CARE HOME ADULTS 18-65
Corner House Nursing Home 116 Cheriton Road Folkestone Kent CT19 5HQ Lead Inspector
Julie Sumner Unannounced 13/10/05 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Corner House Nursing Home Address 116 Cheriton Road Folkestone, Kent CT19 5HQ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01303 258892 01303 258922 Mr William Puxley Registered Care Home 19 Category(ies) of Learning Disability/Physical Disability registration, with number of places Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 05/05/05 Brief Description of the Service: Corner House is part of a group of homes owned by Counticare. The home is registered to provide care and support to adults with physical and learning disabilities, some of whom also have some health conditions and sensory impairment. The people currently living in Corner House have communication difficulties and none are able to speak. It is a large detached home situated in a residential area of Folkestone. The building is in keeping with the local area. The whole of the grounds at the side of the building are concreted over and provides spacious parking with 2 gateways for vehicle access in and out. The home has no garden. There is no outside area for the people living in the home to sit out safely and comfortably. Accommodation is on 3 floors, all of which can be reached by a passenger lift. There are 9 single bedrooms, 5 shared bedrooms and 2 with ensuite bathrooms. A conservatory has been built at the side of the building with the intention to provide more indoor space for service users, although it is not currently being used for this and needs additional security, window and ceiling coverings and appropriate furniture prior to its full use. The home is close to the town centre, leisure centre and parks. Counticare also provide a day service in Folkestone called the Martello that the people living in Corner House have limited access to. Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out during one day in October. A new manager commenced employment with the company in August. The manager has over 10 years experience working in residential homes for people with learning and physical disabilities. An application for registration needs to be processed for her to be the registered manager. The overall impression of the home has improved. The front door is now being used as the main visitor access, which has enhanced service users’ privacy and gives a better impression of the home. All service users have communication difficulties. No service users can speak. Most service users communicate their needs by various noises and behaviour. At present the home continues to give good basic personal care to service users but there is still a need to develop communication methods, to assist understanding and expression, and to increase social experience and interaction. Some of the recommendations have been carried over from the previous inspection without being inspected at this time as it was reported that there had been no change and these will be inspected in future. The majority of this inspection was spent with the new manager discussing the areas of improvement needed in the home, the new manager’s ideas and what had already been put into practice since the last inspection. A sample of service user plans was viewed and there has been some progress in their organisation. There was a tour of the home with discussion about the bathrooms, bedrooms, conservatory, equipment and furnishings. The medication procedures, administration and storage were viewed and discussed. What the service does well:
There is a core staff team who continue to be committed to the support and care of the service users, despite the difficulties that the home has experienced with management and staffing changes and a period of time with the lift out of action. Staff take care with service users’ personal care and general health. All service users spoken to looked clean and well dressed. Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better:
The service still needs to develop considerably to meet national minimum standards. It is a recommendation of this report to have a copy of the National Minimum Standards for Younger Adults available and for all staff to become familiar with its contents to assist with the changes that are being implemented to meet them. Staffing levels have not improved yet, despite the company increasing the staffing budget and advertising for care staff. New staff are being recruited but there has been some loss of staff, sickness and unreliable staff at times. There are usually 5 carers on duty and one nurse, but sometimes this has reduced to 4 carers. The home relies on staff working additional hours and agency staff to supplement the shifts particularly at night. The manager is continuing to recruit staff to increase the staff team. A requirement has been made to provide sufficient staff to meet individually assessed needs. Staff have got to know the people living in the home and can interpret most basic needs but this is quiet limiting and means that they are reliant on staff to interpret their needs and does not assist enough with developing individual
Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 7 communication skills. There need to be some systems and aids to develop expression and response to non-verbal communication in the home. There needs to be a structured system of specialist training for the nursing staff so that they can continue to increase their knowledge and update their practice to teach and guide care staff. The people living in Corner House would benefit from an outside area that they can spend time in safely. At present this is not possible. Many of the people living in the home need at least one-to-one support out in the community and opportunities to go out are limited. The lack of garden restricts their freedom to go out in the fresh air which some may be able to do independently if there was a secure area. The new manager has ideas about developing this. The conservatory was originally built to provide additional communal space and the option of a quieter room. It has not been successful so far. There is no lock or keypad on the outside door for security. It has insufficient window blinds to shield against extremes of weather. One of the bedroom windows looks out onto the conservatory so there is no access to fresh air in this room. It has tiled flooring and this has become slippery during wet weather. A requirement has been made to resolve the issues and make this room safe and useable. All outstanding recommendations from previous inspections have been carried over. 