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Inspection on 12/07/05 for Cherry Tree Nursing Home

Also see our care home review for Cherry Tree Nursing Home for more information

This inspection was carried out on 12th July 2005.

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

The inspector 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

Pre-Admission Assessments take place for all Service Users prior to admission to the Home. All Service Users have individual Careplans, which have recently been reviewed with a new system put in place. The Staff team ensure the privacy and dignity of Service Users is maintained throughout the implementation of personal care. Staff have positive and supportive relationships with Service Users. Visitors and families feel welcomed to the Home and are supported to maintain contact. Service Users and family members were complimentary of the care and support received. The Manager is proactive in implementing change, which benefits the Service Users and aids the Home to professionally develop. The Manager is available and supportive. Activities planned in the Home are designed to ensure the social needs of Service Users are met. Records are maintained and held in line with the Data Protection Act 1998. Staff receive training to ensure they are able to fully meet the needs of the Service Users in a safe and professional manner. The Home is maintained to a high standard and is reflective of a homely and relaxed environment.

What has improved since the last inspection?

The Home is benefiting from strong leadership and guidance from the Manager. An agreed method of Careplanning is now in place. Photographs of individual Service Users are now available on all Medication Administration Sheets. Mandatory training is up-to-date for all staff with a regular programme of training in place. The Manager has attended a POVA training course, which will enable her to implement training to all staff. Staff recruitment files were found to be thorough with all necessary information included in Schedule 2 available.

What the care home could do better:

Dates of opening need to be written on all medication bottles, tubes and vessels containing creams to ensure no out-of-date medications are applied or administered. A requirement was made to this effect.Additional medication storage facilities need to be provided to both floors of the Home to ensure all medication necessary for administration can be available to staff, presently Lactulose and Senna are administered from one bottle or package due to storage issues on the individual floors. A requirement is made to this effect. All Pressure Wound risk assessments that are subject to a change in score on review are written on a new assessment form with the previous form stored in the Careplan for reference. This will ensure there is no confusion when reading and implementing care. A recommendation was made to this effect. The systematic transfer of all Careplans written on the older format continues to ensure continuity of record keeping. A recommendation was made to this effect.

