Inspection on 24/10/07 for Gorselands Nursing Home

This inspection was carried out on 24th October 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

Gorselands Nursing Home 27/02/07

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

CARE HOMES FOR OLDER PEOPLE Gorselands Nursing Home Gorselands Nursing Home Coach Hill Lane Burley Street Ringwood Hampshire BH24 4HN Lead Inspector Anita Tengnah Unannounced Inspection 10:30 24 October 2007 th 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 Gorselands Nursing Home DS0000067854.V347610.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. Gorselands Nursing Home DS0000067854.V347610.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gorselands Nursing Home Address Gorselands Nursing Home Coach Hill Lane Burley Street Ringwood Hampshire BH24 4HN 01425 402316 01425 402110 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) Gorselands in the Forest Limited Mrs Patricia Christine Vinycomb Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37), Physical disability (7), Physical disability of places over 65 years of age (37), Terminally ill (7), Terminally ill over 65 years of age (37) Gorselands Nursing Home DS0000067854.V347610.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th February 2007 Brief Description of the Service: Gorselands is a registered care home providing nursing and personal care for up to 37 residents in the older person category. The home is situated in the village of Burley, in Ringwood. The service is privately owned and benefits from large well-maintained gardens and views of the surrounding New Forest countryside. Accommodation is provided in a homely and tastefully furnished environment on two floors and passenger lifts are available that allows access to all parts of the home. The home has the majority of bedrooms for single occupancy and three shared rooms. The people living at the home benefits from well-maintained and ample communal areas where a number of activities are undertaken. Items that are not included in the fees included hairdressing, chiropody, newspapers and magazines and private telephone. The current fee charged is £540- £880 per week. Gorselands Nursing Home DS0000067854.V347610.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit to the service was undertaken as part of the inspection on the 24th of October 2007. The process included a tour of the service where a number of the bedrooms, communal areas, kitchen, and bathrooms were viewed. As part of case tracking 6 staff and 9 service users views were sought and care records were looked at. Information gained from the Annual Quality Assurance assessment (AQAA) was used and included in this report, as was information gathered by the commission since the last inspection to contribute in assessing judgements in this report. Positive comments were received from the service users regarding the care that they were receiving at the home. The commission received 9 comment cards from the service users and some contained input from their relatives. Care practices observed at the time of the visit indicated that the staff and the service users had developed good relationships and care was provided in a respectful manner. What the service does well: What has improved since the last inspection? The ongoing programme of refurbishment ensures that the home’s environment is maintained to a very high standard and to the satisfaction of people living there. Gorselands Nursing Home DS0000067854.V347610.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Gorselands Nursing Home DS0000067854.V347610.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 Gorselands Nursing Home DS0000067854.V347610.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a process of preadmission in place to ensure that the needs of people using the service are assessed. Pre admission records must be available for all the people admitted to indicate how the service plans to meet the people’s needs. EVIDENCE: The care records of three recently admitted service users were looked at as part of case tracking. Detailed pre admission assessments of needs were available for two of them and staff reported that this information is used to formulate their initial care plans on admission. Other information available included transfer letter from the hospital and list of medications pertaining to one of the people. There was no pre admission assessment record for one of the people record looked at. The manager said that this had been carried out but the record was not found. Gorselands Nursing Home DS0000067854.V347610.R01.S.doc Version 5.2 Page 9 The records of needs assessments seen included dietary needs, manualhandling assessments, and skin integrity, as appropriate in order to ensure that all care needs are identified. Care manager’s assessment should form part of pre admission assessment process as appropriate if funded by social Services. The manager discussed that all new admission received a welcome pack that contained the service user’s guide and a card. The people spoken with and comments received indicated that the manager is proactive and ensures that visits are arranged and all the responses said that a member of their family did visit prior to their admission. A person spoken with on the day of the visit commented that “this was the best place for me” and that her daughter visited the home and said “it was lovely and I am happy living here”. The home does not provide intermediate care but has some people for respite care. Gorselands Nursing Home DS0000067854.V347610.