Inspection on 14/05/09 for Anchorage Nursing Home

This inspection was carried out on 14th May 2009.

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

Anchorage Nursing Home 22/05/08

Anchorage Nursing Home 31/05/07

Anchorage Nursing Home 26/09/06

Anchorage Nursing Home 18/03/06

Anchorage Nursing Home 29/11/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2009.

Key inspection report CARE HOMES FOR OLDER PEOPLE Anchorage Nursing Home 17 Queens Road Hoylake Wirral CH47 2AQ Lead Inspector Joan Adam Unannounced Inspection 14th May 2009 09:30 DS0000065659.V375557.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Anchorage Nursing Home DS0000065659.V375557.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Anchorage Nursing Home DS0000065659.V375557.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Anchorage Nursing Home Address 17 Queens Road Hoylake Wirral CH47 2AQ 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) 0151 632 4504 0151 632 0367 aynsleynursinghome@hotmail.co.uk Rolfields Limited Helen Devaney Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Anchorage Nursing Home DS0000065659.V375557.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home is within the following category: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 35 Date of last inspection 22nd May 2008 Brief Description of the Service: The Anchorage Nursing Home is a three storey building situated in Hoylake. The home is registered to provide nursing care for up to thirty-five service users over the age of 65 years of age. There are bedrooms on all three floors of the home. There are two dining rooms, lounge and conservatory situated on the ground floor, as is the kitchen and laundry room. There is a passenger lift to all floors and a stair/chair lift from ground to first floor. There are two car parks, providing ample space for visitors. Rolfields Ltd owns the home and the registered manager is Helen Devaney. It costs £480.00 per week to live at the home Anchorage Nursing Home DS0000065659.V375557.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The overall quality rating for this service is no stars. This means that the people who use the service experience poor quality outcomes. The site visit was carried out by two inspectors of the Care Quality Commission 14th May 2009 over a period of six hours. This was to assess if peoples needs were being met at the home. A tour of the premises took place, a majority of bedrooms were looked at and the shared areas such as dining rooms and lounges, shared bathrooms and toilets. The manager, several staff and people cared for were spoken with and their views contributed to the inspection of the home. This visit was just one part of the inspection. Before the visit the home was asked to complete a self audit called an annual quality assurance assessment! (AQAA) to provide up to date information about the services at the home. The manager of Anchorage had completed this form. Other information sent to us by the home and other professionals such as social services since the last key inspection was also reviewed so that we could plan what we needed to look at when we visited. We made a short visit to the home in January to assess if the requirements made following the last visit had been met. This is called a random inspection. Requirements were made at the random inspection and progress on how they were being met was looked at on this visit. Feedback was given to the manager at the end of the visit. What the service does well: There is enough staff on each shift so that people living in the home are not rushed and their independence is maintained. The activities on offer are varied so that people have enough to do and can make choices about their day so that they have some control over their lifestyle. Anchorage has a warm homely atmosphere and residents spoken with said “the staff are lovely. The food on offer is good and wholesome and people spoken with said “we get a good variety of food. the food is always nice. A good standard of hygiene was seen throughout the home. Anchorage Nursing Home DS0000065659.V375557.R01.S.doc Version 5.2 Page 6 Staff were seen to be patient and caring with the residents in their care. All staff receive regular training to improve their skills. Recruitment procedures are robust so that people who are employed at the home are safe to work with elderly people. There are some auditing systems in place so that areas of improvement can be identified and acted upon. What has improved since the last inspection? What they could do better: Care plans for people living at the home must improve so that all identified needs and changes to the care are recorded. Treatment and advice must be obtained from other health care professionals so that the health and welfare of people living in the home is addressed. Any visits that have taken place must be recorded so that staff are aware of who has visited and why. Medication administration sheets must be obtained for all prescribed items so that all staff are aware of when and how often prescribed dietary supplements are to be given. All prescribed items must be signed for when given Anchorage Nursing Home DS0000065659.V375557.R01.S.doc Version 5.2 Page 7 Risk assessments must be in place for all people who live in the home who smoke in their bedrooms so that the area of risk is safely managed and what measures are in place to alert staff as to the precautions that should be taken to maintain the safety of these or other people living, working and visiting the home. All fire safety doors throughout the home must be checked regularly to ensure that they close properly to minimise the risk for all people who live, work and visit the home is maintained A fire risk assessment present in the home states smoking outside , however, a smoke room is provide for people who live at the