Inspection on 20/04/06 for Green Pastures Christian Nursing Home

This inspection was carried out on 20th April 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.

Other inspections for this house

Green Pastures Christian Nursing... 12/07/07

Green Pastures Christian Nursing... 19/12/06

Green Pastures Christian Nursing... 15/11/05

Green Pastures Christian Nursing... 01/08/05

Green Pastures Christian Nursing... 04/01/05

Green Pastures Christian Nursing... 14/09/04

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

CARE HOMES FOR OLDER PEOPLE Green Pastures Christian Nursing Home The Hawthorns Banbury Oxfordshire OX16 9FA Lead Inspector Kate Harrison Unannounced Inspection 20th April 2006 09:30 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 Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Green Pastures Christian Nursing Home Address The Hawthorns Banbury Oxfordshire OX16 9FA 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) 01295 279963 01295 701501 john@green-pastures-christian-nursinghome.org.uk Green Pastures Limited Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. On admission persons should be aged 60 years and over. Date of last inspection 15th November 2005 Brief Description of the Service: Green Pastures Christian Nursing Home is a purpose built care home located on the outskirts of the market town of Banbury. The home is operated as a ‘not for profit’ Christian organisation through Green Pastures Ltd, and is a registered charity. The board of directors has responsibility for the home, and the home manager is in day-to-day charge, with the acting nurse manager responsible for the care of residents. The home is set behind a small coppice of mature trees and has a very pleasant enclosed rear garden. The home is registered to provide nursing care for 30 older people aged 60 and over, and the fees range from £581 to £629 per week. There are communal rooms and bedrooms on the ground and first floors, and a lift is provided. The home has a strong Christian ethos, but this does not preclude those people who belong to other denominations and have different religious beliefs. Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. Two inspectors (Kate Harrison and Delia Styles) arrived at the service at 09.30 hours and were in the home for eight hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service manager, and any information that CSCI has received about the service since the last inspection. The home has been without a registered manager for several months, and the acting nurse manager, a registered nurse, is responsible for the care of the residents. The recruitment of a new nurse to be the registered manager is in hand. The inspectors saw all areas of the home and asked the views of the residents and visitors seen during the inspection, although some residents were only able to communicate in a limited way. The views of those who responded to questionnaires that the Commission had sent out were also taken into account, although none were received from relatives or residents. The inspectors also spoke to the home’s manager, the nurse manager, and with the staff responsible for health and safety, the laundry service and the kitchen about the quality of the services provided to residents in the home. A sample of residents’ care records and assessment information about their care needs before they came to live in the home was looked at. A sample of other records kept in the home, such as medication, staff recruitment files and accident records, were also read. The inspectors would like to thank all the residents, relatives and staff who helped with this report. The inspectors looked at how well the service was meeting the standards set by the government through all the key standards, and has in this report made judgements about the standard of the service. What the service does well: The home is warm, clean and attractively decorated, so that residents have comfortable and homely surroundings. The gardens and grounds are well maintained and attractive, giving residents good outlooks from the home, and safe and accessible areas for outdoor activities. Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 Page 6 Residents speak highly of the caring staff, and comments about staff from health care professionals’ questionnaires include ‘very approachable’ and ‘very helpful’. Residents said that the food was ‘good’, and that they appreciate the home’s garden. The home provides a good range of disability equipment for residents. A short meeting for staff is held each morning to draw attention to the main issues of the day, within a Christian context. What has improved since the last inspection? What they could do better: The complaints procedure should be changed to show that individuals can inform the Commission at any time of their complaint to the home, and a copy of the complaints procedure must be supplied to each resident. This will give residents more information and control over their care, will meet regulations and will better meet the home’s Residents’ Rights statements. More detailed information about people’s care needs, not just their physical care, should be included in their assessments, so that they and their families can be confident that the home can meet their needs before they come to live in the home. All the information available about residents’ needs should be used to plan the care of the residents, so that all the residents’ needs are recognised and met. There should be more opportunity for residents and their families to be involved in discussions about individual’s care needs and any changes made to their care plans. Residents or their representatives should sign their care plans to show that they agree with what is written. Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 Page 7 Nurses should make sure that they always follow the good practice guidelines if they have to make any handwritten changes to residents’ medication administration records at the doctor’s request, so that they limit the risk of mistakes being made. The times of medicine rounds should be reviewed to make sure that the doses of medicines that are to be taken more than once a day are equally spaced out, so that the medicines have the best effect for the resident. The home’s medicines policy is still being reviewed and updated and was not available to staff. The changes should be discussed and agreed and the new information circulated to staff as soon as possible. Extra details should be added to the records of the routine ‘finger-prick’ blood tests of residents with diabetes, so that staff can be sure that the same type of equipment has been used, is working properly and is regularly tested for accuracy. The home’s policy on adult abuse should be changed to include reference to Oxfordshire’s agreed practice on the protection of vulnerable adults, and to give important information to staff about the role of Oxfordshire’s adult protection support worker. To improve the quality of care, the home should consider changing the home’s induction programme so that trained and experienced staff supervise new care staff, until more NVQ qualified carers are available in the home. 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. Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 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 Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home’s pre-admission assessments are adequate but could be developed to include all service users’ health and social care needs . EVIDENCE: The pre-admission assessments for three residents were looked at. The written information was scanty and focussed largely on the physical care needs of the prospective residents. The prospective resident and his or her representatives and any relevant professionals should be involved in the assessment process. The person completing the assessment (usually the nurse manager or deputy) may not be the ‘key’ member of staff or ‘named nurse’ who will build up the care plans for the individual after their admission. There is a risk that, if the pre-admission assessment is inadequate, all the needs, including cultural needs, will not be recognised, and that the care plans will not cover all the care needs in enough detail for care staff to meet the individual’s needs. Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 Page 10 It is recommended that the assessment process and written records of assessment should be reviewed and improved, so that all the needs of the residents are considered. The home does not provide intermediate care. Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The arrangements for meeting the residents’ health and welfare needs are adequate. EVIDENCE: The inspectors checked the personal files of four residents and spoke to them about their experiences in the home. The residents said that their health care needs were met, and that the care staff treated them with respect. One resident said that links with other health care professionals, such as GPs and specialist nurses, were good, and another said that she could see her GP as necessary. The home has recently introduced a commercially produced system for assessing the residents’ needs and for planning the care to be delivered. Risk assessments showed that one resident had a high risk of developing pressure related skin damage, and of becoming malnourished, but the care plan did not show that this knowledge was used to influence the resident’s diet or the resident’s need for extra pressure relieving equipment. Staff should be trained Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 Page 12 to understand that the results of the home’s risk assessments should be used to plan residents’ care, so that the needs of the residents are fully understood, anticipated and met. There should be more opportunity for residents and their families to be involved in discussions about individual’s care needs and any changes made to their care plans. Residents or their representatives should sign their care plans to show that they agree with what is written. The home has several different makes of equipment to do routine ‘finger-prick’ blood tests to measure the blood sugar levels of residents with diabetes. The records of these blood tests need to show which type of equipment has been used and when the calibration tests were done, to ensure that the instruments are working properly and can be depended on to give accurate results. Regarding the management of medication, the Medication Administration Records (MAR) showed that there were some instances where the doctor had asked a nurse to alter the medication instructions for residents. When this happens, the changes should be countersigned by the doctor in person as soon as possible, or by a second nurse if the doctor is not available. This good practice advice is intended to reduce the risk of errors. If residents have prescribed skin creams or other preparations applied by care staff at times other than the routine ‘medicine rounds’, the MAR record should indicate whether a separate record is kept. This enables the home’s staff to show that the prescribed treatment has been given in accordance with the instructions. The home’s medication policy was being revised by the home’s management team and was not available to staff in the home. Registered nurses undertake the medicine rounds. None of the current residents are able, or wish, to administer their own medication. On the day of inspection the 08.00 round was still in progress at approximately 09.45. The deployment of staff should be reviewed so that residents receive their medicines at the recommended frequency and are adequately spaced throughout the day, to have the best effect for them. The home has a member of staff who has skills and knowledge regarding palliative care, and works with care staff to cascade knowledge within the home. Specialist nurses and equipment are available to manage pain and relatives are able to stay at the home to support their relatives around the time of death. Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The way residents are helped to maintain their usual lifestyle and social activities is good. EVIDENCE: A new activities coordinator has recently started working part-time, and provides group and individual activities for residents. Outings are arranged such as the recent ‘Men’s Day’ outing to the motor museum, to suit the interests of residents. Residents are able to make choices during the day, and one resident told the inspector that she had decided to have lunch in her room rather than eat in the dining room. One visitor told the inspector that he was able to come to the home at any reasonable time and was always made welcome. A catering company is contracted by the home to manage the catering service. The chef has daily contact with residents to get their views on the food, and the minutes of a recent residents’ meeting showed that residents were pleased with the quality and variety of meals. The inspector visited the kitchen, spoke with the chef and observed the lunchtime meal service in the first floor dining room. Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 Page 14 Some residents could not remember or were not aware of the lunchtime choices. Staff reminded them shortly before the meal. The home should consider ways of helping residents to remember, such as individual menus on the dining tables, with large print, or on a wall mounted noticeboard. Four residents in the downstairs dining room told the inspector that the food was ‘good’. Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The arrangements for making complaints and managing issues of suspected abuse are poor. EVIDENCE: No complaints have been received at the home since the November 2005 inspection. The inspector saw a copy of the Complaints Information, the home’s complaints procedure. The procedure should be amended to show that complainants can contact the Commission at any time and that complaints do not need to be in writing. The complaints procedure is not usually supplied to all the residents, and residents need to ask at reception if they want to read the complaints procedure. A copy of the complaints procedure must be supplied to each resident to meet regulation, and to better meet the home’s Residents’ Rights statement in the Residents’ Guide. Two individuals have informed the Commission of complaints concerning Green Pastures since the November 2005 inspection. The Commission has been concerned about the way the complaints were managed by the home and has met with three directors of the home to discuss the issues. Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 Page 16 The inspector saw the home’s policy on adult protection, which should be updated to include reference to Oxfordshire’s Protection of Vulnerable Adults Codes of Practice. Following the visit the home has written to the inspector stating that all staff are given guidance on Oxfordshire’s Adult Protection Codes of Practice. A recently reported incident of theft from a resident, which was reported to the police, should have been reported to the adult protection support worker and to the Commission. The management of incidents of possible abuse should be appropriately reported. Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment of the home is good. EVIDENCE: Both the inspectors toured the home and saw private and communal facilities, including the laundry and the kitchen. The home provides good facilities, including assisted bathing and showering for residents. The maintenance manager has good systems in place to organise routine maintenance of the building, including redecorating of rooms. The gardens are well designed and well kept, and several residents told the inspector how they appreciated the garden and the spring flowers. Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 Page 18 The home is clean and the laundry service is well managed. The laundry manager knew how to minimise the spread of infection through the use of the home’s procedures, and provided a repairs service for residents’ clothes. One resident told the inspector that his clothes were always well laundered and ironed. Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home’s arrangements for staffing and recruitment of new staff are adequate. EVIDENCE: The home’s manager told the inspector that two new carers and three registered nurses had recently been recruited, and that interviews for the new nurse manager were planned. Agency staff are used when necessary. The inspector saw the staff rota for several weeks, noted the staff numbers on the day of inspection and, from discussion with residents and staff, concluded that appropriate numbers of staff are available to meet the needs of the residents. NVQ training for staff is encouraged at the home, but only three carers have completed Level 2 training. The home has only one NVQ assessor, and uses one visiting assessor, so that there is not the capacity at the home to train appropriate numbers of carers to NVQ level. The inspector looked at a sample of staff files - one for a newly recruited staff member and three for existing employees. There was evidence that the home operates a systematic and satisfactory procedure for screening and selecting suitable staff to work in the home. One of the selected files did not have a photograph of the staff member as required under regulation. The home manager said that this had been an oversight and would be rectified. Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 Page 20 There was a record of topics and questions given to prospective staff at interview, but not of the opinion of the interviewers about the suitability of the applicants to work in the home. It is recommended that the interviewers agree on the criteria for the applicants’ suitability for the jobs they are offering and that a summary of both interviewers’ assessments is recorded. This will provide evidence that the home has used a consistent and thorough approach when selecting and employing new staff to care for vulnerable adults. The home has an induction programme for new staff and a training programme for staff covering care issues and health and safety issues. The induction programme allows for new carers to shadow senior carers but, because of the low levels of NVQ qualified staff, new carers do not regularly work with trained staff. As the induction programme does not specifically cover issues of privacy and dignity, the inspector recommends that a member of staff who is appropriately qualified and experienced should supervise new carers. Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35, 36 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home’s management and administration systems are adequate and improving. EVIDENCE: There has not been a registered manager at the home for some time, although the acting nurse manager has taken on clinical management of the home. Because of this situation, Standard 31 has not been scored at this inspection. It is expected that a new nurse manager will soon be appointed, and that this individual will be put forward to the Commission to be the registered manager. Good systems are in place to manage small amounts of petty cash held for some residents. Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 Page 22 The home’s quality assurance system is undergoing improvements and includes residents’ and relatives’ satisfaction surveys, regular residents’ and staff meetings, visits to the home by members of the management board and regular quality checks on the care delivered by staff and on the cleanliness of the home. The inspector saw the results of the recent residents’ and relatives’ survey on topics including quality of the meals and views of the staff, and understood that the board is looking at the most appropriate way to give feedback to residents and relatives soon. The results showed that satisfaction is high for both topics. Regular one-to-one supervision of staff has started and the acting manager has plans to develop the quality of supervision when the new nurse manager is in post. The home has a health and safety policy statement and provides appropriate equipment and training to help staff avoid injury at work. Training for staff in food hygiene and first aid is provided. The home’s maintenance manager carries out the regular fire systems checks, and the inspector understood from the maintenance manager that the fire service has approved the home’s fire risk assessment. Contractors maintain the home’s gas and electricity services, including the lift. Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 X X X X X X 3 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 N/A X 3 X 3 2 X 3 Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP22 Regulation 22 Requirement A copy of the complaints procedure must be supplied to each resident. Timescale for action 31/05/06 Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP3 Good Practice Recommendations The written assessment information should be improved to show evidence that the assessment has been comprehensive and covers all aspects of prospective residents’ health and social care needs, as set out in the National Minimum Standards for Older People (NMS). • There should be more opportunity for residents and their families to be involved in discussions about individual’s care needs and any changes made to their care plans. Residents or their representatives should sign their care plans to show that they agree with what is written. Staff should be trained to understand that the results of the home’s risk assessments should be used to plan residents’ care, so that the needs of the residents are fully understood, anticipated and met. 2 OP7 • • 3 OP9 • Where nurses are requested by the doctor to make handwritten alterations to the MAR sheets, the doctor or a second nurse should check the alterations with the nurse who received the doctor’s instructions and countersign their entry. • Records of topical applications should be cross- referenced with the MAR record. • The timing of medicine administration should be reviewed to ensure that residents receive their medication at the recommended spacing between doses. • The procedure for recording blood glucose monitoring results should be improved. The home should consider ways of helping residents to remember the meal choices, by having menus with large print on the dining tables, or on a wall mounted notice board. 4 OP15 Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 Page 26 5 OP16 The complaints procedure should be amended to show that individuals can contact the Commission about complaints they have made to the home at any time. The policy on Elder Abuse should be updated to include reference to the Oxfordshire Protection of Vulnerable Adults Codes of Practice, and information for staff on The role of Oxfordshire’s adult protection support worker. • All incidents of suspected abuse should be reported to the appropriate authorities. • • Ensure that the home has all the information and documents in respect of all people working in the home, as set out in the Care Home Regulations 2001. Use an agreed set of criteria for assessing prospective employees’ suitability to work in the home and a summary of the assessment outcomes of the interviewers following the interview process. • 6 OP18 7 OP29 8 OP30 As part of the home’s induction programme for new care staff, a member of staff who is appropriately qualified and experienced should supervise the new carer. Green Pastures Christian Nursing Home DS0000027153.V290296.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Oxford Area Office Burgner House Cascade Way Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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