Inspection on 18/09/06 for Elm View Nursing Home

This inspection was carried out on 18th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Elm View Nursing Home 15/05/07

Elm View Nursing Home 21/03/06

Elm View Nursing Home 30/09/05

Elm View Nursing Home 04/03/05

Elm View Nursing Home 04/11/04

Elm View Nursing Home 02/02/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Elm View Nursing Home Moor Lane Clevedon North Somerset BS21 6EU Lead Inspector Patricia Hellier Unannounced Inspection 18th September 2006 09:00 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 Elm View Nursing Home DS0000020304.V305308.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. Elm View Nursing Home DS0000020304.V305308.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elm View Nursing Home Address Moor Lane Clevedon North Somerset BS21 6EU 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) 01275 872088 01275 872088 Belmont Care Limited Mrs Susan Gready Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (45) of places Elm View Nursing Home DS0000020304.V305308.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. May accommodate 45 persons aged 65 years or over who require nursing care of which 6 may be aged 50 - 65 years. Manager must be a RN on Part 1 or 12 of the NMC register Date of last inspection 21st March 2006 Brief Description of the Service: Elm View is a purpose built home providing 45 beds for residents requiring nursing care. It is situated in an urban area and surrounded by wellmaintained gardens. The building and décor is of a high standard providing a comfortable and homely environment. Accommodation is provided over two floors with a passenger lift giving easy access to all floors. There are 41 single rooms, and 2 double rooms, all with ensuite facilities. All rooms have a call bell system. There is a large open dining area and two comfortable lounges. Part of one lounge is designated as a quiet area and can be used for receiving visitors or for family celebrations. Provision is also enable is available Mare or the made within the home for a variety of activities and outings which close links with the local commumity to be maintained. A minibus to take residents to the local shops, or for trips to Weston-Supersurrounding countryside. The provider makes information available through a company leaflet and service specific booklet about the home. CSCI reports are displayed in the entrance to the home and available for all to read. The fess range from £540 - £635 per week with additional charges being made for hairdressing, chiropody, newspapers, escorts, toiletries and social therapy entrance fees. This information was provided in September 2006. Elm View Nursing Home DS0000020304.V305308.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place over 8 hours with the manager and her deputy present throughout. Before the inspection the information about the home was received from the pre inspection questionnaire and comment cards received from relatives and residents and Health Care Professionals that visit the home. The last inspection report was reviewed together with all correspondence received since the last inspection. The accumulated evidence for this report comes from the above and also fieldwork that included the following: discussions with 18 residents, 6 relatives and 10 staff, observation of practices, tour of the premises, review of documents relating to care, recruitment, health and safety; review of policies; inspection of medication records and storage. Of the 5 resident surveys returned all felt they received the care and support they needed; that the home was clean and fresh, and that they would know who to speak to if they were unhappy. One of the 5 felt they would like more activities and variety. From the 10 relatives’ surveys sent, 9 were returned. All 9 felt welcomed at the home and that they were consulted regarding their relatives care and needs. All 9 stated they were satisfied with the overall care of their relatives; saying ‘very happy with the care and support provided’, ‘a friendly and caring atmosphere’, ‘staff listen and are responsive to comments’. 5 of the respondents said they were not aware of the complaints policy. One relative said ‘I am satisfied with the care, but angry about the fees’. Surveys were sent to 8 Health Care Professionals that visit the home and 5 were returned. All felt that the care given is good, and none had received, or heard, any complaints about the home. All residents and staff spoken with told the inspector that the home was very good and the staff very kind. Comments received were “it is very homely and comfortable”; “I would recommend it to anyone”, “my care needs are well met”. What the service does well: The staff ensure the well-being and comfort of the residents’ and treat them with great respect and kindness. For example 6 residents spoken with said, “the home is lovely, the staff are kind and caring, and the food is good.” Meals are varied, well balanced and nicely presented offering choice and variety. The senior staff ensure that staff receive training appropriate to meet residents needs in a knowledgeable and understanding way. Elm View Nursing Home DS0000020304.V305308.R01.S.doc Version 5.2 Page 6 Residents feel that if they had something to complain about they would speak to a member of staff. All residents spoken with said they had nothing to complain about. One relative said ‘the home is excellent’. A relaxed and friendly atmosphere is felt in this home, which is kept extremely clean and tidy. 