Inspection on 30/08/06 for Cranford Nursing Home

This inspection was carried out on 30th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cranford Nursing Home 21/09/09

Cranford Nursing Home 25/09/07

Cranford Nursing Home 16/11/05

Cranford Nursing Home 05/07/05

Cranford Nursing Home 07/02/05

Cranford Nursing Home 11/10/04

Cranford Nursing Home 12/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Cranford Nursing Home 15 Cranford Avenue Exmouth Devon EX8 2HS Lead Inspector Michelle Oliver Key Unannounced Inspection 30th August 2006 08:45 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 Cranford Nursing Home DS0000026689.V298876.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. Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cranford Nursing Home Address 15 Cranford Avenue Exmouth Devon EX8 2HS 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) 01395 263295 01395 267273 csampford@tiscali.co.uk Baystone Limited Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Notice of Proposal to Grant Registration for staffing/environmental conditions of registration issued 30/9/1996 Registered for 26 - Elderly General Nursing Care Date of last inspection 16th November 2005 Brief Description of the Service: Cranford Nursing Home is a detached 1920s building in a quiet residential part of the East Devon town of Exmouth. It provides residential accommodation to 26 older people who require nursing care. It is situated in attractive gardens. Accommodation is provided on two levels, and has a passenger lift and large staircase. Accommodation is provided in 24 single and 1 double room. 22 single rooms have en suite facilities. The home has a large, welcoming reception hall where seating is provided. Baystone Ltd. owns the Home and the responsible individuals are involved in its day-to-day management. The home’s statement of purpose and service user guide is available at the home, which includes details about the philosophy of the home, a statement of terms and conditions and details about living at the home. This is made available to all potential residents before they make a decision about living at the home. A copy of the most recent inspection report is available on request. Information received from the home indicates that the current fees are £670 weekly [basic]. Services not included in this fee include hairdressing, chiropody, toiletries and personal shopping, laundering of delicate clothing or dry cleaning, televisions, visitors meals and transport at 25p per mile. Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on Wednesday 30th August 2006 over a period of 9 hours. The owners and the manager were present during the inspection. Some positive informative discussion and exchange of information took place. During the inspection 3 residents’ files were looked at in detail, which helps us to understand the experiences of people using the service. A number of other residents were met and spoken with during the course of the day. The inspector also spent a considerable time observing the care and attention given to residents by staff. Several staff were also spoken with during the day. Prior to the inspection 22 questionnaires were sent to residents to obtain their views of the service provided; 16 were returned. Comments were in the main satisfactory with the majority of the respondents confirming that they ‘usually’ receive the care and support they need. Nine people who have relatives living at the home were sent questionnaires; eight replied. All comments were generally positive. Seventeen staff were sent questionnaires in order to hear their confidential views; ten were returned. The staff responses indicate that staff feel supported in their role. Questionnaires were sent to 15 health and social care professionals prior to the inspection, nine of which responded with positive comments about The Cranford. During the visit the inspector toured the premises and a sample number of records were inspected which included care plans, medication records/procedures, staff recruitment files and fire safety records. The manager had completed a pre-inspection questionnaire and the inspector appreciated the preparation undertaken by the manager to assist with this inspection. Finally the outcome of the inspection was discussed with the owners and manager. Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: No residents are admitted to the home unless an assessment of their needs has been undertaken. Improvement is needed to ensure that sufficient detail Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 7 relating to health, social and welfare needs is consistently recorded on which a comprehensive plan of care can be written for individual residents. Care plans should be expanded to clearly show how identified individual needs, will be met by staff at the home. Improvement is required in the procedure for the administration of medicines at the home to ensure that residents are not put at risk. The current manager has been employed at the home since March 2006. An application must be made to the CSCI to register the manager to comply with regulation. The results of surveys undertaken to ensure that the home is run in the best interests of residents should be made available to residents, potential residents, relatives, any interested parties and the CSCI. It is recommended, as good practice, that all staff should receive formal supervision at least 6 times a year. Formal supervision should include the manager, or designated person, meeting with staff and discussing all aspects of practice, philosophy of care in the home, and career development needs. 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. Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 3 & 6. Quality in this outcome is adequate. This has been made using available evidence including a visit to the service. Prospective residents are able to make an informed choice about whether the home is suitable for them before deciding to make it their home. Attention is needed to improve the quality and consistency of pre admission assessments. The home does not admit people needing intermediate care. EVIDENCE: Residents spoken to said that they were given enough information about The Cranford before making a decision to make it their home. Some residents had been living at the home for a number of years and some others could not recall the process but were happy living at the home and with the care they receive. Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 10 A resident who responded to a questionnaire received prior to the inspection said “I looked at several homes and decided the Cranford was the one for me. I have had no reason to regret my decision”. The home’s Statement of Purpose, Service User’s Guide and the most recent inspection report is available on request. The results of a recent quality assurance survey, which would inform potential residents of the views of those already living at the home, is not included in the home’s statement of purpose. [Please refer to standard 33] Sixteen residents returned questionnaires prior to this visit. All stated that they had received enough information about the home before deciding to live there. No resident is admitted to the home without an assessment of their needs being undertaken beforehand. Assessments undertaken for 3 residents were looked at. The assessment process was found to be inconsistent. Not all staff are using the same format for recording information which reflects upon the quality of the information recorded. Pre admission assessments did not identify care needs in sufficient detail on which a plan of care could be written. There is no information to identify, for example, does the staff rota need to be changed to meet care needs, is specialist equipment required, can specific individual dietary requirements be met, is the proposed room suitable and do staff need training updates in a specific field of expertise? Positive discussion took place with the manager and the owners as to the specific information needed and how this would be recorded. The home does not admit people who need intermediate care. Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 7, 8, 9 & 10. Quality in this outcome is adequate. This has been made using available evidence including a visit to the service. Individual care plans have been developed for all residents and most aspects of health. Attention is needed in some area. Medication is generally well managed. Attention is needed in some areas. Residents’ privacy and dignity are met and promoted by the staff and management at the home. EVIDENCE: Care plans have been improved since the last inspection and generally provide information to enable staff to meet residents’ identified care needs. Three plans of care, looked at during this visit, have been designed to included information relating to individual personal details, activities, reviews of medication, details of the involvement of other health care professionals, assessments of risks, including falls, nutrition and those presented by the Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 12 environment, and identified health issues. However, health issues identified do not include sufficient detail of ‘what’, ‘why’, ‘how’, ‘when’ and “who by”. For example, records of dressings state what will be used but no details of the frequency of the dressing, which member of staff carried out the procedure and no record of the progress/ effect of the treatment. Another plan of care did not include accurate, clear information and none included details of how individuals like care, such as personal care, to be carried out. Plans did not include information relating to individual goals agreed with the resident. Information relating to residents’ previous interests or activities or a record of those that residents have taken part in whilst living at the home are inconsistent. Despite these shortfalls the manager is to be commended for the improvement in the care planning process since being employed at the home. The manager is aware of the need to continue the improvement of care plans and positive discussion about recording information in such a way that all staff are able to understand, contribute to and refer to were discussed at the time of this inspection. Residents have access to healthcare services that meet their needs including chiropody, opticians, dentists and specialist services such as dietician, diabetic and skin care specialist nurses. The handling of medication continues to need attention. On arrival at the home, 2 tablets, dispensed into individual pots with no means of identification, were found on a desk in the manager’s office. The deputy manager explained that these had been left out by another member of staff as a reminder for them to be given by the day staff. This practice puts residents at risk of receiving medication which has not been prescribed for them, and does not comply with the home’s policy for the safe administration of medication. Creams with no indication of either when they were opened or when they expired were seen in two residents’ rooms. Creams and ointments deteriorate once opened. Current practice puts residents at risk of infection and decreases the effectiveness of the cream. Residents’ privacy and dignity are met and promoted by the staff and management at the home. Staff are aware of the home’s guidance on respecting residents’ privacy and dignity and were seen respecting this during the inspection. Residents confirmed that all staff are friendly, kind and treat them as they wish to be treated. Throughout the visit good interactions were seen between staff and residents, they were patient, gentle and kind when assisting residents. Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 13 Comments in a questionnaire received from a relative included “The Cranford is, I suspect, exceptional in its standards of care and general ambience. From a relatives point of view it is a great relief to know that my loved one is cared for professionally and lovingly and in a way that gives honour and maintains the dignity of the individual”. Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 12, 13, 14 & 15. Quality in this outcome is good. This has been made using available evidence including a visit to the service. Social needs and meals are generally well managed. Meals are wholesome and nutritious, taking account of the likes and dislikes of individuals. Residents are encouraged to maintain contact with their families or friends as they wish and their rights are recognised and respected within the home EVIDENCE: The daily routine, including getting up, going to bed and mealtimes, appeared to be flexible. Staff said there were no actual routines at the home, residents were able to choose what they did and when. Residents said they are able to lead their lives just as they wish, including times of getting up, going to bed, or when they want to have a bath. During this visit a resident said they had decided not to have a bath and staff had told them they could have it at another time and two residents said that they “felt like a lie in” and were confidant that staff would come to assist them when they wanted to get up. A relative said a resident had expressed their preference in relation to the gender Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 15 of staff that attend them for specific care and that whenever possible these wishes were complied with. A carer at the home takes a particular interest in providing stimulating and interesting activities for residents although all staff, including a cook, are involved. Several residents