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Inspection on 08/03/07 for Carr Green Nursing Home

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

This inspection was carried out on 8th March 2007.

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

The staff are friendly and they make visitors feel welcome. One relative said the home provides a service in a "friendly, homely manner". Another said, "I am very happy with the standard of care and welfare". Relatives felt that the staff kept them well informed about any accidents or concerns about health issues. A relative said "Carr Green is definitely not a show piece but it provides an excellent level of care and support in a down to earth manner" Residents told us they enjoyed their meals, they said there was plenty of variety on the menu. The home is appropriately staffed throughout the day and night to meet the needs of residents.

What has improved since the last inspection?

The care plans have improved in recent months; this means that residents should now be receiving care and support in a more consistent way. The medication system and medication records are much better. The system is being managed properly and residents get their medication at the right times. Daily menus are now on display on the dining tables. The staff recruitment process has improved. All staff are checked before they start work at the home to make sure they are suitable.

What the care home could do better:

The information about the home that is given to prospective residents needs to be updated so that it accurately reflects the service and the accommodation provided.Residents and relatives need to be asked if they would like to be more involved in the care planning process. Some relatives said there was a difference in the responses of some of the staff. We were told, "some staff are excellent, and some just get by". The manager needs to look into this. Residents and relatives all commented on the need to upgrade the decoration throughout the home. We also feel that many areas of the home need to be redecorated. The company needs to produce an action plan showing how and when redecoration will take place. There is no training budget; the staff have to find free training courses. All staff need to be properly trained within the first few months of starting work at the home, to ensure they are competent enough to carry out their duties. The company needs to review the amount of money they are providing towards the cost of occasional entertainment in the home. At the moment the staff have to raise money to cover costs. The staff have should be given contracts which outline their terms and conditions of employment.

