Inspection on 13/07/06 for Bromley Park Nursing Home

This inspection was carried out on 13th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Bromley Park Nursing Home 02/07/07

Bromley Park Nursing Home 06/02/06

Bromley Park Nursing Home 19/08/05

Bromley Park Nursing Home 18/06/05

Bromley Park Nursing Home 25/02/05

Bromley Park Nursing Home 20/09/04

Bromley Park Nursing Home 17/11/03

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

CARE HOMES FOR OLDER PEOPLE Bromley Park Nursing Home 75 Bromley Road Beckenham Kent BR3 5PA Lead Inspector Miss Rosemary Blenkinsopp Unannounced Inspection 13th July 2006 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 Bromley Park Nursing Home DS0000010129.V300178.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. Bromley Park Nursing Home DS0000010129.V300178.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bromley Park Nursing Home Address 75 Bromley Road Beckenham Kent BR3 5PA Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8650 5504 020 8650 6085 bromley.park@nellsar.com Nellsar Limited Jacqueline Hayward-Gant Care Home 50 Category(ies) of Dementia - over 65 years of age (50) registration, with number of places Bromley Park Nursing Home DS0000010129.V300178.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Staffing Notice issued 29 April 1997 Date of last inspection 6/02/06 Brief Description of the Service: Bromley Park Nursing Home has been registered to its current owners since 1993. It is a large, detached house in a residential area of Beckenham, and provides nursing care to a maximum of 50 residents, of either sex who are suffering with Dementia. The building has been adapted for its purpose and has had an extension added. Bedrooms are sited throughout the building and there are two lifts giving access to all floors. Communal areas are on the ground floor. There is a large back garden and car parking to the front of the building. There is a bus stop outside the home. Bromley Park Nursing Home DS0000010129.V300178.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was conducted unannounced by four inspectors. The purpose of the four inspectors addressing the key inspection was to address the relevant standards in one day. The four inspectors addressed different standards throughout the day. The requirements and recommendations relating to previous inspections were monitored for compliance. In general the inspectors were of the opinion that many areas, previously found to be unsatisfactory had improved. This is through the continued efforts of the Manager, her Deputy and the staff team. It has taken considerable effort by all staff involved to address the issues and will need more effort to sustain the improvement. Prior to the inspection comment cards were sent out of residents who were involved in case tracking. Prior to the site visit four comment cards were received. The comments were favourable with the exception of one relating to clothing disappearing. Detailed within the report there are some areas, which require further input and monitoring, these were outlined at the feedback provided to the Manager and Operations Manager, Mrs Osmotherley. What the service does well: What has improved since the last inspection? In general the atmosphere was more relaxed and there were more signs of well being amongst the resident group. Staff were seen to interact with residents on a more spontaneous basis and had a less task orientated approach. Feedback, regarding this issue, was also received by the lead inspector from a professional person, external to the home. Bromley Park Nursing Home DS0000010129.V300178.R01.S.doc Version 5.2 Page 6 Staff saw the appointment of a new Deputy Manager, and her ability to work supernumerary, as very positive. They felt that she was able to advise and teach on care planning and was seen as knowledgeable the field. This is not to detract from the role of the Manager, however her time is fully occupied with other matters regarding the running of the home. The recently appointed administrator has made a positive impact on the organisation and availability of information. She assisted one of the inspectors with inspection documents, and systems were in place for ease of access to this information. Staff also stated that they felt more supported with the stronger management structure and it was evident that there was more confidence in the staff team. 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. Bromley Park Nursing Home DS0000010129.V300178.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 Bromley Park Nursing Home DS0000010129.V300178.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The quality rating in this section is good. This is based on all information received including the site visit. The assessment information was better organised. The information provided to staff prior to admission would prepare them to address the resident’s needs. EVIDENCE: The assessment information was inspected of the two newest residents admitted into Bromley Park nursing home. Within the care notes there was evidence of the assessment conducted by a senior staff member of Bromley Park, which covered activities of daily living, mental health issues, behaviour etc. In addition there was the Social Service assessment including a care plan received prior to the admission. The information was more organised and easier to access. The second assessment information was inspected; again there was an assessment of needs, a hospital discharge letter, and Social Services information received from Lewisham under Community Care procedures. Information included past history, medical conditions and the resident’s diagnosis. The home’s pre-assessment contained some good and relevant Bromley Park Nursing Home DS0000010129.V300178.R01.S.doc Version 5.2 Page 9 information. This resident had been placed in another home prior to their hospital admission, however no information had been received despite attempts to obtain this. Bromley Park Nursing Home DS0000010129.V300178.