CARE HOMES FOR OLDER PEOPLE Cherry Tree Nursing Home Bledlow Road Saunderton, Princes Risborough Bucks HP27 9NG Lead Inspector Sue Smith Unannounced 12th July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cherry Tree Nursing Home Version 1.10 Page 3 SERVICE INFORMATION Name of service Cherry Tree Nursing Home Address Bledlow Road, Saunderton, Princes Risborough, Bucks, HP27 9NG Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01844 346259 01844 342 698 Mr A.S. Dhot Maxine Bennell Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42) of places Cherry Tree Nursing Home Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4/4/05 Brief Description of the Service: Cherry Trees Nursing Home is an established care home and is registered to provide nursing care for up to 42 elderly persons; It is privately owned and managed.The home is situated in a rural location close to the market town of Princes Risborough. It is a two-storey building set in well-maintained gardens with a millstream and large millpond, which attracts wild life and birds. Accommodation is in single rooms with comfortable social areas. There are no rooms with ensuite facilities. There is a passenger lift to the first floor. All service users are registered with the local General Practitioner and have full access to local NHS Services through General Practitioner referral. Cherry Tree Nursing Home Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out over 3.5 hours. The Manager was available throughout the Inspection. During the Inspection an assessment of written records took place, which included Careplans, medication procedures and records, recruitment files, accident/incident records and several health and safety records. The Inspector also undertook a full environmental tour of the Home to assess the facilities and equipment. During the environmental tour the Inspector randomly spoke with Service Users and their visitors to gain their opinions of the Care provision. The Manager ensured privacy was maintained during these discussions by leaving the Inspector to talk privately with the individuals. The Inspector has assessed 20 of the 39 older peoples standards with the outcomes reflected in this report. Of those 20 standards 18 were assessed as fully met and 2 were assessed as partly met. In addition the Inspector reviewed the actions taken in relation to the requirements set in the September 2004 inspection report. These were found to all have been actioned within the appropriate timescales. This was a positive inspection of the Home with two further requirements and two recommendations made. Those standards not assessed will be addressed at the next unannounced inspection. The Inspector would like to thank the Service Users and families for the time they gave the Inspector and the support of the Manager to complete this inspection. What the service does well: Pre-Admission Assessments take place for all Service Users prior to admission to the Home. All Service Users have individual Careplans, which have recently been reviewed with a new system put in place. The Staff team ensure the privacy and dignity of Service Users is maintained throughout the implementation of personal care. Staff have positive and supportive relationships with Service Users. Cherry Tree Nursing Home Version 1.10 Page 6 Visitors and families feel welcomed to the Home and are supported to maintain contact. Service Users and family members were complimentary of the care and support received. The Manager is proactive in implementing change, which benefits the Service Users and aids the Home to professionally develop. The Manager is available and supportive. Activities planned in the Home are designed to ensure the social needs of Service Users are met. Records are maintained and held in line with the Data Protection Act 1998. Staff receive training to ensure they are able to fully meet the needs of the Service Users in a safe and professional manner. The Home is maintained to a high standard and is reflective of a homely and relaxed environment. What has improved since the last inspection? What they could do better: Dates of opening need to be written on all medication bottles, tubes and vessels containing creams to ensure no out-of-date medications are applied or administered. A requirement was made to this effect. Cherry Tree Nursing Home Version 1.10 Page 7 Additional medication storage facilities need to be provided to both floors of the Home to ensure all medication necessary for administration can be available to staff, presently Lactulose and Senna are administered from one bottle or package due to storage issues on the individual floors. A requirement is made to this effect. All Pressure Wound risk assessments that are subject to a change in score on review are written on a new assessment form with the previous form stored in the Careplan for reference. This will ensure there is no confusion when reading and implementing care. A recommendation was made to this effect. The systematic transfer of all Careplans written on the older format continues to ensure continuity of record keeping. A recommendation was made to this effect. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cherry Tree Nursing Home Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Cherry Tree Nursing Home Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 6. All Service Users are subject to a full pre-admission assessment to ensure the Home is able to meet their needs prior to admission. The Home does not offer Intermediate care therefore this standard is not applicable. EVIDENCE: The Manager will visit prospective Service Users prior to admission to ascertain whether the Home is able to meet their needs. Pre-admission assessments are completed at this time with further information gathered from social services, G.P and family members. The Home does not offer Intermediate Care facilities. Cherry Tree Nursing Home Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10. Careplans were found to be up-to-date and were reflective of review dates; further work is needed to develop these plans, which will further enable staff to provide the required care. Staff demonstrated a sound understanding of the needs of Service Users and their interactions and relationships with them was positive, which enabled Service Users to express their thoughts, feelings and needs. Medication Administration Records were found to be appropriately signed with all medication stored and disposed of in a satisfactory manner; prescribed Lactulose and Senna are presently not administered from prescribed bottles and packages as per pharmaceutical guidelines, this obstructs the Home from carrying out an audit of medication and leaves the systems open to abuse. Staff practice in giving and assisting with such elements as personal care and arrangements for medical examinations ensure the privacy and dignity of Service Users. EVIDENCE: Cherry Tree Nursing Home Version 1.10 Page 11 All Service Users have an individual plan of care; these have recently been modified with new paperwork in place for all new admissions. The Manager is reminded to ensure all parts of the Assessment On Admission Document are completed to ensure a full baseline is ascertained. This was discussed with the Manager during the inspection. It was also noted during assessment of the Pressure wound risk assessments that changes were reflected in the