Inspection on 14/11/05 for Bosworth Court Nursing Home

This inspection was carried out on 14th November 2005.

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

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

Other inspections for this house

Bosworth Court Nursing Home 13/03/09

Bosworth Court Nursing Home 04/11/08

Bosworth Court Nursing Home 15/04/08

Bosworth Court Nursing Home 23/05/07

Bosworth Court Nursing Home 13/06/06

Bosworth Court Nursing Home 16/06/05

Bosworth Court Nursing Home 22/12/04

Bosworth Court Nursing Home 21/06/04

Bosworth Court Nursing Home 13/01/04

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

CARE HOMES FOR OLDER PEOPLE Bosworth Court Nursing Home Station Road Market Bosworth Nuneaton Warwickshire CV13 0JP Lead Inspector Mrs Gillian Adkin Unannounced Inspection 14th November 2005 09:00 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 Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 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. Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bosworth Court Nursing Home Address Station Road Market Bosworth Nuneaton Warwickshire CV13 0JP 01455 290867 01455 292455 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) www.givecare.hotmail.com Dr Kumar Tripurari Prasad Mr Anthony C Marson Ms Susan Barker Care Home 47 Category(ies) of Dementia - over 65 years of age (5), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (5), Old age, not falling within any other category (47), Physical disability (5), Physical disability over 65 years of age (24) Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. No person under 55 years falling within category PD may be admitted to the Home No person falling within category PD(E) may be admitted to the Home when 24 persons of that category are already accommodated within the Home No person falling within category PD may be admitted to the Home when 5 persons who fall within that category are already accommodated within the Home Service User Numbers No person falling within categories MD(E) or DE(E) may be admitted to the home when 5 persons in total in these categories/combined categories are already accommodated within the home. Date of last inspection 16th June 2005 Brief Description of the Service: Bosworth Court is a care home registered for forty-seven residents of both sexes over sixty-five years of age. Its registration categories include mental haeklth, older persons, physical disability and dementia. The home is situated in the historic town of Market Bosworth in Leicestershire and is within driving distance of Ibstock, Hinckley, Leicester, Coalville and Nuneaton. It is traditional in style and is situated on two floors, which are accessed by passenger lift. The home has two lounges and each lounge has a separate dining area. On the ground floor, there is also a large conservatory. The home is staffed twentyfour hours per day by trained staff and care staff. Outside the home is a garden patio area, which is accessible to residents both by foot and in wheelchairs. There is adequate parking at the care home, is situated on the main road close to tourist attractions such as Bosworth Field and Country Park, and also to shops, hotels and restaurants. Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was inspected against the Regulations as in the Care Standards Act 2000. This was an unannounced inspection, which took place over one day and commenced at 09.30 am on 14/11/05.The inspection took 7.5hours. The registered manager and acting care manager facilitated the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting three residents and tracking the care they received through review of their records, discussion with them, and their relatives, care staff and observation of care practices. This inspection report additionally addresses specific areas where requirements and/or recommendations were identified at the previous inspection. During this inspection a tour of the accommodation occupied by those case tracked took place and the inspector viewed internal records, and care plans. The inspector spoke to residents, nurses, care and ancillary staff, No relatives were available during this inspection for comments. There were 37 residents accommodated at the time of this inspection of which 25 were residential and 12 nursing, most of whom had been assessed as having medium /high dependency needs. Comments were received from a number of residents including those selected for case tracking. Comments made by residents about the service were all positive. Typical comments included: “Staff ask my opinion and if I am satisfied” “I am aware that I can stay in my room for meals if I wish to ” “I have not seen my care plan but I am not bothered anyway” “I think there is plenty of staff” “Rooms are very comfortable and warm” “I like my own company and choose not to attend activities provided” “ Staff are very kind” “ The meals are very good” Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 Page 6 Discussion with the registered manager indicated that she was in the process of changing roles and an acting care manager who has been in post for approximately two months was being inducted. Upon successful conclusion of the new manager appointment it was indicated that the current registered manager would move to a training role in the company. What the service does well: What has improved since the last inspection? The registered manager has commenced an internal audit of accidents to identify common occurrences. The recording of accidents has improved since the last inspection. The home has re-registered with “Investors in People” which was due to recommence in November 2005. Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 Page 7 What they could do better: Shortfalls were identified at the previous inspection, these included: 1. 2. 3. 4. Privacy and dignity management. Moving and handling of residents. Waiting times at the midday meal. Management of infection control and use of gloves. During this inspection staff were observed to have improved on the management of privacy and dignity with residents, however concerns were raised again with both managers in relation to: A: Moving and handling, use of footplates and use of slings. B: Glove usage. C: Waiting times at lunchtime. D: Storage of personal, confidential and sensitive information such as photographic evidence of wounds. Serious concerns were raised regarding the management of recruitment and in relation to references obtained. The matter was considered serious enough to warrant an immediate requirement notice to be left. A Requirement has been made with regard to commencement of generic risk assessments. Recommendations were made with regard to 1. Ensuring that staff are kept up to date regarding residents hearing aids. 2. Additional training such as pressure area care, infection control, death and dying. 3. Accessing external support agencies to assist with the provision of suitable activities. 4. The commencement of the re-carpeting and re-decoration of the upstairs floor. 5. Ensuring that the care plan evaluation is reflective of the current situation. 6. The return of unrequired controlled medication. 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. Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 Page 8 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 Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Core Standard 6 is not applicable. Residents are assessed by an appropriate person prior to moving into the home, this results in them being assured their needs can be met. EVIDENCE: Three care plans were selected for case tracking one of the care plans tracked contained evidence of a pre-admission assessment Discussion with the registered manager identified that usually assessments are conducted prior to admission. Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7.8.9.10 Residents needs can only be met by ensuring that care plans are succinct and reflect outcomes of care delivered. EVIDENCE: Three residents were selected for case tracking. All three residents had a care plan in place detailing how their care needs should be met. Overall care plans were of reasonable quality and content and were routinely evaluated by a named nurse, however areas for improvement were agreed with the registered manager regarding risk assessments and evaluations to be reflect outcomes of care delivered. Minor concerns were discussed with the registered manager regarding the documentation of overnight care and it was recommended that care plans are checked to ensure that care prescribed in the plan is being regularly undertaken and recorded by night staff. Discussions took place with trained and care staff about their involvement in care plans and all showed good awareness of care plan contents. Observations of staff during the day indicated that care was being delivered as per plan. Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 Page 11 Recommendations were made regarding ensuring that staff were fully appraised of the situation regarding residents hearing aids when a resident tracked was noted to have significant communication problems and when questioned staff indicated they were not aware that the hearing aid had gone for repair and had not been notified of when it was due for return. When questioned about how staff communicated with the resident it was indicated that they had to “shout” to make themselves heard. The medication of those residents tracked was inspected and were found to be well managed and recorded. Controlled medication records seen were found to be accurately maintained although concerns were raised regarding the appropriateness of keeping several CD’s in the cabinet since March 2005.The registered manager said although she was aware of the new method of returning drugs through a licensed disposal company she still preferred to return them via the drug squad. As six months had lapsed since the last dose of the drug had been given and as the resident was now deceased it was considered to be inappropriate to have these drugs in the home. The registered manager indicated she was waiting a visit from the police to collect them. Care records were kept in a draw in the lounges up and down stairs. Two care plans were noted to be on top of the desk. Concerns were raised with the registered manager regarding this as one care plan contained photographs of wounds/pressure sores on private areas of the resident. It was recommended that photographs of wounds should be kept in a more appropriate place such as the treatment room to protect resident’s privacy and dignity. Discussions with the registered manager and acting care manager indicated that death and dying was not currently on the training schedule and it was agreed that this may be beneficial to staff. Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12.13.15 Ensuring that residents experience a homely life, which includes flexible routines and suitable activities means that the experience of living in the care home meets residents specialist and individual needs. EVIDENCE: Activities are provided one day per week with an arts/crafts class, a carer provides two hours, twice a week with activities such as dominoes. The indications were however that for residents upstairs, there continues to be a general lack of stimulation other than the television. It is recognised that a number of residents including those tracked may not have the capacity to join in some activities, however the home should provide a stimulatory environment in line with current good practise guidelines and in recognition of its categories of registration. It was recommended that support been obtained from appropriate external sources in implementing a programme of activity which is appropriate to the needs of those accommodated currently. The home is in the process of recruiting an activities co-ordinator for six hours a week. Staff described how residents attended a regular church service held each month in the home. One resident attended a local church. Two residents spoken with were related and described how they shared a room. Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 Page 13 General discussion with residents indicated that there was some flexibility with routines in the home however routines were observed regarding toileting of residents and mealtimes. No residents spoken with expressed any concerns over the routines of the home. Concerns were raised at the last two inspections regarding the timing of meals and courses served. Residents on the upper floor appeared to experience unacceptably long periods of waiting and requirements were made. Discussion with the registered manager and staff indicated that attempts had been made to improve the length of time that residents were seated at the table and waiting for their meal to be served, however although positive improvements had been made regarding the seating of residents the inspector noted that there was still one hour and five minutes between being seated and receiving their second course. This matter is considered to still require further improvement when considering the categories of residents accommodated and their individual needs. Residents tracked were unable to express views regarding this matter. Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16.18 Complaints are managed efficiently and responded to within given time scales. An adult protection procedure and appropriate training are in place to ensure staff are confident in responding to suspicion or allegation of abuse this ensures the protection of residents in the home. EVIDENCE: Examination of the complaints procedure and associated documentation indicated that complaints are appropriately managed. No complaints were outstanding at time of inspection. Staff and residents spoken with indicated that they felt confident to make a complaint to any member of staff, although those case tracked were not in a position to self-advocate. The registered manager stressed that ongoing day-to-day communication with relatives and professionals may be a factor in keeping the number of complaints to a minimum. The indications are that the home provides adequate training on adult protection; a training folder was inspected which detailed training attended and future training planned. Speaking with members of staff, they appeared to be aware of the correct reporting procedures for allegations /incidents of abuse. Two international staff were spoken with who stated that they would report any incidents to either the manager, acting care manager, or an external agency such as the Social Services Department. Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 Page 15 It was indicated that when the current registered manager rescinds her post for her new training role, she intends to undertake training needs analysis with each member of staff. Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19.22.24.26.26. Clean, safe and well maintained living areas and rooms, and provision of appropriate equipment and facilities ensure that residents live in surroundings, which maximise independence and are comfortable and homely. EVIDENCE: The accommodation of those residents tracked was inspected in addition to communal areas used. Accommodation overall appeared to be improved, the rooms seen were well presented, some with new bedside lockers and furniture and it was indicated that they were appropriate to meeting tracked residents needs. The home was warm, well lit and ventilated and the maintenance person spoken with informed the inspector that the upper floor decoration was due to commence shortly. He described how kick plates were going to be fitted to the badly scratched doors during the decoration programme. It was noted however that despite previous recommendations regarding the badly bleached carpet identified at the last two inspections no action had been Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 Page 17 taken to replace them. The registered provider is reminded again to give urgent consideration to this matter to ensure that the environment is kept in a good state of repair. Communal areas were overall clean and reasonably maintained. However recommendations were made regarding the use of nursing beds where staff were required to and observed manually moving a bed away from the wall to provide care. The registered manager was recommended to audit the current beds in use to establish their suitability/ appropriateness to the resident. No unpleasant odours were noted in the home during this inspection and staff informed the inspector that the maintenance person was responsible for carpet cleaning which is undertaken as required. Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27.29.30 An ongoing programme of induction and training is provided to ensure residents’ needs can be met appropriately. Residents are not fully protected from the risk of harm by the recruitment process. EVIDENCE: Staff rosters were inspected and a calculation of hours indicated that the home was providing 847.00 hours per week of care. This includes all care and trained staff but does not include ancillary staff or the supernumerary hours of the registered manager and acting care manager, which are additional hours. The home was therefore staffing the home appropriately and according to dependency of residents in occupation. A registered nurse is on duty twentyfour hours per day; five or six care staff are on duty in the morning and four in the afternoon. Observation of staff at work indicated that they had adequate time to perform care tasks in a non-rushed manner and were able to afford residents the time for individual discussion. Residents spoken with stated that they did not feel overly rushed by care staff. Inspection of four staff files identified that recruitment practise was in need of improvement in light of the fact that two files were incomplete. One file had no written references in place and an out of date CRB and a second file contained only one written reference. The registered manager stated that the administrators post was currently vacant and indicated that this process would be improved when an administrator was appointed. Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 Page 19 The registered manager is strongly reminded to ensure that CRB and POVA 1st disclosures and written references are put in place before employment commences. (See reqs) Training files were inspected and indicated that a staff receive training appropriate to their roles. The home currently has thirteen members of staff with National Vocational Qualifications and there is a detailed induction programme with new staff having mentors for supervision. Discussion with the registered manager and acting care manager indicated that both were due to attend a “training the trainer” course in moving and handling in the new year and all training was to be assessed as part of the “Investors in people Award” The present registered manager is due to commence a new training role upon successful appointment of the new manager. She stated that it was her intention to develop training through training a needs analysis identified via supervision and appraisal. Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31.32.36.37.38 Overall the home is managed and run in the best interests of residents, however staffs’ failure to comply with safe moving and handling practise has the potential to place them at risk of harm. Failure to securely store information could result in confidential information being disclosed and the welfare of residents not being protected. EVIDENCE: The home is currently being managed by both a registered manager and a acting care manager and is in a transitional stage. The current acting care manager has applied to be registered with the Commission for Social Care Inspection. Staff when spoken with were aware of the current management structure and referred to both parties as managers. It was unclear if residents or relatives were aware of this structure as no relatives were present and residents referred to Sue as the manager. It is Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 Page 21 recommended that residents are kept fully informed of the stages of changes regarding the manager position. Discussion with staff demonstrated that there is an inclusive and transparent management style and all staff felt confidant to approach either person for assistance. Suitable records were seen to demonstrate that both formal and informal supervision is undertaken. Overseas staff talked about the additional support given to them regarding improving their comprehension by the registered manager and how they had been assisted to enrol at a local college. The home is commended for the support given to these staff. A variety of records were inspected and overall were found to be reasonably maintained however concerns were raised with regard to the storage of care plans and associated documentation such as photographic evidence of wounds. It was apparent that these records are kept unlocked in a desk in each of the main lounges and the registered manager stated that this was in order for them to be assessable to staff It was considered to be inappropriate to have residents personal files on top of the desk when not require and it was recommended that photographic evidence of wounds kept in care plans is stored in a more appropriate place such as the treatment room. It has been required that records are stored according to Principal 7 of the Data protection Act 1998 as detailed. Appropriate technical and organisational measures shall be taken against unauthorised or unlawful processing of personal data and against accidental loss or destruction of, or damage to, personal data: • • • • making every effort to keep personal data safe and secure technical - by controlling system access rights, using passwords and making regular backups organisational - adopting appropriate policies, procedures and disaster recovery plans personal - adhering to policies and procedures, being careful about where files are left to prevent unauthorised access or accidental viewing, not gossiping about work matters and avoiding careless talk in public places Requirements were made at the previous inspection regarding safe techniques for moving and handling residents. Several incidents were witnessed where moving