Inspection on 28/10/08 for Ashwood Nursing Home

This inspection was carried out on 28th October 2008.

CSCI found this care home to be providing an Poor service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ashwood Nursing Home 27/04/09

Ashwood Nursing Home 01/05/08

Ashwood Nursing Home 14/09/07

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 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashwood Nursing Home Burwash Common Etchingham East Sussex TN19 7LT     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Melanie Freeman     Date: 2 8 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 32 Information about the care home Name of care home: Address: Ashwood Nursing Home Burwash Common Etchingham East Sussex TN19 7LT 01435-883434 01435883091 ashwoodnh4@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ashwood Nursing Home Ltd Name of registered manager (if applicable) Miss Ann Elizabeth Morrissey Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 19 The registered person may provide the following category of service: Care home with nursing (N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category ; Physical disability (PD) Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home 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 sixtyfive years with a learning disability. Ashwood is in the hamlet of Burwash Common and set in grounds with flat access for residents. A well-stocked 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 Care Homes for Older People Page 4 of 32 care home 19 Over 65 19 0 0 19 Brief description of the care home 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. Current weekly fees range from 554 pounds to 950 pounds, excluding hairdressing, chiropody, physiotherapy, newspapers and aromatherapy. Inhouse activities are rather limited, some external entertainment is however scheduled. Ashwood Nursing home is registered as a limited company and Anne Morrissey is a Director of this company and the homes registered manager. Care Homes for Older People Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: zero star poor service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Ashwood Nursing Home will be referred to as residents. This was a key inspection that included an unannounced visit to the home by two inspectors who spent approximately five hours in the home. The registered manager who is also the Company Director met with the inspectors providing an update on the service and the residents in the home. She was not able to stay for the inspection visit but was happy for the administrator to facilitate. A tour of the premises was undertaken and a range of documentation was reviewed including the homes Care Homes for Older People Page 6 of 32 statement of purpose and service users guide, pre-admission assessment procedures, the systems in place for handling complaints and protecting residents from harm, staff recruitment files, quality assurance systems and some health and safety records. The care documentation pertaining to four residents were reviewed in depth. At the time of the inspection 12 residents were living at Ashwood Nursing Home. All residents were met with and a more lengthy conversation was held with four of these residents. A visiting relative was spoken to and telephone contact was made with two visiting health/social care professionals and a further relative following the inspection visit. What the care home does well: What has improved since the last inspection? What they could do better: This inspection identified that requirements made at the last inspection have not been addressed. This is a serious shortfall and may lead to an enforcement notice being issued. Unmet requirements have been repeated in this report. Care Homes for Older People Page 8 of 32 The care documentation still does not clearly record the service users or their representatives consultation in respect of the preparation or review of the individual plans of care. The system for recording when medicines are not given needs to be improved with clear reasons for omission being recorded. In addition individual guidelines for as required medicines for each residents to ensure these medicines are given in a consistent way need to be developed and recorded. All staff in the home need to be trained on Safeguarding Vulnerable Adults to ensure all residents are not put at risk of harm or abuse. The recruitment practice needs to be improved to ensure all the necessary checks are held in the home completed before staff start to work in the home. This will ensure robust recruitment practice is followed by the home and recruiting Agency and safeguard residents. All staff must be suitably trained so that they have the appropriate skills and competencies to meet the care needs of residents including their specialist care needs. In addition all staff must receive relevant health and safety training to ensure staff and resident safety. A suitable quality monitoring process needs to be established to monitor and improve the service in response to residents and their representatives views this will include any response to complaints raised. Staff need to receive regular supervision to monitor their performance and develop their skills. