Inspection on 30/11/06 for Carrick House Nursing Home

This inspection was carried out on 30th November 2006.

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

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

Other inspections for this house

Carrick House Nursing Home 15/08/08

Carrick House Nursing Home 17/07/07

Carrick House Nursing Home 13/01/06

Carrick House Nursing Home 30/11/04

Carrick House Nursing Home 22/07/04

Carrick House Nursing Home 06/01/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Carrick House Nursing Home 61 Northwick Avenue Kenton Middx HA3 0AU Lead Inspector Mr Ram Sooriah Unannounced Inspection 30th November 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 Carrick House Nursing Home DS0000022921.V322363.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. Carrick House Nursing Home DS0000022921.V322363.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Carrick House Nursing Home Address 61 Northwick Avenue Kenton Middx HA3 0AU Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8907 0399 020 8907 0051 MD Homes Ms Zherabanu Nazerali Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24), Terminally ill over 65 years of age (0) of places Carrick House Nursing Home DS0000022921.V322363.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 24 persons over the age of 60 may be accommodated. Date of last inspection 13th January 2006 Brief Description of the Service: Carrick House Nursing Home is part of MD Homes, a small private company with four care homes mainly for the elderly. The home was established in 1973 and has been run by a range of providers. The current provider took over about eight years ago. The home is registered for 24 service users requiring nursing care. It is a large detached building, with some extensions, in a residential area. Accommodation is provided on the ground and first floors. Service users occupy a mixture of single (eighteen) and double rooms (three). The home has a communal dining room, a lounge, a separate kitchen, toilets and bathrooms, and an attractive conservatory. The home is about five minutes walk from the Kenton Road where buses are available. It is also within five minutes walk from Northwick Park underground station. The home has off street parking for about six cars, but there is also parking on the roads near the home. The home is managed by Zhera Nazerali and her deputy and they are closely supported by the operations director, Zena Chan. Fees charged by the home range from £725 to £810 depending on the needs of service users. The statement of terms and conditions of the home, available to all service users, has details of what is covered by the fees. There were 22 service users in the home at the time of the inspection. Carrick House Nursing Home DS0000022921.V322363.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report contains the findings of a key inspection which took place on Thursday 30th November 2006. It started at 10:00 and finished at 19:00. The inspector was able to observe care practices in the home, talk to six service users, two visitors, the manager and two members of her staff. He also looked at a sample of care, health and safety, personnel, training and other records kept in the home. The home had an unannounced random inspection in April and a report was produced, which is available upon request. That inspection concentrated on care practices in the home and on the management of medicines in the home. The inspector is very grateful to service users and visitors who spoke to him and would like to thank the manager and all her staff for their kind support and welcome to the home. What the service does well: What has improved since the last inspection? The standard of care plans continue to improve including the part of the care plans dealing with the social and recreational needs of service users. Carrick House Nursing Home DS0000022921.V322363.R01.S.doc Version 5.2 Page 6 There has been some improvement with regard to the assessment of the social and recreational needs including the life history of service users. The provision of activities in the home has also improved by the recruitment of an activities coordinator for the organisation (MD Homes), albeit she was spending 1-1.5 days at Carrick House for the provision of activities. The management of medicines has improved particularly with regard to administration. Medicines are now administered to one service user at a time while previously there was a tendency on some shifts to prepare the medicines for a number of service users at a time then administer these medicines. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Carrick House Nursing Home DS0000022921.V322363.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Carrick House Nursing Home DS0000022921.V322363.