Inspection on 22/01/08 for Claremont Nursing Home

This inspection was carried out on 22nd January 2008.

CSCI found this care home to be providing an Adequate service.

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

Claremont Nursing Home 12/01/10

Claremont Nursing Home 06/05/09

Claremont Nursing Home 10/05/08

Claremont Nursing Home 24/01/07

Claremont Nursing Home 28/02/06

Claremont Nursing Home 14/09/05

Claremont Nursing Home 16/12/04

Claremont Nursing Home 23/06/04

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

CARE HOMES FOR OLDER PEOPLE Claremont Nursing Home New Street Farsley Leeds Yorkshire LS28 8ED Lead Inspector Chris Levi Key Unannounced Inspection 22nd January 2008 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 Claremont Nursing Home DS0000045220.V356060.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. Claremont Nursing Home DS0000045220.V356060.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Claremont Nursing Home Address New Street Farsley Leeds Yorkshire LS28 8ED 0113 2360200 0113 2360472 clmont@aol.com 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) Park Homes (UK) Ltd vacant Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39), Physical disability (2), Terminally ill (1), of places Terminally ill over 65 years of age (1) Claremont Nursing Home DS0000045220.V356060.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. PD places are for specified service users only TI(E) place is specifically for named service user Date of last inspection 24th January 2007 Brief Description of the Service: Claremont is a converted, extended, detached property, situated near the centre of the village of Farsley. The home is close to local bus routes and within easy access of a mainline railway station and the main roads to Leeds and Bradford. The home was first registered in September 1991. Park Homes UK Limited owns it. Accommodation is offered in a combination of twenty-one single and eight double rooms; all bedrooms have en-suite facilities. Service users have a choice of two lounges, and there is a spacious dining room. Gardens are available consisting of lawns and an attractive enclosed garden to the rear, with level access from one of the lounges. Car parking is provided to the front of the property. At the time of this report a major building programme is ongoing. This will increase the beds available at the home from 39 to 60. Completion of the work is due at the end of March 2008. Weekly charges are from£518:88 to £559:58. This information was provided during the site visit. Extra charges are made for hairdressing, and chiropody. Claremont Nursing Home DS0000045220.V356060.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. Information about the home requested by the Commission for Social Care Inspection included a new document, the Annual Quality Assurance Assessment (AQAA) was completed by the home manager and returned to the CSCI. This enabled the inspector to analyse information that included the number of reported accidents, complaints and compliments from residents and relatives and other relevant information to help plan for the visit to the home. It also provided opportunities to demonstrate how the home could improve its services to the people who live at the home. The providers were not notified of this inspection in advance. This enabled the inspector to observe how the home is run on a day-to-day basis, without any changes being made to the usual routines of residents and staff. The visit started at 9.30 am and finished at 6pm. The person in charge of the home was the Acting Manager, Mrs K Johnson. Most of the day was spent talking to residents, relatives, and staff, to find out what it is like to live, work and visit Claremont. A major building programme is ongoing at the home. This will increase the beds available at the home from 39 to 60. Completion of the work is due at the end of March 2008. It has caused considerable disruption for both residents and staff and they all said they would be glad when it was finished. Twenty residents and relative survey forms, plus ten staff surveys and five external health professional surveys were sent to the home before the visit, to enable them to provide the Inspector with opinions about standards at the home. Six resident/relative surveys were returned. The comments were mixed. One commented on the kindness of the staff. Without exception all surveys returned had concerns about staffing levels. Comments included: low staffing levels have resulted in low staff moral and this has affected standards of care to residents. 6 staff surveys were returned. Two were positive, the remaining four were negative about staffing levels, training and concerns staff were working Claremont Nursing Home DS0000045220.V356060.R01.S.doc Version 5.2 Page 6 without knowing how to move and handle residents safely. During the visit this information was followed up by talking to residents, relatives, and staff, and it was acknowledgeD that in recent weeks there had been improvements in the staff on duty. There was evidence that new staff have not been trained in safe moving and handling techniques. This could put residents and staff at risk of injury. The three returned surveys from health professionals, who visit the home to provide specialist services to residents, raised concerns that their recommendations to improve residents specific health problems are not always acted upon. Feedback about the findings of the visit was given to the Acting Manager and a senior Park Homes Manager, Mrs B Hogan, at the end of the visit. What the service does well: What has improved since the last inspection? What they could do better: Residents who spend the majority of their day in their own room must have access to the emergency call bell to ensure they can summon help when they need it. For those residents cared for in their room, the manager should provide a contact sheet to enable staff to record when and what they did when Claremont Nursing Home DS0000045220.V356060.R01.S.doc Version 5.2 Page 7 visiting the resident. This should demonstrate the resident is not socially isolated for long periods of time, which may affect their well being. Residents or their representative should give written consent to the home that they agree that nurses in the home will administer their medication. Nurses should take the medication