Inspection on 10/01/06 for Drummuir Nursing and Residential Home

This inspection was carried out on 10th 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 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

Drummuir Nursing and Residential... 29/03/10

Drummuir Nursing and Residential... 03/03/10

Drummuir Nursing and Residential... 02/02/10

Drummuir Nursing and Residential... 02/09/09

Drummuir Nursing and Residential... 03/03/09

Drummuir Nursing and Residential... 11/04/08

Drummuir Nursing and Residential... 11/12/07

Drummuir Nursing and Residential... 05/03/07

Drummuir Nursing and Residential... 26/06/06

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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 Drummuir Nursing & Residential Home 9-11 Northfield Bridgwater Somerset TA6 7EZ Lead Inspector Kathy McCluskey Announced Inspection 10th 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 Drummuir Nursing & Residential Home DS0000065814.V270750.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. Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Drummuir Nursing & Residential Home Address 9-11 Northfield Bridgwater Somerset TA6 7EZ 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) 01278 422144 01278 420397 Ashbourne (Eton) Limited Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Elderly persons of either sex, not less than 60 years, who require general nursing care Up to two persons of either sex, between the ages of 50-60 years who require general nursing care Up to eight places for personal care Date of last inspection 1st September 2005 Brief Description of the Service: Drummuir Nursing Home is situated in a quiet residential area close to the town centre of Bridgwater, Somerset. The home is not purpose built. Drummuir is registered with the Commission for Social Care Inspection to provide general nursing care for up to 38 older people, although the home can only accommodate a maximum of 32 service users. This includes up to 8 service users who require personal care. There is a registered general nurse on duty at all times. The home does not currently have a registered manager. The home has recently been taken over by Southern Cross Healthcare. Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was conducted over one day (5.75hrs) by CSCI Regulation Inspector Kathy McCluskey. The home does not have a registered manager but the acting manager, Wendy Remiszewska, was available throughout the inspection. The home’s operations manager was available for part of the inspection. The inspector was able to meet with a number of staff and service users. No relatives requested to see the inspector. Communal areas and a selection of bedrooms were seen. Records relating to service users, staff and health and safety were examined. As part of this announced inspection, CSCI comment cards were sent to service users and visiting professionals. At the time of this report, 10 completed comment cards were received from service users. Comments were generally positive. The inspector would like to thank service users, staff and the management for their time and cooperation with the inspection process. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. What the service does well: What has improved since the last inspection? Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 Page 6 Staff morale has improved since the last inspection and this can only have a positive outcome for service users. Southern Cross Healthcare have taken appropriate action to ensure that staff and service users are kept informed of changes which will affect them. The company are now conducting monthly management visits to the home. The home’s complaints procedure has been updated and now includes more information and appropriate contact details. Since the last inspection, staff have received training and information relating to the protection of service users from the risk of abuse. The inspector was able to see evidence that care plans were being reviewed at least monthly, though further improvements are required. As required at the last inspection, servicing records for moving and handling hoists, were forwarded to the CSCI. Appropriate action was taken to replace the sealant around an identified bath. The bin was also replaced and the bathroom was decorated. All recommendations raised at the last inspection were addressed. What they could do better: The home must ensure that service user care plans are fully reflective of an individual’s assessed needs and that detailed instructions for staff are recorded. The home maintains appropriate records relating to the prevention of pressure sores but care plans need more information regarding the treatment of the wound. It was evident at this inspection that adjustable beds were not available for some service users with an assessed need. It has been required that this is addressed within a given timescale. The home’s procedures for the recruitment of staff require improvement. It has been required that appropriate references are obtained and that any gaps in employment history are explored. The home does not employ a member of staff until a satisfactory POVAFirst and enhanced CRB check has been received. Two requirements have been raised relating to health and safety. A free standing radiator was found in one bedroom which was very hot to touch. It has been required that a detailed risk assessment is completed and kept under review to reduce any risk to service users. Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 Page 7 The home’s equipment servicing records were generally good though it has been required that copies of the electrical hardwiring certificate and Landlords Gas Safety Certificate are forwarded to the CSCI. 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. Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 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 Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 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): 1, 3, 4 and 5. Standard 6 is not applicable as the home is not registered to provide intermediate care Prospective service users are provided with the information they need to make an informed choice about moving to the home. EVIDENCE: The home has recently been taken over by Southern Cross Healthcare. A revised Statement of Purpose was made available to the inspector. Information provided by the home indicated the home’s current fee range is between £349 and £550 per week. Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 Page 10 Extra charges are made for hairdressing, personal toiletries, papers/magazines and taxis. Prospective service users and/or their representatives are invited to visit the home prior to making a decision about moving to the home. Prospective service users are fully assessed at their home/hospital by the acting manager. This is to ensure that the home is able to meet the assessed needs of an individual. Assessments are also obtained, where appropriate, from other professionals. Documented evidence of this was seen in the care records of the most recent service user. The first four weeks of admission is considered a trial period. This is to ensure that all parties are happy that the home can meet the service users assessed needs. The acting manager confirmed that specialist input is sought where required to ensure the assessed needs of an individual can be met. An example was provided of input from the community mental health team. Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 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): 7, 8 and 10 Care plans do not fully reflect individuals assessed needs. The home does not have an adequate supply of specialist equipment to enable them to meet an individual’s assessed needs. The home ensures that the privacy and dignity of service users is respected. EVIDENCE: Three service user care plans were examined in detail. Care plans contained appropriate and up to date assessments, which included moving and handling needs, reducing the risk of pressure sores and nutrition. It was noted that care needs and interventions for staff required more information. Examples included; one service user with a reduced appetite and weight loss – the care plan was not reflective of this and there were no clear instructions for staff on how to meet these needs. There was no evidence that staff were monitoring the amount of diet taken each day. The inspector was informed that one service user was exhibiting ‘challenging behaviour’. This was also evident from the daily records examined. Although Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 Page 12 the inspector was able to see that input from the mental health team had been sought, no care plan was in place to address these needs. Wound care plans were seen to be in place for those service users with a pressure sore. More information is required to ensure a consistent approach. Prescribed dressings/creams in use were not identified and the frequency of changing dressings was not clear. On examination of bedrooms, the inspector was able to see evidence that appropriate and identified pressure relieving equipment was in place where there was an assessed need. It was very concerning to note that a number of service users identified by the inspector, were being nursed on domestic type beds when their assessed needs indicated that they required an adjustable type bed. This was ascertained on examination of care records, observation, discussion with staff and examination of bedrooms. It has been required that this is addressed within a given timescale. Refer to Standard 24.3 These issues were brought to the attention of the acting manager and the operations manager at the time of the inspection. As required at the last inspection, the inspector was able to see evidence that care plans were being reviewed at least monthly. Service users are weighed monthly and appropriate records are maintained. All service users are registered with a G.P and the inspector was able to see evidence that the acting manager had requested G.P visits/reviews for those service users who had not seen a doctor for a period of time. Service users spoken with during the inspection were positive regarding the care they received. Ten completed CSCI service user comment cards were received and all indicated that they felt safe at the home. Eight indicated that they liked living at the home and that they felt well cared for. Nine stated that their privacy was respected and that staff treated them well. Drummuir Nursing & Residential Home DS0000065814.V270750.