Inspection on 22/11/05 for Bourne House Nursing Home

This inspection was carried out on 22nd 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Bourne House Nursing Home 06/06/06

Bourne House Nursing Home 01/09/05

Bourne House Nursing Home 28/10/04

Bourne House Nursing Home 19/05/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Bourne House Nursing Home 45 Langley Avenue Southborough Surbiton Surrey KT6 6QR Lead Inspector Diane Thackrah Unannounced Inspection 22nd November 2005 10:00 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 Bourne House Nursing Home DS0000026244.V265787.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. Bourne House Nursing Home DS0000026244.V265787.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bourne House Nursing Home Address 45 Langley Avenue Southborough Surbiton Surrey KT6 6QR 0208 399 6022 020 8390 9394 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) London Residential Healthcare Limited Mrs Frances Mary Wheeler Care Home 40 Category(ies) of Dementia - over 65 years of age (40), Old age, registration, with number not falling within any other category (40), of places Physical disability over 65 years of age (40) Bourne House Nursing Home DS0000026244.V265787.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Staffing Levels as follows: Registered Nurses (RN) Nursing Assistants (NA) No. of Residents 16-20 21-25 26-30 31-35 36-40 8am-2pm 1 RN 3 NA 1 RN 4 NA 2 RN 4 NA 2 RN 5 NA 2 RN 6 NA 2pm-8pm 1 RN 2 NA 1 RN 3 NA 2 RN 3 NA 2 RN 4 NA 2 RN 5 NA 8pm-8am 1 RN 2 NA 1 RN 2 NA 1 RN 2 NA 2 RN 2 NA 2 RN 2 NA The home manager is to be supernumery to the above numbers and work full time. There is to be adequate and sufficient staff and/or contract arrangements in place at all times to ensure a good quality catering, domestic, cleaning, laundry, maintenance and administrative service for all users. A maximum of three service users aged between 55 and 65 years of age in the Dementia and Physical disability categories. 1 September 2005 2. Date of last inspection Brief Description of the Service: Bourne House is a registered care home providing nursing care for up to fourty people who have dementia or a physical disability. The home is a large detached property situated in a residential area of Surbiton, with access to public transport systems, churches of a number of denominations, local shops and leisure facilities. The home is owned and managed by London Residential Healthcare Limited. Accommodation is provided over three floors. Passenger lifts are available in the home. There is a large, well maintained garden to the rear of the premises. Bourne House Nursing Home DS0000026244.V265787.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on 22nd November 2005 between 10.00 and 15.15. A partial tour of the premises took place and care records were examined. The Registered Manager and four staff members were spoken with. Some service users were also spoken with, and these expressed their satisfaction with the service. It was not possible to discuss the service with other service users, due to the complexity of their dementia. It was noted however, that all service users appeared comfortable, relaxed and well cared for. Two visitors were also spoken with. What the service does well: What has improved since the last inspection? Bourne House Nursing Home DS0000026244.V265787.R01.S.doc Version 5.0 Page 6 The Registered Manager has provided written documentation regarding incidents in the home, to the Commission for Social Care Inspection, as required. She has also ensured that delays have not occurred in reporting other issues. There have been improvements in the way that medication is handled. Requirements and good practice recommendations made at a Commission for Social Care Inspection, pharmacy inspection have been addressed and there has been training in the safe handling of medication of all staff members responsible for handling medication. Training has also occurred in the protection of vulnerable adults, mental health and continence care. 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. Bourne House Nursing Home DS0000026244.V265787.R01.S.doc Version 5.0 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 Bourne House Nursing Home DS0000026244.V265787.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 4. There are good arrangements for ensuring that the assessed needs of service users are met. EVIDENCE: Two visitors spoken with said that they were happy with the care that their relatives received. One said that they visited often and that there were always plenty of staff members available. The home aims to offer specialist care to people who have dementia, or a physical disability. Toilet doors have been painted a bright colour to aid identification for service users and there are a variety of aids and adaptations provided throughout the home. Small group, and one to one activities are provided. There are two Registered Mental Nurses working in the home. Some staff members have received training in the needs of people who have dementia and on going training is provided in conditions associated with old age. Records indicate that since the last inspection, a number of staff members have undertaken further training in dementia care. Records also indicate that training sessions have occurred for twelve staff members in ‘managing schizophrenia’ this is in line with a Bourne House Nursing Home DS0000026244.V265787.R01.S.doc Version 5.0 Page 9 Requirement made at the lat inspection. Two staff members confirmed that they had received such training. The Registered Manager has also complied with a Requirement made regarding the need to apply for a variation in categories of registration to ensure that the home’s certificate of registration accurately reflects the situation in the home. This application is currently being considered by the Commission for Social Care Inspection. Bourne House Nursing Home DS0000026244.V265787.