Inspection on 14/05/07 for Avonmead Nursing Home

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

Other inspections for this house

Avonmead Nursing Home 24/03/09

Avonmead Nursing Home 19/06/06

Avonmead Nursing Home 16/01/06

Avonmead Nursing Home 21/07/05

Avonmead Nursing Home 02/02/05

Avonmead Nursing Home 19/08/04

Avonmead Nursing Home 04/02/04

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 Avonmead Nursing Home 11 Canal Way Devizes Wiltshire SN10 2UB Lead Inspector Steve Cousins Unannounced Inspection 09:00 14th May 2007 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 Avonmead Nursing Home DS0000015890.V334784.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. Avonmead Nursing Home DS0000015890.V334784.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Avonmead Nursing Home Address 11 Canal Way Devizes Wiltshire SN10 2UB 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) 01380 729188 01380 729299 avonmead@fshc.co.uk www.fshc.co.uk Laudcare Ltd (a wholly owned subsidiary of Four Seasons Health Care Ltd) Sharon Cottrell Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (45), Physical disability (4), Terminally ill (4), of places Terminally ill over 65 years of age (4) Avonmead Nursing Home DS0000015890.V334784.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. No more than 4 service users with a terminal illness may be accommodated at any one time The minimum staffing levels set out in the Notice of Staffing issued by Wiltshire Health Authority and dated 28 May 1999 must be met at all times No more than 4 service users over 55 years of age who are in receipt of Intermediate Care are accommodated at any one time. 19th June 2006 Date of last inspection Brief Description of the Service: Avonmead is a purpose built care home that provides nursing and residential care. The home has single and double en suite accommodation for up to fortyfive persons, distributed over two floors and served by a passenger lift. The home has an enclosed garden and patio area. Shops and local facilities are a short driving distance from the home in the Wiltshire market town of Devizes. There is ample parking on site. The owner of the home is Laudcare Limited, a wholly owned subsidiary of Four Seasons Health Care Limited, a national provider of care. The manager of the home is Mrs Sharon Cottrell who has been in post since the home opened. A deputy manager and a senior sister support Mrs Cottrell. Two qualified nurses are on duty at all times, supported by care assistants. An activity person is employed. Catering, cleaning, maintenance and laundry services are also available. The current fees range between £355 to 695 per week but do not include chiropody, hairdressing, newspapers or transport costs. Avonmead Nursing Home DS0000015890.V334784.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 14th May 2007 in order to inspect all of the key minimum standards relating to care homes for elderly people. Two inspectors visited the home on both days and the lead inspector returned to the home on the 21st May 2007 in order to discuss the outcome of the visits with the manager, Mrs Cottrell. This related to a total of 15 inspection hours. The findings from this inspection are based on a tour of the premises, speaking to residents, relatives, the manager and staff, and visiting frail residents. A number of records were inspected, including care plans, medication records and staff records. The inspectors reviewed the care of seven residents in detail, male and female, and between the ages of 65 and 91. They had varying physical, social and mental health needs. Some were new to the home and others had been at Avonmead for some time. The care of other residents was reviewed in less detail. Consideration was given to issues of ethnicity and diversity. Comment cards were received from sixteen residents’ prior to the inspection (some of which had been completed by relatives on their behalf) and their views are incorporated in this report. The judgements contained in this report have been made from evidence gathered during the inspection and take into account the views and experiences of people using the service. What the service does well: What has improved since the last inspection? The findings of this inspection indicate an overall improvement in many areas relating to the National Minimum Standards, which is a reflection of the efforts of the management team. Improvement has been noted in the quality of care planning and in the level of support given to residents in relation to maintaining their personal hygiene. Medication procedures are safer and all residents who needed one, had access to a call bell. Improvements to environment continue. These include new carpeting in corridors, sitting rooms Avonmead Nursing Home DS0000015890.V334784.R01.S.doc Version 5.2 Page 6 and some bedrooms. New flooring has been provided in dining rooms and the garden areas improved. There have also been improvements to the bathing and showering facilities. 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. Avonmead Nursing Home DS0000015890.V334784.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 Avonmead Nursing Home DS0000015890.V334784.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): 1 and 3. This home does not provide intermediate care (Standard 6). The majority of people feel that they have enough information about the home to make a choice about moving in, and residents’ needs are assessed prior to moving in. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a statement of purpose and a service users guide. The manager reported that an information pack is sent out to people who wish to move into the home, or to their next of kin should they lack the capacity to make the decision without support. The information included a brochure, a letter about fees and funding advice. A copy of the last CSCI inspection report was available. Terms and conditions of residence are issued. In response to the comment card question: Did you receive enough Avonmead Nursing Home DS0000015890.V334784.R01.S.doc Version 5.2 Page 9 information about this home before you moved in so you could decide if it was the right place for you? Eleven people replied ‘Yes’ and three ‘no’, although two of these indicated that they were admitted as ‘an emergency’. Comments added included ‘Very informative and helpful when I visited before my mother moved here’’. ‘I am very happy he is in this home’ and ‘With regard to my father settling in, a lot of patience and care was shown toward him at this time’. Pre admission assessment documentation was reviewed. The manager or her deputy had completed assessments and assessment forms were included in residents’ care plans. The assessments were satisfactory and in some cases it was evident that other relevant people were present during the assessment procedure. In two cases, other information, such as assessments from the residents care manager was also available. One resident was able to confirm that the manager had visited them prior to admission and, although they said they had moved in ‘at fairly short notice’ and had not had an opportunity to visit, the person felt that she had received enough information about the home to help make a choice. Another resident stated that their relatives had visited the home on their behalf prior to admission. Avonmead Nursing Home DS0000015890.V334784.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. There have been improvements in the standard of care planning and to the level of care and support people receive, particularly with regard their health needs. Many, but not all residents were happy with the support they receive and the home should review these findings. Improvement is needed in the care of one person in the home who has particular specific needs. Medication procedures generally protect the residents and people appear to be treated with dignity and respect. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspectors reviewed the care plans of seven residents in detail. These showed an improvement on previous inspections and contained more information relating to care needs and clearer direction to staff in how to meet those needs. Avonmead Nursing Home DS0000015890.V334784.R01.S.doc Version 5.2 Page 11 There was recorded evidence to suggest that peoples’ health care needs were addressed. One resident who had a sacral pressure sore on admission had improved and their urinary catheter had been removed in an effort to restore their continence. Once the catheter had been removed the care plan had been altered. Another person who had been admitted with a pressure sore had made improvements since moving into the home and there were good treatment records. Another resident who was at risk of developing pressure damage was provided with an air mattress on their bed and a cushion for their chair. The GP had been called as they had developed a rash and due to their poor nutritional intake, they had also been seen by dietician. Records indicated that staff were prompt in referring residents to their General Practitioner (GP) when required and to other health care professionals, such as the tissue viability nurse and speech and language therapist. The inspectors visited the residents and found that interventions were generally in place to meet their assessed needs, such as pressure relief equipment, continence aids and manual handling equipment. Residents are weighed monthly and a record is kept. Records of interventions such as drinks and position changes were kept and appeared contemporaneous. By their appearance, people seemed to be having their personal hygiene and grooming needs met and those who were unable to dress themselves were dressed in clothing that maintained their dignity. Residents who returned comment cards were divided in their opinion of the support given to meet their care needs. In reply to the question ‘do you receive the care and support you need?’ Eight stated ‘always’, six ‘usually’ and two ‘sometimes’. One person told the inspector that they felt the home did not provide adequate support for their needs, which they felt was due to a lack of knowledge of their specific illness. When asked ‘Do you receive the medical support you need?’ Eleven said ‘always’, five ‘usually’ and one ‘sometimes’. One relative added the comment: ’As soon as my father had an illness, or needed attention to his hearing or an eye examination, a doctor was called and/ or appropriate action was taken. Another person told the inspector ‘Oh yes they look after me well and phone the doctor if I am not well’. One resident told the inspector that they had asked for their medications to be reviewed by the GP and that this had happened. Fourteen residents who returned comment cards felt that staff listened and acted on what they say, however one added the comment ‘Usually but sometimes the foreign care workers have very little English and this can cause problems. Another resident who stated, ‘I have problems understanding overseas staff, they don’t listen to me’, confirmed this view. There was evidence to suggest