Inspection on 17/01/07 for Chestnuts Nursing & Residential Care Home (The)

This inspection was carried out on 17th January 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.

Other inspections for this house

Chestnuts Nursing & Residential... 09/10/07

Chestnuts Nursing & Residential... 11/05/06

Chestnuts Nursing & Residential... 21/02/06

Chestnuts Nursing & Residential... 22/08/05

Chestnuts Nursing & Residential... 01/02/05

Chestnuts Nursing & Residential... 23/07/04

Chestnuts Nursing & Residential... 14/01/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Chestnuts Nursing & Residential Care Home (The) 63 Cambridge Park Wanstead London E11 2PR Lead Inspector Ms Gwen Lording Key Unannounced Inspection 09:30 17th January 2007 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 DS0000025950.V321699.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. DS0000025950.V321699.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chestnuts Nursing & Residential Care Home (The) 63 Cambridge Park Wanstead London E11 2PR Address 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) 0208 989 3519 0208 530 6211 thechestnutscarehome@yahoo.co.uk Ms Avril Stein Not currently registered Care Home 51 Category(ies) of Old age, not falling within any other category registration, with number (45), Physical disability (6) of places DS0000025950.V321699.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service can only admit people in the category of PD (Physical disability) who are 55 years of age and above. 26th July 2006 Date of last inspection Brief Description of the Service: The Chestnuts is a care home registered to provide accommodation with personal care and nursing for up to fifty-one residents, including six places for residents over 55 years who have a physical disability. The registered provider is the sole proprietor. The large property is situated in its own grounds with a large secluded garden to the rear. The majority of rooms are single and all have en suite facilities. There are two passenger lifts, with access to all floors. The home is set well back on a busy main road in Wanstead, in the London Borough of Redbridge. The home is well served by public transport and close to shops and other local amenities. On the day of the inspection the range of fees for the home was between £435.00 and £800.00 per week. A copy of the Statement of Purpose and Service User Guide to the home is made available to both the resident and the family. There is a copy of the guide in each bedroom and is also provided on request. DS0000025950.V321699.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken by two inspectors, namely the lead inspector Gwen Lording and Sandra Parnell Hopkinson. It started at 9.30am and took place over six and a half hours. The recently appointed manager was available throughout the visit to aid the inspection process. This was a key inspection visit in the inspection programme for 2006/2007. Discussion took place with the recently appointed manager, several members of nursing and care staff, the head cook, maintenance person, administrative staff, laundry person and activities co-ordinators. Nursing, care staff and activities co-ordinators were asked about the care that residents receive, and were also observed carrying out their duties. The inspectors spoke to a number of residents and relatives. Where possible residents were asked to give their views on the service and their experience of living in the home. Questionnaires were sent out to a random sample of residents, relatives, members of staff and care managers/ placing authorities. A very high number of questionnaires were returned by residents, staff and relatives. However, ten questionnaires were sent to care managers/ placing authorities and only two returned, which is a disappointing response. The response from residents and relatives was that they were very satisfied with the care being provided, and that staff were kind, caring and supportive. A tour of the premises, including the laundry and the kitchen, was undertaken and all rooms were clean and tidy with no offensive odours. A random sample of residents’ files were case tracked, together with the examination of other staff and home records, including medication administration, staff rotas, training schedules, activity programmes, maintenance records, menus, complaints, fire safety, accident/ incident records and staff recruitment procedures and files. Information was also taken from a pre-inspection questionnaire, which was completed and returned. At the end of the visit the inspectors were able to feedback to the manager and the home’s proprietor, Ms Avril Stein. The inspectors would like to thank the staff and residents for their input and assistance during the inspection. DS0000025950.V321699.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: Whilst care planning has improved, further development is needed to ensure that care plans provide staff with up to date information about residents day to day care needs. DS0000025950.V321699.R01.S.doc Version 5.2 Page 7 Where food intake charts are indicated, staff must record the amount of food intake as well as the type. This detail of recording will ensure that an accurate record is being maintained of nutrition. 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. DS0000025950.V321699.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 DS0000025950.V321699.