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Inspection on 23/05/06 for Flowerdown Nursing Home

Also see our care home review for Flowerdown Nursing Home for more information

This inspection was carried out on 23rd May 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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 atmosphere throughout the home was calm and the residents appeared unhurried with care being given at the resident`s own pace. Residents spoken to confirmed that they were able to make decisions about how they spent their day. They complimented all the staff on their kind and supportive approach towards them and many stated, "that nothing was ever too much trouble, I only have to ask and I get all the help I need". Staff commented that the new manager is very approachable and they find her "open door policy" enables them to discuss issues as they arise which ensures that the home continues to be operated in a calm and efficient manner. It was noted by the inspector that meals served to those residents who required assistance were served in a quiet and appropriate manner. A visitor to the home commented that the whole atmosphere in the home had changed for the better over the past few months and "how nice it was to actually see the care staff sitting and talking to the residents".

What has improved since the last inspection?

Progress has been made on the reviewing and reformatting of much of the personal documentation for the residents. However, the manager acknowledges that some of the documentation in the home still needs further reviewing and up dating.The programme of activities in the home has improved since the last visit to the home, but the manager acknowledges that there is still room for a lot more improvement in the variety of activates that could be offered to the residents. Residents spoken to confirmed this. Since the last visit made to the home the programme of redecoration and refurbishment has been completed to a very high standard. The manager has identified that staff employed from outside of the United Kingdom need support to improve their English Language skills and has arranged for this support to be provided at a local college of education.

What the care home could do better:

Residents spoken to confirmed this. The budget for activities is limited and the person responsible for arranging the programmes tries hard to maintain the variety. The company who operates the home has approved the purchase of a mini-bus, which will improve the home`s ability to take more residents out to local places of interest and to go shopping. A formal training programme was not available at the time of the visit. The manager was working on this and told the inspector that she wants to be able to provide the staff with more opportunities for a wider variety of training subjects. She is also hoping to establish links with local hospitals and other agencies to use their training facilities and trainers. Staff commented that they are not provided with sufficient equipment for the safe moving and handling of the residents. The home only provides two hoists and one stand aid which means this equipment has to be shared between two floors and fifty residents when the home is at it`s maximum number. This results in staff in having to wait to use the equipment, move it between two floors at the busiest periods of the day.

CARE HOMES FOR OLDER PEOPLE Flowerdown Nursing Home Harestock Road Winchester Hampshire SO22 6NT Lead Inspector Sue Maynard Unannounced Inspection 09:30 23 & 24th May 2006 rd 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 Flowerdown Nursing Home DS0000011652.V289519.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. Flowerdown Nursing Home DS0000011652.V289519.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Flowerdown Nursing Home Address Harestock Road Winchester Hampshire SO22 6NT 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) 01962 881060 01962 881935 Tamhealth Ltd, a wholly owned subsidiary of Four Seasons Health CareTamhealth Limited (a wholly owne Care Home 53 Category(ies) of Old age, not falling within any other category registration, with number (53) of places Flowerdown Nursing Home DS0000011652.V289519.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One service user date of birth 19th November 1939 can be accommodated 11th October 2005 Date of last inspection Brief Description of the Service: Flowerdown Nursing Home provides care and accommodation for fifty older persons who require nursing care. The home has been extended over the years and accommodation is provided in forty eight single rooms and one shared room, situated on two floors of the old house and the new extension. The home has recently completed extensive programme of redecoration and refurbishment. The home has large well-maintained gardens and ample parking space. Flowerdown is owned and operated by Four Seasons Health Care, a large independent care provider in the UK. The home is situated in a semi rural area on the outskirts of Winchester, Hampshire. The home accepts residents funded by Social Services with £100 “top-up”. The fees for self funded residents is £650-£800. Flowerdown Nursing Home DS0000011652.V289519.