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Inspection on 12/08/05 for Camberwell Green Nursing Home

Also see our care home review for Camberwell Green Nursing Home for more information

This inspection was carried out on 12th August 2005.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service users can maintain contact with their family and friends as they choose when they visit the home. Generally the home is safe and well maintained. The home is purpose built and spacious and there are communal areas on the ground floor.

What has improved since the last inspection?

This was the first inspection of this home by this inspector so it is more difficult to say what has improved. One of the last reports` recommendations had been met in that now service users have their own individual toiletries in their rooms.

What the care home could do better:

Although there are care plans in place they do not cover all areas of service users` individual needs and are not consistently completed. This means that the home cannot know that they are operating all established programmes of care and cannot evidence that they are meeting all service users needs.The home is not consistently operating the procedures for effective medication management and administration and as such service users may be put at risk. The lifestyle of service users does not reflect their expectations and preferences and does not satisfy all of their social, cultural and recreational needs. Service users are not being supported to access the local community as they choose. The home cannot show that they are providing food that is pleasing to service users as some service users and their families said they are not happy with the food provided and there is not enough choice for people form a non-British ethnic background. The complaints procedure does not include an explanation of who the Commission is and why service users may want to complain to them. The home is not as comfortable as it should be given that noise levels were high in one area and signage around the home is in some cases excessive and inappropriate. There are enough toilets and shower/rooms in the home but they are decorated in an institutional manner and not suitable for service users` needs. There is specialist equipment in use in the home but it has not been assessed by an occupational therapist which means that service users may not be using the safest, most effective equipment to meet their needs. The building is not entirely safe and secure as the front area of the home is open to the street and on hot days the front doors are kept open. On the day of the inspection some areas of the home smelt of urine. Service users needs are not being met by a sufficient number of staff. The home is not achieving the required levels of qualified staff and as such service users are not being supported by the most effectively trained staff team possible. There has not been a permanent manager in post or a Registered Manager of this service for some time and as such the home is not yet managed by a permanent person fit to be in charge. Given the various differing opinions of service users and their families the home is not evidencing that it is run in the best interest of the service users and there is not a consistent appropriate level of satisfaction with the home. The record keeping procedure is not being maintained and service users` information is not being held securely. Although generally the health and safety of service users is being maintained they are being placed at some risk by the treatment room not being locked at all times.

CARE HOMES FOR OLDER PEOPLE Camberwell Green Nursing Home Camberwell Green Care Centre 54 Camberwell Green Camberwell, London SE5 7AS Lead Inspector Lisa Wilde Unannounced 12 August 2005, 10:00am th 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 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. Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Camberwell Green Nursing Home Address Camberwell Green Care Centre, 54 Camberwell Green, Camberwell Green, Camberwell, London, SE5 7AS Telephone number Fax number Email 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 7708 0026 020 7708 0027 Apta Healthcare (UK) LTD Carol Lee CRH Care Home N Care home with nursing 55 Category(ies) of OP Old Age registration, with number PD Physical Disability of places Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Until notification is received from Operations Director, this home will accommodate 42 service users only, aged 60 years and above (female) and 65 years and above (male). 1 April 2002. 2. and chronic sick and disabled persons aged 40 years and above. 1 April 2002 3. up to six residents to be accommodated on the ground floor. 13 June 2005 Date of last inspection 17th February 2005 Brief Description of the Service: Camberwell Green Care Centre Care Centre is operated by Ashbourne Eton Limited, a subsidiary company of Ashbourne Holdings Limited. Ashbourne is an independent provider of healthcare services in the UK. Services include residential and nursing care for older people, people with mental health needs, younger people with physical disabilities and intermediate care services.Camberwell Green Nursing Home was able to provide care with nursing for up to 55 people up until June 2004. The home asked to reduce its numbers at that time. The home can currently accommodate a maximum of 42 service users and a condition of registration is in force which states this. The Certificate of Registration been amended to reflect these changes Service users may be older people or aged forty and over and require care as a result of physical disability. The home is purpose built and located in the centre of Camberwell close to public transport routes, shopping and leisure facilities. The home has four floors and there are two lifts available. Since June 2004 three floors are being used and the fourth floor has been closed. Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day in August 2005. The inspector spoke with the acting manager, staff, service users and visitors to the home. Given that the acting manager is only in place for a few weeks until the new permanent manager starts in mid-September the decision was made to announce the second inspection in a few months time when the new manager was in post. Families of service users had different views of this home, some being very pleased with it saying that it was much better than any other home their relative had lived at, while other families were very unhappy saying that they were very concerned about the care of their family member. The home has not had permanent management in place for a considerable time now and so the inspector would hope that as a result of the post being filled in the very near future that the views of families and service users will be sought as a priority as part of establishing how best to develop this service. The inspector will expect the issues raised at this inspection to have been addressed by the next inspection to feel satisfied that the organisation and the new management are recognising the work that is necessary to bring this home further in line with the requirements of the National Minimum Standards. What the service does well: What has improved since the last inspection? What they could do better: Although there are care plans in place they do not cover all areas of service users’ individual needs and are not consistently completed. This means that the home cannot know that they are operating all established programmes of care and cannot evidence that they are meeting all service users needs. Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 Page 6 The home is not consistently operating the procedures for effective medication management and administration and as such service users may be put at risk. The lifestyle of service users does not reflect their expectations and preferences and does not satisfy all of their social, cultural and recreational needs. Service users are not being supported to access the local community as they choose. The home cannot show that they are providing food that is pleasing to service users as some service users and their families said they are not happy with the food provided and there is not enough choice for people form a non-British ethnic background. The complaints procedure does not include an explanation of who the Commission is and why service users may want to complain to them. The home is not as comfortable as it should be given that noise levels were high in one area and signage around the home is in some cases excessive and inappropriate. There are enough toilets and shower/rooms in the home but they are decorated in an institutional manner and not suitable for service users’ needs. There is specialist equipment in use in the home but it has not been assessed by an occupational therapist which means that service users may not be using the safest, most effective equipment to meet their needs. The building is not entirely safe and secure as the front area of the home is open to the street and on hot days the front doors are kept open. On the day of the inspection some areas of the home smelt of urine. Service users needs are not being met by a sufficient number of staff. The home is not achieving the required levels of qualified staff and as such service users are not being supported by the most effectively trained staff team possible. There has not been a permanent manager in post or a Registered Manager of this service for some time and as such the home is not yet managed by a permanent person fit to be in charge. Given the various differing opinions of service users and their families the home is not evidencing that it is run in the best interest of the service users and there is not a consistent appropriate level of satisfaction with the home. The record keeping procedure is not being maintained and service users’ information is not being held securely. Although generally the health and safety of service users is being maintained they are being placed at some risk by the treatment room not being locked at all times. 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. Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 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 standard(s) X These standards were not assessed but were met at the last inspection. They will be prioritised at the next inspection given that the rooms on the ground floor are now available at the home. Standard 6 does not apply as this home does not provide intermediate care. EVIDENCE: Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 Page 9 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 standard(s) 7, 8 & 9 Although there are care plans in place they do not cover all areas of service users’ individual needs and are not consistently completed. This means that the home cannot know that they are operating all established programmes of care and cannot evidence that they are meeting all service users needs. The home is not consistently operating the procedures for effective medication management and administration and as such service users may be put at risk. EVIDENCE: Six files were examined and found to have a lot of information held in them but it was not consistent across all files. As mentioned under other standards issues about holding of keys and preferred bed times were not recorded. Some service users have a care plan around social interaction (that is the same for everyone and only states that they should be brought to the communal areas to watch TV and talk with other service users) and other service users do not. Some monthly reviews of the care plans had been missed. One person needed to have physiotherapy from staff three times a week but there was no chart in place to monitor whether this was done or not. (See Requirements 1 & 2 and Recommendation 1) There was a previous recommendation that the Manager should check that all service users currently have their own toiletries in their bedrooms and ensure Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 Page 10 that staff are aware that toiletries should not be taken from one service user’s room