that residents’ privacy and dignity was respected. It was observed that personal care was being given behind closed Avonmead Nursing Home DS0000015890.V334784.R01.S.doc Version 5.2 Page 12 doors and staff knocked on doors before entering a room. Residents seemed to be having their personal hygiene needs met and those who were unable to dress themselves were dressed in clothing that maintained their dignity. The arrangements relating to medication were reviewed. Medicines were stored appropriately including controlled drugs and items requiring refrigeration. There were no residents self-medicating. Administration records were complete and two signatures were evident where there had been handwritten additions or amendments. Staff were not currently recording the amount when controlled drugs were being destroyed and it is recommended that his be done as a matter of good practice. Staff also need to ensure that written evidence is in place to prove that any medications brought in for residents who are admitted for short respite stays have been prescribed by a GP. Avonmead Nursing Home DS0000015890.V334784.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): 12, 13, 14 and 15. Social activities are available which people appear to enjoy and they are supported to maintain contact with friends and relatives. Efforts are made to support people to live their lives as they wish however improvements could be made and further thought should be given to reviewing those who are cared for in bed, in order to ascertain if this is a necessity. The standard of meals appears to vary as residents’ opinion about the food differed. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An activity person is employed and a programme of the activities planned is given to the residents weekly. One resident was able to tell the inspector what activities had been planned and also said that they enjoyed playing Whist with seven others. Social care plans were in place. In response to the question on the comment card ‘Are there activities arranged by the home that you can take part in?’ Six residents responded ‘always’, seven replied ‘usually’ and three ‘sometimes’. One person added the comment Avonmead Nursing Home DS0000015890.V334784.R01.S.doc Version 5.2 Page 14 ‘The entertainment is very good’. Another person told the inspector “I like going to the activities in the lounge’. Relatives were around the home at different times during the inspection and there were no restrictions on visiting. Residents confirmed that they could receive visitors in their rooms or the communal sitting room. Residents and relatives reported that they were able to keep in touch with each other. Many of the residents depended on staff to meet their needs however some of their comments during the inspection indicated that they had some control over how they lived their lives For example some people confirmed that staff endeavoured to assist them to go to bed and get up at the times they requested and it was recorded that a resident had requested and enjoyed a cup of tea in the middle of the night. One resident informed the inspector that they had asked and had been put back to bed for a rest before lunch. People were are able to bring in personal items and furniture if required and some bedrooms showed evidence of personalisation. However one resident told the inspector that they had requested to be out of bed by a certain time as they were expecting visitors, however they were not assisted to get up until after their visitors had arrived. Another issue of concern related to the number of people who were cared for in bed where there was no physical need and the home should review the reasons for this to ensure that the person’s health is not being compromised and that they are respecting peoples’ autonomy and choice. This has been a requirement of previous inspections and every effort should be made to meet this requirement within the timescale given. Residents spoken to were generally devided about the meals available. Those who returned comment cards stated that they either ‘always’ or ’usually’ enjoyed the food, although one replied ‘sometimes’. One person added the comment ‘meals can be of a very poor quality – more fresh fruit and vegetables are needed –.’ Another told the inspector “Some days (the meals) are better than others” and another “Food sometimes good, some times not.” Residents were observed eating in their own rooms or in the dining room or lounge if preferred and staff were observed assisting some residents to eat and giving them sufficient time. Avonmead Nursing Home DS0000015890.V334784.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): 16 and 18 People are aware of how to complain if they need to and staff are aware of procedures in place relating to reporting alleged abuse, and receive training in abuse awareness. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure that is on view and contained in the service users guide, which is available in each person’s bedroom. Comment cards received indicated that residents either ‘always’ or ‘usually’ know who to speak to if they are unhappy. All of the people who returned cards said that they knew how to make a complaint. One relative commented ‘I visit my husband nearly every day and find the kindness and attention people receive is excellent, I have never heard a sharp word being spoken to them –.’ Review of the complaints log indicated that the home had not received any complaints in the period following the last inspection, nor had the Commission. The procedure for the reporting of alleged abuse was reviewed. This is provided by the company and is in line with Government guidelines, however to improve clarity it is suggested that the statement ‘At no time should any investigation commence unless instructed to do so by the POVA team’ which currently is made at the end of the procedure, be moved to the beginning as Avonmead Nursing Home DS0000015890.V334784.R01.S.doc Version 5.2 Page 16 people following the procedure may take inadvertently take inappropriate action before reading this statement. Staff spoken to demonstrated an awareness of correct abuse reporting procedures. Records indicated that some staff required updating in protection of vulnerable adults training. The manager stated that this had been arranged. Review of recruitment records confirmed that POVA checks and references are obtained on staff prior to starting work and that enhanced CRB checks are undertaken. Avonmead Nursing Home DS0000015890.V334784.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): 19, 24 and 26 The home is clean and well maintained. The majority of peoples rooms are furnished to met their needs, however some require comfortable seating. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A maintenance person is employed and a tour of the home, along with records seen, indicated that essential services and equipment are being regularly serviced. There have been many improvements to the home since the last key inspection in June 2006. These include new carpeting in corridors, sitting rooms and some bedrooms. New flooring has been provided in dining rooms and the garden areas improved. There have also been improvements to the bathing and showering facilities. Avonmead Nursing Home DS0000015890.V334784.R01.S.doc Version 5.2 Page 18 Residents’ bedrooms were well decorated and equipment was provided to meet their needs, such as adjustable beds and pressure relief mattresses. Some, but not all residents had comfortable chairs provided in their rooms to enable them to spend time out of their beds and this should be reviewed. In response to the comment card question ‘Is the home fresh and clean?’ Eight residents responded ‘always’ and eight ‘usually’. One resident added - Very rarely any problems’ Another resident commented - Not enough cleaners; although the inspector’s findings did not support this. The inspectors visited all bedrooms and communal areas. These were found to be clean and free from unpleasant odours. The laundry was clean and uncluttered and clear infection control procedures were in place. The kitchen was clean and food safety checks undertaken and recorded. A cleaning schedule was in place in the kitchen. The cook reported that a hot trolley was not working, however the manager stated that a replacement had been ordered, which has since been delivered. Avonmead Nursing Home DS0000015890.V334784.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): 27, 28, 29 and 30 Comments received would indicate that there are times when staff availability impacts on residents receiving prompt attention and the home should review care staff levels to ensure that they are adequate to meet peoples needs. Recruitment procedure supports and protects the residents. There is a commitment to staff training although health and safety training needs to be improved and the number of care staff with an NVQ increased. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents comment cards indicated that there were some concerns about the number of care staff in the home. When asked ‘Are staff available when you need them?’ Four said ‘always’ eight ’usually’ and three ‘sometimes’. One added the comment ‘shortage of staff sometimes at weekends’. Other comments received raised some concerns about staff availability. One relative commented ‘they are very nice but too few staff for too many patients’ and another ‘it can take up to 15 minutes for a room bell to be answered’ although during this inspection it was noted that staff responded promptly to bells and no residents reported any undue delays. Avonmead Nursing Home DS0000015890.V334784.R01.S.doc Version 5.2 Page 20 The recruitment records of three recently recruited staff members were reviewed. Criminal Record Bureau (CRB) checks had been obtained and references and Protection of Vulnerable Adults (POVA) checks had been obtained prior to the person starting employment. Other documentation required was in place. Staff training records were reviewed. Induction training for care staff is in line with Skills for Care standards and the records of a recently appointed staff member indicated that they had received appropriate training; the staff member confirmed this. Some comments received indicated that some staff had poor English language skills. One resident also stated: “The staff do not listen to me or they do not understand me because of the language problems”. The manager was aware of this and stated that the company was reviewing its overseas recruitment policy and that the current overseas staff were attending English language classes. The manager confirmed that six out of fifteen care assistants had an NVQ in care but that there were no others currently undertaking one. Mandatory staff training included moving and handling, infection control, fire safety, protection of vulnerable people and health and safety. Records indicated that some staff required updates in their health and safety training. The manager stated that she was aware of this issue and that further training sessions had been organised. Avonmead Nursing Home DS0000015890.V334784.