Inspection on 25/04/07 for Aspreys Nursing Home

This inspection was carried out on 25th April 2007.

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

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

Other inspections for this house

Aspreys Nursing Home 23/04/09

Aspreys Nursing Home 04/06/08

Aspreys Nursing Home 06/12/07

Aspreys Nursing Home 13/09/06

Aspreys Nursing Home 08/12/05

Aspreys Nursing Home 06/04/05

Aspreys Nursing Home 12/10/04

Aspreys Nursing Home 29/06/04

Aspreys Nursing Home 04/03/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Aspreys Nursing Home I Kents Road Torquay Devon TQ1 2NL Lead Inspector Rachel Proctor Unannounced Inspection 25th April 2007 10:20 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 Aspreys Nursing Home DS0000028780.V331300.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. Aspreys Nursing Home DS0000028780.V331300.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Aspreys Nursing Home Address I Kents Road Torquay Devon TQ1 2NL 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) 01803 201500 01803 201700 matron@aspreys.co.uk Friendly Care Homes Ltd Vacancy Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (10), Physical disability over 65 years of age of places (25) Aspreys Nursing Home DS0000028780.V331300.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Two lower ground floor rooms must not be used for Service Users who require nursing The number of Service Users who require nursing is limited to 31 A minimum staffing level that follows the previously agreed Health Authority staffing notice must be available to meet the needs/dependency of Service Users who require nursing One named Service User, named elsewhere, under 60 yrs of age (PD Category) Service Users from age 60 years and above may reside at the home. 4. 5. Date of last inspection 13th September 2006 Brief Description of the Service: Aspreys Nursing Home is located in Wellswood, approximately one mile from Torquay town centre. It has level access to the local shops, pubic house and restaurants all being within 100 yards from the home. The St Matthias Church is within 200 yards of the home. The home operates its services on all of the four floors with the dining room and rear garden area being on the lower ground level, the lounges, matrons office and some rooms on the ground floor and the remaining rooms being on each of the two upper floors. All floors can be reached by a shaft lift. The home offers both Nursing and personal care mainly to people over the age of retirement (60 years). The home is registered for 31 peoples who require nursing and 2 peoples who require personal care The staff group is made up of registered nurses and trained social care staff (Health Care Assistants). There is a good level of specialist equipment like a Parker bath, hoists and stand aides available to meet the needs of disabled people. The statement of purpose, inspection reports and service user guide are available on request at the home. The fee levels were stated at the time of this inspection as from £350- £540. These are dependant on the care needs of the peoples and the room occupied. Additional charges include chiropody and hairdressing. Aspreys Nursing Home DS0000028780.V331300.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection. A site visit was undertaken as part of the inspection. During this visit a tour of the home was completed. Peoples and staff were spoken to and some records were inspected. Information received from the home since the last inspection was also reviewed. The inspector spoke to health and social care professionals who visit the home. Two relatives and one-health professional comment cards were received prior to the inspection. Comments made in these have been incorporated into this inspection report. What the service does well: What has improved since the last inspection? What they could do better: Medication records must be completed clearly and fully to ensure people receive the mediation they need. Since the appointed manager left in August 2006 the home has not had a manager to lead the staff team. The owner and all registered nurses have taken responsibility for ensuring they meet people’s needs. However without a clear leader who can direct the way health care is delivered the people who live at Aspreys nursing home may not always receive a consistent quality of care. The home has two care staff trained to NVQ level 2 or above, which is below the 50 recommended, although it was clear from discuss with staff that they had been encouraged to start their NVQ training by the owner. Providing NVQ Aspreys Nursing Home DS0000028780.V331300.R01.S.doc Version 5.2 Page 6 training for staff should increase staff knowledge and skills to care of the people who live in the home. The results of quality audits should be made available to the people who live at the home and the Commission. This will enable people to make informed choices about the home they live in. 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. Aspreys Nursing Home DS0000028780.V331300.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 Aspreys Nursing Home DS0000028780.V331300.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): Quality in this outcome area is good, 3,6 This judgement has been made using available evidence including a visit to this service. The new assessment process adopted for emergency admissions should ensure that peoples have their care needs assessed in a way that will enable the care staff to meet their needs. EVIDENCE: Four people had their care followed as part of this inspection. Two of these were emergency admissions through the crisis team. The four plans of care contained assessments of the people’s care needs and included medical history and medication requirements. The equipment needed for their care had also been recorded. The nurse in charge advised that the people are asked about what is important to them. A record of the people’s likes and dislikes for meals had been recorded. The two people admitted through the crisis team were spoken to during the inspection. They said that staff had spoken to them about their care needs Aspreys Nursing Home DS0000028780.V331300.R01.S.doc Version 5.2 Page 9 and staff at the home