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Inspection on 01/12/06 for Foxearth Lodge Nursing Home

Also see our care home review for Foxearth Lodge Nursing Home for more information

This inspection was carried out on 1st December 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 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 fabric of the building is in very good condition and is well maintained, providing a homely, comfortable, and attractive home. The home provides a good range of wholesome food, with good choices for service users. Food and drink is presented to suit service users` preferences, in a relaxed and convivial way. The home has a good social programme. Staffing ratios are good within the home.

What has improved since the last inspection?

Fewer lap belts were in use, and full risk assessments and recording were in place for the three service users for whom these were judged necessary. The whistle blowing policy had been reviewed and extended. The system of medicine administration had been reviewed and some improvements made, but further work is required. Hazardous substances were appropriately stored. Two signatures, plus the service user`s (or their representative`s) signature are now required on records and transactions relating to service users` money held by the home.

What the care home could do better:

A comprehensive malnutrition screening tool must be used were the need is indicated. Food and fluid intake for residents who are dependent upon being fed must be recorded. A record of turns and tilts must be maintained for residents who require this intervention. Proper arrangements must be put in place for the disposal of medicines, whether disposed of on the premises or via a clinical waste contractor, and the policy must state these arrangements and the recording practices required to support it. Medicines must be selected, administered and recorded on a one resident at a time basis. Staff recruited following a PoVA first check but prior to receipt of a CRB must be directly supervised by a suitable named staff member. Staffs` proficiency in English must be assessed. Mops must be stored in accordance with the control of infection policy. A record must be maintained of all valuables deposited by a resident for safekeeping or received on their behalf, and it must include written acknowledgement of return of valuables.

CARE HOMES FOR OLDER PEOPLE Foxearth Lodge Nursing Home Little Green Saxtead Woodbridge Suffolk IP13 9QY Lead Inspector Mary Jeffries Unannounced Inspection 1st December 2006 14:40 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 Foxearth Lodge Nursing Home DS0000024391.V301879.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. Foxearth Lodge Nursing Home DS0000024391.V301879.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Foxearth Lodge Nursing Home Address Little Green Saxtead Woodbridge Suffolk IP13 9QY 01728 685599 01728 685599 admin@foxearthlodge.co.uk 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) Mrs Eileen Patricia Cantrell Mr Brian Cantrell Mrs Eileen Patricia Cantrell Care Home 62 Category(ies) of Dementia - over 65 years of age (33), Learning registration, with number disability over 65 years of age (1), Old age, not of places falling within any other category (29) Foxearth Lodge Nursing Home DS0000024391.V301879.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home may accommodate 9 service users with dementia as named in the letters from Foxearth Lodge dated 01/02/06 and 14/07/06, so long as their needs may continue to be met outside of Woodlands unit. The home may accommodate one named service user who is an older person with a learning disability and dementia as named in variation application dated 4/8/06. 19th January 2006 Date of last inspection Brief Description of the Service: Foxearth Lodge Nursing Home provides nursing care to a maximum of 62 elderly service users, comprising of 29 older persons (OP), 33 older persons with a diagnosis of dementia (DE)(E), and 1 older person with Learning Disabilities LD (E). The home is in a rural location, a few miles from the market town of Framlingham and is set in large grounds, which are accessible to service users. Woodlands Unit (which caters for up to 24 older people with dementia) is on ground floor level and comprises 2 double and 20 single bedrooms, all with en suite toilet facilities. Foxearth main and Barn units are on two floors, linked by a shaft lift, and comprise 2 double and 34 single bedrooms, of which have en suite toilet facilities. There are several lounges, dining rooms and small, quiet communal areas throughout the premises. The home has a condition of Registration that allows it to accommodate 9 named service users with dementia, so long as their needs can be met, outside of Woodlands. The home charges £686.00 per week. There are no additional charges. Foxearth Lodge Nursing Home DS0000024391.V301879.