CARE HOMES FOR OLDER PEOPLE
Avenue Nursing Home Avenue Nursing Home 32 The Avenue Cheam Surrey SM2 7QB Lead Inspector
Alison Ford Key Unannounced Inspection 3rd July 2007 10:00a 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 Avenue Nursing Home DS0000063984.V344517.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. Avenue Nursing Home DS0000063984.V344517.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Avenue Nursing Home Address Avenue Nursing Home 32 The Avenue Cheam Surrey SM2 7QB 020 8642 3912 F/P 020 8642 3912 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) Avenue Nursing Home Ltd Celeste Hyacynth Sealy Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Avenue Nursing Home DS0000063984.V344517.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. One service user may be aged 55 plus years. A registered manager must be in post within 6 months. The building works as per plans submitted must be completed within six months. 11th May 2006 Date of last inspection Brief Description of the Service: Avenue Nursing Home is an older style detached property situated in an attractive residential area of Cheam. It is registered with The Commission for Social Care Inspection to provide nursing care for up to twenty people over the age of sixty-five although there is currently a variation in place to allow one younger resident to live there. Accommodation is arranged over two floors with toilets and bathrooms on each floor and there is a passenger lift. Since being purchased by the current owners the home has benefited from redecoration and refurbishment, the lounge area has been extended and the garden has been attended to, in order to allow residents to take advantage of any warmer weather. At the time of the inspection on 3rd July 2007 fees ranged from £550-£600 per week with additional costs for personal items which would be discussed prior to admission. A copy of the homes Statement of Purpose and the latest inspection report can be obtained from them. The inspection report can also be obtained from the Commission for Social Care Inspection or downloaded from their website. Avenue Nursing Home DS0000063984.V344517.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced visit to the home was made as a part of the inspection process for the year 2007/2008. It took place over six hours during the daytime. When compiling this report, consideration has also been given to information received since the last inspection including complaints, the reporting of accidents and pre-inspection comment cards. The report also reflects conversations held with residents, staff and visitors both during the visit and at a subsequent relatives meeting held on 13th July. In addition to the PreInspection Questionnaire the homes management team have submitted an Annual Quality Assurance Assessment. This is a document that they are required to complete in order to supply The Commission with details about how well they are providing a service for the people that they are supporting. During the visit a tour of the premises was undertaken, there was an inspection of staff files, an assessment of a number of care plans and also of the medication procedures and storage. The homes manager was present throughout the visit and the majority of the residents and the staff on duty were spoken with. All of those standards considered, by The Commission, to be key to the inspection process were assessed. At the time of the inspection there were fifteen elderly people living in the home. Problems with gaining planning permission have prevented two refurbished rooms on the first floor being occupied. Since the last inspection one concern had been brought to the attention of The Commission regarding the increase in fees this year: this is being responded to by The Responsible Person for the home. The home is currently applying to extend its registration status to allow them to take more people who are suffering from dementia. What the service does well:
This home provides a generally comfortable environment for up to twenty elderly people who enjoy living in a smaller home. Several of them have been Avenue Nursing Home DS0000063984.V344517.R01.S.doc Version 5.2 Page 6 there for some time and have built up good relationships both with other residents and some of the staff members. On the day of the visit the majority of them were sitting in the lounge and they appeared well cared for and happy. Those able to express an opinion agreed that they were well looked after,one said “people are alright here” another that “ staff are kind to them”. Relatives that completed comment cards prior to the inspection, and attended the relatives meeting shared this view although several raised concerns about an apparent shortage of staff. Before considering the admission of any new resident a careful assessment of their needs is undertaken to ensure that they can be met by the home. However, there was a lack of regular review of these in some care plans that were seen which could lead to healthcare needs not always being met if they change. There is a limited range of activities offered to residents in the home, which could probably be improved upon although some residents are able to go out of the home on a regular basis and two are going on a holiday. The garden has now been attended to so that people will be able to enjoy sitting out there. All of the people who use this service agreed that the food that is served in the home suits them and the fact that the home is quite small allows the chef to be a key member of the staff team. He was seen to be frequently in the lounge and had a good relationship with the residents. Policies and procedures that are required to be kept as evidence of the homes commitment to the health and safety of the people who use this service were generally in good order now that these are all in line with the other homes in this group. What has improved since the last inspection?