had told them about the home and it’s services. Their care planning information and assessments also contained copies of their community assessments and care plan. These detailed the aims of the emergency placement. The nurse in charge advised that information for those people admitted in an emergency did not always have clear information provided about their care needs. They went on to say that this had sometimes been a problem, when new people had been admitted out of hours. New check lists had been introduced by the homes staff team to ensure that basic information about a persons care needs are obtained as soon as possible. Assessment check lists had been completed in the care plans seen during the inspection. The people spoken who had been admitted in an emergency said the staff had done all they could to help them settle in to the home and they did not have any concerns. Two people who had bed guards fitted to their beds were asked if they had consented to their use. One person said they had asked for the bed guards as they had fallen out of bed in hospital once before and felt safer with them up. A consent form signed by this person was contained in their plan of care. Aspreys Nursing Home DS0000028780.V331300.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): Quality in this outcome area is good, 7,8,9,10, This judgement has been made using available evidence including a visit to this service. The way the people’s health and personal care is managed by the caring staff team should ensure that their needs are met. EVIDENCE: One complaint regarding the way healthcare was provided for one person has been received since the last inspection. This complaint was partially upheld. The inspector discussed this complaint with the owner and senior nurse to establish what actions had been taken to address the concerns raised by the complainant. The concerns included the use of restraint (bed guards) call bell not working and medication issues. The owner was able to confirm that staff use a system of checking people at risk and those admitted in an emergency hourly at night. The records of these checks were seen. One person whose care was followed had been admitted in an emergency two days earlier. They said they had not needed to use the call bell at night because “staff kept popping in to see if they were alright though out the night”. This person had Aspreys Nursing Home DS0000028780.V331300.R01.S.doc Version 5.2 Page 11 bed guards fitted to their bed. The inspector asked if they had given their permission for these to be used. They responded that they had asked for them because they felt safer with them. This persons care plan contained a signed consent for the use of bed guards. This evidenced that the issues raised by the complainant had been taken seriously and actions taken to reduce the risk of similar issues occurring again. Each of the four people whose care was followed had a plan of care in place, which had been developed from an assessment of need. Two of these people had been admitted to the home for an emergency placement. These people had copies of the community assessment and care plan, which included a record of the medication that person required. The nurse in charge advised that medication is checked with the GP surgery on admission where possible. And the person or their representatives are also asked about medication. A new record for checking all relevant information is available for the people admitted for emergency placement had been introduced since the last inspection. These had been completed for the two people whose care was followed. Three of the four plans of care had been reviewed monthly or sooner if the persons care needs changed. The nurse in charge advised that the person whose care review had not been recorded had not had any changes in their care needs. This person said that staff regularly discuss their care needs and what is important to them. They said their care needs were being met and staff were friendly and supportive to them. When the GP had seen a person this had been documented separately in their care plan. The inspector saw high dependency pressure relief mattresses in use for those people who required them. Each of the care plans viewed had a completed pressure sore risk assessment. One of the people whose care was followed was identified as high risk of developing a pressure sore. They had a pressure relief mattress on their bed. This person said staff regular help them to alter position in bed. They also said staff had been very kind and polite to them. They commented that they had been off their food a bit and staff knew they liked ice cream so they were providing this. This persons care plan had a nutritional risk assessment including what they liked to eat and a care plan to address their poor appetite. The controlled drug record was checked against the stock held for one person. There was an issue where a staff member had not followed on sequentially in the record, however the number of tablets in stock agreed with the number recorded on close examination by the registered nurse on duty at the time of inspection. A drug fridge provided for storage of medication such as insulin and eye drops that need to be stored at low temperatures was locked. A record of the fridge temperature was also being kept. The records of medication disposed of were completed dated and signed as required. The home has a lockable medication trolley for storage of medication in use, which Aspreys Nursing Home DS0000028780.V331300.R01.S.doc Version 5.2 Page 12 can be moved to the individual people’s room. A selection of medication being stored was checked, this was seen to be for the current people and with in date. Medication records for the four people whose care was followed were viewed. One of these did not have the reason for a prescribed medication not being given on two occasions. The nurse in charge advised that she would make sure all the registered nurses were aware. Aspreys Nursing Home DS0000028780.V331300.