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Inspection on 03/05/06 for Farrant House Nursing Home

Also see our care home review for Farrant House Nursing Home for more information

This inspection was carried out on 3rd May 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.

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

What the care home does well

The home carries out assessments of each perspective resident before admission to the home to make sure that the home can meet all the needs of the resident. The relationships between residents and staff appeared to be very good. Staff were seen talking and joking with the residents. One resident said, "the staff are wonderful, they are always willing to help and are pleasant and respectful". The home had an open visiting policy and residents spoken to said that they could have visitors at any time. One resident said, "I have 3 children who come to see me and bring my grandchildren and they are always made welcome". The acting manger said that residents are helped to make choices and have control over their daily lives, unless it poses a risk to their care, and residents spoken to confirmed this. The residents` spoken to were happy about the quality, choice and quantity of food. One resident said "you get more than enough food and there is always a choice". There was evidence of a varied menu and the meal served on the day of inspection looked and smelt nice. Staff were seen helping residents at mealtimes. Food stocks were examined, and it was noted that a well-stocked larder was available to the chef. The kitchen was clean and well organised. The home looked after residents` monies safely.

What has improved since the last inspection?

The newly appointed acting manager was in the process of reviewing all of the residents` plans of care and it was clear during discussions with her that the care plans are a high priority. The standard of care plans was seen to have improved and the things that needed to be done from the last inspection had been met, but one issue was remaining, which is discussed below. It was encouraging that they included the importance of maintaining privacy and dignity of the residents and also encouraged residents to be as independent as possible. At the last inspection it was required that the carpet on the ground floor corridor must be cleaned or replaced. The acting manager said that the carpet and many of the lounge chairs had been cleaned and was now being cleaned on a regular basis.

What the care home could do better:

Although the plans of care were seen to be much improved they must contain more detail of the actions needed to be taken by care staff to make sure that all of the residents care needs are met. This is a matter outstanding from the last inspection. Although the corridor carpet had been cleaned it was seen that the carpet in the ground floor lounge was in a poor condition. The systems and procedures for dealing with medicines needed improvements to protect residents, for example, some prescribed medications had not been signed as being given but had been given for 18 days.The acting manager was not able to find the adult protection procedure and the staff spoken to told the inspector that they had not received any training on what action to be taken in the event of an allegation of abuse. This has the potentional to put residents at risk. The adult protection procedure must be available to all staff and contain the correct telephone numbers for making a referral. Providing staff with the necessary training is important to make sure that the residents needs can be properly met. Evidence could not be provided of all staff training or that all staff had been through an induction process. At the last inspection it was required that the hoist slings are not stored on top of each other as this causes a possible risk of cross infection. Although the homes action plans stated that they were "being stored in an appropriate manner" this was not the case. The requirement has been made again in this report.