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. Elm View Nursing Home DS0000020304.V305308.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 Elm View Nursing Home DS0000020304.V305308.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): 1,2,3,4,5 The quality outcome in this area is good. The Statement of Purpose and Service User Guide is comprehensive and provides prospective residents with information to make an informed choice. The home’s assessment process is thorough and ensures that it is able to meet residents’ needs. Prospective residents and relatives are encouraged to visit the home to assess suitability. EVIDENCE: Residents are provided with a comprehensive Service User Guide containing the Statement of Purpose and all the information required to ensure they or their relatives have access to the relevant information at all times. 3 of the 5 resident surveys returned stated they had not received a contract of residency. Resident files inspected showed that all privately funded residents receive a contract of Conditions of Admission and Terms of Business, and those who are publicly funded receive a copy of the Terms and Conditions document which forms a contract of agreement. In these documents the breakdown of fees, and who is responsible for their payment is not clearly stated. This is recommended as outlined in the recent ‘Fair Price for Care’ report. Elm View Nursing Home DS0000020304.V305308.R01.S.doc Version 5.2 Page 9 Care needs are well met through a full assessment process and the completion of a care plan from this information. The assessment includes all the elements listed in the standard. A comprehensive assessment was seen for a recently admitted resident. The resident when spoken to said ‘I am well looked after; they know what I need. I am getting used to it and the staff are interested in me, and helping me a lot.’’ Social services care plans had been obtained where relevant. Care practices observed showed that staff were fully aware of the residents needs as stated in their assessments. Elm View Nursing Home DS0000020304.V305308.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): 7,8,9,10 The quality outcome in this area is adequate. Residents benefit from care plans that are well formulated and give clear information to enable staff to meet residents’ health and social care needs. Personal and environmental risks are well managed. Medication receipt, administration, storage, recording and disposal of medicines systems are poor, and place residents at risk. Respect and dignity are well maintained by kind and caring staff. EVIDENCE: Individual records are kept for each of the residents, which includes a social history. Five care plans were inspected and all reflected clearly current identified health and social care needs. One care plan that had identified mobility issues had a referral to a physiotherapist and showed Interprofessional working, for the benefit of the resident. Another care plan clearly demonstrated weight loss had been noted, and a nutritional guidance plan implemented, for the health and well being of the resident. These good practices are to be commended. Clear actions to met identified needs were recorded and regular evaluation noted. Two of the four care plans showed resident involvement. This practice needs to be extended to all residents or their relatives. All care plans Elm View Nursing Home DS0000020304.V305308.R01.S.doc Version 5.2 Page 11 contained well-formulated risk assessments for Manual Handling and falls. Other personal and environmental risk assessments were present to ensure the safety of the resident while promoting independence as able. Daily records were up to date and written in a respectful manner. Care practices observed showed caring interactions and good communication skills from staff. Choices and preferences were observed being discussed and offered. One instance of poor practice was observed in the dining room, where a carer who was assisting a resident with their lunch was standing over them, rather that sitting beside them. Other residents being assisted with their meal had the carer sitting beside them. Regular audits of Medication Administration Record charts are not undertaken and it is not possible to clearly trace all medication received, administered and disposed of, in the home. An example of this was seen where there was a discrepancy between the number of tablets supplied, administered and disposed of and the number left in the bottle. This is poor practice and potentially puts residents at risk. No homely remedies were seen on the Medication Administration Record Sheets or in the drug book entries sampled. The Homely Remedies policy is clear, but is not dated for review purposes, and is not signed by the local GP’s to demonstrate their agreement with it. The lunchtime medication routine observed was safe and complied with the guidance. Residents who are self medicating had signed a form to take responsibility for this. In the policy file a competency