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 32 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides prospective residents, with a good level of information about the home, its facilities, services and the costs involved. The admission procedure allows for the needs of prospective residents to be assessed by a competent person before admission. Evidence: The statement of purpose and service users guide was available on request along with the last key inspection report. These documents have both been updated since the the last inspection and provide useful information. Further review and updating is required on an ongoing basis to ensure the document is up to date and reflects the current staffing arrangements and facilities. It also still needs to refer to how any specialist care needs of residents are to be met. In addition a copy of the service users guide should be provided to all residents for reference purposes. Discussion with residents Care Homes for Older People Page 11 of 32 Evidence: and visitors confirmed that people make a positive decision to move to Ashwood Nursing Home based on personal experience, or recommendation. An assessment of the admission process included a review of the documentation used in respect of the last three admissions to the home. This confirmed that all prospective residents are assessed by the registered manager. This assessment documentation could be further improved, by recording where the assessment was completed and who else was involved and consulted as part of the admission process. This was also suggested during the random inspection completed on 29 July 2008 and would demonstrate and record, a multi disciplinary approach to the assessment process. Following the needs assessment the home writes to the prospective residents or their representatives confirming the terms and conditions of residency. This letter however still does not confirm in writing that the home is able to meet the assessed needs, of the prospective resident. This was clearly identified at the last random inspection. The homes administrator confirmed that this letter was being updated, and was able to provide a copy of the letter to be used in the future to the Commission following the inspection. It was again noted that staff are not trained to meet the specialist care needs of residents living in the home including those with epilepsy, dementia or a learning disabilities. Intermediate or rehabilitative care is not provided at Ashwood Nursing Home. Care Homes for Older People Page 12 of 32 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The individual plans of care set out most of the residents personal and health care needs although the use of risk assessments needs to be more thorough, and residents or their representatives views need to be incorporated. Residents health care needs are met with the advice and support of community health care professionals. On the whole the homes practice ensure residents medicines are stored and administered safely. Care is delivered in such a way that promotes and protects the residents privacy, dignity and individuality. Evidence: The care documentation pertaining to four residents was reviewed as part of the inspection process, and each of these residents were met with during the inspection visit to the home. Following admission a full needs and nursing assessment is completed, this was mostly well completed and focused on the residents individual Care Homes for Older People Page 13 of 32 Evidence: needs, taking into account peoples choices and preferences. Base line observations are also completed and provide information on health care needs. All residents had a plan of care and there was evidence that this was updated regularly. These recorded the physical and health care needs of residents, although further attention needs to be given to individual social and psychological needs, and ensuring that they reflect the current care being provided. There was no evidence that either residents or their representative are consulted in respect of the preparation, or review, of the individual plans of care. This shortfall has been raised in the last two key inspections, and was included within a statutory notice served on the 4 June 2008. This requirement will be repeated in this report and may be included within a further enforcement notice. The documentation recorded community health care professionals input into care when contacted, and daily records are maintained and provide a record of residents activity, wellbeing, and medical condition. Routine risk assessments are usually completed and include those related to falls, pressure sore development, safe moving and handling and nutrition. It was however noted that risk assessments completed are not always accurate. Staff need to receive further instruction to ensure they are used appropriately as necessary, reflect the current risk and are responded to. There was evidence in the home to confirm that the staff look after residents who are at risk of developing or have moved to the home with pressure sores very well. Records identified that a number of residents admitted with pressure sores had benefited by the nursing care given resulting in the sores healing. During the review of documentation it was noted that not all residents have a photograph contained within their care documentation. Residents, relatives and visiting professional were positive about the care received and provided. Comments included so very nice here very good to me here although rather be at home Good quality care is provided the home is excellent. The medicine room was found to be satisfactory although there had been a leak from the fridge. This was highlighted to staff and responded to. The records examined on the whole were accuarte and well maintained and the use of iqued correction fluid has been stopped. The system for recording when medicines are not given however was not clear and there was no area on the chart to explain an X recorded on the medicine dministartion chart. In adittion individual guidelines for as required medicines for each residents to ensure these medicines are given in a consistent way need to be developed and recorded. The home works to reduce unnecessary medicines wherever possible and consults with Care Homes for Older People Page 14 of 32 Evidence: the allocated Doctor with