 Page 11 All the care plans showed evidence of regular review and were available in the rooms of the people they were written about, allowing them and staff easy access. Two people were asked if they had been given opportunity to contribute to the development of their care plans and both confirmed this had been offered. One care worker confirmed that since care plans are now stored in peoples bedroom they are more routinely referred to and more useful. She commented that she and colleagues now take a more active role in developing and improving peoples care plans. An agency Registered Nurse who had worked in the home for just a few days, confirmed that they found that the care plans provide them with the information they need to care for people properly. Several peoples beds were equipped with bed rails to help prevent them falling from bed. We saw that risk assessments had been completed before these rails had been fitted, demonstrating that the rails were safe to use and the best approach for managing each individuals risk of falling and their need to feel safe. We also saw risks assessment which had been completed with regard to three people who use the homes stair lift. These assessments were clear about what the potential risks were and how staff should manage/minimise these risks and reassure the people using the lift. All five people living at the home who returned our questionnaires confirmed they “always” receive the “medical support” they need. People we spoke with also confirmed that they are helped to access the health care they need and that they receive help to maintain their personal care from gentle sensitive staff. All the people we met were dressed in a way that reflected their individuality, with attention having been paid to their personal grooming (hair/nails etc). When asked “…are individuals health care needs met by the care service” two visiting health care professionals who returned our questionnaires, responded “always” and four “usually”. Comments written on questionnaires included they “recognise when people are unwell…” and “staff have always acted appropriately in my experience…” . A specialist nurse wrote, “…Guidance provided is acted on properly”. People we spoke with confirmed that staff are polite and respectful at all times. Throughout the inspection site visit we heard staff addressing people living at the home warmly and respectfully. Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 Page 12 We saw one of the registered nurses administering medications to people at the home. Each persons prescribed medications was listed on a medication administration record, which was signed by the nurse directly after medicines were given. Medications administration charts were completed properly and included record of the receipt of medications as well as record of when and who had administered medicines. Medicines are securely stored and we saw that the administration of controlled medications is properly recorded with two staff checking and signing when they are administered. The homes medication policies have been updated and provide staff with appropriate guidance to help them manage people’s medicines safely. We looked at the administration record of one person who was prescribed a variable dose medication. The homes policy had been clarified regarding the administration of variable dose medicines however these persons’ records did not indicate why staff had elected to give particular doses or the effects of these decisions. Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who live at this home can be confident that their friends and families will be helped to feel welcome and that they will receive food they like. Their choices will be respected however they may not receive all the support they need to be active. EVIDENCE: Care plans describe peoples interests and what activities they would like to be involved in. For example one care plan described the person’s interest in light classical music and that they would like opportunity to go on outings. This person told us that they had not been on any outings since being at the home, that there is “not much to do” and that they would like more opportunity to be active. It was not evident from records how people were being supported to peruse their personal interests. Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 Page 14 Care staff said that, though staffing levels are now improving, over the past months they have had little time to spend with people on a one to one basis, to take them out of the home or supporting them to pursue their interests. We were told that an arts and craft group is run weekly, a singer/entertainer visits monthly and a monthly poetry and exercise group has just been started. However the acting manger agreed that currently people living at the home do not get enough individual support to be active and that this as an area to be improved as staffing levels are improved. Everyone we spoke with confirmed that they spend time where and with whom they choose and that they get up and go to bed when they choose. One person said that they find the quality of the food is variable. Everyone else described it as good or very good. A person who told us they need a soft diet confirmed that it is nicely presented and that food is tasty. We saw soft diets presented as individual portions. People who need help to eat were being properly supported to eat. A relative wrote on one of our questionnaires “they have coped extremely well with mums allergies”. People confirmed that their visitors are made to feel welcome. We saw one visitor warmly greeted when they arrived and offered a drink. A relative wrote in one of our questionnaires “they never fail to advice me of any problems and always greet me with a friendly hello and a smile”. Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at this home can be confident that their complaints would be listened to and acted upon. Staff would recognise abuse and act to protect them if they were being abused. However the lack of clear procedures to follow in case of suspected abuse could mean that staff would not respond in the best and most effective way to protect people living at the home from harm. EVIDENCE: The homes complaints procedure is clearly posted on a notice board and, although a little updating is needed, it provides the information people would need. We saw that the home has a system for recording concerns/complaints and compliments. The record contained information about three issues raised since January 2007 and described how they had been resolved. People living at the home said that they would raise complaints with the staff directly and with one exception indicated confidence that complaints would be listened to and acted upon. Where doubt had been raised by one person, the acting manager was able to describe what actions had been taken to address this persons complaint. Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 Page 16 We read the homes protection of vulnerable adults from abuse policy, which provided some general guidance to staff about how to respond if they had concerns that a person living at the home was being abused. However the guidance was not specific in terms how they should respond, who they should contact, how they should protect evidence, what/where they should record and so forth. We asked three staff about what they would do if they were concerned that a person living at the home was being abused and both care workers displayed common sense saying they would report to a senior on duty. A registered nurse also said they would report concerns but was not specifically aware of the home policy on reporting abuse. All three that they have received some training to help the recognise abuse and highlighting their responsibilities to protect vulnerable people from abuse. Amberwood Nursing Home DS0000026696.V333818.