Inspection on 07/11/06 for Greetwell House Nursing Home

This inspection was carried out on 7th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Greetwell House Nursing Home 04/02/10

Greetwell House Nursing Home 26/08/09

Greetwell House Nursing Home 04/09/08

Greetwell House Nursing Home 05/09/07

Greetwell House Nursing Home 05/04/06

Greetwell House Nursing Home 16/01/06

Greetwell House Nursing Home 13/10/05

Greetwell House Nursing Home 09/03/05

Greetwell House Nursing Home 13/05/04

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

CARE HOMES FOR OLDER PEOPLE Greetwell House Nursing Home 70 Greetwell Close Lincoln Lincs LN2 4BA Lead Inspector Jean Cope Key Unannounced Inspection 09:00 7th November 2006 and 13th November 2006 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 Greetwell House Nursing Home DS0000002600.V318446.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. Greetwell House Nursing Home DS0000002600.V318446.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greetwell House Nursing Home Address 70 Greetwell Close Lincoln Lincs LN2 4BA 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) 01522 521830 Dr Sharaf Abd El Monem Salem Mrs Patricia Wilson Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25), Physical disability (1) of places Greetwell House Nursing Home DS0000002600.V318446.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service user in the category of PD is on a named basis and is aged 62 years and over. 21st July 2006 Date of last inspection Brief Description of the Service: Greetwell House Nursing Home is a privately run, twenty-five bedded, Gothicstyle property situated in a quiet residential area in the centre of Lincoln, opposite Lincoln County Hospital. There is a regular bus service into the city and a shopping centre within half a mile. The Home is a two-storey, Victorian building, which has been adapted and extended to provide personal and nursing care for up to twenty-five people of both sexes over the age of 65 years. The home is currently accommodating one resident over the age of 60 years with a physical disability. The residents are accommodated in sixteen single rooms, of which are ensuite and six shared rooms, of which are ensuite. Two staircases and a passenger lift give access to the upper floor. Communally, there are three bathrooms, a shower room and three toilets. There is a small garden to the side of the property and a limited car parking area to the side and rear of the property. Details of the cost of care in the home could not be made available for the inspector on either of the days of the inspection. Details of the cost of the service could not be provided by any of the staff during the two visits by the inspector. Greetwell House Nursing Home DS0000002600.V318446.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection was undertaken using a review of all the information available to the Inspector regarding our service history about Greetwell House, and through undertaking two visits to the home, with the inspector using a method of inspection called “case tracking”. This involved identifying individual residents who currently live at the home and tracking the experience of the care and support they have received during the time they have lived there. This key inspection visit was achieved over a nine-hour period by the inspector touring the home, looking at information on care plans and files, talking to residents and care staff, and observing day-to-day care practice within the home. What the service does well: What has improved since the last inspection? What they could do better: The home does not have a registered manager. A management structure needs to be put in place by the homeowner to promote the safety and well being of residents. Written information is available about the home, but residents and relatives spoken with did not understand that it was there for them to read. This information includes the complaints procedure, which is not readily available for residents who did not know who they would complain to if they had a complaint. Residents would benefit from have regular activities to occupy them during the day to prevent them becoming bored. Choice should be offered to residents about how they do spend time in the home. Views of residents about the service they receive from the home have not been sought. Greetwell House Nursing Home DS0000002600.V318446.R01.S.doc Version 5.2 Page 6 The registered provider should ensure that the home does not run out of basic food stocks. Staff would benefit from a training programme to develop their skills and knowledge. Since the last key inspection, a random inspection was completed on the 21st July 2006. Requirements were made which remain outstanding and need to be addressed by the registered provider. 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. Greetwell House Nursing Home DS0000002600.V318446.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 Greetwell House Nursing Home DS0000002600.V318446.