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 and 14 The home enables service users to maintain contact with family and friends. Where ever possible, service users are supported to exercise control and choice over their lives. EVIDENCE: Visitors are made welcome at any reasonable time and the rights and wishes of service users are respected. A visitor’s policy is clearly displayed in the reception area of the home, which also covers action to be taken in the event of an accident or fire. Service users are encouraged to personalise their bedrooms. This was evident from bedrooms examined at this inspection. Service users spoken with, who were able to express a view, informed the inspector that they chose how or where to spend their day. This is not the case for all service users as due to their physical needs. A programme of activities was made available to the inspector. This indicated that activities take place on a Monday, Wednesday and Friday. Activities identified included; hairdresser, videos, flower arranging, bingo, board games and a sing-a-long. Once a month, shopping trips are arranged. Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 Page 14 Service users spoken with during the inspection were generally satisfied with the activities offered. Many stated that they preferred to watch T.V or enjoyed time in their bedroom. Eight of the ten completed CSCI service user comment cards indicated that the home provided suitable activities. At the last inspection, it was recommended that staff duties were reviewed to ensure that sufficient numbers of staff were on duty to enable appropriate assistance for service users with drinks. This was discussed with the acting manager who informed the inspector that this continues to be under review. The inspector was able to see service users in the lounge being assisted with morning drinks by the ‘house-assistant’. All service users appeared to enjoy a hot drink with appropriate levels of assistance. This should continue to be monitored. Drummuir Nursing & Residential Home DS0000065814.V270750.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, 17 and 18 The home’s procedures for reporting complaints and abuse have improved. EVIDENCE: As required at the last inspection, the home’s complaints procedure has been updated and now includes timescales for action and clear contact details, including the contact details of the CSCI. A copy was seen to be displayed in the reception area of the home. Service users spoken with did not raise any concerns with the inspector and stated that they would raise any concerns, should they have any. Eight of the ten completed CSCI service user comment cards indicated that service users knew who to speak to if they had any concerns about their care. The home has investigated one complaint since the last inspection and the inspector was able to see evidence that appropriate action had been taken to address. No concerns have been raised directly with the CSCI. At the last inspection it was required that the home’s whistle blowing policy is updated to include contact details of appropriate external agencies, including the CSCI and to include appropriate information on the types of abuse. It was also required that the home takes appropriate action to raise staff awareness. Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 Page 16 Although the revised policy still focuses on the ‘Public Interest Disclosure Act’, the inspector was able to see evidence that the home’s induction and training programme identifies abuse in more detail. Staff spoken with confirmed that they had recently been given a pack to read and that this had been discussed with them. The contact details of appropriate external agencies, including the CSCI, are now identified on the home’s policy. The registered person should ensure that staff’s understanding and awareness is monitored through regular supervision sessions and/or staff meetings. Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 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): 19, 20, 21, 22, 23, 24, 25 and 26 Service users live in a comfortable environment. Redecoration of some areas would have a positive outcome for service users. The home does not have an adequate supply of specialist beds. The home takes appropriate steps to reduce the risk of the spread of infection. EVIDENCE: Drummuir Nursing home is not purpose built. The home is a large Victorian property which, as far as possible, has been adapted to meet the needs of service users. Accommodation is arranged over three floors, with a shaft lift giving access to the first and second floor. The home has a very small garden area. Although registered for 38 service users, the home can only physically accommodate 32. This is due to the past reduction of triple occupancy bedrooms. Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 Page 18 As identified at the last inspection, some areas of the home would benefit from redecoration. Paint on some doors and skirting boards were noted to be badly chipped. The manager stated that the home has a redecoration programme and that these areas would be addressed. Paintwork to both stairs and one bathroom have been decorated since the last inspection. On the ground floor is a large communal lounge/dining room and smaller quiet lounge. Bedrooms are arranged over three floors. The home has 17 single bedrooms of which 2 have en-suite toilet facilities. Four of the single bedrooms are below 10 sq metres. The NMS state a minimum of 12 sq metres. These bedrooms should be kept under review to ensure that the needs, including manual handling needs of service users occupying them, can be met. 4 of the 8 double bedrooms are fitted with en-suite toilet facilities. Screens are available in double bedrooms. All bedrooms are fitted with a wash hand basin and bedroom doors are fitted with a lock, which can be accessed by staff in the case of an emergency. As previously mentioned in this report, it was concerning to note that adjustable beds were not available for all service users