regard to this. All prescribed medicines were available in the home for administration. The Controlled Drug cupboard and register were checked and found to be well maintained and records were accurate. It was however noted that Oramorph was included on a medicine chart although it was not being given this was raised with the manager for her to investigate and resolve. The relationship between staff and residents was seen to be positive and productive, and enjoyed by residents and staff. Staff know the residents well and the manager although not providing direct care has a thorough overview of the care provided. Care Homes for Older People Page 15 of 32 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activity is mainly focused around the daily life activities in the home. Links with friends, relatives and the community are encouraged and choices made are respected. Residents receive a wholesome and appealing diet. Evidence: Structured daily activities do not take place, leaving residents to spend their time as they wish to, providing their own entertainment. Some residents choose to spend their time in the privacy of their bedrooms and others prefer to sit in the day room. During this visit there was no evidence of specific activity or entertainment provision however the staff spent time with residents and this was said to be what the residents enjoy most. Observation during the inspection confirmed that the relationship between staff and residents is an important productive one which is enjoyed. Many of the staff have worked in the home for a long time and caring relationships have evolved. Care Homes for Older People Page 16 of 32 Evidence: Visitors are also an important part of residents life and one residents said how important the visits from her granddaughter are to her. Visiting is encouraged and one visitor spoken to said that he was very comfortable to visit the home at any time and is always welcomed. Residents religious needs are explored and responded to with a resident saying that she attended church regularly. The manager was able to discuss residents choices and how they are responded to on a daily basis,enabling residents to take control of their lifes. Although residents have the opportunity to eat communally most choose to eat in their own rooms. The meals provided were well received one resident saying if anything the food is too much and too regular another said the food is very good. A relative advised that the food was good and well cooked and that her mother can be a fussy eater and the staff always get her something that she would like. Although menus are in place and these reflected a well balanced diet these were not being adhered to when the inspection visit was completed, this was said to be because the regular cook was on holiday. The administrator confirmed that the menus are currently being reviewed. The records maintained in respect of what each resident has eaten need to be improved to reflect clearly an individual record of what has been eaten and in what quantity. The meal was well received and focused on home cooking with fresh ingredients, although one resident was reluctant to eat as it had not been long since she had finished her breakfast. More attention needs to be given to what and when residents want to eat. Care Homes for Older People Page 17 of 32 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a complaints procedure and residents and their advocates feel that their comments are listened to and acted on. Whilst the home has relevant policies and procedures around Safeguarding Vulnerable Adults staff training does not ensure they have appropriate skills. Evidence: The home has a clear complaints procedure and a copy of this is available within the service users guide, and displayed on the wall in the entrance hallway. This procedure has been implemented and a complaint form would be used to record and complaint made. A copy of the procedure and complaint form is to be made available to each resident as they are contained within the service users guide a copy of which is to be provided to all prospective and current residents. There have been no formal complaints made since the last inspection to either the home or the Commission. People spoken to during the inspection process were all confident that if they had a concern the manager would listen and respond to the issue. The home has a safeguarding Vulnerable Adults and Whistle blowing procedure in place and the most recent local procedures are available in the home. It was again Care Homes for Older People Page 18 of 32 Evidence: noted that staff have not received training on this important subject. Although it is acknowledged that staff would report any concern directly to the home manager they need training on what constitutes abuse, how to recognise it, and what to do in response to an allegation or suspicion of abuse, especially if the manager is not immediately available. Care Homes for Older People Page 19 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in an attractive home like environment that is well maintained and clean. Evidence: Ashwood Nursing home is a converted premise that has retained a home like environment. The home was found to be clean with many of the residents rooms being very personalised. Residents rooms are viewed as there own space and reflect the interests of the person occupying the room. There is a large well-maintained garden at the rear of the home for residents to enjoy in good weather. The home was found to be well maintained and safe. During the inspection visit the availability of gloves and plastic aprons was found to be minimal and staff spoken to were unable to locate either. They were eventually found in the laundry area. Protective clothing must be readily available to ensure staff