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. Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 The statement of purpose needs further development for it to be an informative and useful document for funding authorities placing service users into the home. A meaningful service user guide needs to be designed that provides a basis for modified guides designed for individuals with limited understanding and communication. EVIDENCE: The statement of purpose has been reviewed and updated since the last inspection. The service provided to the people living in Corner House needs to be developed and the statement of purpose needs to accurately reflect what is actually provided. The core service user guide is in progress with participation from the nurses and needs to be put into one finished document. Modified versions need to be designed as part of the developing communication aids. Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 Some service user plans have been organised and contain useful relevant information but the majority have not been updated and are still confusing. Risk assessments are carried out and appropriate measures are put in place to protect service users from harm. EVIDENCE: A sample of service user plans was viewed. Some service user plans have been reviewed and organised so that irrelevant information has been removed and they are indexed for easier access to contents. Some progress has been made but not all service user plans have been organised and the requirement set at the previous inspection remains. The manager said she plans to redesign the service user plan format but it was agreed that this could be introduced as the manager feels is appropriate and was not necessary to meet the outstanding requirement but to continue to sort out the current information first. Risk assessments in the sample of service user plans were clear and up to date but all risk assessments for individuals living in the home need to be reviewed with the service user plan reviews. Risk assessments and measures put in place to support and protect service users were also discussed with reference
Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 11 to a particular recent event. The documentation was viewed and was clearly written. Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 12 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 14, 16 The manager has acknowledged that service users lead a limited lifestyle overall with little more than basic care being offered and is putting plans into place to address it. Service users are still unable to freely and safely go outside or access the conservatory. EVIDENCE: This group of standards was inspected at the last inspection and changes needed to be made to meet the standards. Please refer to the previous inspection report. The manager has been introducing more activities to stimulate and occupy service users and some of the records were briefly viewed. This is an area that is being developed and will be inspected more thoroughly at the next inspection. Communication aids are in the process of being designed and activity programmes developed. The speech and language therapist had visited during the morning to assist with two service user who have swallowing and eating
Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 13 difficulties. One service user’s behaviour, referred to in the previous inspection report, had become calmer and she was responsive when the manager spoke and used signs and gestures to her. The new manager has identified the need for further training for staff to support service users with meaningful interaction, social and recreational activities. The new manager said she is developing this part of the service as priority. An external keypad/lock needs to be fitted to the outside conservatory door so that the conservatory can be used by service users when it is fully furnished. An outside area needs to be identified and made secure so that service users are able to go outside safely if they wish. Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 14 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 The systems for recording medication administration need to be reviewed to make sure that there are clear guidelines for where and when to record medication/treatment given and that these are carried out. Monitoring is carried out effectively to make sure that service users have received the correct medication. EVIDENCE: Medication storage and administration records were viewed. There were some occasional gaps in signing for some medication on the MAR sheet. These omissions had been addressed by the manager when monitoring the previous week. Some of the gaps related to meal supplements and prescription creams and there was some discussion about a better system of recording that these had been given and applied. A recommendation was given to ensure that recording is accurate and to review the recording system for administration of creams and food/drink supplements with advice from prescribing GP and pharmacist. Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: Not inspected at this time. Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 16 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 28, 30 Some improvements have been made to the home. Some areas have been redecorated and the home is cleaner, making it brighter and more pleasant for service users. Improvements need to continue to be made to ensure the home comfortable. EVIDENCE: A tour of the home was carried out, initially with the nurse on duty and then with the manager. A physiotherapist is contracted to develop programmes of support for the service users and supervise the physiotherapy aides that are based in the home. Some of the equipment and furniture is purchased with reference to her advice. New beds are being purchased with reference to the physiotherapist’s advice. The manager wants to rearrange the seating in the lounge. The manager discussed her ideas for improvements to the facilities for service users. It is recommended that any changes proposed be in consultation with relevant professionals, for example, CSCI pharmacist, Occupational Therapist to make sure that comply with relevant legislation particularly in light of the difficulties experienced with the conservatory.
Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 17 The manager is considering different more attractive ways to provide privacy in shared bedrooms and some ideas were discussed. Some service users are able to use their bedroom during the day for some quiet time but there are still insufficient places for service users to go if they want to be away from the general noise and activity in the home. The conservatory was originally intended to provide additional communal space but this has not been satisfactory and was not available for use by service users at the time of the inspection. The manager explained that she was concerned for the safety and comfort of staff and service users due to extremes in temperature and the floor became very slippery in wetter weather. There is currently no lock/keypad on the external door so the room is not secure. A requirement has been made to provide additional communal space. If the conservatory is to be used for this then an external lock needs to be provided for security, sufficient window and ceiling coverings and appropriate furnishings need to be provided and there needs to be a means of controlling temperature by heating/air conditioning to protect against hot and cold weather conditions. The type of flooring needs to be risk assessed and appropriate measures taken to make sure that it is not hazardous. The home was clean and odour free with the exception of identified bedrooms discussed at the time of the inspection. The housekeeping staff have been increased and there was an evident improvement. All staff are provided with protective clothing. Flip top bins and an extractor fan have been installed into bathroom/toilets improve infection control. The manager has developed the cleaning schedules in the home and designed new policies for housekeeping and infection control. Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 18 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 35 Staff are committed and many are prepared to work additional hours to provide support to service users. Service users benefit from good basic care, being given by staff who are competent in meeting their health and personal care needs. Staff need to develop skills to support individual needs including: communication, social interaction and occupation. EVIDENCE: The home is not able to carry out the proposal to have 6 carers on duty with a nurse in charge despite recruitment. Staffing was discussed and the duty rota viewed. There are constant changes to cover staff unavailable to work with staff working additional hours and the use of agency staff. The manager has to work within the staffing budget and with some unreliability with staff occasionally the shift has comprised of only 4 carers. There is always a nurse on duty in addition to the manager. A copy of the training matrix was given, indicating booked training and renewal dates. Staff training has continued to be provided and planned for on a routine basis to keep staff up to date with mandatory training, including fire safety, health and safety, infection control, food hygiene, moving and handling and
Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 19 first aid. Some staff have also been provided with training in dementia, epilepsy, makaton, autism and life planning. The nursing staff had attended mandatory training courses and some additional courses but there was no evidence of the nursing staff being able to update specialised knowledge of nursing and supporting people with learning disabilities. It is recommended that the nursing staff develop their specialised nursing skills to update and increase their knowledge of current good practice with people with learning disabilities. Nurses could then cascade an increasing amount of relevant information and guide staff to develop individual social skills, communication and independence skills. Evidence was not seen of actual attendance for all training courses provided, as the matrix did not indicate this. Certificates will be viewed at another inspection. The manager had identified the need to consider different priorities for staff training in the areas highlighted in this and previous inspections and was planning to address these in the staff appraisal process. The manager is also addressing staffing issues within the supervision and appraisal process. It is a recommendation to consider all relevant training to enable service users to participate in meaningful activities and develop social and communication skills. Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 20 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38, 42 The home is benefiting from having a manager and having some leadership and direction. The manager has a good understanding of the areas in which the home needs to improve. EVIDENCE: The company has employed a new manager who is a trained nurse for people with learning disabilities. Margaret Everitt and has over 10 years of experience working in residential care with nursing and also has experience in supporting individual social, recreational and communication skill development as part of her previous role. She has commenced studying NVQ 4 management. The manager discussed her plans to improve the service users’ quality of life and improve standards in the home. Communication aids were being designed. The manager was introducing more meaningful activities but in doing this had identified a need for staff training. Various improvements to the
Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 21 environment were being considered and decoration was in progress. The organisation of staff roles had been re-evaluated and some established practices were also being re-evaluated to promote good practice. The manager had taken previous inspection requirements into account and had made some progress although not all have been completed. Timescales have been given for outstanding requirements and outcomes agreed. Quality assurance was discussed and the manager needs to consider how an effective system can be put into place. The building and equipment has been serviced within recommended timescales. The hoists have been serviced 6 monthly. The lift is now in full working order having broken down twice since the last inspection and requiring extensive repair work. The fire log has been completed accurately and staff have received drill practices and fire training. Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x x x x Standard No 22 23
ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 2 x x 2 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 2 x x x 2 x 3 Standard No 11 12 13 14 15 16 17 2 x x 2 x 2 x Standard No 31 32 33 34 35 36 Score x 2 x x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Corner House Nursing Home Score x x 2 x Standard No 37 38 39 40 41 42 43 Score x 2 x x x 3 x H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 23 yes Are there any outstanding requirements from the last inspection? 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 1 Regulation 4 (1-3) 5 (1-3) 6 Requirement a)The statement of purpose needs to be a working and reliable document for providing information on what the people moving into the home and their relatives/advocates/ representatives can expect. This needs to be kept under review. b)Complete service user guide and a modified version suitable for service users in the home with communication difficulties. Previous timescale of 30th November 2004 not met) Service user plans need to be organised so that information is accessible and appropriate to maintain continuity of care and support. Remove outdated and irrelevant information and plan reviews to complete updated care plans and risk assessments by timescale. a)Make sure there is sufficient ventilation and it is possible to control the temperature throughout the home, including the conservatory, to promote a healthy environment. Proposal in action plan to CSCI by timescale. b)Make provision for additional Timescale for action 15/12/05 2. 6 15 (1), (2) (b) 15/12/05 3. 24.6, 26.2vii 28 23(2)(p) 15/12/05 Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 24 4. 32 18 (1) (a-c i,ii) communal space for service users. If the conservatory is going to provide this, then it needs to be made safe, secure and comfortable. Action plan to be supplied by timescale. Increase the staff team to provide sufficient staff on each shift to meet individually assessed needs and not to leave shifts with less staff than have been agreed. Update on recruitment to be forwarded by timescale. 15/12/05 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 1 - 43 Good Practice Recommendations A copy of the National Minimum Standards for Younger Adults needs to be available for staff to become familiar with what is expected of them and assist with the implementation of the development of the service to meet the standards. Design systems and aids to support effective communication between service users and staff that will also be universally understood. To continue to revise the financial procedures to enable individually accountable expenditure and appropriate participation by more able service users. To provide opportunities to develop social skills and leisure activities. Staff administering medication to make sure that it is accurately recorded. Review the recording system for creams and food/drink supplements. a)Need to provide a lock/keypad for external door into conservatory for security. b)Need to install sufficient window and ceiling coverings and heating/air conditioning to protect against hot and cold weather conditions. c)The type of flooring needs to be risk assessed and appropriate measures taken to make sure that it is not hazardous.
H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 25 2. 3. 4. 5. 6. 6, 7, 8 11, 23 11, 14 20 24 Corner House Nursing Home 7. 8. 9. 24 32 33, 35 10. 39 To consider how the home can be organised into clusters of up to ten people. To be implemented by 2007. To continue to work towards 50 of the staff team achieving NVQ level 2 or above. For nursing staff to access specialised training to update knowledge in supporting people with learning disabilities and guide staff with current good practice. To develop the staff training range to incorporate supporting communication, socialisation and increase meaningful occupation. To strengthen the quality assurance process and development plan utilising feedback and information gathered to monitor the effectiveness and care standards in the home. Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent, TN23 1HU 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. Extracts may not be used or reproduced without the express permission of CSCI Corner House Nursing Home H56-H05 S26088 Corner House Nursing Home V245004 13102005 Stage 4.doc Version 1.40 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