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The quality rating in this section is adequate. This is based on all information received including the site visit There was evidence that care planning and supporting risk assessment information had improved although further work is required to ensure that all care plans have comprehensive, consistent information available for staff to base care upon. EVIDENCE: Two care plans, viewed by one of the inspectors, were of a mixed standard. One care plan provided good information in relation to the individual’s needs although there were some gaps identified. For example supporting documentation highlighted the resident as being overweight and the affect this has on the mobility but there was no care plan or any risk assessments detailing what action the home was taken to address this. Risk assessment had been developed for pressure sores, eating, moving and handling. There was some evidence of reviews taking place but no evidence of residents or their families being involved. The second care plan, whilst it contained some basic information on the individual’s needs, did not reflect all of the current issues of the resident. Bromley Park Nursing Home DS0000010129.V300178.R01.S.doc Version 5.2 Page 11 There were no care plans in relation to eating, medication or personal care or specific health issues even though the evidence from the staff, dietician and supporting documentation shows a number of areas of concern. The risk assessments were limited and did not highlight risks in many of the areas including non-compliance with medication and pressure sore risks. The two care plans viewed by the inspector, contained limited information regarding any access to healthcare except in one file there were good records regarding chiropody visits. This is a cause for concern as one resident is insulin dependent; has heart problems, is non compliant with medication and refuses to eat at times. Another inspector viewed care plans on two residents .The first care plan detailed that the resident had been admitted 16/11/03 from Gosport in Hampshire, by Social Services. The care plan provided good information on how to care for this person, with a summary at the front of the file giving an easy to follow breakdown of needs and how to meet them. The named nurse and key worker were both identified. This resident was due to be moving from the home at the end of July. The inspector spoke to the resident’s daughter who stated that she was very happy with the care her mum received. In addition she felt that the staff and management of the home were approachable, caring and supportive – she had written a letter stating the following: “we have been very happy with the care Mum has received and I will be writing to you (at greater length) shortly. I will really miss you all and I’m sure Mum will too – as much as she is able to. I intend to keep in touch with you and, when we are in London we will call in and see everyone.” The home has been involved with the family in choosing a new home for this resident and details of the new home were on file along with details of how the move will be managed. Monthly reviews were in place relating to specific care plans, risk assessments, continence, nutrition, weight and moving and handling. There was evidence of intervention by healthcare professionals e.g. Chiropodist, GP, optician and dentist. The care plans were signed and dated, daily evaluation completed. The second care plan was of a resident who had been admitted on 05/08/04 from Lewisham Hospital. The care plan was specific to the resident with detailed interventions, reviewed appropriately and risk assessments in place and monitored monthly. This resident is on warfarinstaff in this home are trained to take bloods, the results are recorded in a blood test book and this is sent to the hospital. Further instructions on the dose to be administered to the resident are issued. Generally the inspector felt the care plans were better, files organised and information much easier to find now the file is sectioned and indexed. The recordings were good, reviews were undertaken, however care needs to be taken when dating and signing progress notes. The files themselves are still unwieldy but the Model Care summary gives a good indication of the residents needs and how they are to be met. Bromley Park Nursing Home DS0000010129.V300178.R01.S.doc Version 5.2 Page 12 Two other resident files inspected contained very similar information with care plans referencing physical, behaviour and mental health issues, however more detail was needed in some areas. Risk assessments were in place although again more detail was required. Review dates were met although the cot side risk assessment was overdue. The medications were well organised and no over stocking was evident. On the medication charts photographs were attached and allergies recorded. Those medications, which were received in to the home were signed