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection, which focused on the core National Minimum Standards relating to older people. The report has been written using accumulated evidence gathered prior to and during the inspection. The inspection took place one afternoon and early evening in December 2006. It took five and a half hours. The inspection was facilitated by the Deputy Nurse Manager. Nursing staff and domestic staff contributed to the inspection. A site visit was also undertaken in respect of a major variation application. Forty-two comment cards were received from relatives and or visitors of service users prior to the inspection. This is a response of approximately 66 . A pre inspection questionnaire was provided by the home. The inspection focused on the main part of the home; Woodlands, the specialist unit for residents with dementia was not inspected on this occasion. All of the nine residents who are living on the nursing unit in the main house who have a diagnosis of dementia were observed. There were three resident vacancies in the home at the time of the inspection, one of which was on Woodlands. What the service does well: What has improved since the last inspection? Fewer lap belts were in use, and full risk assessments and recording were in place for the three service users for whom these were judged necessary. The whistle blowing policy had been reviewed and extended. The system of medicine administration had been reviewed and some improvements made, but further work is required. Foxearth Lodge Nursing Home DS0000024391.V301879.R01.S.doc Version 5.2 Page 6 Hazardous substances were appropriately stored. Two signatures, plus the service user’s (or their representative’s) signature are now required on records and transactions relating to service users’ money held by the home. 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. The summary of this inspection report can be made available in other formats on request. Foxearth Lodge Nursing Home DS0000024391.V301879.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Foxearth Lodge Nursing Home DS0000024391.V301879.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to be have their needs assessed prior to moving into the home, and to have access to good information upon which to make a choice of home. EVIDENCE: The Statement of Purpose was on display in the foyer of the home. The Service User Guide was available in the home. It had been reviewed in 2006. The guide included the complaints policy and the outcomes and requirements of the last CSCI inspection. Foxearth Lodge Nursing Home DS0000024391.V301879.R01.S.doc Version 5.2 Page 9 The Service User Guide also included a copy of the standard contract. There were no residents accommodated on a respite care basis at the time of the inspection, but the home was able to provide a standard copy of a contract for respite care. The files of two recently admitted residents were inspected and were found to include pre admission assessments. The deputy nurse manager confirmed that the home does not provide intermediate treatment care. Foxearth Lodge Nursing Home DS0000024391.V301879.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents can expect to have a care plan which sets out their needs, but Those who are at risk of pressure areas or malnutrition cannot be assured that all are receiving appropriate care. The home’s system of administration of medicine involves some unnecessary risks for service users. EVIDENCE: All 42 relatives/ friends who sent in comments cards indicated that overall, they were satisfied with the overall care provided. Comments included the following: “I am more than happy with the care provided.” “……….is beautifully cared for and I cannot praise the home more highly.” Foxearth Lodge Nursing Home DS0000024391.V301879.R01.S.doc Version 5.2 Page 11 “Patients are beautifully cared for at all times- clean and nicely dressed, and there is no unpleasant smell.” “…………has made significant advances since (their) transfer from hospital. This is due to the care ( they) received at Foxearth.” One relative provided a written comment, “for a resident who suffers from a degree of dementia and a range of medical conditions requiring supervision, the “nursing model” is too rigid. Staff are somewhat possessive of her and question the wisdom of……our insistence that (they) still be given choices and (their) wishes respected. They added, however, we full acknowledge Foxearth’s excellence, but it would not take much to make it superb.” Five of the residents with dementia who were bed-ridden were seen in their rooms. The doors to the rooms were open, but were on automatic closures. Music was playing softly in these rooms, but later, when one of these residents was sleeping the music had been, appropriately turned off. The residents had profiling beds and appeared to be comfortable. One of the residents on this unit had a pressure sore; others were on turn regimes because of fragile skin. The care plans of the residents with dementia whose nursing care needs were upper most and resided on this unit were inspected. Recording of food and drink intake was not done consistently. Where it was recorded, the amount taken, approximately was entered. Turns and tilts were not recorded. The nurse and deputy nurse manager explained that a regime of turning was followed, where by at each meal time and each drink time, the resident was turned. One resident had a regime for frequent drinks in their plan, but there was space left where the frequency should have been inserted. The nurse in charge of this unit advised that for this resident the drinks were hourly. This is more frequently that the drink/meal regime which is spaced out at approximately 2.5 hours, and yet there