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 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The acting manager assesses the needs of new residents, which helps to ensure that residents needs can be met. Information is not made fully available to prospective or current service users to enable choices to be made. EVIDENCE: The home has a statement of purpose and a service user guide, one of which was found in one of the bedrooms and in the conservatory. This needs to be reviewed by the proprietor to show the staff changes in the home. Residents and a relative spoken with did not know what the service user guide was and that it was there for them to read. There is an acting manager in the home who had written an initial assessment document for a resident who was coming to stay for two weeks. Information had been taken from the social worker and family of the resident. The home does not provide a service for intermediate care. Greetwell House Nursing Home DS0000002600.V318446.R01.S.doc Version 5.2 Page 9 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 have a care plan, however, these are not referred to when providing basic care, which means that their changing needs may not be met safely. There are safe arrangements for the storage of medication, but the means of administering and disposing of unused medications could put residents at risk. EVIDENCE: Each resident has a care plan which is kept in the office. One resident takes a bus into the city every day, but there was no risk assessment as to whether he was safe to do so, and if he had a problem whilst in town, what was to be done about it. Care plans do not reflect the personal choices and preferences of residents. The bank nurse on duty on the first day of the inspection had worked in the home on one previous occasion and had not had time to look at residents’ care plans. Care plans are not regularly consulted by staff, who obtain information about residents from the daily notes and handover. However, staff were able to give a good account of the needs of individual residents living in the home. Greetwell House Nursing Home DS0000002600.V318446.R01.S.doc Version 5.2 Page 10 There was evidence in care plans and in the home’s diary that residents had received visits from doctors and community nurses. On the first day of the inspection the nurse in charge of the home was contacting a specialist nurse for extra advice regarding one of the residents living in the home. A resident also said that they had attended an outpatient appointment at the hospital and that one of the carers had taken her in a wheelchair as the hospital is very close by. One of the nurses working in the home orders the medication for residents. There was good stock control of medication, with the room and fridge temperature being recorded on a daily basis. On both days of the inspection, medication was seen to be carried to service users in pots. On the first day, the nurse in charge said that she had looked at the medication administration sheet, which had a photograph of the resident attached to it, put their medication in a pot with a name in, and walked upstairs to give it to them. The medication trolley was not taken upstairs. Medication was signed off as having been given immediately afterwards. Qualified staff are receiving training on the management of medications. During a tour of the building a medicinal cream prescribed for an individual resident was found in another residents room. The nurse on duty removed this. Medicines that are no longer required are kept in a clinical waste open tub, which is on top of a filing cabinet in the office. The office is not locked on a regular basis. This was pointed out as being a potential hazard on the day of the inspection. A visitor confirmed that when staff were assisting residents with their personal care needs that doors were shut and care was offered respectfully. Greetwell House Nursing Home DS0000002600.V318446.R01.S.doc Version 5.2 Page 11 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 and 15 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents are not always supported by staff to take part in activities of their choice which leaves them feeling bored. A menu is prepared a month in advance, but has to be changed according to what food is available in the home which means that choice for residents is not always available. EVIDENCE: One of the staff engages residents in activities and is given six hours a week to do this. She also works as a care assistant and second chef in the home. On the day of the second inspection, she was covering night shifts for a carer who had gone off sick, so there were no activities provided for residents. Activities for residents were not taking place on either of the days of the inspection. One resident said on the first day, that there was ‘little to do in the home’ and when asked if the went on trips out, responded by saying, ‘there is nothing like that here’. Staff said that there had been one outing to the pub for a birthday lunch, but another trip had to be cancelled, as the transport booked through the sister home was needed for an emergency. On the second day of the inspection, one resident said that she was ‘fed-up of sitting down’. If residents are mobile they are able to maintain their links with the community, however Greetwell House Nursing Home DS0000002600.V318446.R01.S.doc Version 5.2 Page 12 there is little support for residents who need assistance or transport, to leave the confines of the home. A resident confirmed that they still continued to follow their religious worship with the assistance of the church community and staff said that they received