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Inspection on 26/01/06 for Firbank House Nursing Home

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

This inspection was carried out on 26th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

What has improved since the last inspection?

Since the last inspection few improvements have been made and in some areas a further deterioration in standards was noted. At the last inspection the bath water temperature in some parts of the home was extremely hot which led to a risk of scalding the residents. This has now been corrected. Some essential equipment such as dishwashers and hot water geysers has been provided and the hallway carpet in the annexe has been replaced.

What the care home could do better:

A number of standards, which were not met at the last inspection, were reviewed again at this inspection to assess if any improvements had been made. These standards related to the planning of care for residents, the storage of medication, the provision of activities, the maintenance of the environment and equipment, staffing levels, staff training and health and safety issues. More care needs to be taken to ensure that a complete assessment is undertaken of all residents before they come into the home so the home can be sure their needs can be met. This also applies to residents who are being readmitted to the home following hospitalisation as their needs may have changed. Care plans need to be more specific so all staff have detailed knowledge about how to meet all aspects of care for the residents. Standards in relation to the storage of medicines need to be improved. Despite some efforts on the part of the staff and a small improvement noted, social stimulation and leisure activities for residents remain very limited. Although some new kitchen equipment has been purchased and some minor improvements have been made to the environment the home still presents as untidy and cluttered in parts and shortfalls in hygiene practices could have an impact on residents` health and safety. A manager is now in post at the home but there remain concerns that there are not always sufficient staff on duty to care for the residents. The shortage of kitchen and cleaning staff on occasion makes this worse. Recruitment procedures need to be more rigorous to be sure that all the necessary checks have been made before a new employee starts work. Over the last year training has been almost non-existent and this gives serious cause for concern that staff do not have the skills and knowledge to properly care for the residents.

CARE HOMES FOR OLDER PEOPLE Firbank House Nursing Home 24 Smallshaw Lane Ashton-under-Lyne Tameside OL6 8PN Lead Inspector Mrs Fiona Bryan Unannounced Inspection 26th January 2006 09:10 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 Firbank House Nursing Home DS0000025433.V278944.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. Firbank House Nursing Home DS0000025433.V278944.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Firbank House Nursing Home Address 24 Smallshaw Lane Ashton-under-Lyne Tameside OL6 8PN 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 343 1251 0161 343 1007 Partnership Caring Limited Care Home 42 Category(ies) of Dementia (20), Dementia - over 65 years of age registration, with number (20), Old age, not falling within any other of places category (42), Physical disability (22), Physical disability over 65 years of age (22) Firbank House Nursing Home DS0000025433.V278944.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. No service user under 55 years of age can be admitted to the establishment. Two first level Registered Nurses to be on duty between 8 am - 5 pm. One first level Nurse to be on duty between 5 pm - 8 am. Managers hours to be supernumerary to 2 & 3 above. No more than 30 places can be used for nursing care. Date of last inspection 21st June 2005 Brief Description of the Service: Firbank House consists of two buildings, referred to as the main building and the annexe, and is situated near to Ashton-under-Lyne town centre. The home is able to accommodate up to 42 service users and provides both personal and nursing care. The home is owned by Partnership Caring Limited, which is a private company, and is under the day-to-day control of a manager who is also a registered nurse. Twenty-one service users are accommodated in each building with rooms being spread over two floors. There are a total of 36 single rooms and three double rooms, of which the majority have en-suite facilities.Seven communal rooms offer a variety of settings in which service users are able to receive visitors, socialise and participate in activities. The home is close to local shops and bus routes. There is ample parking for those who choose to travel to the home by car. Firbank House Nursing Home DS0000025433.V278944.