Inspection on 14/09/07 for Ashwood Nursing Home

This inspection was carried out on 14th September 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ashwood Nursing Home 27/04/09

Ashwood Nursing Home 28/10/08

Ashwood Nursing Home 01/05/08

Ashwood Nursing Home 06/03/07

Ashwood Nursing Home 13/06/06

Ashwood Nursing Home 28/02/06

Ashwood Nursing Home 19/09/05

Ashwood Nursing Home 07/03/05

Ashwood Nursing Home 14/01/05

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Ashwood Nursing Home Burwash Common Etchingham East Sussex TN19 7LT Lead Inspector Elizabeth Baker Key Unannounced Inspection 14th September 2007 09:40 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 Ashwood Nursing Home DS0000013957.V342376.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. Ashwood Nursing Home DS0000013957.V342376.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashwood Nursing Home Address Burwash Common Etchingham East Sussex TN19 7LT 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) 01435-883434 01435 883091 ashwoodnh4@hotmail.co.uk Ashwood Nursing Home Ltd Miss Ann Elizabeth Morrissey Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19), Physical disability (19) of places Ashwood Nursing Home DS0000013957.V342376.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is nineteen (19). Service users must be older people aged sixty-five (65) or over on admission, and those with a physical disability. Two named service users under sixty-five (65) years on admission with a learning disability only to be accommodated. 6th March 2007 Date of last inspection Brief Description of the Service: Ashwood is a nursing home that provides care up to nineteen older people or those with physical disabilities over the age of 65 years and three residents less than sixty-five years with a learning disability. Ashwood is in the hamlet of Burwash Common and set in grounds with flat access for residents. A wellstocked and managed garden is available to be used by the residents. There is ample off road parking for visitors. The nearest town is Heathfield; the village of Burwash is two miles away. The home is situated on the bus route and there is a railway station in Stonegate a nearby village. The home provides eleven single rooms, and four shared rooms over two floors, situated on the ground and first floors. Eight rooms provide en-suite facilities. Day space consists of a combined lounge/dining room. A passenger lift allows level access throughout the home. The latest inspection report is available on request in the manager’s office. Current weekly fees range from £550.00 to £950.00 excluding hairdressing, chiropody, physiotherapy, newspapers and aromatherapy. Inhouse activities are limited, but external entertainers provide a range of activities at seasonal times and for a couple of hours one afternoon per fortnight. Ashwood Nursing Home DS0000013957.V342376.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first key unannounced visit to the home for the inspection period 2007/08. Allocated inspector Elizabeth Baker and link inspector Melanie Freeman carried out the visit on 14 September 2007. The visit lasted about seven and a half hours. As well as briefly touring the premises, the visit consisted of talking with some residents and staff. Two residents, one member of staff and one visitor were interviewed. Feedback was provided to the registered manager during and at the conclusion of the visit. At the time of compiling the report, in support of the visit, the Commission received survey forms about the service from one resident and two relatives/advocates. At the Commission’s request the manager completed and returned an Annual Quality Assurance Assessment (AQAA). Some of the information gathered from these sources has been incorporated into the report. At the time of the visit, 14 residents requiring nursing care were residing at the home. What the service does well: Many residents like the fact the home is near to where they used to live, as well as the unrestricted access their visitors have. The home manager has a good understanding of residents’ holistic needs and tries to assist them in achieving the best possible outcomes. Even if this means the home picking up additional costs which are not reimbursed by sponsoring authorities. Residents are supported in transferring to homes in other areas where the move would benefit the resident and family as a whole. Comments from residents and correspondents included “I’m perfectly satisfied here”; “Feel quite at home here”; “Food is very good - home made cakes”; “[the manager] is marvellous, always has a chat with relatives and visitors”; “bedroom is kept spotless”; “meals are quite nice”; “[the home] looks after individual whims and fancies. Good care for the dying, good medical care and plenty of freedom for the more able”. Ashwood Nursing Home DS0000013957.V342376.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. The summary of this inspection report can be made available in other formats on request. Ashwood Nursing Home DS0000013957.V342376.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 Ashwood Nursing Home DS0000013957.V342376.