Most of the issues of concern that were raised at the last inspection have now been addressed. The programme of redecoration in the home continues and the garden has been tidied up so that residents will be able to sit there when the weather is warm. New blinds have been purchased for the conservatory so that it is not quite so hot in there and new kitchen equipment has included a “bain marie” so that food can be kept hot more safely and will be more palatable. New kitchen staff have also been employed so that care staff no longer have to carry out any catering duties. Keypads have been fitted so that residents would not be able to open doors themselves. This will minimise the risk of any accidents occurring to them on the stairs or of them leaving the home unnoticed.
Avenue Nursing Home DS0000063984.V344517.R01.S.doc Version 5.2 Page 7 In an attempt to try to gain the views of those people who use this service regular meetings are being held for relatives although it was disappointing to see that residents were not being invited to these. What they could do better:
Several comments were received during the inspection process about the perceived lack of staff in the home. Off duty rotas showed that generally staffing levels are of the agreed numbers however, few of the staff members are employed directly by the home. The home relies heavily on help from the other homes in the group and trained nurses are, at times used as a substitute for carers. The home will need to make efforts to recruit sufficient staff of their own in order to provide a stable working environment and continuity of care for residents. They should also consider more innovative ways of working in order to have enough staff at times of peak activity in the home. Staff members are still not receiving regular supervision sessions in order to monitor their performance and identify any training needs. In order for this to happen additional administration support is required in the home. This will enable the Registered Manager to fulfil her role more effectively. Consideration must be given to ensuring that residents are able to influence the care being provided in the home. There are currently meetings for relatives however, it was felt that some of the people who live in the home could also contribute to these and they must be given this opportunity. On the evening of the meeting that was attended it was noted that the majority of residents seemed to be in the process of going to bed very early. There must be evidence that this has been discussed with them and that this is their choice and not for convenience. Given the frailty and disabilities of those people who use this service, the home should consider producing information that is intended for them in alternative formats such as audio and large print or pictorial form. This will allow more of them to be able to understand what has been written. It was noted that it was uncomfortably hot in some areas of the home on the day of the inspection. There must be evidence that heating systems have been serviced and repaired if necessary and radiators must be able to be regulated in individual residents rooms. Ventilation must also be improved in one of the bedrooms that is very hot. There were some concerns raised in relation to the health and safety of residents in the home. A fire risk assessment has not yet been compiled to show that any risks have been identified and steps taken to minimise these. Hot water temperatures are still not being monitored on a weekly basis and could possibly pose a hazard to frail elderly people.
Avenue Nursing Home DS0000063984.V344517.R01.S.doc Version 5.2 Page 8 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. Avenue Nursing Home DS0000063984.V344517.R01.S.doc Version 5.2 Page 9 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 Avenue Nursing Home DS0000063984.V344517.R01.S.doc Version 5.2 Page 10 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): Standards 1,3,6 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The people who use this service still do not have all of the information that they need to decide whether the home is suitable for them although a preadmission assessment will ensure that their healthcare needs can be met. This home does not offer intermediate care; this standard does not apply. EVIDENCE: A new Statement of Purpose and Service User Guide have been produced for the home since its acquisition by the present owners, and were seen at the inspection. Copies have been distributed to all the residents and are kept in their rooms. These now need to be amended in line with current legislation to contain more information regarding the fees payable. This will include an indication of the reasons for any increases and how much prior notice will be
Avenue Nursing Home DS0000063984.V344517.R01.S.doc Version 5.2 Page 11 given. In this way residents and their representatives will have access to all of the information that they need to make a decision about the homes suitability for them. Given the frailty of the residents, the home should consider producing this information in additional formats such as an audio version so that it is more suited to their abilities. According to information from the home a website is currently being updated to provide potential residents and their families with more information about the home. Pre-admission assessments are undertaken by the Registered Manager to ensure that residents healthcare needs can be met prior to their moving in to the home and some of these were seen. They showed that there had been careful consideration of the individual’s needs and how they might be supported in the home. Avenue Nursing Home DS0000063984.V344517.R01.S.doc Version 5.2 Page 12 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): Standards 7,8,9,10 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People who use this service have an individual care plan however, a lack of regular review means they cannot be sure that their assessed healthcare needs will always be met. They can be confident that they will always be treated in a way, which respects their dignity, and privacy and that they are protected by the homes medication procedures. EVIDENCE: Four care plans were assessed at this inspection. For those residents who had been admitted since the last inspection there was a good pre-admission assessment in place. However, all of the care plans indicated that residents were at high risk of developing pressure sores yet factors that might predispose to this were not being reviewed on a regular basis.