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): Standards 1, 2, 3, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Comprehensive assessments are being undertaken for all residents prior to them moving into the home. Care Plans are drawn up from the information in this assessment, ensuring that the needs of the residents are identified, understood and met. The home does not offer intermediate care. EVIDENCE: Individual records are kept for each residents and a total of six files were examined. All records inspected have assessment information recorded and the information had been used to continue assessment following admission to the home, and develop written care plans. The records showed that residents, where capable and their relatives are involved in the assessment process. The DS0000025950.V321699.R01.S.doc Version 5.2 Page 10 inspectors were satisfied that a full assessment of need is undertaken prior to residents moving into the home, and that the manager would not admit a new residents unless she was sure that the assessed needs could be met. Prospective residents and their relatives/ representatives are provided with information about the home and there is always the opportunity to visit the home prior to making any decision to move in. At the last inspection a requirement was made that each resident be provided with a statement of the terms and conditions of placement at Chestnuts. Through discussion with the manager it was evident that this is being effected for all new residents with a gradual implementation for all residents. The Care Homes Regulations 2001 have been amended with effect from the 1st September 2006, for new residents, and for existing residents with effect from the 1st October 2006, so that more comprehensive information is to be included in the service users’ guide. Details of information to be included are contained within the amended regulations. Therefore, the service user guide must be reviewed and amended by the stated timescales. The manager was also provided with a copy of the Commission’s ‘Policy and Guidance on Provision of Fees Information by Care Homes’. DS0000025950.V321699.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): Standards 7, 8, 9, 10 & 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health, personal and social care needs are set out in individual care plans and a significant improvement was noted in the standard of care plans. However, care plans require further development to ensure that they provide staff with up to date information about residents care, to ensure that care needs are being understood and met on a daily basis. EVIDENCE: The style of care plan in current use is a standardised format, which is then individualised to address the specific elements of an individuals care. The inspectors noted a significant improvement in the standard of care planning since the last inspection. However, the manager is planning to change the care planning documentation so that all members of staff regard the care plan as a working tool, which they understand and work to. Individual care plans were available for each resident and a total of six residents were case tracked and their care plans and related documentation DS0000025950.V321699.R01.S.doc Version 5.2 Page 12 inspected. Care plans were found to be generally detailed, with monthly reviews being undertaken. Risk assessments are being routinely undertaken on admission around nutrition, manual handling, continence, risk of falls and pressure sore prevention; and are being reviewed on a regular basis. There was evidence that allergies were being recorded on the initial documentation, but that this information was not always being transcribed onto later documentation. The nurses must ensure that such information is always transcribed accurately to ensure that full information is always available on all documents relating to a resident. Residents were being weighed on admission and then generally on a monthly basis with fluctuations in weight being monitored. However, in the case of one resident it had not been possible to weigh this person for two months but there was no plan in place regarding the nutritional monitoring. It is important in such cases to ensure that records are being maintained regarding fluid and dietary intake in case of possible dehydration or weight loss. The documentation/ health records relating to wound management; catheter care; the management of a resident with insulin dependant diabetes; and the most recently admitted resident, were again found to be generally detailed; adequately maintained; and of an improved standard since the last inspection. Two of the residents who were case tracked were diabetics, and it was evident from their files that care plans around the management and treatment of the diabetes were in place and being followed by the nurses and care staff. However, one of these residents has to privately purchase the services of a chiropodist because there is a long waiting list for a National Health Service chiropodist. This resident was seen by the diabetes nurse on the 8th January 2007. The care plan of one resident recorded that he had an indwelling catheter. However, through case tracking it was evident that the catheter had been removed some months earlier. Whilst the daily notes and evaluation recorded this information the initial care plan did not. In such cases the care plan must be re-stated so as to provide up to date information about an individuals care needs. Files evidenced involvement from health care professionals including, tissue viability nurse specialist, dietician, diabetic nurse specialist; dental optical and chiropody services. The tissue viability nurse had visited the home on the 16th January 2007 to review the care plans for those residents who had