visits from church helpers in Lincoln. One visitor said that their relative had a visit most days of the week, and that as visitors; they were made to feel welcome and were offered refreshments and a meal if they came at mealtime. Many of the residents living in the home receive no visitors. Residents are provided with a choice of cereal, fruit and toast and a cooked breakfast is provided on a weekly basis. There are two choices available on the menu at midday. The chef said that a menu was prepared for a month in advance ordered foodstuffs accordingly, however the proprietor does not always provide these. One of the residents commented that there had not been enough prunes for everyone and had been given another breakfast fruit, which they did not like. One resident said that the food was ‘alright’ another said that they did not eat very much. On the whole, the food looked tasty and was well presented. The chef said that they talked with the residents who would soon tell him and the staff if they didn’t like anything. A list of specialist diets is kept in the kitchen and signed off by the nurse in charge. Please see the comments in outcomes for Standard 19. Greetwell House Nursing Home DS0000002600.V318446.R01.S.doc Version 5.2 Page 13 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 and 18. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The complaints procedure is not readily available which means that residents do not know how to complain. Staff are not sufficiently trained to protect service users from harm. EVIDENCE: In the absence of the acting manager, staff were unable to confirm whether there had been any complaints made. The complaints book was examined and there were no complaints recorded since the last inspection, although one had been referred directly to CSCI and returned to the provider to respond to. Residents spoken with did not know how to make a complaint if they had one. The home does have a complaints procedure, which should be made more available to residents and relatives. One staff member has received training on how to protect residents from abuse, but three other staff members interviewed had not and information received by the Commission since the visits, indicates that staff had not reported a recent safeguarding adults issue to the appropriate authority. Greetwell House Nursing Home DS0000002600.V318446.R01.S.doc Version 5.2 Page 14 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 and 26. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Areas within the home are poorly maintained and are not safe for service users and staff. There are not robust systems in place to prevent the spread of infection, which could put residents at risk. EVIDENCE: Since the last inspection, the kitchen door has been made safe with a keypad so that residents cannot come to any harm from hot surfaces, but was freely opening on the second day of the inspection. Since the inspection visit to the home, information has been received by the Commission informing them that one of the residents had trapped and broken one of their fingers in the door. Residents were pleased with the new replacement windows in the conservatory, which enables them to see outside more easily. During a tour of the building it was noted that in the kitchen, the floor, cooker canopy and the cooker were dirty. The chef works five hours a day, which Greetwell House Nursing Home DS0000002600.V318446.R01.S.doc Version 5.2 Page 15 does not allow for cleaning time. This was recommended in the last local authority environmental health inspection, but this has not been complied with. There were two electrical items in the kitchen that had been condemned; the electrical deep fryer and the fly executor. One item was still plugged in, this was removed immediately it came to the notice of the chef. Neither of these items had been removed or replaced on the day of the second inspection. Curtains were hanging off rails in some bedrooms, some of the beds are of an old fashioned nursing/hospital type and they look institutionalised. Some of the commodes needed replacing to ensure that they could be kept properly clean. Some toilet seats, which are black, are whitening with continuing cleaning and need replacing. Bins for clinical waste kept in bathrooms had either no lids, or broken lids. This does not provide a homely, comfortable or hygienic setting for residents to live in. When the hot water tap was run in the bathroom upstairs the temperature of the water appeared cool and measured at 38 degrees centigrade. The normal temperature would be expected to run at 43 degrees centigrade. When questioned, staff said that because of the lack of hot water they were only able to run one bath a day. There are two washing machines in the cellar and two tumble driers. On both the days of the inspection, only one of each machine was in working order. Neither of the washing machines had a sluicing facility, so staff were sluicing down soiled linen by hand without using any protection for their face or eyes. This was discussed at the last inspection with the then manager of the home. There was a water leak in the cellar, the source of which could not be located, but staff had found themselves in a position of ironing clothing with an electrical press, with water around their feet. Several towels were on the floor to ensure