with an assessed need. A requirement has been raised that this is addressed within a given timescale. Call bells are fitted throughout the home. The home appears to have an appropriate number and selection of hoists with up to date servicing records. Wheelchairs are available to service users where there is an assessed need. The home appears to have an appropriate number of assisted baths and toilets to meet the assessed needs of service users. Some baths are fitted with shower attachments. As required at the last inspection, appropriate action has been taken to replace the sealant around a downstairs bath. The pedal bin has been replaced and the bathroom has been decorated. At this inspection, a bathroom on the second floor was noted to be very cold and the radiator was not on. This was brought to the attention of the acting manager and operations manager at the time of the inspection, who agreed to address. The home has two sluice areas and an automatic sluice disinfector. Locks are fitted to bathroom and toilet doors to ensure the privacy of service users. These can be overridden by staff in the event of an emergency. Staff hand washing facilities are appropriately sited around the home. Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 Page 19 To ensure the safety of service users, radiators are either low surface temperature or are fitted with a guard. It was noted however that a free standing radiator, which was very hot to the touch, was in a service user’s bedroom. The acting manager was advised to ensure that a robust risk assessment was in place, which will ensure that the service user, and other service users, would not be at risk of injury. A requirement has been raised. Refer to Standard 38. Regular checks are made on all hot water outlets to ensure the safety of service users. Records are well maintained. Bath hot water outlets checked at this inspection and were found to be within HSE recommended guidelines. To ensure the safety of service users, upstairs windows are appropriately restricted and wardrobes are secured to the wall. Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 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): 27, 29 and 30 Staffing levels at the home are adequate. Staff morale has improved. The home’s recruitment procedures require improvement. EVIDENCE: A registered nurse is on duty covering a 24hr period. In addition to the nurse, 5 care staff are on duty during the morning, four in the afternoon and 2 at night. Staff spoken with during the inspection did not express any concerns about staffing levels. Service users were positive regarding the care they received. In addition to care staff, the home employs suitable numbers of ancillary staff. The home also employs an activities person for 16 hours a week and an administrator. The inspector was informed that deficits in care hours are covered by staff from the company’s sister home or through an agency. At the last inspection, staff morale was noted to be very low. The inspector was able to speak to some staff in depth about this and was informed that ‘things were getting better’ and that representatives from the new company, Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 Page 21 Southern Cross, had been communicating with them. A formal meeting was due to take place this week. Two staff recruitment files were examined at this inspection. It was noted that for one member of staff, a large gap in employment had not been explored and that one reference had not been received from the most recent employer. The home had accepted a reference addressed, ‘to whom it may concern’ and there were no identified contact details of the referee. Copies of POVAFirst checks and enhanced CRB’s were available in both files. Staff spoken with informed the inspector that they had received mandatory training. Detailed records were available for staff training but it was difficult to ascertain how the manager would be able to identify when mandatory training would be due. It has been recommended that a staff training matrix is maintained which would clearly identify all staff members training achievements and requirements. It could not be ascertained at this inspection what additional or specialist training is offered to staff. This will be followed up at the next inspection as the inspector was informed that staff training and NVQ’s were due to be discussed at the forthcoming meeting with Southern Cross Healthcare. Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 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): 32, 34, 37 and 38 The company’s management support to the home has improved. Further improvements are required to ensure the health and safety of service users, staff and visitors to the home. EVIDENCE: Standard 31 was not fully assessed on this occasion, as the home does not have a registered manager. Wendy Remiszewska is acting manager and since the last inspection, has withdrawn her application with the CSCI to be registered manager. The inspector was informed that the company is in the process of interviewing a suitable candidate. Progress will continue to be monitored closely by the CSCI as the home has been without a registered manager since November 2004. Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 Page 23 Staff and service users spoken with at the inspection were positive regarding the management style of the acting manager and that they found her approachable. Wendy continues to provide ‘hands on’ care and is very aware of the needs of service users. Wendy confirmed that she was well supported by the operations manager of Southern Cross and that a home ‘buddy’ system has been put in place to enable the home to contact one of its sister homes where required. The acting manager confirmed that the manager from one of the sister homes had also been providing support to the home. As required at the last inspection monthly visits are carried out by the company, in accordance with Regulation 26 of the Care Homes Regulations 2001. Staff meetings have been conducted for staff. Meetings have been arranged for service users, staff and relatives. Staff feel better informed. The home displays an appropriate and up to date employers liability insurance certificate which expires 29/09/06. Records seen at this inspection were appropriately stored. Service users have access to their personal records in accordance with the Data Protection Act 1998. Some improvements are required to ensure the health and safety of service users, staff and visitors. This was ascertained by a tour of the premises and on examination of records; FIRE SAFETY – The home conducts weekly checks on the home’s fire detection systems and monthly checks on emergency lighting. Records are maintained. Fire detection systems and fire fighting equipment are serviced by an outside contractor on an annual basis. This was last recorded as 01/08/05 & 18/10/05. Staff confirmed that they received regular fire safety training though it has been recommended that a clear staff training matrix is maintained. Refer to Standard 30. ELECTRICAL SAFETY – The home’s portable appliances (PAT) are tested annually. This was last carried out in July 2005. The home’s Electrical hardwiring was due to be checked in October 2005. The inspector was informed that this would be completed this month. It has been required that a copy of the electrical hardwiring certificate is forwarded to the CSCI. GAS SAFETY – A copy of the home’s annual Landlords Gas Safety Certificate could not be located for this inspection. It has been required that this is forwarded to the CSCI. Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 Page 24 HOT WATER OUTLETS/SURFACES – Regular checks are recorded for temperatures of hot water outlets. Those checked at the time of the inspection were within HSE recommended limits. To reduce the risk of injury, radiators are either of low surface temperature type or have been fitted with a guard. A free-standing radiator was found in one bedroom and was extremely hot to touch. It has been required that the acting manager ensures that an appropriate risk assessment is completed which will reduce any risk to service users. EQUIPMENT SERVICING – All equipment relating to the transportation of service users is serviced by an outside company in accordance with LOLER regulations every 6 months. The home’s passenger lift was serviced on 31/10/05. Mobile and fixed hoists were last serviced on 07/09/05. To ensure the safety of service users, all upstairs windows are restricted, and wardrobes are secured to the wall. As recommended at the last inspection, appropriate warning signage has been placed on the inside of the toilet doors which open out directly onto stairs. Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 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 3 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 1 3 3 STAFFING Standard No Score 27 3 28 x 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 3 x 3 x x 3 1 Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 Page 26 Are there any outstanding requirements from the last inspection? No 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 OP7 Regulation 15(1) Requirement The registered person must ensure that service user care plans are fully reflective of assessed needs and that they identify clear instructions for staff. The registered person must ensure that wound care plans contain more detailed information regarding the treatment/management of pressure sores. The registered person must ensure that suitable adjustable beds are provided for those service users with an assessed need. The registered person must ensure that two satisfactory references are obtained for employees, which include one from the most recent employer. Gaps in employment history should be explored. The registered person shall provide the CSCI with an application to register a suitable manager. Timescale for action 03/02/06 2 OP8 17(1)(a) sch3 (n) 03/02/06 3 OP24 16(1) & 16(2)(c) 31/03/06 4 OP29 19 & Schedule 2 (5) 03/02/06 5 OP31 8(1)&(2) 28/02/06 Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 Page 27 6 OP38 13(4) 7 OP38 13(4) The registered person must ensure that appropriate risk assessments are completed and kept under review, for free standing radiators in use. The registered person must forward to the CSCI, up to date copies of certificates for the home’s electrical hardwiring and Landlord’s gas safety. 16/01/06 31/01/06 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 Refer to Standard OP32 OP30 Good Practice Recommendations The registered person should keep under review the arrangements for assisting service users with drinks. The registered person should ensure that staff training achievements and needs are clearly identified on a training matrix. Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 Page 28 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Drummuir Nursing & Residential Home DS0000065814.V270750.R01.S.doc Version 5.0 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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