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over two days with a total of twelve and half hours spent in the home. The inspection was unannounced and was the key inspection for 2006/2007. A tour of the building was made and the inspector noted that unpleasant odours were noted in the bedroom of one resident. A requirement made from the last visit to the home has not been fully complied with and the manager is still addressing this with the company who operates the home, Four Seasons. As part of the inspection process the records for four residents were examined and four staff records were examined also. The inspector spoke to both residents and visitors to the home. All those spoken to were very satisfied with the care and services that were being provided. The inspector observed interaction between staff and the residents in communal lounge areas and the dining areas. What the service does well: What has improved since the last inspection? Progress has been made on the reviewing and reformatting of much of the personal documentation for the residents. However, the manager acknowledges that some of the documentation in the home still needs further reviewing and up dating. Flowerdown Nursing Home DS0000011652.V289519.R01.S.doc Version 5.1 Page 6 The programme of activities in the home has improved since the last visit to the home, but the manager acknowledges that there is still room for a lot more improvement in the variety of activates that could be offered to the residents. Residents spoken to confirmed this. Since the last visit made to the home the programme of redecoration and refurbishment has been completed to a very high standard. The manager has identified that staff employed from outside of the United Kingdom need support to improve their English Language skills and has arranged for this support to be provided at a local college of education. 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. Flowerdown Nursing Home DS0000011652.V289519.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 Flowerdown Nursing Home DS0000011652.V289519.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): 1 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. A Statement of Purpose with up to date and accurate information ensures that prospective residents and their families are able to make an informed decision about whether they wish to come and live in the home. The pre-admission procedure ensures that a comprehensive assessment is undertaken and assures people moving into the home that their needs will be met. Standard 6 does not apply to this service. EVIDENCE: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Since the completion of the visit to the home an up to date and detailed Statement of Purpose has been supplied to the Commission. The information contained in the Statement of Purpose will enable prospective residents to Flowerdown Nursing Home DS0000011652.V289519.R01.S.doc Version 5.1 Page 9 make an informed decision about whether they want to come and live in the home. Details of staff employed in the home and the services supplied are documented. A very comprehensive pre-admission assessment format is in place, which has replaced the format, used previously. The assessment looks at all aspects of the prospective resident’s health care needs, both physical and psychological. Provision is made in the document to demonstrate that any involvement that has been provided by previous carers, family members and other health care professionals is recorded. The information obtained forms the basis that identifies the care needs of the prospective resident and forms the basis for the manager to decide whether these needs can be met by the home. Flowerdown Nursing Home DS0000011652.V289519.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 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Progress has been made on improving arrangements to ensure that the health care needs of the residents are identified and met and they are placed at risk. The residents are protected by the home’s policies and procedures for the safe administration of medications. Staff training ensures that the residents are treated with respect and that their right to privacy is respected at all times. EVIDENCE: It was identified on previous visits to the home that the care planning for the residents was inadequate and many of the care plans were incomplete. The manager and senior staff have been reviewing and re-formatting of the care plans as part of a total review of all documentation within the home. There was Flowerdown Nursing Home DS0000011652.V289519.R01.S.doc Version 5.1 Page 11 evidence that all the care plans and risk assessments had been reviewed and up dated. The daily records were very comprehensive and concise. The records for four residents were examined. All the records contained risk assessments for safe moving and handling and the corresponding care plan identified how the risk to the resident would be minimised by the use of the appropriate equipment and number of staff required to perform the task. The records for one resident identified that she had frequent falls. The falls were recorded in the accident records but there was no evidence that the pattern of these falls was being addressed to minimise the falls. The files contained some incomplete assessment forms including social assessment, documented visits by the chiropodist and involvement with the resident or their family in the care planning process. This was brought to the attention of the manager who acknowledged that there is still a great deal of work to be undertaken on much of the documentation within the home. She is confident that this will be achieved within the forthcoming months and praised all the staff for the work they have done so far. There was evidence in the residents’ records that visits are made by other health care professionals, including chiropodists and opticians. The manager confirmed that residents are able to remain with the doctor who was attending them prior to their admission to the home if the doctor is agreeable. The home has access to three local doctors surgeries and is very satisfied with the service they provide. The manager informed the inspector that she is having problems accessing dental care for the residents. The local domiciliary dentist is not currently available so an alternative is being sought. Residents who are able may visit their own dentist in the community. The inspector observed part of a medication round. This was undertaken appropriately with close attention to checking the name of the resident on the prescription sheet and the medication to be dispensed. All the medication records contain a clear photograph of the resident for identification. Policies