Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 16/06/06 for Cranham Court Nursing Home

Also see our care home review for Cranham Court Nursing Home for more information

This inspection was carried out on 16th June 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.

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

What the care home does well

The home has a relatively stable staff team and residents receive good care from committed staff teams who have the skills and training to meet their needs. There is a relaxed atmosphere throughout the home and residents appeared unhurried and are given sufficient time and support in their everyday lives. The proprietor/ manager is an experienced person and the resident`s benefit as the home is run in their best interests.

What has improved since the last inspection?

The proprietor/ manager has introduced an effective system for undertaking monthly audits of a number of key areas. This includes admissions, discharges, pressure care, training, and accidents/ incidents. Improvement was noted in the management of medication records.

What the care home could do better:

Many of the bedrooms on the Main Building/ Extension are designated as double bedrooms but currently are generally being used by only one person. The unused beds must be removed from these rooms; furniture such as wardrobes and chests of drawers must be replaced and bedrooms decorated. Whilst it is acknowledged that the registered providers have long term plans to upgrade this part of the home, improvements must be made in the short term. This would greatly improve the environment and space for current residents and also for any prospective resident.

CARE HOMES FOR OLDER PEOPLE Cranham Court Nursing Home 435 St Marys Lane Upminster Essex RM14 3NU Lead Inspector Ms Gwen Lording Unannounced Inspection 16th June 2006 10:00 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 Cranham Court Nursing Home DS0000015588.V300580.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. Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cranham Court Nursing Home Address 435 St Marys Lane Upminster Essex RM14 3NU 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) 01708 250 422 01708 227 728 THE HOLMES CARE LTD Mrs Indumati Lakhani Care Home 82 Category(ies) of Old age, not falling within any other category registration, with number (82) of places Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 82 BEDS FOR ELDERLY INFIRM MINIMUM STAFFING NOTICE Date of last inspection 5th February 2006 Brief Description of the Service: Cranham Court Nursing Home is registered to provide accommodation and nursing care to eighty-two older persons. Originally opened in 1982 with twelve places, considerable expansion has occurred with the addition of a rear extension in the late nineteen-eighties, and the well-designed Woodlands Unit being opened in 1995. Currently there are fifty single, and sixteen double bedrooms. The original house with rear extension, and the more modern Woodlands Unit are operated separately. One of the owners, Mrs Lakhani, has managed the home since it opened, with each of the two distinct units having a Care Manager, both of whom have been at the home for more than ten years. It is set in eleven acres of attractive, well maintained woodlands and grounds, the original house retaining many of it’s distinctive architectural features. Due to its location, the families of prospective residents are told that access by public transport can be difficult. The range of care needs is wide - from those who are mentally alert but have physical frailties, some of whom need to be nursed in bed - to people showing signs of mental deterioration. On the day of the inspection the range of fees for the home was between £500.00 and £600.00 per week. A copy of the Statement of Purpose and service user guide to the home is made available to both the resident and the family. There is a copy of both these documents on each of the units and at the main reception. A copy of the most recent inspection report is located in the main reception. Cranham Court Nursing Home DS0000015588.V300580.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 started at 10.am. It took place over five and a half hours during the late morning and afternoon. The inspection was undertaken by two inspectors, namely the lead inspector Gwen Lording and Sandra Parnell-Hopkinson. The proprietor/ registered manager and senior nurses on both units were available throughout the visit to aid the inspection process. This was a key inspection visit in the inspection programme for 2006/2007. Discussion took place with the proprietor/ registered manager; senior nurses on both the Woodlands Unit and Main Building/ Extension; several members of care staff; the person in charge of the kitchen; and the person in charge of the laundry on the day of the visit. Nursing and care staff were asked about the care that residents receive, and were also observed carrying out their duties. The Inspectors’ spoke to a number of residents and relatives/ visitors. Where possible residents were asked to give their views on the service and their experience of living in the home. All parts of the home were visited and a number of staff, care and home records were looked at. The inspectors’ would like to thank the staff and residents for their input and assistance during the inspection. What the service does well: The home has a relatively stable staff team and residents receive good care from committed staff teams who have the skills and training to meet their needs. There is a relaxed atmosphere throughout the home and residents appeared unhurried and are given sufficient time and support in their everyday lives. The proprietor/ manager is an experienced person and the resident’s benefit as the home is run in their best interests. Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 3, 4 & 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose and service user guide provides residents with information about the service. However, these documents must be provided in alternative formats to meet the capacity of all residents. Comprehensive assessments are being undertaken for all residents prior to them moving into the home. Care plans are drawn up from the information in this assessment, ensuring that the needs of the residents are identified, understood and met. The home does not offer intermediate care. EVIDENCE: The home has a Statement of Purpose and service user guide, which provide residents, and their relatives/ representatives with the information they need to make an informed choice about whether the home will meet their needs. However, the service user guide needs to be provided in alternative formats Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 9 that are suitable for the capacity of all residents. For example, simpler format, part pictorial or large print. The Care Homes Regulations 2001 have been amended with effect from the 1st September, 2006 for new residents, and for existing residents with effect from the 1st October, 2006 so that more comprehensive information is to be included in the service users’ guide. Details of information to be included are contained within the amended regulations. Therefore, the service users’ guide must be reviewed and amended by the stated timescales. Prospective residents and their relatives/ representatives can visit the home prior to admission. All records inspected have assessment information recorded and the information had been used to continue assessment following admission to the home and develop written care plans. Where appropriate, information provided by the placing authority was also on file. Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9, 10 and 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health, personal care and social care needs are set out in individual care plans and provide staff with the information they need to satisfactorily identify and meet residents’ needs. There are clear medication policies and procedures for staff to follow. However, there are some inconsistencies in the recording of medication, which may result in unsafe practices. EVIDENCE: A total of eight residents were case tracked and their care plans and related documentation inspected. All residents had comprehensive care plans, which covered health and personal care needs. There was evidence that care plans were being reviewed on a monthly basis and updated to reflect changing needs. The documentation/ health records relating to wound management and the management of residents with diabetes, were detailed and being adequately maintained. Risk assessments are routinely undertaken on Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 11 admission for all residents around nutrition, manual handling, continence and pressure sore prevention; and reviewed on a regular basis. Turning regimes and fluid monitoring charts were all up to date. Records indicated that residents are seen by other health professionals such as tissue viability nurse, dietician, optician and dentist. The home has a very good relationship with the local GP and tissue viability nurse. Referrals are made to the dentist and an optician visits the home annually, or more frequently if necessary. It would appear that the local PCT no longer provides chiropody services and all of the residents who require chiropody care pay for this privately. Nutritional screening is undertaken on admission and weights are monitored monthly. If a referral to a dietician is indicated then this is undertaken. However, due to staff shortages within the local PCT the home is now being told that the home’s nurses should be able to give advice and address issues. The nurses are continuing to make referrals to the dietician, but are also discussing with the GP who will issue a prescription for nutritional supplements. Nurses have attended a seminar on nutritional intake. There was no evidence in the files of “end of life” care plans and the importance of the development of these was discussed with the proprietor/ manager and the nurses, during the inspection. However, from viewing letters received from relatives it was apparent that staff dealt with a person’s dying and death in a sensitive and understanding manner, both for the individual and relatives. One friend had written: “Having terminal cancer my friend’s needs were great but she continually praised the care and attention given by staff. Also that the food was great. So my thanks go to you for making the last days of her life a comfortable and contented time”. Staff were observed to treat residents with respect and were seen to be very gentle when undertaking moving and handling tasks. However, a carer was observed to be pushing a resident in a wheelchair without the footplates being in position. It is essential that all carers ensure that wheelchair footplates are always used unless a completed risk assessment indicates otherwise. There are policies and procedures for the handling and recording of medications. The administration of medication was observed on the Main Building/ Extension and this was in accordance with the home’s policy and procedure. An audit was undertaken of the management of medications within both the Woodlands Unit and the Main Building/ Extension. The records for controlled drugs, temperatures of the room and refrigerator were in order. A random sample of Medication Administration Records (MAR) charts were examined. The following issues were discussed with the nurses in charge of the particular units: Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 12 • • Handwritten entries on MAR charts must be signed and dated by the person making the entry. The entry must also include the source of the information i.e. GP. When directions for administering medications are variable e.g. one or two tablets, then the dose given is to be entered on the MAR chart. Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a general programme of activities available but more consideration needs to be given to planning activities, which are suitable to the needs of individual residents. This will ensure that all residents have a sufficiently stimulating and varied choice of activities. EVIDENCE: Activities are available four days a week, but these should be extended to include activities seven days a week and be more focused as to the needs of individual residents. Some residents were observed to be reading or watching TV, but it was apparent that some residents would not be able to do this, and generally were just sitting and not occupied or engaged in any meaningful activities. More consideration must be given to provide meaningful activities for those residents who lack the capacity to be involved in the general activity programme for the home. Various functions are arranged such as summer fete and “bring and buy”, and residents, where able, are encouraged to make small things such as greetings cards for sale on these occasions. Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 14 From observation and talking with several residents it was evident that the routines of daily living are flexible and varied to suit the differing needs and preferences of residents. The inspectors observed members of staff allowing time for residents to express their wishes and supporting individuals to make choices in their daily lives, for example choosing a drink, where to sit or where they wished to take their meal. Relatives are encouraged to visit the home and there are no restrictions on when relatives and friends can visit. Visiting can be undertaken in the lounges or in the privacy of the resident’s room. The lunchtime meal was observed and residents received a varied, appealing and nutritious meal. Pureed meals were presented in an attractive and appealing manner and residents who required assistance were not hurried. Staff were seen to offer assistance where necessary and this was done discreetly and individually. Generally residents were assisted to the dining room for lunch, but others took their meal in the lounge or in their rooms according to their individual needs and choices. Meals were served on trays laid with tray cloths and nicely presented. On the day of the inspection the weather was very hot and ceiling fans were in operation in the lounge of the Main Building and the ceiling windows were also open. A gazebo was also being erected in the garden area between the two wings of the building. Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 15 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): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The proprietor/ manager and staff make very effort to sort out any problems or concerns and makes sure that residents and their relatives feel confident that their complaints and concerns are listened to and will be acted upon. Staff working in the home have received training in Adult Protection/ Abuse Awareness to ensure that there is a proper response to any suspicion or allegation of abuse. EVIDENCE: From viewing the complaints record and discussions with the proprietor/ manager it was evident that all complaints, whether made formally in writing, or verbally, are taken seriously and dealt with effectively. The proprietor/ manager always acknowledges the complaints and responds in writing. Also on file were many letters and cards complimenting the staff on the care given to residents. Several residents spoken to were aware of how to complain and to whom. One resident commented: “I only have to mention that I am not happy with something and it is immediately put right”. Staff have recently undertaken training in adult protection and this training is provided to all staff during their induction. Those staff spoken to during the Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 16 inspection were aware of the action to be taken if they had concerns about the safety and welfare of residents. Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 17 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): Standards 19, 20, 21, 22, 23, 24 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The overall atmosphere in the home is welcoming. However, the environment on the Main Building/ Extension does not always meet the resident’s needs and does not provide people living in these units of the home with comfortable and well-maintained premises. EVIDENCE: The building was toured by the inspectors, accompanied by one of the senior nurses, at the start of the visit, and all units were visited unaccompanied later during the day. Some bedrooms were seen either by invitation of the service users, or with permission, whilst others were seen because the doors were open. All areas of the home were clean, tidy and free from odour. The Woodlands Unit is a newer purpose built unit and environmentally is of a much better standard than that of the Main Building/ Extension. Many of the bedrooms on the Main Building/ Extension are designated as double bedrooms Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 18 but currently are generally being used by only one person, because of the demand for single rooms. Many of these rooms are still furnished with two single beds, although only one is in use. Also some of the furniture such as chest of drawers and wardrobes need replacing. The inspectors did discuss this with the proprietor/ manager around the need to remove the unused beds from the rooms; to replace some of the furniture and re-decorate many of the bedrooms in the Main Building/ Extension. This would greatly improve the environment and space for current residents and also for any prospective resident. There are sufficient toilets and bathrooms for the needs of the residents. Adaptations and equipment are in situ which are capable of meeting the needs of all residents. Call alarm systems are provided and were accessible and within reach of residents whilst in their rooms. The kitchen was visited by one of the inspectors and was found to be clean and tidy; and generally food was being stored and labelled appropriately. However, there were two items of cooked meat, which were out of date, and these were disposed of by the cook. The laundry area was visited by one of the inspectors and this was found to be clean, with soiled articles, clothing and foul linen being stored appropriately, pending washing. Personal protective clothing and equipment were available and in use. Hand washing facilities are prominently sited and staff were observed to be practising an adequate standard of hand hygiene. Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 19 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): Standards 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are satisfactory and there are sufficient staff on duty to meet the individual assessed needs of the residents. The procedures for the recruitment of staff are robust and provide safeguards for people living in the home. Residents benefit from committed staff teams who have the skills and training to meet their needs. EVIDENCE: Staff rotas were inspected and the staffing levels and skill mix of qualified nurses and care staff, on all units of the home, was sufficient to meet the assessed nursing and personal care needs of residents. Care workers were being effectively deployed to ensure that residents choosing, or needing to remain in their bedrooms were being cared for appropriately. The home has a relatively stable staff team and effective team working was observed and evidenced throughout the inspection. Staff interacted well, both with each other and residents. Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 20 A random sample of staff personnel files were inspected and these were found to be in good order with necessary references, criminal records bureau disclosures, and application forms duly completed and interview notes. It was evident that the recruitment procedures are robust and in accordance with the Care Homes Regulations. Staff training is readily available and a record is maintained of training undertaken. Recently this has included training on POVA, pressure care, moving and handling, nutrition, COSHH and infection control. Staff have also received training specific to the care of individuals with multiple sclerosis and diabetes. 50 of care staff are qualified to NVQ level 2 and a further 3 staff are working towards this qualification. Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 21 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): Standards 31, 32, 33, 35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The proprietor/ manager of the home is a well qualified and experienced person and the residents benefit as the home is run in their best interests. Residents benefit from a committed staff team who have the skills and training necessary to meet their needs. EVIDENCE: The registered manager is also the proprietor of the home. She is a qualified nurse and has also completed the Registered Manager’s Award. She does Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 22 ensure that the management approach of the home creates an open, positive and inclusive atmosphere. Policies and procedures are regularly reviewed and updated to reflect changing legislation and good practice advice. Quality assurance systems are effective and many monthly audits are undertaken around admissions, discharges, pressure care, training and accident/ incidents amongst other areas. Financial procedures for the home are robust and the services of an accountant are employed. The home does not manage any personal finances for any resident. Risk assessments are undertaken and reviewed where necessary. Staff receive regular training in health and safety and safe working practices. A wide range of records were looked at including fire safety, emergency lighting, water temperature checks and health and safety audits. These records were found to be detailed, up to date and accurate. Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 23 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 2 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 3 2 2 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 3 3 3 X 3 X X 2 Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 24 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 OP1 Regulation 5 Requirement The service user guide must be produced in alternative formats to meet the capacity of all residents. All handwritten entries on Medication Administration Records (MAR) charts must be signed and dated by the person making the entry and include the source of the information. When directions for administering medications are variable e.g. one or two tablets, then the dose given is to be entered on the MAR chart. Wheelchair footplates must always be in position, unless a completed risk assessment indicates otherwise. “End of Life” care plans must be developed for all residents. The home must provide a more varied programme of activities, which are suitable to the needs of individual residents. The unused beds must be removed from the double bedrooms in the Main Building/ DS0000015588.V300580.R01.S.doc Timescale for action 31/08/06 2. OP9 13 16/06/06 3. OP8 13 16/06/06 4. 5. OP11 OP12 15 16 31/07/06 31/08/06 6. OP19 OP23 OP24 16 & 23 31/08/06 Cranham Court Nursing Home Version 5.2 Page 25 Extension. Bedroom furniture must be replaced where identified. Re-decoration must take place in the rooms identified. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 Cranham Court Nursing Home DS0000015588.V300580.R01.S.doc Version 5.2 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!