Inspection on 26/02/07 for Chichester Court Nursing Home

This inspection was carried out on 26th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Chichester Court Nursing Home 25/11/08

Chichester Court Nursing Home 25/03/08

Chichester Court Nursing Home 22/08/06

Chichester Court Nursing Home 14/12/05

Chichester Court Nursing Home 20/07/05

Chichester Court Nursing Home 22/02/05

Chichester Court Nursing Home 09/08/04

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOMES FOR OLDER PEOPLE Chichester Court Nursing Home Chichester Road South Shields Tyne And Wear NE33 4HE Lead Inspector Irene Bowater Key Unannounced Inspection 09:00 26 February & 1st March 2007 th 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 Chichester Court Nursing Home DS0000000272.V328754.R02.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. Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chichester Court Nursing Home Address Chichester Road South Shields Tyne And Wear NE33 4HE 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) 0191 454 5882 0191 454 6455 chichester.court@fshc.co.uk Grandcross Limited(wholly owned subsidiary of Four Seasons Health Care Ltd) Ms Heather Reid Care Home 52 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (52), of places Physical disability (15) Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 22nd August 2006 Brief Description of the Service: Chichester Court Nursing Home was purpose designed and built in 1997. It is registered to accommodate up to 52 older people with personal care and nursing needs. The building is single storey with wide corridors and doors providing good access for people with mobility difficulties, or wheelchair users. All bedrooms have en-suite toilet facilities. A variety of lounges and sitting areas are available, also two dining rooms, and two internal courtyards that provide outdoor seating areas. An additional, paved outdoor seating area is provided at the top end of the home. The home is located close to public transport facilities including the Metro railway system, and buses, and is within easy reach of local shops and amenities, and the town centre. Local parks and the seacoast are approximately two miles away. Fee rates vary as follows : Local Authority rates vary from £349 with the free nursing care contribution added. That contribution is set nationally. Private fee rates for personal and social care is £420. Private nursing care fees are £460 with the free nursing care contribution added. Toiletries, hairdressing, chiropody, clothing, newspapers and magazines are not included in fee rates. Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit took one and a half days to complete and was carried out by one Inspector. Work was carried out before and after the visit to make up the key unannounced inspection. The last key inspection took place in August 2006 and a random inspection was completed in June 2006. These inspections were carried out to see what improvements had been made following recent complaints and safeguarding adult meetings, and the last visits made by the Commission. During the site visits the inspector looked around and talked to residents and staff, and saw the contact between them. Time was also spent checking the cleanliness, maintenance and decoration of the home. The inspector also joined the residents for lunch. The registered manager helped throughout the site visit and time was spent with her discussing the management and development of the care and services in the home. A number of records were looked at including, care plans, training, maintenance, catering, medication, financial, recruitment, health and safety, and complaint records. What the service does well: The home is nicely decorated, fresh smelling and comfortable. The residents have brought some small items with them making their own bedrooms individualised and homely. Information about the home, advocacy and events are readily available in the reception entrance. Visitors are made welcome and there are links with the local community. Relatives said they could visit at any time. The recruitment procedures are properly followed which help prevent risk to residents by making sure that the right checks are carried out before starting work. Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 6 What has improved since the last inspection? The manager is now registered with the Commission and she has worked hard with the staff team and other professionals to improve the service. Systems have been put in place to improve care plans. Further work is needed on them so that they are clear and detailed about the care provided. Staff are making sure that they respect residents’ rights to privacy and dignity. Care was given discreetly and with sensitivity. Residents said the food was “much better”. The quality, choices and availability of meals have improved with records of likes and dislikes kept. A programme of activities has been developed so that residents can enjoy social and leisure events that meet their individual needs. Relatives said they could see how the home had improved over recent months. Staff team. have received some training and are starting to work together in a Quality assurance and quality monitoring systems have been introduced, to promote and improve the quality of the service offered to residents. Staff have a new handbook which tells them what the Company expects from them in their role and outlines their terms and conditions. This includes a section about ‘equality and diversity’. Six requirements from the last inspection have been met within the given timescales. What they could do better: The current registered manager is leaving soon. Staff, residents’ and relatives are worried that the improvements made to the care and service will “drop”. The Provider needs to recruit a suitably experienced manager as soon as possible. There are broad ranging assessments available for staff to use before admission, however the staff in the home are not using them properly. Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 7 Staff need to complete risk assessments and initial care plans in detail and include information about previous lifestyles, religion/beliefs, sexuality and disability. Further work is needed on the care plans so that they are clear and detailed about the care provided. Residents and their representatives need to be involved in the writing of care plans. Staff must make sure that all medicines are given before the expiry dates are reached. The bathroom and toilets are showing signs of wear and tear and need to be updated as part of the planned programme. The staff need to make sure they follow infection control guidance at all times. All staff must receive up to date training in safe working practices and receive specialist training to make sure they can improve the care given to residents. A review of how residents can access their own money at any time needs to put in place. Health and safety procedures need to be followed at all times. The registered persons must make sure all requirements in the report are dealt within specified timescales. 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. Chichester Court Nursing Home DS0000000272.V328754.R02.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 Chichester Court Nursing Home DS0000000272.V328754.R02.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): 3, Standard 6 is not applicable. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to the service. Pre admission assessments are carried out before admission. However this information is not always developed into a care plan. Residents holistic care needs therefore may not always be met. EVIDENCE: Before moving into the home residents have an assessment of need, which is completed by, care managers, nurse assessors and the home manager. Should the resident be privately funded the home manager uses the Company’s’ assessment tools. The Company have introduced a new assessment document. The document when completed in detail will show what a residents assessed needs are and how the staff should meet individual needs based on a “person centred approach” to care. Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 10 Care plans showed that the assessments and recorded information have not led to completed risk assessments or a care plan. One resident who was admitted two weeks ago had none of the assessments completed in detail. Social care plans were incomplete and nutritional assessments and weights were not done. There was limited information how to move and assist residents and pressure sore risk assessments were incomplete. In all care plans information about previous lifestyles; current social preferences, ethnic origin and wishes at the end stage of life were incomplete. None of the assessments were dated or signed by the author. Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care planning documentation is comprehensive and person centred. However, lack of recorded detail prevents the system from being fully effective. This means that residents’ needs may not be recognised and fully met. The health needs of residents are being met. The systems for the administration of medicines are not sufficiently robust to ensure resident’s wellbeing is fully met. Personal support is currently promoting residents rights to privacy and dignity. EVIDENCE: Each resident has a plan of care. The plan is based on preadmission assessments carried out by care managers, the home manager and when necessary the nurse assessor. Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 12 Additional assessment tools are kept with the plan and include pressure sore risk assessments, dependency, moving and handling, nutritional assessments using the Malnutrition Universal Screening Tool (MUST), continence and fall risk assessments. These tools are to help the staff decide what level of risk the resident has about all aspects of their care. The risk level is numerical so it is not always clear from the assessment information whether the score means the risk is high, medium or low. Although there has been some improvement in the record keeping there remains evidence of incomplete risk assessments, weights not done, pressure sore care plans not regularly up dated and recommendations from the Speech and Language specialists not recorded into a care plan. Short-term care plans for a resident who had a chest infection and a resident who was in considerable pain were not available. As the staff have not completed the initial care plans using the information from the manager, nurse assessors and care managers the long-term care plans are incomplete. In many instances the care plans are not dated or signed. A weekly record of social events and activities is available in each care plan, however none of the residents has a social plan of care. Staff are still writing comments such as “dressing renewed”, “attention seeking behaviour”, “progress continues”, and “needs attended to”. These comments do not demonstrate how staff have assisted and supported residents in their daily lives. The residents have access to all NHS facilities to ensure their healthcare needs are met. There are regular visits from GP’s and other health professionals including, opticians and chiropody services. Several of the residents have air cell mattresses and cushions to prevent pressure damage. Advice is gained from other professional such as tissue viability specialists, speech therapists and continence advisors. Visits from the multi disciplinary team are clearly recorded in individual care plans. The home has medication policies and procedures for staff to use. Records are in place for all medicines received, administered and disposed of. An audit of Controlled Drugs and the Medicine Administration Records (M.A.R.) showed no discrepancies. The treatment room was clean, tidy and medicines were safely stored. Calogen, which was being stored in the drug fridge, was still being used after the expiry date. The qualified nurse took the bottles out of use immediately. Handwritten directions on the Medicine Administration Records did not have two signatures. The treatment room was very warm and the room temperature should continue to be recorded to make sure a temperature of 25 C is not exceeded. Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 13 Residents spoken to felt that they are treated with respect and their right to privacy is upheld. Residents spoke about their personal wishes and preferences, which are respected by staff. Examples include locking their bedroom doors, knocking on doors and waiting for permission before entering, receiving their mail unopened and being addressed by their preferred name. Staff knew how to care for individual residents and the relationships were friendly and professional. Residents said, “they are good”, “I am looked after”, “I have everything I need they always help me.” Relatives spoken to were generally satisfied with the improvements in the care provision in the home. Their main concern at the present time was that the manager was leaving and they felt that the improvements would not be maintained. Chichester Court Nursing Home DS0000000272.V328754.R02.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): 12,13,14,15 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to the service. A range of social activities are provided which offer stimulation and interest for residents living in the home. Support from relatives and representatives provide residents with good opportunities to maintain their previous lifestyles. Residents are well supported to make choices and take control over their lives. Dietary needs of residents are well catered for with a balance of food available that meets residents’ needs. EVIDENCE: The home has an activities organiser and activities are planned on a four-week programme. There is also pictorial evidence of events that have taken place both inside and out of the home. Activities include armchair aerobics, sing-alongs, cake making, musical bingo, video afternoons, and board games. Once a week a relative has a reading afternoon. Residents can catch up on local and national news and listen to poetry. Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 15 On the first day of inspection the residents and relatives enjoyed a cheese and wine afternoon. A bric-a-brac stall was set up and residents enjoyed buying small items or just browsed. Visitors said that they are always welcomed in the home and can share in the care of their relatives. Residents have been encouraged to bring small items of furniture and other belongings with them, making their rooms individualised and reflective of their lifestyles. They are encouraged to take responsibility for their own financial affairs for as long as possible. Information about advocacy is available in the home. There are two dining rooms for residents to use. Both were pleasantly decorated and tables set appropriately for all meals. There were choices of cereals, cooked breakfast, toast, jams, fruit juices and hot drinks for breakfast. Several of the residents had breakfast served to them in their rooms. Midmorning drinks and biscuits were served to all residents. Residents could choose from mince pie or chicken kiev, chips and peas. Dessert choices were spotted dick and custard, yoghurts, fresh fruit and banana and custard. Hot and cold drinks were readily available throughout the meal. Alternatives were available for residents who need specialist diets. One resident who needs to have the meals pureed often refuses to eat, as they look unappetising. Both the cook and the manager are trying different methods of presentation and have involved dieticians in the process. The meals are still served from a “hot lock” by the kitchen staff which limits choice for residents. The inspector joined the residents for the lunchtime meal, which was nicely presented, hot and tasty. Staff were attentive to all of the residents needs and gave assistance in a discreet sensitive manner. Residents said that the “meals are nice”, I get plenty to eat” and “the food has improved a lot”. Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to the service. The complaints procedures are clear. Residents and relatives are now confident that their views are listened to and acted upon. Clear protection procedures are in place to protect service users from risk of harm. But formal training has not yet been given to all staff at the home which may mean that staff don’t recognise when to raise an alert. EVIDENCE: The Company has comprehensive complaints policies and procedures in place; these are readily available throughout the home. Residents said they would be able to make complaints if they needed to. Relatives said that the manager was always available and they would be comfortable approaching her with any concerns that they had. There have been two recorded complaints since the last inspection of September 2006.These have been dealt with appropriately at home level. Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 17 Not all of the staff have received up to date formal training in Protection of Vulnerable Adults. Training records show that this is ongoing with South Tyneside. Staff were able to discuss the steps they would take should there be any allegation or suspicion of abuse. One Protection of Vulnerable Adults investigation has reopened. The staff handbook sets out what steps to take if raising concerns under the Public Interest Disclosure Act and whistle blowing. Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides a nicely decorated, comfortable environment for residents to live in. There are infection control and safety issues, which potentially place residents at risk. EVIDENCE: The home is a single storey purpose built home, which is close to all local facilities and the sea front. There are several lounges and two dining rooms, which are close to all residents’ bedrooms. Inner courtyards offer safe external areas, which are well maintained with seats, and shrubs. Residents and relatives said this was a lovely area to sit in the warmer weather. Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 19 The home is nicely decorated and furnished and it has an ongoing redecoration and refurbishment programme. All of the bedrooms have an en-suite facility and there are sufficient bathrooms and toilets close to all communal areas. The manager said that one of the bathing areas was to be changed into a store area. This would reduce the required numbers of bathrooms needed in the home and the manager was told this could not happen. Some refurbishment is needed to the shower and bathing facilities in the home: ● the shower room flooring next to toilet 4 is stained with a cracked tile and the grouting discoloured. ● one shower room is being used as a storeroom ● various incontinence aids, garden furniture, chair cushions, wheelchair footrests and the bath sides have been damaged by the hoist in the bathroom opposite room 28 ● the shower room was used to store personal toiletries, a rusty commode/shower chair. The flooring was marked and the tiles were mouldy and discoloured. The laundry was locked and separate from residents’ areas. It was generally clean and organised. The dirty utility room remains full of equipment and there was no clear access to the disposal unit .The clinical waste bin had no lid and not all areas had liquid hand soap. Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome is adequate. This judgement has been made from evidence gathered both during and before the visit to the service. The current staffing levels ensures the residents’ needs are met. Training opportunities are well planned but not all staff have received up to date mandatory training to make sure they have the competence to care for the residents needs. The residents are kept safe and supported by comprehensive recruitment procedures, which prevent unsuitable people from working in the home. EVIDENCE: On the day of the site visit there were thirty-one residents who needed nursing care and nine residents who have social and personal care needs. The district nursing services will provide nursing care to these residents if necessary. On the day of inspection there were two qualified nurses and six care staff on duty. The numbers of care staff reduce to five in the afternoon and evening. Overnight there is one qualified nurse and three care staff on duty. The manager is supernumerary to make sure that there is a consistent care and general management provision. Ancillary staff include domestic, laundress, administrator, maintenance, chef, kitchen assistants and activity organiser. There are plans to increase the number of senior care staff in the home. Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 21 Relatives said that there had been some improvements in the staffing, but still felt that at times they could not find anyone. This could be due to the open layout of the home or that staff are busy in residents’ rooms. However, the manager is aware that staffing levels need to be regularly reviewed and staffing changed should residents’ dependency levels increase. Relatives also voiced concerns that again there were to be a change in manager. They said that they were worried that the improvements in the care would “drop” and that other staff would leave. They were worried that there would be vacancies and use of agency staff, which would spoil the hard work being done in the home. Since the last key inspection the manager has produced an improvement plan which sets out how and when issues will be put right and the regularly reviewed. The staff are completing NVQ level 2 training. However the 50 target has not been reached. Recruitment procedures are followed to minimise the risks to residents by ensuring proper checks are carried out. There was evidence of completed application forms, two written references, Criminal Record Bureau checks and proof of identity. Personal Identification Numbers (P.I.N.) numbers of qualified nurses are checked with the Nursing and Midwifery Council to make sure nurses are registered. Staff are now given a “Staff Handbook” which covers all aspects of employment matters and care practice. It also covers areas of equality and diversity and valuing that everyone has a contribution to bring to the home. Staff have yet to receive formal training although “new” staff receive training throughout their induction. The induction training is over twelve weeks and follows the “Common Induction Standards” from Skills for Care. Following a training needs analysis the manager has produced a training matrix, which shows what individual training has taken place. It also shows what future training is needed for the staff team. There is evidence that some staff have completed mandatory training, however moving and handling and Safeguarding Adults training is behind renewal timescales. The Company have carried out training for staff in the home. Training includes, customer care, care planning and a “person centred approach to care”. There are areas such as record keeping and specialist training which still need to be addressed. Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is adequate. This judgment has been made from evidence gathered both during and before the visit to this service. The current manager is well qualified to run the home and provides direction and leadership to staff. This has resulted in general improvements in the quality of care residents receive. The systems for consultation and quality monitoring to improve the service are now in place, with evidence that views of residents and their representatives are being sought. Residents personal accounts are safeguarded, however they do not have access to individual accounts and their money at all times. Some health and safety practices carried out do not fully promote and safeguard the health, safety and welfare of the people living there. Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 23 EVIDENCE: Since the last inspection the manager has become registered with the Commission. She is a qualified first level nurse who has considerable experience working with older people. She is very aware of the issues raised in the last inspection report and has worked hard to improve the quality of life for the residents who live in the home. Relatives said that she is approachable and “everything has started to improve” in the home. Staff said that they can talk to her and she listened to their concerns. Residents, staff and relatives were concerned that she had decided to leave and the main concern was when a new manager would start and what would happen then. Relatives said there had been many managers and it would be good to have someone who stayed and continued to improve the home. Relative resident and staff meetings are being held with minutes recorded. The Company has put a quality monitoring system in place and the results are collated nationally. In house audits regularly take place. These include education and training, medication, care plans, kitchen and health and safety audits. All residents have an individual balance record that is reconciled every week if any transactions have taken place. Monies are held in one joint non- interest making account. This should be reviewed as some banks are now offering individual account facilities so that residents will then be able to gain interest on their money. The home holds an appropriate float and two staff signatures; receipts are available for all transactions. Staff supervision has started and progress is being made to complete the records so that the member of staff and the line manager are clear about the ethos of the home, training and individual career development. A fire risk assessment is available and updated in November 2006. Staff receive regular statutory updates. The fire logbook is completed on a weekly basis. Staff need to sign that they have completed fire drills. The fire officer competed an inspection of the home in February 2007. Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 24 Regular health and safety checks are carried out including checks on water temperatures, and in house health and safety. These records need to be signed and dated. Not all bathrooms and shower rooms had access to bath thermometers. The accident recording was being appropriately documented with monthly analysis being completed. The analysis tracks trends to produce an action plan to reduce further risks if possible. External maintenance certificates are up to date. The kitchen was generally organised and the staff are using “Safer Food Better Business” guidance. The extractor fans and the deep fat fryer are ready for deep cleaning and the shelves in the fridge cannot be cleaned properly as the plastic is missing. All staff need further training in health and safety including moving and handling and first aid. Chichester Court Nursing Home DS0000000272.V328754.R02.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 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X 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 2 3 X 2 X X X X 2 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 2 X 2 Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 26 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 OP3 Regulation 14,15 Requirement The registered persons must ensure that the preadmission information is formulated into a comprehensive care plan. The registered persons must ensure that the care plans set out in detail the action which needs to be taken by staff to ensure that all aspects of the health, personal and social care needs of residents are met. Timescales of 30/09/06 not met The registered persons must ensure that all risk assessments are completed in detail. The care plans must be reviewed at least monthly and updated to reflect changing needs and current objectives for health and personal care. All entries must be dated and signed. The registered persons must ensure that all medication is used within the expiry date. The registered persons must ensure that staff receive Safeguarding Adults training DS0000000272.V328754.R02.S.doc Timescale for action 30/04/07 2 OP7 15 30/04/07 3 OP7 13,15 30/04/07 4 5 OP9 OP18 13(2) 13(6) 01/04/07 01/09/07 Chichester Court Nursing Home Version 5.2 Page 27 6 OP26 12,13 7 8 OP28 OP30 18 18 9 OP35 12,20 10 OP36 18 11 OP38 18(1) 13(40) 23(4) 12 OP38 13 13 OP38 13 Timescale of 30/09/06 not met The registered persons must ensure that the utility room is cleaned and staff have access to the disposal unit. The clinical waste bins must have suitable lids. Liquid soap must be provided in all resident areas to allow effective hand washing. The registered persons must ensure that staff continue to receive training to NVQ level 2. The registered persons must ensure that the staff receive specialist training to meet the residents assessed needs. The registered persons must ensure residents are enabled to open their own bank accounts and have full access to their money. The registered persons must ensure that all staff receive formal supervision at least 6 times a year with records kept. The registered persons must ensure that all staff receive up to date safe working practices training. Staff must sign to confirm that they have completed fire training. Moving and handling training must be completed for all staff. The registered persons must ensure that there are bath thermometers in every bathing area. The registered persons must ensure that the deep fat fryer and the extractors in the kitchen are deep cleaned. The rusty shelving in the fridge must be replaced. 30/04/07 01/12/07 01/09/07 01/09/07 01/09/07 01/09/07 01/04/07 01/04/07 Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 28 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 Chichester Court Nursing Home DS0000000272.V328754.R02.S.doc Version 5.2 Page 29 Commission for Social Care Inspection South Shields Area Office 4th Floor St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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. 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