Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 01/11/07 for Camellia House Nursing Home Ltd

Also see our care home review for Camellia House Nursing Home Ltd for more information

This inspection was carried out on 1st November 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

Nursing and personal care provided at the home remains generally good. Staff at the home access a range of services including general practitioner, optician, dentists, speech and language therapists and other NHS services. The home has many adaptations to help people living at the home keep as independent as possible and ensure staff work in a safe way. The well maintained garden area and patio can be viewed from the lounge and can be used more frequently by people in the fine weather. People are given the opportunity to personalise their individual rooms with items of their choice. Improvements to the accommodation have continued since the last inspection. The home is well maintained, cleaned and personalised to reflect people`s likes and dislikes. Visitors are welcome at the home at all times and people are able to go out with their families if they are able to do so. The way people`s care is planned and assessed by the staff team at Camellia house ensures that their care needs are understood. And staff have the information they need to provide continuity of care people. Staff report that they have access to training that helps them to do their jobs and the manager is supportive of them.

What has improved since the last inspection?

CARE HOMES FOR OLDER PEOPLE Camellia House Nursing Home Ltd 5 Oak Park Villas Elm Grove Road Dawlish Devon EX7 0DE Lead Inspector Rachel Proctor Unannounced Inspection 1st November 2007 10:30 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 Camellia House Nursing Home Ltd DS0000066799.V337937.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. Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Camellia House Nursing Home Ltd Address 5 Oak Park Villas Elm Grove Road Dawlish Devon EX7 0DE 01626 864272 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) Camellia House Nursing Home Ltd Susan Edey Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (30), Old age, not falling within any other category (30), Physical disability over 65 years of age (30) Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Dementia - over 65 years of age (DE(E)) 30 Mental Disorder, excluding learning disability or dementia - over 65 years of age (MD(E)) 30 Old Age, not falling within any other category (OP) 30 Physical Disability - over 65 years of age PD(E)) 30 Date of last inspection 27th February 2007 Brief Description of the Service: Camellia House is a Care home that is registered to provide personal and Nursing Care to a maximum of 30 Residents. The house is a large, extending Victorian Villa built on level ground with an extensive walled accessible garden, which Residents access and enjoy during fine weather. The home is found within a quiet residential area, which is within one mile of the seaside town of Dawlish. The accommodation is arranged over two floors, which are accessed by stairs, lift or ramps. There are a variety of communal areas for residents to access. The home has been adapted to meet the needs of residents. The home has ramps; grab rails and specialist equipment, which include disabled shower and bathing facilities. There is a registered nurse on duty 24 hours a day. The home is under new ownership. The registered manager is a registered nurse and is supported by a team of registered nurses and care staff. The Inspection report can be found in the Managers office in the home. The scale of charges at the time of inspection varied depending on care need and room. These fees ranged from £ 373 to £ 650. The fees did not include: Hairdresser- £3.00-£25.00, Chiropody- £10-£12, Physiotherapist- variable, Papers- 20p-£1.20 and Transport (Taxis) which depended upon vehicle and distance of trip. Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection, which took place on 1st November 2007 between 10 am and 4.30 pm. Three people had their care followed as part of this inspection. Discussion with the manager, some of the staff on duty, people living at the home and relatives took place. A tour of the home was completed and some records relating to the way care is delivered and the management of the home were inspected. Survey forms were returned from four people asked. What the service does well: What has improved since the last inspection? The improvement in the standard of care, level of service and accommodation provided for people living at Camellia house has continued since the last inspection. Throughout the inspection, the manager remained clear about what had been achieved, what was planned and what had not been achieved. The manager was able to give reasonable explanations as to why some of the Requirements and Recommendations had not been fully met. Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 Page 6 New nursing beds were being used for those people who required them at this inspection. A planned programme for redecoration and refurnishing of bedrooms had started. The manager provides a training matrix, which shows the training that staff had completed, and when training was planned. This shows that the improvements noted at the last inspection had continued. The manager was able to confirm that all staff had had moving and handling and fire training. Staff observed during this inspection were ensuring that explanations were given to people they were providing personal care for as this was given. People were being addressed respectfully by the staff caring for them. Since the last inspection an activities coordinator has been appointed. This should enable activities to be planned around the preferences and personal choices of the people