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): 31, 33, 35 and 38. The manager has the experience and qualifications to run the home and continues to make efforts to improve the quality of service. The findings of this inspection indicate an overall improvement in many areas relating to the National Minimum Standards, which is a reflection of the efforts of the management team. Systems are in place to ensure that the home is run in the residents’ best interests. Residents’ financial interests are safeguarded and health and safety arrangements generally protect residents and staff. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Avonmead Nursing Home DS0000015890.V334784.R01.S.doc Version 5.2 Page 22 Sharon Cottrell is the homes manager. She is a registered nurse who has worked at Avonmead since it opened. Mrs Cottrell has the ability experience to run the home and has worked hard to meet many of the statutory requirements set at the previous inspection. A deputy supports Mrs Cottrell and she is line managed by an area manager. The quality assurance systems in the home were reviewed. Residents meetings are held and the manager reported that some relatives also attended these. Records of these meetings were seen. A ‘Customer Care Survey’ is carried out on an annual basis, the last one being in September 2006. The home operates a ‘Team Audit Process’ whereby key staff are involved in quality audits, results are reviewed by the manager and action plans drawn up on the findings and include timescales for correcting any deficits. Small amounts of money are held on behalf of some residents. Correct procedures for the handling of service users’ monies are in place and money is kept in a safe. The current system of paying all monies received for service users’ personal use into one non interest accruing bank account does not meet regulation 20(1)(a)(b) of The Care Homes Regulations 2001. However the Commission recognises that the procedure is in place for the benefit of the residents and is well regulated and monitored to ensure probity. The arrangements regarding the management of health and safety were reviewed. Records indicated that essential services and equipment are being regularly serviced and that staff receive mandatory training in health and safety issues. The fire log indicated that fire safety checks are undertaken at appropriate intervals. Any accidents are recorded and regularly audited. Suitable moving and handling equipment is provided and staff are trained in its use. Moving and handling assessments are carried out. Avonmead Nursing Home DS0000015890.V334784.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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 2 X 3 STAFFING Standard No Score 27 2 28 2 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 3 Avonmead Nursing Home DS0000015890.V334784.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 OP7 Regulation Requirement Timescale for action 01/08/07 2 OP15 3 OP24 4 OP30 14(2ab)15 The home must review why (1) certain residents are cared for in bed most of the time, with full assessments as to why this is needed for the resident. Where indicated, care plans must be put in place to assist such service users to increase their time out of bed. (This requirement is in progress from the previous inspection but has not yet been met IN FULL. The timescale for action was 31/01/07. As progress has been made, a new timescale has been set.) 16 (2,i) The home must review the 01/08/07 quality of the meals provided to ensure that they meet the requirements of the residents. 16 (2,c) The home must ensure all 01/08/07 residents have comfortable chairs provided in their rooms to enable them to spend time out of their beds if necessary. 18(1c,i) The home must be able to fully 01/10/07 evidence that all staff are trained and competent to perform their roles and receive statutory DS0000015890.V334784.R01.S.doc Version 5.2 Avonmead Nursing Home Page 25 training at the frequency required. (This requirement is in progress from the previous inspection but has not yet been met IN FULL. The timescale for action was 31/12/06. As progress has been made, a new timescale has been set). 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 Refer to Standard OP8 OP9 OP18 Good Practice Recommendations It is recommended that residents’ opinion be sought in relation to the support given to meet their medical and care needs. When controlled drugs are being destroyed, it is recommended that staff record the amount In the procedure for the reporting of alleged abuse, the statement ‘At no time should any investigation commence unless instructed to do so by the POVA team’, which currently is made at the end of the procedure should be moved to the beginning as people following the procedure may take inadvertently take inappropriate action before reading this statement and compromise any investigation by the POVA team. It is recommended that a review of staffing levels be undertaken to ensure that they meet residents’ needs throughout the day. Care staff should be supported and encouraged to undertake NVQ training. A system for regular reviews of care plans should be set up with residents and their relatives for residents who fund themselves. 4 5 6 OP27 OP28 OP7 Avonmead Nursing Home DS0000015890.V334784.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Avonmead Nursing Home DS0000015890.V334784.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. 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!