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Inspection on 02/06/08 for Aston House Care Home

Also see our care home review for Aston House Care Home for more information

This inspection was carried out on 2nd June 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is being effectively managed and this has led to marked improvements throughout the home. Prospective residents are fully assessed prior to admission to ensure the home can meet their needs. Staff care for residents in a gentle, caring and professional manner, respecting dignity, privacy and cultural and diversity needs. The home has an open visiting policy and visiting is encouraged. The food provision is good with varied choices on the menu to meet personal and individual preferences. Complaints and safeguarding adults issues are appropriately managed at the home. Infection control procedures are in place and are adhered to. The training provision is good and the NVQ in care training is being progressed to bring the home up to 50% of care staff with this qualification. Systems are in place for effectively reviewing the quality of care provided and for reviewing all aspects of the home for quality assurance purposes. Any monies held on behalf of residents are being appropriately managed and securely stored. Robust systems for the management of health & safety are in place.

What has improved since the last inspection?

Overall there has been an improvement in the formulation and review of the service user plans. Some shortfalls were identified and these must be addressed. All assessment documentation viewed was complete and up to date. Where weight loss had been reported, systems were in place for referral to the GP and dietician. There has been an improvement in medication management. We found that medications were being accurately recorded when administered and in accordance with the prescribed dose. Some shortfalls were identified at this visit and should be easy to address. Improvements have been made in the area of activity provision with residents being able to participate in a variety of activities, with more work being done in this area. There has been a marked improvement in the environment of the home both internally and externally. The home was clean and issues with malodours had been addressed. Systems for the vetting and recruitment of staff are robust and are followed. The Manager has been in post since March 2008 and is effectively managing the home. Staff had received training and updates in all aspects of health and safety, although records did not always reflect this. Staff spoken with commented on the marked improvement in the training provision.

CARE HOMES FOR OLDER PEOPLE Aston House Care Home Angel Lane Hayes Middlesex UB3 2QX Lead Inspector Clare Henderson-Roe Key Unannounced Inspection 10:40 2 and 3rd June 2008 nd 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 Aston House Care Home DS0000010924.V364045.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. Aston House Care Home DS0000010924.V364045.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Aston House Care Home Address Angel Lane Hayes Middlesex UB3 2QX 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) 020 8569 1499 020 8569 1488 www.schealthcare.co.uk Southern Cross Healthcare Services Ltd Acting Manager Care Home 48 Category(ies) of Dementia - over 65 years of age (0), Learning registration, with number disability over 65 years of age (0), Mental of places disorder, excluding learning disability or dementia (1) Aston House Care Home DS0000010924.V364045.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. To Comply with the Minimum Staffing Notice required by the previous regulator as at 31st March 2002. As agreed on 26th July 2006, one named service user under the age of 65 years, with a mental disorder, can be accommodated. The CSCI must be informed if this service user no longer resides at the home. 23rd July 2007 Date of last inspection Brief Description of the Service: Aston House is a purpose built establishment situated in a residential area of Hayes. It is registered for 48 service users who are accommodated on the ground and first floors of a three-storey building. Thirty-two of the bedrooms are single and 8 are double and most have en suite facilities. There are two communal rooms on both the ground and first floors, with an additional quiet room with snoozelen equipment on the first floor. An activities room has been created on the second floor. There is an enclosed garden to the rear of the home with garden furniture and room for those in wheelchairs to sit out. The home is easily accessible by public transport. The current fees paid range from £578 - £813 per week. Aston House Care Home DS0000010924.V364045.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was an unannounced inspection carried out as part of the regulatory process. A total of 22 hours was spent on the inspection process, and was carried out by 2 Inspectors. We carried out a tour of the home, and service user plans, medication records & management, staff rosters, staff records, financial & administration records and maintenance & servicing records were viewed. 