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Inspection on 20/12/07 for Claremount House Nursing Home

Also see our care home review for Claremount House Nursing Home for more information

This inspection was carried out on 20th December 2007.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The manager is committed to providing good leadership to the staff team and making sure people`s rights are protected. The manager and staff create a warm and friendly atmosphere and treat everyone as individuals. Comments from people living at the home and relatives included "everyone is caring and will help in any way they can" and "I am very happy living at Claremont."Comments from relatives included "every person is treated as an individual and their needs are met accordingly" and "the staff are kind and caring and I am always made to feel very welcome."

What has improved since the last inspection?

In the absence of the manager the clinical nurse manager has taken on this role and is providing the staff with good leadership and giving them a clear sense of direction.

What the care home could do better:

Staff must have the skills, experience and training they need to care for people with mental health problems, so that people can be confident that the home can meet their needs. All care staff must be able to use the care plans as working documents so that people`s healthcare needs are not compromised. An accurate stock control system must be maintained for medication administered on a PRN (as and when required) basis, so that people can be confident that medication is being given as prescribed. The home must make sure that all care staff are able to speak English and have a good understanding of the English language before they are employed. So that people can be confident that they understand what they say and act accordingly. The present position regarding the manager must be resolved and a registration application submitted to CSCI without further delay.