CARE HOMES FOR OLDER PEOPLE Carr Green Nursing Home Carr Green Lane Rastrick Brighouse West Yorkshire HD6 3LT Lead Inspector Lynda Jones Unannounced Inspection 8th March 2007 09:30 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 Carr Green Nursing Home DS0000001046.V332337.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. Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Carr Green Nursing Home Address Carr Green Lane Rastrick Brighouse West Yorkshire HD6 3LT 01484 710626 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) Flowertouch Limited Mrs Sandra June Speight Care Home 31 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (31), of places Terminally ill over 65 years of age (2) Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Can provide accommodation and care for seven named services users - category DE(E) 9 October 2006 Date of last inspection Brief Description of the Service: Carr Green provides both personal and nursing care for 31 older people in what was once a school. The home is located in Rastrick close to local amenities. There is a small garden area and car parking is available in the grounds. All of the residents accommodation is on one level. There are single and double bedrooms available. None of the bedrooms have en-suite toilets. There is one large lounge and a dining room. There are four bathrooms and six separate toilets. The kitchen and laundry are in the basement. The fees range from £390 to £485 per week. Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way in which care services are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group for example Choice of Home. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers outcomes to the people using the service. The judgements categories are “excellent”, “good”, “adequate” and “poor”. The judgements are recorded within the main body of this report. More detailed information about these changes is available on our website – www.csci.org.uk We have visited the home once since the last key inspection in May 2006. We carried out a random inspection in October 2006 to see what progress had been made in meeting the requirements that were made following the May inspection. This inspection was carried out to assess the quality of care that people living at the home are receiving and to check what progress had been made on meeting the requirements from the previous inspection visits. A pre-inspection questionnaire was sent to the home before the visit took place. The information provided, has been used as part of the inspection and used in the preparation of this report. Two inspectors visited the home and spent 6.5 hours there. During the visit we looked around the home, we talked to residents, staff, and visitors. We looked at a selection of records including; residents’ care plans, risk assessments, admission assessments, staff recruitment and training records and medication records. We sent comment cards to a sample of residents and their relatives and to two Gps. These cards provide an opportunity for people to share their views of the service with us. Comments received in this way are shared with the provider without revealing the identity of those completing them. Six relatives, two residents and two GPs wrote to us with their comments. Information from the comment cards has been used in this report. Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The information about the home that is given to prospective residents needs to be updated so that it accurately reflects the service and the accommodation provided. Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 7 Residents and relatives need to be asked if they would like to be more involved in the care planning process. Some relatives said there was a difference in the responses of some of the staff. We were told, “some staff are excellent, and some just get by”. The manager needs to look into this. Residents and relatives all commented on the need to upgrade the decoration throughout the home. We also feel that many areas of the home need to be redecorated. The company needs to produce an action plan showing how and when redecoration will take place. There is no training budget; the staff have to find free training courses. All staff need to be properly trained within the first few months of starting work at the home, to ensure they are competent enough to carry out their duties. The company needs to review the amount of money they are providing towards the cost of occasional entertainment in the home. At the moment the staff have to raise money to cover costs. The staff have should be given contracts which outline their terms and conditions of employment. 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. The summary of this inspection report can be made available in other formats on request. Carr Green Nursing Home DS0000001046.V332337.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 Carr Green Nursing Home DS0000001046.V332337.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): 1,3,5 (6 does not apply) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is evidence that people are assessed before they move into the home to make sure their needs can be met. Prospective residents and their families are encouraged to visit before making a decision about moving in. Information about the home needs to be updated so that it accurately reflects the service that is available. EVIDENCE: Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 10 Anyone considering taking up residence is welcome to visit the home to have a look round and talk to other people who live there. Relatives can call at any time if prospective residents are unable to get there. All prospective service users are assessed before they move in to make sure that their needs can be met at the home. We found evidence of this with in the care plans. The service user guide and statement of purpose are available in the entrance area. Both of these documents provide information about the home and the service that is provided. We felt that they should be reviewed because they don’t accurately reflect the service provided. The home is registered to provide accommodation for 31 older people. The statement of purpose states that the home offers 30 places, the service user guide says the home has 22 single rooms and 2 doubles, providing a total of 26 places. Both documents need amending if the home is to continue with the current registration. The service user guide does not contain enough information about the fees and the arrangements for paying the fees. The home does not provide intermediate care. Carr Green Nursing Home DS0000001046.V332337.