assessment form was seen, but this did not show how the resident’s competency to self medicate was assessed, for their safety. The assessment form requires review and updating for the safety of residents. Some unexplained gaps on the Medication Administration Record charts were seen. One record sheet showed showed gaps for eye drop administration and another had not recorded if a regularly prescribed bowel preparation had been administered or not. Variable dose prescriptions do not show the dose administered at any one time. All the above practices potentially place residents at risk. Actions to rectify these poor practices are required for the protection of service users, as stated in the last report. Inspection of stock levels showed them to be well managed. The temperature of the medicine fridges are recorded weekly. Temperatures recorded in recent weeks showed the fridge temperature as 8°C and above, which is too high for medication that needs storing in a fridge. This needs urgent attention, to ensure the appropriate storage of medication, for the safety of residents. The medication room temperatures are not recorded. The temperature of the room during inspection was very warm and likely to be above 25°C and therefore potentially unsafe for the storage of medicines. It is required that this is Elm View Nursing Home DS0000020304.V305308.R01.S.doc Version 5.2 Page 12 recorded and any necessary action taken to maintain the temperature below 25°C for the correct storage of medicines and the protection of residents. Most products are marked with the date of opening at the time of their opening. Hand transcribed prescriptions were seen and these had not been signed by two members of staff when written, thus not providing the recommended safeguard for residents. All residents spoken with felt that kind and caring staff respected their dignity and privacy. The home has Equality and Diversity policy that recognises the cultural and social needs and differences that are present in society. In discussion with the manager and staff these issues have not yet arisen within the service provision. Both management and staff demonstrated clear knowledge and desire to meet cultural and diversity needs as and when they should arise. Elm View Nursing Home DS0000020304.V305308.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): 12,13,14,15 The quality outcome in this area is good. Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. Residents right to choice and control over their lives is well respected, and encouraged. Autonomy and personal choice is promoted via advocacy services, helping residents to maintain independence. Friendly staff always welcome relatives and visitors EVIDENCE: An excellent range of activities is provided with posters displaying information of forthcoming events throughout the home. Residents spoken with said, “we have plenty of choice and variety, there are quizzes and things to help keep your mind active, also outings.” “The staff are always willing to accommodate what we want”. A social therapist is employed 3 days a week to ensure that all residents social care needs are well met. Care records recorded personal preferences and routines. During the inspection a number of residents were seen enjoying the garden, with staff ensuring they had appropriate sitting arrangements. Activities were observed to have a high profile in the home and staff were keen that residents had all they needed to enjoy them. They are to be commended for their work in this Elm View Nursing Home DS0000020304.V305308.R01.S.doc Version 5.2 Page 14 homely process. Spiritual needs are catered for and the home holds a monthly church service. Several visitors were seen coming and going during the inspection. Relatives spoken with said they could come any time and felt that their relatives were well looked after by friendly staff. All the residents said that the ‘food is good’ and that they liked the daily choices offered. For example one resident said ’if you don’t like something they’ll change it’. Menus showed a varied, balanced and nutritious diet. The manager told the inspector that she and the cook have recently discussed the nutritional needs of the residents, following an audit as part of the homes quality assurance processes, and changed the menus. They also identified certain residents’ additional nutritional needs to the kitchen staff. This good practice is to be commended. The kitchen is clean, tidy and well organised. The dining room is homely and tables well presented. Good practice was observed in the dining room where care staff were helping residents with their meal. One incident of poor practice was seen where a carer was standing over the resident, rather than sitting down beside the resident to help them with their meal. Elm View Nursing Home DS0000020304.V305308.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): 16,18 The quality outcome in this area is good. Residents are confident that they are listened to and their requests acted upon. Knowledgeable and competent staff protect residents. EVIDENCE: The home has a comprehensive complaints procedure and all residents receive a copy on admission. 