said they are told of activities going on in the home and are able to choose whether to take part or not, others said they enjoyed spending time in their rooms and chose not to take part. On the day of this visit residents were looking forward to a person coming to the home to give a piano recital. Residents are encouraged and supported to go shopping if they wish and regular activities include arts and crafts, bingo, aromatherapy and relaxation, exercise, skittles reading, music, outings and outside activities, and board games. Fifteen questionnaires received from residents stated there were always or usually activities arranged by the home that they can take part in. Residents are supported to maintain their religious beliefs by staff at the home. There is no restriction on visiting times and throughout the day visitors came to the home and were made to feel welcome. Staff greeted them in a kind, friendly manner and visitors confirmed that this was always the case. Residents may choose where they want to spend time with their visitors, either in the privacy of their rooms, the quiet dining room or in the lounge. All residents spoken to said they enjoyed the food served at the home. During the visit good quality, fresh, fruit and vegetables were seen and the midday meal was balanced and nutritious. The home caters for all dietary needs including vegetarian and diabetics. Residents are given the choice of being served their meals either in their rooms, the lounge or the dining room. Staff consult with all residents daily telling them the meal planned for the day and offering an alternative if requested. A cook visits all residents when they move to the home so that a comprehensive record of their likes and dislikes can be recorded and also visits all residents daily to ask them what they would like for their evening meal. The cook said that if a resident doesn’t want what is on the menu a meal of their choice will be prepared. The inspector was present when lunch was served; the meal was well presented and nutritious. A questionnaire returned by a resident stated that the home has an “imaginative menu”. Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 16 & 18. Quality in this outcome is good. This has been made using available evidence including a visit to the service. The home has a satisfactory complaints process. Staff were able to demonstrate a good knowledge and understanding of the forms of abuse thereby ensuring that residents are protected at the home. EVIDENCE: Residents confirmed that they feel comfortable discussing any concerns with staff at the home. No complaints have been made to the home or the Commission since the last inspection. Sixteen residents’ questionnaires confirmed that they always know who to speak to if unhappy and know how to make a complaint. All but two of the eight questionnaires returned by relatives confirmed that they were aware of the home’s complaints procedure. None had ever made a complaint. There was nothing to suggest that residents are anything other than well cared for at the home. Residents said that staff were very helpful, respectful and that Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 17 nothing was ever too much trouble for them. Staff have undertaken Adult Protection training since the last inspection and were able to discuss different forms of abuse. They all said that they would not hesitate to report any suspicion of poor practice. Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 19 & 26. Quality in this outcome is good. This has been made using available evidence including a visit to the service. The home is clean, pleasant and homely and meets the needs of the residents. Environmental risk is well managed. EVIDENCE: The Cranford is well maintained, with homely and comfortable accommodation including a pleasant lounge and dining room. The manager said the home has a programme for redecoration and improvement. The home was clean and free from offensive odours throughout. The laundry facilities were well organised. There is a good supply of protective clothing and hand-washing facilities at the home and the laundry has equipment which should effectively reduce the risk of cross infection. Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 19 The home was warm, very clean and comfortable at the time of this visit. All residents’ rooms visited during the inspection were well maintained. They are individualised and provide ample space for residents to bring personal possessions and items of small furniture with them when they decide to make The Cranford their home. Since the last inspection four residents’ rooms have been redecorated, the home has been double glazed throughout and sun blinds have been provided for the sitting room and some rooms as required. The décor in some parts of the home is looking tired and would benefit from redecoration. This was highlighted by the owners who are waiting for some major re plumbing work to be undertaken before starting the redecoration. The grounds and gardens are accessible and attractive and the home is maintained and upgraded to a high standard. Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 27, 28, 29 & 30. Quality in this outcome is good. This has been made using available evidence including a visit to the service. The number of staff on duty throughout the day and night meets residents’ personal and health needs. Residents benefit from being cared for by staff who are qualified and competent and are protected by the robust recruitment practice followed at the home. EVIDENCE: On the day of the inspection a deputy matron, five carers, a cook, a kitchen assistant, two domestics, a laundry person and an office manager were on duty. In the afternoon this changed to three care staff, and in the evening five care staff. The rota shows that there are two waking staff on duty throughout the night until 8 am. There is always a registered nurse on duty throughout the day and night at the home. Eight residents and relatives who returned questionnaires felt there are always enough staff to care for them and seven felt that there usually were. One resident commented “an extra member of staff at night would be an advantage. The staff on duty are unbelievably busy. There are currently only two on duty and although no one is neglected they are kept very busy”. Comments from staff included “There is often a lack of staff which puts a lot of pressure on all of the staff” and when asked to comment on one thing to Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 21 improve the home wrote “more communication” and another “ improve communication between staff”. This was discussed with the owners and the manager. The manager is currently promoting the role of key workers for each resident with the aim that they know they get to know the