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 7,8,9,10 The care plans and records of care given were detailed. Staff had information about the support that the service users required with their care. The health care needs and access to external agencies were well managed. All medication received and administered to the people using the service must be accurately recorded in order to safeguard their welfare. The service users are treated with respect and dignity and their right to privacy maintained EVIDENCE: The care plans of 4 people using the service was seen as part of this visit to look at how the home plans to meet their needs. The care plans were detailed and contained information about the assessed needs of the service users and actions required in order to meet them. These included assessments such as Gorselands Nursing Home DS0000067854.V347610.R01.S.doc Version 5.2 Page 11 manual handling, fall assessments, and the psychological needs. There was evidence that the service users were involved in these assessments. The daily records were maintained of the care given and these contained a lot of details in particular for a newly admitted person where staff had experienced some early problems in managing her care. Staff had used a multidisciplinary team approach to resolve this problem. It was noted that a generic care plan was in place on admission and these were further developed for two of the people. However another person had a catheter in place, there was no care plan to demonstrate how this was being managed and there was a lack of information to inform practice. As part of care of care planning, night care plans should also be developed. Another care plan seen indicated that the person was “reluctant to eat” and was receiving supplement drinks. The manager has informed us that she was putting in place nutritional assessments as part of the assessment procedure. Comments received from people using the service indicated that they had autonomy and choice regarding their activity of daily living. A comment was “ I feel I receive a lot of help especially with personal care and my clothes are washed and well looked after.” Another comment included staff “ answer bell promptly in my room”. People spoken with said that they went to bed at various time. One person said that she went to her room and watched television till late before she retired to bed. All the people were registered with the three local surgeries. The manager reported that the home had good relationship with the local primary care trust and the service users were supported to access health care services as required. The GP did not undertake regular visits to the home but was available on request. The manager reported that the physiotherapist was available visa GP referral and also privately. Equipment for the treatment and prevention of pressure ulcers were available that included profiling beds. There records of pressure ulcers were available. The wound care records seen contained some information about the management of pressure ulcers. However there was a lack of care plans to show the type of dressing needed and to inform practice. The assessment must be completed to include the size of the wound and would help in the evaluation of wound care. The home has a medication policy and procedure for staff. The home was using the Monitored Dosage system (MDS) and ordered on a monthly basis. The manager reported that the staff did not see the prescription as these went directly to the chemist. Further information as discussed on management of medication is available in the Royal Pharmaceutical guidelines and staff should ensure that these are followed. The manager has written to the commission following the visit and indicated that she had raised this with the pharmacist. Gorselands Nursing Home DS0000067854.V347610.R01.S.doc Version 5.2 Page 12 Medication was stored safely and the manager confirmed that the registered nurses were responsible for the management of medication. A sample of the Medication Administration Record (MAR) seen at the time of the visit showed a number of gaps in the MAR records. The manager must ensure that accurate records of all medication administered must be maintained in order to ensure that the welfare of the people are safeguarded. Staff must ensure that any medication not given/ missed is clearly identified by using the coding on the MAR sheets to inform practice. Record of medication received on the printed sheets from the pharmacy was recorded on receipt, however these were not available for all medication received in particular for those that had been transcribed by staff onto MAR sheets. The manager must ensure that there is a record maintained of all medication received into the care home. Comments cards received and 6 of the service users spoken with confirmed that the home provided a good service and they had autonomy and choice regarding the activities of daily living. Comments included ”this is very good home”. Another service user said “everyone of the staff is so kind and helpful” and they “always felt safe”. Two of the service users stated that there were no restrictions about what time they went to bed or got up. Gorselands Nursing Home DS0000067854.V347610.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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 12,13,14,15 The social and recreational facilities for the service users meet their needs. The service users are supported to maintain links with the community and their family and friends. The service users autonomy and choices are respected in their activity of daily living. The meals are very good and meet with the satisfaction of the service users. EVIDENCE: The home has a planned and varied programme of activities for the service users. People spoken with and comment cards received indicated that they are supported in pursuing activities of their choice. Activities included regular visits from external entertainers. Some of the planned activities are a pink day for Gorselands Nursing Home DS0000067854.V347610.R01.S.doc Version 5.2 Page 14 cancer research, fish and chips lunch and Halloween party. The manager reported that she was in the process of recruiting an activity coordinator and was using carers in the interim to undertake activities with the residents. Eight comments received indicated that “usually” there is activities arranged that they could take part in. Another comment was “ I also like quiet time for reading”. The home had a library that the residents could use and appeared well organised with a variety of books to suit all tastes. One of the people spoken with said that she enjoyed her books and her daughter brought them in regularly for her. The manager reported that she went to the local library and brought in books such as large prints as requested. Another person talked about her love for painting and she was able to continue with her hobby since her admission to the service. The manager reported that the local vicar attended the service on a monthly basis and communion was available to people as they chose. The Salvation Army also visited at regular intervals. The home has an open visiting policy and it was evident from the record of visitors as kept by the home that there