Inspection on 29/08/07 for Fosse House Nursing Home

This inspection was carried out on 29th August 2007.

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

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

Other inspections for this house

Fosse House Nursing Home 29/01/08

Fosse House Nursing Home 03/01/07

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Fosse House Nursing Home South Street Stratton on the Fosse Radstock Somerset BA3 4RA Lead Inspector Barbara Ludlow Unannounced Inspection 29th August 2007 10:20 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 Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fosse House Nursing Home Address South Street Stratton on the Fosse Radstock Somerset BA3 4RA 01761 233018 01761 233632 fossehouse01@btconnect.com 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) TC Carehome Ltd Awaiting registration Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. An application must be made to the Commission for Social Care Inspection by the home manager to become the registered manager within 6 months following the registration date. Elderly persons of either sex, not less than 60 years, who require general nursing care. Up to 3 places for personal care. Date of last inspection 3rd January 2007 Brief Description of the Service: Fosse House Nursing Home is set in the village of Stratton-on-the-Fosse approximately 5 miles from Shepton Mallett and the City of Bath respectively. Fosse House is a registered care home that provides nursing and personal care to elderly persons of either sex, not less than 60 years, who require general nursing care. The home is registered to accommodate up to thirty seven service users. Fosse House was developed from the conversion of a large character house with an additional newer accommodation extension. The accommodation is on two floors and bedrooms are spacious. The home comprises 31 single rooms and three double rooms, plus communal space. The upper floors are serviced by a passenger lift. There are communal rooms on both floors. The large rooms are both lounge / diners. All services are provided in the home and the home is surrounded by wellmaintained accessible gardens. Registered nurses and carers staff the home 24 hours a day. The current fees charged are £550.00 - £650.00 per week. Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of this inspection visit was to inspect relevant key standards under the Commission’s ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are: - excellent, good, adequate and poor. This unannounced inspection was carried out by B Ludlow for CSCI. The inspector was at the home for a little over eight hours. The home manager Mrs A Sankey was on duty and remained at the home to assist with the inspection process and receive feedback at the conclusion of the visit. The manager had completed and returned the Annual Quality Assurance Assessment (AQAA) now required by CSCI. Residents, their relatives and visiting professionals had all returned questionnaires to CSCI with their views of the service, to inform the inspection process. Residents were seen and spoken with in the communal areas of the home and in their rooms. Staff were observed at work and a small number were spoken with. A tour of the premises was made and records were sampled with the assistance of the home’s administrator and the manager. Daily life at the home was observed during the day. The preparation for meals and activities were seen but were not observed throughout. The home had a number of visiting professionals at the home, two nurses were reassessing all residents for their registered Nurse Care Contribution (RNCC) and a visiting dietician was undertaking a review of residents to prepare a pilot study of resident’s nutritional status, their dietary intake and any special needs. Both events called upon the senior nursing team time, the manager had prearranged for the deputy manager to come in on her day off to work with the dieticians. All appeared to be handled very professionally and smoothly. This was a positive inspection. What the service does well: There has been investment in the premises and upgrading of some facilities. The house looks out onto open fields and has very pleasant and well kept gardens that are accessible and have seating. Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 6 Staff said they felt they ‘communicate well’ with the residents and have time to spend with them. The residents and their relatives felt that the staff are hardworking and comment included that staff are ‘very nice’ and ‘excellent’. What has improved since the last inspection? What they could do better: Work should continue to develop care practice and record keeping that fully embraces the principles of person centred care at the home. Environmental infection control would be enhanced with the use of foot operated flip top bins for staff hand wash waste and protective gloves and aprons. Raised toilet seats and commodes were seen at this inspection that had varying amounts of rust on the frames. These cannot be cleaned sufficiently and are unhygienic. They must be repaired or replaced. All catering staff are appropriately trained in food handling and hygiene. Care staff are involved with food handling and assisting residents with their meals. It is recommended that all care staff should as good practice receive some basic food hygiene training to ensure safe food handling at all times. A record should be kept of any training given. The fire risk assessment for the premises was not requested for inspection. The manager was alerted to the more recent review of the fire service regulations that now request an evacuation plan be written. Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 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 Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3, Quality in this outcome area is good. There is a new informative service users guide and a statement of purpose to help the prospective resident make an informed decision about moving into the home. Both documents are available to read in large print. The manager carries out preadmission assessment and gathers information from health professionals to ensure that the service and the home can meet the person’s needs. Contracts are issued and are clearly written. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The new home manager has developed a meaningful statement of purpose and service user guide. Copies of these documents were given to the inspector and Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 10 will be held on file at CSCI. A large print version is available and has been used to help one prospective person with visual impairment. Contracts are clearly written, a copy of the contract is included in the service users guide. The room to be occupied is stated and that the first four weeks of residence is a trial period. A sample of contracts were seen for a privately funded and a social services funded resident. The manager carries out an assessment and acquires the Single Assessment documentation (SAP) from the community health care professionals pre admission. Care plans were sampled and there was sufficient information gathered to judge whether or not the service would be able to meet the needs of the prospective service user. This template used for recording this information has been improved by Mrs Sankey to include mental health care needs. The information available to prospective residents and families was sufficient to enable then to make an informed choice of care home placement. Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good The care plans are more person centred; this has been achieved since the last inspection. The home is becoming more involved with the community health care professionals to ensure the best care for the service users in residence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Good feedback about the health care at the home was received the doctors and social workers asked by questionnaire. The community nurses assessors were visiting the home at the time of this visit to assess and reassess residents entitled to a Registered Nurse Care Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 12 Contribution (RNCC). The homes nurses supported this work, making records available. There were also dieticians visiting to commence a dietary assessment trial with residents who were able to consent to joining. The deputy manager was available on her day off to assist with this. Two people were chosen for the trial. The manager and deputy are confident that this trial and learning experience will be of benefit to all residents at the home. Medications management was assessed and was found to be thorough and clearly managed. Storage was satisfactory with two trolleys, one for each floor. A lockable treatment storeroom houses the medications fridge and there is staff hand washing facility. Appropriate waste management was evidenced for a care home with nursing. Controlled medication was safely stored and fully recorded. Oxygen cylinders not in use were securely stored. The nurse spoken with who is responsible for the ordering was knowledgeable of the medications in use and the recording system, an appropriate reference book was available and in use. Chronic ill health conditions such as diabetes was well managed. Insulin was stored appropriately and blood sugar monitoring was recorded. Staff were working safely. Medication Administration Records for the ground and first floor were complete and signed, photographic identification of the resident was in place, There was a record of staff signatures and list of homely remedies from all four doctors surgeries that have residents registered with them. A suggestion was made to record the due date of a three monthly injection on the MAR as well as the daily diary; this was implemented at the inspection. Residents said they were well cared for. Some residents had particular staff they liked and all the care staff received praise for their hard work. One resident who remained in bed said that their care was good. It was noted that the trained staff were making enquiries to help one resident who had particular problems with their hearing aid appliance. Input from the community nurse had been sought via the visiting doctor to offer specialist opinion on wound management in the absence of a tissue viability nurse being accessible to the community. Carers are allocated to residents as key workers. There was no real sense of this system being in place with the staff or the residents that were asked what key working meant to them. The role of the key worker should be explored through staff meetings and training to develop the role more effectively. Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. The management of activities is improving. Care staff undertake activities with residents. Visitors asked said that they are made welcome at the home. The food was reported to be ‘good’ and there is a ‘choice’. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One member of care staff was allocated to under activities. Two care staff have received activities training and the manager plans to train another two care staff. Mrs Sankey wants activities to be part of the carer’s role to make their role more rewarding and interesting and to improve the skill range of staff. Relatives and friends are made welcome and residents spoken with commented on their relatives being welcome and visiting regularly. One Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 14 relative spoken with was very happy with the ‘excellent care that is provided’ and they came in every day. Mealtimes are very social and well organised. Residents were seen as they were assisted to the meal tables to sit together. The tables were attractively presented. Residents were satisfied with the menu commented on having a choice at each meal. The inspector did not see the lunch being served but heard from the residents that it had been ‘very good’. Teatime was soup and sandwiches. No complaints were heard about the food or the service. Drinks served late morning and assistance was given where needed. Cold drinks of fruit squash were available in jugs in the communal rooms. Staff said they were aware of the service users who needed to be prompted or assisted with drinking. Staff were asked what they thought the home did well, one commented that the food was good, always plenty and a lot of choice, puddings being especially nice. The residents are offered a menu choice of by the kitchen assistant each day who checks to see what people would like to eat on that day. An environmental health visit recently had been satisfactory. Residents can purchase toiletries from a small stock held at the home. The hairdresser visits the home once a week but residents can have their own hairdresser visiting if they wish. Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. Satisfactory recruitment procedures are undertaken; these should offer residents protection from unsuitable people working at the home. The complaints policy is very clear and is in the service user guide given to each resident and their family. Concerns that have been raised at the home have been appropriately followed up. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff recruitment was sampled for three new starters. Two references were on file. Criminal Record Bureau checks are made and Protection Of Vulnerable Adults list is checked (POVA First) before new people can start working at the home. The staff receive a letter of appointment and have a contract issued after their three month introductory period. A sample of the letter, a contract and a job description were forwarded to the inspector after the inspection. Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 16 The homes administrator confirmed that registered nurses are checked against the Nursing and Midwifery Council (NMC) register to ensure registration and to ensure continued registration at each three year renewal. The method used was seen, the administrator does not currently use the on line system but will try this as this gives an opportunity to print out the entry confirmation details. Staff have received POVA training and are aware of the vulnerability of the residents in their care. Residents asked all said they would raise any concerns they may have with the manager or with staff. One visiting relative also said they were aware of the complaints procedure and would voice any concerns should they have any they felt they needed to raise. One visiting relative was asked if they felt able to complain or raise a concern, they felt they would and said they had raised an observation of their relative with the nursing staff today to ensure it received attention. Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is adequate. The care home is suitably adapted to meet the needs of service users requiring nursing care. The home is being maintained and upgraded by the new owner. Bedrooms and communal areas were clean and comfortable. Malodour of varying degrees was noted in three bedrooms. A number of commodes and over the toilet raised seats need to be replaced or repaired as they were in poor and rusting condition. This compromises the ability to keep them clean and hygienic. Foot operated flip top bins should be available for staff hand wash waste to reduce the risk of cross infection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises was made. Domestic staff were on duty and were seen cleaning bedrooms. Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 18 Bedrooms can be personalised and this was evident with lots of homely bedrooms with photos, pictures, and small pieces of furniture, Televisions, radios and personal ornaments. Beds seem comfortable and were nicely made with clean and attractive bed linen. The amount of natural light around the home is good but in one or two bedrooms it was less good. Mrs Sankey said that extra light fittings are to be installed to improve the lighting in some of the bedrooms where the shape of the room does not allow the optimum light from just one fitting. One pressure pad was in place in a bedroom where the resident was at risk of falling. One relative had reported that their relative’s room was dirty. Many service users and relatives commented that the home is clean and tidy. Varying degrees of malodour were noted in three bedrooms. En suites have hand wash facilities, the waste bins were not all foot operated, this was discussed with Mrs Sankey who agreed to review the bins and risk assess where changes need to be made. Many raised toilet seats and wheeling commodes chairs were seen to be rusting, some badly, others not too bad, the rust can prevent thorough cleaning and be unhygienic. These must be repaired or replaced. Communal areas were clean and tidy, armchairs looked comfortable, and specially adapted chairs were seen in use. The dining tables were attractively laid at lunchtime with table linen. The environment has been improved with redecoration and some new carpets. A shower ‘wet room’ has been installed which is spacious, very practical and is well used. A new dishwasher has been purchased and a sluice room was installed by the new owner. A new garden shed has been purchased for storage and repairs to all hoists following a safety alert have been made. A garden wall was rebuilt and the manager stated that quotes have been taken for some new windows. Carpets in need of sufficient cleansing to control odour and improve their look have also had quotes for this work. The home is fitted with a fire alarm system, which is maintained and serviced. See also Management section. The home has a nurse call system in place, which is quite loud; the manager said that the volume of this is reduced at night. The homes fire risk assessment was not seen, this should be checked by the manager in line with the most recent fire service regulations and guidance for an evacuation action plan. Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate There is a skill mixed staff team. There is a registered nurse on duty at all times. The nursing staff were professional and knowledgeable. The residents commented that the care staff are ‘good’ and ‘excellent’. Induction training and staff training has improved. Recruitment processes are safe and the manager hopes to recruit more staff to the team to ensure it can always be fully staffed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the unannounced inspection the home was fully staffed. The manager was on duty and the deputy had come in on her day off to assist with a research project the home are supporting. Dieticians were visiting to study weight management and begin a supplementary diet pilot. The manager is pleased to have had the opportunity to join the research which she feels will benefit the residents and be an educational opportunity for the staff team. Residents and relatives spoken with and those responding in writing to the CSCI questionnaires praised carers. Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 20 There is a skill mixed staff team with catering, care, cleaning. The manager is developing some generically trained staff to assist if shortfalls occur in other departments. Staff hours were variable, geared to suit the individual. The manager is actively recruiting staff to ensure the home has staff to work at the weekend. Agency staff are not used, the homes own staff choosing to work any vacant extra hours. The duty rotas seen for the week of the inspection and the week before the inspection were acceptable with staffing levels at a minimum of six staff each morning. Induction for new staff is carried out over their first three months in post. A contract of employment is issued after three months. Staff recruitment files were sampled. Application forms with a health declaration had been completed. POVA First checks and Criminal Record Bureau checks were in place before the person commenced working at the home and 2 satisfactory references were on each file. A full work history was seen on the application forms. A copy of the staff job descriptions and letter of confirmation were not seen at the inspection but copies of these documents were faxed through to CSCI on 30.08.07. A record of the mandatory training for fire, manual handling, POVA was seen for each new member staff, with certificates. The manager stated that infection control was covered in the staff meetings. This should be more formally recognised in line with National Health Service guidance for all staff in care homes and hospitals (to reduce infection rates.) The manager has changed the method for recording training and a training matrix has been formulated and was seen, this included all staff working at the home. Basic food hygiene training should also be treated separately as all staff help with meals and drinks and use the kitchen to collect food and may make the soup and drinks in the evening. One new staff member seen working in laundry confirmed the storage of chemicals and use of alginate bags for contaminated laundry. Staff supervision is currently undertaken by the manager for all staff. The manager must encourage the care staff group to work towards achieving a minimum of 50 with an NVQ Level 2 or above. Currently nine of the thirty one care staff have an NVQ Level 2 or above. The AQAA stated that six care staff are working towards NVQ Level 2. Staff asked said they were hoping to start their NVQ training. Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 33,35,38 Quality in this outcome area is adequate. The manager is making an impact upon the home and feedback to CSCI included comments from professionals, residents and relatives to say that the service is improving. The manager has yet to be registered with the CSCI. The maintenance of the home is of a good standard. Measurement of Quality by questionnaire has been made although the interpretation of this into service improvement cannot be measured at this early stage. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Quality assurance questionnaires to professionals, relatives and groups of residents had been completed and were seen. The manager has not yet Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 22 analysed the information but feels it was helpful and meeting with groups was worth doing. Changes are planned from the feedback such as weekend cleaning, staff for this are being actively recruited. Storage of all records was secure, one original CRB was seen and the manager is advised to review this regarding Data protection and was advised to refer to the CRB guidance on the CSCI Professionals website. The manager, Mrs Sankey has reviewed the management of the home and a lot of progress has been achieved. The home has an administrator who has many years of experience at the home, assisting with the accounting, management of service user finances and the safe storage of all records. Maintenance records were sampled for fire safety and servicing, hoist and lift servicing, gas servicing, portable appliance testing and mains installation work. All records seen were up to date. The homes fire risk assessment was not seen, the manager is advised to ensure this is compliant with the latest fire service regulation guidance, which now requires emergency evacuation management planning. Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 2 X X X X X X 1 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 X X 3 Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 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 OP19 OP26 Regulation 23(2)(c) 13(3) Requirement Rusting raised toilet seats and commodes cannot be thoroughly cleaned and are unhygienic. Some had missing ferrules. This equipment must be repaired or replaced. Open waste bins must be risk assessed and replaced as necessary with foot operated flip top bins for staff hand wash waste and used protective clothing such as gloves and aprons. This will reduce the risk of cross infection. Odour control in bedrooms must be improved with sufficient cleansing of carpets and furniture or be replaced. Timescale for action 05/10/07 2. OP26 13(3) 05/10/07 3. OP26 16(2)(k) 05/10/07 Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard OP8 OP33 OP28 OP8 Good Practice Recommendations The registered person should ensure staff receive appropriate training to carry out person centred care. The analysis of quality monitoring should be interpreted and used to improve the service at the home in line with the service users wishes. The home should continue to work towards a minimum of 50 or more of care staff achieving an NVQ Level 2 or above. The key-working role should be developed as a more meaningful aid to person centred care. Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Fosse House Nursing Home DS0000067689.V341707.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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