CARE HOMES FOR OLDER PEOPLE Claremount House Nursing Home Claremount Road Claremount Halifax West Yorkshire HX3 6AN Lead Inspector Steve Marsh Key Unannounced Inspection 20th December 2007 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 Claremount House Nursing Home DS0000001047.V356984.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. Claremount House Nursing Home DS0000001047.V356984.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Claremount House Nursing Home Address Claremount Road Claremount Halifax West Yorkshire HX3 6AN 01422 331121 01422 367289 claremount.house@craegmoor.co.uk Craegmore.co.uk Park Care Homes (No 2) Ltd 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) ** Post Vacant *** Care Home 22 Category(ies) of Dementia - over 65 years of age (22), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (22) Claremount House Nursing Home DS0000001047.V356984.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Elderly service users over 60 years of age Can accommodate a maximum of 2 services users aged 55 to 65 years, category MD and DE. Can accommodate one named service user under 65 years of age, category DE. 21st September 2006 Date of last inspection Brief Description of the Service: Claremount House is registered to provide nursing and personal care for up to 22 older people with mental health needs. The establishment is situated in the Claremount district of Halifax with easy public transport links to the town centre. The establishment is generally well maintained. All bedrooms are single with en-suite facilities and there are spacious communal areas. There is an attractive garden area for people to use and a car park to the rear of the building. The fee for the service is currently £875:00 per week. A copy of the previous inspection report is made available on request. Claremount House Nursing Home DS0000001047.V356984.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out between the hours of 09:30 and 17:00hrs. The purpose of this inspection was to assess what progress the service had made in meeting the requirements made in the last inspection report and the impact of any changes in the quality of life experienced by people living at the home. The methods we used included looking at records, watching staff at work, talking to people living at the home and their relatives, talking with staff and looking around the property. Survey questionnaires were also sent out to relatives, staff and other healthcare professionals so that they could share their views and opinions of the service with us. Six relatives, fifteen staff and two healthcare professionals returned the questionnaires and the information they provided has been used as evidence in the report. Mr Roy Bennett the manager is currently on long-term sick leave and in his absence the clinical nurse manager has taken on this role. The Area Manager for Craegmoor Healthcare was present for part of the visit. The manager had completed an annual quality assurance assessment form and the information provided has also been used as evidence in the report. Feedback was given to the manager following the visit. What the service does well: The manager is committed to providing good leadership to the staff team and making sure people’s rights are protected. The manager and staff create a warm and friendly atmosphere and treat everyone as individuals. Comments from people living at the home and relatives included “everyone is caring and will help in any way they can” and “I am very happy living at Claremont.” Claremount House Nursing Home DS0000001047.V356984.R01.S.doc Version 5.2 Page 6 Comments from relatives included “every person is treated as an individual and their needs are met accordingly” and “the staff are kind and caring and I am always made to feel very welcome.” What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Claremount House Nursing Home DS0000001047.V356984.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 Claremount House Nursing Home DS0000001047.V356984.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4 and 5 – standard 6 does not apply to this service. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The admission procedure is thorough. However, some care staff do not have the skills, training and experience they need to care for people with complex mental health problems. EVIDENCE: The records show that pre-admission assessment visits are carried out to see people before they are admitted to the home and the needs identified during this visit form the basis for the initial care plan. In addition to the pre-assessment visit people are encouraged to visit the home before admission to view the accommodation and meet the staff and other people living there. Claremount House Nursing Home DS0000001047.V356984.R01.S.doc Version 5.2 Page 9 The manager confirmed that people offered a place at the home are always supported throughout the admission process and care is taken to make sure they settle into their new environment. However, concerns were raised with the manager about the lack of skill and experience within the care staff team to care for people with complex healthcare needs. On the day of the visit, with the exception of the qualified nurses, the six care staff on duty had only between one month and one year experience caring for people with mental health problems or suffering from dementia. The manager is aware that more needs to be done to improve the skill mix within the staff team and confirmed that staff that have not attended dementia care training will do so in the near future. Concerns were also raised with the manager about the home employing overseas staff that were unable to speak English as clearly two staff on duty had little grasp of the English language. These concerns are highlighted in more detail in the “staffing” section of this report. Claremount House Nursing Home DS0000001047.V356984.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Care records provide accurate and up to date information, which should mean that people receive the level of support and care they require to meet their health, personal and social care needs. However, some care staff are not able to use the care plans as working documents and therefore people’s healthcare needs may be compromised. EVIDENCE: Care plans have been completed for all people living at the home and cover all aspects of their social and healthcare needs. The manager confirmed that care plans are reviewed on a regular basis and accurately reflect the current level of care and/or support required by the individual. The care plan is drawn up with the involvement of the person using the service and/or their relatives and forms the basis for the care to be provided. This Claremount House Nursing Home DS0000001047.V356984.R01.S.doc Version 5.2 Page 11 means that people are consulted about how they want their care and support to be provided. The four care plans reviewed were completed to a good standard although in some instances information was difficult to find. The manager confirmed that the organisation is presently reviewing the format to make it easier to use. Concerns were also raised about the number of overseas care staff that are unable to read and understand the care plans. The care plan is a working document, which provides clear guidance on how the individual’s needs are to be met and therefore it is essential that all staff are able to use it as such. All people living at the home are registered with a general practitioner and are supported in having access to the full range of NHS services. The input of other healthcare professionals is clearly recorded in the documentation available, which shows that staff are seeking advice if they have concerns