11 residents, 10 staff, 1 healthcare professional and 2 visitors were spoken with as part of the inspection process. The pre-inspection Annual Quality Assurance Assessment (AQAA) document completed by the home. CSCI surveys for representatives, healthcare professionals, staff and care managers were distributed by the home, however only 2 responses were received. What the service does well: What has improved since the last inspection? Overall there has been an improvement in the formulation and review of the service user plans. Some shortfalls were identified and these must be addressed. All assessment documentation viewed was complete and up to date. Where weight loss had been reported, systems were in place for referral to the GP and dietician. There has been an improvement in medication management. We found that medications were being accurately recorded when administered and in accordance with the prescribed dose. Some shortfalls were Aston House Care Home DS0000010924.V364045.R01.S.doc Version 5.2 Page 6 identified at this visit and should be easy to address. Improvements have been made in the area of activity provision with residents being able to participate in a variety of activities, with more work being done in this area. There has been a marked improvement in the environment of the home both internally and externally. The home was clean and issues with malodours had been addressed. Systems for the vetting and recruitment of staff are robust and are followed. The Manager has been in post since March 2008 and is effectively managing the home. Staff had received training and updates in all aspects of health and safety, although records did not always reflect this. Staff spoken with commented on the marked improvement in the training provision. 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. Aston House Care Home DS0000010924.V364045.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 Aston House Care Home DS0000010924.V364045.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. The home does not provide intermediate care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are fully assessed prior to admission, thus the home ensures they are able to meet each persons needs. EVIDENCE: The home has a comprehensive pre-admission assessment document that provides a good picture of the resident and their needs. This is completed for all prospective residents in order to ascertain if the home is able to fully meet their needs. Completed assessments were viewed on each floor and had been well completed. The home also obtains a copy of the assessment undertaken by social services. Aston House Care Home DS0000010924.V364045.R01.S.doc Version 5.2 Page 9 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, 10 & 11. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall the service user plans were being completed to provide staff with the information to meet each resident’s needs. Shortfalls should be easy to address. Medications are generally being well managed at the home, however shortfalls could place residents at risk. Staff care for residents in a caring, gentle and professional manner, thus respecting their privacy and dignity. Information regarding the wishes of residents and their representatives in respect of end of life care is not fully ascertained, which could lead to their wishes not being met. EVIDENCE: We viewed 7 service user plans. The majority had been well completed and gave a clear picture of each resident and how their needs are to be met. For 2 residents who had been living at the home for some time, the service user plans were still somewhat general in content and needed personalising. There was no evidence that the resident or their representative had been involved in the formulation and review of the service user plans, with the exception of Aston House Care Home DS0000010924.V364045.R01.S.doc Version 5.2 Page 10 written consents for the use of bedrails. It is important that residents or, where the resident does not have the capacity to contribute, their representative is involved with the service user plan so that they can provide valuable background and personalised information regarding the residents’ preferences and wishes. This was discussed with the Manager and the Deputy Manager, both of whom are aware of the need to implement this without delay. There were risk assessments for falls and for the use of bedrails in place. Documentation in relation to wound care was viewed. Overall this was well completed and up to date, with one wound care plan being updated at the time of inspection. Pressure sore assessments and risk assessments for skin integrity are available, and the importance of ensuring all available relevant documentation is completed was discussed. Where weight loss had been identified residents were being weighed weekly. The Manager explained that he had carried out an audit of weight loss and where any significant losses had been noted he had written to the GPs requesting a referral to the Dietician. Continence and moving & handling assessments were in place and up to date. There was evidence of input from healthcare professionals to include GP, Tissue Viability nurse specialist, Chiropodist and Speech and Language therapist. Medication management was viewed on both floors. On both floors a list of nurse signatures was available. For residents who are diabetic approved individual lancing devices were in use and had been clearly labelled. Overall receipts were being recorded for medications received at the beginning of the medication cycle. Where residents required additional medication mid cycle receipts were not always being recorded. For one resident the date of opening had not been recorded on liquid antibiotics. Dates of opening were recorded on other liquid medications and eye drops. For one resident who required Risedronate the instructions on the Medication Administration Record were not clear as to the specific information required when administering