and handling of residents was again considered unsafe or inappropriate such as a resident who was tipped back in her chair whilst being transported from room to room. Discussion was held with the registered manager and acting care manager about the safety issues related to this matter. Discussion with staff and observation of them performing moving and handling techniques varied and it was indicated that they were unclear with regard to Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 Page 22 how / which slings were selected for use. It was stated that they would use the same sling for all residents. Records tracked demonstrated that although moving and handling assessments were in place they did not include the equipment to be used. It was unclear from discussion if they referred to the care plan for MH information. Discussion with the acting care manager in relation to generic risk assessments for the home indicated that this was a task that was to be undertaken with the outgoing registered manager. The registered provider is strongly reminded to ensure that risk assessments are completed and are available for the next inspection. Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 N/A 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 N/A 18 3 3 N/A N/A N/A N/A 3 3 3 STAFFING Standard No Score 27 3 28 N/A 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 N/A N/A N/A 3 2 2 Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? 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 OP29 Regulation 19(1) 4(b)(c) 5(d) 19 Schedule 2 Requirement The registered provider must ensure that satisfactory written references are obtained prior to an offer of employment being made. The registered provider must ensure that CRB disclosures are renewed according to recommended guidelines i.e. every two years or as directed by the CRB. The registered provider must store sensitive /confidential information such as care records in accordance with principle 7 of the Data Protection Act 1998 Suitable arrangements must be made to ensure safe techniques are used for moving and handling residents. Timescale for action 14/11/05 2 OP29 14/11/05 3 OP37 17 (1) b (a) 20/12/05 4 38.2 13 (5) 14/11/05 5 OP38 13(5) 6 OP38 13(5) Requirement not met from last inspection. A review of the current moving 20/12/05 and handling proforma document must be undertaken and revised to include equipment to be used such as type of hoist, slings and use footplates. Moving and handling documents 20/12/05 in place in care plans must be DS0000001891.V266445.R01.S.doc Version 5.0 Page 25 Bosworth Court Nursing Home 7 8 OP38 OP9 13(4) b.c 13(2) updated to reflect type of equipment used. Generic risk assessments for the 20/11/05 home must be commenced without delay. The registered provider must 20/11/05 make appropriate arrangements for the safe return of medication. 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 OP3 OP8 Good Practice Recommendations It is recommended that is recommended that the initial assessments of a resident are kept in the care plan for immediate access. It is recommended that staff are made aware of the daily current situation with regard residents hearing aids when they have been sent for repair in order to ensure adequate communication is maintained. It is recommended that unrequired controlled medication be removed within reasonable timeframes and in accordance with the new Clinical Waste guidelines for medication. It is recommended that photographic evidence of wounds kept in care plans is stored in a more appropriate place. It is recommended that death and dying training is provided to staff. It is recommended that external agencies such as the Alzheimer’s society be contacted to assist with planning of activities to the resident categories. It is recommended that property lists are completed on admission and reviewed periodically. It is recommended that the replacement of carpets (as identified in previous inspections) and the redecoration of the upper floor commences without delay. It is recommended that an audit of beds takes place to ensure that the most appropriate beds are being used for each resident, particularly where frequent moving and handling is taking place. Where identified as necessary it is recommended that more suitable beds are provided. DS0000001891.V266445.R01.S.doc Version 5.0 Page 26 3 OP9 4 5 6 7 8 9 OP10 OP11 OP12 OP18 OP19 OP24 Bosworth Court Nursing Home 10 11 12 13 14 OP26 OP29 OP37 OP38 OP15 15 OP19 It is recommended that the registered manager and acting care manager continue to monitor the use of gloves by staff. It is recommended that as part of the ongoing training provided that pressure area care and infection control are included in the schedule. It is recommended that care plan evaluations are accurate and reflective of care needs as detailed in them. It is recommended that the registered manager /acting care manager randomly audit the use of slings to ensure staff comply with identified moving and handling needs. It is recommended that monitoring of the times that each course of the mid day meal is served continues, and that improvements are made where waiting times between courses are excessive in order to reduce the times that residents are seated. It is recommended that the registered provider commence the programme of redecoration and replacement of carpets on the upper floor without delay. Bosworth Court Nursing Home DS0000001891.V266445.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 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. 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