pressure sores. Monitoring charts such as fluid intake/ output; turning regimes and blood sugar monitoring, were up to date and being adequately maintained. Food intake charts are maintained where necessary however, staff must record the DS0000025950.V321699.R01.S.doc Version 5.2 Page 13 amount of food intake as well as the type of food. For example, entries included “porridge, soup, sandwich”. The amount of food taken by the resident must be clearly recorded for example, two tablespoons; large bowl; size and number of sandwiches. The detail of this recording will ensure that an accurate record is being maintained of nutrition. There was no evidence in the files of ‘End of Life’ care plans and the importance of developing these was discussed with the manager, during the inspection. However, from discussions with the manager and staff it was apparent that staff dealt with a person’s dying and death in a sensitive and understanding manner, both for the individual and relatives. The development of ‘night ‘ care plans was also discussed with the manager and it was evident that the new care planning system will identify and detail such specific choices as the time a resident wishes to go to bed; number of pillows; have their light turned off; low light left on all night; and preferred night time drink. There are policies and procedures for the handling and recording of medicines. An audit was undertaken of the management of medicines within the home and a random sample of Medication Administration record (MAR) charts were examined. Discussions with staff and the review of medication records show that staff are following policies and procedures, so as to ensure that residents are safeguarded with regard to medication. As oxygen is being stored in the treatment room a warning sign must be displayed on the door to indicate as such. The manager was given a copy of the Medical Advice Alert (MDA/2006/066) issued by the Medicines and Healthcare Products Regulatory Agency (MHRA) on Lancing Devices used in nursing and care homes for blood glucose monitoring. She confirmed that she had already received a copy of this alert and had taken the appropriate action. Staff talked about and were observed to treat residents in a respectful and sensitive manner. They were seen to be very gentle when undertaking moving and handling tasks and offered explanation and reassurance throughout the activity. DS0000025950.V321699.R01.S.doc Version 5.2 Page 14 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): Standards 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. The lifestyle within the home matches the preferences of residents with regard to social, cultural, religious and recreational interests and needs. The attitude and practice of the service and that of the staff working in the home, promote opportunities for residents to remain independent, exercise choice and express their wishes and needs. The nutritional needs of the residents are well considered so that food and mealtimes are seen as being important for all residents. EVIDENCE: Following observations, discussions with some service users, the two activities co-ordinators and the manager, the inspectors were satisfied that service users do have individual care plans around activities. Some of these activities are individual and some group, and care staff are also now more involved in undertaking some activities with residents, such as sitting and talking to them, or reading a newspaper with them. During the inspection some of the residents were taking part in a quiz. DS0000025950.V321699.R01.S.doc Version 5.2 Page 15 Privately purchased massage is available from an external provider and some service users do take advantage of this. A hairdresser also visits the home on a regular basis, and she was visiting on the day of the inspection much to the delight of many of the residents. One resident spoken to by the inspector said: “I am waiting for the hairdresser to come and get me because I really enjoy having my hair done, it makes me feel so much better.” Residents are encouraged to maintain contact with family and friends, and both the manager and the activities co-ordinators are clear that residents will be encouraged to build and maintain community contacts. Books are available within the home and these are on loan from the local library. The majority of residents are white British and of a Christian persuasion and religious services take place within the home. However, some of the residents are Jewish and the proprietor ensures that they participate in the traditional Friday evening service (Shabbat) in preparation for the Sabbath. Another resident is Muslim and again arrangements are in place to ensure that she is able to visit a mosque, and a carer has been allocated as her key worker who speaks the same language and is also a Muslim. Two of the communal areas have been re-designated as dining rooms and this has made the participation in meals more congenial for those residents who choose to use them. Tables were seen to be being nicely laid with tablecloths, cruets and cutlery. It was evident during the inspection that residents had easy and frequent access to drinks, and those residents that needed assistance were being given this by care staff. There are four meals a day, but drinks and snacks are available throughout the day: Breakfast – from 8a.m. Lunch – from 12.30p.m. Tea – from 5.30p.m. Supper – from 9p.m. From discussions with the cook, from a visit to the kitchen, viewing the menus and conversations with some residents, the inspectors were satisfied that the residents receive a varied, appealing