was no consistent recording of drinks for this resident. All residents have the same General Practitioner. This was discussed with the Deputy Nurse Manager, who advised that this was on account of the home’s rural location. The General Practitioner attends the home for a “round” twice a week. There was evidence of other referrals to and appointments with a range of medical specialists on the care plans inspected. Nutritional screening was discussed with the Deputy nurse manager and nurse in charge of the unit. They advised that food and fluid charts were set up if the G.P. advised it was necessary, but that they did not use a screening tool for malnutrition. The deputy nurse manager advised that it is intended to introduce this. Foxearth Lodge Nursing Home DS0000024391.V301879.R01.S.doc Version 5.2 Page 12 A risk assessment in respect of the possibility of wandering, for an ambulant service user with dementia who has direct access to a non-secure garden had been regularly reviewed. This resident was not on the unit during the afternoon, a nurse advised that the resident had a friend on Woodlands and had was spending the day with them. This was noted on the resident’s cardex entry. A requirement was made at the last inspection that the use of lap belts as a restraint must be in accordance with the home’s policy. The deputy nurse manager advised that lap belts were used with three residents, none of which resided on Woodlands. The record and risk assessment for one of these was selected at random and was found to be in order. The teatime medication round was observed, Medication Administration Record (MAR) sheets for 9 residents were inspected and the controlled drugs book and stock were inspected. Prior to the inspection an anonymous complainant had, amongst a number of concerns, stated that a relative had been given a medication disguised in food. At the time of the inspection, the particular medication that was concerned had been changed for a patch. The home’s medication policy stated that Medications will never be given to patients without their consent (informed or implied). In exceptional circumstances, with the G.P.’s consent, medicines may be secreted in a drink or in food and this information will be recorded both in the care plan and on the drug chart. The home’s medication policy and procedures had been reviewed since the last inspection, when three requirements, including a requirement to have this review had been made. Whilst a record was being maintained of medications returned, the medication policy did not include details of the arrangements for waste medicines. An inspection was made of controlled drugs, and these were found to be in order and in accordance with recorded details. All 42 who sent in comment cards indicated that they could visit their relatives and that they could see their friend/relative in private. Foxearth Lodge Nursing Home DS0000024391.V301879.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. This judgement has been made using available evidence including a visit to this service. Residents can expect to have access to a range of activities, and for their relatives to be made to feel welcome at the home. Residents living on the nursing unit who have dementia can expect to be included in mainstream activities wherever possible. EVIDENCE: An annual programme of outings and activities was available, and a quarterly programme was displayed. On the afternoon of the inspection, an organ player was performing in the residents lounge in the barn, and a number of residents, including two of those with a dementia diagnosis were in the lounge enjoying this session. Another resident was enjoying the care and attention of a manicure being carried out. This activity was as on the programme displayed, and was listed as a fortnightly event, alternating with the “Cranford Singers”. Flower arrangements and a clothes party were also scheduled within the period, and in December the home had an outing to Wyevale for Christmas Foxearth Lodge Nursing Home DS0000024391.V301879.R01.S.doc Version 5.2 Page 14 shopping, a Christmas Party and a pantomime. Other outings had been held during the year to a tea dance at Felixstowe, Bury Gardens, and Aldeburgh and Thorpeness. A member of staff advised that those with dementia who are not bed fast are encouraged to come into the lounge areas and participate. Residents also have a list of ongoing activities that they can participate in, in addition to an annual programme of activities. These include reading – residents are offered a regular visit from a visiting librarian, and seeing the retired guide dog that visits weekly. There is a weekly house Church of England Communion service, and the possibility of visits from C of E lay elder or representatives of other religions. This list also included cake decorations, and the housekeeper and a resident confirmed that they had recently made cakes together. Relatives comments cards were all positive about being made to feel welcome, two commented; “All staff from top to bottom speak to you on arrival and on leaving the home and make you feel very welcome” and “The staff are wonderfully kind and loving and are very supportive of relatives.” The vast majority of relatives providing feedback to the CSCI indicated that they were consulted about their friend or relatives care if