scoring when a review takes place, however the changes took place by crossing out the original score and placing the changed score in its place. This practice needs to be reviewed, it is recommended that if there is a change in the scoring of a pressure wound assessment it would be good practice to complete the assessment on a new form to avoid confusion. The old assessment can be kept with the Careplan for easy reference. Family members and Service Users spoken with during the Inspection were complimentary of the standards maintained by the Staff team. Staff demonstrated a clear understanding of the individual needs of Service users and how care needed to be implemented. Staff were observed chatting with Service Users in a caring and sensitive manner. Due to the changes in the Careplan format the Home presently has two styles of Careplan in place, as new admissions arrive at the Home the Nurses are completing all Careplans on the new format. Other Careplans are being transferred to the new paperwork during the review process. The Inspector recommends this action continues. The Inspector is satisfied the Home are systematically working towards meeting requirement 1, set in the September 2004 inspection. No further requirement is made. Medication records were found to be up-to-date and appropriately signed. The Proprietors are presently securing a medication disposal system with their clinical waste provider to ensure they are in line with current guidance. All medication is stored appropriately with no out-of-date medication held in the Home. The Home is required to ensure all bottles, tubes and creams have dates of opening recorded on the labels to ensure no out of date medication is administered. The Inspector highlighted one area of concern; it is the practice of the Home to administer lactulose and Senna from one bottle and pack, this has been agreed with the G.P. service, as storage in the medication cabinets is limited. The Inspector can appreciate the issues of storage, however the practice is in breach of current pharmaceutical guidelines, and obstructs the Home from carrying out an accurate audit of medication. A requirement is made that all medication including Senna and Lactulose is administered from the container prescribed for the individual. To enable the Home to carry out this practice additional medication storage facilities will need to be provided. Until such time as these are in place, the Home will need to ensure written permission from the G.P. is sought to provide the Home with evidence that they are in agreement to the practice in the short-term. The Clinic room is well stocked with information relevant to Nurses available. Controlled drugs were stored appropriately with administration records up-to-date and reflective Cherry Tree Nursing Home Version 1.10 Page 12 of good practice. All medication administration records now have a photo of the individual Service User for reference; therefore the Home has met Requirement 2 of the September 2004 inspection report. Service Users spoken with believed the Staff team approached personal care in a sensitive manner. Staff knock before entering bedrooms and ensure doors are shut to bathrooms and bedrooms when undertaking care. Attention is given to ensuring the privacy and dignity of Service Users is maintained during personal care. Service Users and family members spoken with at the time of Inspection were complimentary of the care provided and the professional conduct of staff. All medical examinations take place in the privacy of the Service Users own room. Cherry Tree Nursing Home Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13. The Home implements activities suitable for the Service User group, this enables Service Users to interact on a social level and form new friendships with each other as well as staff. Visitors are welcomed at the Home during all reasonable hours with no restrictions in place. This enables Service Users to maintain their friendships and relationships whilst residing at the Home. EVIDENCE: The Home provides a dedicated activities co-ordinator 3 days a week. All activities are programmed. Postings of coming events were seen throughout the Home. A recent Strawberry Tea was a huge success with all Service Users and family members spoken with complimentary of the day. In addition to the activities co-ordinator a lady comes to the Home to undertake an arts and crafts day (Thursdays) for Service Users to enjoy. Service Users liked the activities offered and were happy with the service provided. On the day of inspection Service Users were found to be outside enjoying the beautiful gardens and sunshine. Visitors spoken with felt welcomed to the Home and were acknowledged as an important part of the care of their loved one. Staff were friendly towards Cherry Tree Nursing Home Version 1.10 Page 14 visitors offering support as needed. There are no unreasonable restrictions on visiting times with a relaxed and family centred approach. Cherry Tree Nursing Home Version 1.10 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16. The Home has a comprehensive complaints procedure, with records of complaints and investigations open to inspection. The complaints procedure is made available to Service Users and significant others, which ensure all relevant persons are able to make a formal complaint appropriately. The Home follows the Inter-Agency protection of Vulnerable adults policy and has begun the process of training staff in abuse protection to ensure the Service User group are protected from abuse. EVIDENCE: The Complaints file is maintained ensuring confidentiality is preserved. All complaints and issues of concern are recorded with investigation records attached with the original complaint. A comprehensive complaints procedure is in place to support the Manager. Family members felt they were able to approach the Manager to raise issues of concern. The Manager has now undertaken a training the trainer course on adult protection with Buckinghamshire County Council; the next step for the Home is to implement further training to all its staff. The Inspector is satisfied the Manager is working towards meeting Requirement 4 of the September 2004 report. At this time a further requirement is not made as planned training is in place. The Manager is reminded to ensure this does take place. Cherry Tree Nursing Home Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25, 26. The Home is well maintained to ensure Service Users live in a safe environment. Comfy furnishings, ornaments, T.V., fixtures and fittings are supplied in communal areas making the environment homely for Service Users. Suitable single sleeping accommodation is provided with evidence of personal possessions to make these more homely for Service Users. The Home has designated cleaners, which ensure the home is clean, hygienic and free from offensive odours. Sufficient numbers of communal toilets and bathroom are available to ensure the needs of Service Users are met. The Home is situated in scenic gardens, which is accessible to all Service Users. EVIDENCE: Cherry Tree Nursing Home Version 1.10 Page 17 The Home provides single accommodation bedrooms; these vary in size with all rooms meeting the needs of Service Users. Adaptations and equipment necessary to maintain the health and safety of Service Users in the environment are in place. Ongoing assessments of needs