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good, 12,13,14,15. This judgement has been made using available evidence including a visit to this service. The staff at Aspreys try to ensure that people living at the home have access to the activities they prefer and enjoy. EVIDENCE: Three peoples in one of the lounges were spoken to during the inspection. They said several activities were organised for them. One said they particularly liked the musician that placed songs they could sing along to. Another said they enjoyed the quiz sessions and were please to say they had one the last time. All appeared to agree that the activities were meeting their needs. The nurse in charge advised that activities are arranged on a weekly basis. A copy of the list of planned entertainment was sent with the pre inspection information. People in the second lounge were observed to be frail and not as able to communicate or take part in activities. Staff were going in and out of this lounge to offer assistance and speak to them. One carer who came on duty during the inspection was observed greeting the peoples in this lounge Aspreys Nursing Home DS0000028780.V331300.R01.S.doc Version 5.2 Page 14 and speaking to them individually asking them how they were. Those involved appeared to be enjoying the attention the carer was giving them. The owner advised that for the majority of people either their relatives or the person’s representative helped them with their money. One person maintains control of their finances with the help of the home owner. The records of money held for this person were checked against records during the inspection. This person said staff buy items for them such as toiletries and they pay them back. Receipts for these were being kept in this persons file for expenditure made on their behalf. Visitors were coming and going through out the inspection. Those spoken to said staff made them feel welcome and keep them informed. The mealtime observed during the inspection was unhurried. People were eating their meals at their own pace. Members of staff was giving those who needed assistants one-to-one help. A staff member was heard telling a person about the food they were helping them to eat and making general conversation even though the person was unable to respond verbally. This showed that staff try to involve people in their care. The menus were discussed with the nurse in charge. She advised that the menus are planned in discussion with the people who live at the home and the cook. The member of staff responsible for preparing meals on the day of inspection advised that the meals are planned to enable the people to have food they enjoy eating. Three people in the lounge were asked about the food. All said they really enjoy the meals and look forward to mealtimes. One person told the inspector that if there was something that they didnt like an alternative was offered. Others who had chosen to stay in their own rooms said that staff had asked them where they would like to eat their meals. They commented that the meals are hot when they get them and they usually enjoy the food. Aspreys Nursing Home DS0000028780.V331300.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. The staff team at Aspreys value the people who live there and take any concerns they raise seriously. Evidence shows that management use concerns raised to improve people’s experience of care, by reviewing practice and making changes. EVIDENCE: One complaint about the quality of the care provided at Aspreys had been received since the last inspection. This related to the how the information for people admitted in an emergency was provided, some aspects of their care and availability of their call bell particularly at night. Since this complaint new protocol and checks have been put in place to ensure all relevant information for people admitted in an emergency is obtained. The nurse in charge advised that this is done as soon as possible after their admission to the home and where possible before admission. Two people who had been admitted to the home in an emergency had their care followed. Records of the information provided for these two people were viewed. These contained information relating to their care needs, their medication, equipment required and what was important to them. When these people were asked about the care they were receiving both said that the staff were very kind and helpful. When asked about being able to call staff at night both said that the staff check on them regularly though out the night and they Aspreys Nursing Home DS0000028780.V331300.R01.S.doc Version 5.2 Page 16 had not needed to use their call bell. The Commission is satisfied that the homes owner and registered nurses have taken appropriate action to address the concerns raised by the complaint. The complaints procedure and policy is easily available for people who live in the home, relative and staff. The people spoken to during the inspection and the two comment cards received from people living at the home indicated that they knew who to complain to if they had any concerns and had confidence that any concerns they raised would be dealt with sensitively by the staff team. The owner confirmed that he regularly talks to the people who live in the home and their representatives. Relatives comment card received indicated that they felt able to raise concerns and were satisfied with the response. One relative spoken to during the inspection said whenever they asked or raised any concerns the staff dealt these with. They went on to say that they felt able to discuss any concerns they had with the owner or the staff. Three staff files were viewed during the inspection. These contained the information required. The home has a recruitment policy, in place. A record of training received and copies of certificates were provided in the staff files. These included fire training and manual handling. A training pack was also available for the staff regarding adult protection. Policies and procedures are in place to guide staff regard prevention, recognition and handling of incidents of abuse. Aspreys Nursing Home DS0000028780.V331300.