about an individual’s health. Survey questionnaires returned by two healthcare professionals confirmed that the home provides a good level of care and staff are well supported by the manager and qualified nursing staff. However, one questionnaire indicated that problems arise when dealing with care staff that don’t speak English as their first language. Questionnaires returned by five staff also show that there are some communication problems in the home due to the number of overseas workers. Comments included “I don’t think staff sometimes understand what is being asked of them” and “some staff are not able to read the care plans or communicate effectively with people.” Feedback from relatives shows that they are pleased with the standard of care provided and are kept informed of any changes in the individual’s personal circumstances. Comments included “the staff are very kind and caring” and “staff always treat people with respect and are willing to do anything to assist them.” On reviewing the medication system we noted that a stock control system is required for PRN (as and when required) medication so that people can be confident it is being given as prescribed. A discussion was also held with the manager regard a recent discrepancy in the stock control figure for a controlled drug securely held at the home. The manager was able to explain the reason why the discrepancy had occurred and confirmed that procedures had now been put in place to make sure this could not happen again. Claremount House Nursing Home DS0000001047.V356984.R01.S.doc Version 5.2 Page 12 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 and 15 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People living at the home are encouraged and supported to participate in a range of activities, which helps to improve their quality of life. EVIDENCE: The home employs an activities co-ordinator who is responsible for organising outings, entertainment and daily activities for people living at the home. People’s personal interests and preferences are recorded in their care plan and wherever possible they are encouraged to follow their own daily routines. People who were able said that they were generally happy with the level of activities organised for them and feedback from relatives confirmed that regular activities take place. Comments included “The home offers a range of activities from simple board games to shopping trips and outings to the park” and “staff try hard to involve everyone in activities no matter what their disability.” Claremount House Nursing Home DS0000001047.V356984.R01.S.doc Version 5.2 Page 13 The home has a small snoozelum (multi sensory room) and staff are currently in the process of collecting old items of furniture and memorabilia to create a reminiscence room for people to enjoy. Throughout the visit staff were observed to interact well with the people in their care and people were relaxed and clearly felt comfortable in their presence. Relatives confirmed that they were able to see people in their own room if they wished to do so and they were always made to feel welcome and offered light refreshment. On the day of the visit the cook was absent and therefore fish and chips were purchased for the lunchtime meal. However, feedback from relatives and people that use the service indicates that meals are generally of a good quality and special diets are catered for. Following a recent Food Hygiene Inspection by the Environmental Health Department, the home received a three star rating (out of a possible 5 stars). Claremount House Nursing Home DS0000001047.V356984.R01.S.doc Version 5.2 Page 14 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 and 18 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Thorough complaint and adult protection policies and procedures make sure that individuals are listened to and protected from any form of abuse. EVIDENCE: There is a clear complaints procedure in place and a relative spoken with said that he would have no problems approaching the manager if he had any concerns about the standard of care being provided. Questionnaires returned by relatives also clearly indicated that they were aware of the complaints procedure and who to contact if they had any concerns. Information provided in the self-assessment form shows that two complaints have been received in the last twelve-months both of which were investigated within the appropriate timescales. Adult protection policies and procedures are in place and with two exceptions all staff have received appropriate training in the recognition and reporting of abuse. However, because some staff do not speak English as their first language it was difficult when speaking to them to ascertain if they were aware of what to do if any practices at the home were not in the best interest of the people using the service. Claremount House Nursing Home DS0000001047.V356984.R01.S.doc Version 5.2 Page 15 Two referrals have been made to the Bradford Adult Protection Team since the last inspection, both of which have been dealt with appropriately by the home. Policies and procedures are available regarding staff involvement in the financial affairs of people living at the home, which does not allow them to become involved in the making of, or benefiting from their wills. Claremount House Nursing Home DS0000001047.V356984.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24 and 26 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home provides people with a pleasant and comfortable environment in which to live. EVIDENCE: As part of this visit a tour of the building was conducted, this included a number of people’s bedrooms, communal lounges, bathrooms and the dining room. All communal areas are situated on the ground floor of the home, close to toilet facilities. The standard of décor and furnishing in the communal areas is satisfactory although some rooms would benefit from decorating. The use of coded locks between the lounge areas and dining room should also be reviewed and a risk assessment completed to establish if they are still required. Claremount House Nursing Home DS0000001047.V356984.R01.S.doc Version 5.2 Page 17 Bedrooms are situated on both the first and ground floors and are all single rooms with en-suite facilities. The standard of décor and furnishings in the rooms we saw was generally good although some would benefit from decorating as part of the home’s ongoing programme of refurbishment. A passenger lift is available to the bedrooms on the first floor to assist people with mobility problems access the accommodation and handrails are in place where required. Bathrooms and toilets are conveniently located throughout the building and as required in the last inspection report a new assisted bath has been installed in the bathroom on the first floor. However, locks require fitting to a number of bathroom and toilet doors to make sure that people’s right to privacy is respected when they use the facility. On the day of the visit the standard of hygiene and cleanliness throughout the home was good and with the exception of one bedroom no unpleasant odours were noted in the bedrooms or communal areas. Feedback from people living at the home and relatives showed that they are generally pleased with the standard of accommodation. Comments included “the home is always kept spotless” and “some areas would benefit from decorating and modernising but overall I am happy with the standard of accommodation provided.” Externally, the grounds are generally well maintained although the self assessment form completed by the manager shows that they intend to improve the garden area in the next twelve months. The car park surface is also starting to break up in one area and work is planned to address this matter. Claremount House Nursing Home DS0000001047.V356984.