Inspection on 20/11/06 for Chilton House Nursing Home

This inspection was carried out on 20th November 2006.

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.

Other inspections for this house

Chilton House Nursing Home 08/03/06

Chilton House Nursing Home 12/10/05

Chilton House Nursing Home 09/03/05

Chilton House Nursing Home 31/08/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Chilton House Nursing Home Chilton Aylesbury Bucks HP18 9LR Lead Inspector Joan Browne Unannounced Inspection 20th November 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Chilton House Nursing Home DS0000019194.V312890.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. Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chilton House Nursing Home Address Chilton Aylesbury Bucks HP18 9LR 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) 01844 265200 01844 265202 Chilton House Limited Laura Bale Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Maxim of 45 residents Service Users receiving intermediate care 60 years of age and over (6) This includes a maximum of 10 nursing care Date of last inspection 8th March 2006 Brief Description of the Service: Chilton House is a grade two listed Manor House set in extensive landscaped grounds in the rural village of Chilton. Due to it’s location the home is isolated from shopping facilities and local amenities, and is not served by local public transport networks. However, the home possesses two cars for use by the activity organisers, which are used to take residents out for meals, shopping and activities at their request. The home is registered to provide care for 45 older people, up to ten of whom may also receive nursing care. The main part of the home is utilised to provide residential care, and nursing residents are accommodated in a separate wing where nursing care is used to provide intermediate care to older people who are recovering from surgery or illness. The home provides individual accommodation, decorated and furnished to an extremely high standard, on three floors, with reception, lounge and dining areas on the ground floor. There are extensive and well maintained grounds with large patio areas accessible to mobile residents and wheelchair users. An experienced team of nursing, care, catering and housekeeping staff supports the manager. The proprietors live adjacent to the home and visit staff and residents on a frequent basis, and as a result are easily accessible. The home has an internet web site, which provides information as to the services provided at Chilton House. Fees range from £750.00-£1,750.00. Additional charges are made for hairdressing, physiotherapy, chiropody, beauty treatments and escorting. Chilton House Nursing Home DS0000019194.V312890.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 of the home that took place on 20 November 2006. Prior to the fieldwork visit previous information about the home was reviewed and the outcome of the previous inspection noted. Comment cards were received from eight residents, eleven relatives and the general practitioner. During the visit residents and relatives who were visiting were spoken to. Overall they were very satisfied with the care provision. A tour of the premises was undertaken and records and care documentation were examined. The care of four residents was ‘case tracked from their original contact with the home to the care that they are now receiving. Care practices and the home’s approach to quality and diversity issues were observed. What the service does well: What has improved since the last inspection? Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 6 The ground floor bathroom has been removed and replaced with a nurse’s office. The bathroom on the first floor has been converted to a hairdressing salon. A new Malibu bath has been installed on the first floor. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home’s admission process works well giving prospective residents and those admitted for convalescence the confidence that their diverse needs can be met. EVIDENCE: Residents are admitted to the home only after a full assessment of needs has been undertaken and the home’s staff are confident that they would be able to meet the assessed needs. The manager described visiting prospective residents in hospital or inviting them to the home to be assessed before being admitted. The home has an assessment tool that covers all aspects of health, personal and social care needs. The home provides convalescent care packages to residents who are recovering from an operation or illness. This is tailor made to meet individuals’ needs and to maximise independence. A particular resident who was convalescing said that he was pleased with the treatment that he was receiving. He was also delighted that the home was able to accommodate his Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 9 wife and pet Corgi during his convalescent. He compared the home as being in a ‘first class hotel’. Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Arrangements are in place to ensure that residents’ health care needs are catered for. Residents and relatives spoken to were confident that staff who understand their care needs were supporting them. However, some weaknesses identified in the medication procedure and staff’s practice would need to be addressed. EVIDENCE: The home uses the Standex system of care planning documentation. Four care plans were examined and information relating to individuals’ long-term and short-term goals were recorded and comprehensively completed. Plans seen were being reviewed monthly and were signed and dated by residents, which indicated their involvement. Sheets relating to social activity, multidisciplinary and doctor’s visits were being maintained. Falls, tissue viability and moving and handling risk assessments were in place and were reviewed monthly or as and when required. Staff spoken to were knowledgeable on residents’ needs and were able to describe the care they were providing to residents whose care was case tracked. Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 11 Residents spoken to said that they were registered with a general practitioner who visits the home weekly or when required. Care plans seen indicated that they have access to a chiropodist who visits the home regularly. The opportunity to see a physiotherapist privately is also available. Care plans showed that some residents have had nutritional assessments and are weighed regularly. The general practitioner was complimentary about the high standard of care that was being provided and felt that the home had a good communication system in place and worked in partnership with him. The home has access to other health care professionals such as community nurse specialists in the areas of palliative care, continence and wound care. Equipment such as pressure relieving mattresses to prevent pressure soars and aids and adaptation to promote continence and mobility are also provided. Residents spoken to confirmed that arrangements are made for them to access the dentist and optician when required. The home uses the Nomad monitored dose system. Wherever possible residents are encouraged to look after their medication with the appropriate risk assessments in place. A resident who self-administers was spoken to and was happy with the support provided by the home. There are storage facilities in bedrooms for medication to be stored safely. There were no unexplained gaps on the medication administration record (MAR) sheets seen. However, some inconsistencies in staff’s practice were noted. For example, staff were not using the appropriate code to indicate the reason why medication was not administered. A particular resident’s medication was not administered because the individual was on leave. Staff recorded the O code (which means other) instead of the L code (which means on leave). Scribbled over entries were noted. This suggested that the entry might have been recorded in error. Entries recorded in error should have a line drawn through it and the reason for the error recorded at the back of the MAR sheet. Controlled drugs were safely stored and recorded correctly. The procedure for the storage and administration of Temazepam medication, which should be treated as a controlled drug was not in place. It is strongly recommended that Temazepam medication be treated as a controlled drug and a record is maintained. Records of the receipt and disposal of medication were clear and accurate. Residents spoken to said that staff respect their privacy and dignity. Residents’ preferred term of address was recorded in their care plans. Staff were observed knocking on bedroom doors and waiting for a reply before entering. Throughout the visit staff were polite and friendly in their interaction with residents. Medical examination and treatment are provided in residents’ bedrooms. Residents have access to a telephone for use in private in their bedrooms. A hairdresser visits the home twice weekly. Residents looked well groomed with attention to detail. Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 12 Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Residents are consulted by staff as to their interests and are provided with a choice of meaningful and stimulating activities to meet their diverse needs. The standard of food and its presentation is high and meets residents’ cultural and dietary needs. Meals are served in pleasant surroundings at times convenient to them. EVIDENCE: Residents spoken to confirmed that the home’s routines were varied and flexible and they were able to choose what they wished to. The home provides a range of leisure and recreational activities to suit individuals’ likes and abilities. There are two activity organisers known as “hosts” who are responsible for organising activities and entertainers. The home has its own transport facilities and residents are able to go out daily or when required. Residents’ interests were recorded in care plans seen. Those who wish to are taken out to pub lunches, on shopping trips, to the theatre, garden centres and national trust houses. In-house activities include cards, scrabble, quizzes, a book club, music to movement, video films in the drawing room and presentation talks on different topics such as textiles, fabric and lace. On the Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 14 day of the inspection several residents went out on a shopping trip and for lunch. All residents spoken to said that they were able to exercise their choice in relation to their religious observance. A priest visits the home and offers Holy Communion and residents are escorted to the village church on a Sunday if they wished to. There are no restrictions on visiting. Visitors are able to visit residents in their rooms or communal areas including lounges. Residents confirmed that visitors are made to feel welcome by staff and they are offered refreshments. The following comments were noted: ‘My visitors are made to feel most welcome whenever they visit.’ Visitors visiting at the time of the inspection were spoken to and they were complimentary about the care provision, the cleanliness of the home and staff’s hospitality. From discussions with residents it was evident that they are given every opportunity to exercise choice and control over their lives. All residents are expected to handle their own financial affairs for as long as they are able to and have the capacity to do so. Those who are not able to are supported by their family. It was evident that residents are made aware of their entitlement to have some personal possessions and furniture, which is arranged and agreed prior to admission. Some rooms seen were homely with personal furniture, paintings, family pictures and mementoes. Three full meals are provided daily with hot and cold drinks and snacks offered throughout the day and night. Comments from residents about the food are as follows: ‘The cooking is superb with wide range of menu.’ We have a varied menu, the food is good and well presented.’ Special diets are provided if required. Breakfast is served in residents’ bedrooms at a time of their choice. Lunch and supper can be taken in the dining room or in their bedrooms. The standard of food and its presentation is high and meets residents’ dietary, cultural and nutritional needs. The menu seen was varied with sufficient fruit, home made cakes, biscuits and vegetable dishes. It was noted that residents’ choice of foods were recorded in the care plans seen. The dining room is attractive with a pleasant ambience. Residents confirmed that mealtimes were unhurried and a relaxed occasion. Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. The home has policies on complaints and the protection of vulnerable adults. This should give residents and their families confidence that their concerns will be addressed. EVIDENCE: Information on the pre-inspection questionnaire indicated that the home had not received any complaints about the service. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. The home’s complaints procedure is made available to residents and their relatives. Residents spoken to were aware of the procedure and whom they should raise any concerns to if required. All residents spoken to said that they were happy with the provision of care and have never had the need to complain. Residents and visitors spoken to during the inspection said that they were extremely satisfied with the service provision, feel very safe and well supported by a highly aware organisation. The Commission has not received any information concerning any suspicion or evidence of abuse or neglect made to the service since the last inspection. Staff spoken to were aware of what action should be taken if they suspected or witnessed a resident being abused. The home’s training matrix indicated that staff had undertaken training in the protection of vulnerable adults. Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 & 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Residents live in pleasant surroundings, which are clean warm comfortable and maintained to a high standard. EVIDENCE: Chilton house is a Georgian Manor set in the rural village of Chilton. The home is suitable for its stated purpose and has extensive gardens that are well maintained. There is a large patio area with garden furniture where residents can sit and enjoy in good weather. Corridors in the main part of the house are wide to accommodate wheelchair users. The manager confirmed in writing to the Commission that the requirement made by the local fire services to ensure that fire doors close fully on their stops from all angles of opening had been complied with. The environmental health officer visited the home in February 2006 and there were no requirements made. Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 17 There are communal areas within the home including a dining room, drawing room and reception hall. All bedrooms provide single accommodation with en suite facilities. Bedrooms viewed looked warm, bright, welcoming and homely and were personalised with residents’ personal belongings that reflected their character and interests. Private and communal spaces were decorated to a very high standard and furnished to reflect the age and character of the home. The house was extremely clean and tidy with no unpleasant odours noted. It was noted that the housekeeping and maintenance staff provide an excellent service maintaining all areas in the home. The laundry room is situated away from where food is prepared and stored and is equipped with washing machines and driers with the specified programming ability to meet disinfection standards. The floors and walls of the laundry room are impermeable. The manager said that plans were in hand to replace the floor covering in the laundry room. The training matrix seen indicated that staff had undertaken training in infection control. Hand washing facilities were prominently sited in areas of the building. Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home has recruitment policy and practices in place, which appears to protect residents from the employment of unsuitable staff. There is an ongoing training programme in place, which should indicate that staff are trained and competent to do their jobs. EVIDENCE: At the time of the inspection the home appeared to be adequately staffed. Rotas submitted with the pre-inspection questionnaire indicated that six staff are on an early shift, four on a late shift and three on a night shift. In addition to nursing and care staff there is a team of activity organisers, physiotherapists, hospitality and kitchen staff, housekeeping and maintenance staff. It was noted in care plans seen that the dependency levels of residents are kept under review and were being reviewed monthly. All staff appear to work well as a team to the benefit of residents to ensure that their diverse needs would be met. It was noted that no agency staff have been used by the home for sometime. This provides residents with continuity of care and ensures that residents are cared for by staff that are fully aware of their needs. Residents spoken to were complimentary about the staff team. The following comments were noted: ‘Matron is a great administrator with an excellent team of nurses.’ ‘All staff are so pleasantly attentive.’ Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 19 Information submitted on the pre-inspection questionnaire indicated that the home employs fifteen care staff. Three of these staff have acquired the national vocational qualification (NVQ) in direct care at level 3 and a further three are working towards achieving the NVQ 3 qualification. A fourth staff member was working towards achieving the NVQ 4 qualification independently. The files of four recently recruited members of staff were examined. They all contained application forms, terms and conditions of employment, two satisfactory references and photographic verification of their identity. Those staff members recruited from overseas had the appropriate work permits in place. There was evidence that PoVA first checks and criminal record bureau (CRB) clearances had been applied for and obtained. However, clarification was sought from the manager regarding the start date in one of the files seen. It was noted that the individual’s start date was 8 May 2006 and the PoVA first check was applied for on the same date. The manager confirmed that the member of staff did not commence work until the PoVA first check had been obtained. It is advised that the individual’s start date be amended. In a second file seen there was no written evidence that gaps in employment records had been explored at interview. It is recommended that gaps in employment records are explored and a footnote is written on the application form to confirm that a satisfactory explanation had been obtained. Staff spoken to confirmed that they had undertaken an induction when they commenced employment. Staff’s files examined indicated that induction training had been provided. Information submitted to the Commission with the pre-inspection questionnaire indicated that the home has an ongoing training programme and all mandatory training such as moving and handling, fire awareness, health and safety, food handling and hygiene and the protection of vulnerable adults are regularly updated. It was noted that only three staff hold a current first aid certificate. It is acknowledged that there are trained nurses on duty at all times and they are expected to update their skills and knowledge in the use of the automated defibrillator However, arrangements should be made for staff to undertake emergency first aid training and there is a nominated first-aider on every shift to comply with the health and safety guidelines. Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. There are systems in place to ensure that the home is run in the best interests of residents. Health and safety checks and records are maintained and should indicate that resident’s health and safety are protected and promoted. However, the home needs to ensure that there is a nominated first-aider on each shift to comply with the health and safety regulations. EVIDENCE: The manager has been qualified as a registered nurse since 1972. She held ward sister posts in hospitals in London and Oxford before being commissioned into Queen Alexandra’s Royal Army Nursing Corps in 1981. She has a BSc (Hons) in Health Services Management and is working towards achieving her masters in Health Services Management. She has been managing the home since May 2004. She undertakes periodic training to update her knowledge Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 21 skills and competence and networks with other colleagues. Staff spoken to said that the manager was approachable. Regular staff meetings and heads of department meetings are held. There appeared to be clear lines of accountability within the home. An evaluation of service provision is given to all short stay residents on completion of their stay. Comments received are generally used to develop the service further. Twenty comment cards were received in connection with this inspection. Eight from residents, eleven from relatives and one from the general practitioner. All resident respondents said that they liked living in the home, felt well cared for, felt well treated by staff and knew who to complain to if they were unhappy. All liked the food. Additional comments included: ‘The cooking is superb with wide range of menu.’ ‘The management under matron is excellent.’ ‘I like it here.’ I consider the care in Chilton house is of the highest order.’ Relatives were equally positive in their views: All said that they were welcome at any time, could visit the resident in private, were kept informed of important matters, were aware of the complaints procedure and were satisfied overall with the care provided. Additional comments included: ‘A fantastic caring environment. The majority of staff are superb. I can’t imagine a better place to end one’s days.’ ‘Staff respond very positively to suggestions and someone is always available to speak to me. Great efforts are made to respect the wishes of users and relatives.’ ‘ I appreciate the efforts made to entertain visitors on individual visits and social events’. The home does not manage residents’ money. Information recorded on the pre-inspection questionnaire indicated that twenty-three residents were handling their own finances and five were subject to Power of Attorney. A mini safe is provided in all rooms for the safekeeping of money and valuables. The home has systems in place for the regular maintenance of equipment. These include the following: Central heating system checked 20 April 2006, Legionella checked 10 September 2006, bath and portable hoists checked 30 September 2006 and 14 August 2006, the passenger lift checked 5 September 2006. The manager confirmed that portable appliance (PAT) testing on electrical equipment had been carried out and a certificate had been issued for the electrical wiring check carried out in September 2006. The manufacturers checked all fire equipment in August 2006. The fire panel is checked weekly and there are random fire drills. The most recent being 28 August 2006. The home has a rolling programme fire training, which commenced in November 2006. The home has acquired six evacuation chairs for fire and emergency situations. Arrangements for the storage of COSHH solutions (Control of Substances Hazardous to Health) were in place and staff are trained on their use. All radiators seen were covered and restrictors have been fitted to windows. Wheelchairs were serviced on 23 March 2006. Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 22 It was noted that only three staff hold a current first aid certificate. In order to comply with the Health and Safety (First Aid) Regulations 1981 there should be a nominated first aider on duty at all times. A recommendation to this effect has been made. It is acknowledged that there are trained nurses on duty twenty-four hours a day. Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 23 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 3 X X X 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 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 OP9 Good Practice Recommendations It is strongly recommended that the registered manager should ensure that Temazepam medication be treated as a controlled drug and a record on its administration is maintained. It is recommended that the registered manager should ensure that scribbled over entries on the medication administration record (MAR) sheets be ceased. It is recommended that the registered manager should ensure that there is written evidence that gaps in employment history have been explored. It is recommended that the registered manager should ensure that there is a nominated first aider on each shift to comply with the Health and Safety (First Aid) Regulations 1981. 2 3 4 OP9 OP29 OP38 Chilton House Nursing Home DS0000019194.V312890.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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. 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