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Residents who use the service experience good outcomes. This judgement has been made using a range of evidence including a site visit to the service. In the main most residents can be sure the home should be able to meet their assessed needs. EVIDENCE: Prospective residents are generally visited by the home manager in their current place of occupation prior to a decision of admission being made. At that time the prospective resident and or their advocates would be given information about the home. Where practically possible prospective residents visit the home. However where this is not possible, relatives or advocates visit on their behalf. The information gathered at these visits is recorded. However one of the available assessments seen had not been dated or signed and did not record where the assessment had been completed. As part of the admission process new residents and or their advocates are provided with a letter offering them a place at the home. The letter refers to the home’s terms and conditions of residence. However it does not specifically confirm the home can meet the residents’ assessed needs. Ashwood Nursing Home DS0000013957.V342376.R01.S.doc Version 5.2 Page 9 Not all care staff have received specific training in dementia, epilepsy and learning disabilities. Some of the residents admitted into the home have these conditions. Standard 27 refers. The home is not registered for intermediate care. Standard 6 is not applicable. Ashwood Nursing Home DS0000013957.V342376.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Residents who use the service experience adequate outcomes. This judgement has been made using a range of evidence including a site visit to the service. Although care records do not sufficiently evidence this, residents’ health needs are generally met. Medicine management is still not robust enough to fully minimise all potential risks to residents. EVIDENCE: Since the last visit the home has introduced new care documentation. Sadly the first attempt proved unsatisfactory. This visit coincided with the introduction of another system. Because of this it was difficult to obtain a coherent picture of residents’ current health, social and personal care needs and preferences. However from the three records inspected it was again identified that not all clinical and risk assessment information was in place. Where it was available not all of it was up to date or detailed enough. This included wound management. There were no risk assessments in place for a resident provided with bedrails and another who uses a hot water bottle. Where pain is identified in the daily record, there was no accompanying pain assessment chart to monitor the effectiveness of the treatment. Not all the records contained residents’ weights or nutritional screening assessments. The home uses “stand-on” type scales, which are not suitable for residents who cannot weight bear. Advice is sought and input obtained from GPs and Ashwood Nursing Home DS0000013957.V342376.R01.S.doc Version 5.2 Page 11 specialist clinicians where there is an assessed need. Disappointedly this information is not always included in the care plan. The care plans inspected did not contain details of residents’ social care needs. But the care plans did evidence that the home is now striving to obtain details of residents’ wishes and preferences in the event of death and dying. Following a pharmacy inspection carried out at the home on the 8 March 2007 there has been an improvement in medicine management. The temperature of the room used to store medicines is now monitored and recorded to ensure their efficacy. Arrangements are now in place for the legal disposal of waste medicines. The way medicines are administered to residents is done in accordance with safe practice. However it was noted that some creams in use had not been dated on opening and eye-drops were not always dated and changed when expired. An Epipen was found to be out of date. Where medicines are administered on a “administer when required” basis there was no clear guidance for staff when to do this. There was still insufficient information in a care plan of a resident who spends much of their time away from the home to determine whether or not the home actually supplies the medicines to be administered during the absence. It was again identified that lancing devices intended for single person use were not being used appropriately. The controlled drugs register was inspected and found to be confusing. Although some medicines are not used for long periods a system of regular checking has not been established. Indeed there was no recorded evidence that the shortfall identified at the last visit had been investigated. There is still no system in place for testing nursing equipment such as nebulizers and suction machines. This must be carried out in accordance with manufacturers instructions. Ashwood Nursing Home DS0000013957.V342376.