was no restriction on visiting. Comment received and five of the service users confirmed that they have autonomy to receive their visitors in private. A relative said that she visited her relative regularly and was ”always welcome”. The home has a planned menu that is rotated on a regular basis. Comment cards received and the service users spoken with said that the meals were “ very good” and hot and cold drinks were available at all times. Comments included “excellent food” and “ very good choice “. All the service users are provide with a daily menu and staff supported them in choosing from the menu. The menu was displayed in the entrance hall outside the dining room. The people spoken with reported that they chose from the menu the previous day for their lunch and teatime. The process of offering choices/menu for the breakfast time was unclear; the manager has confirmed that a breakfast menu has been developed since the visit to make it clearer about the choice of cooked breakfast. The chef reported that cakes are baked daily for afternoon tea, lunch and supper menu consisted of homemade soups, a baked dish and selection of sandwiches was available at teatime. Comment was “food cannot be faulted”. Lunchtime meal was observed and appeared well presented, nourishing and well balanced and the people spoken with said that they shared the same table and enjoyed meeting up with their friends at lunchtime. Staff were available to offer support with meals as needed. One of the people commented about not being aware that snacks were available at suppertime. This was discussed with the manager who had since confirmed that this had been reinforced to the people using the service and staff. Other comments about the food included ” I eat it all. I’m always enjoying the food “. Another person said, ”I have lots of salad and I like that. Doesn’t eat meat and always offered alternative.” Gorselands Nursing Home DS0000067854.V347610.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 16,18 The complaint was in place and people are confident that their complaints would be listened to. Staff have understanding of adult protection and ongoing training would ensure that the service users are protected EVIDENCE: The home has a complaint policy and procedure that staff and the service users spoken with said that they were able to use. Comments included “there is nothing to complain about” and “I am very happy here.” Two of the people said that they would speak to the matron if they were unhappy with anything. The complaint procedure was displayed in the lobby; this should be reviewed so that it contains the name of the current commission. The manager reported that a copy of the complaint procedure was given to all new resident on admission as part of the information in the service users’ guide. A complaint log was maintained at the service, record seen and manager confirmed that there has been no complaint received. Staff stated that any concerns are dealt with at the time and any serious issues are passed to the manager to investigate. The home has the Hampshire adult protection procedure in place. The manager reported that they have training materials for the prevention of abuse for the Gorselands Nursing Home DS0000067854.V347610.R01.S.doc Version 5.2 Page 16 staff. Staff spoken with said that they would report any allegation to the manager. Evidence that all staff had completed training in the prevention of abuse was not available at the time of the visit. The manager has confirmed that this would be developed and record maintained as required. Gorselands Nursing Home DS0000067854.V347610.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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 19,26 The home provides the people living at the service with a high standard, homely, clean and well-maintained accommodation that meets their needs. The infection control procedures at the home are good and ensure that the service users are protected EVIDENCE: A tour of the premises was undertaken as part of the visit and a number of bedrooms, communal areas, bathrooms, and kitchen were viewed. It was evident that the home has an ongoing programme of refurbishment. Information from the AQAA indicated that recent refurbishment included a new porch providing seating area, visitor’s cloakroom and wheelchair access to front and side of the building and new ramps. Gorselands Nursing Home DS0000067854.V347610.R01.S.doc Version 5.2 Page 18 The home was warm, bright, clean and homely. Furnishing was of very good standard and appropriate to the needs of the service users. The service users are provided with ample communal areas where a variety of activities are undertaken. Most of the bedrooms seen have views of the garden. The service users’ bedrooms were highly personalised with pictures, televisions, small item of furniture and family photos. It was evident that the service users are encouraged to bring in items of personal belongings on admission. The manager said that the en suite bathrooms were planned for refurbishment this year as part of the ongoing renovation programme. Comments from the service users included ”this is a lovely home” and “I am lucky to be living here.” A relative commented that “they are always changing things such as carpets and the home is always very clean.” Staff must ensure that an inventory of the items brought into the home on admission is maintained in the resident’s files. The home has well maintained gardens that a service user described ”wonderful to watch. ” Some of them said that they enjoyed sitting out during the summer. Seating was available in the garden and accessible to wheelchair users with level paths that surrounded the building. The garden had been landscaped with the provision of a sensory garden and an herb garden. The home has a laundry where all the service users laundry is undertaken internally. The laundry room was clean and well equipped. The washing machines were fitted with sluicing facilities. Information on infection control was available. Staff practices observed indicated that they were aware of them and used protective gloves and aprons as needed. Gorselands Nursing Home DS0000067854.V347610.