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Thursday 26th January 2006 and was undertaken by one inspector who spent time talking with residents and staff and observing how residents spent their day. A selection of documents was examined including residents’ care files and medicine records, staff personnel records and residents’ personal finances records. This was the second full inspection of the year but two monitoring visits were also carried out on 8th September and 3rd November 2005 as the home had no manager and concerns were raised by the advocacy service about how care was being planned and delivered to residents. Four key standards, which have to be assessed at least once year were not examined at the last inspection, and were therefore considered at this inspection. These standards included how the home dealt with residents’ personal finances, how the home recruited new staff, the arrangements the home made for residents to receive visitors and the qualifications of the staff. Since the last inspection a new manager has been appointed who is in the process of applying for registration with the CSCI. What the service does well: What has improved since the last inspection? Since the last inspection few improvements have been made and in some areas a further deterioration in standards was noted. At the last inspection the bath water temperature in some parts of the home was extremely hot which led to a risk of scalding the residents. This has now been corrected. Some essential equipment such as dishwashers and hot water geysers has been provided and the hallway carpet in the annexe has been replaced. Firbank House Nursing Home DS0000025433.V278944.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Firbank House Nursing Home DS0000025433.V278944.R01.S.doc Version 5.1 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 Firbank House Nursing Home DS0000025433.V278944.R01.S.doc Version 5.1 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): 3 and 4 Lack of proper assessment puts residents at risk that their needs will not be met. Lack of staff training in specific topics means that staff may not have the skills or knowledge to deliver care effectively. EVIDENCE: Examination of a selection of care files indicated that some assessments were completed after the resident had been admitted to the home, for example, the assessment for one resident who was admitted on 16/1/06 was dated 17/1/06. Furthermore, one resident who was hospitalised did not have their assessment reviewed prior to their return to the home. It was clear from the records that the resident was still medically unstable on their return and they were consequently transferred back to hospital five days later where they spent a further month. If the resident had been reassessed before transfer back to the home it may have been identified that they were still unfit for discharge and they would not have been subjected to unnecessary moves. The daily record indicated that when the resident returned to the home the second time their Firbank House Nursing Home DS0000025433.V278944.R01.S.doc Version 5.1 Page 9 assessment was still not reviewed prior to their return as it was reported that the hospital had phoned up on the day of transfer and said they were sending the resident back. When they arrived back at the home no information was sent by the staff on the ward and the home had to phone and ask them to send the resident’ s discharge letter and medicines. Dementia care training is still required for staff despite requirements being made over the past two inspections. Since the last inspection staff have not received any training in any topic. Firbank House Nursing Home DS0000025433.V278944.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 and 9 Care plans did not always give full details regarding the needs of residents, leading to a risk that residents’ health care needs may not be met. The home has failed to improve some of their procedures for storing medicines, placing residents at risk. EVIDENCE: Examination of care files indicated that some care plans were inaccurate, for example one care plan stated that the resident was incontinent although in practice they were catheterised. Social care plans tended to make general statements such as “encourage (the resident) to participate in the home’s activities”, although in some cases a fair amount of information regarding the resident’s preferences and interests were provided as part of the assessment. This information however had not been used to develop a personalised plan. Pressure care plans did not contain specific details about the type of mattress required for residents. This information should be included together with the Firbank House Nursing Home DS0000025433.V278944.R01.S.doc Version 5.1 Page 11 pump setting if applicable, of alternating pressure mattresses, so that staff can ensure they are working effectively. Some risk assessments were not fully completed or were not reviewed monthly. Examination of a selection of medication administration records indicated that they had generally been completed satisfactorily although some handwritten medication administration details had not been signed, dated or validated by an additional member of staff. The home utilises resident photographs as a formal system of identification prior to medication administration. On the day of inspection there were a number of resident photographs missing. Numerous oxygen cylinders were found in various