Avenue Nursing Home DS0000063984.V344517.R01.S.doc Version 5.2 Page 13 Residents consider that their healthcare needs are met however, the plans must be audited on a regular basis so that they remain up to date and reflect the care and support that is currently needed. All of the residents are registered with a local doctor and other healthcare professionals would be asked for advice as needed. Dietary intake is now monitored and advice would be taken if necessary. Medication records and storage were in order although bottles of eye drops must be labelled, on the container when they are opened. All personal care is delivered in resident’s own rooms and staff were observed interacting with them politely and with kindness. Staff that have been working in the home for some time have built strong relationships with some of the residents and understand them well. Avenue Nursing Home DS0000063984.V344517.R01.S.doc Version 5.2 Page 14 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): Standards 12,13,14,15 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People who use this service know that although limited, the range of activities in the home is suitable for them, and visitors are made welcome so that family contacts and friendships can be continued. However, it is not clear how much choice they are able to exercise over their daily lives. They enjoy a nutritious balanced diet, which maintains their health and wellbeing and suits their preferences. EVIDENCE: Some activities are offered in the home, and residents are able to choose whether or not they wish to participate. It is recommended that these could be improved to offer more interest and stimulation to residents. Two residents are able to go to a nearby church and another attends a skills centre and the local stroke club. As in the past, two residents will be going on holiday this year.
Avenue Nursing Home DS0000063984.V344517.R01.S.doc Version 5.2 Page 15 It was concerning to note that on the evening of the meeting held for relatives by 18:40 there were only two residents in the sitting room. The others appeared to be either in bed or in the process of going to bed. Relatives also remarked that bedtime seemed particularly early. If residents wish to go to bed early there must be documentary evidence that this has been discussed with them and it is their choice. Those living in the home enjoy the meals that are served and the chef talks to them so that he is aware of their particular preferences. Choices would always be made available. It is suggested that the use of picture menus would help the residents to make these choices. Residents have been encouraged to bring personal possessions into the home to make their bedrooms more homely however none of them are currently able to look after their own financial affairs. Avenue Nursing Home DS0000063984.V344517.R01.S.doc Version 5.2 Page 16 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): Standards16, 18 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. People who use this service can be confident that their concerns and complaints will be taken seriously and acted upon appropriately and procedures are in place, which will protect them from abuse. EVIDENCE: There is a complaints procedure, which clearly sets out the procedures to be followed and this is detailed in the Service User Guide that everyone has in their room and in the reception area. There is a complaints book also there, which was seen. The home should consider producing this procedure in additional formats such as an audio version in order to make it more suited to the abilities of the residents. Policies concerned with adult abuse are in place and recruitment checks contain evidence that appropriate clearance has been gained for new members of staff prior to employment. All staff have received training in issues concerned with adult abuse during the last year however updates must be held on a regular basis. Avenue Nursing Home DS0000063984.V344517.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): Standards 19,25,26 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The people who use this service live in a clean and generally comfortable environment, which suits their needs. EVIDENCE: This home provides a clean and generally well-maintained environment for the residents who live there and the garden has recently been tidied up to make it more pleasant for them to sit in. Bedrooms have all been redecorated and residents have been encouraged to bring in their own possessions to personalise them and make them more homely. It was noted that some commodes still need replacing. On the day of the inspection the home was extremely hot. It appeared that radiators could not be individually controlled due to the construction of the