that the water did not reach the area of the electrical press. This matter was reported to the Health and Safety Executive in Nottinghamshire. On the first day of the inspection one of the housekeeping staff was seen cleaning the stairs with a hand brush as the vacuum cleaner had to be left for up to 45 minutes to cool down before it could be used again. There is a maintenance person available to the home but set days or times are not stipulated. An ongoing maintenance plan could not be found in the home. Greetwell House Nursing Home DS0000002600.V318446.R01.S.doc Version 5.2 Page 16 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 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff have not been adequately trained in order for them to be able to meet residents’ needs. There are insufficient staff on duty and an inadequate staffing structure in place to meet the residents needs. EVIDENCE: A visitor said that the staff were ‘very kind’ and that ‘they could not be faulted’. Good interactions were observed between the staff and residents, with one resident saying ‘it is ever so nice here’. There is always a qualified nurse on duty during the day supported by two care assistants. There are two part time housekeepers who also undertake laundry duties. A member of staff, who had worked in the home for some months, confirmed that they had had a two week in house induction in to the home and had been shown how to move and handle residents. They were also aware of the importance of preventing the spread of infection, however they had received no further training. Some staff interviewed could not remember what training Greetwell House Nursing Home DS0000002600.V318446.R01.S.doc Version 5.2 Page 17 they had received and they said that their training files did not contain all their training certificates. A trained nurse explained that the staff had recently received training from a diabetic specialist nurse, which had been very useful. Some staff working in the home have received training on how to care for people with dementia, and at the last site visit to the home, said they felt that they needed more training. Further training on dementia care has not been provided. The qualified nursing staff are undertaking training relating to the management of medication. A training plan for staff working in the home was not available. Greetwell House Nursing Home DS0000002600.V318446.R01.S.doc Version 5.2 Page 18 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 and 36. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staff roles and responsibilities are not defined and are unclear putting residents at risk. Unsafe health and safety practices put residents and staff at risk. There is no registered manager. EVIDENCE: Please see comments in the outcomes for Standard 19. The home does not have a registered manager and in the absence of the acting manager there was no individual person in charge of the home, or to assist with the inspection process. On the day of the second inspection the nurse in charge of the shift was undertaking the ordering of provisions for the week but only knew that she had to do this because the previous manager had put this in the diary before she left. The rota runs on a two weekly basis, but in the absence of the manager, Greetwell House Nursing Home DS0000002600.V318446.R01.S.doc Version 5.2 Page 19 staff were covering shifts themselves when other staff members had gone off sick. Staff said that there was no actual rota for the following week. There was no evidence or knowledge of who was responsible for co-ordinating this. There has not been a staff meeting since the new manager came into post and some staff had not had a proper chance to meet him. There was no evidence of any quality assurance arrangements other than verbal discussion, which took place with the chef regarding the provision and choice of food. One service user was seen asking the nurse in charge if she could have some of her own personal monies which was locked in the safe, but the nurse did not have a key to the safe and could not assist her. The resident was upset as another resident’s visitor had bought her some personal items and she was unable to pay for them. A key to the safe had not been available since the acting manager had gone off duty. Service certificates for electrical equipment and hoists could not be viewed as they could not be found, however the fixed wiring electrical certificate showed that it was valid until 2007. There was evidence that fire bells and emergency electrical lighting were tested on a weekly basis. One fire sign was on the floor and not affixed to the wall. One service user who prefers to have her door propped open with a door wedge, still does so which could put residents at risk should there be a fire in the home. The clinical waste container bin in the car park was overflowing and couldn’t be shut with yellow clinical bin bags scattered on the floor. There was another yellow clinical waste bin, which appeared to be full of leaves. The general waste container was also overflowing and could not be shut with several black bags on the floor surrounded by many cardboard boxes. This situation has previously occurred, and staff have reported that vermin had been seen in the vicinity. This situation was reported to the environmental health officer at the local