in. Records relating to fridge temperature were in place. Medication charts were generally well completed. At the last inspection there was a requirement that covert administration guidelines be drawn up, to date this had not been addressed. One resident was noted as having refused his medication for a period. This had been referred to the GP. The medications, which had been refused, included heart drugs. As well as referring this to the GP, staff must look at other avenues to ensure the resident’s physical well being is maintained. Staff must assess his level of capacity in respect of this issue, as well as considering other options available; including covert administration, bearing in mind this resident has s diagnosis of Dementia. The inspector noted that those medications to be administered “ as required“ needed comprehensive instructions including maximum dose, reason for the administration of the medication, and where applicable, the duration. One resident was on injectable medication, which is given by staff in the home. This medication has significant side effects. Two qualified staff, with whom the inspector spoke, were unaware of these side effects. As with any medication staff must be aware of any possible side effects and contra indications. There was a BNF drug reference book although somewhat out of date. The Deputy Manager had her own up to date copy, an up to date copy needs to be available for all staff to reference. Please see Requirements 1,2 and 3. Bromley Park Nursing Home DS0000010129.V300178.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 The quality rating in this section is adequate. This is based on all information received including the site visit. Routines and structures are in place to enable care to be addressed however more activities and choices were evident within the resident’s day. EVIDENCE: During the course of the inspection several visitors were in. Visiting is open and encouraged. Again positive comments regarding the staff and the welcome they received were related to the inspectors. Relatives were seen to have tea with their loved ones, which was provided promptly on arrival. The PAT a pet therapy dog was in and again the handler for this dog was very kind and patient with the residents, talking to residents taking them into the garden and generally displaying warmth and kindness to all. Lunch was a more relaxed affair and the noise throughout the lunch period was significant less than on previous inspections. Dining tables were well presented; juice was available and plate guards in use. Condiments, crockery and cutlery were in good order. Choices were provided and staff actively assisted several of the residents to dine in a dignified manner. A four weekly cycle menu is in place with the emphasis on healthy eating including varied and nutritious meals. The menu includes pictures of food Bromley Park Nursing Home DS0000010129.V300178.R01.S.doc Version 5.2 Page 14 although this is not always used and needs to be further extended; some staff were not aware how the pictures were to be used. Residents are offered a cooked breakfast daily as well as other choices. The cook stated that more cooked breakfasts are being ordered. The inspector observed part of the breakfast serving, and found the food to well presented and looked appetizing. Kitchen staff all have the Food Hygiene Certificates, staff are also due to undertake the Certificate in Nutrition and Health. The “Clean Food Award” from Bromley was issued to a Gold Standard. All relevant temperatures were recorded correctly and accurately. Cleaning schedules are implemented and up to date. Special diets are catered for including diabetics, low fat, egg allergy, and one low potassium. The kitchen was clean and tidy, food stored correctly. There is an activities coordinator who promotes a varied programme of events. In the sitting areas old tyme music was playing in the background. The activities coordinator has organised external trips including one to Brighton in June. The activities coordinator works 09.30 – 4 pm Monday to Friday. In addition there are monthly entertainers in the home. There is a visiting hairdresser to the home. There were more signs of well being – notably residents chatting to one another and to staff. Residents seemed more alert and less drowsy than on previous inspections. Bromley Park Nursing Home DS0000010129.V300178.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The quality rating in this section is adequate. This is based on all information received including the site visit. Information policies and procedures are in place to address complaints. Complaints information is available and on display. Adult protection procedures are in place although staff need to be further instructed in this matter. Staff need to be fully conversant in respect of adult protection procedures and the avenues for referral including external bodies. EVIDENCE: The complaints procedure was available in the hall as was the Statement of Purpose. This is useful for relatives and visitors although would have limited use for the resident’s population all of whom suffer Dementia to varying degrees. Residents are reliant on relatives /advocates to look after their welfare. The CSCI has received no complaints regarding this service since the last inspection. One complaint is still under investigation through the CSCI Complaints procedure. Complaints which have been addressed through the home, have been handled in a professional open manner. Within 1. 