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. There is a poor skill/experience mix within the care staff team and a number of overseas workers have a poor grasp of the English language, which makes communication difficult at times. EVIDENCE: There is a recruitment and selection procedure in place, which includes obtaining at least two written references and a Criminal Record Bureau check before a new member of staff is employed. The staff rota showed that sufficient care staff are employed on day and night duty to care for people and meet their needs. However, over the last twelve months the home has experienced a high turnover of care staff and because of this now employs a number of overseas workers who do not speak English as their first language. At least two staff on duty had problems communicating and understanding what was said to them in English and were unable to read the care plans or daily records. Claremount House Nursing Home DS0000001047.V356984.R01.S.doc Version 5.2 Page 19 Both staff were observed to interact well with people throughout the day however it is important that when caring for someone with dementia that staff speak very clearly, so that they can understand what is being asked of them. The manager confirmed that she was aware of the problem and three staff that are experiencing difficulty with the language are currently attending college to improve their skills. The Area Manager also confirmed that the organisations Human Resource Dept responsible for employing overseas worker has recently reviewed the recruitment and selection procedure and all staff employed must now have a good understanding of the English language. The manager confirmed that all staff receive induction training following which there is then an expectation that they will achieve a National Vocational Qualification (NVQ) at level two or above depending on the post they hold. Information provided by the manager shows that currently only three care staff have achieved the award and one staff is working towards it. The manager is aware that more emphasis needs to be placed on NVQ training and is currently addressing this matter. Questionnaires returned by four staff clearly showed that they did not feel that they received sufficient training to meet people’s needs. Comments included “sometimes we don’t have the training we need to care for people with behavioural problems and there too many care staff that don’t speak good English” and “some staff don’t have the skills, experience and training they need to work in a specialist mental health unit.” Although the self-assessment form completed by the manager shows that the level of training has actually increased in the last year it is apparent that some staff feel that that they need more specialist training before they feel confident to care for people with mental health problems. Claremount House Nursing Home DS0000001047.V356984.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The acting manager provides good leadership to the staff team and ensures people’s rights are protected and their needs are met in line with their care plan. EVIDENCE: Mr Roy Bennett, the manager is currently on long-term sick leave and in his absence the clinical nurse manager has taken on this role. She has many years experience in the caring profession and is a qualified nurse. Claremount House Nursing Home DS0000001047.V356984.R01.S.doc Version 5.2 Page 21 The home has now been without a registered manager for over two years, however the Area Manager confirmed that once Mr Bennett’s position is clarified this matter will be resolved quickly. Through discussion with the manager it is apparent that she is aware of the shortfalls in the service and supported by the Area Manager is working hard to make sure that the home is run in the best interest of the people living there. Feedback from staff indicates that the manager has an open and approachable management style and ensures clear channels of communication within the home by holding regular staff meetings. All staff also receive formal one-toone supervision with the manager on a regular basis to discuss care practices, training needs and their personal development. The home holds money in safekeeping for a number of people and transaction sheets are in place showing income, expenditure and a balance. Only senior staff deal with financial transactions and regular audits are carried out to make sure the records are accurate and in good order. Receipts are obtained for any items purchased by staff on behalf of people. Recognised quality assurance monitoring systems are in place and regular audits are carried out to ensure standards are being maintained. Following an audit an improvement plan is drawn up and the manager addresses any short falls. This is to make sure that people’s expectations of the home and the care they receive are met. Information provided in the self–assessment form also indicates that all equipment in use at the home such as the passenger lift and hoists are serviced in line with the manufacturers guideline, so that people can be sure that they are in good working order. Claremount House Nursing Home DS0000001047.V356984.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. 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 1 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 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 3 2 X X 3 X 3 STAFFING Standard No Score 27 1 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 3 X 3 Claremount House Nursing Home DS0000001047.V356984.R01.S.doc Version 5.2 Page 23 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 OP4 OP30 Regulation 18 Requirement Staff must have the skills, training and experience required to care for people with mental health problems, so that people can be confident that the home can meet their needs. All care staff must be able to use the care plans as working documents so that people’s healthcare needs are not compromised. An accurate stock control system must be maintained for medication administered on a PRN (as and when required) basis, so that people can be confident that medication is being given as prescribed. To respect the individuals right to privacy appropriate locks must be fitted to bathroom/toilet doors. All care staff must be able to communicate effectively with people in their care before they are employed. So that people can be confident that staff understand what they say and act accordingly. DS0000001047.V356984.R01.S.doc Timescale for action 31/03/08 2. OP7 19 31/03/08 3. OP9 13(2) 31/01/08 4. OP21 23 31/01/08 5. OP27 19 31/01/08 Claremount House Nursing Home Version 5.2 Page 24 6. OP31 9 The present position regarding the manager must be resolved and a registration application submitted to CSCI without further delay. Outstanding from the last two inspections – timescales 30/04/06 and 31/01/07 not met. 29/02/08 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. 2. Refer to Standard OP19 OP28 Good Practice Recommendations The use of coded door locks should be reviewed and a risk assessment completed to establish if they are needed. More emphasis should be placed on NVQ training so that people can be sure that they are being cared for be a professionally trained staff team. Claremount House Nursing Home DS0000001047.V356984.R01.S.doc Version 5.2 Page 25 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. Extracts may not be used or reproduced without the express permission of CSCI Claremount House Nursing Home DS0000001047.V356984.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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