home. The fire risk assessment must be updated to include all the above risks. Fire alarm checks must be carried out weekly to ensure that they are working correctly. The bathrooms and toilets throughout the home need to be fitted with overridable locks as none of the bathrooms and toilets can be locked to maintain the privacy and dignity of the residents living there. This was a requirement at the last visit, however, the registered manager informed us that she would purchase the locks and have them fitted. Some window frames are rotting and could be dangerous. All window frames must be risk assessed to maintain the safety of people living in the home and a programme of replacement or repair should be forwarded to CQC. All areas identified with regard to the environment must be addressed. The toilets and bathrooms throughout the home need to be identified as each door within the corridors are the same and this could cause confusion to the residents who are trying to find a toilet. There were no names on the bedrooms doors and this could cause some residents to be unable to find their own bedroom, as the corridors were similar. This was discussed with the manager at the last visit. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Anchorage Nursing Home DS0000065659.V375557.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Anchorage Nursing Home DS0000065659.V375557.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3, People using the service experience 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 the service had their needs assessed before they lived there so that they knew the home could meet their needs. EVIDENCE: There have been no new people living at the home since the last visit so this standard was not assessed. Anchorage Nursing Home DS0000065659.V375557.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 People using the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health care needs of people who live in the home are not well managed or recorded so that their care needs may not be fully met and their privacy and dignity is not always respected. EVIDENCE: The AQAA told us that care plans are in place which are regularly reviewed. When we visited we found that everyone who lives in the home has a care plan. We looked at the care plans of four people living at the home. Care plans had been rewritten on new documentation and at a short visit made to the home by us in January 2009 care plans had improved and were more detailed than at the visit in May 2008. Anchorage Nursing Home DS0000065659.V375557.R01.S.doc Version 5.2 Page 11 However, two people were found to be smoking in their bedrooms but no mention was made of this in the care plans. There were no risk assessments in place to manage this or to alert staff as to the precautions that should be taken to maintain the safety of these or other people living at the home. This was discussed fully with the registered manager at the time of the visit. We contacted the fire officer responsible for assessing the home following our visit to inform him of our concerns. One care plan stated that this person had a gastric ulcer but there was nothing recorded as to when the GP visited and who had made this diagnosis. One care plan looked at said that the person had no problems with breathing, however they had recently had a chest infection and the physiotherapist had attended to provide chest physio. Another care plan looked at had a nutritional risk assessment in place which said that they were at a high risk. On looking at the monthly weights recorded it appeared that this person had lost a considerable amount of weight, however there was no reference to this within the care plan, evaluations or the daily records. There was no record of this person being seen by the dietician or GP with regard to weight loss. There was a chart in their bedroom which recorded how often they had their position changed and how often they ate. This did not give a good account of what was eaten and comments such as “ate most of their lunch, ate a pudding” was recorded. There was no indication as to what the meal consisted of, what was the nutritional value of the meal how much was being eaten. The care plan also recorded a pressure sore, however the wound assessment charts which were completed when the wound was redressed stated that the person had three pressure sores. There was no record of advice from the tissue viability nurse since September 2008. One care plan stated that the person had a pressure sore but the evaluation stated that this had healed. The care plan had not been updated to reflect the changes that had taken place and to inform all staff of this information. A care plan looked at said that the person who lived at the home was not receiving general baths when they were first admitted at their request. The evaluation now states that general baths are given but the care plan had not been updated to reflect this change. Two people had prescribed dietary supplements stored in the cellar area. There were no medicine administration sheets in place for these so that staff would know when these were to be given and how often. One of the persons’ care plans was looked at and this did not record that these supplements were to be given. On looking at the monthly weights it stated that the person could not be weighed. The home should find an alternative way to assess the weight of this person so that any loss of weight can be properly monitored. Staff were observed to have a good relationship with the people in their care. They treated people with respect and were seen to knock on doors before entering the bedrooms and bathrooms. Anchorage Nursing Home DS0000065659.V375557.R01.S.doc Version 5.2 Page 12 Medication management was looked at. The medicine administration sheets (MAR) had all been completed correctly. Medicines were stored safely. Controlled drugs had been checked by two staff members and this was recorded correctly. As previously stated there were no MAR sheets in place for prescribed dietary supplements for two people who lived at the home so that staff would know when these were to be given and how often. Anchorage Nursing Home DS0000065659.V375557.