to use for another. The acting manager stated that staff have been made aware of this and there was no evidence of shared toiletries in people’s rooms. There was a previous recommendation that the Manager should seek feedback from service users about current day and night time routines, in particular the time that service users are assisted with preparation for bed. The acting manager stated that people’s preferred bedtimes is now recorded in the files but on checking a sample of files thee was no evidence of this. Staff reported that it is difficult to get everyone ready for bed when they chose as there are not enough night staff on duty so the day time staff often get people ready for bed. (See Requirement 3) The medication stocks and records on both floors were checked. Some labels stated “as directed” instead of specific instructions on administration. F was used as a code on the charts but was not specified what this meant. Some staff were signing with only one initial. One medication was not recorded at all on the administration chart. Not all the stocks checked tallied with the recorded amounts. There was a gap in recording of one administered medication. (See Requirement 4) Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 Page 11 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 standard(s) 12, 13 & 14 The lifestyle of service users does not reflect their expectations and preferences and does not satisfy all of their social, cultural and recreational needs. Service users are not being supported to access the local community as they choose. Service users can maintain contact with their family and friends as they choose when they visit the home. The home cannot show that they are providing food that is pleasing to service users as some service users and their families said they are not happy with the food provided and there is not enough choice for people form a non-British ethnic background. EVIDENCE: A hairdresser attends the home every week but on talking with one service user it appears that they are not able to cut African or Caribbean hair (See Requirement 5) There is a full-time activities co-ordinator at the home who talked through the events and activities that she organises each week. These include skittles, bingo, board games, Holy Communion, hair and nails, videos. TV, books and some trips out for lunch. Service users stated that they do not go out regularly. Staff said that there are not enough staff to take service users out at Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 Page 12 all. On the day of the inspection all service users were noted sitting in the home only going out for hospital appointments. (See Requirements 6 & 7) Visitors are allowed to come and go as they please with the only restrictions being placed for issues of safety at night. As stated above there is little evidence that there are enough staff available at this home for service users to regularly access the local community. On the day of the inspection the inspector talked with service users who were waiting in the hallway for their ambulance escort to take them to hospital appointments. The stated that some days they can wait for hours in the entrance hall as the ambulance often turns up late and staff bring them down early. On the day of the inspection the inspector noted that these service users were waiting for two hours for the ambulance. (See Requirement 8) The inspector spoke with service users and visitors about the food on offer at the home and had varying responses. Some said that they were happy with it and other said that it was very poor. One service user said that they do not get a large choice of cultural food. (See Requirement 9) Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 Page 13 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 standard(s) 16 Service users and their families do not have full information about who is available to listen to their complaints. EVIDENCE: There is a complaints procedure in place but it still refers to the NCSC instead of the new name of CSCI. There is also no explanation of who the Commission is or why service users may want to complaint to them (See Requirement 10) Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 Page 14 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 standard(s) 19, 20, 21, 22, 25 & 26 Generally the home is safe and well maintained. The home is not as comfortable as it should be given that noise levels were high in one area and signage around the home is in some cases excessive and inappropriate. Toilets and shower/rooms in the home are decorated in an institutional manner and not suitable for service users needs. Specialist equipment in use in the home has not been assessed by an occupational therapist which means that service users may not be using the safest most effective equipment to meet their needs. The building is not entirely safe and secure as on hot days the front doors are kept open. On the day of the inspection some areas of the home smelt of urine. EVIDENCE: Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 Page 15 There was a previous recommendation that the Registered Provider should seek an alternative location for the photocopying machine. This had apparently been done but the copier had then been moved back. Staff said there was a plan to move the offices round and when this happens the photocopier will be moved out of the communal hallway. (See Recommendation 2) On the day of the inspection two televisions were on in the lounge on different channels. The volume was high on both TVs and this created uncomfortable levels of sound in the lounge. The acting manager stated that this was because some service users were hard of hearing but there must be better ways found of ensuring everyone is sitting in a comfortable environment. (See Requirement 11) There was a previous requirement that the Registered Manager must arrange for service users to be provided with keys to their rooms unless their risk assessment suggests otherwise. The acting-up manager stated that this had been done but upon checking the files