Avenue Nursing Home DS0000063984.V344517.R01.S.doc Version 5.2 Page 18 covers over them. These must be made so that the heating in bedrooms can be controlled according to the needs of the resident In one bedroom downstairs the wallpaper is peeling from the wall and must be repaired. This room was particularly hot, because of its location in the home, and the windows only open a limited amount. There is an extractor fan however, the controls cannot be reached. Ventilation to this room must be improved in order to make it a more pleasant environment for the resident who occupies it. There is no dining area in the home although the conservatory could be used for this. There was some concern that residents may be left sitting in the same chair for some while as their meals are served on small tables in the sitting room. It is therefore recommended that the conservatory could be better utilised. The home is in the process of applying for a variation to admit residents with dementia and security keypads have been fitted so that they cannot go through doors unnoticed. Additional adaptations such as handrails and increased signage will also need to be provided in this event. Avenue Nursing Home DS0000063984.V344517.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): Standards 27,28,29,30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The people who use this service cannot be sure that there will always be enough appropriately trained staff on duty to meet their healthcare needs. Robust recruitment procedures are in place to ensue their protection. EVIDENCE: Comment cards received prior to the inspection, concerns raised in the complaints book and discussion with residents and their relatives all highlighted a shortage of staff in the home. This was particularly apparent at what was perceived as being busy times in the day when residents needed an increased amount of help. Inspection of the off duty rotas showed that there are generally enough staff on duty however few of them are only employed to work in this home. Staffing levels are only being maintained by using staff from another home in the same group. Several members of staff have left the home during recent months and recruitment has been difficult. Avenue Nursing Home DS0000063984.V344517.R01.S.doc Version 5.2 Page 20 The management team will have to explore ways of improving recruitment and retention of staff and also using staff members in a more innovative way so that they are available at times of peak activity during the day. If the variation for caring for more people with dementia is approved then staffing levels will need to be reviewed again. This group of home employs its own trainer however; the records seen showed that training for staff in this home appears to have been limited. A requirement is given to ensure that training is improved for all staff so that they are able to access both the statutory training that is needed and additional training relevant to the needs of the residents. The care staff that are actually employed solely to work in this home have all been in post for some time and have all gained an NVQ qualification. Personnel files that were seen showed that robust recruitment procedures are in place and appropriate pre-employment checks are completed. Avenue Nursing Home DS0000063984.V344517.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): Standards 31,33,35,36,38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The people who use this service know that a suitably qualified person is in charge however they cannot always be sure that their views are taken into account and listened to. Safe working practices are not always in place to protect them. EVIDENCE: The home now has a registered manager she is currently studying for The Registered Managers Award and several residents commented upon her kindness. Avenue Nursing Home DS0000063984.V344517.R01.S.doc Version 5.2 Page 22 Some problems seem to be being experienced due to a lack of administration support. In order for the manager to carry out her role effectively additional administrative support will be needed. In order to seek the views of residents relatives and representatives regular meetings are now being held. They appear to be well attended although several people expressed a doubt as to whether their suggestions were listened to. It was also disappointing to note that no residents were being invited to these meetings although there are some people living in the home who would be able to make a positive contribution. An increased effort must be made to gain the views of the people who are using the service. Attempts to gain views from questionnaires have been difficult as few are ever returned. Comments and concerns arising from meetings must be made available to the Registered Providers of the service and their responses fed back to those who have attended. The home does not take responsibility for the