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Residents who use the service experience good outcomes. This judgement has been made using a range of evidence including a site visit to the service. Residents generally spend their days as they wish to. EVIDENCE: Structured daily activities do not take place, leaving residents to spend their time as they wish to. Some residents choose to spend their time in the privacy of their bedrooms and others prefer to sit in the day room and or frequently go out. Many residents are enabled to continue contacts with previous clubs and links to former care homes. Residents are welcome at any time and refreshments made available. External entertainers visit the home and fortnightly motivation sessions take place. Arrangements are made for residents to celebrate special occasions at the home with family and friends invited. Seasonal activities take place and advocates are invited to attend. Weather permitting, garden parties are held and these are much enjoyed. Religious ministers from different denominations visit residents who request this and a religious service takes place at the home on a monthly basis. One to one care is or has been provided to some residents through the use of aromatherapy, play and music sessions. Despite this a couple of residents looked isolated in their bedrooms. The care record review identified limited social information is available to assist all care staff in interacting with residents. Ashwood Nursing Home DS0000013957.V342376.R01.S.doc Version 5.2 Page 13 Residents spoken with indicated their meals are good and that staff are aware of their likes and dislikes. Ashwood Nursing Home DS0000013957.V342376.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Residents who use the service experience good outcomes. This judgement has been made using a range of evidence including a site visit to the service. The home has a complaints procedure and residents and their advocates feel their comments are listened to and acted on. EVIDENCE: Residents described the action they would take if they had cause to complain or were not happy about their care. The home’s complaints procedure is displayed near to the entrance, for the public’s ease of access. The returned AQAA indicates the home has not received any complaints over the last 12 months. A complaint records book is maintained. However it is not the home’s practice to record or make reference to all types of complaints and niggles received about the service. This may prevent the home obtaining an up to date picture of people’s views on the home’s facilities, services and practices currently provided for quality assurance purposes. The home now has an up to date copy of the County’s Multi-Agency Policies and Procedures for Safeguarding Vulnerable Adults. However specific training has not yet been provided to all care staff to reflect this. Ashwood Nursing Home DS0000013957.V342376.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Residents who use the service experience adequate outcomes. This judgement has been made using a range of evidence including a site visit to the service. Although residents live in a clean home, they are potentially at risk because not all environmental checks are carried out to ensure the safety of the home. EVIDENCE: Residents are able to individualise their bedrooms with personal affects. Indeed one resident said this was very important to them so they could be reminded of their own home. There is a large well-maintained garden at the rear of the home for residents to enjoy in good weather. The returned AQAA indicated and it was confirmed at the visit that the home’s fixed wiring installation survey is out of date. Arrangements are now in hand to obtain quotations for this work to be carried out. During the visit it was identified that fire safety in-house checks are not always carried as often as they should be. This included the monthly in-house emergency lighting and visual fire equipment checks. Standard 38 also refers. Areas visited were fresh and Ashwood Nursing Home DS0000013957.V342376.R01.S.doc Version 5.2 Page 16 odour free. Indeed a visitor said they visit the home regularly at different times and the home never smells. The home has an appropriately equipped laundry, which is used to wash residents’ clothes and the home’s linen. Ashwood Nursing Home DS0000013957.V342376.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Residents who use the service experience adequate outcomes. This judgement has been made using a range of evidence including a site visit to the service. Although recruitment procedures have improved they are still not sufficiently robust to minimise potential risks to residents. EVIDENCE: As expected of a care home providing nursing care, the home is staffed 24 hours a day and a registered nurse is always on duty. In addition to care staff, staff are employed for cooking, administration, maintenance, gardening and cleaning. There are times when care staff undertake other duties, such as kitchen and cleaning duties and preparing food on occasions. This forms part of their contract. Arrangements are in hand for staff to receive food hygiene, fire and first aid training. This is expected to take place in October 2007. As stated previously