follow appropriate infection control measures at all times, and the manager was advised regarding this shortfall. The communal space available is located on the ground floor and consists of one room that is used as a lounge and a dining room. This room is attractive but would be Care Homes for Older People Page 20 of 32 Evidence: cramped when the home is fully occupied. There was written evidence to confirm that the home is completing individual risk assessments that take into account the environment. The laundry facilities were seen and were appropriate for the size of the home, the manager has in the past confirmed that the two washing machines have sluice cycles that can be used for any soiled laundry. Care Homes for Older People Page 21 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing arrangements and qualified staff numbers ensure that residents health and personal care needs are met although staff training needs to be improved to ensure they have the necessary skills to meet all care needs. The homes recruitment practice needs to ensure evidence that all the necessary checks are completed in respect of all staff to safeguard residents. Evidence: At the time of this inspection visit the home was occupied by 12 residents and staffing levels observed were found to be appropriate to meet their individual health care needs, and the level of activity in the home. A visiting health care professional confirmed that the staffing levels are appropriate for the current occupancy of the home. Staffing rotas are now being recorded and evidenced that staffing levels are maintained with a registered nurse on duty throughout the day and night. The manager is not recorded on the duty rota and discussions with her confirmed that although she is not working in the home taking charge of the day to day care, she is available on the telephone. All feedback received about the staff working in the home was very positive and comments received included The nursing care is good and the staff are all very Care Homes for Older People Page 22 of 32 Evidence: friendly with staff spending time with my mother, talking with her. The recruitment files pertaining to four staff were reviewed as part of the inspection process, three of these staff were recruited via an Agency and a number of shortfalls in the recruitment files were noted. These included evidence of those staff that are recruited from abroad that they have the right to work, evidence of the health check completed, a copy of the police check completed in the recruited staffs country of origin and evidence of the second reference sourced. The administrator confirmed in writting following the inspection visit that the recruiting Agency will be supplying the home with copies of all the required information and that this will be retained on the recruitment files for future reference. In addition the home needs to ensure all staff have a photograph on their files. Recruitment files reviewed confirmed that applications are completed along with the required Criminal Records Bureau and POVA checks. Although there was evidence that induction training is provided it was not clear what the training included or that it adequately follows the Skills for Care training specifications for the provision of social care. Most staff have or are progressing a National Vocational Qualification in care. Evidence that any staff training had been progressed since the last inspection was not available to the inspectors during the inspection visit. A training matrix is not used and records within individual files did not confirm training in the last year. Contact with the manager following the inspection gave her the opportunity to supply further evidence, this was not supplied. Therefore their was no evidence to confirm that staff had received training as required in Health and Safety, infection control, safe moving and handling or Safeguarding Vulnerable Adults. As previously mentioned in this report staff have not received training in respect of the specialist care needs of residents. Care Homes for Older People Page 23 of 32 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this 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 registered manager has the relevant skills and experience, however the current management arrangements do not provide the necessary framework for the training and supervision of staff. Quality assurance processes need further development to ensure that the Home is run in the best interests of residents. Residents financial interests are safeguarded. The health, safety and welfare of residents and staff are generally promoted although staff training needs to be maintained. Evidence: The registered manager is a Registered Nurse and has attained the Registered Managers Award and has owned and run the home for over 20 years. Although she is available to the home by telephone each day if required, she does not work in day to Care Homes for Older People Page 24 of 32 Evidence: day control of the care provided. She has a deep understanding of each residents needs knowing each resident well and said that she goes to the home each day. There was no evidence that the home seeks residents and their representatives views on the service and care provided by the home as part of their quality monitoring system. This shortfall was identified at the last key inspection and the requirement made in the corresponding report has not been addressed. The registered manager confirmed that she does not have any involvement with residents monies and all residents have an identified person who deals with their finances. Staff are not receiving regular supervision and the manager confirmed that this was not taking place on a formal basis. As identified earlier in this report staff are not provided with the