council and to the Health and Safety Executive in Nottinghamshire, as it was such a concern. An immediate requirement notice was issued to the registered provider requiring him to clean the area and dispose of the rubbish. Domestic staff were seen decanting cleaning fluid into a spray bottle, which did not indicate effectively what it was. The staff said that they brought in the spray bottles, as the ones in the home did not work. The staff said that registered provider visits briefly once a week. Regulations require a monthly written report to be compiled by the registered provider and sent to the Commission, about the home including residents and relatives views. The Commission has only received three in 2006. Greetwell House Nursing Home DS0000002600.V318446.R01.S.doc Version 5.2 Page 20 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 2 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 1 1 X X X X X X 1 STAFFING Standard No Score 27 1 28 1 29 X 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 1 1 X 1 X 2 1 Greetwell House Nursing Home DS0000002600.V318446.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement Care plans must give clear and detailed instructions as to the care that is to be delivered to a service user taking into consideration health needs, social stimulation, personal choice and preferences of the individual service user. They must be updated and reviewed regularly. Medicinal creams must not be used for persons they are not prescribed for. The means of disposing of medication must be made safe. The registered provider must ensure that service users are enabled to fully participate in activities, which meets their individual needs, wishes and cultural background. The registered provider must ensure that a variety and choice of foods is made available to service users. The registered provider must provide a written copy of the complaints procedure in a form DS0000002600.V318446.R01.S.doc Timescale for action 31/12/06 2 OP9 13(2) 31/12/06 3 OP12 16 (2)(m)(n) 31/12/06 4 OP15 16(2)(i) 31/12/06 5 OP16 22 30/01/07 Greetwell House Nursing Home Version 5.2 Page 22 6 OP18 OP28 13(6) 7 OP19 16(2)(j) 13(4)(c) 8 OP19 23(2)(c) 9 OP19 13(4)(c) 10 OP19 13(4)(c) 11 OP26 23 (2) 12 OP26 16(2)(k) which is suitable for individual service users. Arrangements must be made by training staff or by other measures to prevent service users being harmed or risk of abuse. The registered provider must ensure that the: The kitchen is clean and safe. Electrical items in the kitchen that are labelled as condemned must be removed. Staff must not be exposed to avoidable risk by use of electrical equipment in the laundry where there is a water leak. There must be sufficient hot water at an appropriate temperature available in the home to ensure that residents can have a regular bath. An immediate requirement notice was left on the first day of the inspection requiring the proprietor to inform the Commission of what steps would be taken to ensure that a solution was found to this problem. Doors should not be wedged open. This remains outstanding from the inspection of 21/07/06 The registered provider must ensure that suitable sluicing facilities are in place to reduce risk. This remains outstanding from the inspection of 5/04/06 The registered provider must ensure that clinical and ordinary waste is properly contained and hygienically disposed of. An immediate requirement 30/01/07 31/12/06 31/12/06 31/12/06 31/12/06 31/12/06 31/12/06 Greetwell House Nursing Home DS0000002600.V318446.R01.S.doc Version 5.2 Page 23 13 14 15 OP28 OP31 OP33 18(1)(c) 8(1) 24 16 OP35 16(2)(l) 17 18 OP38 OP38 26 13(4)(c) notice was left requiring the rubbish to be disposed of within 48 hours. An immediate requirement was left regarding this issue at the last inspection. Staff should receive training suitable for the work they are to perform The registered provider must put forward a manager to become registered. The registered provider must ensure that there is an effective quality assurance and quality monitoring systems based on seeking the views of service users. The registered provider must ensure that appropriate systems are in place which enable services users to access their money, which is held on their behalf. The registered provider must make available Regulation 26 visit reports to the Commission. The registered provider must ensure that unavoidable risks are eliminated by clearly labelling hazardous substances in cleaning spray containers. 31/03/07 30/01/07 31/03/07 31/12/06 31/12/06 31/12/06 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 OP1 Good Practice Recommendations It is strongly recommended that the home’s statement of purpose and service user guide must be updated to reflect the changes in the home. Ways must be found to ensure that residents and relatives know what it is and where to DS0000002600.V318446.R01.S.doc Version 5.2 Page 24 Greetwell House Nursing Home 3 OP36 find it. It is recommended that staff supervision should take place six times per year. The manager has commenced some supervision sessions with staff. Greetwell House Nursing Home DS0000002600.V318446.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Greetwell House Nursing Home DS0000002600.V318446.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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