administration record to the resident when administering their medication. This should reduce the risk of failing to sign for medication given. The kitchen flooring is damaged and is a health and safety hazard to staff who walk on it. Whilst the menus indicate a choice of mid day meal, there was no evidence to confirm this is available. Residents are not involved in developing the menus, as such some of their known favourite food is not on the menu. To enable resident independence, the owners should consider introducing a large menu board displayed in the home, to inform residents what food is on offer that day. Improvement is needed with the way the home deals with information that should be referred to the adult protection unit. There was no evidence to confirm all nurses who are in charge of the home know the process to follow if an allegation of abuse is made. The manager must ensure staff undertake an induction programme which complies with the Skills for Care, Common Induction programme. Also all staff must undertake training in caring for people with dementia, Infection Control, safe Moving and Handling and Safeguarding Adults from Abuse to ensure they are competent to care for people living at Claremont. The clutter in the upstairs bathroom prevents it being suitable for use, thus restricting the number of bathrooms available to residents. This clutter must be removed, along with the clutter in the laundry that could be a fire hazard. 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. Claremont Nursing Home DS0000045220.V356060.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 Claremont Nursing Home DS0000045220.V356060.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 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is written information about the home to help people decide if they wish to live there. The needs of prospective residents are adequately assessed to ensure staff can meet their needs. EVIDENCE: Documentation about services provided by the home is available in writing. It is displayed in the entrance hall, and sent out to people who want to know about the home and its services. There was evidence that the assessed needs of people before they move to the home are detailed. This provides staff with opportunities to develop effective plans of support in preparation for the person as they move into the home. Claremont Nursing Home DS0000045220.V356060.R01.S.doc Version 5.2 Page 10 Residents or their representatives are given their contract of occupancy. Two were seen, but did not reflect the accurate charges made as the contracts were two years old. Residents or their representatives should be given in writing a copy of the accurate fees charged when they are increased, and this information should be sent to them and a copy held on file. Claremont Nursing Home DS0000045220.V356060.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 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ care plans identify their personal and health care needs. The dignity for residents is not always maintained. EVIDENCE: Two care plans were seen and the overall standard was good. Where a care need was identified a plan of care was in place to meet that need. This was also the case for risk assessments. Residents are risk assessed in areas such as falls, nutrition, tissue viability and continence. The nursing staff reviewed these documents monthly. Evidence was seen to show that when a resident needed to be reviewed by another health care professional, then this was done. One resident with wounds had been referred to the tissue viability nurse. Another identified with continence problems had the involvement of a specialist nurse. Claremont Nursing Home DS0000045220.V356060.R01.S.doc Version 5.2 Page 12 A doctor visiting the home during the inspection said staff were helpful and gave her relevant information about the resident to help her decide what treatment was needed. However, three returned surveys from health professionals who visit the home to provide specialist services to residents raised concerns that their recommendations to improve residents specific health problems are not always acted upon. This information was shared with the acting manager. Residents or their representatives should give written consent to the home that they agree that nurses in the home will administer their medication. Nurses should take the medication administration record to the resident when administering their medication. This should reduce the risk of failing to sign for medication given. Medication is stored safely and nurses administering medication had recently attended training to up date their practice. Residents who spend the majority of their day in their own room must have access to the emergency call bell to ensure they can summon help when they need it. It was noted that two residents did not have access to the call bell and this compromised their dignity and privacy and put them at risk of failing to receive help when they need it. For those residents cared for in their room, the manager should provide a contact sheet to enable staff to record when and what they did when visiting the resident. This should demonstrate the resident is not socially isolated for long periods of time, which may affect their well being. Claremont Nursing Home DS0000045220.V356060.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social activities for the people living in the home have improved, and are relevant to people participating in them. Within the social and physical limitations of individuals, there is choice regarding how, and where, people spend their day. The standard of meals provided do not offer the range identified in the menus, nor does it reflect the resident’s likes and dislikes. EVIDENCE: The home employs an activity coordinator. This person develops a care plan for each resident and keeps regular updates as to what they have been involved in. This documentation was seen and was relevant to the individual. Residents and relatives expressed their thanks to all staff for making Christmas a special time. Claremont Nursing Home DS0000045220.V356060.R01.S.doc Version 5.2 Page 14 A thank you letter had recently been sent to the local paper by a relative expressing her thanks for the care given to her mother whilst at Claremont. One resident with speech difficulties was seen communicating