CARE HOMES FOR OLDER PEOPLE Farrant House Nursing Home 44 Farrant Road Longsight Manchester M12 4PF Lead Inspector Geraldine Blow Key Unannounced Inspection 3rd May 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 Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 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. Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Farrant House Nursing Home Address 44 Farrant Road Longsight Manchester M12 4PF 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) 0161 257 3323 0161 225 9920 Southern Cross Healthcare Services Limited Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (4) of places Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 44 service users will be accommodated. The home can accommodate up to 24 service users requiring nursing care on the ground floor and up to 20 service users requiring personal care only on the first floor. All service users will be aged over 60 years of age except where a variation has been granted in respect of age for a named individual. One named service user requires personal care only, out of category by reason of age. If this service user no longer resides at the home or their primary reason for requiring care changes, the service user category will revert to OP (old age). Minimum nursing staffing levels indicated in the Notice originally issued in accordance with Section 13 of the Care Standards Act on 20 August 2002 and here re-issued must be maintained in relation to those service users accommodated for nursing care; please see attached matrix. The service should, at all times, employ a suitably qualified and experienced manager. 10th November 2005 2. 3. 4. Date of last inspection Brief Description of the Service: Farrent House Nursing Home provides accommodation with nursing care for up to 44 older people. The home is situated in the Longsight area of Manchester close to a main public transport route, a local market, shops and a supermarket, public houses and other social facilities and amenities. The home is a purpose built, two-storey home set in its own small, wellmaintained and accessible grounds. The home offered accommodation in 40 single and 2 double bedrooms. 18 bedrooms, including both double bedrooms, have en-suite facilities. Access to the home was at ground level. A passenger lift was provided. The front door was digitally locked for security reasons and exit could be achieved by pressing a switch at the side of the door. CCTV covered the homes entrances and grounds. The home provided smoking and non-smoking areas for the residents. The homes hairdressing salon and the administrators office was situated in the reception area. Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced visit took place on Wednesday 3 May 2006. The opportunity was taken to look at all the core standards of the National Minimum Standards (NMS) and was used to decide how often the home needs to be visited to make sure that it meets the required standards. Since the last inspection the registered manager has left the home and a new acting manager had been appointed on 23 March 2006. As part of the visit time was spent with the residents who live at the home, observing how staff work with residents, discussions with staff and the acting manager, assessing relevant documents and files and a tour of the premises was undertaken. Some supporting evidence within this report was based on information received in the pre-inspection questionnaire that was submitted to Commission for Social Care Inspection (CSCI) prior to this inspection taking place. The last visit to the home identified a number of areas that the home needed to improve to meet the NMS. The home had sent the CSCI an action plan setting out how they were going to address these issues. It was found that progress had been made in the majority of areas with most of the requirements fully actioned. The remaining issues will be repeated in this report. The CSCI had not received any complaints or concerns about the home since the last visit. What the service does well: The home carries out assessments of each perspective resident before admission to the home to make sure that the home can meet all the needs of the resident. The relationships between residents and staff appeared to be very good. Staff were seen talking and joking with the residents. One resident said, “the staff are wonderful, they are always willing to help and are pleasant and respectful”. The home had an open visiting policy and residents spoken to said that they could have visitors at any time. One resident said, “I have 3 children who come to see me and bring my grandchildren and they are always made welcome”. Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 Page 6 The acting manger said that residents are helped to make choices and have control over their daily lives, unless it poses a risk to their care, and residents spoken to confirmed this. The residents’ spoken to were happy about the quality, choice and quantity of food. One resident said “you get more than enough food and there is always a choice”. There was evidence of a varied menu and the meal served on the day of inspection looked and smelt nice. Staff were seen helping residents at mealtimes. Food stocks were examined, and it was noted that a well-stocked larder was available to the chef. The kitchen was clean and well organised. The home looked after residents’ monies safely. What has improved since the last inspection? What they could do better: Although the plans of care were seen to be much improved they must contain more detail of the actions needed to be taken by care staff to make sure that all of the residents care needs are met. This is a matter outstanding from the last inspection. Although the corridor carpet had been cleaned it was seen that the carpet in the ground floor lounge was in a poor condition. The systems and procedures for dealing with medicines needed improvements to protect residents, for example, some prescribed medications had not been signed as being given but had been given for 18 days. Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 Page 7 The acting manager was not able to find the adult protection procedure and the staff spoken to told the inspector that they had not received any training on what action to be taken in the event of an allegation of abuse. This has the potentional to put residents at risk. The adult protection procedure must be available to all staff and contain the correct telephone numbers for making a referral. Providing staff with the necessary training is important to make sure that the residents needs can be properly met. Evidence could not be provided of all staff training or that all staff had been through an induction process. At the last inspection it was required that the hoist slings are not stored on top of each other as this causes a possible risk of cross infection. Although the homes action plans stated that they were “being stored in an appropriate manner” this was not the case. The requirement has been made again in this report. 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. Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 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 Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 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): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The home undertakes an assessment of prospective residents’ care needs prior to their admission. EVIDENCE: The home conducts a pre-admission assessment of prospective residents to ensure that the home can meet all assessed needs. Following this assessment the home must confirm in writing to the prospective resident that the home is able/not able to meet their assessed needs. For residents who are referred through Care Management arrangements the home obtains a summary of the Care Management Assessment prior to admission. The home does not provide an intermediate care service. Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 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, 7, 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service Each resident had an individual plan of care, which promoted privacy and dignity. However, some areas of the plan required improvements to ensure residents’ health, personal and social care needs are fully met. The systems and procedures for dealing with medicines did not protect residents. EVIDENCE: A random sample of care plans were examined. Evidence was seen of ongoing work to improve the documentation of the care planning system and the acting manager was in the process of auditing all of the care plans. Risk assessments had been included and evidence was seen that monthly reviews had taken place. As already stated in this report it was encouraging to note that independence was encouraged and privacy and dignity was promoted. In the main the plans of care set out the action to be taken by care staff to ensure the needs of the residents were met, however some parts were found Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 Page 11 to be rather vague e.g. “use appropriate slings” and “encourage a lot of fluids”. In order to ensure all appropriate care is given to residents the care plan must set out in detail the actions which need to be taken by staff. Evidence was seen of peoples’ Care Management reviews that were undertaken and looked at the overall care and support of the resident at the home. The daily statements of health were found to be vague in places for example all hygiene care given. It is recommended that these contain more detail to accurately reflect the nursing care provided to residents. The requirement made at the last inspection, for accountability reasons, that the member of staff completing any documentation must sign and date it had been met. Evidence was seen that residents/families had been involved in the care planning process. All residents were registered with local General Practitioners and had access to visiting healthcare professionals e.g., Dietician, Chiropody, Dentistry and Ophthalmology. This ensured residents were in receipt of appropriate health services necessary to support their health care needs. Medication records were examined during this inspection. Some MAR sheets did not record receipt of medication into the home. In one instance medication had not been signed for since the 15/4/06 yet on checking the stock level and talking to the nurse it had clearly been given to the resident. There were gaps in the recording of several other medication. As a result it was not possible to ensure that the residents had received the required medication and this could impact on residents health care. On a number of MAR sheets it was documented “non supplied” particularly for creams and no recordings had been made. The explanation given to the inspector by the acting manager was that the residents no longer required the cream so the home had not ordered it. However, no evidence could be found to confirm this and it was unclear as to whether the resident required the creams or not, or that contact had been made with the relevant GP to discuss the matter. In line with the Royal Pharmaceutical Guidelines the home did not receive the prescritions or sign the exemption declaration on the back of the prescription prior to them being submitted to the pharmacy for dispensing. Professional guidelines indicate that the home should see the prescriptions prior to dispensing and good practice indicates a copy of the prescription should be kept of these prescriptions. Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 Page 12 It was encouraging to note that medication with a limited life had the date of opening clearly marked to ensure out of date medications are not given to residents and therefore protecting and safeguarding their health. From observations made during the inspection and discussions with members of staff and residents it appeared that the nurses and care staff treated the residents with respect and dignity. Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Limited activities were provided but residents were able to maintain contact with family and friends. Residents were able to exercise choice and control over their lives and the residents enjoy the meals that they choose. EVIDENCE: The home has a designated senior carer who is employed as a part time the activity coordinator. Staff who were spoken to said that residents were encouraged to participate in activities in the home and a programme of activities were on display. The care files on the residential unit were seen to have an activity sheet to record activities undertaken. However it appeared that this had not regularly been completed. The member of staff spoken to said that the activity co-ordinator did consult the residents regarding the activities they wished to undertake but on the day of inspection this paperwork could not be found. Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 Page 14 The home had an open visiting policy and visitors could be received in the residents’ own room or any of the communal areas of the home. Residents spoken to during the inspection confirmed this. From speaking to residents and staff it appeared that residents are able to exercise choice and control over theirs lives. It was encouraging to note that a large button telephone was provided in the room of one resident who was blind in an order to promote his independence and exercise some control over his life. Evidence was seen that residents are able to bring personal possessions into the home and a list of belongings is completed on admission. Residents spoken to during this inspection spoke highly of the quantity and quality meals offered in the home. Residents confirmed that they were offered a choice of meals and could request snacks or drinks at any time. Evidence was seen that religious and cultural dietary needs are assessed prior to admission and have been catered for. The acting manager said that the home were currently providing a Muslim diet and an Africian Caribbean diet. Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 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 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service The home has the systems and procedures in place that allow people to express their complaints/concerns However, people are not fully protected as staff had not undertaken the relevant training. EVIDENCE: The home had a complaint procedure and the acting manager was aware of the need to keep a record of all complaints made which includes details of any investigations and any action taken. The home has not received any complaints or allegations of abuse since the last inspection. One resident spoken to said that she had never had to make a complaint but would do so if she ever to. Although the acting manager said that the home had policies and procedures relating to the Protection of Vulnerable Adults and had access to the Manchester Multi-Agency Adult Protection Procedures they could not be found. In addition, the home supports residents who are placed by different local authorities and they did not have the necessary contact details for making adult protection referrals. The adult protection procedure must be easily accessible at all times and contain the information relevant for making referrals to the appropriate local authority. Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 Page 16 The acting manager said that staff have not received any adult protection training and this was confirmed by the staff spoken to. In order to protect the residents living at the home all staff must receive Protection of Vulnerable Training, which includes the actions to be taken in the event of an allegation of abuse. Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The premises generally were clean and comfortable for the residents living there. EVIDENCE: The premises were generally clean and tidy. The acting manager said that she had ensured that the ground floor corridor carpet and lounge chairs had been thoroughly cleaned and would continue to be done on an on going basis. However, as already identified in this report the ground floor lounge/dinning room carpet require cleaning or replacing if that proves ineffective. The décor and furnishings were homely in nature but were beginning to show signs of general ‘wear and tear’. The acting manager said that since the last inspection there had not been any re-decoration or new furniture purchased. Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 Page 18 The home’s laundry was situated on the ground floor “service” corridor. Soiled linen did not come into contact with food storage, preparation, cooking, serving or dining areas. At the last inspection, it was identified that the home had had an outbreak of scabies and it was required that the hoist slings were not to be stored on top of each other on the ground floor corridor as this poses a risk of cross infection. The requirement had not been met and has bee reiterated in this report. Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 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, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service The number and deployment of staff available appeared sufficient to meet the residents’ assessed needs. However, the home was unable to demonstrate that its staff had completed the required training to meet resident’s needs. The procedures for recruiting staff were robust and provided adequate safeguards to protect residents. EVIDENCE: On the day of the inspection the staffing numbers and skill mix appeared appropriate to meet the needs of the residents accommodated. The home employs 22 carers, 4 members of staff have successfully achieved NVQ level 2 and 4 had achieved NVQ Level 3, 10 members of care staff had successfully completed NVQ Level 2 and were awaiting their certificate. The acting manager said that the home does have an induction process although it is not always documented and no evidence could be provided that mandatory training had been provided for staff or that staff had an individual training and development programme. Skills for Care have introduced an induction module for all social care staff. It is recommended that the home’s induction programme be reviewed and updated, were required, to meet the Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 Page 20 requirements of the Skills for Care Induction and documented evidence of induction should be maintained. A random sample of staff files were inspected which were seen to include all the information listed in Schedule 2 of the Care Homes Regulations 2001, such as evidence of a CRB and POVA checks, 2 written references and valid work permits. Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 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, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The home has the systems in place to monitor the service based on peoples views. Systems and procedures were in place, which safeguards and protects residents’ financial interests and in the main the home was seen to promote the health, safety and welfare of the residents and staff. EVIDENCE: The acting manager took up post on 23/3/06. She is a RGN who has had previous experience in deputy management positions. The Manager has received the application forms to register with CSCI. The home has an “opinion questionnaire” in an attempt to seek the opinions of residents and relatives regarding the service delivered. The acting manager Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 Page 22 said that it was her intention to send them out in the near future and then an action plan for the further development of the service would be produced. It is recommended that the questionnaire is also sent to visiting professionals in order seek their views of the service provided. The acting manager stated that it was her intention to review all the homes policies and procedures and make them accessible to all staff. These will be thoroughly inspected at the next inspection. Evidence was seen that the systems in place did safeguard resident’s financial interests and secure facilities were provided for any money or valuables held on behalf of residents. A recommendation was made at the last inspection that the home should liaise with the Fire Service for advice regarding the risk assessments and self-closing door devises, as residents bedroom doors were being wedged open. The homes action plan documented that advice was sought and the fire officer made recommendations regarding the risk assessments. However the acting manager could not find the risk assessments although she assured the inspector that they had been completed. The home was maintaining an accurate fire log with the required checks and fire drills. Up to date risk assessments were seen of safe working practises and the premises. Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 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 x x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 2 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 X 3 X X 2 Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? Yes YES Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 Page 25 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 Requirement Following the pre-admission assessment the home must confirm in writing to the perspective resident that the home is able/not able to meet their assessed needs. The residents’ plan of care must set out in detail the actions which need to be taken by staff to ensure that all aspects of health, personal and social care needs are met. (The previous timescale of 31/12/05 had not been met). 3. OP9 13 The Registered Person must make arrangements for the recording, handling, safekeeping and safe administration of medicines which are detailed below: • All prescribed medication must be signed for by the person administrating them. In accordance with the Royal Pharmaceutical Guidelines the manager/desingnated person must sign the exemption declaration on Version 5.1 Page 26 Timescale for action 31/05/06 2. OP7 15 31/05/06 07/05/06 • Farrant House Nursing Home DS0000021642.V292364.R01.S.doc the back of the prescription form on behalf of the resident if the resident is uanble to do this themselves, prior to the prescription being submitted to the pharmacy for dispensing. (The previous timescale of 31/12/05 had not been met). • • All medication records must be accurate All medication must be administered as prescribed. 31/05/06 4. OP18 13 1. The adult protection procedure must be easily accessible at all times and contain the information relevant for making referrals to the appropriate local authority. 2. Evidence must be provided that all staff have received Protection of Vulnerable Adult training which includes the actions to be taken in the event of an allegation of abuse. 5. OP19 23 The provider must ensure that the carpet in the ground floor lounge/dining area is thoroughly cleaned or, if this proves ineffective, replaced. Evidence must be provided that all staff have undertaken the necessary training in order for the home to ensure that it provides suitably qualified, competent and experienced staff to ensure the health and welfare of the residents are met. 04/06/06 7. OP30 18 30/06/06 Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 Page 27 8. OP31 9 The provider must submit an application in respect of a manager to be registered with CSCI. Evidence must be provided that the fire officer’s recommendations have been implemented and all adequate precautions have been taken. 16/05/06 9. OP38 23 31/05/06 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. 3. 4. Refer to Standard OP7 OP9 OP12 OP30 Good Practice Recommendations It is recommended that the daily statement of health contain more detail to accurately reflect the nursing care provided. It is recommended that 2 staff witness and sign for the disposal of waste medication. It is recommended that the activity sheets are kept up to date and the activity co-ordinator keeps an accurate record of her consultations with the residents. Skills for Care have introduced new requirements for staff induction and training. It is recommended that the home take account of the new requirements and include them in their induction programme and that a record of induction is maintained. It is recommended that the quality audit questionnaire (the opinion questionnaire) also be sent to visitng professionals in order to gain their view of the service being delivered. It is recommended that the home liaise with the Fire Service for further advice regarding risk assessments and self-closing door devices. 5. OP33 6. OP38 Farrant House Nursing Home DS0000021642.V292364.R01.S.doc Version 5.1 Page 28 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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. 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