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 care plans have improved. They now contain better information about the needs of residents and what action the staff need to take to meet those needs. The medication system has improved, records are better maintained and residents get their medication in the way it has been prescribed. EVIDENCE: We looked at four care plans in detail. Evidence indicated that the quality of the plans has improved over recent months, this needs to continue. The plans contain details of residents’ life experience, information about their families and about hobbies and interests. Some good information is recorded about daily routines; this enables staff to provide care and support in a way that suits residents. Details are also included about individual likes and Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 12 dislikes. This should enable to staff to deliver care and support in a consistent way. The plans are reviewed every month to make sure the information is relevant and up to date. We saw evidence on only one plan that confirmed that a resident and relative had been involved in a review. Staff need to consult with residents and their representatives about how often they wish to be involved. A range of risk assessments are in place, these are also reviewed each month. During the day we noted that staff were following what was in the moving and handling plans and using the equipment that was provided. The plans indicate that health care needs are monitored. The records show details of all contacts with health care providers such as GPs, district nurses, chiropodist, dietician etc. together with the reasons for visits and the outcomes. This is an improvement on the position reported on in May and October 2006. The GPs who completed comment cards said they thought the home met the care needs of the people living there. In their responses, relatives said they thought the home usually delivered the care and support residents needed and they were satisfied with the performance of the home. All of the relatives said they felt that they were kept informed about care issues. From their comments, relatives suggest that there is some variation in the performance of staff. One person said, “Some of the staff are very good and some not so good” another said, “most of the staff are excellent, some just get by”. One resident said, “sometimes they do what you ask, sometimes they are awkward” This needs to be explored further by the manager, staff should be providing a consistently good service. We noted a significant improvement in the medication system at the home. The monitored dose system and supplying pharmacist has changed since we last visited. The medication administration records have improved, medication had been “booked in” correctly and a “brought forward” system is used for medication that is administered when required. Carr Green Nursing Home DS0000001046.V332337.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 good. This judgement has been made using available evidence including a visit to this service. Residents are consulted about how they want to spend their time. Activities are on offer if people want to join in. The funding the company provides for activities and entertainment is insufficient and does not cover the full costs. The menus offer plenty of choice and residents enjoy the meals provided. The dining room could be improved so that people can eat in pleasant surroundings. EVIDENCE: Residents are asked about their preferred routines and about their hobbies and interests when they first move in. If residents are not able to give this information, relatives are asked to assist. One of the care staff has time set aside from care duties when she specifically concentrates on organising activities. These activities take into account what Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 14 residents have said they enjoy doing. While we were at the home people were sat chatting and watching TV. Some people chose to stay in their rooms watching TV. In the afternoon some people were involved in making cards for Easter. The staff spent time sitting and talking to residents throughout the day, they checked on people who were in their rooms and took them drinks and biscuits. Records are kept of individual involvement in all the activities that take place each week. We saw a group of residents in the lounge being consulted about some future entertainment they would like organising. Visiting entertainers are booked about every six weeks. Residents were highly delighted with a proposed visit from an organisation that runs a rural therapy centre in West Yorkshire. They plan to bring some of their small animals to the home so that residents could see them. We learned that the company does not provide enough money to cover the cost of entertainment. The staff have to raise the money themselves. They are covering the entire cost of the visit from the rural therapy centre. We were told that a small group of residents enjoyed the occasional glass of sherry when they watched TV; this cost is also not covered by the company. The sherry is provided by the staff or donated by relatives. Staff told us the company would only pay £45 towards the cost of entertainment. This figure had not been reviewed for some time and has not kept pace with rising costs. We raised this issue with the person responsible for the home at the end of the visit and asked him to refer this back to the company for review. Residents told us they enjoyed the meals at the home. Everyone had been consulted about what they wanted to eat, several people remembered what they were having and the new menus on the tables served as a reminder. We have commented on the appearance of the dining room in the section of this report on the environment. We acknowledge the effort made by staff to improve the appearance of the tables at mealtimes and in making the menus for the tables, the room itself needs considerable attention. At the last visit we noted that all of the residents were provided with disposable “bibs” at meal times, this appeared to be out of habit rather than necessity. We asked staff to consider whether these were really necessary and if something more appropriate and dignified could be used. There has been no change to this practice. Carr Green Nursing Home DS0000001046.V332337.