they were unable to make their own decisions. One, only thought not, and two thought they were not always consulted in these circumstances. Only one out of 42 relatives/ friends were of the opinion that they were not kept informed of important matters affecting their friend’s care. During the afternoon, a hot drink was served to all residents, and a number of residents who were in bed were seen to be assisted. This was seen to be undertaken with care and gentleness. Residents were seen to be having their teatime meals in a variety of places; some sat at the table, some had individual chairs and tables, some were assisted in their rooms. The cook was spoken with, and it was clear they had a good knowledge of residents’ preferences and needs. The housekeeper referred to a list that recorded all service users preferences and needs in terms of the size of meal (plate) they wanted, the type of cup they liked to drink out of, the strength of drink they preferred. This included any that needed a liquidised diet. The menu was seen; a wholesome varied and balanced diet is provided. Foxearth Lodge Nursing Home DS0000024391.V301879.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 adequate. This judgement has been made using available evidence including a visit to this service. Residents can expect the home to be open to complaints and to respond properly to them. However the recruitment procedures need to be more robust to ensure residents are protected. EVIDENCE: The home had maintained a complete complaints log. This contained a number of complaints that had all been responded to in a timely way and the content of which varied from small to larger concerns. The home’s policy on prevention of abuse had been reviewed in December 2006. It was consistent with local interagency policy, clarified staffs responsibilities and included advice that if an alerter fearing victimisation may be protected by the Public Interest Act 1998. Some new staff had commenced work after a PoVA check had been completed, but prior to the Criminal Record Bureau check being obtained. For the first two weeks new staff work alongside another worker, but there after they do not have direct supervision. There were two newly recruited staff for whom PoVA checks had been received, but for whom no CRB who had not yet been Foxearth Lodge Nursing Home DS0000024391.V301879.R01.S.doc Version 5.2 Page 16 received. The supervision in place for these workers was not direct after the first two weeks. An immediate requirement was made, and a new Policy regarding this, plus a timetable showing supervisory arrangements for these two staff whilst on duty was received within two working days. A PoVA check for one member of staff was not available on the day, the complete file for this worker having been removed for other purposes; it was however forwarded immediately following the inspection. Other staff files inspected had Criminal Records Bureau checks on file. Foxearth Lodge Nursing Home DS0000024391.V301879.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 good. This judgement has been made using available evidence including a visit to this service. Residents can expect to live in an attractive, clean and well-maintained home. EVIDENCE: A tour of the buildings, excluding Woodlands, was made. Individual rooms, the kitchen, sluice and laundry and communal areas were inspected. The home was very clean and comfortable, and well maintained. The home’s business plan includes details of ongoing refurbishment and redecorating plans. Foxearth Lodge Nursing Home DS0000024391.V301879.R01.S.doc Version 5.2 Page 18 Relative’s comments cards supported the view that standards of cleanliness at the home are well maintained. They included; “Every where is very clean” and “Foxearth never exudes an old people’s home smell.” The communal areas were homely and were being well used on the day of the inspection. The kitchen, sluice and laundry were all clean and well maintained. The home had a comprehensive infection control policy and procedure, which included instruction for the proper storage of mops, however a mop was found stored in a bucket, with (damp) head down. The housekeeper was aware of the policy, and advised that this matter would be raised in the next cleaners meeting. Foxearth Lodge Nursing Home DS0000024391.V301879.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 good. This judgement has been made using available evidence including a visit to this service. Residents can expect to live in a well staffed home where staff attend their duties in a respectful and kind manner. They can expect staff to have appropriate training for their roles. Residents may find some accents and language limitations of staff from overseas limit communication. EVIDENCE: Thirty-seven of forty two comment cards received indicated that relatives and friends were of the opinion that there were always enough staff on duty, three did not answer this question, and three thought there were not always enough. The home was well staffed on the day of the inspection. Rotas were seen and consistently good staffing levels were recorded. Two members of staff were asked if they felt that their were sufficient staff on duty, they confirmed that it was busy at times, but that they thought that staffing was adequate. Foxearth Lodge Nursing Home