and procedures are in place for the safe disposal of medications. The home has recently changed its supplying pharmacy and is so far satisfied with the service being provided. The registered nurses have had training updates for the safe administration of medication. All medications are kept in a locked storage area. There were no omission of signatures identified on the medication record sheets and the records had been completed appropriately where a resident had declined or had been unable to take to take their medication. A requirement was made for the second time from the inspection undertaken in October 2005 that locks must be fitted to all residents bedroom doors. As part of the recent refurbishment of the building all bedroom doors have now been fitted with locks and therefore the requirement has been met. Staff were observed knocking on the doors of residents bedrooms before entering. Residents and relatives spoken to during the inspection confirmed that the staff are respectful and polite at all times. Flowerdown Nursing Home DS0000011652.V289519.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): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Social activities are well organised but the limited budget does not provide the residents with sufficient variety and stimulation. The residents are supported and encouraged to make choices about how they live their lives including choosing from a daily menu that provides them with a well balanced and varied diet. EVIDENCE: The home employs an activity co-ordinator for 20 hours a week. Although the programme of activities appears to be varied and the home tries to include entertainment by external providers and where possible trips to local places of interest, they are constrained by a very limited the budget provided. The manager has had confirmation that the home is to be provided with their own mini-bus, which will enable more residents to be taken out. Residents and visitors to the home confirmed that the activity programme has greatly improved and that the manager encourages the residents to be involved in the activities but think that the variety of activities could be greatly improved. The manager acknowledges this and she would like to do more but at this time she is constrained by her budget. A comment was made to the inspector by a Flowerdown Nursing Home DS0000011652.V289519.R01.S.doc Version 5.1 Page 13 resident and a visitor to the home that the staff now make time to sit and talk to the residents which never happened prior to the new manager being in post. The resident who made this comment stated, “she didn’t care about bingo, it was just nice to have somebody to talk to.” At this time the activity co-ordinator has not undertaken any training for activities appropriate for the residents living in the home. The manager hopes to encourage her to consider this in the near future when she is more established in her post. Residents and visitors to the home confirmed that the home has open visiting and that visitors are welcome at all times. The clergy from a local church visits the home each month and holds a service for those residents who wish to attend. Residents confirmed that they are able to have choice over many aspects of their daily lives. They are able to choose what time they get up and go to bed, what clothes they wish to wear and where they spend their day and eat their meals. One resident spoken to stated that if she chose to spend the day in bed the staff were quite happy to comply with her wishes. She also told the inspector how helpful the maintenance man was and that she was looking forward to him coming to plant some summer plants outside her room that her son had brought in for her. She stated as with all the staff “nothing was ever too much trouble. Everybody is so kind”. The home provides a varied selection of food. Menus are available and run on a four-week rotation. Residents confirmed that they are always asked what they want to eat and may change their mind at any time and will be offered an alternative. The breakfast menu offers a cooked option as well as cereals and toast. Lunch offers two alternatives with fresh vegetables. A vegetarian option is available as required. Cakes provided at mid afternoon tea are always homemade. At suppertime a hot meals is offered as well as sandwiches. Catering staff are employed to prepare each meal, care staff do not prepare any meals. Staff were observed supporting those residents who require additional assistance at meal times. They made every effort to make this an enjoyable experience and the residents appeared to be happy and relaxed. Residents are encouraged to come to the dining room for their meals but may have them in their room if they so wish. All the meals seen by the inspector were well presented and looked very appetising. All the residents spoken to stated that the food was good and that they enjoyed it. Relatives who are visiting are able to have a meal with the resident they are visiting. The meal is served in a separate dining room to give the resident and their family additional privacy. Flowerdown Nursing Home DS0000011652.V289519.