places around the home, which were not stored safely. The rooms in which the oxygen cylinders were stored were not labelled for the storage of oxygen. The oxygen was prescribed for residents who were no longer living at the home. One container of eye drops had not been labelled with the date of opening of the container. This practice ensures that the item can be discarded 28 days after this date to prevent bacterial contamination. The home possesses a refrigerator for the storage of medication requiring refrigeration. The temperature of these refrigerators was not monitored and recorded consistently. In the annexe, medicines that were assembled to be collected by the waste disposal company were stored in an unlocked room. Firbank House Nursing Home DS0000025433.V278944.R01.S.doc Version 5.1 Page 12 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 and 13 Further consideration is needed as to how the home meets the social and recreational needs of all its residents. The home supports residents to maintain family and community contacts. EVIDENCE: A number of residents said that activities were very limited in the home and that they mainly spent their time watching television. One resident enjoyed knitting and another said they liked listening to music but they had no radio in their room. During the afternoon on the day of the inspection some residents were participating in a session of armchair aerobics. Residents said staff were flexible about their daily routine and they could “please themselves what they did”. One resident said he sometimes got up very early and went to bed late but catnapped during the day – staff put no pressure on him to change his routine. The manager reported that carers undertake activities if they have time such as crosswords, jigsaws and manicures. However, as highlighted at the last inspection, staff find it difficult to make time for this due to staffing levels, especially in the afternoons. Firbank House Nursing Home DS0000025433.V278944.R01.S.doc Version 5.1 Page 13 Many of the residents are quite highly dependent, which create challenges for staff in trying to meet their need for social stimulation. As discussed elsewhere in this report further efforts to use the information from residents’ social histories may provide ideas for other meaningful activities. Residents all confirmed that their visitors were made welcome and they were able to receive visitors at any time. Firbank House Nursing Home DS0000025433.V278944.R01.S.doc Version 5.1 Page 14 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): 18 Lack of staff training means that the home is failing to protect residents from harm or abuse. EVIDENCE: A requirement made at the last inspection in respect of staff training in adult protection, prevention of abuse and dealing with challenging behaviour has not been met. Staff have still not received this training. Firbank House Nursing Home DS0000025433.V278944.R01.S.doc Version 5.1 Page 15 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, 21, 22, 25 and 26 The standard of the environment is generally poor and procedures in respect of hygiene are inadequate. It does not present therefore as a safe, clean, tidy and comfortable home for residents to live in. EVIDENCE: There has been little redecoration or refurbishment since the last inspection. Monitoring visits undertaken on 8th September 2005 and 3rd November 2005, confirmed that requirements from the last inspection in respect of the trees at the side of the annexe that required pruning, bath water temperatures and the replacement of the hallway carpet in the annexe had been met. A dishwasher is now provided in both buildings. However, during this inspection a number of residents’ rooms and one bathroom were cluttered with boxes, equipment, wheelchairs, commodes, suitcases etc. One resident said his room was a bit dreary and depressing, although other residents liked their rooms. Firbank House Nursing Home DS0000025433.V278944.R01.S.doc Version 5.1 Page 16 The nurse call bell for one resident was not within reach and the resident said they had to shout if they needed help. Systems for the management of laundry were not adequate as clean clothes and dirty clothes are transported around the home using the same baskets. Procedures are not always followed correctly where residents have infections, as staff put residents’ personal clothing in red bags together with bed linen and towels. This means that laundry staff have to open the bags to separate the clothes as they can not be washed at the same temperature. Soap was not provided in some staff areas such as sluices and where soap was available it was not always liquid soap. Bar soap can harbour bacteria and should not be used for staff hand washing. Firbank House Nursing Home DS0000025433.V278944.