DS0000024391.V301879.R01.S.doc Version 5.2 Page 20 The staff files of two recently recruited members of staff were inspected and were found to have al appropriate pre – employment information and induction training. Two comments were made by relatives who responded to the pre inspection survey about some language difficulties. “I think it would help if some of the carers spoke better English, having said that there is no doubting their affection for the residents in their care and the kindness they show.” “It probably can’t be helped, but ……….has great difficulty understanding some of the staff owing to ethnic origin.” The anonymous complainant mentioned elsewhere in this report who had found it difficult to gain assurances from staff had also commented that language had seemed to be a barrier. The inspector found some difficultly in understanding some communication with nursing staff, although the home provides 2hrs per week conversation class for those for whom English is not a first language. A training analysis had been conducted for each individual, member of staff. A nurse spoken with advised that they had received a manual handling update in 2006; records seen confirmed this. The assistant manager advised that PoVA training had been undertaken by staff. Certificates in respect of this training were seen for two members of staff selected. The action required in the event of suspicion of a PoVA was discussed with one of these members of staff who was on duty, they had a good understanding and knowledge of appropriate action to take. The deputy nurse manager advised that they had undertaken Malnutrition Universal Screening Tool (MUST) training, and a certificate evidencing this was seen. Staff had also received training in the use of this tool from a dietician at Ipswich Hospital, but it had not yet been introduced. Foxearth Lodge Nursing Home DS0000024391.V301879.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): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to live in a well managed home where their health and safety are well protected. EVIDENCE: The Registered Manager is a Registered Nurse with over 21 years experience of operating Foxearth Lodge. The home has responded promptly to requirements and had met all of those made at the last inspection. Foxearth Lodge Nursing Home DS0000024391.V301879.R01.S.doc Version 5.2 Page 22 A requirement was made at the last inspection that monies deposited, withdrawn or spent on behalf of service users must be signed for by the service user or their representative and a second member of staff. These records were checked and this was found to be actioned. It was found that a formal record was not maintained for valuables deposited. Cupboard doors marked as fire doors were checked and were found to be locked. No inappropriate storage of substances hazardous to health was found. Records of fridge and freezer temperatures were maintained. A copy of the home’s three-year business plan was provided. This gave reference to consultation with residents. The home’s insurance certificate and Registration Certificate were displayed. Foxearth Lodge Nursing Home DS0000024391.V301879.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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 2 X X 3 Foxearth Lodge Nursing Home DS0000024391.V301879.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 OP8 Regulation 17(1)(a) Schedule 3 17(1)(a) Schedule 3 14(1) 13(4) 13(2) Requirement Food and fluid intake for residents who are dependent upon being fed must be recorded. A record of turns and tilts must be maintained for residents who Require this intervention. A comprehensive malnutrition screening tool must be used were the need is indicated. Medicines must be selected, administered and recorded on a one resident at a time basis. Proper arrangements must be put in place for the disposal of medicines, whether disposed of on the premises or via a clinical waste contractor, and the policy must state these arrangements and the recording practices required to support it. Staff recruited prior following a PoVA first check but prior to receipt of a CRB must be directly supervised by a suitable named staff member. Mops must be stored in accordance with the control of infection policy. DS0000024391.V301879.R01.S.doc Timescale for action 04/12/06 2. 3. 4. 5. OP8 01/01/07 01/01/07 10/01/07 10/01/07 OP8 OP9 OP9 6. OP18 19(11) (a)(b) 01/12/06 7. OP26 16(2)(j) 01/12/06 Foxearth Lodge Nursing Home Version 5.2 Page 25 8. 9. OP30 OP35 18(1)(a) 17(2) Schedule Staffs’ proficiency in English must be assessed and monitored. A record must be maintained of all valuables deposited by a resident for safekeeping or received on their behalf, and it must include written acknowledgement of return of valuables. 31/03/07 01/01/07 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. Refer to Standard OP9 OP9 Good Practice Recommendations The process and recording of medicine disposal should be witnessed by a second nurse. Should a need be identified to give medicines covertly, a multidisciplinary effort should be made to authorise this, including a social worker or advocate. Foxearth Lodge Nursing Home DS0000024391.V301879.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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. 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