5 of the relatives who returned surveys, and 2 relatives spoken with during the inspection, were not aware of the complaints policy. There have been 4 complaints since the last inspection, of which all were upheld, and resolved, to the complainants’ satisfaction. All residents stated that if they were not happy about anything they would speak to the manager. Staff and residents spoken to, say the manager is very approachable and understanding. One service user said ‘I’ve nothing to complain about, it’s the best home I’ve been in”. A record of complaints received, with actions taken and outcomes is kept to show residents are responded to, and the information used to inform the running of the home for the residents’ benefit. The home has a copy of the ‘No Secrets’ in North Somerset guide and a comprehensive local policy and procedure for responding to allegations of abuse for the protection of residents. Staff interviewed were conversant with the home’s Adult Protection policy and demonstrated good knowledge of the adult protection procedure that should be followed if abuse is suspected. The home also has a Whislteblowing policy and staff said they would report any concerns to the manager. Staff said they had never seen any signs of abuse in the home. Elm View Nursing Home DS0000020304.V305308.R01.S.doc Version 5.2 Page 16 All of the staff interviewed had a clear understanding of what constitutes abuse and said they had received training. This was verified during inspection of training records. Elm View Nursing Home DS0000020304.V305308.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): 19,22,24,26 The quality outcome in this area is excellent. Residents are provided with homely, safe and comfortable surroundings. Outdoor space is attractive and accessible for residents to enjoy. The home has suitable equipment to maximise resident independence. Robust Infection control practices are followed. EVIDENCE: The home is purpose built, light, airy and furnished to a good quality, arranged over two floors with a passenger lift to enable access. The property is well maintained, with homely and comfortable communal spaces. The living accommodation is well decorated and homely. Residents’ rooms are personalised and comfortable. All rooms are provided with ensuite facilities. The décor, fixtures and fittings are in excellent order. The home has grab rails situated at relevant points and a shaft lift that is easily used to assist resident mobility and aid independence within the home. All resident rooms are provided with a lockable space for securing personal possessions, if desired, and door locks that are accessible to staff in an emergency. Elm View Nursing Home DS0000020304.V305308.R01.S.doc Version 5.2 Page 18 The home was clean and free from offensive odours throughout. The laundry facilities were well organised. Staff interviewed and observed demonstrated good understanding of Infection Control procedures and practices and maintained a clean and hygienic environment. The home has good facilities for ensuring that staff can maintain good hand washing practices, between caring for residents. Elm View Nursing Home DS0000020304.V305308.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): 27,29,30 The quality outcome in this area is good. The home’s staffing levels are sufficient to manage the care needs of residents. The procedures for the recruitment of staff are robust and provide the safeguards to protect residents. Staff access external training to ensure training is matched to the residents needs. EVIDENCE: Staff went about their duties in an unhurried manner and had time to deal with surprise visitors, numerous phone calls, and to spend with residents. Residents reported “staff never rush us through personal care tasks but always go at our pace”. “Staff regularly make time for a chat”. Staff approached residents with directness, openness and consideration. Each of the resident’s with whom the inspector spoke said, “how nice the staff are”, and many people gave examples of particular instances of kindness. Copies of two weeks staffing rosters were supplied to the inspector. Staffing levels rostered are in accordance with CSCI requirements. A sufficient team of ancillary workers support care and nursing staff to ensure the smooth running of the service. The home has a Key Worker system in place for all residents. Residents and staff were aware of the role and said, “it worked well”. A number of staff from overseas are employed at the home and form part of the care team. Residents and staff said, “Communication can sometimes be difficult”. The home supports staff to attend college to develop their language Elm View Nursing Home DS0000020304.V305308.R01.S.doc Version 5.2 Page 20 skills. Overseas staff interviewed said they ‘felt very welcomed in the home, enjoyed their jobs and were improving their English’. Recruitment procedures are robust and all four files inspected contained the required documentation. All staff interviewed stated they had contracts of employment and job descriptions. Newly appointed staff confirmed they had completed an induction programme and evidence of this was seen in personnel files. The home employs a trainer to provide mandatory training. All induction training is provided ‘in house’ and specialist training, e.g. Care of the Elderly, Diabetes, is accessed from the local Primary Care Trust and outside providers. Evidence was seen in files of a wide range of courses having been completed by staff. Interviews with staff verified this. Elm View Nursing Home DS0000020304.V305308.