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service live in a comfortable, homely environment, which is kept clean. EVIDENCE: Of the five people living at the home who returned our questionnaires four responded “always” when asked if the home is kept fresh and clean, and one “usually”. Every one we spoke with during the site visit said they were satisfied with the standards of cleaning and hygiene around the home. We looked at all the shared areas of the home and most of the private bedrooms. All areas were clean and no unpleasant odours were detected. All areas were comfortably furnished and private bedrooms were personalised reflecting the people who occupied them. Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 Page 18 Many of the private bedrooms and one of the shared toilets did not have privacy locks, which potentially compromises people’s dignity. The acting manager said that everyone living at the home is offered a lock on their bedroom door and they are supplied on request. She confirmed that a privacy lock will be fitted to the toilet door without delay. The home laundry is small but suitably equipped with sluicing washing machine. Soluble laundry bags were available for use with foul laundry. Amberwood Nursing Home DS0000026696.V333818.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 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. People who live at this home can be confident that staff will treat them kindly and with respect. Planned improvements to the staffing levels need to be followed through to before people can be fully confident that staff will be on duty in sufficient numbers to care for them to the highest possible standards. Recruitment practices help to protect people living at the home from people unsuitable to work for them, although small improvements could be made to ensure the system is fully robust. EVIDENCE: Of the five people living at this home who returned our questionnaires four responded “usually” when asked “are staff available when you need them” and one “always”. One person wrote “there are busy times when staff are not available”. When asked do staff listen and act on what you say all five responded “always”. One person wrote the comment “they are always very kind” and a relative added the comment “staff…are without exception kind and dedicated to residents…” Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 Page 20 People we spoke with during the site visit were positive about staff confirming that they are kind, gentle and patient. Two people said that sometimes they have to wait longer than they would like for help, indicating that at times there are not enough staff on duty. Others confirmed that while they do sometimes experience delay in receiving help, that they were never asked to wait for unreasonably long periods and that this did not cause them concern. Care staff said that in recent months staffing levels had not been sufficient meaning they had to rush and not allowing them time to spend with people on an individual basis. However they also said that over the past couple of weeks staffing levels had improved, with more agency staff being used and that new staff being recruited. The acting manager confirmed that she is actively recruiting more staff and her intention to improve the staffing levels. As indicated earlier (see daily life and social activities outcome group) she confirmed that staffing levels have prevented some people living at the home receiving the one to one support they need to be active. We spoke with an agency registered nurse on duty during the site visit. He said he found the care workers to be “excellent and confident” and that they seem to know the needs of the people who live at the home well. Care staff were asked about their training and qualifications. One person in post a year said they had done NVQ 3 (a nationally recognised care qualification) while employed else where, but had not received any training since working at Amberwood. Another in post just four weeks said they had NVQ 2 and felt that their induction to the home had been helpful and allowed her to settle in and get to know the people and routines. One of the registered nurses working at the home said that they had received training about first aid, food and hygiene, moving and handling, care of the terminally ill and abuse during the past couple of years. Records to confirm the training received by staff were incomplete. We were given copy of a training “matrix” (overview of training done and needed by the whole staff group), this indicates that six staff have not had up to date manual handling training and just one staff member has received training to allow them to administer first aid (See management and administration outcome group). The acting manager said that training in the home is not up to date but that plans are in place to ensure all staff receive the training they need. We were shown lists of training that has been booked for the coming three months. Care staff spoken with confirmed that they are being asked to attend several training sessions in the coming months. Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 Page 21 Health care professionals who returned our questionnaires were asked “do the care staff have the right skills and experience to support individual’s social and health care needs”. To which four answered “always” one “usually” and one wrote, “as far as I am aware”. One professional wrote “staff appear to be caring and knowledgeable of their clients medical problems” and another wrote, “staff regularly attend study sessions provided by the tissue viability service”. We looked at the recruitment records for four staff. Two had been recruited since the last inspection. One of these was for a staff member recruited and supplied by an recruitment agency and provided confirmation, from this agency, that the required pre-employment checks had been made. The other contained all the required checks dated as having been received before the staff member started work. However neither of this persons references were from their last employer as is recommended. The acting manager agreed to request a reference from this employer. Job descriptions were not present in either of these staff files although the acting manager said that they had been issued. The file for one person who had been in post for over two years contained a Criminal records bureau check (CRB) but this had been received from a previous employer and not completed since being employed at Amberwood as it should have been. The acting manager agreed to request an updated CRB for this person and to audit all staff files to ensure that all staff have undergone full, thorough and up-to date recruitment checks. Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 Page 22 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 adequate. This judgement has been made using available evidence including a visit to this service. People who live at this home can be confident that a competent person manages it and that the building is safely maintained. Plans for staff training and to implement systems for monitoring and improving the quality of the service need to be acted upon before people can be confident that they will receive a consistently high quality service and their health and safety will be best protected. Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 Page 23 EVIDENCE: This home does not currently have a registered manager. The home has an acting manager who told us she took on responsibility for managing the home about two months ago and has been trying to spend about three days per week on site. She remains registered manager of another care home and is also supporting the management of a third care home; all owned by Alextor Ltd. The acting manager is very experienced and staff described her as approachable, responsive and supportive. The acting manager was able to describe actions taken or planned to address all the requirements made following the last inspection. As mentioned earlier in the report (see Choice of home and Health and personal Care outcome groups) significant progress has been made regarding the homes arrangements for assessing the needs people who want to move to the home and planning and monitoring peoples care. The acting manager told us that a new manager has been recruited for Amberwood, though was not yet in post. She confirmed that an application for registration of the new manager will be submitted to the Commission in the coming weeks. One person who returned one of our questionnaires wrote the comment “this home is very well run”. The acting manager said that questionnaires asking for peoples views about the quality of the service provided had been sent to people living and working at the home, relatives and visitors (including visiting professionals) during the week preceding the site visit. We saw that a small number had so far been returned. The acting manager also described and provided example from another service she runs, a system which she intends introducing designed to monitor/audit compliance of the service with all of the thirty eight national minimum standards for care homes for older people. At the time of the site visit we were told that the home was holding money on behalf of three people living there. We saw that this money was securely stored and clear records were maintained of deposits and withdrawals. We checked one account against the money held which was correct. As mentioned in the staffing outcome section of the report, evidence was not available of all staff having received up to date training in health and safety topics. Nor was it evident that there is always a suitably skilled first aider on duty in the home at all times. Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 Page 24 We spoke with the person responsible for maintenance and fire safety in the home. He told us that he had attended training to permit him to train care staff on fire prevention and fire response. He said that all staff have a basic introduction to fire procedures when they start in the home and more in-depth training annually. A new member of staff we spoke with was able to describe what their responsibilities would be if the fire alarm were to sound. We saw the homes fire risk assessment (this was not read) and it was dated as having been updated in April 2007. The homes records showed that the fire alarms are tested weekly and the extinguishers and emergency lights tested monthly as is recommended by fire officers. We saw records that the homes portable electrical appliances (PAT) are tested regularly. A current gas safety certificate was available for inspection. While walking around the home we saw that upper floor windows were restricted to reduce the risk of people falling from them. Hot surfaces seen were guarded to prevent people burning themselves. Equipment for assisting people to move such as hoists were marked as having been serviced within the past twelve months to ensure they work safely. Amberwood Nursing Home DS0000026696.V333818.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 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 Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 Page 26 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 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 2 Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 Page 27 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 Standard OP29 Regulation Requirement 19 (1) Schedule 2 To help protect people living in the home from people unsuitable to work with them all staff should have been subject Criminal Records Bureau Check. To make sure the quality and safety of the service is consistently monitored and improved and the views of people living at the home are taken into account in the planning and running of the service; the planned system for reviewing and improving the quality of the service should be fully implemented. Timescale for action 20/11/07 2 OP33 24 20/01/08 3 OP38 13 (4) To make sure people living in the 20/10/07 home receive prompt and appropriate first aid treatment arrangements should be made to make sure there is always a suitably skilled/trained first aider on duty in the care home. Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 Page 28 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 OP9 Good Practice Recommendations To make sure people receive variable dose medications consistently and in the most effective way, the homes policy on managing variable doses should be more closely adhered to. Care plans should describe the indications for administering particular doses and records of the effectiveness of the doses given should be maintained. People living at the home should be provided with more support to be active and have more opportunities for stimulation and recreational activities in and outside the home, which suit their needs preferences and capacities. To help make sure people who live at the home are properly protected from abuse. And to ensure staff respond in the best way possible if they are suspect that a person living in the home is being abused. The homes procedure to guide staff on how they should report their suspicions needs to be developed to make them clearer. All staff should be fully aware of the homes policies and procedures regarding recognition and reporting of abuse. 4 OP27 To ensure people living at the home receive the personal care they need promptly and that they receive adequate support to active and pursue their interests; staffing levels need to continue to improve. To help ensure the suitability of new recruits, references requested should include references from their most recent employer. To make sure staff are clear about their roles and responsibilities all staff should be issued with statements of terms and conditions of their employment. 2 OP12 3 OP18 5 OP29 Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 Page 29 6 OP38 To make sure that staff working in this home have the skills they need to support people safely and in the way that they need, all care staff must receive up to date training (as planned) in relation to moving and handling. Amberwood Nursing Home DS0000026696.V333818.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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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