with staff through a collection of pictures to identify his needs. In conversation with some carers they did not feel it was part of their role to initiate or support with social activities. The management team should undertake to train staff towards more person centred approach to care, as it is currently task focussed and residents are missing out on opportunities for social interaction. One lady was observed enjoying her knitting. Whilst the major building programme is ongoing it has had an impact on what activities take place, as the large lounge is currently out of action. Residents said they miss the opportunity to be together for some of the group activities that take place in this room. The coordinator is working hard to offer reasonable alternatives until the building work is completed. Relatives said staff made them feel welcome, and informed them of changes in the wellbeing of their relative living at the home. All relatives spoken with said there had been long standing concerns about poor staffing levels but acknowledged that in the past few weeks levels had generally been satisfactory. Food served at the home was considered satisfactory. Whilst the menus indicate a choice of mid day meal, there was no evidence to confirm this is offered. On the day of the visit only Shepard’s pie was served. Residents are not involved in developing the menus, and as such some of their known favourite food is not on the menu. The cook should consider using a sugar substitute in home baking. This will Give people who are diabetics the opportunity to enjoy a full range of puddings available. Tea is served at approximately 4pm. As lunch is not served until 12.30 pm and often people have not finished eating until 1pm, the manager and catering team should consider increasing the gap between meals. Also offer a more substantial supper, as it is a long time lapse without food until breakfast time. To enable resident independence, the owners should consider introducing a large menu board displayed in the home, to inform residents what food is on offer that day. The kitchen flooring is damaged and is a health and safety hazard to staff who walk on it. It must be repaired or replaced. Claremont Nursing Home DS0000045220.V356060.R01.S.doc Version 5.2 Page 15 A recent Environmental Health Inspection resulted in the kitchen being awarded three out of five stars. Claremont Nursing Home DS0000045220.V356060.R01.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): Standards 16 and 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents have a good understanding of the complaints procedure and are assured their complaints will be dealt with properly. The system for recording complaints has been improved. Residents may be at risk as some senior staff are not aware of the process for reporting allegations of abuse. EVIDENCE: Since the last inspection in the CSCI received a significant number of complaints about the service at Claremont. The majority of the complaints related to low staffing levels and lack of care for residents. The providers were asked to investigate the complaints and respond to the complainants. Some of these complaints required multi-agency meetings to ensure the resident was safe at the home. The providers participated in these meetings and outcomes were agreed. Since September 2007 no further complaints have been received by the CSCI. Three had been recorded at the home and there was evidence that they had been recorded, investigated and the complainant responded to in writing. Claremont Nursing Home DS0000045220.V356060.R01.S.doc Version 5.2 Page 17 Residents and relatives said they would talk to the person in charge if they had a concern about the service provided at the home. In discussion with some staff, they said they had not received training relating to Safeguarding adults from abuse. In conversation they said they would report any concerns to the manager. However all staff need to be trained to understand, and recognise different types of abuse, to enable them to protect residents in their care. Some nurses who take responsibility for the home did not know the process to follow if an allegation of abuse is made. This lack of knowledge may put residents at risk. Claremont Nursing Home DS0000045220.V356060.R01.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): Standards19, 20, 21 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The overall environment of the home is of a good standard and meets the needs of the residents. However, the current building programme has had a negative impact on the environment for residents. EVIDENCE: Despite the upheaval due to the building works feedback about the environment and cleanliness of the home from residents and relatives was satisfactory. Although everyone said they would be glad when the building work was finished to get back to normal. There are a number of domestic workers employed by the home. Two who spoke with the inspector had not received training in the safe handling of substances hazardous to health. One Claremont Nursing Home DS0000045220.V356060.R01.S.doc Version 5.2 Page 19 had not received moving and handling training. This lack of training could put residents and staff at risk of injury. Two care staff were noted to deal with soiled linen in a way that could put themselves and residents at risk from cross infection. On the day of the visit the home was clean and there were no unpleasant odours. During a tour of the building it was noted that the clutter in the upstairs bathroom prevents it being suitable for use, thus restricting the number of bathrooms available to residents. This clutter must be removed, along with the clutter in the laundry that could be a fire hazard. Claremont Nursing Home DS0000045220.V356060.R01.