not all care staff have received training for dementia, learning disabilities or epilepsy, despite some residents having these conditions. At the last visit the home was provided with details of the Skills for Care website. This was because the home’s current induction programme does not adequately follow the Skills for Care training specifications for the provision of social care. It is the manager’s intention to obtain details from the website so that this can be implemented. To date 36 of unregistered care staff are now trained to NVQ level 2 or higher. Five care staff are currently working towards this qualification. Ashwood Nursing Home DS0000013957.V342376.R01.S.doc Version 5.2 Page 18 Systems are in place for the recruitment and appointment of staff. An agency is used to assist the home in recruiting care staff from overseas. However this system has not always provided references addressed specifically to the home as the intended employer. It is not the home’s practice to attempt to obtain their own references either from the original referees. Accepting this type of reference is contrary to good practice. To assist the home, the Commission’s publications Better safe than sorry – Improving the system that safeguards adults living in care homes (November 2006) and Safe and sound? – Checking the suitability of new care staff in regulated social care services (June 2006) were provided at the last visit. A government agency has recently checked details of work permits and passports of overseas staff. The findings were in order. Since the last visit the home has contracted with a professional financial organisation to assist the manager in ensuring the home complies with current employment law and practices. The home is about to implement the new system, which will include issuing all staff with new contracts. Ashwood Nursing Home DS0000013957.V342376.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. Residents who use the service experience adequate outcomes. This judgement has been made using a range of evidence including a site visit to the service. The manager has an in-depth knowledge of residents’ needs, but records and risk assessments are not adequately maintained to reflect this. The manager is fully aware and accepts there are deficiencies in the service and is taking steps to address the issues. EVIDENCE: The manager is a Registered Nurse and has attained the Registered Managers Award. The manager has run the home for just over 20 years. The home is a member of a trade organisation. To assist the home in developing its quality assurance systems, the home has acquired from the trade organisation a quality assurance programme, as well as guidance on the Commission’s new AQAA process. The manager intends to implement a quality assurance programme shortly. Although formal meetings have not been held recently, the manager is readily available to speak with residents and or their Ashwood Nursing Home DS0000013957.V342376.R01.S.doc Version 5.2 Page 20 advocates at any time. Indeed a resident and visitor commented on this. Formal individual staff supervision sessions are not currently taking place, although the home manager is aware of the importance of this. In the interim staff meetings have taken place, with attendance being compulsory. Since the last visit many of the home’s policies and procedures, including medicine management, have been reviewed and updated to reflect current good practice and legislation. However one medicine policy was not reflective of the current legal requirement with regard to the disposal of waste medicines from a care home providing nursing care. Waste medicines were being disposed of appropriately. The home currently has one hoist and other equipment to assist staff in safely transferring or moving residents. Care records contained moving and handling assessments. Disappointingly staff do not always follow the instructions, potentially placing the residents and themselves at risk. Care records are still not maintained in an order to provide the reader with a clear and precise picture of residents’ holistic needs. And there is still no structured way of monitoring residents’ falls so that preventive measures can be taken, if there is an identified need. The home continues to maintain personal monies of one resident in a manner, which prevents the resident accruing interest as well as potentially placing the monies at risk. The home has had discussions with the sponsoring authority, which so far have proved unhelpful in providing a satisfactory solution to this matter. The Commission’s InFocus document In safe keeping – Supporting people who use regulated care services with their finances (May 2007), may assist the home in reaching a resolution with the sponsor. A copy was provided at the visit. As stated previously, not all in-house fire safety checks are carried out as regularly as required. First aid, fire and food hygiene training is being accessed externally. It is expected this will take place in October 2007. As mentioned previously the date for re-surveying the home’s fixed wiring electrical installation has expired. The home manager said quotations for the work to be carried out would now be sought. Temperatures of the hot water from baths used by residents are taken to ensure the temperatures conform to current guidance to maximise residents’ safety. However it has not been the home’s practice to record the findings. This could prove a problem if hot water temperatures were required as evidence, following an incident or complaint being made. Ashwood Nursing Home DS0000013957.V342376.