take place to identify further equipment that may be necessary. Bathrooms and toilets are situated within easy access to bedrooms on each floor. These were found to be clean and tidy with no evidence of offensive odours. The Home has designated cleaners who were seen throughout the Inspection undertaking their duties. All items of C.O.S.H.H. were appropriately stored by the cleaning staff with C.O.S.H.H. data/risk assessment sheets available. Odours due to incontinence were minimised by the cleaning practices with areas of concern identified for additional cleaning throughout the day. The Home has two communal lounges, which provide T.V., Video and DVD equipment as well as a HI FI system. There is adequate space within these facilities to meet the communal needs of Service Users. Doors on the ground floor open onto a well-maintained and picturesque garden. Service Users enjoy this facility and are supported to spend time relaxing in this area. A large kitchen is situated on the ground floor, which provides all meals. The Home follows and acts upon guidance and requirements made by the Environmental Health Inspectors. The Inspector is concerned that the only internal access to the Managers office is through the dishwashing area of the kitchen. This has been raised as an issue of concern by the previous inspector. Discussion with the Proprietors separate to this report will take place to problem solve this issue. At this time no requirements are made in relation to this issue. The environment is clean and tidy throughout and is homely and well maintained. Cherry Tree Nursing Home Version 1.10 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29, 30. The Home has a recruitment procedure in place, which is in line with Schedule 2 and Standard 29, all relevant security checks are undertaken to ensure the protection of Service Users. Staff training is in place to support Staff in meeting Service Users needs. EVIDENCE: Recent recruitment files were inspected and found to be in line with schedule two and standard 29. The Home have now met Requirement 6 of the September 2004 inspection. Mandatory training for all staff has been taking place; twice-yearly fire training has been undertaken facilitated by an outside agency. All Nurses have attended First Aid training with twelve carers also holding a valid First Aid Certificate. Moving and Handling is up-to-date with the Manager holding a Moving and Handling trainer qualification. Training for night staff has now been up-dated in line with Requirement 7 of the September 2004 inspection report, in addition the night Sister is now an NVQ Assessor. Food Hygiene training is almost completed with only two staff outstanding. The Manager has delegated the planning of training to a Senior Carer who is successfully coordinating mandatory training for staff. The Inspector wishes to take the opportunity to remind Nurses it is their professional responsibility to ensure they keep themselves up-to-date with changes in professional guidance and take responsibility for their own Cherry Tree Nursing Home Version 1.10 Page 19 professional development, this can be maintained by reading articles and accessing information made available by the Department of Health. The Home is working towards reaching its 50 ratio of NVQ trained staff, presently two night carers are working towards their NVQ 2, and three day carers are also working towards NVQ 2. One carer has recently completed NVQ 2, two staff are working towards their NVQ 3 and one member of staff is working towards NVQ 3 and the Assessors Award. The Manager and night sister are also NVQ Assessors. The Home is staffed by suitably qualified Nurses and Carers to ensure the needs of Service Users are met. Shift patterns have recently been changed to ensure there are adequate numbers of staff in the Home during the heavier working times such as between 7am and 8am. Cherry Tree Nursing Home Version 1.10 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 37. The Manager has the necessary skills and training for her role, to ensure practice in the Home is in the best interest of Service Users. Individual records were up-to-date and stored appropriately, ensuring the Home are safeguarding Service User information and working within guidance of the Data Protection Act 1998. EVIDENCE: The Manager has now completed her RMA, once her assessor has checked through her portfolio it will be submitted for verification. Until such time as this has been achieved the Home are unable to fully meet this standard, however this is not a reflection of the Management of the Home. The Manager is to be congratulated for her dedication in completing her RMA. The Manager has been in post for one year and in this time has worked hard to ensure the Home is working within current guidance and the Care Standards Cherry Tree Nursing Home Version 1.10 Page 21 Act 2000. The meeting of requirements set in the September 2004 inspection report is further evidence of her commitment and understanding of her role. All records held in relation to Service Users are held in secure facilities with confidentiality maintained. Records were found to be up-to-date and relevant to the individual needs of Service Users, further work necessary to ensure the development of these records has been reflected in this report. The Home ensures the Health and Safety of Service Users, Staff and Visitors to the Home, working within current guidance. This standard was not fully assessed during this inspection and will be addressed further in the next unannounced inspection. Records for fire safety were assessed and found to be up-to-date. Accident/incident reporting forms were assessed and found to be in line with current guidance. There was minimal falls reported in the past twelve months with risk assessment and plans of action put in place in response to any reported incidents. Thermostatic valves have been fitted to hot water outlets and a programme to cover radiators in communal areas is in place. Cherry Tree Nursing Home Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 x 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 2 3 x x x x 3 x Cherry Tree Nursing Home Version 1.10 Page 23 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 9 Regulation 13 (2) Requirement Dates of opening are written on all bottles, creams and tubes to ensure no out of date medication is administered. All medication (including Senna and Lactulose) is administered from the container prescribed for the individual. Additional storage facilities will need to be provided to support this change in practice. Timescale for action 12/7/05 2. 9 13 (2) 12/10/05 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 7 Good Practice Recommendations All pressure Wound risk assessments that are subject to a change in score on review are written on a new assessment form with the previous form stored in the Careplan for reference. The Inspector recommends the systematic transfer of all Careplans written on the older format to the new paperwork continues during review to ensure continuity of record keeping. 2. 7 Cherry Tree Nursing Home Version 1.10 Page 24 Commission for Social Care Inspection Cambridge House, 8 Bell Business Park, Smeaton Close, Aylesbury Buckinghamshire HP19 8JR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cherry Tree Nursing Home Version 1.10 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!