there was no evidence that the risk assessment had been carried out or that the outcome had been written in service users’ care plans. The requirement is therefore repeated. (See Requirement 12) The front garden area of the building is open to the road and the doors to the home were open because of the heat, this meant that direct access to the home was possible from the street and it is not always possible for staff to be in that area. The acting manager stated that there are plans to landscape the garden area with a patio, trellis and gate. (See Requirement 13) Throughout the building the bathrooms and toilets were clean but decorated in an institutional manner and in some cases were becoming tatty and in need of redecoration. There were boxes with rubbish that needed to be thrown out in one bathroom and shower chairs/hoists stored in one shower room that were supposed to be on another floor which made the shower room difficult to use. (See Requirement 14) The acting manager stated that he did not think an occupational therapist’s assessment had been carried out on all the equipment and adaptations that are in use in the home. Given the nature and extent of the service users’ physical disabilities at this home this is necessary. (See Requirement 15) Throughout the tour of the building the inspector noted many posters on the walls of communal areas and service users’ room that were notices reminding staff of certain behaviour and were not in keeping with making the home appear more homely and comfortable. The complaints procedure was posted on the wall of each floor but it was at standing head height when the majority of people who live at this home use wheelchairs. (See Requirement 16) On the day of the inspection the lift and the first floor smelt of stale urine. This has been a major issue for this home on previous inspections but much improvement had been noted at the last inspection. (See Requirement 17) Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 28 Service users needs are not being met by a sufficient number of staff. The home is not achieving the required levels of qualified staff and as such service users are not being supported by the most effectively trained staff team possible. EVIDENCE: As discussed under Standard 12 staff reported that there are not enough staff to take service users out of the building. On the day of the inspection the inspector noticed one service user wandering the hallway for a considerable time until staff were available to help. The current staffing levels are one nurse and three care assistants for each shift on each floor of sixteen service users. At night there are three care staff and two nurses for the building. Currently the ground floor is not being used as the rooms are being decorated. There has been a recent variation to change these six beds from nursing to residential but the acting manager stated that there are plans to request to change them back to nursing as there are no referrals for residential beds coming through to them. The acting manager stated that there had been plans for the extra staffing for the ground floor to be taken from the current staffing levels on the other floors which would not be acceptable. (See Requirements 18 & 19) There was a previous recommendation that the Registered Provider should ensure that a minimum of 50 of staff have NVQ 2 by 2005. The acting-up manager was not sure whether this had been achieved or not and could not find the records. This recommendation is made into a requirement as the deadline for achieving the 50 target has now been reached. (See Requirement 20) Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 37 & 38 The home is not yet managed by a permanent person fit to be in charge. The home is not evidencing that it is run in the best interest of the service users and there is not a consistent appropriate level of satisfaction with the home. The record keeping procedure is not being maintained and service users’ information is not being held securely. Although generally the health and safety of service users is being maintained they are being placed at some risk by the treatment room not being locked at all times. EVIDENCE: The manager post has been filled by a temporary person until recently and has now been recruited to with the new permanent manager due to start in midSeptember. One of the nursing staff is acting-up till the new manager starts. Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 Page 18 Given the length of time since there has been a Registered Manager at this service the new manager must ensure that they put in an application to the Commission as soon as they start employment. (See Requirement 21) Given the varied views of the home gathered by the inspector during this inspection the new manager must ensure that work is done as a priority to find out what the concerns are and develop a plan to address those concerns. (See Requirement 22) The cabinets in which service users files are kept were not locked and are not in secure office space. (See Requirement 23) On the tour of the building the treatment room on the second floor where medication is kept was not locked. (See Requirement 24) Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 x COMPLAINTS AND PROTECTION 3 2 2 x x x 2 2 STAFFING Standard No Score 27 2 28 2 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x x x x x x x 2 2 Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 Page 20 NO 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 OP7 Regulation 15 & 12 (2) & (3) Requirement The Registered Manager must ensure that all care plans are consistent, written with the involvement of the service user and reviewed monthly as required. The Registered Manager must ensure that service users are consulted about their preferred times of getting up and going to bed, that this is recorded in their care plan and that in practice this is carried out by staff. The Registered Manager must ensure that information around service users healthcare needs is held and recorded/monitored in the care files. The Registered Manager must ensure