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 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 2 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 2 2 2 Ashwood Nursing Home DS0000013957.V342376.R01.S.doc Version 5.2 Page 22 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 OP38 Regulation 18(1)(c) (i) Requirement That each shift has an appropriately qualified first aid person on duty. Training has been arranged for October 2007 Care plans must be complete of all needs, preferences, wishes and support of each resident. Timescale 31/08/07 not met Care plans must be composed and reviewed with input from the resident and or their advocate, unless the offer is declined. Timescale 31/08/07 not met. The home must develop a prevention of falls assessment in order that each resident is appropriately risk assessed. Timescale 31/08/07 not met. Controlled drugs must be accurately recorded in the controlled drugs register and discrepancies investigated. Timescale 05/04/07 not met. There must be arrangements for accurate recording of medicine administration and supply of medicines for temporary absence of a resident from the home. DS0000013957.V342376.R01.S.doc Timescale for action 31/10/07 2 OP7 15 30/11/07 3 OP7 15 30/11/07 4 OP7 13(4) 30/11/07 5 OP9 13(2) 30/09/07 6 OP9 13(2) 30/09/07 Ashwood Nursing Home Version 5.2 Page 23 7 OP8 12(1)(a) 8 OP29 19 9 OP37 17(3) 10 OP38 12 and 13 11 OP3 14(1)(d) 12 OP9 13(2) 13 14 OP19 OP38 23(4) 23(2) 15 OP38 13(5) Timescale 22/03/07 not totally met Lancing devices intended for single person use must not be used for more than one resident. Timescale 08/03/07 not met Specific staff references must be received and recorded. Timescale 30/04/07 not totally met All records relating to residents must be complete and up to date. Timescale 31/05/07 not met All potential risks to residents must be assessed and recorded. This includes the provision of bedrails and the use of hot water bottles. Timescale 31/05/07 not met Prospective residents must be provided with written confirmation that the care home is suitable for the purpose of meeting their health and welfare needs. Medicines must be stored and used according to manufacturers’ instructions. Limited life preparations including creams and eye drops must be dated on opening. In-house fire checks must be regularly carried out the information recorded. An appropriate contractor must survey the home’s electrical fixed wiring installation to ensure it does not present a risk. Residents must be moved and or transferred according to their respective moving and handling assessments. 20/09/07 30/11/07 30/11/07 31/10/07 31/12/07 20/09/07 30/09/07 30/11/07 20/09/07 Ashwood Nursing Home DS0000013957.V342376.R01.S.doc Version 5.2 Page 24 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 3 4 5 6 7 8 9 10 11 Refer to Standard OP38 OP38 OP3 OP8 OP8 OP8 OP9 OP16 OP18 OP28 OP30 Good Practice Recommendations That accident records be reviewed for trends and patterns and show when risk assessment are updated. That staff working in the kitchen are qualified in basic food hygiene. Training arranged for October 2007 Admission assessments must be completed and signed. It is strongly recommended that medical equipment be maintained according to the manufacturer’s directions. It is strongly recommended that pain management tools be included in care plans, when appropriate. Risk assessments including nutrition, skin integrity and moving and handling, must be completed in full and regularly reviewed. The medicine waste policy must reflect current legislation. It is strongly recommended that all types of niggles and concerns be recorded. All care staff should receive adult protection training to reflect the County’s current policies and procedures 50 of unregistered care staff should be trained to NVQ level II care. All care staff must be appropriately trained to reflect the assessed care needs of the current residents. This includes conditions such as epilepsy, dementia and learning disabilities. A formal quality assurance programme needs to be implemented, including obtaining views of residents, advocates and staff It is strongly recommended that alternative arrangements be explored for maintaining and managing monies on behalf of the resident. Structured supervision should be introduced so that practice, training and performance matters can be discussed and properly recorded. 12 13 14 OP33 OP35 OP36 Ashwood Nursing Home DS0000013957.V342376.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ashwood Nursing Home DS0000013957.V342376.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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