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15, People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Anchorage are able to enjoy a stimulating lifestyle with a variety of options to choose from. EVIDENCE: The AQAA told us that the home has a variety of activities on offer. We found this to be true .The home has two activity co-ordinators employed. A varied activities plan is on offer at the home. Some people were playing scrabble at the time of the visit. A care plan was in place for every one living at the home with regard to their social needs. The garden has a green house which is full of tomato plants and orange trees. The people who live in the home are involved in the garden and are growing their own vegetables. Photographs had been taken of events that had taken place such as St Patrick’s Day. Staff and people Anchorage Nursing Home DS0000065659.V375557.R01.S.doc Version 5.2 Page 14 who live at the home were seen to be dressed up and some people were seen to be enjoying a pint of Guinness in the garden. The home has two budgies which are very tame and there were photos of people who live in the home holding them. A quarterly newsletter is published so that people are kept up to date with events and news. A varied menu is on offer and the meals are written on the board in the dining room. Lunch on offer on the day of the visit was beef casserole or quiche with boiled potatoes and vegetables. This looked appetising and people spoken with said “it’s smashing” “food is always good” People who needed assistance with their meal were helped by staff in a dignified and sensitive manner. Anchorage Nursing Home DS0000065659.V375557.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know how to complain and believe staff will take action to address any concerns that they may have. EVIDENCE: We looked at the AQAA which said that no complaints have been made to the home since the last visit. The home has a complaints procedure which is on the notice board in the main entrance. This needs to be up date to include the address of CQC. Staff have received training with regard to the safeguarding of adults so that they know what to do in the case of abuse being suspected. They have also received training regarding whistle blowing so that they are aware of their rights. Anchorage Nursing Home DS0000065659.V375557.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 People using the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment needs to improve so that people who use the service live in a safe, comfortable and well-maintained environment, which is equipped to meet their needs. EVIDENCE: The home has had some bedrooms redecorated since the last visit. A new dishwasher has been purchased for the kitchen. A rotting window frame identified at the last visit has been replaced. Anchorage Nursing Home DS0000065659.V375557.R01.S.doc Version 5.2 Page 17 Some new chairs and beds have been purchased to replace old worn ones. A new shower room has been installed so that people who live in the home can have a choice of bathing. There were however, still some areas of the home that require improvement. Some bedrooms have electric heaters as the main central heating boiler is to be replaced. The registered manager informed us that this work is to commence in July when the weather has improved. The bathrooms and toilets throughout the home need to be fitted with overridable locks as none of the bathrooms and toilets can be locked to maintain the privacy and dignity of the residents living there. This was a requirement at the last visit, however, the registered manager informed us that she would purchase the locks and have them fitted. The toilets and bathrooms throughout the home need to be identified as each door within the corridors are the same and this could cause confusion to the residents who are trying to find a toilet. This was discussed with the manager at the last visit. There were no names on the bedrooms doors and this could cause some residents to be unable to find their own bedroom, as the corridors were similar. Some bedroom doors were not closing fully. These doors are fire safety doors and must close fully to maintain the safety of people living in the home. The bedroom door of a person that was found to be smoking in their bedroom was not closing fully. All bedroom doors should be checked regularly and adjustments made to ensure they fit properly. Some window frames on the outside of the home are rotting and an assessment of these should be made with the view to replacing or repairing them. The fire safety door outside the laundry did not close properly and had a gap of about half an inch. This does not maintain the safety of the people living and working in the home. A fire risk assessment completed in March 2009 has identified this and an action plan has not been addressed. The lighting in the laundry is poor and needs to improve. The cellar area is used for storage and although this is organised well it is advised that the arrangements are discussed with the fire service. Following the visit we telephoned the local fire service to discuss areas of concern. The home was cleaned to a high standard and the domestic staff spoken with take pride in their work One staff member has attained an NVQ level two in housekeeping. Anchorage Nursing Home DS0000065659.V375557.