resident well and support them with personal tasks. This works towards meeting the homes’ ethos of maintaining person centred care for all residents living at The Cranford. According to the pre-inspection information, 55 of the care staff group have an NV2 in care or above, which is a good achievement. All newly employed staff undergo a period of training when they start working at the home to enable them to get to know the residents, the home’s philosophy of care, safety procedure, care procedures, and the general layout of the home. The time taken to complete this training will depend on past experience and individual ability. According to pre inspection information staff have undertaken a variety of courses provided by an outside training group, this includes food hygiene, first aid and protection of vulnerable adults. Training currently being undertaken by staff includes principles of manual handling and fire training. Training planned to take place during the next 12 months include manual handling training and training for two carers who have expressed an interest in undertaking NVQ training. Ensuring that residents are cared for by a competent team of staff further promotes person centred care and safety. The home operates a good recruitment procedure that clearly highlights the processes to be followed. Three staff recruitment files were looked at during this visit. The documentation was consistent with evidence of a safe and robust recruitment process being carried out before a person is employed at the home. This protects residents, as only people who have undergone this robust procedure will be employed to work at their home. Twelve staff confirmed in questionnaires that they had all undergone a thorough, robust recruitment procedure. Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 31, 33, 35, 36 & 38. Quality in this outcome is good. This has been made using available evidence including a visit to the service. The home is generally well managed, run in the best interest of residents, and their health and safety are properly attended to. EVIDENCE: The home has employed a manager since the last inspection and is due to submit an application to the CSCI for them to be registered. Twelve members of staff commented in their written responses that they felt well supported by the manager, office manager and owners. One response stated “I work closely with my manager and as problems arise we sort them out as they present themselves”. Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 23 Several residents said that they felt the manager was approachable and is always available During the inspection the manager demonstrated good knowledge about the needs of residents A quality audit has been undertaken since the last inspection to gather views of residents and visitors related to the running of, and the quality of life experienced at the home, including standards of care, quality and variety of food, activities, cleanliness, laundry, privacy and management and administration at the home. The results of the survey have not been made available to current or prospective residents, or their representatives/ interested parties or the CSCI. The owners carry out an unannounced inspection of the home monthly and a copy of this report is sent to the Commission. It is recommended, as good practice, that all staff should receive formal supervision at least 6 times a year. Formal supervision should include the manager, or designated person, meeting with staff and discussing all aspects of practice, philosophy of care in the home, and career development needs. Three staff members confirmed in questionnaires that they had formal supervision and two stated that as part of supervision their practice was observed. Eight staff confirmed that they had not received formal supervision nor had they had been observed whilst undertaking their normal duties. Comments received from those who had not received supervision included “As the trained nurse on duty I am the sister supervising the other members of staff”, I am unaware of one to one planned supervision but it may occur informally” and” I expect this is because as a confident and trained nurse I do this with care assistants”. All staff should receive formal supervision. This was discussed with the manager who said that supervision is one of the standards which is being introduced into the home and records are kept of those sessions already undertaken. The temperature of hot water in bathrooms is checked before a resident is bathed to ensure that the resident is protected from the risk of scalds. All first floor windows checked were fitted with window restrictors promoting safety within the home by reducing the risk of residents falling from them. Fridge and freezer temperatures are recorded which is good practice. Staff involved in food preparation confirmed that they had food hygiene qualifications. Eighteen residents’ rooms were visited and radiators had been covered to promote the safety of residents. Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 24 Records show that staff undertake training in the prevention of fire, and fire alarms and emergency lighting have been carried out regularly. An assessment of identified hazards and associated risk relating to the environment, including fire hazards, is due to be undertaken which will contribute towards ensuring that The Cranford Nursing Home is a safe place to live. Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 2 X 3 Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 26 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 OP9 Regulation 13(2) Timescale for action The registered person shall make 29/09/06 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the home. [This refers to: tablets being dispensed into pots and left on desk] Requirement Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. Refer to Standard OP3 OP7 OP9 OP31 OP33 OP36 Good Practice Recommendations Pre admission assessments should include sufficient detail relating to health, social and welfare needs on which a comprehensive plan of care can be written. Care plans should be expanded to clearly show how identified individual needs, will be met by staff at the home. Date of expiry, or opening, should be recorded on medication when opened. [This relates to creams not being dated when opened.] The registered person shall appoint an individual to manage the care home. The results of residents’ surveys should be made available to all interested parties including current residents. Care staff should receive supervision at least 6 times a year. Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Cranford Nursing Home DS0000026689.V298876.R01.S.doc Version 5.2 Page 29 - 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. 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