this medication. On the first floor insulin pens were being stored in the medicines fridge. We recommended that the pen in use for each individual be labelled. No controlled drugs were in use in the home. Fridge and room temperatures were being recorded on both floors and were within safe range. Correct disposal procedures were in place for medications. Medication was well organised. Staff were seen caring for residents in a gentle and courteous manner, respecting their privacy and dignity, and there was good interaction noted between staff and residents. Residents looked well cared for and there was generally a calm and content atmosphere throughout. Residents’ individual clothing is labelled with their name or room number and residents were dressed to reflect individuality. The service user plans viewed did contain some information regarding end of life care wishes, to include resuscitation status. In some instances this was Aston House Care Home DS0000010924.V364045.R01.S.doc Version 5.2 Page 11 very general, although overall information was more personalised and representatives had been involved. For one resident, information was clarified at the time of inspection. The Manager said that work is now being done to gain up to date and personalised information for each resident in this area of care. The Operations Manager explained that Southern Cross Healthcare are implementing a programme of training for end of life care to ensure that all relevant information is sensitively discussed, and that the wishes of the resident and their families can be recorded and respected. Aston House Care Home DS0000010924.V364045.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 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The activity provision for the home has improved, providing a variety of activities and entertainments to meet the residents needs. The home has an open visiting policy, thus encouraging residents to maintain contact with family and friends. Information regarding advocacy services is available, thus ensuring the service users right to independent representation is respected. The food provision in the home is good, offering variety and choice, with resident’s choices being respected. EVIDENCE: The home has a new activities co-ordinator in post. This is someone who has worked as a carer at the home and who has a good knowledge of the residents on the First Floor. He said that he is aware of the need to ensure he gets to know the residents on the Ground Floor, and gain more information in relation to past hobbies and interests. It was clear from speaking with the activities coordinator that he has started identifying individual interests, for example, gardening, and is getting residents involved in garden projects. Activities were taking place at the time of inspection, especially on the First Floor, and residents appeared to be enjoying themselves. Activities programmes were being formulated and there is a social profile document for each resident, Aston House Care Home DS0000010924.V364045.R01.S.doc Version 5.2 Page 13 which needs to be completed with the help of residents and their representatives. Staff spoken with said that there are definitely more activities now taking place. The activities co-ordinator said that he had attended a training course specifically for the provision of activities, plus he had done the ‘Yesterday, Today & Tomorrow’ dementia care training. On the second day of inspection a representative from one of the local Churches attended the home to visit a resident. The home has an open visiting policy and visiting is encouraged. Visitors spoken with said that they are made welcome at the home, with refreshments being offered. The Manager said that there had been a recent visit from a Hillingdon Advocacy Service, and that he was in communication with them to provide advocacy services for residents who require it. Enquiries are also being made into advocacy services in respect of end of life care. We viewed the kitchen. The area was clean and records were up to date. The home has implemented the new ‘NUTMEG’ system of nutrition and this has introduced more fresh produce and home baking. There was a good supply of fresh produce as well as frozen and dried products, and items viewed were within their expiry dates. We sampled the lunchtime meal on the first day of inspection and the meals were well presented and tasty. For residents who require liquidised meals, they receive their meals first and staff are available to assist them. Then the general meals are served, and staff supervise and offer assistance as needed. Comments received reflected and improvement in the meal provision at the home and it was clear from speaking with the chef that he has a good understanding of providing a nutritious and appropriate menu. There is a choice of meals and a record is kept of the meal choice partaken by each resident. Snacks and drinks are available throughout the 24 hour period. At the last inspection ‘snack boxes’ were available in the communal rooms, however these were not in evidence at this inspection. The Manager said that the provision of these boxes is being reviewed to ensure good food hygiene practices. Aston House Care Home DS0000010924.V364045.