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): 31,32,33,36,37,38 The quality outcome in this area is good. The manager provides clear leadership and guidance to staff to ensure residents receive consistent care in a safe environment. Quality assurance processes in the home are formal, demonstrating that the home consults with residents, families and visiting professionals. Health and safety issues are monitored in the home to ensure that issues are identified and addressed where they arise. EVIDENCE: The manager is relatively newly appointed, and recently registered with CSCI. She has a wealth of experience in care of the elderly and has just commenced her Registered Manager’s Award to ensure the provision of current good practice. She gives clear leadership, guidance and direction to staff. Residents feel the manager is approachable, available and seeks to ensure all their needs are met. Staff interviewed stated that they felt well supported by an approachable manager. Elm View Nursing Home DS0000020304.V305308.R01.S.doc Version 5.2 Page 22 A formal quality assurance tool was available for inspection in order to demonstrate that the home consults with residents, and that comments from them are acted upon. Feedback to residents and relatives is provided through the displaying of results, and discussion of these at residents / relatives meetings. The results are also discussed at staff meetings to inform practice and implement changes for the benefit of residents’ health and well being. Two residents interviewed said ‘the staff make it possible to be happy here they do anything you ask, and nothing is too much trouble’. Another resident said ‘they always do what they can to make it as you want’. Each member of staff has an element of their practice directly supervised by one of the seniors at least every two months. This is a very effective way of helping to ensure that practice is of a consistently high standard. Supervision records inspected indicated the standard of practice observed, and showed discussion of the persons training and development needs. Staff interviewed verified the helpfulness of supervision. Records inspected indicated regular safety and fire checks are carried out. Staff spoken to confirmed that regular fire instruction and drills had taken place. A number of staff have received First Aid training. A record of accidents is kept which complies with Data Protection to maintain staff and resident confidentiality. However it is not the recommended format and the home are advised to obtain the recommend format from the Health and Safety Executive to maintain best practice. Hot water outlets to baths and showers are thermostatically controlled to reduce risk of burns and scalds. On the day of inspection in one bathroom, and three resident’s rooms, these were found to be above 43°C. There were signs stating that the water is very hot. These are not appropriate for residents who have some degree of memory loss and function, as they are unable to understand the notice and thus, they are at risk of scalds. This was reported to the maintenance man during the inspection. Hot water outlets in resident’s rooms are not thermostatically controlled and this is recommended for the protection of residents’ from potential harm. Records were inspected of weekly temperature checks and were seen to be above the recommended 43°C. Elm View Nursing Home DS0000020304.V305308.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 3 2 3 4 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 3 Elm View Nursing Home DS0000020304.V305308.R01.S.doc Version 5.2 Page 24 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13.2 Requirement The registered manager must ensure that all prescribed medicines are administered and the administration or nonadministration is recorded on the medicine administration record with a code or initial of the registered nurse administering the medicines. Previous timescale of 30/03/06 not met. The registered manager to ensure that a clear audit trail is maintained of all medication entering and leaving the home. The registered manager to ensure all medication is stored at the recommended temperatures for the correct and safe administration. The registered manager to ensure that all hot water outlets that residents’ have access to, are as far as possible free from scald hazards to residents. Timescale for action 01/11/06 2. OP9 13.2 12/11/06 3 OP9 13.2 12/11/06 4 OP38 13.4 12/11/06 Elm View Nursing Home DS0000020304.V305308.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2 3 Refer to Standard OP9 OP9 OP16 Good Practice Recommendations A review of the self-medication assessment/consent form to demonstrate how competency assessment has been made. To ensure the dose administered, of variable dose prescriptions, is documented. To ensure all residents and relatives are aware of the complaints process. Elm View Nursing Home DS0000020304.V305308.R01.S.doc Version 5.2 Page 26 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 Elm View Nursing Home DS0000020304.V305308.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!