2. 3. the complaint log there were four complaints recorded as follows: Chiropodist – not advised of cancellation of services. Relative regarding the cost of toiletries Relative regarding the labelling of clothing, not being advised of a fall, home’s failure to communicate information. 4. Relative relating to respite care. DS0000010129.V300178.R01.S.doc Version 5.2 Page 16 Bromley Park Nursing Home All the above were resolved to the satisfaction of the complainants and the correct policy and procedures followed with supporting documentation. The home has clear information in relation to abuse which is available to staff. Within the training information provided several training sessions have been addressed on abuse and complaints with more planned for August, September and October this year. Staff with whom the inspectors met had a limited knowledge of adult protection and the appropriate action to take. Adult protection training needs to be addressed with all staff, so they have a comprehensive understanding of the topic and all are fully aware of what avenues including external parties to refer information onto. POVA training had been provided to some staff May 2005. Further training on adult abuse is planned for August 2006 and needs to include all staff, ancillary, care and qualified nurses. Please see Requirement 4 Bromley Park Nursing Home DS0000010129.V300178.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 The quality rating in this section is adequate. This is based on all information received including the site visit. Ongoing efforts have improved the environment both the communal areas and the individual bedrooms. EVIDENCE: The home is an adapted building located close to Beckenham. It has fifty beds some within shared bedrooms located throughout three floors. Communal areas are located on the lower ground floor including a sitting area and separate dining area. Improvements had been made to the environment and work was underway on the ground floor. The home felt cooler and areas were cleaner and relatively hazard free. Clocks and calendars were in some bedrooms. Bedrooms were in the main personalised. In one bedroom where the two residents were in bed, there was no stimulation for these residents by way of a radio or TV. An odour was present. More effort is needed to ensure that residents who are nursed in bed are not isolated and have regular contact with staff. Bromley Park Nursing Home DS0000010129.V300178.R01.S.doc Version 5.2 Page 18 The bed linen, which was seen, was in better condition than on previous inspections. More attention is needed to ensure each residents hand towels and flannels. The hot water was initially hot although did run at a satisfactory temperature within a few seconds. The tap in Room B needs fixing as it was continually leaking. The laundry was inspected and the following points were noted: • • • • • • • • • • Floor still not done; however contractors have been informed and the home is aware work needs to be done as soon as possible. Machines all in working order. Infection control – red bags in use – laundry person aware of infection control measures and of COSHH Regulations. Colour coded cleaning equipment in place plus colour coded laundry bags. All clothing seen – labelled. Clothing and linen in a reasonable condition and in good supply. Laundry clean and tidy – new labelled baskets in place for each resident – colour coded. Ventilation remains a problem the area is very hot. Fire procedure and fire training in place confirmed by the laundry person Laundry person confirmed that supervision and appraisal received on a regular basis, and that requested training needs are met. Bromley Park Nursing Home DS0000010129.V300178.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The quality rating in this section is adequate. This is based on all information received including the site visit. Staff are provided in sufficient numbers although the skill mix is not always appropriate to meet residents needs, namely there is an absence of an RMN on the shift. Recruitment procedures are satisfactory and relevant training is provided. EVIDENCE: The home appeared to be meeting their staffing level with the exception of gaps in the RMN required to be on duty. The Manager has also revised the deputy manager’s roster in compliance with the Commissions request to ensure there is adequate supernumerary management time. There was evidence of a good deal of dementia training having taken place over the last few months. There was some evidence of induction also taking place however this was variable lasing form a day to five days for some staff. The home must ensure that staff are trained and competent in core areas before placing on the roster. For example staff should not commence on the roster until there is evidence of moving and handling training from certificates provided or a competent person in the home has trained them. The home accesses training through the Bromley consortium as well as external providers and internal training. There is evidence of planned training for staff and a record of individual training. Some of the core training is overdue including moving and handling, whilst first aid has not been provided due to the nursing qualifications of the shift leaders. However, the Manager was reminded of the need to ensure that there must be one member of staff Bromley Park Nursing Home DS0000010129.V300178.R01.S.doc Version 5.2 Page 20 who is first aid trained on each shift even if they