wholesome and nutritious diet which is suited to individual requirements. For instance Kosher and Halal foods are available for those residents who require this. Fruit platters are prepared daily for the residents, and they do seem to enjoy this. One resident said: “the puddings are always good, and the custard is lovely.” Another said: “I really enjoy my breakfast”, and another said: “I have put on weight DS0000025950.V321699.R01.S.doc Version 5.2 Page 16 since living here.” Custards, porridge and milk drinks are now made with full cream milk, and hopefully this together with a varied and nutritious diet will reduce the need for additional nutritional supplements such as Ensure. The cook is also aware of the birthday of each resident and makes sure that there is always a celebration cake. Residents are encouraged to personalise their bedrooms, and many of the residents had chosen to do this. On visiting residents in their bedrooms the inspectors were reassured to note that all had their call alarms within easy reach. DS0000025950.V321699.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and staff make very effort to sort out any problems or concerns and makes sure that residents and their relatives feel confident that their complaints and concerns will be listened to and acted upon. Staff working in the home have received training in adult protection/ abuse awareness to ensure that there is a proper response to any suspicion or allegation of abuse. EVIDENCE: At the last inspection a requirement was made for all concerns or complaints, however made, to be accurately recorded together with the action taken. The home’s complaints log was inspected and it indicated the number of complaints and issues of concern received since the last inspection and included details of investigation, action taken to resolve them and the outcome for the complainant. This included all concerns and complaints made in writing, as well as verbally. Those residents spoken to were aware of how to complain and to whom. The manager intends to review the complaints procedure and include staff training in awareness of the home’s procedure. In discussions with the manager, staff and from viewing training records it was evident that staff have received training in adult protection. The inspectors were talking to two staff members who both said: “We had adult protection DS0000025950.V321699.R01.S.doc Version 5.2 Page 18 training and it was really good, it has changed the way we work and look at things.” Since the last inspection there have not been any adult protection issues. DS0000025950.V321699.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 20, 24 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A significant improvement was noted generally in the standard of maintenance and cleanliness of the premises. The overall atmosphere in the home is welcoming and all areas of the home are clean and comfortable and provide residents with a safe and well-maintained environment. EVIDENCE: The building was toured by the inspectors, accompanied by the senior nurse in charge at the start of the visit, and all areas were visited later during the day. There were no offensive odours in the home, all areas of the home were found to be very clean and the new domestic/ maintenance regime is ensuring that The Chestnuts is now a safe and well-maintained environment. Some bedrooms were seen either by invitation of the residents, whilst others were seen because the doors were open or being cleaned. All of the bedrooms DS0000025950.V321699.R01.S.doc Version 5.2 Page 20 seen were personalised and were representative of the occupant’s interests. There is a call alarm system fitted to each bedroom, and is located within easy reach of each residents’ bed. Fire doors were closed and fire extinguishers were not obscured by items of furniture or hoists. There was a small lounge to the front of the building and this has been refurbished to provide an office for the registered manager. This now provides the manager with a well-equipped office, which will allow her to maintain a high profile within the home, for the benefit of residents, staff and visitors. There are now two dining rooms and three lounges, which are well furnished and maintained. The kitchen was very clean, food in the refrigerators was in date order and clearly labelled, as were the dry goods and fresh foods. The inspectors had no concerns with regard to the kitchen area. Sanitisers were located in each bedroom and these were filled with the necessary liquid. Hand washing facilities are prominently sited and staff were observed to be practising an adequate standard of hand hygiene. The rear garden was well maintained and the fishponds were clean and the fish visible. The laundry area was visited and this was found to be clean, with soiled articles, clothing and foul linen being appropriately stored, pending washing. The laundry person was aware of health and safety regulations with regard to handling and storage of chemicals. Personal Protective equipment (PPE) such as clothing, gloves, goggles and facemasks were available and in use. DS0000025950.V321699.