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): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Complaints that have been made to the home have been handled appropriately and have provided residents and their families with confidence that their concerns will be listened to, taken seriously and acted upon. Robust procedures and staff training and awareness ensure that the residents are protected from abuse. EVIDENCE: Since the last inspection the home has received three complaints. One complaint has been resolved. Two are still being investigated in accordance with the home’s complaints procedure. The complaints records for the home are comprehensive and document the investigation undertaken and the outcome achieved. The home provides training for staff for the protection of vulnerable adults. The manager informed the inspector that a further update for this training is to take place in June 2006. Members of staff spoken to confirmed that they have received this training previously and are aware of the procedure to be followed if they witnessed any incident that constituted abuse towards a vulnerable adult. The manager reported that the company who owns the home has reviewed all the policies and procedures for the home. The procedure adult protection supplied by Four Seasons was looked at and was found to contained contradictory advice to anyone reading it. This was discussed in detail with the manager who agreed with the inspector and confirmed that she will speak to Flowerdown Nursing Home DS0000011652.V289519.R01.S.doc Version 5.1 Page 15 her line manager and ask for the information to be clarified and re-written where necessary. The home has a copy of the Hampshire Adult Protection procedure and the manager confirmed that she is aware of the procedure to be followed in the event that an incident of abuse is reported. Flowerdown Nursing Home DS0000011652.V289519.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The home is well maintained; however offensive odours noted in one area does not ensure that the residents are living in a totally clean environment. Lack of sufficient specialist equipment for safe moving and handling will place residents at risk. EVIDENCE: The home has recently undergone a total refurbishment. New furniture has been supplied in resident’s rooms and communal areas. Flooring and carpets have been replaced throughout the building. The colour schemes have been carefully chosen and the whole effect is very tasteful. Residents spoken to are very pleased with the final result. Both residents and staff were very surprised and pleased that the workmen caused the minimal of disruption during the whole operation. Flowerdown Nursing Home DS0000011652.V289519.R01.S.doc Version 5.1 Page 17 Staff spoken to raised concerns about the lack of suitable lifting equipment in the home. Currently the home has only one stand-aid and two hoists. Staff told the inspector that they consider time is wasted getting residents up and putting them to bed when they have to wait to use the equipment and in addition possibly have to move it from one floor to another. They are concerned that when the home has the maximum number of residents their work will be delayed further. On both days of the visit the home was noted to very tidy and generally very clean. However on the second day offensive odours were noted in one resident’s bedroom. This was brought to the attention of the manager who confirmed that she would speak to the housekeeper and ensure that the carpet was cleaned immediately. Flowerdown Nursing Home DS0000011652.V289519.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The number of staff on night duty currently meets the needs of the residents in the home. An increase of resident numbers with current number of staff may put residents at risk and their care needs may not be met. The manager for the home ensures that staff recruitment procedures are followed and residents are not put at risk. All staff undertake training to ensure they are competent to do their job but a formal programme of training would ensure that the staff’s training needs are identified and addressed. EVIDENCE: The number of residents in the home has been reduced during the programme of re-decoration and re-furbishment. The staff rota demonstrates that the number of staff on duty over a twenty-four hour period is sufficient for the current number of residents. The manager confirmed that as more residents are admitted the staff numbers will be increased. At the last inspection the number of night staff was considered to be inadequate to meet the needs of the residents. The manager reported that the company, Four Seasons was aware of the requirement but decided to leave these numbers unchanged due to the decreased number of residents. The manager has assessed the dependency needs of the residents and assured the inspector that their needs are currently being met. Residents spoken to confirmed that they had no complaints at this time about their care at night and stated that the staff were Flowerdown Nursing Home DS0000011652.V289519.R01.S.doc Version 5.1 Page 19 always prompt to respond to the call alarm. The manager confirmed that she would reassess the number of night staff when resident numbers increase. Currently the home has not met the target of 50 of the care staff with NVQ level 2 or above. Two members of staff have achieved NVQ level 2, two have level 3 and one has level 4. Many of the care staff are from overseas and hold qualifications that are not recognised in the United Kingdom. One member of the care staff is a physiotherapist in their country of origin another is a qualified doctor. The manager of the home is trying to get their qualifications recognised at an appropriate NVQ level in this country. Some of the members of staff spoken to were quite despondent that their qualifications have been not recognised. Samples of records for four members of staff were examined. The records for one member of staff, who had been recruited by the previous manager, contained only one written reference and there was no evidence that a programme of induction had taken place on commencement of employment. There was no evidence that supervision was taking place for this person. All the records demonstrated that appropriate police checks with the Criminal Records Bureau (CRB) had been undertaken and checks with the Provision of Vulnerable Adults register (POVA) had been undertaken. The manager confirmed that a formal training programme for staff working in the home has not yet been completed. Staff confirmed that they have undertaken training for fire safety, safe moving and handling, protection of vulnerable adults, infection control and tissue viability and training certificates in some of the staff records seen confirmed this. The manager has been able to access English language training for the overseas staff, which it is hoped, will improve their spoken and written English skills. A local university has recently audited the home and student nurses will be undertaking one of their clinical placements at the home from October 2006. Flowerdown Nursing Home DS0000011652.V289519.