are qualified nurses. There is evidence of the home commencing staff on food hygiene training. Discussions with staff also showed that they have a basic understanding in emergency procedures including how to deal with accidents in the home. The training records show staff to have undertaken training in relation to nursing care needs and nursing staff updating some of their training namely PREPP requirements. Five staff personnel files were inspected in depth. Generally there was evidence of improvement in the organisation of the information. The administrator is creating a schedule to ensure all recruitment checks are addressed. Mr Richard Turner gave further advice, to ensure that all items as required under Schedule 2, Care Standard Act 2000, are met. Four personnel files were check and found to be of a good standard. One file required further attention. Two staff with whom the inspector met confirmed that induction had taken place over a three day period. This had included statutory topics including manual handling and health and safety. Staff felt that the level of day to day support had improved as well as training opportunities and welcomed the additional support provided through the extra management cover. Please see Requirements 5 and 6. Please see Recommendation 2. Bromley Park Nursing Home DS0000010129.V300178.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38. The quality rating in this section is adequate. This is based on all information received including the site visit. The home has strengthened its management structure which has overall improved standards within the home. Health and safety aspects are addressed within the home with regular service contracts, on going works and the in house handy man. EVIDENCE: A tour of the home and viewing of a number of documents showed that the home maintains the equipment and plant to a satisfactory standard. The Manager was due to provide training for staff on infection control on the day of the inspection. The records viewed showed that there had been little training in this area up until this time. This needs to be addressed to ensure all staff have a sound understanding and knowledge of infection control and best practices. Bromley Park Nursing Home DS0000010129.V300178.R01.S.doc Version 5.2 Page 22 The training and fire records viewed showed that there is regular fire training taking place. It was however, confusing to identify whether some records showed staff attending fire drills or they had attended fire instruction. The Manager must ensure that fire drills and fire training are kept separate with a separate agenda identified for fire instruction of staff. Lifting equipment including bath hoists had LOLER inspection stickers dated between February and April this year. In respect of quality assurance Regulation 26 visits are conducted and forwarded to the CSCI. A resident’s questionnaire was dated May 2006. The findings in the main were positive although reference to lack of external outings and some basic healthcare needs was commented upon. Staff meeting minutes were not inspected although were said to be available. The last minutes of relatives meetings was dated October 2004, this is something, which the home needs to resurrect. The home complies with the placement requirements for students from Greenwich University. No residents’ money is retained on site, except one. The records relating to this were not checked at this visit. Bromley Park Nursing Home DS0000010129.V300178.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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X 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 Bromley Park Nursing Home DS0000010129.V300178.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 15 Requirement Timescale for action 30/12/06 2 OP8 13 3. OP9 13 4 OP18 13 The Registered Manager must ensure that care plans are comprehensive in content and reflective of all identified needs. Previous timeframe for action 30/06/06. This is now outstanding. The Registered Manager must 30/09/06 ensure that risk assessments are comprehensive in content and robust enough to address the identified risk. The Registered Manager must 30/09/06 ensure that comprehensive information is available relating to all medications, including that for as required and covert medication administration. Previous timeframe for action 30/05/06. This is now outstanding. The Registered Manager must 30/09/06 ensure that all staff are fully conversant with adult protection and whistle blowing procedures. Bromley Park Nursing Home DS0000010129.V300178.R01.S.doc Version 5.2 Page 25 5 OP27 18 The Registered Manager must ensure that staff induction includes all statutory topics and is evidence through an induction checklist. The Registered Manager must ensure that there is a trained first aider on every shift throughout the 24-hour period. 30/09/06 6 OP38 13 30/09/06 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 OP12 Good Practice Recommendations The Registered Manager should explore alternative ways of addressing care focusing on individuality, choice and preferences. The Registered Manager should expand upon the current training to address all mental health issues relevant to the residents group. 2. OP30 Bromley Park Nursing Home DS0000010129.V300178.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Bromley Park Nursing Home DS0000010129.V300178.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. 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