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive care and support from skilled staff that they like. EVIDENCE: We looked at the homes AQAA which showed us that a variety of staff are employed to provide care and support to the people who live in the home and that the staff was recruited correctly. We found this to be true. We found that staff are supplied in sufficient numbers to meet peoples’ needs and people who live in the home said they thought that there was enough staff on duty on each shift. We saw that most of the staff working in the home have achieved a national vocational qualification in care. This shows that staff have had formal training to carry out their roles. We saw staff training has improved and is on-going and that all staff have received mandatory training in key subjects. This means that staff have been given the skills to promote peoples health and welfare. Anchorage Nursing Home DS0000065659.V375557.R01.S.doc Version 5.2 Page 19 Anchorage Nursing Home DS0000065659.V375557.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 People using the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management needs to improve so that the health, safety and welfare of people who live at the home are protected. EVIDENCE: The manager is an experienced nurse and has been registered with CQC (previously CSCI.) She has achieved the NVQ level 4 in management. The home has some auditing systems in place and has attained IS0 9001. Audits are completed monthly on care plans and medication management. Questionnaires are sent out to relatives and comments received were positive. Anchorage Nursing Home DS0000065659.V375557.R01.S.doc Version 5.2 Page 21 Comments such as “staff are very patient and kind” “the home is always clean” “staff are friendly and dedicated” were written. Two comments regarding the request for new glasses and the fact that some clothes had gone missing had been addressed by the manager. The AQAA told us that all the required safety certificates were in place. Staff have received up dated fire safety training so that they know what to do in the case of a fire. A fire risk assessment has been completed but this states that people must smoke outside. A smoking lounge is provided for people who live at the home and the risk assessment must be up dated to reflect all known risks. Fire alarm points and emergency lights are tested monthly and this is recorded. However, fire alarm points should be tested weekly as advised by the fire service. We were concerned that some bedroom doors, which are fire safety doors, were not closing fully so that people are being kept safe. One of these doors was a bedroom of a person that smoked in their bedroom. The manager informed us that these doors are not checked on a regular basis as part of the fire safety checks. The fire safety door outside the laundry did not close properly and had a gap of about half an inch. This does not maintain the safety of the people living and working in the home. A fire risk assessment completed in March 2009 has identified this and an action plan has not been addressed. This was fully discussed with the manager at the time of the visit. Following the visit we telephoned the local fire service to discuss areas of concern. Anchorage Nursing Home DS0000065659.V375557.R01.S.doc Version 5.2 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 1 Anchorage Nursing Home DS0000065659.V375557.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 (2)(b, c & d) Requirement Ensure that each service user has a written service user’s plan identifying all their needs in respect of health and welfare and detailing instructions for staff on what action they must take to meet those needs. Ensure that service users’ plans are kept under review to assess whether they are effective in meeting service users’ needs. Ensure that service users’ plans are amended should the service users’ needs change. Ensure that records of nutritional intake are sufficiently detailed to demonstrate the nutritional value of the food consumed, so that they provide sufficient information to determine whether the service user plan is being followed and whether the service user’s dietary DS0000065659.V375557.R01.S.doc Timescale for action 30/06/09 2 OP7 15(2)(b, c & d) 30/06/09 3 OP7 15(2)(b, c & d) 15(2)(b, c & d) 30/06/09 4 OP7 30/06/09 Anchorage Nursing Home Version 5.2 Page 24 requirements are being met. 5 OP8 13 Advice must be obtained from other health care professionals to maintain the health and welfare of people living at the home. Medicine administration sheets must be obtained with regard to prescribed dietary supplements. So that staff are aware of when to give the supplements and how often. An inventory of all window frames must be made and a plan of how these are to be replaced or repaired sent to CQC. All fire safety doors must be checked on a regular basis to ensure that they are fitting correctly and appropriate means of adjusting the doors is made. So that people who live, work and visit are kept safe. The fire risk assessment must be updated to include all areas of risk identified. A risk assessment must be in place for all people who smoke in their bedrooms and a management plan put in to place to minimise this risk so that people who live, work and visit the home are safe. The toilet and bathroom doors in the home must be identified so that people who live in the home are aware of where the facilities are. Fire alarm safety checks must be carried out on weekly basis as advised by the fire service. 30/06/09 6 OP9 13 30/06/09 7 OP19 23 30/06/09 8 OP19 23 30/06/09 9 10 OP38 OP38 24 24 30/06/09 12/06/09 11 OP8 23 30/06/09 12 OP38 24 12/06/09 Anchorage Nursing Home DS0000065659.V375557.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Anchorage Nursing Home DS0000065659.V375557.R01.S.doc Version 5.2 Page 26 Care Quality Commission Care Quality Commission Unit 1 Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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