financial affairs of any of the residents. Supervision and appraisal is not occurring on a regular basis for all staff members. In order to monitor performance and identify future training needs there must be evidence that this is happening at least six times a year. The pre-inspection questionnaire states that all services and equipment are being maintained and checked appropriately although, as previously identified, there must be evidence that the central heating in the home has been serviced and any repairs carried out. A fire risk assessment still needs to be done in line with current legislation to ensure the health and safety of both residents and staff and minimise any risks in the event of a fire. It is recommended that professional advice should be sought regarding this. Hot water temperatures are not being tested on a weekly basis to ensure that they remain around 43 degrees Celsius although they are checked prior to residents having a bath. Weekly checks must be started in order to ensure that residents are not at risk from accidents with excessively hot water. Avenue Nursing Home DS0000063984.V344517.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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X 2 3 STAFFING Standard No Score 27 1 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 1 X 1 Avenue Nursing Home DS0000063984.V344517.R01.S.doc Version 5.2 Page 24 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 OP1 Regulation 4 Requirement The Statement Of Purpose must be amended to contain all of the information required by the regulations in order to help people who use this service make a decision as to whether it will suit their needs. There must be evidence that care plans are being reviewed on a regular basis to ensure that residents changing healthcare needs remain met. Eye drops must be labelled with the date of opening on the bottle to minimise the risk of errors occurring. There must be documentary evidence that residents have been consulted about the time that they wish to go to bed in the evening. All staff must have regular training sessions in issues concerned with adult abuse. Worn commodes in resident’s bedrooms must be replaced. Radiators in resident’s bedrooms must be individually controllable. Torn wallpaper must be repaired
DS0000063984.V344517.R01.S.doc Timescale for action 30/10/07 2 OP8 15(2) 30/10/07 3 OP9 13(2) 30/10/07 4 OP14 12(2) 30/10/07 5 6 7 8 OP18 OP19 OP25 OP19 18(1)(c) 23(2)(c) 23(2)(p) 23(2)(d) 30/10/07 30/10/07 30/10/07 30/10/07
Page 25 Avenue Nursing Home Version 5.2 9 OP25 23(20(p) 10 OP31 18(1)(a) 11 OP33 12(3) 12 OP33 12(3) 13 OP36 18(2) Improving the ventilation in rooms that are too hot must be addressed to ensure the comfort of the people who use this service. There must be an increase in the provision of administration support in the home to enable the Registered Manager to fulfil her role There must be an opportunity for residents to contribute their ideas and views in order to influence the running of the home. Comments from relatives meetings must be given to the Registered Providers and their responses fed back. All care staff must receive supervision at least six times a year in order to monitor their performance and identify future training needs. 30/10/07 30/10/07 30/10/07 30/10/07 30/10/07 14 OP38 13(4)(c) 15 OP38 13(4)(c) 16 OP38 23(2)(p) (Previous Timescale 28/02/07 not achieved) A fire risk assessment must be 30/10/07 produced for the home to provide evidence that all risks to the health and safety of staff and residents have been considered and as far as possible minimised. There must be record available 30/10/07 to show that hot water temperatures in the home are monitored weekly to ensure that they remain around 43 degrees Celsius. There must be evidence that the 30/10/07 central heating system has been serviced and, if necessary, repaired. Avenue Nursing Home DS0000063984.V344517.R01.S.doc Version 5.2 Page 26 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 OP1 OP12 OP15 OP19 OP38 Good Practice Recommendations It is recommended that information intended for those people who use this service should be produced in additional formats suitable for their needs. It is recommended that the range of organised activities in the home could be extended in line with resident’s capabilities. It is recommended that picture menus could be introduced to help residents with their meal choices. It is recommended that consideration should be given to creating a dining room in the conservatory area. It is recommended that professional advice should be sought regarding the preparation of a fire risk assessment. Avenue Nursing Home DS0000063984.V344517.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Avenue Nursing Home DS0000063984.V344517.R01.S.doc Version 5.2 Page 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