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Staffing levels are not always sufficient to meet the needs of the residents. The percentage of care staff working at the home who have completed NVQ training does not meet the required targets. Recruitment practices do not fully protect residents. Staff training is not sufficiently planned and consistent to ensure that staff have the skills and knowledge to care for the residents properly. EVIDENCE: Examination of staff duty rotas indicated that there were insufficient numbers of carers on duty especially during the afternoons on several occasions. The rota for the week prior to the inspection showed that only one nurse was on duty on Saturday 21st January 2006 in the afternoon, which does not meet the home’s conditions of registration. Shortfalls were also noted in domestic and laundry cover. Five carers have completed NVQ 2 or 3. As there are 24 carers in total in employment, the target of 50 of care staff having achieved this qualification has not been met. Examination of staff personnel files indicated that in some cases references had been obtained after the staff member had commenced work and it was not clear in all cases how long the referee had known the applicant and it what Firbank House Nursing Home DS0000025433.V278944.R01.S.doc Version 5.1 Page 18 capacity. In some cases the employment histories of the employees were not fully completed. Some staff had started employment at the home without first having been checked for inclusion on the POVA register and without an up to date criminal records disclosure certificate. Staff had received no training over the last six months. Training had been booked for small number of staff to attend various sessions over the next few months such as care of the dying, risk assessment, First Aid, management of pressure sores and continence awareness. Firbank House Nursing Home DS0000025433.V278944.R01.S.doc Version 5.1 Page 19 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, 35 and 38 The management of the home have not so far, addressed all the issues identified at previous inspections. This has a negative impact on residents and could put them at risk. Residents’ financial interests are safeguarded. Failure to follow policies and procedures correctly and lack of staff training puts staff and residents’ health and safety at risk. EVIDENCE: Although a requirement was made at the last inspection the provider has not sent reports of visits undertaken under Regulation 26 of the Care Homes Regulations 2001 to the CSCI. The fact that a number of requirements made at the last inspection have still not been complied with reflects on the management of the home. Firbank House Nursing Home DS0000025433.V278944.R01.S.doc Version 5.1 Page 20 The majority of residents are assisted with their finances by their families. Records and receipts are maintained of all transactions made on behalf of the residents. Invoices for sundry expenses are usually sent to residents’ families. The last recorded fire drill was July 2005 when 7 staff attended. Fire drills should be held regularly and at varying times to ensure that all staff participate and understand the correct procedure to follow. It was noted that some fire exits were partially impeded by furniture and other items. Moving and handling training was provided on 17/1/06 but only 3 staff attended. Laundry staff require updated training regarding COSHH. One cleaner, who had been working at the home for four weeks, had not been provided with a uniform. As stated elsewhere in this report other environmental hazards were noted such as the incorrect storage of medicines and oxygen and the lack of liquid soap for staff. The fridge in the annexe kitchen had a worn and ill-fitting seal. Sluices were not locked and contained cleaning products. The CSCI has not been notified via a Regulation 37 report in all cases where incidents in the home may affect the welfare of residents, for example on the occasion when there was only one nurse on duty instead of two as required by the home’s conditions of registration. Firbank House Nursing Home DS0000025433.V278944.R01.S.doc Version 5.1 Page 21 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 1 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 2 X 2 2 X X 3 2 STAFFING Standard No Score 27 2 28 2 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 1 X X 3 X X 1 Firbank House Nursing Home DS0000025433.V278944.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14 Requirement The registered person must ensure that detailed assessments are undertaken for all residents prior to them entering the home. The registered person must ensure that staff receive training in dementia care and other training specific to the needs of the residents. (Previous timescale of 31/12/05 not met). The registered person must ensure that care plans are detailed, accurate and developed to address all residents’ needs. (Previous timescale of 31/08/06 not met). The registered person must ensure that risk assessments are reviewed and reflect changes to the residents’ condition. The registered person must ensure that handwritten medication details on the medication administration records are signed and dated and the details are validated by an additional member of staff. The registered person must DS0000025433.V278944.R01.S.doc Timescale for action 31/03/06 2 OP4OPOP3 0 18 30/06/06 3 OP7 15 31/03/06 4 OP8 13 31/03/06 5 OP9 13 31/03/06 6 OP9 13 31/03/06 Page 23 Firbank House Nursing Home Version 5.1 7 OP9OP38 13 8 OP9 13 9 OP9 13 10 OP9 13 11 OP12 