living at Camellia house. External activities are also organised for people living at the home. Suitable door guards or other suitable devices had been provided for people who chose to keep their bedroom doors open. The majority of these had been fitted prior to the inspection. People who require their food puréed were being given their meal in a way that allowed them to enjoy the different flavours and textures of the meal provided. People said they enjoyed the food provided. And very little wastage has seen the lunchtime meal. The staff files viewed during the inspection supports that the robust recruitment policy in place had been followed for new staff. Information required for staff files was available and the manager confirmed that staff whose first language was not English had been given the opportunity to take English classes if they so wish. What they could do better: The Manager should ensure that the remaining door guards or other suitable devises for people who like their doors kept open are installed. This will promote people’s safety and choice. The Manager must complete the training programmed in respect of: First Aid, Infection Control and Food hygiene. This will provide staff with the information they need to work safely. Risk assessments must be completed for people who use wheel chairs with out footplates. And staff must be made aware of the risks to people when wheel chairs are used with out footplates. This will ensure people are safe when being transported in the home using a wheel chair. Please contact the provider for advice of actions taken in response to this Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6.Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. The opportunity to visit the home prior to admission was provided where possible and sufficient information given to people and their representatives about the home and it’s services. The assessment process adopted by the manager enables people’s care needs to be recorded clearly. This should ensure people know if their care needs can be met by the homes staff team and the homes facilities EVIDENCE: Three people had their care followed as part of this inspection. People had a clear assessment of their care needs completed. One person who had been admitted to the home three weeks earlier had an assessment of their care needs completed and a copy of the care management assessment and care plan with their information. A pre admission assessment had been completed for this person. The information provided prior to the inspection also stated that the homes admission documentation had improved. Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 Page 10 One relative commented that they had chosen the home for their relative and were pleased with the way they were being looked after. A survey form from a person living at the home also indicated they were given information about the home prior to moving in. Information was provided in the home for people to access, which gave information about the home and it’s services. Two people asked said they were given information about the home prior to deciding to use the home. The home does not provide intermediate care. Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of personal and nursing care given is good but interaction/conversation between people living at Camellia House and some staff could be improved further. EVIDENCE: The three people who had there care followed as part of this inspection all had clear care plans, which guided staff how their care should be given. They also included personal preferences the person or their representative had discussed with the staff member completing the care plan. Risk assessments were an integral part of the care planning process. These included manual handling, Nutritional risk assessments, continence assessments and pressure sore risk assessments. One person whose care was followed had increased care needs from their original assessment of need. The care plan had been up dated to reflect their changed care needs. This included how the increased risk of pressure sore development was being managed. An airflow pressure relief mattress was in Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 Page 12 use for this person. The care plan also showed they were at risk of falls from bed. A risk assessment for the use of bed guards had been completed and their was evidence this had been discussed with the persons relative. The manager confirmed that people’s plan of care are reviewed monthly or sooner if their care needs change. The three people whose plans of care were seen during the inspection all had their care reviews completed monthly. One person had a record of a review carried out with the person their relative and a representative from the home. A record of the GP visits to the individual people whose care was followed was available with their care planning information. The involvement of other members of the multi disciplinary team were also recorded in people’s plans of care. This included chiropody, opticians and specialist nurses. The manager advised that an NHS nurse had assessed people who receive nursing care at the home. The way individual peoples medication was managed in the home was discussed with the manager and medication records and medication stored for people whose care was followed were seen. People’s medication was being stored in locked cupboard and registered nurses manage the administration. A system for assessing people’s ability to manage their own medication was in place. The manager confirmed that people who are able are encouraged to self medicate. The controlled drug record book was checked against the stock for one person whose care was followed as correct. A waste disposal company disposes of unwanted medication for the home. Collection boxes for medication were in use. The manager explained how the system for disposal of medication is managed in the home. Records of medication that had been disposed of were being kept. A lockable drug storage fridge has been provided for storage of medication, which requires refrigeration. During the inspection staff were observed assisting people to go to the toilet when they asked. This was being done in a respectful way. However some of the staff did not engage in conversation with the people they were helping. They were talking briefly to people about the task in hand. While other staff instigated discussion or conversation with people living at the home as they provided care. Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The introduction of a part time member of staff to provide social stimulation and activities for people should enable people to have some of their social care needs met. However for some people living at Camellia House the social stimulation appears task based rather than individualised. EVIDENCE: The manager advised that since the last inspection an activities co-ordinator had been appointed in June 2007. She further advised that they worked four days a week between 2pm and 4pm. The person provides one to one support for people or organises activities that those who wish can join in with. The records of entertainment provided showed those entertainers are provided, which include a music session twice a month and tranquil moment every month. People were receiving music entertainment during this inspection and those that were taking part appeared to be enjoying this. The manager confirmed that the home has an open visiting policy and relatives are encouraged to visit. One relative said they visit every day at lunchtime. They said they had been offered a meal when they visit if they wanted it. They confirmed that they were able to see their relative in the privacy of their own Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 Page 14 room. Two relatives survey form were returned one commented “Therapy and activity sessions may help those residents who just sit and fall asleep in the lounge every day”. A survey form returned from a person living at the home indicated that they sometimes get activities provided for them. The individual plans of care viewed during the inspection had a record of the person’s personal preferences and choices. These included the meals they enjoyed and activities they liked to participate in. The manager advised that people are given the option to stay in their own rooms if they wish. During the inspection several of the people living their chose to return to their rooms after lunch. Peoples rooms entered during this inspection had been personalised with items of there choice this included photographs of family and friends and ornaments. Part of the lunch time period was spent in the lounge/dining room with the people living at the home. Staff spoke to people as they moved them to the tables for lunch or provided them with a portable table for their meal. People were heard asking what was for lunch and staff were heard taking to them about their meal. One person who required a hoist to move to a wheel chair was being hoisted into the wheel chair just before lunch. The staff doing this were explaining what they were doing. Some people in the lounge were repeatedly asking staff the same questions. Staff responded politely and respectfully each time the question was asked. However observation of some staff speaking with the people living at Camellia House were of a functional nature rather than conversation. Not all staff on duty during this inspection were instigating conversation with people in the lounge. This may mean people are not getting the stimulation they need to engage in what is going on around them. The lunchtime meal was attractively presented and nutritional balanced. Staff were telling people what was on their plate as they gave them their meal. One person who needed their food pureed was being given this in a way that enabled them to taste the different tastes of the food. The manager advised that a new chef had been appointed and that they regularly speak to people about the meals they prepare and look for alternatives or different menu ideas that people have said they like where possible. One person asked said the food is always good and they looked forward to meal times. They also said that the staff are very helpful and friendly towards them. One survey form returned from a person living at the home indicated they usually liked the meals provided. Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. People who live at Camellia House and their relatives can have confidence that their concerns will be listened to and acted on by a staff team who have their best interests at heart. EVIDENCE: The Commission for Social Care Commission have not received any complaints or concerns regarding Camellia House since the last inspection in February 2007. The Manager advised that all issues raised are dealt with as they occur. A complaints book used for recording minor issues and their outcomes was seen. One person living at the home spoken to said ‘you can’t ask for better.’ Relatives spoken to said ‘little things are sorted out quickly’ and the manager and staff listen to their concerns and act on them. All those spoken to said they knew who to go to if they needed to complain and would feel confident that complaints would be dealt with. Three survey forms returned indicated that people knew who to complain to and the homes staff had responded appropriately to any concerns raised. Discussion with the manager showed that the majority of staff have attended POVA (Protection of Vulnerable adults) training. A new training record matrix for April 2007 –April 2008 was provided. This showed that protection of vulnerable adult training was a key training area for staff. Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The continued improvements in the standard of decor in the home will provide a pleasant environment for people to live in. EVIDENCE: A tour of the home showed that improvements to the décor have continued. The manager advised that the hall carpet was due to be replaced soon. The purchase of specialist beds for people who require nursing has continued. The manager commented that this made it easier to care for people who were being cared for in bed in their own rooms. One relative spoken to advised that their relative’s room had been measured for a new carpet. A pleasant garden area with a patio that provides shade is available for people who live at the home to use with the support of staff. The manager advised Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 Page 17 that the garden is planted out with spring flowers and a variety of shrubs, which flower in the summer. The home was fresh and clean in all areas entered during the inspection. Staff observed were using gloves and aprons when attending to individuals personal care needs. Supplies of gloves and aprons were seen to be easily available for staff to use. The home was clean, tidy and free from offensive odours on the day of inspection. The three survey forms returned indicated that cleanliness is maintained. One commenting,” The standard of cleanliness is high”. The planned improvements to one ground floor bathroom had not been completed. The manager advised that this bathroom, when up dated would give people more options for showering, as the room would allow hoist access into the shower room. The laundry area is situated away from the food preparation areas. Washing machines have the ability to meet disinfection standards. Sluice machines are provided for disposal of bodily waste and clearing commode pots. Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has a robust recruitment policy, which is followed to ensure suitable staff care for people. A commitment to training staff is evident. This should ensure a knowledgeable staff team cares for people. The improvements to the induction programme for new staff should ensure they have the support they need to start work in the care home. EVIDENCE: The manager provides a duty rota, which shows the staff on duty and in what capacity they are employed. The numbers of staff on duty appeared to be meeting the needs of the people being cared for at Camellia house during the inspection. Staff spoken to during the inspection said they could usually meet the needs of the people they are caring for with the numbers of staff they have. However two comments received from staff indicated that when people they are caring for become unwell sometimes its difficult to complete all the care tasks in a timely way. The duty rota showed that more staff are on duty at peak times during the day. The manager advised that the numbers of staff would be adjusted if the Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 Page 19 needs of the people being cared for at the home increased. In addition to the care staff the home employs ancillary staff, which include; domestic staff, Cook and maintenance person. Training provided at the home was discussed with the manager. The preinspection information provided by the manager showed that 42 of the care staff had achieved an NVQ level 2 or above in care and one member of staff was working towards this qualification. The manager also provided a training matrix, which included NVQ this indicated that the member of staff working towards their NVQ had started this in June 2006. The manager confirmed that there is a firm commitment to making sure that staff have the training they need to do their jobs well. The staff survey form returned indicated that they had access to training, which was relevant to their role, helps them understand and meet individual’s needs and keeps them up to date. The preinspection information provided by the manager showed that staff records include all the relevant paperwork. Three staff files were viewed during this inspection. Each contains proof of identity, an application form, two written references and proof that a police check had been undertaken before they started work. The manager advised that she saw all certificates to support qualifications the person had at interview. However copies of these still needed to be taken for one member of staff. Each of the staff files viewed also had a copy of the interview pro forma which showed how the decision was made to employ a particular member of staff. The preinspection information also stated that induction paperwork is in place and that there were plans to make improvements to the induction training. Although the manager confirmed the new induction programme was in place this was still to be used for new staff. One new member of staff spoken to during the inspection said the manager and other staff who work at the home were supporting them. They also said they had been working along side other staff and had not worked independently. They confirmed that the manager had given them an induction pack to work through. A staff survey form returned commented, “We work hard as a team to maintain good standards of care.” At the last inspection it was noted that some staff whose first language was that English were finding it difficult to speak with people who live Camellia house. The preinspection information indicated that they would ensure all new staff employed are tested for their ability to speak, write and understand English and they would be taking advice on how to facilitate this. The manager confirmed that existing staff whose first language isn’t English would be given the opportunity to access training to improve if they needed this. Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The improved management at the home and changes being introduced continue to increase the level of care and safety of Residents and morale of staff. Once these are fully implemented the home will be effectively managed and will be a safe and effective place to live and work. EVIDENCE: The manager is a first level registered nurse with experience caring for older people. She confirmed that she keeps up to date with changes in care practices. The manager informed the Commission that she would be leaving the home and a new manager had been appointed to lead the team from December 2007. Staff and relatives spoken to confirm there are clear lines of accountability with in the home. Relatives spoken and survey form received Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 Page 21 indicated they knew who to speak to if they had any concerns and felt their concerns were listened to. Discussion with the manager confirmed that that staff training has continued on a rolling programme but not yet 100 complete. The Manager explained that moving and handling is regularly booked. The manager advised that the Requirement for staff training to be completed in first aid, food hygiene and infection control had not been fully met. The Manager was honest throughout the inspection about what had and had not been done. The annual quality audit required by the Commission was provided prior to this inspection. This showed how the home had improved and what planned improvements were to be completed. The manager has been working towards meeting the Requirements and Recommendation made at the last inspection and the majority of these had been met or partially met. Policies and procedures were available for staff use. The manager confirmed that these are reviewed on a regular basis. The pre inspection information stated these were last reviewed in June 2006. The manager confirmed that their family or representative manages people’s money. She further explained a billing system in use for expenditure made on behalf of people living at the home. How staff are supervised and supported to do their work was discussed with the manager. She confirmed a new template had been introduced to record supervision, however not all staff had received regularly formal supervision. Training and development plans for some staff had not been reviewed and up dated recently. The staff spoken to and comments received indicate that staff feel supported to do their work and the manager is approachable and helpful. The manager had not ensured staff fully understood safe working practice when using wheel chairs to move people around the home. Four people were being moved in wheel chairs with out footplates attached. People were being expected to hold their legs up while staff wheeled the wheel chairs. This was putting them at risk of injury. The care plans for these people did not contain a risk assessment as to why footplates were not used. Although the manager confirmed that checks are carried out by the maintenance man for risk of legionella a record of these was not being kept. Records of maintenance were checked at the inspection in February 2007 as meeting Requirements; these were not checked again at this inspection. Not all staff had received training in safe working practices for first aid, foods hygiene and infection control at the time of this inspection. However training information provided showed that the manager was working towards this and suitable trainers had been found. Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 2 Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 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 OP38 Regulation 23(4a) Requirement (4) The registered person shall after consultation with the fire authority (a) take adequate precautions against the risk of fire, including the provision of suitable fire Equipment; The Manager must install door guards or other suitable devises to residents who like their doors kept open. Previous time scale 30/06/07 not met. Because this was almost met the time scale has been extended Staffing 10/01/08 18. - (1) The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users (c) Ensure that the persons employed by the registered person to work at the care home receive (i) Training appropriate to the work they are to perform; and (ii) suitable assistance, including DS0000066799.V337937.R01.S.doc Version 5.2 Page 24 Timescale for action 10/01/08 2. OP38 18(1) Camellia House Nursing Home Ltd time off, for the purpose of obtaining further qualifications appropriate to such work. The Manager must complete the training programmed in respect of: First Aid Infection Control Food hygiene. Previous time scale 30/06/07 not met. Because this had almost been completed the time scale has been further extended. 13(4)(b)(c The registered person shall 10/01/08 ) ensured that(b)Any activities in which service users participate are so far as possible recently practically free from avoidable risks; and (c)Unnecessary risk to health was safety of service users are identified and so far as possible eliminated. Risk assessments must be completed for people who use wheel chairs with out footplates. Staff must be made aware of the risks to people when wheel chairs are used with out footplates. 3 OP38 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 Manager should ensure staff ensure residents have DS0000066799.V337937.R01.S.doc Version 5.2 Page 25 Camellia House Nursing Home Ltd 2. 3. OP36 OP30 some stimulation on a day to day basis and have a choice of what activities they participate in. The Manager should continue with the planned programme of supervision. The Manager should continue with the planned programme of induction Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Camellia House Nursing Home Ltd DS0000066799.V337937.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!