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1-4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are assessed appropriately prior to be offered a place in the home to ensure that their needs would be met in the home. They are provided with the terms and conditions of the placement and most information about the service, except for information about the range of fees charged by the home. EVIDENCE: Copies of the service users’ guide (SUG) were available in all the bedrooms of service users. Visitors knew that these were there and could refer to them if necessary. The manager stated that she also verbally explains things that are contained in the SUG to service users/representatives. This was confirmed by a visitor and a service user that the inspector spoke to. It was however noted that the service user guide did not contain information about the range of fees that are charged by the home and the arrangement in Carrick House Nursing Home DS0000022921.V322363.R01.S.doc Version 5.2 Page 9 place for payment of these fees and the way that the home deals with the Free Nursing Care Contribution. Service users who were self-funding had a copy of their contract in place. The financial matters are normally dealt with by the head office of the organisation and therefore copies of the contract were not available in the home, but at the head office. Copies were later forwarded to the inspector to evidence this. The manager stated that copies of the statement of the terms and conditions of the service are provided to all service users and that copies are available in the SUG. A copy of the statement of the terms and conditions was indeed available for inspection in the SUG. The inspector noted that all new service users have been assessed by the manager or by the operations director of the organisation before the service users were accepted for placement. Copies of the assessments of the funding authorities and discharge letters from the hospital were also available on files. The home accommodates service users from a range of cultural and ethnic backgrounds and staff were on the whole familiar with the needs of the service users. It was noted that the manager and her staff work closely with service users and their relatives to understand the needs of the service users and the actions that need to be taken to meet the identified needs. Sufficiently trained members of staff are also provided in appropriate numbers to ensure that the needs of the service users can be met in the home with the support of other community healthcare professionals. Service users from ethnic minorities were well represented within the staff team, although white Caucasian service users were not so well represented. Carrick House Nursing Home DS0000022921.V322363.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7-11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans normally addressed the needs of service users, but they could have been more comprehensive to address all the actions that need to be taken to meet the needs of the service users. The healthcare needs of service users were in the main addressed appropriately in the home. It was however not always clear when service users were having showers/baths. Medicines management was good, except that there must be a risk assessment and an appropriate storage place for the medicines in cases where service users are self-administering their medicines. End of life care in the home is managed sensitively and appropriately to provide comfort to the service users as well as to their relatives. EVIDENCE: Three care plans were inspected. These were kept in a locked cupboard in the dining area. They were all in good order. Carrick House Nursing Home DS0000022921.V322363.R01.S.doc Version 5.2 Page 11 Once admitted to the home, the needs assessments of the service users were completed for care plan purposes. The inspector noted some progress in this area as the assessments were on whole completed appropriately, but some sections of the assessments could have been more comprehensive. The section on communication for one service user did not describe the first language of the service user and the ability to comprehend English or to express himself. The manual handling risk assessment did not also address all manual handling manoeuvres such as moving in bed and the equipment to use for this purpose. Care plans of service users were also not always clear with regard to the action to take to meet the identified needs of service users. For example one care plan said ‘to perform catheter care’; ‘inspect skin regularly’, ‘reposition regularly’ but did not say how these actions should be carried out. Another with regard to gastrostomy feeding said ‘administer prescribed feed’ and did not say what were the prescribed food and the rate at which the service user should be fed. As a result of the above the inspector concluded that the assessment of needs could have been more comprehensive and the care plans of service users could have been clearer with regard to the action to take to meet the needs of service users. The inspector also noted that care plans could have been more explicit about the cultural aspects of the needs of service users such as when addressing a service user’s particular need with regard to washing, dressing and grooming. The home had a comprehensive risk assessment format where service users were assessed against a number of possible risks. Risk assessments were agreed with the representatives of service users. The inspector noted that service users or their representatives had also signed the needs assessment form. The care plans were however not signed to show that these have been agreed with the representatives of service users. The manager stated that she normally explain the care plans to service users and their representatives. All service users in the home were appropriately dressed and seemed to be having a good standard of hygiene. The care plans of service users on hygiene did not always address the bath/shower of service users and the daily progress notes did not always describe the occasions when service users were having regular bath or showers. As a result it was difficult to evidence whether service users were having regular showers and bath. Care plans of service users with regard to hygiene did not also incorporate the cultural aspect and usual habit of the service user in the care