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 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has clear complaints procedures in place to address any concerns raised by residents and their visitors. Policies and procedures are in place and are followed for safeguarding adults, thus protecting residents. EVIDENCE: The home has a clear complaints procedure and copies of this were seen on display throughout the home. There have been 5 complaints since the last inspection. The Manager records all concerns, however minor, in order that they can be fully investigated and responded to. The Manager has a positive approach to the management of complaints and encourages the expression of any concerns so that they can be addressed and practice can improve. The home has procedures in place for safeguarding adults, and also has copies of the Hillingdon Safeguarding documentation. The Manager reports any incidents that may have safeguarding adults implications to the Safeguarding co-ordinator at Hillingdon Social Services. Aston House Care Home DS0000010924.V364045.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, 21, 22 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was purpose built and is now being well maintained, thus providing a clean and homely environment for residents to live in. There is evidence of refurbishment, thus providing appropriate furnishings and fittings to meet the needs of the residents. Clear infection control procedures are in place and being adhered to, thus safeguarding residents. EVIDENCE: A tour of each floor was carried out. There has been a marked improvement in the environment of the home, both internally and externally. The outside of the building has been painted to a good standard. Corridors and some bedrooms and communal rooms have also been redecorated, plus the lighting in the corridors has been renewed. Furnishings to include beds, some carpets, floorings, chairs and bedroom furniture have been replaced. Overall the environment is much more homely and bright and provides a pleasant place to live. Sensory wall-hangings have been placed on the walls. Work has also been Aston House Care Home DS0000010924.V364045.R01.S.doc Version 5.2 Page 16 done to improve and brighten up the garden, and more work is planned for the raised bed areas outside the front of the home. There are bath and shower facilities available. On the First Floor one of the bathrooms is not in use as it is not possible to use a hoist due to the positioning of the bath. This was discussed with the Manager and Operations Manager and action is to be taken to make the bath accessible. There are 2 hoists available on each floor. Comment was received that due to the increased dependency of some residents, if the hoists are in use then there can be a delay in meeting other residents needs. This was discussed with the Manager and Operations Manager and it was agreed that the purchase of another suitable hoist would be investigated. The home has a laundry on the Second Floor. There are 2 washing machines and 2 tumble dryers. On the first day of inspection one of the dryers went out of order and action was taken promptly to arrange a repair. Good practice laundry instructions were on display in the laundry room. The home was clean and fresh throughout. Staff spoken with said that with the new carpet cleaning machine and new cleaning schedules it was easier to keep the home cleaned to a good standard. Aston House Care Home DS0000010924.V364045.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 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is being appropriately staffed, thus the needs of the residents can be met. There has been an improvement in the training programme, to provide staff with the skills and knowledge to care for residents effectively. Systems for vetting and recruitment practices are in place and protect residents. EVIDENCE: At the time of inspection the home was being appropriately staffed to meet the needs of the residents. The home has a nursing skill mix of registered nurses and registered nurses with a mental health qualification. Ancillary staff are employed in such numbers as to meet the overall needs of the home. Staff spoken with said that they felt there had been an improvement in the teamwork. The home has care staff with an NVQ in care qualification, however this is currently less than 50 of the care staff. The Manager said that he was in the process of ascertaining the eligibility of staff without an NVQ qualification to do so. We viewed 3 sets of staff employment records. With the exception of one photograph these contained the information required. For 2 new care staff POVA First checks had been carried out, however Criminal Record Bureau clearance was still being awaited. The Manager said that these staff were being Aston House Care Home DS0000010924.V364045.R01.S.doc Version 5.2 Page 18 supervised until the check was received. The importance of ensuring that they are chaperoned until this time was discussed. The Manager said that he would ensure a photograph was obtained prior to the person commencing their next shift. The Manager said that since coming into post he had ensured that all staff, to include those not recently employed, had completed the induction programme for working at the home, and for all new staff this is being completed. Staff spoken with said that there had been a big improvement in the training provision with frequent training sessions for mandatory and other topics relevant to the needs of the residents. Many of the staff have attended the Yesterday, Today & Tomorrow’ dementia care training. A list of training was available and advertisements were seen on display for various planned training sessions. Aston House Care Home DS0000010924.V364045.