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 adequate. This judgement has been made using available evidence including a visit to this service. There is a complaints procedure that is available within the home. Staff need to be clear about what they should be recording in the complaints log. EVIDENCE: There is a complaints procedure and details are on display in the home. The information needs updating to include details of the Commission for Social Care Inspection and the address of the area office. Four out of six relatives who completed surveys said they knew about the procedure, all six relatives said they would go straight to the manager if they had any complaints. The two residents who returned comment cards said they would “talk to the matron” if they were not happy. We found that some of the issues recorded as complaints had been logged inappropriately. Some issues that had been recorded were about staffing matters. If staff make allegations about the behaviour of other members of the team, these should be investigated and dealt with, and the outcome should be recorded with the relevant staff file. Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 16 Staff have received training about protecting vulnerable adults in recent months and local procedures are available in the home. Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,23,24,25,26. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Some of the fixtures and fittings need replacing and the décor requires upgrading. The home does not have a coordinated development plan to show how and when bedrooms and shared areas will be re-decorated and refurbished. EVIDENCE: There have been some improvements to the home since the last inspection, but there is still a great deal to be done to raise the standard of accommodation for residents. When we looked round, all parts of the home were clean and odour free. In the main, the bedrooms are quite large. Many were double rooms that are now being used as singles. There is plenty of space to create a sitting area in Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 18 the bedrooms, which some people have done. Some residents prefer to stay in their rooms during the day and watch TV or read. Every bedroom is personalised, many residents have their family photos on display and everyone has their own toiletries in their room. We were disappointed to see signs stuck on the front of some wardrobe doors, which were headed “nappy stock list”. This is unnecessary and disrespectful. The nurse in charge removed them while we were there. The building was once a school and many of the original features have been retained. In some ways, this is disadvantageous to residents. The windows in the bedrooms are high which means that residents can’t see outside when they are sitting in their room. We were concerned for the safety of one resident who we found standing on a footstool to see out of the window. At the end of the inspection we told the nurse in charge and the person who is responsible for the home about this and asked them to look into the safety issue. The bedroom windows only open at the top; they are opened by pulling a cord that hangs down from the top of the window. Unfortunately, many of the cords were not visible or could not be reached which meant that the windows could not be opened. Many of the bedrooms have strip fluorescent lighting in them. This is not the sort of lighting that is usually used in a bedroom, in a domestic setting. When the rooms are upgraded, consideration should be given to changing the lights. Some of the curtains in the bedrooms are dirty and some do not have enough hooks in them so that they cannot be opened and closed easily. Some bedrooms have not been redecorated for a number of years and the wallpaper is marked and worn. We commented on the need to improve the way the home looked in our reports from visits in May and October 2006. In October we were told that some bedrooms had been earmarked for redecoration, new carpets and new curtains. In the information sent to us, we were told that two rooms had been redecorated and four had new floor coverings since our last visit. The dining room has been repainted since the last visit. We were told that the paint that was provided was not the colour that had been chosen. As the walls will not now match the new curtains, the room is going to be repainted. The room is bare and uninviting. The dining tables are lightweight and “wobble” when residents hold onto them as they raise themselves up from the dining chairs. The walls are bare and the lighting is dull. Radiator covers in this room are made from wire mesh and they look unsightly. On a positive note, the presentation at the tables has improved. The table settings are brighter and look pleasant and each table has the menu for the day as a centrepiece. Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 19 Improvements have been made to the bathing facilities since the last inspection. Residents now have the option of having a shower if they wish. A hoist has also been fitted in one of the bathrooms. The bathrooms continue to look bare and functional. They are not conducive to a pleasant, relaxing bath time experience and need to be improved. One of the toilets needs the floor covering replacing where it has curled up and come away from the edge of the room. This is unhygienic and is also a safety hazard. There is one bright spacious lounge which most people use throughout the day. Some of the chairs have been arranged in the centre of the room so that residents can be closer to the TV, instead of sitting round the edge of the large room. The room would benefit from redecoration, as the wallpaper is old and stained in some areas. There are not enough hooks in the curtains in this room, which means that some curtains cannot be closed. Relatives who returned comment cards said “ the fabric of the building and interior decorations could do with updating” “some areas need attention ” “the rooms need redecorating” One visitor said “the home could do with an upgrade, it needs some money spending on it”. One of the residents said, “The place could do with a lick of paint”. We were told that the manager has made a list of all of the decorating that needs to be done in the home. Unfortunately, the manager has no budgetary control over redecoration and no control over when the work will be done. There seems to be no plan and no timetable for the work. Overall, we could find little evidence of any significant and sustained improvement. Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 20 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 adequate. This judgement has been made using available evidence including a visit to this service. There are sufficient staff on duty at all times of the day and night to meet the needs of residents. Recruitment practices are good; all staff are checked appropriately before they start work in the home. The company does not support or encourage the development of a competent staff team in key areas. The manager is left to find free courses for staff training purposes. EVIDENCE: When we visited there were 23 people in residence. We talked to staff, looked at a sample of staff rosters and observed practice during the day and we concluded that the home is adequately staffed to meet the needs of residents. We looked at a sample of staff files to see if new staff are properly checked before they start work in the home. There has been an improvement in the performance of the home in this area. References are taken up and checks are carried out with the Criminal Records Bureau and Protection of Vulnerable Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 21 Adults register. On one file we looked at we could not find evidence that the PIN number (which shows that the nurse is registered with the Nursing and Midwifery Council) of the nurse had been checked before employment commenced. Staff are being consulted by the manager, we saw the minutes of recent meetings of care and catering staff. We asked about staff training and we were told that the company does not routinely pay for staff to go on training courses. Staff and management have to find free courses, which makes it difficult to organise essential mandatory training for staff. We were unable to find out whether all staff had completed training in areas such as basic food hygiene, moving and handling, first aid, fire safety, health and safety and infection control. It is important that staff receive this training when they start work at the home to ensure that they are competent to carry out their duties. The company has a responsibility to make sure that this is provided for the safety of all residents and staff. Several staff on duty told us they were very unhappy with the company’s repeated failure to pay their wages correctly. This needs to be resolved urgently to avoid further staff demoralisation. At the end of the visit this matter was raised with the person who acts on behalf of the company. Staff told us that most of them have not been issued with terms and conditions of their employment. We found only one copy on the staff files we looked at, on which there were no details of the rate of pay. Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 22 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. There have been some improvements in the way the home is managed on a day-to-day basis. Record keeping has improved; consultation with residents and their families is better. These improvements have been brought about by the manager and staff at the home, there has been little support from the company. EVIDENCE: Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 23 The registered manager is an experienced nurse who has worked with older people for a number of years. She has not yet completed her NVQ level 4 in management. Residents and relatives are satisfied with the way the home is managed on a day-to-day basis. Residents and relatives meetings have taken place so that they can make their views known and the staff ask for residents opinions on things most days on an informal basis. The company that owns the home does not provide sufficient support to the management team. The management team and staff are aware of the shortfalls highlighted in this report. The registered manager has no control in certain areas, particularly where funding is involved. Most of the areas in need of action that have been highlighted in this report involve expenditure and forward planning. There is a heavy reliance from the company on ‘staff good will’ to raise money for entertainment and other items that benefit residents. There is a lack of any planned investment in the maintenance of the building or in staff development. There is no annual development plan for the home, which sets out areas for improvement and timescales for the improvements to be carried out. Management and staff have made some improvements to the records in recent months, which is to their credit. Improvements in the quality of record keeping need to continue. We looked at the maintenance records and the records for the servicing of equipment and these were up to date. We talked to a member of staff who will be taking over the management of resident’s money. The records show details of all expenditure, receipts are obtained for any purchases made on behalf of residents. Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 24 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 2 X 3 X 3 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 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 X 2 X 2 2 2 2 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 2 X X 2 Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO 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. OP1 Standard Regulation Schedule 1 Requirement The statement of purpose and service user’s guide need to indicate the number of people the home can accommodate. The statement of purpose should provide information about the range of needs that the home can accommodate. Residents and relatives should be asked about how much involvement they want to have in the construction and review of the care plans. The complaints procedure needs to be updated to include the address of the area office of the commission. The floor covering in the toilet must be replaced, as it no longer fits properly. It presents a safety hazard and it is unhygienic. The responsible individual must provide a redecoration/refurbishment plan showing what work needs to be done in the home together with timescales for completion. Timescale for action 30/04/07 2 OP7 15 30/04/07 3 OP16 4 OP21 5 OP19 22 30/04/07 13 30/06/07 23 31/05/07 Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 26 6 OP25 7 OP28 23(2)(p) 18(1) (a)(c) 8 OP29 19 The windows in the bedrooms must be checked to make sure that they can all be opened. All staff must receive training in the following to make sure residents are kept safe: Moving and handling Food hygiene First aid Infection control Fire Safety Food hygiene. The UKCC register must be checked in respect of nursing staff before they start work in the home, this is to make sure they are suitable to work at the home. 30/04/07 30/06/07 13/04/07 Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 27 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 OP12 2 OP25 3 OP24 Refer to Standard Good Practice Recommendations The company should review the amount of funding provided towards the cost of entertainment. Consideration should be given to changing the lighting in bedrooms when the rooms are upgraded. The bedrooms need to be audited and a plan put in place for redecoration and refurbishment. Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND 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 Carr Green Nursing Home DS0000001046.V332337.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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