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 and 10. There continues to be, in general, good arrangements for addressing the personal, health and social care needs of service users; this allows service user’s needs to be met. There is a need, however, for further consultation with service user’s representatives during the care planning process. There have been some improvements in the way that medication is handled, however, there continues to be poor practice in medication handling and therefore the well being of service users is not fully protected. EVIDENCE: The arrangements for meeting the personal, health and social care needs of service users continue to be, in general, good. Care plans examined set out in detail how staff members should address individual needs and there were risk assessments in relation to moving and handling and falls. One care plan detailed the number of staff members required to support the service user to carry out specific tasks as well as areas were to service user was independent. There were records indicating that the care plan had been reviewed regularly. There were no records to indicate that the family members of one service user Bourne House Nursing Home DS0000026244.V265787.R01.S.doc Version 5.0 Page 11 had been involved in the care planning process and the Registered Manager said that family members are not always available to discuss care plans. Previous inspections have highlighted that service users, or their representatives have not signed care plans. This raises questions about whether there is a thorough consultation process regarding the planning for care. Care plans must be agreed and signed by the service user or their representative. Were the service user or their representative chooses not to sign the care plan, their must be records detailing why this has not occurred. Records indicate that the health needs of service users are well met. Records for one service user detailed that a Physiotherapist, Optician, General Practitioner, Dietician and Speech Therapist had visited them in the home. There were records detailing that the weight of another service user had been monitored. The Commission for Social Care Inspection Pharmacy Inspector has recently examined medication systems in the home as a result of the Registered Manager identifying a large number of irregularities in the handling of medication. Serious errors in administration of medication and errors and omissions in recording were found. Seven Requirements and two good practice recommendations were made as a result of the inspection. Initial timescales for meeting Requirements were not met by the home. Timescales were extended, and on a third visited to the home by the Pharmacy Inspector, all Requirements were met. There were records detailing that staff members responsible for handling medication have all received refresher sessions in medication handling. Staff members spoken with confirmed this. The home has also introduced the ‘blister pack’ system for handling medication, which reduces the risk of errors being made. Disciplinary procedures are being followed in relation to errors made in handling medication. Despite recent training in the safe handling of medication, further concerns regarding medication handling are raised as a result of this inspection. There were two pots of sudacream, without lids, stored on an open shelf in a top floor bathroom. There was one Medication Administration Record that detailed that a service user should take one or two paracetamol tablets each day, however, it was unclear on the records whether tablets had been administered. Records for another service user detailed that their General Practitioner had prescribed them eye drops, but the home had not obtained these for three days after the prescribed start date. A nurse said that this was an error on the part of the chemist. However, these issues are of concern as they place the well being of service users at risk. It is of particular concern that such errors have occurred, despite recent updates in staff training taking place. Five further Requirements are made in relation to the need for medication to be handled safely. There must be close monitoring of medication handling by the Registered Manager (and personal in charge following the resignation of the current Registered Manager) Bourne House Nursing Home DS0000026244.V265787.R01.S.doc Version 5.0 Page 12 There were two issues identified at the last inspection of the home that compromised the dignity and privacy of service users. These issues have now been addressed and no other problems were identified regarding this issue. The home has also ensured that any incidents that have occurred in the home have been reported to the Commission for Social Care Inspection, in line with a Requirement made at the last inspection. Bourne House Nursing Home DS0000026244.V265787.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 15. There continues to be good opportunities for engaging in social activities, ensuring that social needs are met. Meals are varied and nutritious, ensuring that health is promoted and differing tastes are catered for. EVIDENCE: There continues to be an ongoing programme of organised activities. There was a notice board in the main lounge detailing what activities were on offer. This included music and hand massage. A number of service users were noted to be enjoying hand massages during this inspection. Photos displayed in the entrance hall showed service users involved on outings to a pub, Richmond Park and Hampton Court. There was also a poster advertising a forthcoming Christmas party to be held in the home. One service user said that they had been on a few of the bus trips with the home, and had enjoyed them. There are televisions and music equipment in each communal lounge. Gentle music was playing in each lounge at the time of this inspection. The kitchen was clean, well organised and there was a good supply of fresh fruit and vegetables. The menu for the day was clearly displayed in the lounge, and a weekly menu also available. Service users appeared to enjoy the meal provided at lunchtime and received good support from staff members Bourne House Nursing Home DS0000026244.V265787.R01.S.doc Version 5.0 Page 14 throughout the meal. Some family members helped to feed their relatives at meal times during this inspection. Bourne House Nursing Home DS0000026244.V265787.