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staffing numbers are adequate to meet the present needs of the service users. The home has system in place to ensure that staff have the skills to deliver care safely. The recruitment process is very good. All checks are undertaken prior to employment to ensure the safety of the service users. There is a training programme in place to ensure that staff are supported in their work. Record of all mandatory training must be put in place, as this was not available. EVIDENCE: The home has a duty roster for nurses and carers and a separate roster for ancillary workers. The manager reported that there are one trained staff and seven carers on the early shifts, and 1 trained staff and five carers on the afternoon shifts. The night staff included 1 trained staff and 3 carers. The manager was not included in the numbers although she spent some of her time providing care. Gorselands Nursing Home DS0000067854.V347610.R01.S.doc Version 5.2 Page 20 Staff and people spoken with confirmed that they felt that there was adequate staff to meet their needs. Comments from the residents and relatives were positive and full of praise about the attitude and caring manner of the staff. Comments were that there was “always” staff available when they needed assistance. Another comment was “I would recommend the home to anyone”. It was evident for the practices observed that the staff and residents and their family had developed and maintained good relationships with each other. Information from the AQAA indicated that the home has eight carers who have completed National Vocational Qualification (NVQ) 2 or above and seven of them were working towards achieving this qualification. A visiting professional commented that the staff are supported in achieving this training. The manager reported that she was planning to introduce the Skills for Care induction programme for new staff. A sample of staff records seen indicated that all new staff completed an application form and all checks including CRB and POVA first checks were completed prior to employment. The manager had in place a robust employment procedure to ensure that people are safeguarded. Staff spoken with and information received indicated that there is a training programme in place included palliative care and NVQ training. The were some records for mandatory training, however this needed to be further developed in order to evidence that all staff have completed mandatory training as required. As discussed the development of a training matrix would help in the records of training and also identify any gaps so that action could be taken. The manager has confirmed that a training matrix has been developed since the visit in order to record and monitor all staff mandatory training. Gorselands Nursing Home DS0000067854.V347610.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 31,33,35,38 The home has a manager who is highly regarded and has clear lines of accountability for the service. The financial interests of the service users are safeguarded through good accounting. There is a process of seeking the service users’ views to ensure that the service is run in their best interests. The supervision programme for staff was in place; further development would ensure that all staff have regular supervision as part of their practice There is a satisfactory procedure in place to ensure the health and safety of the service users is promoted. Gorselands Nursing Home DS0000067854.V347610.R01.S.doc Version 5.2 Page 22 EVIDENCE: The home has a registered manager who is also a registered nurse with a number of years experience in the care of the elderly. The manager has an open door policy and demonstrated clear lines of accountability within the home. She was undertaking her registered manager’s award. She undertook regular updates to maintain her skills and to upkeep her nursing registration. Service users spoke highly of the manager and said that she was “She is here if you need her”. It was evident from interaction observed that the staff and the service users had developed good relationships with each other. Comments from service users included “the staff are kind and attentive”. A relative said, “staff are always ready to help.” A sample of the personal allowance as managed by the home was looked at. There was a system in place and all the service users’ money were kept separately. Receipts and invoices were maintained of transactions. Random checks of two of the people’s personal account were found to be accurate. The administrator reported that minimal amount of money was held and that all of them had family/ advocates dealing with their financial affairs. The records seen indicated that the manager had started reviews of policies and procedures. This should continue to ensure that these remain current and take into account changes in regulations and good practices guidance. The provider is involved in the management of the service and it was evident that he was committed to ensure that the people living at the service have a high standard of safe and well maintained accommodation/ environment that met with their needs. Comments from the people spoken with included “ you could not wish for a better home” and “everything is done with lots of care”. The home has a structured supervision programme in place. Records seen indicated that not all the staff had completed regular supervision in order to meet the requirements for structured supervised practice. The manager was aware of this shortfall and would be addressing this. Information received indicated that there is an ongoing programme for the servicing of fire equipment, hoists, wheelchairs, lift and emergency lighting. Records of these were maintained at the service. All substances that are hazardous to health (COSHH) were kept locked away. Gorselands Nursing Home DS0000067854.V347610.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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 4 2 X 4 Gorselands Nursing Home DS0000067854.V347610.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 OP9 Regulation 17(1) (a) Schedule 3 Requirement An accurate record of all medicines and the date that these were administered to the service user must be maintained. Timescale for action 15/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Gorselands Nursing Home DS0000067854.V347610.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Gorselands Nursing Home DS0000067854.V347610.R01.S.doc Version 5.2 Page 26 - 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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