16 12 OP18OP30 13 13 OP21 23 ensure that photographs of residents used for identification purposes are kept up to date. The registered person must ensure that oxygen cylinders are stored in a designated area with appropriate safety signage. (Previous timescale of 31/07/05 not met). The registered person must ensure that oxygen is not administered to residents unless it has been prescribed by their GP. (Previous timescale of 31/07/05 not met). The registered person must ensure that the temperature of the medicines refrigerators are monitored and recorded daily using a maximum/minimum thermometer and that staff members understand the action to take if the temperature recorded is outside the normal range. The registered person must ensure that all medicines within the custody of the home are stored appropriately and not accessible to unauthorised persons. (Previous timescale of 31/07/05 not met). The registered person must ensure that a programme of recreational and social activities is developed that meets the needs of the residents. (Previous timescale of 31/8/05 not met). The registered person must ensure that staff receive training in adult protection, prevention of abuse and dealing with challenging behaviour. (Previous timescale of 30/09/05 not met). The registered person must ensure that bathrooms and toilets are clean, tidy and pleasant for residents to use. DS0000025433.V278944.R01.S.doc 31/03/06 31/03/06 31/03/06 31/03/06 31/05/06 30/06/06 31/03/06 Firbank House Nursing Home Version 5.1 Page 24 14 OP22 16 15 OP26 13, 16 16 OP26 13, 16 17 OP26 13, 16 18 OP27 18 19 OP28 18 20 OP29 19 21 OP29 19 22 OP32 26 (Previous timescale of 31/07/05 not met). The registered person must ensure that the nurse call system is accessible for all residents who are able to use it. The registered person must ensure that clean linen and dirty linen are not transported using the same receptacles to prevent cross infection. The registered person must ensure that staff follow correct procedures for the handling of infected laundry. The registered person must ensure that liquid soap is provided in all staff hand washing areas. The registered person must ensure that at all times suitably qualified, competent and experienced staff are working at the home in such numbers as are appropriate for the health and welfare of residents. (Previous timescale of 31/07/05 not met). The registered person must ensure that care staff are supported to undertake NVQ training to ensure that the target ratio is achieved. The registered person must ensure that appropriate references are obtained for all employees prior to their commencement at the home. The registered person must ensure that CRB’s are applied for prior to a new employee commencing work and that confirmation has been received that the person is not included on the POVA list. The registered person must ensure that visits are undertaken in accordance with this DS0000025433.V278944.R01.S.doc 31/03/06 31/03/06 31/03/06 31/03/06 31/03/06 31/08/06 31/03/06 31/03/06 15/03/06 Firbank House Nursing Home Version 5.1 Page 25 23 OP38 23 24 OP38 23 25 OP30OP38 18 26 OP26OP38 13 27 OP38 16 28 29 OP38 OP38 COSHH 1988 37 regulation and a report is supplied to the CSCI each month. (Previous timescale of 15/07/05 not met). The registered person must ensure that fire drills are carried out at suitable intervals. (Previous timescale of 31/07/05 not met). The registered person must ensure that fire exits are free from obstruction. (Previous timescale of 31/07/05 not met). The registered person must ensure that staff receive updates in mandatory health and safety topics, including COSHH. (Previous timescale of 30/09/05 not met). The registered person must ensure that staff are provided with appropriate protective clothing. The registered person must ensure that the fridge in the annexe kitchen is repaired or replaced. The registered person must ensure that cleaning products are stored in a locked cupboard. The registered person must ensure that notice is given to the CSCI of any incident that may affect the welfare of the residents. 31/03/06 15/03/06 30/04/06 31/03/06 30/04/06 31/03/06 15/03/06 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 Refer to Standard OP8 Good Practice Recommendations The registered person should ensure that care plans DS0000025433.V278944.R01.S.doc Version 5.1 Page 26 Firbank House Nursing Home 2 OP9 include specific details about the type of pressure mattresses being used and the pump settings if applicable so that staff can ensure they are working properly. The registered person should ensure that all eye drops and eye ointments are labelled with the date of opening of the container, and discarded 28 days after this date. If the resident is being treated for an open eye infection and both eyes require treatment, the home should ensure that a separate bottle of eye drops is obtained for each eye. Firbank House Nursing Home DS0000025433.V278944.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Firbank House Nursing Home DS0000025433.V278944.R01.S.doc Version 5.1 Page 28 - 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. 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