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are satisfactory and there are sufficient staff on duty to meet the individual assessed needs of the residents. The procedures for the recruitment of staff are robust and provide safeguards for people living in the home. EVIDENCE: Staff rotas were inspected and the staffing level and skill mix of qualified nurses and care staff was sufficient to meet the assessed nursing and personal care needs of residents. Care workers were being effectively deployed to ensure that residents’ choosing, or needing to remain in their bedrooms were being cared for appropriately. Nursing staff were in evidence and observed to be supervising care staff. The new manager has undertaken a review of staffing levels and has the authority to use staffing levels flexibly according to the assessed needs and numbers of residents. Since the last inspection staff have received training in essential areas such as moving and handling, fire safety, adult protection and food hygiene. Other training undertaken includes, oral health and denture care, management of diabetes, nutrition, care of the dying and palliative care needs, and introduction to dementia. The new manager recognises the importance of a DS0000025950.V321699.R01.S.doc Version 5.2 Page 22 well developed and trained staff team and is committed to ensuring that all staff receive relevant training that is targeted and focussed on improving outcomes for residents. The pre-inspection questionnaire completed by the deputy manager states that 67 of care staff are qualified to NVQ level 2 or above. A random sample of the personnel files of the three most recently recruited staff were examined. These were found to be in good order with necessary references, Criminal Records Bureau (CRB) disclosures, and application forms duly completed. DS0000025950.V321699.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33, 35, 36, 37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The new manager of the home is a well qualified and experienced person and residents benefit as the home is run in their best interests. Monitoring visits are undertaken regularly by the proprietor of the home to monitor and report on the quality of the service being provided in the home. EVIDENCE: The manager has been in post for approximately two months and is currently progressing an application with the Commission to be registered as the manager. Ms Humphries is very well qualified and has extensive experience in both health and social care settings. She has previously been registered with the Commission as the manager of a care home and has a good understanding DS0000025950.V321699.R01.S.doc Version 5.2 Page 24 of the areas in which the home needs to improve and develop. She is keen to work in collaboration with external agencies and the Commission and is committed to further improve the quality of care for people living in the home. All staff spoken to throughout the visit, both care and departmental staff, spoke very positively about the manager and her open and inclusive style of management. Currently the manager does not act as an appointed agent for any resident. Residents’ financial affairs are managed by their relatives/ representatives. The home has responsibility for the personal allowance of several residents. There is a computerised financial system in place, which is managed by the home’s financial manager. Secure facilities are provided for the safekeeping of money and valuables held on resident’s behalf. The proprietor undertakes Regulation 26 monitoring visits on a monthly basis to monitor and report on the quality of the service being provided in the home. A copy of the report is sent to the Commission. The inspectors were able to speak to the maintenance person and to inspect the various maintenance records. All were up to date and in good order and it was evident that the fire alarms are tested on a regular basis and from different points within the home. Staff have undertaken fire safety training. The maintenance person was very well aware of the new fire regulations, which came into effect in October, 2006 and the fire risk assessment for the home has been undertaken. There is appropriate insurance in place for the lift, and recently a thorough examination of the lift was undertaken by the insurers in accordance with the Lifting Operating and Lifting Equipment Regulations 1998. DS0000025950.V321699.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 2 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 3 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 DS0000025950.V321699.R01.S.doc Version 5.2 Page 26 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. Standard OP7 OP8 OP11 Regulation 12 & 15 Requirement The registered persons must ensure that care plans provide staff with up to date information about residents care, to ensure that care needs are being understood and met on a daily basis, and include ‘End of Life’ choices. The registered persons must ensure that where food intake charts are being maintained, staff must record the amount as well as the type of food. For example, two tablespoons, large bowl, size and number of sandwiches. This detail of recording will ensure that an accurate record is being maintained of nutrition. The registered persons must ensure that when allergies are identified on a residents initial documentation, that such information is always transcribed accurately onto all other documentation. This will ensure that full information is always available on all documents relating to a resident. DS0000025950.V321699.R01.S.doc Timescale for action 28/02/07 2. OP8 12 17/01/07 3. OP7 OP8 12 & 15 17/01/07 Version 5.2 Page 27 4. OP9 13 The registered persons must ensure that where oxygen cylinders are being stored or in use, then a sign indicating such must be displayed 17/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000025950.V321699.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 DS0000025950.V321699.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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