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16. There is a system in place for the effective handling of complaints and service users and their relatives are encouraged to raise any concerns they have. Service users therefore know that their concerns will be acted upon. EVIDENCE: There are policies and procedures in place for dealing with complaints. The Registered Manager is currently in the process of dealing with a complaint made by a staff member. Procedures have been followed appropriately. Bourne House Nursing Home DS0000026244.V265787.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, 25 and 26. The home is, in general, maintained, decorated and furnished to a good standard and facilities are clean and safe. This ensures that most service users live in a pleasant, homely and comfortable environment. However, there continues to be a need for improvements to ensure that all service users benefit from living in a well-maintained environment. EVIDENCE: Bourne House Nursing Home DS0000026244.V265787.R01.S.doc Version 5.0 Page 17 A maintenance worker is employed in the home and there are regular checks on maintenance standards with records kept. Furniture provided throughout the home was generally of good quality. However, it was identified at the last inspection of the home that one bedroom contained a broken desk and badly fitted headboard. Efforts have been made to address these issues, however, the desk legs are still wobbly, as is the headboard. A headboard that wobbles will not provide support, or comfort to the service user using this bed. These items of furniture must be replaced if they cannot be made stable. The local fire officer has carried out an inspection of the home in 2005 and found it to comply with safety regulations. Records detail that the local environmental health department, on 21 February 2005, visited the home and that it complies with their requirements. CCTV cameras are not used in the home. Six bedrooms were viewed. These were naturally ventilated and windows had restrictors. The window in bedroom thirty-two was broken and a staff member said that the service user had been given an alternative bedroom until the window was fixed. Bedrooms contained radiators with low temperature surfaces that could be individually controlled. Hand washbasins were provided, however, no hot water was available in bedrooms twenty-one and twenty nine. This issue must be addressed. Some service users had a television in their bedroom and one service user also had a telephone. There were some photographs and ornaments in two service users bedrooms, whilst others contained no personal possessions. These bedrooms did not appear homely. A staff member said that some family members do not bring personal possessions for their relative. It is recommended that the home make further efforts to inform family members that bedrooms can be personalised in order to help the service user’s settle into the home. It is also recommended that the home be more proactive in creating a homely, comfortable and domestic environment for service users to live in. The home was very clean and free from offensive odours. The laundry is sited well away from the kitchen and there is a contract for the collection of clinical waste. Policies and procedures are in place to deal with the safe handling of clinical waste. Staff members receive in house infection control training. One visitor spoken with said that they had always found the home to be clean. Bourne House Nursing Home DS0000026244.V265787.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): 29 and 30. The procedures for the recruitment of staff members are not robust and therefore do not fully provide the safeguards to offer protection to people living in the home. There has been ongoing staff training that has allowed staff members to develop the skills necessary for doing their jobs, and therefore meeting the needs of service users. EVIDENCE: The previous two inspections of the home have highlighted that pre recruitment checks carried out on staff members employed from overseas have not been robust and therefore do not offer protection to service users. Staff members employed directly from overseas are not checked against the Protection of vulnerable adults list, and do not have Criminal Records Bureau checks prior to them commencing work. A representative from the home stated that it has not been possible to obtain these checks, as they require the staff member to have lived in the UK, prior to commencing work. In four files examined, there were police checks from the staff member’s country of origin. In three of these files there was all other information and documentation required by regulation for the protection of vulnerable adults, other than a Criminal Records Bureau and Protection of vulnerable adults check. One file contained all information required, but only one written reference that had been applied for by the home. There has been a failure to address the Requirement made at the last inspection regarding the need for the home to Bourne House Nursing Home DS0000026244.V265787.R01.S.doc Version 5.0 Page 19 apply for police checks directly. However, there have been changes in Commission for Social Care Inspection policy since the last inspection of the home. Staff members must not be employed until a satisfactory Criminal Records Bureau and Protection of vulnerable adults check has been applied for, and obtained by the home. This includes staff members who have been directly employed from overseas. There must also be two written references, applied for by the home, in place for each staff member prior to them commencing work in the home. Failures to comply with these Requirements may result in enforcement action being taken. Records available detailed that there has been a large amount of staff training since the last inspection. There were records detailing that sixteen staff members have attended ‘Elder Abuse’ training by the Community and District Nursing Association. The personal training file for one staff member contained certificates indicating that training in elder abuse, moving and handling, dementia awareness and infection control had occurred in 2005. Two staff members spoken with said that they had attended training sessions on wound care, dementia care, continence care and mental health. Records also indicated that all staff members responsible for handling medication have received refresher training in the safe handling of medication. However, Requirements have been made regarding poor practice in relation to handling medication as a result of this inspection (See Standard 8) and it is therefore recommended that additional refresher sessions in handling medication occur. Bourne House Nursing Home DS0000026244.V265787.