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good, 19,25,26 This judgement has been made using available evidence including a visit to this service. Aspreys nursing home provides a pleasant, homely environment for the people who live there. EVIDENCE: A tour of the home was completed. All areas entered during the inspection were clean and fresh. Individual people’s rooms were clean and had been personalised with items of that person’s choice. Several of the people’s rooms entered had been re-decorated and new carpets fitted. A maintenance man had been appointed since the last inspection they were working in the home redecorating one person’s room during the inspection. They advised that as rooms were vacated these were refreshed. The people spoken to during the inspection said their rooms were kept fresh and clean. One of the people who lived at the home commented that they like to have a laugh and a joke with Aspreys Nursing Home DS0000028780.V331300.R01.S.doc Version 5.2 Page 18 the cleaners as they clean their room. One of the domestic staff spoken to during the inspection said they took pride in making sure the home was clean and fresh for the people who live there. The owner confirmed that new domestic staff had been appointed since the last inspection. The divan style beds in use in people’s rooms had been adjusted to allow hoists access under the bed. The owner advised that people who required height adjustable beds would be provided with them. Two height adjustable beds were seen in use for people who required complex care. The hair salon on the lower ground floor had been completed, the decorations on the furnishings made it look like an external hair salon. A relative of one of the people who lived at the home had commented that their relative had enjoyed being able to go to the salon to have their hair done. The people seen in their own rooms had call bells easily accessible to them. Four of these people who were asked about their call bell system said staff responded when they called although sometimes they took a little bit longer particularly at mealtimes and weekends. Two people who had been admitted as an emergency to the home advised that they had not needed to use the call bell at night as staff came in to check if they were all right throughout the night. During the inspection call bells were being answered in a timely manner. Not all the radiators in the home had been guarded. The owner confirmed that radiators were continuing to be covered on a risk assessment basis. People can adjust the heating in their individual rooms to suit their tastes. Different people’s rooms entered were being heated to different temperatures, which suited individual people in those rooms. Infection control policies and procedures are available for staff in the office. The staff observe providing care for people were using gloves and aprons provided when providing personal care. Staff were observed washing their hands between care for individuals. A yellow bag clinical waste disposal system was being used and a clinical waste disposal contract had been arranged. Staff had access to disposable gloves and aprons throughout the home. The Homes laundry is situated on the lower ground floor away from food preparation area. Washing machines are capable of providing a disinfecting sluice cycle. Individual baskets for people who lived in the home were provided in the laundry room. Aspreys Nursing Home DS0000028780.V331300.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate 27,28,29,30. This judgement has been made using available evidence including a visit to this service. People at Aspreys nursing home are cared for by a friendly and supportive staff team that have their best interests at heart. The way staff are trained and their skills developed needs to continue to improve, to ensure people are cared for by a staff team who understand their care needs. EVIDENCE: A duty rota was provided, which showed the number of staff on duty during the day and night. This showed that a registered nurse is on duty over a 24hour period seven days a week to monitor and manage peoples health care. The staff spoken to during the inspection felt they had enough time to care for peoples needs. Two professionals comment cards indicated that they were happy with the care and support the patient they were caring for received. Comments included “The nursing care has been excellent as has been their support with rehabilitation”. Two comment cards received from relatives indicated that the care needs of their relatives were always met and they were kept up-to-date with the important issues affecting their relative or friend. One relative spoken to Aspreys Nursing Home DS0000028780.V331300.R01.S.doc Version 5.2 Page 20 during the inspection said, Staff are very caring and seem to understand whats needed. When asked if the care staff have the right skills and experience to look after people properly. A relative responded, Difficult to expand on, staff have varying expertise and experience, the overall impression is one of a well drilled care team. During the inspection and maintenance man and domestic staff were working in the home in addition to the care staff. One relative spoken to during the inspection said they had some concerns about the number of staff on duty at night. Discussion with people using this service during the inspection indicated that staff were available to them during the night if they needed help. One of the people living at home commented that staff sometimes take longer to answer call bells at night although they didnt see this as a problem. A further two people living at the home commented that they had not had to use their call bell at night as the staff kept popping in to see how they were. The duty rota indicated that they were always two staff on duty at night, one of which was a registered nurse. The rota also showed some nights had two carers and a registered nurse on duty. The pre-inspection information provided did not indicate the number of staff who had achieved NVQ level 2 or above. Discussion with the owner revealed that because of the changeover with in the staff team they had not achieved a 50 minimum of care staff trained to NVQ level 2 or above. The staff spoken to during the inspection said that access to training had improved. One staff member commented that they were in the process of completing NVQ training programme. Records of induction receive for care staff and registered nurses had been completed, these were in the form of the tick list. The owner advised that they were in the process of introducing