that systems and procedures for the management, administration and recording of medication are operated consistently and effectively by all staff. The Registered Manager must ensure that service users have access to a hairdresser in the home who can cut African and Caribbean hair. The Registered Manager must Timescale for action 30/11/05 2. OP7 & OP8 15 30/11/05 3. OP7 & OP8 15 30/11/05 4. OP9 13 (2) 30/09/05 5. OP12 12 (4) (b) 31/10/05 6. OP12 16 (2) 30/11/05 Page 21 Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 (m) & (n) 18 (1) (a) 7. OP12 & OP27 18 (1) (a) 8. OP12 12 (4) (a) 18 (1) (a) 9. OP14 16 (2) (i) 12 (4) (b) 12 (3) 10. OP16 22 11. OP20 12 (1) (a) 12 (4) (a) 12. OP20 12 (4) (a) ensure that a consultation is carried out with all service users as to what activities they would choose to engage with on a dayto-day basis. The results of this survey must then lead to an individual programme of activities support being drawn up in the care plan and offered to each service user. The Registered Manager must ensure that there are sufficient staff on duty at all times to ensure that all service users needs are met The Registered Manager must ensure that service users are not left in the entrance hall for significant periods of time while they are waiting for their ambulance escort. The Registered Manager must ensure that a consultation takes place around the issue of food at the home, that includes reference to cultural, ethnic and other preferences and that the results of this consultation are acted upon. The Registered Individuals must ensure that the Complaints Procedure includes the new name of the Commission and makes reference to who they are and why someone may want to complain to them. The Registered Manager must investigate alternate systems such as loop systems for the hard of hearing to listen to TVs in communal areas so that the practice of having the TV volume on loud and on different channels in the same room can stop. The Registered Manager must arrange for service users to be provided with keys to their 31/01/06 14/09/05 30/11/05 31/12/05 30/11/05 30/11/05 Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 Page 22 13. YA20 13 (4) (a) & (c) 14. OP21 23 (2) (d) 12 (3) 15. OP22 & OP25 23 (2) (n) 16. OP25 12 (4) 17. OP26 16 (2) (k) 18. OP27 18 (1) (a) rooms unless their risk assessment suggests otherwise. Previous requirement: Unmet timescale 30/04/05. The Registered Individuals must ensure that the planned development of the front garden area is carried out as priority to ensure the safety of service users and security of the building when the front doors are open. The Registered Manager must ensure that work is carried out on all the toilets and shower/bathrooms to decorate them in a manner that is noninstitutional, chosen by the service users and as homely as possible given the equipment that may need to be kept in some of them. The Registered Individuals must ensure that an occupational therapists assessment of the building and all equipment and adaptations within it is carried out to ensure that service users are safe and receiving the most appropriate specialist support. Any recommmendations made in the report must be addressed. The Registered Manager must ensure that notices to staff and other posters are not placed on the walls of the home unless they are absolutely necessary and that any information placed on walls is physically accessible to service users.. The Registered Manager must ensure that the home is free from offensive odours at all times. The Registered Individuals must ensure that a staffing review takes places that establishes how many hours of care and support service users require (to 31/12/05 31/12/05 31/12/05 30/09/05 30/09/05 31/12/05 Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 Page 23 19. OP27 18 (1) (a) 20. OP28 13 (6) 18 (1) (c) (i) 11 (1) Care Standards Act 12 (3) 24 21. OP31 22. OP33 23. OP37 17 (1) (b) include social and recreational suppport) and how those hours are being met by the numbers of staff currently on duty. This review must be sent to the Commission. The Registered Individual must ensure that the additional staffing requirements and rotas of the ground floor are established prior to service users moving into this floor and that it is not an expectation that staff from other floors take on the entire work of this floor. The Registered Individuals must ensure that 50 of non-nursing care staff hold the NVQ Level 2 in Care. The Registered Individual must ensure that the new manager puts in an application with the Commission to become Registered Manager as soon as they commence employment. The Registered Manager must ensure that service users and their families are consulted about their satisfaction with all aspects of life at the home and that a development plan is drawn up (to be reviewed at least annually) that addresses any issues raised. The Registered Manager must ensure that the cabinets containing service users files are kept locked at all times. The Registered Manager must ensure that all doors required to be locked to maintain the health and safety of service users, are kept locked when not in use. 31/10/05 31/12/05 30/09/05 31/12/05 24. OP38 13 (4) (a) & (c) 14/09/05 (This was met on the day of the inspection) 14/09/05 (This was met on the day of the inspection) Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 Page 24 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 OP7 OP22 Good Practice Recommendations The Registered Manager should ensure that care files are organised into sections to make information clearer and easier to access. The Registered Provider should seek an alternative location for the photocopying machine. This is an unmet and repeated recommendation. Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Ground Floor 46 Loman Street Southwark SE1 0EH 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 Camberwell Green Nursing Home G52-G02 S7012 Camberwell Green V240142 120805 Stage 4.doc Version 1.40 Page 26 - 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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