necessary health and safety training, there was no evidence that any staff had received relevant health and safety training that included infection control, COSHH, moving and handling over the past year. The home has suitable systems in place to ensure the home and the equipment is suitably maintained and that regular checks on equipment are maintained. The electrical installation safety check has been completed since the last key inspection and a fire risk assessment was available in the home at the time of this inspection visit. Care Homes for Older People Page 25 of 32 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 7 15 Care plans must be 29/07/2008 composed and reviewed with input from the resident and or their advocate, unless the offer is declined. (outstanding requirement from last 2 inspection report with a completion date of 30/11/07) 2 9 13(2) There must be arrangements 29/07/2008 for accurate recording of medicine administration and supply of medicines. (outstanding requirement from last inspection report with a completion date of 30/09/07) 3 18 13(6) That the registered Person makes arrangements to ensure staff are suitably trained to prevent residents being harmed or put at risk of harm or abuse. 29/07/2008 4 30 19 (5) That staff receive regular 01/09/2008 training to ensure that they are appropriately qualified and competent and have the skills to meet all the needs of Page 26 of 32 Care Homes for Older People residents in the home. 5 33 24(1)(a)(b) (2)(3) That a suitable quality 29/07/2008 monitoring system is maintained to ensure residents and their representatives views are taken into account and demonstrates ongoing review and improvement to the quality of care and services in the home. This should take into account any complaints and concerns raised with the home. 6 36 18(2) Care staff should receive 29/07/2008 regular formal supervision. The sessions should cover all aspects of practice, the philosophy and care in the Home and the career development needs of the individual. 7 38 12 (1) 13 (5) That suitable arrangements are put in place to promote residents and staff health and safety. This should include appropriate staff training. 29/07/2008 Care Homes for Older People Page 27 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Care plans must be 30/01/2009 composed and reviewed with input from the resident and or their advocate, unless the offer is declined. This will ensure that service users or their representatives are involved and agree with the care to be provided. (This is a repeated requirement) 2 8 14 That the registered person 30/01/2009 ensures that appropriate risk assessments are accurately completed and cover all areas of risk and are responded to. This will ensure any risk is identified, fully assessed and responded to in order to minimise risks associated with residents care. 3 9 15 That clear individual guidelines for those medicines prescribed on an as required basis are 30/01/2009 Care Homes for Older People Page 28 of 32 provided and cross referenced to residents plans of care. This will ensure that as required medicines are given in a consistent way and in accordance with prescriptions. 4 9 13 There must be arrangements for accurate recording of medicine administration and supply of medicines. Accurate records will ensure residents receive their prescribed medication as they need them. 30/01/2009 5 15 17 Records relating to what 30/01/2009 residents are offered to eat and what they actually eat needs to be improved. This will ensure that sufficient records are held to demonstrate the diet eaten by a residents can be assessed with regard to its suitability. That the registered Person makes arrangements to ensure staff are suitably trained to prevent residents being harmed or put at risk of harm or abuse. Appropriate staff training will ensure that they can identify any form of abuse and respond to it appropriately. (This is a repeated requirement. ) 22/01/2009 6 18 13 Care Homes for Older People Page 29 of 32 7 30 18 That staff receive regular training to ensure that they are appropriately qualified and competent and have the skills to meet all the needs of residents in the home. This will provide staff with the necessary skills to meet the varied needs of residents in the home. (This is a repeated requirement.) That a suitable quality monitoring system is maintained to ensure residents and their representatives views are taken into account and demonstrates ongoing review and improvement to the quality of care and services in the home. This should take into account any complaints and concerns raised with the home. This will ensure that the service responds to the views of residents and their representatives, so the service can evolve and improve as necessary. (This is a repeated requirement.) 30/01/2009 8 33 24 30/01/2009 9 36 18 Care staff should receive 30/01/2009 regular formal supervision. The sessions should cover all aspects of practice, the philosophy and care in the Home and Care Homes for Older People Page 30 of 32 the career development needs of the individual. This will ensure staff are appropriately supervised and are supported and monitored in a way that promotes good care within the home. (This is a repeated requirement.) 10 38 12 That suitable arrangements are put in place to promote residents and staff health and safety. This should include appropriate staff training. This will promote the safety residents living in the home and staff working in the home. (This is a repeated requirement) 30/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 31 of 32 Helpline: 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 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. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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