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, 33, 35 and 38. Staff members currently receive good support and guidance, ensuring that the home is run in the best interests of the service users. However, the Registered Manager has resigned form her post. Should this position not be filled in the near future, there is potential for a lack of leadership, resulting in staff members not receiving the support required for them to do their jobs well. Health and safety is taken seriously and therefore practices promote and safeguard the health, safety and welfare of people using the service EVIDENCE: The current Registered Manager has demonstrated competence and good leadership skills since commencing post. She has addressed some Requirements made at the last inspection well, and in a timely fashion. Staff members said that they received support from the Registered Manager and two visitors spoken with said that the she was approachable and helpful. The Bourne House Nursing Home DS0000026244.V265787.R01.S.doc Version 5.0 Page 21 Registered Manager has now resigned from her post. The Responsible Individual said that he would be taking overall responsibility for the day-to-day running of the home until the post is filled. There have been a number of changes in the person responsible for running the home in the last few years and it is hoped that this post will be filled without delay in order to provide stability and continuity for service users, their family members and staff members. There are good systems in place for monitoring the quality of the service, including monthly, unannounced visits to the home by the Responsible Individual, family meetings and informal feedback from service users. The Registered Manager said that a quality monitoring survey has recently been sent to all family members. The home does not handle money for any service user. There are good arrangements for ensuring safe working practices in the home. All staff members undergo training in safe working practices and safety procedures are posted throughout the home. Risk assessments of the premises and individuals are in place. All accidents and incidents are recorded. There were records detailing that the gas system had been serviced in October 2005. Portable appliances were tested in October 2005. Testing for legionella occurs. All hoists in the home were serviced in February 2005. There are good systems in place for fire safety including regular testing of the fire alarm and emergency lighting and regular fire drills. Bourne House Nursing Home DS0000026244.V265787.R01.S.doc Version 5.0 Page 22 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 X 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 X X X X X 2 3 STAFFING Standard No Score 27 X 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Bourne House Nursing Home DS0000026244.V265787.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? YES. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 (1) Requirement The Registered Provider must: 1. Ensure that care plans are agreed and signed by the service user or their representative. 2. Were the service user or their representative chooses not to sign the care plan, there must be records detailing the reason for this. 01/01/06 The Registered Provider must: 1. Ensure that all medication is stored securely in the home. 2. Ensure that lids are not left off sudacream pots. 3. Ensure that Medication Administration Records accurately reflect General Practitioners instructions and staff members administer medication, only in line with these instructions. 4. Ensure medication Bourne House Nursing Home DS0000026244.V265787.R01.S.doc Version 5.0 Page 24 Timescale for action 01/03/06 2 OP9 13 (2) prescribed to service users is obtained, without delay, from the pharmacist. 5. Medication audits occur, at least weekly. Records of these must be made available for inspection. 3 OP19 16 (2)(c) 13 (4)(a) The Registered Provider must 01/01/06 ensure that the headboard in bedroom 34 is fixed securely to the bed and that the broken desk in this bedroom is repaired or replaced. Repeat Requirement. Timescale of 01.10.05 unmet. The Registered Provider must 01/01/06 ensure that hot water, at a temperature close to 43 Degrees is available from hand washbasins in bedrooms 21 and 29. The Registered Provider must 01/01/06 ensure that two written references, a satisfactory Criminal Records Bureau and Protection of Vulnerable Adults check is in place for each staff member, prior to them comencing work in the home. These checks must be applied for directly by the home. These documents must be made available for inspection. Repeat Requirement. Timescales of 01.01.05 and 01.10.05 unmet. 4 OP25 23 (2)(j) 4 OP29 19 (1)(a)(b) (i) Bourne House Nursing Home DS0000026244.V265787.R01.S.doc Version 5.0 Page 25 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 Refer to Standard OP25 Good Practice Recommendations The Registered Provider should ensure that further efforts are made to inform family members that bedrooms can be personalised in order to help the service user’s settle into the home. And also, be more proactive in creating a homely, comfortable and domestic environment for service users to live in. The Registered Provider should ensure that refresher training in the safe handling of medication is ongoing. 2 OP30 Bourne House Nursing Home DS0000026244.V265787.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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. Extracts may not be used or reproduced without the express permission of CSCI Bourne House Nursing Home DS0000026244.V265787.R01.S.doc Version 5.0 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. 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