CARE HOMES FOR OLDER PEOPLE
Cowbridge Nursing Home Rosehill Lostwithiel Cornwall PL22 0JW Lead Inspector
Lynda Kirtland Unannounced 16 August 2005 09:30 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 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. Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Cowbridge Nursing Home Address Rosehill Lostwithiel Cornwall PL22 0JW 01208 872227 01208 873109 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) Cornwallis Care Services Mr V Herren Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (30) Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1) Service users to include one named adult with a mental disorder aged under 65 years (MD) Date of last inspection 27 January 2005 Brief Description of the Service: Cornwallis Care Services Ltd, own two nursing and one resdiential care home in Cornwall. Cowbridge Nursing Home is registerd to provide accomodation and care to 30 service users of which some may experience mental health or dementia . The registerd manager Mr Herren, has been in post for approximately six months. Cornwallis Nursing Home is a detached property situated on the outskirts of Lostwithiel. The original house has a modern day extension. The grounds are extensive with views over the surrounding countryside. There is an area of garden that has been made accessible to service users. Accommodation is provided on two floors with a passenger lift for access. There are rooms for both single and double accommodation – only one room has en-suite facilities. Assisted bathing facilities are provided. All rooms have call bells. There are three non-smoking sitting rooms and a separate dining room. Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Two inspectors visited Cowbridge Nursing Home on the 16 August 2005 and spent five and a half hours at the home. This was an unannounced visit. The purpose of the inspection was to gain an update on the progress of compliance to the requirements that were identified in the last inspection report dated 27 January 2005. This report identified 30 requirements and 13 recommendations. Due to the number of requirements and recommendations CSCI have been visiting the home on approximately a monthly bases to monitor the progress that the home is making. This inspection focused on the progress that the registered manager has made in the following key areas of care: choice of home, care planning, health care, leisure, complaints, and some environmental and management areas. On the day of inspection twenty-four service users were resident in the home. The methods used to undertake the inspection are to meet with a number of residents, relatives, staff and the registered manager to gain their views on the services that Cowbridge offer. Cowbridge nursing home records, policies and procedures were examined and the inspector toured the building. This report summarises the findings of this inspection. Since the previous inspection the registered manager has complied with 10 requirements and 7 recommendations from the previous inspection. However 20 requirements have been re notified and this inspection also identified a further 6 requirements. Therefore CSCI remain concerned due to the high number of requirements and the amount of work that the registered manager and registered provider need to achieve to ensure compliance with the national minimum standards. Due to this CSCI will continue to visit the home regularly to monitor the progress that the home is making. What the service does well:
Residents and their relatives stated that Cowbridge provides good quality care and individual accommodation. They made various comments about staff such as; they are ‘kind’ and ‘caring’. Family members commented that they felt that they were consulted about their relatives care needs which staff ‘ met’. Relatives commented that there are sufficient staffing levels on duty. Family members commented that the welcome to the home for their relative was a positive experience and ‘relieved anxiety’ about moving into a care home. Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 Page 6 Residents felt their visitors were welcomed to the home. Residents, relatives and staff stated that if there were any issues they felt able to approach the registered manager directly and that their ideas would be listened to and where appropriate acted on. The registered manager and staff at Cowbridge welcome the inspectors to the home. They are keen to discuss ways in how to improve standards in the care that Cowbridge provides to its service users. What has improved since the last inspection? What they could do better:
This inspection focused on the requirements and recommendations set at the previous inspection to monitor how the home had progressed in improving standards of care. Whilst it is acknowledged that the registered manager has met 10 of these requirements the remaining 20 are re notified, plus 6 recommendations. This inspection also identified a further 6 requirements and 1 recommendation. The main areas of improvements identified are in the following areas of care: To continue developing care plans ensuring that residents or their family are involved in this process. Care needs must be identified accurately and staff interventions to approach the individual care need are specified. This will then allow staff to approach care in a consistent manner to individual residents. The registered manager needs to develop the homes information that it provides to inform prospective residents of what services the home can provide. This will then enable residents and family members to make an
Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 Page 7 informed decision as to if Cowbridge is an appropriate home for them to live at. In addition terms of residency and expectations of the placement must be completed on all admissions to the home so that residents and their family members are aware of their rights at the home. The registered manager needs to audit some of the medication processes to ensure that resident’s medication needs are provided in a safer manner. Particular policies in respect of medication, adult protection, restraint, managing challenging behaviour and complaints need to be reviewed and developed further. Some environmental improvements to the home are needed for example ensuring appropriate infection control measures are in place. Two immediate requirements were identified at this inspection in respect of external environmental issues. The outbuildings need to be made safe and protective clothing and COSHH products must be stored safely. The registered manager has written to CSCI to say that all chemicals are now stored safely. The inspectors would like to thank residents, visitors, staff and the registered manager for their kind assistance during this inspection process. 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. Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3, The information provided to prospective residents and their families has improved but needs to be expanded further so that a accurate reflection of the services available are presented and a informed choice can be made. The statement of terms and conditions must be issued to all residents in the home. Pre admission assessment process have improved but need to be expanded to address all service users care needs to ensure the home can provide adequate care. EVIDENCE: Since the previous inspection the registered manager has reviewed Cowbridge combined statement of purpose and service users guide. Inspectors acknowledged that there has been some improvements to the document but that they need to be expanded further to fully comply with the national minimum standards requirements and relevant advice was provided. The registered manager agreed to address this. Two previous requirements identified in the January inspection was examined that relate to the residents statement of terms and conditions. The registered
Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 Page 10 manager stated that the homes headquarters, based in St Ives is responsible for issuing these contracts and was therefore unable to provide an update on this area. From inspection of resident’s files these documents could not be found. From inspection of resident’s files it was evident that in some the pre admission process that Cowbridge undertake with prospective residents has improved. However it is required that this process is expanded further to cover a assessment of all care needs as specified in the national minimum standards. Advise was provided to the registered manager who agreed to incorporate this into the homes pre admission process. Documentation evidenced that referrals and assessments had been received from referring agencies. Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,9,10 Individual care plans are generated for each service user but do not adequately inform and direct the staff in their care provision. There are suitable systems in place for dealing with service users medicines: the medication policy needs to be expanded further plus extra vigilance is required in some areas to further ensure service users safety. Residents receive their care from staff in a respectful manner. EVIDENCE: The previous inspection identified five requirements and one recommendation in respect of care planning. The registered manager has introduced and implemented individual care plans for all residents at Cowbridge nursing home. However the care plans are generalised and need to be individualised to ensure that all residents care needs are identified accurately. In addition the care plans must identify residents care needs and specify what staff interventions are needed to address the need in a consistent manner by all staff. Monthly reviews of the care plans must be evidenced. It is acknowledged that this area of care has developed but that further work in this area is needed. Therefore the five requirements are re notified to the registered manager. Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 Page 12 Nutritional and Waterlow assessments inspected were satisfactory. The moving and handling assessment needs to be expanded further so that staff are aware of what actions need to be taken in the assistance of transferring a individual. Cowbridge has a medicines policy, which was in the main satisfactory. Some amendments to this are needed: to include disposal of medication, reporting of medication errors, use of insulin, creams/lotions and medicines gases. From inspection of medication it was observed that all medication was stored safely. A monitored dose system was in use in the home and a qualified nurse administers the medications at all times. No service user was self administering their medicines at the time of the inspection. Inspectors required that an audit of completing medication records be undertaken, as they were not completed satisfactorily. In addition inspectors observed medication in a pot with no identification, the registered manager was unclear whose medication this was and stated that the home disposed of medication ‘down the sink’. Inspectors advised him that this is incorrect method of disposal of medication. The medication room was in the main tidy. But hand towels were present and inspectors advised that these are removed to prevent staff using them and possible cross infections. The registered manager stated that medication pots are washed in the kitchen area and dried immediately, which is good practice. Patient information leaflets are kept and an updated medicines book has been obtained. From discussions with residents and relatives they stated that staff display respect in their daily interactions. From observations it was evident that staff ensure that residents privacy and dignity is maintained and saw staff communicating with residents in a professional manner at all times. Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 The home provides suitable activities and aims to offer a lifestyle that meets individual service users needs. Links with family, friends and the community are good and allow service users the opportunity to socialise. EVIDENCE: Since the previous inspection the registered manager has employed an activities coordinator three times a week. Activities were observed during the inspection, and on some monthly monitoring visits: for example flower arranging, knitting, jigsaws, quizzes, cake decorating, tea in the garden, reminiscent group and discussion groups. Records demonstrate who has been involved in these leisure activities. Relatives and staff said that residents could receive visitors at anytime and there was a record of visitors to the home. The daily logs showed that residents received visits from family and friends. Relatives commented that they were welcomed to the home in a positive manner. Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 The home has a variety of complaints procedures, there must be one procedure used throughout the home so all know how complaints will be managed. Adult protection policy and procedure needs expanding to ensure that all residents are protected from all forms of abuse with staff having knowledge through training of Adult Protection issues. EVIDENCE: There were three different complaints policies in the home; the registered Manager must decide which policy is to be implemented. Cowbridge have not received any complaints. CSCI have received a complaint regarding systems and processes in the home that is currently being investigated. A log for recording complaints is now implemented. A compliment log was advised to be kept. The adult protection policy shown to the Inspectors requires review and amending to ensure that all staff is aware of the process needed when a allegation or suspicion of abuse is identified. There was a policy for referral to the POVA list. Adult protection training for staff had not yet commenced but was in hand. Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 Page 15 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,21,24,25,26 Some areas of satisfactory redecoration and refurbishment have shown recent investment in the internal décor of the home. The home would benefit from promoting infection control measures. The external grounds of the property are not safe for residents, visitors or staff to explore, measures to ensure safety must be taken. EVIDENCE: The home is maintained internally to a satisfactory standard. The home caters for residents with mobility difficulties and all parts within the home are accessible to residents. The home is a secure unit and has access to a secure garden area. The front garden area was in process of having a fence installed to ensure safety for all who visit the front of the property. The communal areas are comfortably furnished and decorated to a satisfactory standard. All the bathroom facilities were inspected and some had a variety of aids and adaptations e.g. hoists, grab rails. The bathroom facilities were decorated to a satisfactory standard and all were clean. New lino had been fitted on some bathroom floors and all toilet facilities are now labelled.
Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 Page 16 A sample of resident’s private accommodation was inspected. The majority of rooms are for single occupancy and were decorated to a good standard. The rooms were personalised and resident’s relatives commented they were ‘happy’ with the accommodation and facilities. The inspectors noted that Cowbridge was clean and tidy throughout with limited obvious odours. Cowbridge is a no smoking environment. The registered provider has employed a consultant to audit the homes premises. A detailed document has been produced which highlights areas that the home must address to ensure safety of all who live, work or visit the home. The inspectors require a summary of this audit and how the registered provider will address the issues identified. Therefore the previous requirement in respect of health and safety issues in the home has been amended to reflect this. The laundry and kitchen facilities are located on the ground floor but where not inspected on this occasion. Inspectors observed the following issues to be addressed during a tour of the home: a lack of ensuring that COSHH substances were safely secured: vegetable oil drums located in the staff smoking room: protective clothing stored in dirty environment: wheelchairs with no footrest attached; bathrooms with no paper towel dispensers or liquid soap to promote infection control: room 23 had no floor covering on the en suite facility which increases infection control difficulties. These were relayed to the registered manager. From inspecting the external premises the inspectors identified two immediate requirements. One was to ensure that the outbuildings were made safe and secure for residents, visitors and staff as the buildings are in need of repair and the area being dangerous i.e. broken glass outside the property. Following a letter from the registered manager since the inspection negotiations for timescale for compliance has been agreed. The second was to ensure that all COSHH substances and protective clothing are removed from the outbuildings and stored securely. Since this requirement has been made the registered manager has written to CSCI to state that this requirement has been addressed, therefore this is not included in the requirement section of this report. However this will be checked on the inspector’s next visit to the home to ensure compliance. Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 30 A structured induction programme for all staff employed has been implemented which promotes Cowbridge philosophy of care to all who work at the home. EVIDENCE: The induction programme for staff was only inspected on this occasion. From inspection of training records this evidenced that an induction programme is now in place. In addition staff have attended recent training in the areas of moving and handling, Parkinson’s, food hygiene and infection control. Planned training has also been booked on the following courses: adult protection and venepuncture. The inspectors required that staff also attend training on managing challenging behaviour/ restraint techniques after inspecting the accident book that demonstrated that accidents have occurred when this behaviour is displayed. Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 The health and safety of all who live, work or visit the home needs to be improved on to ensure that all at safe whilst present at Cowbridge. EVIDENCE: Equipment and systems in the home were serviced and maintained. Fire prevention systems in the home and records for the testing of fire equipment were satisfactory. Staff attended training with regard to Moving and Handling and Fire Safety. Accidents were recorded and comply with data protection requirements. The registered manager stated that progress of the requirements in this section is as follows: Changing facilities for staff had been reviewed and there were plans to address these. The homes external consultants have also identified water temperatures difficulties and this must be addressed. The registered manager stated that 75 of staff has attended infection control training. The home’s policies and procedures were all being reviewed and updated.
Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 2 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x
COMPLAINTS AND PROTECTION 1 x 3 x x 2 2 2 STAFFING Standard No Score 27 x 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 x x x x x x x 2 Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 Page 20 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 4,6 Requirement The statement of purpose and service users guide must be reviewed and updated in line with the Care Homes Regulations and National Minimum Standards. A copy of the revised version must be sent to the CSCI. All service users must have a relevant signed contract on file. Third Notification A copy of the home’s statement of terms and conditions must be given to all service users in the home irrespective of their funding status. third Notification The assessment arrangements for prospective service users must be developed and reviewed. The information recorded must have more detail regarding the identified needs and how they will be met Each service user must have a written care plan that includes all of their individual health, personal and social care needs, expected outcomes and how needs will be met. Second notification The individual care plans must
D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Timescale for action 30/10/05 2. 3. 2 2 5 5 30/10/05 30/10/05 4. 3 14 30/11/05 5. 7 15 30/11/05 6. 7 15 30/11/053
Page 21 Cowbridge Nursing Home Version 1.40 7. 7 15 be drawn up and reviewed with the service user and /or representative whenever possible and signed as agreed. 3rd Notification The care plans must include the interventions required and the specific action to be taken to meet the needs of individual service user. 3rd Notification Social, emotional and religious needs must be addressed in the care plans. 3rd Notification The risk assessments for individual service users must be available to care staff at all times. Second notification Medicines policy must be reviewed and updated. 3rd notification. medicines received into the home must be checked, recorded appropriately on the MAR charts and signed as correct. 3rd notification Medication must be disposed of by all staff in the apporved manner as specified by the Royal Pharamecutical Guidelines. An appropriate complaints policy must be implemented. 2nd notification The home’s adult protection policy must be reviewed and updated. 2nd notification Adult protection training for staff must take place. 2nd notification Following the health and safety consultation in respect of the premises, the Registered Provider must forward an action plan to CCSI in how it will addres the issues raised. Immediate requirement: Outbuildings must be made safe 0/11/05 30/11/05 8. 7 15 30/11/05 9. 7 12 30/11/05 10. 11. 9 9 13 13 30/10/05 30/10/05 12. 9 13 30/09/05 13. 14. 15. 16. 16 18 18 19 22 12 13 13,23 30/09/05 30/12/05 30/12/05 30/11/05 17. 19 13 30/11/05 Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 Page 22 18. 19. 21 22 13 13,23 20. 24 12 21. 22. 26 29 13 17 23. 30 13 24. 38/ 25 12,23 25. 38 23 26. 37 17 and secure for residents, visitors and staff. (after negoitation timescale agreed) The flooring in the en suite facility in room 23 must be impervious All wheelcahirs must be in correct working order and have foot rests attrtached to ensure safety when moving service users around the home. Individual risk assessments must be undertaken and recorded with regard to service users having a key to their room. 3rd Notification Paper towel and soap dispensers must be installed to promote infection control. Recruitment records required by legislation must be maintained. (remains as 2nd notification as not inspected on this occasion) All staff must attend training in the manamgment of challenging behaviour and restraint techniques. Where service users utilise facilities that do not have the water temperature regulated to 43c a comprehensive risk assessment must be undertaken for the service users and the facilities they use. Appropriate hot water signage must be in place. 3rd notification There must be adequate changing facilities for staff ( a facility for catering staff) with lockable storage for personal belongings. 3rd notification All records required by legislation must be kept in the home. (2nd notification) 30/11/05 30/10/05 30/12/05 30/11/05 30/10/05 30/12/05 30/11/05 30/04/06 30/12/05 Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 Page 23 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. 3. Refer to Standard 7 9 19 Good Practice Recommendations Individual life histories should be compiled for each service user Hand towels should be removed form the medicines room to promote infection control. Registered Provider should seek the advice of other agencies that specialise in the provision of facilities and services for people with dementia, particularly those involved with environmental design. There needs to be a review of the bathing facilities in the home to ensure they are suitable for the service users accommodated. Service users should be encouraged to choose the colour décor of their room There needs to be a sluice with a washer disinfector upstairs. Signed staff contracts, terms and conditions of employment and job descriptions should be held in the home. 4. 5. 6. 7. 8. 21 24 26 29 Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection John keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Cowbridge Nursing Home D52-D04 S9169 Cowbridge V243211 160805 Stage 4.doc Version 1.40 Page 25 - 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!