a new induction system for new staff. Three staff files review during the inspection. These contain the information required, which included references, police checks and application forms. The owner confirmed that new staff work supervised when they first start at the home. The home has a recruitment policy in place, which is based on equal opportunities ensuring protection of people. A list of the training of staff had received was provided with the pre-inspection questionnaire. Copies of certificates of training staff had received were also contained in the staff files. The owner advised that he was in the process of developing a training matrix, which would identify the training staff had completed and the training they needed. Information about various training events were available in the office of the home. However although the staff had training and development plans in place not all of those seen were up to date. Completed training and development plans seen for three staff gave clear information about their training and development needs. The nurse in charge advised that she was in the process of completing these for all staff. Aspreys Nursing Home DS0000028780.V331300.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A suitably qualified manager to lead the staff and oversee the quality of care would ensure that the people who live at Aspreys nursing home continue to have their health, safety and welfare promoted. The continued improvements and the commitment of the staff and owner should enable the people who live at Aspreys to have confidence that the home is being run in their best interests. EVIDENCE: The previously appointed manager and deputy have left. The management of the home is being organised with the owner who manages the business side. Each registered nurse covers as nurse in charge of the people’s health and Aspreys Nursing Home DS0000028780.V331300.R01.S.doc Version 5.2 Page 22 personal care while on duty. The owner advised that he had placed several adverts locally and national and was hoping to find a suitable manager as soon as possible. Two relatives commented that they were disappointed that a new manager was taking so long to find. They further commented that they felt this was putting extra pressure on the registered nurses who were managing the day-to-day care of their relatives. The survey questionnaires completed since the last inspection were available for inspection. The owner advised that these had not been summarised or results made available for the people who live at Aspreys or the Commission. The owner was able to show what actions he had taken as a result of the feedback from the survey questionnaires. One relative said that the owner and the registered nurses regularly speak to them about their relatives care and they felt their ideas were listened to. The two comment cards received from relatives indicated that they were kept informed and involved. Two health professional cards received praised the way people admitted in an emergency had been cared for. One commenting, “ The owner and management are keen to ensure all patients are well catered for medically and emotionally”. Although it was clear that there were ongoing improvement to the environment and repairs and renewals taking place a formal annual development plan had not been provided. The owner advised that an ongoing redecoration and improvement of the environment would continue to be done on an as needed basis. All requirement made at the last inspection had been met with in time scales. This shows that the owner is responsive and committed to improving the home and the experience of care for the people who live there. Policies for health and safety are provided for staff. Information for infection control, manual handling and food hygiene were available in the office for staff. Accidents records completed showed the action taken to reduce risks where they had been identified. Falls risk assessments were an integral part of the care plan for people whose care was followed. The pre inspection information showed the dates equipment had been serviced. The fire logbook had been completed and checks for fire safety completed. Staff training information showed that staff had received instruction for fire safety and manual handling. One member of staff said they were looking forward to completing a food hygiene course they had been put forward for. They also commented that training had improved and they now felt they had more opportunities to access training that helped them do their job. Aspreys Nursing Home DS0000028780.V331300.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 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 3 X X X X X 2 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 3 Aspreys Nursing Home DS0000028780.V331300.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13(2) Requirement Controlled drug records must be recorded clearly to ensure all registered nurses who administer these are aware of the pages being used to record controlled drug medication given. Timescale for action 30/06/07 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 Refer to Standard OP9 OP19 OP25 OP28 OP30 Good Practice Recommendations Medication practice in the home should ensure that medication records completed include the reason why medication was not given. A routine programme of maintenance should be available for inspection The covering of all radiators in peoples areas should continue using the risk assessment process in place 50 of the care staff should be trained to N.V.Q level 2 or above. The completion of training and development plans for staff should continue until all staff have up to date personal training and development plans. DS0000028780.V331300.R01.S.doc Version 5.2 Page 25 Aspreys Nursing Home 5. 6. OP31 OP33 There should be a manager to lead the staff team who is registered with the Commission. Results of quality audits should be available for people who use the service and the Commission. Aspreys Nursing Home DS0000028780.V331300.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Aspreys Nursing Home DS0000028780.V331300.R01.S.doc Version 5.2 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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