plan. The care plans for two service users and their medical history showed that they were both prone to chest infection. While there was close monitoring of their condition by at least daily or more frequent vital signs observations, care plans were not always in place addressing these needs. Inspection of the management of medicines showed that medicines were appropriately recorded when received, administered and disposed of. It was noted that the procedure for the administration of medicines has been Carrick House Nursing Home DS0000022921.V322363.R01.S.doc Version 5.2 Page 12 tightened after the last inspection to ensure the safety of service users. Controlled medicines in the home were also being appropriately managed. One issue, which needed to be addressed, was the storage of medicines for service users who self-administer medicines and the risk assessment that must be in place to ensure the safety of the service user and of other service users. The care records of service users contained some information about the arrangement in place for end of life care and for managing death. A care plan was normally in place addressing this area of care. The manager and her deputy have had training in palliative care. Another member of staff and the manager have also had training in end of life care. The manager said that relatives of service users could stay with the service users who were not well during the course of the day and the night if they wished to. Regulation 37 notifications showed that the death of service users are appropriately managed in the home. The inspector noted that the status of service users with regard to resuscitation was not always clearly identified in care plans. Carrick House Nursing Home DS0000022921.V322363.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): 12-15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are stimulated by the provision of appropriate social and recreational activities within the home. Outings are arranged taking into consideration the needs and wishes of service users. The home provides appropriate meals, which suit the needs of the service users. EVIDENCE: MD Homes has appointed an activities coordinator to work across the four homes. Currently the activities coordinator spends about 1.5 days at Carrick House. Feedback from service users and visitors about the input of the activities coordinator was very positive. When the activities coordinator is not on duty, care staff are the responsible to carry out activities according to a programme of activities. There was also evidence that other people were booked to provide entertainment for service users. The records about the social and recreational activities including the assessment of the social and recreational needs and a care plan addressing these needs were in place on most occasions. Carrick House Nursing Home DS0000022921.V322363.R01.S.doc Version 5.2 Page 14 The inspector was informed that there has been some attempts at arranging outings. For example an outing has been arranged for service users to go and see Christmas Lights. One service user is able to go out independently and the manager stated that other service users are able to go out with their relatives if they wished to. The home has an open visiting policy and it was noted that a number of visitors came into the home to see service users. They were appropriately welcomed by the manager and her staff and shown to the service users that they had come to see. They were also offered to see service users in private and were asked if they wanted drinks. On the day of the inspection, there was roast chicken, roast potatoes, rice, cauliflower, carrot and swede for lunch. Although the menu contained a second choice on this occasion only the roast chicken was prepared as all service users chose the chicken. The inspector noted a menu sheet, which was completed by the chef in the morning when she asked all service users about their choices. There was vegetable soup, sausage rolls, bake bean and sandwiches for supper. Desert consisted of blueberry muffin and custard. Service users who were able to respond to the inspector were satisfied with the meals provided by the home. The home kept all the necessary records such as fridges’ and freezers’ temperature, a cleaning schedule as well as the food cooked in the home on a daily basis. The inspector was informed that cultural food is provided to service users according to their needs and wishes. The inspector was informed that the relatives also bring appropriate food for service users who are from ethnic minorities. Carrick House Nursing Home DS0000022921.V322363.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints and allegations and suspicions of abuse are taken seriously and are dealt with appropriately. EVIDENCE: The home has had one complaint since the inspection in March/April 2006. Copies of correspondence were seen and it was noted that the complaint had been appropriately investigated and responded to. The complaint procedure is found in the service users’ guide, which is given to all service user/representatives. Copies were also available in the foyer of the home. Service users and their representatives said that they would approach the manager if they had any complaints or concerns that they wanted to raise. Records showed that staff have had training on abuse and on safeguarding adults. The home has not had any allegation of abuse since the last inspection in March/April 2006. The manager was however clear of the procedure that needs to be followed in cases where there have been allegations of abuse. Carrick House Nursing Home DS0000022921.V322363.