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The manager is able to demonstrate that she is suitably qualified to ensure that the home is well run and that the needs of the residents are met. Registration with the Commission has yet to confirmed. There is no quality assurance process in place at this time to monitor that the home is run in the best interest of the residents. Procedures are in place to ensure that the residents’ financial interests are safeguarded. Close monitoring of practices within the home safeguard the health, safety and welfare of residents, staff and visitors to the home. Flowerdown Nursing Home DS0000011652.V289519.R01.S.doc Version 5.1 Page 21 EVIDENCE: The current manager has been in post since November 2005. She is a Registered General Nurse (RGN) level 1 and is also a Registered Sick Children’s Nurse (RSCN). She has undertaken other educational courses including, nurse teaching, mentorship and assessors course and a specialist course for the management of diabetes. At this time her application to be the registered manager for the home has not been submitted to the Commission as a part of the required documentation to be submitted with the application are have not been completed. The manager also holds her Registered Manager’s Award (RMA). Shortly after taking up the post of manager the programme of redecoration was commenced. Members of staff told the inspector that she coped very well with being the new manager and having the workmen in the building and her support towards the staff enabled them to keep disruption to a minimum so it did not affect the lives of the residents too much. The manager operates an “open door” policy in the home and staff and visitors to the home are encouraged to speak to the manager or her deputy at any time. Members of staff spoken to said that they found the manager and her deputy very approachable and supportive. Visitors to the home spoke to the inspector and said that the atmosphere in the home had changed since the new manager had been in post. All the staff were more relaxed and friendly and one visitor remarked that “it is so nice to see the staff actually sitting and talking to the residents”. Residents spoken to confirmed this and said how much they enjoyed staff spending time with them. The manager has held several meetings with relatives, which have been well attended. Minutes of the meetings were documented. The manager reported to the inspector that she is trying to encourage the relatives to be more involved with some of the social events that are arranged for the residents but so far has not had a good response from them. At this time the manager has not undertaken any quality assurance questionnaires with the residents and visitors but is planning to do so as part of her future plans for the home. The company who owns the home, Four Seasons, has undertaken surveys but the results of these are unknown, not having been passed to the manager. The home has a secure system for the safe storage of small sums of money for the residents. A member of staff has been appointed as “fire warden” for the home and is responsible for ensuring that the fire safety training for all staff employed in the home is regularly undertaken. Records provided evidence that this training has been undertaken. Other records demonstrated that all the fire safety equipment, including emergency lighting and alarms is regularly checked and maintained. During the visit to the home the fire alarm was activated as part of the regular unannounced random testing of system. Staff reacted very Flowerdown Nursing Home DS0000011652.V289519.R01.S.doc Version 5.1 Page 22 promptly and assembled at the appointed fire assembly point. Service contracts seen demonstrated that equipment and systems in use in the home are regularly maintained and repaired as necessary. Staff confirmed they have regular training up dates for safe moving and handling and infection control. Flowerdown Nursing Home DS0000011652.V289519.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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 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 2 X X X 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Flowerdown Nursing Home DS0000011652.V289519.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15(1) Requirement All care plans must be drawn up and signed by the resident or their representative as evidence that they have been involved in the care planning process. The home must provide such equipment that is suitable for the needs of the residents and ensure their safety at all times. The home must be kept clean and free from offensive odours at all times. A minimum of 50 of the care staff in the home must achieve NVQ level 2 or above. The registered person must ensure there is a staff training development programme I place to ensure that the staff is competent to do their job. A quality assurance and monitoring system, based on the views of the residents, must be implemented to ensure that the home is meeting the aims and objects as stated in the Statement of Purpose. Timescale for action 31/07/06 2 OP22 16(2)(c) 31/07/06 3 4 5 OP26 OP28 OP30 16(2)(j) 18(1) 18(1) 30/06/06 01/11/06 30/06/06 6 OP33 24(1) 31/07/06 Flowerdown Nursing Home DS0000011652.V289519.R01.S.doc Version 5.1 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. Refer to Standard Good Practice Recommendations Flowerdown Nursing Home DS0000011652.V289519.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Flowerdown Nursing Home DS0000011652.V289519.R01.S.doc Version 5.1 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. 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