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 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager has the skills and experience to manage the home effectively, with an open approach, thus supporting staff, residents and visitors. Systems for quality assurance are in place, thus providing an ongoing process of review and feedback. Resident’s monies are being managed and securely stored. Systems for the management of health and safety throughout the home are good, thus safeguarding residents, staff and visitors. EVIDENCE: The Manager is a registered nurse with some years of experience in a management capacity. He also has experience in care of the elderly and will complete the Registered Managers Award, NVQ level 4 in July 2008. Staff commented that the Manager is approachable, supportive, and has a gentle Aston House Care Home DS0000010924.V364045.R01.S.doc Version 5.2 Page 20 and effective management style. The Deputy Manager is a registered nurse with a mental health qualification and has experience with working with the elderly. From discussions it was clear that they both have a ‘hands on’ approach and provide a good level of leadership and support for the staff. The home has a quality assurance system in place. This includes monthly auditing of various areas of the home plus medication audits had been carried out. The Manager explained that service user plan auditing has been implemented and shortfalls are clearly recorded so that the registered nurse responsible for each service user plan can carry out a full review. The Manager has instigated 2 weekly meetings for care staff, nursing staff and ancillary staff. He has also held one relatives meeting and further meetings are planned. The Manager has an open door policy and is happy to meet individually with relatives whenever they wish to do so. Regulation 26 visits are carried out on behalf of the Registered Person. The homes Administrator was not available at the time of inspection. An Administrator from another home attended to address some of the administration tasks. Some monies are held on behalf of residents. Computerised records of income and expenditure are maintained for each individual for whom monies are held. These records had not been updated for a couple of months, however up to date receipts were available for income and expenditure. It is strongly recommended that the computer records be kept up to date as this provides up to date individual financial records for all residents for whom monies are held. The servicing and maintenance records were sampled and those viewed were complete and up to date. The maintenance man maintains a good standard of written records. Fire drills are carried out every 2 months for day and night staff. The fire risk assessment was fully updated in May 2008. The training matrix for health & safety training did not accurately reflect the actual numbers of staff who had undertaken training and the Operations Manager said that this had been identified as an issue to be resolved by Southern Cross Healthcare. 3 staff are trained moving & handling instructors, with 2 more to attend this training. Staff confirmed that there has been extensive training available in the home and it was also clear that staff can attend training at other nearby Southern Cross Healthcare Homes. The Manager was able to produce lists of staff attendance at several recent training sessions. There were no health & safety concerns noted at the time of inspection. Aston House Care Home DS0000010924.V364045.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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 3 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Aston House Care Home DS0000010924.V364045.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 OP7 Regulation 15(2)(c) Requirement Unless it is impracticable to do so, input from residents and their representatives must be sought in the formulation and review of the service user plans. Previous timescale of 01/09/07 not met. The service user plan documentation must be personalised so that the needs of each person are clearly identified and the care plans compiled to address each individuals needs. Receipts for all medication received into the home must be recorded in order that there is a clear audit trail. Dates of opening must be recorded on all liquid medications and eye drops. Information regarding service users wishes in the event of deterioration in their health, plus their care in their final days must be ascertained and recorded. Previous timescale of 01/09/07 partially met. Care plans for activities and interests must be personalised DS0000010924.V364045.R01.S.doc Timescale for action 01/08/08 2. OP7 17 01/08/08 3. OP9 13(2) 01/08/08 4. 5. OP9 OP11 13(2) 12 01/08/08 01/08/08 6. OP12 16(2)(m) &(n) 01/08/08 Aston House Care Home Version 5.2 Page 23 7. OP38 13(4)18 and completed for each resident. Previous timescale of 01/09/07 not met. The records for health & safety training must accurately reflect the training that staff has actually undertaken in order that it can be ascertained that all staff have attended training at the required intervals. 01/07/08 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. Refer to Standard OP9 OP9 Good Practice Recommendations It is recommended that insulin pens in use are labelled with the name of the resident. Clear instructions should be recorded on the Medication Administration Record in relation to Risderonate. Aston House Care Home DS0000010924.V364045.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Aston House Care Home DS0000010924.V364045.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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