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): 19,24 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The living and communal areas of the home are suited to meet the needs of service users. Other areas such as the laundry and kitchen areas require improvement. EVIDENCE: The outside of the home was in keeping with the time of the year. The grounds were in the main tidy and the exterior of the building was in good condition. The home was clean, warm and free from odours. It was in a good decorative order throughout. The manager stated that recent work in the home included the carpet in a few bedrooms which has been changed and a few bedrooms which have been repainted. The manager has a plan for the refurbishment of the home as part of her budget. This was seen and included re-carpeting of three bedrooms, the Carrick House Nursing Home DS0000022921.V322363.R01.S.doc Version 5.2 Page 17 acquisition of a suction machine and a carpet shampoo machine. A new washing machine has recently been purchased by the home. The communal areas were appropriately furnished and decorated. There were a television and a music system in the lounge for service users to enjoy. The home has had plans for a number of years to completely overhaul the kitchen and to have separate laundry and sluice areas with a steriliser. These plans have not yet been realised. The sluice is currently found in the laundry area and the home does not have a steriliser. The manager reported that she was awaiting a response from the Environmental Health Department of the local authority before starting work in the kitchen. She added that once the kitchen is completed then the work on the laundry and the sluice would start. Carrick House Nursing Home DS0000022921.V322363.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): 27-30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides appropriately trained staff and in adequate numbers to ensure that the needs of service users are met in the home. The home has about 50 of its care staff trained to at least NVQ level 2. Recruitment in the home was not always thorough to ensure the safety of service at all times. EVIDENCE: The duty roster was available for inspection. The inspector noted that correction fluid was used to make changes to the duty roster. As the latter is a statutorily required document, correction fluid must not be used to make changes to it. On the day of the inspection there were two trained nurses, including the manager, and six care staff for the morning shift and one trained nurse and four carers in the afternoon. The manager is normally part of the staff team from 08:00 to 14:00 after which she is supernumerary. At night there was one trained nurse and one carer. The inspector looked at the personnel files of three members of staff to check if the home had robust recruitment procedures. The files were kept safely in the manager’s office and were kept in good condition. There was evidence that CRB checks has been carried out for all the three members of staff and that they all have had appropriate interviews. All the files contained an application Carrick House Nursing Home DS0000022921.V322363.R01.S.doc Version 5.2 Page 19 form, but the work history in the application form was not completed to the nearest month to enable the exploration of all gaps in the employment history. It was also noted that not all of the applicants had two references. The manager stated that all new members of the care staff have to complete the common induction programme from the Skills for Care Council. There was also evidence in the training records to show that members of staff had received statutory training. The training in some instances consisted of watching a training video. The manager stated that the training videos are used while waiting for certificated training to be arranged. It was noted that the manager has arranged more in depth training for staff who handle food, as this was also recommended by the Environmental officer who visited the home recently. The inspector was informed that the home has 8 carers who require the NVQ 2 in care. The rest of the care staff are nurses from abroad and were awaiting placement for an adaptation course. Out of the eight carers, 4 already have qualifications equivalent to the NVQ level 2 or above. This therefore means that the home has 50 of its care staff trained to at least NVQ level 2. The home had a training plan based on individual training profiles which the manager was updating at the time of the inspection. Carrick House Nursing Home DS0000022921.V322363.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 and 38 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The manager leads her team by example and runs the home in an open and inclusive manner. The home has a quality assurance system, which was not being applied consistently. The home has systems in place to ensure that service users’ money is managed in an appropriate manner. Most health and safety issues were being attended to for the safety of service users. EVIDENCE: The manager has been registered for a number of years and has completed her Registered Managers Award. She stated that she has kept herself up to Carrick House Nursing Home DS0000022921.V322363.R01.S.doc Version 5.2 Page 21 date and has recently attended a study day on End of Life care and was keen to introduce some of the things that she has learnt in the home. There was evidence that apart from having an open door policy, the manager has also arranged meetings for staff and for service users and their