Inspection on 04/01/06 for Crawfords Walk Nursing Home

This inspection was carried out on 4th January 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Crawfords Walk Nursing Home 21/03/07

Crawfords Walk Nursing Home 26/08/05

Crawfords Walk Nursing Home 08/02/05

Crawfords Walk Nursing Home 23/09/04

Crawfords Walk Nursing Home 16/01/04

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

CARE HOMES FOR OLDER PEOPLE Crawfords Walk Nursing Home Lightfoot Street Hoole Chester Cheshire CH2 3AD Lead Inspector Wendy Smith Unannounced Inspection 4th January 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 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. Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Crawfords Walk Nursing Home Address Lightfoot Street Hoole Chester Cheshire CH2 3AD 01244 318567 01244 344326 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) BUPA Care Homes Limited Mrs Kathleen Margaret Webber Care Home 120 Category(ies) of Dementia (6), Dementia - over 65 years of age registration, with number (60), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (30), Old age, not falling within any other category (30), Terminally ill over 65 years of age (1) Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The total number of service users must not exceed 120 No more than 60 service users in the category DE(E) (Dementia over the age of 65 years) in receipt of nursing care may be accommodated on Watergate House and Eastgate House Within the maximum of 60 service users no more than 6 service users in the category DE (Dementia) may be accommodated on Watergate House and Eastgate House No more than 30 service users in the category of MD(E) (Mental disorder, excluding learning disability or dementia over the age of 65 years) may be accommodated in Northgate House No more than 30 service users in the category of OP (Old age, not falling within any other category) may be accommodated on Bridgegate House Within the maximum of 30 service users 1 service user in the category of TI(E) (Terminal illness over 65 years of age) may be accommodated on Bridgegate House 26th August 2005 2. 3. 4. 5. 6. 7. Date of last inspection Brief Description of the Service: Crawfords Walk Nursing Home comprises five purpose-built bungalows set in landscaped gardens in the Hoole area of Chester. The home is owned and operated by BUPA Care Homes. A number of the places in the home are contracted to the local Health Authority. Bridgegate House provides care for 30 frail older people; Eastgate House and Watergate House each provide care for 30 people with dementia, and Northgate House provides care for 30 people with enduring mental illness. The fifth building houses the kitchen, laundry, administration and staff facilities. The four residential units are all single storey and all residents have single bedrooms. There are no en-suite facilities. Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by three inspectors on 4th January 2006, as part of the Commission for Social Care Inspection’s statutory inspection programme. Each of the four residential units was visited. Residents, relatives and members of staff were spoken with on each of the houses, and time was spent in discussion with the service manager. Staff records, financial records and health and safety records were inspected. Some of the information in this report is taken from the pre-inspection questionnaire completed by the home manager. What the service does well: What has improved since the last inspection? Baths and showers have been replaced as needed. The grounds of the home have been improved for the benefit of residents. Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 Page 6 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. Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 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 Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 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): 1, 3 and 4. Written information about the home is provided for residents. Residents admitted for short-term care do not always have a full assessment to ensure Crawford’s walk can meet their needs. EVIDENCE: Written information about the home is available for residents and their relatives. Residents spoken with on Bridgegate House confirmed that they had received a copy of the resident guide to the home. There was evidence that residents admitted for continuing care are assessed prior to admission, however the manager expressed her concern that health and social work professionals sometimes seek to make emergency short term placements inappropriately and without full information and/or appropriate support services being in place. This has sometimes resulted in difficult situations that have compromised the health and safety of residents. At the time of the inspection a resident admitted for emergency respite care was trying to leave the building and required constant observation. Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 Page 9 Residents accommodated on the dementia care unit may move to Bridgegate House when they become physically frail. See requirement 1. Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 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): 7, 8, 9 and 10. Each resident has a care plan that details their needs and how their needs will be met but improvements in care planning could be made. Crawford’s walk has breached its categories of registration by admitting residents who fall outside of the categories of registration to Watergate and Northgate House. EVIDENCE: On the day of the inspection, 24 residents were living in Eastgate House. None of these residents were very ill and none were confined to bed. No residents had a pressure sore, and the manager said that good preventative measures were in place, with pressure relieving cushions and mattresses always accessible as needed. A consultant psychiatrist was visiting one resident. She was not able to prescribe the new medication she advised for this person and had to contact the GP to arrange this. The unit manager said that it could take up to a week for a prescription to be received. The home has no regular visits from a GP. The unit manager and her deputy write all the care plans, and care plans examined were written and maintained to a good standard. Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 Page 11 Residents in Eastgate House were clean and tidy and appropriately dressed in warm winter clothes. Female residents were wearing stockings or tights unless by individual choice. The unit manager has connections with the Alzheimer’s Society and had put together an information folder that was available for staff and relatives. During the visit to Bridgegate House five residents, four visitors and two members of staff were spoken with. They confirmed that residents receive their mail unopened. The staff induction programme included instruction on how to treat residents with respect. The residents said that staff treated them with respect and helped them to maintain their privacy and dignity. One said “the staff are lovely, whenever they need to help me with any personal care they make sure it is done in private.” On Watergate House twenty-five residents were accommodated. The manager and staff confirmed that a resident who was presenting challenging, unmanageable behaviour identified at the previous visit was no longer accommodated. This decision had been taken following a review of the resident’s mental health needs. The records of two residents who had recently moved into Watergate House were examined. There were detailed pre admission assessments and care plans in place. One of the residents was identified as being incontinent but no continence assessment was completed. One of the residents had a diagnosis of schizophrenia ands no diagnosis of dementia. Watergate House is registered to care for adults diagnosed with dementia. The manager confirmed that the resident had been accommodated on Watergate House as there were no beds available on Northgate House and the care home accommodating the resident was closing down. This decision had not been discussed with CSCI and an application to vary the registration categories to accommodate the resident had not been made. There was evidence of the reviews of the resident’s care, which recorded positive improvement in her care and family involvement of personalising her bedroom. There were concerns raised by relatives about the resident’s verbally aggressive behaviour toward them and other residents. A consultant psychiatrist following this reviewed the resident and altered her medication. On Northgate House 29 residents were accommodated. A resident was transferred from Watergate House with a diagnosis of dementia. Northgate House is registered to accommodate residents diagnosed with mental disorder and not dementia. The manager said she had taken the decision to transfer the resident after he displayed sexually inappropriate behaviour to females and was a risk to them. This decision had not been discussed with CSCI and an application to vary the registration categories to accommodate the resident had not been made. The CSCI had not been informed of the incidents of inappropriate sexualised behaviour toward other female residents. There was a care plan and action plan in place to monitor and manage the behaviour. The action plan instructed staff to discretely monitor the resident and divert his attention from females. The reviews of the care plan for the last two months Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 Page 12 recorded only one incident, which was managed by staff. Two residents had been involved in an aggressive incident, which was not reported to the CSCI. Following the incident a care plan and action plan to manage one of the resident’s behaviour was put into place. There have been no further incidents. The nurse in charge identified that the resident’s behaviour may be triggered by alcohol, which was identified in the care plan. The action plan for this did not identify how staff were to manage the resident’s antisocial behaviour associated with alcohol. Medicines were inspected on Bridgegate House. The unit has its own clinical room where the medicines are stored. The storage facilities included medicine cupboards, a controlled drugs cabinet, two medicine trolleys and a drugs fridge. All complied with legislation and a record of the fridge temperatures was maintained to ensure that medicines requiring refrigeration were stored at the correct temperature. Several bottles of eye drops were appropriately stored in the fridge, but these had not been dated on opening. It is important that this is done because they only have a shelf life of 28 days after opening. A stock check was carried out on the controlled drugs and the amounts tallied with those recorded in the controlled drugs register. The home uses the Nomad system of supply. Medicines within the Nomad boxes are delivered weekly and all other medication is delivered monthly. Medication administration record sheets were checked against the medicines in stock. Records of amounts received were recorded and the amount carried forward from the previous month was recorded for analgesics. The amount of tablets in stock for those medications supplied monthly did not tally with the records. In all instances there were more than were documented. One resident was prescribed one or two painkillers up to four times a day. Staff were administering these as required but not recording whether the resident had had one or two. For some of the resident’s other medication a code ‘O’ was recorded in several places on the MAR sheet, but there was no explanation for this code. On Watergate House there is a clinical room where the medicines are stored. The storage facilities included medicine cupboards, a controlled drugs cabinet, medicine trolley and a drugs fridge. All complied with legislation and a record of the fridge temperatures was maintained to ensure that medicines requiring refrigeration were stored at the correct temperature. Medicine administration records examined found a number of omitted signatures for medicines that had been administered. Two residents’ medicines were not being administered correctly. One medicine was prescribed twice daily and one was prescribed three times a day. They were only being administered once daily. Satisfactory arrangements were in place for the disposal of unused medicines. See requirements 2 to 4 and recommendations 1 and 2. Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 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): 12, 13, 14 and 15. Social activities are provided for residents. Visitors are welcomed at the home at any reasonable time. Residents are able to exercise choices in daily living. A good choice of meals is available for residents. EVIDENCE: Residents living in Eastgate House are able to walk around freely. The sluices and storerooms are kept locked, but residents have free access to other areas. The unit manager said that she intended to make the toilets and bathrooms more easily identifiable for residents by having them painted in a recognisable colour and adding pictorial symbols. A few residents were sitting in their bedrooms, most were in the lounge and five were walking around. Chairs were situated in the corridors for residents who walk around to be able to sit down and rest. The activities organiser provides social activities four afternoons a week. The unit manager said that the kitchen provides a very good choice of meals. Residents on Bridgegate House confirmed that they could make choices in their daily lives. For example, what they had to eat, where they spent their time, when they got up and when they went to bed. Visitors confirmed that they could visit at any reasonable time. One visitor said that he sometimes had lunch with his wife for a very small charge and they both enjoyed being able to eat together. He also said that relatives were also invited to any parties held Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 Page 14 on the unit. All residents spoken with were very complimentary about the food and said that there was plenty of variety and choices were always offered. On Watergate House residents were seen to enjoy a cooked breakfast. Residents had the choice to sit in the dining area or and sit in an armchair with a table. Residents said they enjoyed their breakfast and staff offered them a choice of a cooked breakfast. Later the activities coordinator sat with a group of residents and discussed current affairs from the daily newspapers. Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 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): 16 and 18 Complaints are dealt with appropriately. Residents are protected from abuse. EVIDENCE: One complaint had been recorded since last inspection, and records examined showed that the complaint was fully investigated by the home manager and was well documented. The home’s complaints procedure is displayed in all parts of the building. Eastgate House had a copy of No Secrets, and training relating to this is included in the home’s induction programme for new staff. There was no record that staff had received any further training regarding adult protection. Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22 and 26 Residents live in a clean, well maintained and comfortable environment. EVIDENCE: The home is set in its own grounds and each of the residential units has its own enclosed garden. The grounds were very well maintained and pleasant areas had been provided for residents to sit and walk in. On the day of the visit repairs were being carried out to the roof of the administration block. Eastgate House was clean and tidy. All areas were appropriately decorated and furnished and were maintained in good condition. Some bedrooms had been redecorated. Bridgegate House was nicely decorated and well maintained. Decoration of residents’ bedrooms on Watergate House was progressing. The handyman was decorating a bedroom on the day of the visit. Bedrooms that Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 Page 17 had been decorated had been personalised. A bath has been replaced with a walk-in shower. On Northgate House two bathrooms had been refurbished. A bath had been replaced in one and in the other the shower tray removed and the floor fitted with a flush drain to make this accessible to a shower chair. The home has a full time maintenance manager and two part time members of staff who assist him and who maintain the gardens. Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Staff are provided in sufficient numbers to meet the needs of residents. The home provides a good skill mix, however the target for 50 of care staff to have a qualification has not been achieved. Good recruitment procedures are followed. All staff receive appropriate training for their work. EVIDENCE: The home employs 29 nurses, 36 care staff and 20 ancillary staff. There is very little use of agency staff. In Eastgate House there were three nurses and two care assistants on duty. The two senior staff members are registered mental nurses. The unit manger said that she had a full team of staff and couldn’t wish for better staff. A housekeeper is on duty between 9am and 6pm. On duty in Bridgegate House were one RGN, three nurses on supervised practice, and two care assistants. They were on duty for the whole day. There were also two student nurses on duty in the morning. On Watergate House there were two qualified staff and four care staff on duty. One staff was on an induction programme having transferred from another unit. On Northgate House there were two qualified staff and three care staff on duty. The Houses still display the staffing notice from a previous registration authority and staff to the figures specified in the notice. Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 Page 19 12 care staff (35 percent) have an NVQ qualification. A number of the staff who had achieved NVQ qualification had left the home to pursue other opportunities. Three more staff were undertaking NVQ training at the time of the inspection. Two of the care staff working on Eastgate House were hoping to start NVQ level 2 in the near future. On Northgate House an NVQ assessor was assessing staff. Four personnel files were chosen at random and reviewed. All the required information and documentation was present to demonstrate that the home had carried out all necessary checks prior to employment. The manager keeps a central record of all training undertaken by staff. In addition, all staff has their own personal training record kept on the unit. All new staff receive a comprehensive induction that covers all the Skills for Care foundation standards. In addition, staff had been supported to attend various training days throughout the previous year. These had included administration of medication, elder abuse, dementia and dealing with challenging behaviour, giving the best nutrition, holistic care, towards an understanding of Parkinson’s disease, risk assessment and pressure ulcers, introduction to integrated care pathways and care of the dying and bereaved. Training records kept on Eastgate House showed that all staff had fire training during December 2005, and all staff completed infection control training during 2005. Staff had also received training regarding the care of wheelchairs and moving and handling updates were held in August 2005. See recommendation 3. Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. The home has a competent and experienced manager however the management of the home needs to improve ensure that conditions of registration are adhered to. Quality assurance systems are in place. Residents’ money is handled appropriately. A system of staff support is in place but is not always implemented. The health and safety of staff and residents are protected. EVIDENCE: The home manager has been in post for seven years. She is a registered mental nurse and has the registered manager award. The manager informed the inspectors that she would be absent from the home for the next few weeks in order to provide management cover for another home. She was training a senior member of staff to act as manager during this period. The manager confirmed that she took the decision to admit residents to Crawford’s Walk who were outside of the categories of registration. Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 Page 21 An area manager carries out visits required by regulation 26 of the Care Homes Regulations. BUPA care homes have a Quality and Development self audit. This is a very large document and was completed at Crawfords Walk in 2003. The home manager said that this Quality Assurance system is now under review. The home manager carries out care plan audits on each of the units, and records were available for inspection. A medication audit and a nutrition audit have recently been introduced. All accident forms are sent to the manager. The home manager said that Crawfords Walk will have a ‘clinical services manager’ in near future, and quality monitoring will be part of the role. Staff are currently involved in a ‘personal best’ initiative, to improve the quality of the service provided. The residential units hold their own staff meetings. Heads of department meeting are held monthly and include catering and housekeeping. External consultants on behalf of BUPA carried out a satisfaction survey in March 2005. Crawfords Walk scored well, particularly in questions about care, and the only area that had reduced down from the last survey was activities. The home has a full time administrator and a part time receptionist. The administrator is appointee for 14 residents, mainly living on Northgate House, under long standing arrangements. Some of the other residents have personal spending money in safekeeping. Residents’ money is not kept on the premises but is paid into a bank account. All monies are held in one bank account in which each person has a separate account that yields its own interest. The administrator draws out personal spending money weekly. Good records, both written and electronic, are kept and were examined. 24 residents are subject to power of attorney, and one has a guardianship order. The home had a system for formal, documented supervision of staff but individual records showed that this was not carried out an a regular basis. Managers said that staff were supervised as part of the management process on a continual basis, but records of this were rarely maintained. Records demonstrated that staff had received training and regular updates in fire safety, moving and handling, first aid, and food hygiene and infection control. Examination of the maintenance records showed that all equipment was checked and serviced at the required intervals. See requirement 5 and recommendation 4. Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 1 1 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 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 3 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 1 X 3 X 3 2 X 3 Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14 and 15 Timescale for action The registered person must 01/03/06 ensure that residents’ needs are adequately assessed before admission and keep their needs under review when considering discharge. The registered person must 04/01/06 ensure the home’s conditions of registration are met at all times. The registered person must 01/02/06 inform the Commission for Social Care Inspection of any event in the care home, which adversely affects the well being, or safety of any resident. (Timescale 01/10/05 not met) The registered person must 04/01/06 ensure that medicines are given and recorded reliably, safely and appropriately stored. The registered person must 04/01/06 ensure that the care home is conducted to make proper provision for the health and welfare of residents including DS0000018716.V273463.R01.S.doc Version 5.0 Page 24 Requirement 2. OP8OP4 CSA 2000 PII 13(3) 37 3 OP37 4 OP9 13(2) 5 OP31 12 13(6&7) Crawfords Walk Nursing Home admission of residents appropriate categories registration. into of RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations All assessment tools to verify the health needs of residents should be completed and all action plans should record how resident’s antisocial behaviour is managed. At the next delivery of medicines a full stock check should be carried out to verify the exact amount of all drugs in stock and carry these forward onto the medicine administration record. Further investment should be made to provide a skilled workforce. Staff supervision should be provided on a regular basis. 2 OP9 3 4 OP28 OP36 Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Crawfords Walk Nursing Home DS0000018716.V273463.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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