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): Standards 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff recruitment is thorough but minor improvements would increase the checks necessary to ensure staff are safe to work with vulnerable adults. Improvements are required to ensure staff receive the appropriate induction and on going training to ensure they are competent to do their job. EVIDENCE: The numbers and skills mix of staff on duty at the time of the visit was satisfactory to meet the needs of the 24 residents in the home. Whilst it is acknowledged that staff attendance has improved, the management team need to ensure action is taken to maintain this, in view of the previous concerns raised by people about inadequate staffing levels which impact on standards of care offered to residents. The home does have a recruitment policy in place. Two recruitment files were looked at. There was evidence that the home’s recruitment procedures are thorough. These can be further improved by exploring the gaps in an applicant’s employment history, to ensure they are safe to work with vulnerable adults. Claremont Nursing Home DS0000045220.V356060.R01.S.doc Version 5.2 Page 21 The home has yet to achieve a target of 50 of care staff with a formal care qualification. Some staff are working towards this award. Staff must undertake an induction programme that complies with the Skills for Care, Common Induction programme. One member of staff said she had been given a Park Home induction book and told to complete it. This is neither safe nor suitable for new member of staff. Not all staff have undertaken training in Infection Control. This could result in staff unknowingly working in ways that would put themselves and residents at risk from infection. Not all staff has undertaken training in dementia care or safeguarding and understanding adult abuse. Again, this may be putting residents at risk. Claremont Nursing Home DS0000045220.V356060.R01.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): Standards 31, 32, 33, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is effectively managed for the benefit of residents, relatives and staff. EVIDENCE: The home has a vacancy for a Manager. As an interim measure the Park Homes Operations Manager, Mrs K Johnson, has been acting manager of Claremont for a number of months. She is a registered nurse with management qualifications and many years experience managing care homes. Claremont Nursing Home DS0000045220.V356060.R01.S.doc Version 5.2 Page 23 During this time she has worked hard and achieved improvements in standards of care and management practice that required addressing. Residents, and relatives and staff said she is approachable and listens to concerns raised. Park Homes are currently recruiting a permanent manager for the home. There was evidence of regular meeting with residents, relatives and staff. This has been especially important with the on going building project and the disruption it causes. There was evidence of completed resident/relative questionnaires as part of a quality review. However, no action plan and findings report was produced as a result of the analysis of the information received. A report available to those people who took part in the review would inform them of any changes made to the services, as a result of the review. Written evidence that staff have regular one to one supervision to discuss their practice and development needs was seen. The home employs in-house maintenance person who has responsibility for a number of health and safety checks around the house. There were records of these checks, and they were up to date. It was noted that the hot water temperatures were being recorded at 44°C this is the top end of the safety scale. Claremont Nursing Home DS0000045220.V356060.R01.S.doc Version 5.2 Page 24 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 x x N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 2 2 2 x x x x 3 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 3 2 x x 3 x 3 Claremont Nursing Home DS0000045220.V356060.R01.S.doc Version 5.2 Page 25 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 OP9 Regulation 12 Requirement The manager must ensure consent to look after and administer medication is obtained from the resident or their representative.(previous timescale not met.) Nurses must take the medication administration record to the resident when administering their medication. This should reduce the risk of failing to sign for medication given. The registered person must ensure staff promote and maintain the privacy and dignity of residents at all times. This refers to residents who were not able to access the emergency call bell whilst being cared for in their room. Meals provided to residents must be to the standard and choice that is agreed. The kitchen flooring is damaged and is a health and safety hazard to staff who walk on it. It must be repaired or replaced. Claremont Nursing Home DS0000045220.V356060.R01.S.doc Version 5.2 Page 26 Timescale for action 30/03/08 2. OP10 12 28/02/08 3. OP15 16 30/03/08 Residents should be involved in developing the menus, so that their favourite foods are included. The cook should consider using a sugar substitute in home baking. This will give people who are diabetics the opportunity to enjoy a full range of puddings available. Senior staff must be aware of the process to follow when an allegation of abuse is made. 50 of care staff must be trained to NVQ level 2 or above. The previous timescale of 30/09/07 has not been met. The registered person must ensure that staff receive an induction that includes Skills for Care Common Induction Programme. Also all staff must undertake training in caring for people with dementia, Infection Control, COSHH, Safe Moving and Handling and Safeguarding Adults from Abuse, to ensure they are competent to care for people living at Claremont. The home must provide evidence of an annual quality monitoring review. With written information that informs those that participated the outcomes and improvements that will be introduced as a result of the review. The clutter in the upstairs bathroom prevents it being suitable for use, thus restricting the number of bathrooms available to residents. This clutter must be removed, along with the clutter in the laundry that could be a fire hazard. DS0000045220.V356060.R01.S.doc 4. 5. OP18 OP28 12 18 30/03/08 30/06/08 6. OP30 12 30/04/08 7 OP33 24 30/05/08 8 OP21 OP19 12 30/03/08 Claremont Nursing Home Version 5.2 Page 27 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 OP15 Good Practice Recommendations To enable resident independence, the owners should consider introducing a large menu board displayed in the home, to inform residents what food is on offer that day. Claremont Nursing Home DS0000045220.V356060.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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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