relatives to ensure that staff, service users and their relatives have a say in the way the home is run. The home uses the Blue Cross quality system which has been developed by the Registered Nursing Home Association. This consists of a number of audits of key areas in the home including, care, maintenance, quality assurance and records. One set of audit on the quality assurance system was available for inspection and carried out in 2005. There was no audit for 2006. There was however a customer satisfaction survey which was carried out in August 2006 and an analysis of the survey. There was no action plan following the survey. The home only manages the personal money of one service user. The money of the service user is in a bank account with access only to one of the Directors of MD Homes. Small amounts of money for the service user are requested by the manager of Carrick house as required to provide for day to day expenses such as toiletries and hairdressing. Records kept about the expenses were appropriate and receipts were kept as evidence. A bank statement of the service user’s account was forwarded to the inspector. Management of health and safety in the home was generally good. There was evidence that all equipment in the home was being maintained and that all safety certificates had been updated. The home had a fire risk assessment, fire emergency plan and a health and safety risk assessment. There were weekly fire detectors tests and monthly water temperature tests, but there were no records of monthly emergency lights test and wheelchair checks. It was noted that the Environmental Health Officer had visited the home recently and had noted that a fridge and a freezer were running at a higher temperature than they should be. The manager stated that the fridge and freezer would be replaced when work on the new kitchen starts. As a result of the above the registered manager must ensure that an appropriate risk assessment is in place with regard to storing food in the fridge and the freezer which are not working properly. Carrick House Nursing Home DS0000022921.V322363.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 2 3 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X 3 X 2 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Carrick House Nursing Home DS0000022921.V322363.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 OP1 Regulation 5 Requirement The service users’ guide must have information about the range of fees charged by the home The registered person must ensure that service users have a comprehensive assessment of their needs and that the care plans clearly identify the actions to take to meet the identified needs of service users. (Previous requirementtimescale 30/06/06 partly met). These must as far as possible contain information about the cultural and ethnic aspects of the needs of the service users. Care plans must be in place in cases where problems have been identified such as when service users are prone to chest infections. That care plans must contain clear details about the arrangements in place for the baths/showers of service users to evaluate if the needs of service users with regard to DS0000022921.V322363.R01.S.doc Timescale for action 31/01/07 2 OP7 15 31/01/07 3 OP8 15(1) 31/01/07 4 OP8 15 31/01/07 Carrick House Nursing Home Version 5.2 Page 24 baths/showers are being met (Previous requirementtimescale 30/06/06 not met). 5 OP9 13(2,4) The registered person must ensure that there are appropriate risk assessments in cases where service users administer their own medicines and that there are appropriate storage areas for the medicines. The registered person must ensure that the kitchen is refurbished as soon as possible. (Previous requirementtimescales of 31/3/05 and 01/4/06 not met) The home must have separate premises for the sluice and laundry to ensure good infection control systems. It must also have a sluicing disinfector. (Previous requirementtimescales of 31/3/05 and 01/04/06 not met) Correction fluid must not be used to make changes to the duty roster. The registered person must ensure that all applicants have two references before they are offered employment in the home and that the work history of each applicant is completed to the nearest month and that any gaps in the work history are explored during the interview. The registered person must ensure that audits are carried out according to its quality assurance procedure and within the identified timescale. The registered manager must ensure that an appropriate risk assessment is in place with regard to storing food in the DS0000022921.V322363.R01.S.doc 31/01/07 6 OP19 23(2)(b) 30/06/07 7 OP26 13(3) 30/06/07 8 9 OP27 OP29 17(2) 19(1) 31/01/07 31/01/07 10 OP33 24 30/04/07 11 OP38 13(4) 15/01/07 Carrick House Nursing Home Version 5.2 Page 25 12 OP38 13(4) fridge and the freezer which are not working properly. The registered person must ensure that there are regular emergency lights and wheelchair checks in the home. 15/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP8 OP11 Good Practice Recommendations That the registered person make a record when service users/representatives have agreed to the plans of care to meet the identified needs of the service users. The manager should consider addressing the status of service users with regard to resuscitation in the care records. Carrick House Nursing Home DS0000022921.V322363.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 Carrick House Nursing Home DS0000022921.V322363.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. 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