CARE HOMES FOR OLDER PEOPLE
Camellia House Nursing Home Ltd 5 Oak Park Villas Elm Grove Road Dawlish Devon EX7 0DE Lead Inspector
Clare Medlock Unannounced Inspection 21st June 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 Camellia House Nursing Home Ltd DS0000066799.V293668.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.V293668.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 with Nursing 29 Category(ies) of Dementia - over 65 years of age (29), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (29), Old age, not falling within any other category (29), Physical disability over 65 years of age (29) Camellia House Nursing Home Ltd DS0000066799.V293668.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)) 29 Mental Disorder, excluding learning disability or dementia - over 65 years of age (MD(E)) 29 Old Age, not falling within any other category (OP) 29 Physical Disability - over 65 years of age PD(E)) 29 Date of last inspection 14 February 2006 Brief Description of the Service: Camellia House is a Care home that is registered to provide personal and Nursing Care to a maximum of 29 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 have 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. Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was announced the day before the inspection to allow the Providers to travel from Brighton to be at the first inspection. It occurred on Wednesday 21st June 2006. The inspection consisted of speaking with residents, relatives, staff and management at the home. A full tour of the building took place. Records, Care Plans, staff files and other documents were inspected. Two staff and two relative questionnaires were received regarding Camellia House and the Manager produced a detailed pre inspection questionnaire. What the service does well: What has improved since the last inspection?
The home has changed ownership since the previous inspection. Although there remain Requirements and Recommendations, the number of these has reduced considerably. Since the new ownership there have been a large number of improvements in the home in a small timescale. Many improvements have been commenced or planned. Some have been completed. If these improvements continue it is anticipated that the quality of care at the home should continue to increase. There has been a new Manager. This ‘approachable’ Manager provides a daily presence for staff for support, advice and leadership. Staff state that any requests or concerns are listened to and acted upon. The Manager has met all staff and many health care professionals.
Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 6 New documents are being introduced to improve written records and communication. New pre admission records are being introduced to ensure the home have enough information to know whether they can meet the needs of the resident. Transfer letters have been devised so that hospital staff are aware of the needs for residents who get transferred to hospital. Care Plan review forms and restraint policies have also begun to be introduced. Some Mandatory Training has being given. This includes infection control and fire safety. Other training has been arranged and plans for the future have been made to ensure staff have regular updates. This will make sure staff have the correct knowledge to perform their roles. Equipment has been provided to ensure staff move residents in a safe manner. New beds have been ordered. New Call bells have been replaced where necessary. Quotes have been obtained to continue with the programme of covering radiators and introduction of door guards. This will reduce risks to residents The safe management of medicines continues to improve. Communication has improved at the home. Staff meetings have been held. Statement of Purpose and Service User Guides have been introduced which are being regularly reviewed to ensure the documents reflect the service that is provided. The overall management and organisation has improved at the home. The office has been organised so the manager is easily able to locate policies, procedures, and the recently performed maintenance records. Staff files have been checked and missing documents requested from staff. New Files demonstrated a good recruitment process which shows staff have received all the checks required prior to working at the home. The Management of the kitchen has improved which helps prevent infection and promotes good hygiene standards. Access to the kitchen is now restricted and a new chef employed. A new fridge and bin have been purchased to meet with Environmental Health Office recommendations. The Manager has attended training sessions to ensure the home will comply with new legislation and good practice guidelines introduced by the food standards Agency. Communication between the Manager and Commission for Social Care Inspection has improved. The Number of complaints and Concerns expressed regarding Camellia House have reduced. The home is much cleaner and brighter. More cleaning staff hours have been created. Cleaning staff have a new trolley to ensure all equipment is at hand. Gloves and aprons are available for staff and wall mounted soap dispensers are being introduced. Infection control training has been implemented. First Aid boxes have been re stocked, checked and cleaned. Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 7 Windows have been cleaned. Curtains have been washed and are being repaired. New towels, flannels and tablecloths been purchased. Bedrooms are being re decorated as they become vacant. Plans to eventually replace worn furniture were made. There is a maintenance man to perform odd jobs and repairs. The garden has been cleared so residents are able to sit out and use the garden if they chose to do so. The Providers visit at least once a month and perform a check on the service provided. Resident/Relative questionnaires have been devised to make sure residents and relatives are happy with the care they recieve. What they could do better:
Quality of life for Residents at Camellia House has been judged in this report using the available evidence at this inspection. It is anticipated that should the Provider implement the planned changes stated at this inspection, this quality judgement should continue to improve by the next inspection. These plans must be implemented to continue to improve the quality of life for residents and working life for staff. The Manager must improve the way care is planned and recorded. This will ensure all staff are aware of what the individual short and long term needs are for each resident. Records should detail any changes in care to show what the changes in condition are. The Manager should continue to introduce the new records produced at inspection but should make sure the pre admission assessment contains all information recommended. The Manager must also continue with the training programme to ensure that all staff are up to date with their mandatory training. She should also enrol on the Registered Managers Award course and inform the Commission for Social Care Inspection. when she has done this. Staff should be continued to be supported and supervised on a daily basis but the formal supervision and appraisal system should be introduced. The management of the medication system could be further improved to protect staff and residents from errors. This could include getting two staff to check hand written entries are correctly transferred to Medicine sheets and getting two staff to witness the destruction of controlled drugs. Staff must also make sure they label sharps bins correctly and the Provider should consider obtaining a drugs fridge. Improvements to the environment should continue and must include the completion of the radiator covers and door guards. Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 8 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. Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 9 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.V293668.R01.S.doc Version 5.2 Page 10 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): 1,2,3,4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Improved communication and information provided by the new manager means that residents and their families are able to decide whether Camellia House is the right place for them to be. EVIDENCE: A new Statement of Purpose and Service User Guide was provided at inspection. The Provider explained that it is under review to ensure all changes are made and will be issued when this inspection report is finalised to ensure Residents and Representatives can see any changes that have been made. New Contracts have been devised for Residents. These were inspected and contained all information required. Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 11 Discussion with the new Manager confirmed information is obtained on residents prior to their admission. However the new document to be introduced does not contain all information listed in standard 3. The Manager stated she would include this information. The Manager stated that she does not have any Service Users from other cultures although some existing staff are from overseas and their command of the English Language is not adequate and that English lessons have been planned. Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 12 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 and 11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The new Leadership in the home has begun to improve the level of service provided. This will continue to improve if the planned introduction of new records happens by staff at the home. EVIDENCE: All Residents seen on the day of inspection appeared well cared for with the finer details of care given. Those Residents who were being cared for in bed appeared warm, clean, comfortable and pain free. Records confirmed information is obtained from health care professionals and social workers prior to admission. In addition to this the staff at the home visit residents to ensure they are able to care for them. The New Manager produced a pre admission assessment form which is to be introduced. This will need minor changes to ensure it contains prompts to ask about all issues listed in standard 3. The homes diary and care plans confirmed that staff at the home continue to access a full range of health care services for the residents.
Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 13 Two care plans were inspected on this occasion. The Manager explained that the care plans had been reorganised to improve efficiency and assist the recording process. The Manager stated that not all care plans would be complete or up to date as she and trained nursing staff had begun to introduce new documents. Examples of these were produced and included; pre admission sheet, transfer letters, restraint policies and consent forms, updated waterlow and manual handling sheets, care plan review forms, joint communication forms and monthly review summaries. On inspection the Care Plans had begun to improve. However in some files inspection found unsatisfactory specific details of care planning. This is despite a previous requirement. Skin care records continued not to record size, shape, or colour of any marks and what has caused marks and what care had been planned. Indirect observation and listening when personal care was being given confirmed care on the day of inspection was being performed in an appropriate manner. Staff appeared to have a good rapport with the residents. Laughter was heard during the inspection. Residents were observed to be wearing their own clothes and were called by the name of their choice. Residents who needed personal care to be given were taken out of communal areas to their bedrooms on the day of inspection. Residents spoken to said they felt well cared for and the staff were very kind and worked very hard. One resident said the staff seemed to smile more. Relatives spoken to said they had met the new manager and that they continued to be happy with the standard of care provided and ‘felt happy going home knowing they were in good hands’. Staff spoken to said they felt the standard of care had improved. One member of staff said the new Manager had bought new equipment which made the work easier and safer. Another member of staff said because morale had improved the staff were more cheerful with the residents. The management of the medication system has improved since the last inspection. A blister pack has been introduced and a safer method of drug disposal has been introduced. The treatment room has been cleared of overstocked and expired items. A new drug reference guide has been obtained. A random check of the controlled drug cupboard was correct. There was one oxygen cylinder in the cupboard. The Manager stated that she had asked the supplier to remove this as the Resident was no longer at the home. The home do not have a drugs fridge. Discussion with the Providers and Managers confirmed this will be looked into. A tour of the building confirmed that sharps bins were not labelled correctly. Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 14 Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 15 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The New Management team have begun to improve the quality of the social contact and activities EVIDENCE: The New Manager stated that additional activities have been arranged for residents. This has included a violinist. This is in addition to the ‘tranquil moments activity, multi denominational communion service, and hair dressing that occurs regularly. Discussion with residents and staff confirm resident have their TV on in the morning if this is what they want and the radio is often on in the lounge if requested by residents. One Resident stated she was happy in her own room and despite bed rest had things to do. A tour of the premises confirmed that staff appeared to interact more with residents. One member of staff said she thought that because staff were happier this ‘rubbed off’ onto the residents. New Records to be introduced confirmed that residents will be asked about their social preferences and choices on admission.
Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 16 Discussion with the Manager confirmed she had been considering a BBQ/Garden party for residents and their families and future appointment of an activities coordinator. Staff spoken to said the Providers and Manager have done lots of little things that make an enormous difference. Examples were given of clearing the garden to allow residents to sit outside and washing windows so residents had a clearer view of the garden. Records and discussion with the Manager confirmed that she acts as appointee for two of the residents. Records were presented for inspection which contained receipts and records of transactions. Discussion with residents, relatives and staff confirmed the new chef has been welcomed to the home and produces a variety of home cooked meals. On the day of inspection the liver and onions and bred and butter was enjoyed by all residents spoken to. Observation and discussion with the Manager and staff confirmed that The Management of the kitchen has improved. Access to the kitchen is now restricted and a new chef employed. A new fridge and bin have been purchased. The Manager has attended training sessions to ensure the home will comply with new legislation and good practice guidelines introduced by the food standards Agency. Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 17 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 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The large reduction of complaints and concerns at Camellia and planned adult Protection Training will help protect Residents. EVIDENCE: Since the new ownership there have been no concerns, correspondence or complaints made to the Commission for Social Care Inspection about Camellia House. The Manager stated that one complaint had been received since the new ownership and this was being given to the Providers to investigate. On reading the complaint it was unclear from lack of detail whether the issues were new or old. Three Residents and one relative were spoken to who were all complimentary about the staff at the home and the care they receive. One resident said the staff seem to smile more. Staff spoken to said the little things have made a big difference to the lives of residents. Examples given included new table clothes, towels, flannels, bib/napkins, cushion and pads used in the bed. Other staff said that even tidying the garden meant residents could sit outside. One member of staff said because staff morale had improved that this had an impact on the lives of Residents. Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 18 Discussion with the Manager confirmed that Adult Protection training had been booked. Initially this is for her and the Senior Trained nurse with a view to then sending the remaining staff. Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 19 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): 19,20,21,22,24,25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Improvements within the home have improved the quality of life for residents. EVIDENCE: A full tour of the building was conducted on this inspection. There were many changes and improvements. The home is much cleaner and brighter. There were no offensive odours on this visit. Residents, relatives and staff say the home is much cleaner. One relative said ‘the air feels cleaner’. More cleaning staff hours have been created. Cleaning staff have a new trolley to ensure all equipment is at hand. Facilities to improve infection control methods in the home have been introduced and the majority of staff have received infection control training by the Health Protection agency Nurse. Gloves and aprons are available for staff and wall mounted soap dispensers are being introduced.
Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 20 The laundry continues to contain washing machines with sluice cycles and be found in suitable premises away from the kitchen and dining areas. All bathrooms and toilets were clean and tidy although not all bathrooms are used due to their layout. Camellia have two assisted baths. Some rooms at the home are shared and screening is provided. Windows have been cleaned. Curtains have been washed and are being repaired. The garden has been cleared so residents are able to sit out and use the garden if they chose to do so. Equipment has been provided to ensure staff move residents in a safe manner. New beds have been ordered. New Call bells have been replaced where necessary. Quotes have been obtained to continue with the programme of covering radiators and introduction of door guards. Plans for storage of large equipment were explained by the manager. New towels, tablecloths, bibs bedrail protectors and pads have been purchased. New nursing beds have been ordered and manual handling equipment ordered. Maintenance plans were explained by the manager to replace worn furniture in the future. A new maintenance man has been introduced to perform ad hoc and general repairs. The manager has ensured all maintenance records are up to date and stated that some of these records were absent so have been performed to ensure the home is safe. The Tour of the building confirmed that rooms were being re decorated as they become vacant with plans to replace some flooring and worn furniture in the future. Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 21 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The planned programme of supervision, training and improved recruitment procedures will ensure residents are cared for by a skilled safe team of staff. EVIDENCE: Records confirmed that the usage of agency staff has reduced under the new ownership. The Manager confirmed that the turnover of staff has been low. Discussion with the Manager and records confirmed that all new staff are carefully recruited with records kept to show this process is thorough. Two new staff files were inspected and contained all information required. Some induction records were present however the Manager stated that she will be improving these. The Manager stated staff supervision was out of date but would be implemented in the future. Staff spoken to said they felt well supported. Trained staff said it was good working on a daily basis with another trained nurse. Staff also said the Manager was always there and was supported. Cleaning staff numbers have increased since the last inspection, which is reflected in the standard of cleanliness in the home.
Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 22 The Manager stated that she will be looking at NVQ training but that courses she has looked at start in September. Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 23 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The feedback from residents, relatives and staff are regarding the new management has been positive. EVIDENCE: The Home is now under new management. The Providers are based in Brighton and visit the home monthly to ensure residents are well cared for. The Providers have produced a visit record to the Commission for Social Care Inspection and have devised a quality assurance questionnaire. The Providers also produced evidence of financial viability at inspection. The Manager stated that she acts as appointee for two Residents in the absence of family. Records were provided to show records and receipts were maintained. This system was not closely inspected on this occasion. The Manager is a registered nurse and not yet enrolled on the RMA. (Registered Managers Award)
Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 24 Discussion with the Manager confirmed that she is going through all procedures at the home making changes or plans for improvements where needed and that this will be achieved eventually. Feedback from Residents, Relatives and staff throughout the inspection was extremely complimentary. Comments include: ‘The staff smile more these days’ and ‘the air seems cleaner’ ‘when they(the Providers) came in first they went round with a notebook and you could see them making notes and saying what needed to be done. Gradually these things have been done’ ‘It’s all that was needed, they (the owners) care about the place and it shows.’ ‘She (the manager) gives an aura of listening’ ‘It’s definitely better, life’s looking good. We know there’s a way to go, but Sue is here (The manager) and things get done’ ‘We’ve got training booked and the new manager has got us equipment which makes the job easier and safer’. And ‘It’s all good, it’s great to have another trained nurse.’ Staff spoken to also said the little things have made a big difference to the lives of residents. Examples given included new table clothes, towels, flannels, bib/napkins, cushion and pads used in the bed. Other staff said that even tidying the garden meant residents could sit outside. One member of staff said because staff morale had improved that this had an impact on the lives of Residents. The Manager and Providers were approachable throughout the inspection. Staff were all polite and smartly dressed. The Manager was aware of the shortfalls throughout the inspection but explained what had been planned. These included some staff training, supervision, care plans, record keeping, social activities, environmental issues. The Manager stated that Quotes have been obtained to continue with the programme of covering radiators and introduction of door guards. Infection control training has been given since the last inspection. Some Staff said they had received fire safety training and that moving and handling training was arranged for next week. Water temperatures have been commenced for the prevention of legionella. Service Records were seen for Lift Service, Hoists, Sluices, Gas Safety, and
Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 25 specialist baths. Electrical checks have been arranged and service contracts for the safe disposal of waste and clinical waste 9including medicines were also seen. First Aid boxes have been re stocked, checked and cleaned. Accident records have been followed up by the manager, and risk assessments seen for the use of bed rails. Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 26 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 3 3 2 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 3 11 3 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 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 3 3 2 2 2 Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 (1,2) Requirement Carried forward from the previous inspection. New timescale given: The Manager must ensure Skin Care Plans and charts are 1. Written in such a way that clearly identify size, shape, possible cause, treatment and specific needs Carried forward from the previous inspection. New timescale given: The Manager should ensure Care Plans are written in such a way that they set out in detail the action which needs to be taken by care staff to ensure that all aspects of health, personal and social needs of the Service User are met. The Manager must ensure all sharps boxes are correctly labelled The Manager must enrol on a RMA management course and inform the Commission for Social Care Inspection when this is done The Manager must continue with
DS0000066799.V293668.R01.S.doc Timescale for action 11/10/06 2 OP7 15(1) 11/10/06 3 4 OP9 OP31 13(2) 9(2bi 11/10/06 11/10/06 5 OP38 12(4a) 11/10/06
Page 28 Camellia House Nursing Home Ltd Version 5.2 23(4a) the planned programme to cover radiators and install door guards or other suitable devise. 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 OP3 Good Practice Recommendations Carried forward from the previous inspection: The Manager should ensure that evidence is provided to ensure that all information in standard 3.3 is obtained on Service Users prior to admission. The Manager should consider: o Introducing a drugs fridge o Obtaining two signatures on all hand written MAR sheets o Obtaining two signatures when recording the disposal of controlled drugs into the DOOM kit. The Manager should consider increasing the range and choice of activities for residents The Manager should continue with the planned programme of POVA training to ensure all staff attend. The Manager should continue with the planned training programme as discussed at inspection The Manager should continue with the planned programme of supervision. The Manager should continue with the planned improvements in records and record keeping including care plans 2 OP9 3 4 5 6 7 OP12 OP18 OP38 OP30 OP28 OP36 OP37 Camellia House Nursing Home Ltd DS0000066799.V293668.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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