Inspection on 11/02/06 for Guardian House Nursing & Residential Home

This inspection was carried out on 11th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Guardian House Nursing &... 10/03/09

Guardian House Nursing &... 17/12/07

Guardian House Nursing &... 20/07/06

Guardian House Nursing &... 13/09/05

Guardian House Nursing &... 29/01/05

Guardian House Nursing &... 23/06/04

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

CARE HOMES FOR OLDER PEOPLE Guardian House Nursing & Residential Home Cobden Street Dresden Stoke-on-trent Staffordshire ST3 4EL Lead Inspector Mr Keith Jones Unannounced Inspection 11th February 2006 09:00 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 Guardian House Nursing & Residential Home DS0000026947.V282177.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. Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Guardian House Nursing & Residential Home Address Cobden Street Dresden Stoke-on-trent Staffordshire ST3 4EL 01782 598330 01782 644950 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) Guardian Care Nursing The Nightingale Group Mrs J Wood Care Home 24 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (24), of places Physical disability over 65 years of age (3) Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th September 2005 Brief Description of the Service: Guardian House is a purpose built home that provides nursing care for up to 24 older people. It is part of the Nightingale Group Ltd, Guardian Care Centre, Longton Road, Trentham, Stoke on Trent. Guardian House is situated in Dresden, a residential area between Trentham and Longton and is close to local amenities. The home is set back from the main road and has its own small garden for service users to enjoy. There is a small car park to the side of the home that is accessed from the drive. Accommodation is provided on two floors that are accessible by stairs or passenger lift. There are 16 rooms and four companion rooms available and 30 have en-suite facilities. The home has a large open plan lounge that has three distinct areas, one social area where service users can enjoy participating in activities, a quieter sitting area and the dining area. There is a designated smoking area for service users. The home has adapted bathing and toileting facilities on both floors. Catering and laundry facilities are provided at the home. Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was conducted with the senior duty carer and a recently appointed registered general nurse. The last inspection report was discussed, and it was noted that there were no outstanding requirements or recommendations. The tour of the home was carried out in a relaxed, courteous and professional manner, everyone concerned expressed confidence in the atmosphere, liking it to a family feeling. All the service users approached were highly complimentary of the care, service and attention they received from a willing, attentive care team. There were 24 service users on the day of inspection, 2 categorised as high dependency. Three service users were case tracked confirmed the establishment of a well run, very comfortable and ‘homely’ establishment. Relatives who were present were equally complementary of the family approach to care, the freedom they enjoyed and the involvement that the manager and her staff encouraged. Everyone appeared comfortable and at ease with their surroundings. A sample review of the administration confirmed solid practice and effective management. A full report was offered at the end of the inspection with open discussion involving the registered nurse and senior carer. What the service does well: Guardian House offers a genuine commitment to care with an open and personable approach, which reflects the homeliness of a confident relationship between carer and resident. The establishment of a professionally accountability towards effective assessment, detailed care planning and review of resident’s needs are meaningful and robust, in formulating a good standard of care. This highly personable attitude and approach to care is appreciated and welcome by residents and visitors alike. The management style demonstrated a professional approach in maintaining an environment conducive to the care of the elderly. There is a constant appraisal and review process of facilities and services to maintain that environment, by the Nightingale Group management. Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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. Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 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 Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 Guardian House ensures that prospective residents have the necessary information to enable an informed choice to be made. Aims and objectives, terms and conditions are clearly presented in a way to facilitate easy understanding of services and standards of care. The Home ensures that the admission process is a reflection of a joint understanding that residents are aware, and that staff are able to meet expectations to realise a comfortable transition. EVIDENCE: The care management adheres to an admission policy of personal supervision of the pre-admission assessment. Case tracking of three resident’s files demonstrated the presentation of a highly personal approach to prospective residents and their relatives on pre-admission. A detailed assessment was examined and found to collect a full profile of physical and psychological needs, as well as social, cultural and environmental circumstances. Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 Page 9 An appraisal is made, and discussed, to ensure the home can satisfactorily meet those needs. Case tracking and discussion with service users confirmed that this standard continues to be well met. Following an assessment the senior assessor determines the suitability of the application in view of the facilities available, and at the capacity of the home, to manage the individual and any special needs. Likewise the applicants are informed of those facilities and are encouraged to seek clarification concerning the general and specific services available for the prospective service user. Case tracking confirmed that a valuable exchange between service users, family members and assessor took place and resources made available. These resources were seen to be an appraisal of staffing skills, equipment and general environment. Prospective service users and their relatives are able to visit and assess the quality, facilities and suitability of Guardian House at any reasonable time, to meet with staff and management. The management style is highly personable and inclusive, generating a warmth and comfortable environment. Relatives are welcome to view the facilities and participate in the planning and assessment of care, as recommended in the last inspection report. Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11 The pre-admission assessment is recognised as the foundation for a comprehensive care planning process. A profile of the service user’s social, physical and psychological status offers an individual plan of care to be implemented and reviewed. The policy of the home is to maintain service users own GP support wherever practical, otherwise local GPs covered on a regular basis. Service users spoken to were particularly pleased in the way their privacy and dignity was respected, not only by the care staff, but everyone connected to the running of the home. EVIDENCE: Examination of case track records identifies a continuing meeting of these standards. The pre-admission assessment represented the foundation for a well-considered and detailed care planning process. A profile of the service user’s social, physical and psychological status offered an individual plan of care, based upon an individual model of care need. Inspection of three residents care records confirmed that each service user’s individual plan of care is reviewed monthly, including service users and relatives views, to reflect their changing needs. Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 Page 11 Included in the care records were established monitoring systems following a process of goals, care and evaluation models of monthly assessment. The assessment made at admission determines the initial health care needs of service users, and ensures that access to the necessary services is arranged. Each service user has a named carer (key-worker) who is responsible for maintaining an in-depth awareness of those service users. There was evidence of specialists’ health care input, attendance at hospital appointments and the use of specialist equipment. The medication systems were found to be well organised, secure and efficient. There were no residents self-medicating at the time of inspection. Case tracking confirmed the attention to detail that the senior staff had taken in prepared the plans for care. The inspector observed the free, courteous interaction between service users and staff based on a level of confidence of mutual trust and respect. A lively and friendly atmosphere in the lounge was enjoyed by residents, relatives and staff alike. The good quality facilities and bedrooms were presented to facilitate privacy for the individual, which according to the care staff included medical examinations and personal care procedures, being performed in private. The deployment of institutional notices in bedrooms needs to be more discrete. The procedure for handling accidents and incidents was inspected and found to hold a policy of referral for medical/paramedical opinion if in doubt. Reports were informative, detailed and meaningful. Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 Page 12 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 14 Routine is seen as flexible to acknowledge individuality, yet maintain a focal point for service users to latch on to without dictating events. Service users’ life-styles and interests are recorded in their care plan, discussed with their relatives prior to admission, and documented as far as possible to enhance a position of supported independence. Personal choice and relative selfdetermination are respected in policy and action. Those who wish to bring in personal possessions are encouraged to do so. Service users were offered a varied and nutritious choice of meals from a 4week rotating menu. The kitchen area was generally well presented, although the routines for controlling prepared food need to be reviewed. Access to the kitchen area should be restricted to authorised staff with suitable overclothing provided. Staff were seen to offer discreet assistance to those who required it. EVIDENCE: Discussions with service users and staff clearly identified a relaxed atmosphere in which the service user’s needs were respected. A routine exists to establish a framework for managing the home, not as a yardstick for service users to comply with. Several residents expressed their appreciation for the freedom they enjoyed, with the security that there are familiar events to the day they could relate to. Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 Page 13 Those service users’ rooms inspected showed a significant influence of personalisation in the inclusion of belongings, some furniture and general décor. The standards of catering at Guardian House offered a good service, to which service users spoken to were complimentary of all aspects of quality. A menu on a four weekly cycle offered a wholesome, varied and excellent choice, served in a well-furnished and clean dining room. Staff were seen to offer discreet assistance to those who required it. The choice of dining room, lounge or bedroom was at the discretion of service users. The kitchen was inspected with the temporary cook and found to present a well equipped and organised area. However sandwiches prepared the day before were still stored in a fridge, and pureed foodstuff were undated and unlabelled. The routines for controlling prepared meals require review to ensure consistency with the overall standards observed, and recognised by residents. Access to the kitchen area will be restricted to staff authorised to enter, and be provided with suitable protective clothing. All fridges and freezers were well maintained and checked daily by the kitchen staff. A cleaning schedule was examined and found to be satisfactory. Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 Page 14 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): 16,17 and 17 The home had a meaningful complaints policy, clearly identifying the CSCI as a resource to approach with a complaint or grievance. No formal complaint had been received via the Commission since the last inspection. Service users’ legal rights are protected by the systems in place. Staff induction and in-house training programmes clarified the responsibilities of all staff in their daily contact with service users, especially their privileged position in protecting service users from abuse, of all natures. EVIDENCE: A complaints book is maintained which shows a responsible approach in handling complaints appropriately. Experience has proven the depth of sensitivity of senior staff to addressing complaints in an effective manner. Minor complaints were received in-house and found to be resolved to complainant’s satisfaction. Case tracking confirmed the effectiveness of a care manager and staff sensitive to service users needs and readiness to test the robustness of their information and report structures. As part of the process of encouraging self-determination a policy exists to be able to offer advocacy services should they be required. Family involvement has been the usual means of representation in the past. Residents’ legal rights are protected by the systems in place in the home to safeguard them, including their contract, the continual assessment of care planning and policies in place i.e. the complaints procedure. This process was evidenced on examination, and case tracking as previously reported upon. Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 Page 15 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): 19,20,21,22,23,24,25 and 26 A tour of the premises found the home to be clean and tidy throughout. It is homely and comfortable. The main lounge area provides a comfortable, odour free and a popular centre for socialising and relaxation. The standard and presentation of all the toilets and bathrooms were of a high quality, clean, uncluttered and odour-free. Adequate attention has been given to ensure maximum privacy within riskassessed boundaries. Individual assessment ensures the special needs of service users are accommodated. There is a good standard of furnishing complimented with a variety of personal belongings. There was however some evidence of institutional notices being stuck to wardrobes and doors. It was recognised that the practice could be done more discretely, as had been recognised at a previous inspection. Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 Page 16 EVIDENCE: The lounge area was seen to be comfortable, odour free and a popular centre for socialising and relaxation. The home provides sitting, dining room and outdoor communal facilities which all service users have access to, that are safe and comfortable. Facilities for wheelchair and disabled access were satisfactory, and residents have access to sufficient and suitable WCs that are accessible for all service users and within close proximity for all communal areas. The home is well equipped to meet the demands of each resident, with appropriate movement and handling facilities, hand and grab rails, ramps and call alarms. The care manager confirmed a willingness on the part of management to meet any reasonable demand for special needs. There is an on-going redecoration programme to further enhance the refurbishment of service users bedrooms, with the care manager actively pursuing a prioritisation of needs through an agreed development plan. The décor was looking a little worn and tired in places and it is required that the programme of redecoration and refurbishment is continued. The Home was requested to forward a refurbishment plan for 2006/07, before the next inspection. There is generally a good standard of furnishing with one or two bedrooms seen to have furniture in need of repair or renewal. Most rooms were complimented with a variety of personal belongings. The nurse-call alarm system was satisfactorily tested and service record checked. All personal electrical equipment where seen to be PAT tested. The heating is by thermostatic controlled central heating, with low surface temperature radiators, with pipe work guarded; this system is regularly serviced and maintained. Lighting is satisfactory in all bedrooms, corridors and communal areas, with emergency lighting tested monthly. Temperatures are well controlled, and recorded. Ventilation is via open window and natural airing. The laundry was well organised and equipped to a good standard. COSHH regulations were clearly displayed and relevant to solutions in use. There was evidence of the use of pressure relieving equipment, mobile hoists, aids and adaptations, toilet frames and raised toilet seats, grab rails and passenger lift. Baths had also been adapted. It was noted that there was a broken thermostat in a bathroom and the carer was advised to secure a bath thermometer for each bathroom. Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 Page 17 The standard and presentation of all the toilets and bathrooms were of a high quality, clean, uncluttered and odour-free. The care management was asked to ensure that toilet cistern lids are kept free. Adequate attention has been given to ensure maximum privacy within risk-assessed boundaries. Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 Page 18 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 Through discussion with senior care staff on duty it was reaffirmed that staff are carefully selected to work at the care home and residents are safeguarded from harm or abuse by this process. The daily care staffing rota showed adequate balance between skills, qualifications and numbers to provide a good standard of care. There was flexible rostering to meet unexpected shortages. EVIDENCE: At the time of the inspection the home was fully occupied with 24 residents all in receipt of nursing care. The staffing rota for three weeks were examined and the numbers of staff provided corresponded with the minimum requirements of the existing staffing notice. The manager usually worked supranumery but covered some shifts on the floor occasionally. She was supported by a deputy manager who worked on the floor. At the time of inspection the duty rotas confirmed staff coverage as thus: 0700 1400 1700 1900 – – – 1400 1700 1900 0700 1 Registered nurse 4 care assistants 1 Registered nurse 3 care assistants 1 Registered nurse 4 care assistants 1 Registered nurse 1 care assistant plus there was a care assistant working a twilight shift until 10 or 11pm. Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 Page 19 The provision of maintenance services has been improved since the last report. The kitchen was adequately staffed from 7am-8pm. The domestic assistant also worked in the laundry daily from 7am-4pm or sometimes 5pm. The provision of domestic hours has increased by a full time domestic assistant, and a part time laundry assistant employed. Evidence showed attention to supervised training involving a shared aspect of responsibility between staff and trainer. Training plans drawn up were examined and found to offer an excellent commitment to the educational, supervision and appraisal process. Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 Page 20 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): 31, 32, 33, 34, 35, 36, 37 and 38 The newly appointed care manager was on annual leave at the time of this inspection. However the Inspector was impressed with the depth of knowledge, awareness and professionalism as presented by the nursing and senior care staff on duty. The inspector continued to be impressed by the openness and confidence in the observed interactions of staff, relatives and service users. The relationships were seen to be of mutual trust and respect. Administration is provided by Guardian Care centre. Evidence was secured to confirm a quality monitoring system has been introduced, based upon audit of standards, care plans and feed back from service users and relatives. The administration and management of the home is efficient, uncomplicated and sensitive to the needs of service users. Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 Page 21 EVIDENCE: The inspector observed at first hand the confident interrelationship that exist, not only between management and staff, but also between staff, service users and relatives. Evidence was secured to confirm that an effective quality monitoring system operated, based upon audit of standards, care plans, general audits and feed back from service users, relatives and visiting professionals. Standards are discussed at staff meetings, daily reports, direct observation and involvement and one to one staff meetings. Regular audits and on-site inspections by Guardian Care offered written evidence of a management firmly in control, well organised and prepared to facilitate meaningful accountability. Discussions with two staff members indicated that employment policies are effective and meaningful. An examination of administrative, monitoring, planning and care records showed an organised and professional attitude to effective record keeping. In general they were found to be well maintained, accurate and up to date, ensuring that the service users’ rights and best interests are safeguarded. All records and medical notes are kept confidential and secure. Records inspected included, fire prevention tests on equipment, six monthly fire training and procedures, Health and Safety checks on equipment servicing, gas servicing, and call alarm maintenance and risk assessments. The accident books for staff and service users were checked and found to be accurate, up to date and Riddor sensitive. These issues and routines ensured the health, safety and welfare of service users and staff. The administration and management of the home is efficient, uncomplicated and sensitive to the needs of service users. Relevant legislation and prevailing care issues were discussed and are fully appreciated by the management. Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 Page 22 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 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 4 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 3 3 3 3 3 Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 Page 23 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 OP38 Regulation 13.3 Requirement That a review of procedures in storing prepared meal/foodstuff be undertaken. Sandwiches should not be stored overnight and pureed food should be specifically labelled and dated Timescale for action 01/03/06 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 1 2 3 Refer to Standard OP26 OP38 OP24 OP2 Good Practice Recommendations Access to the kitchen area be controlled to authorised staff. The practice of storing items on toilet pedestal lids cease That the practice of displaying Home instructions in service users bedrooms be more discrete. To ensure that equipment provided at the care home are of sound construction and kept in good repair at all times, i.e. repair of cupboard and freezer in dining room, and upstairs bath. Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 Page 24 4 5 OP33 OP25 The management provide the CSCI a refurbishment/development plan for the Guardian House site for period 2005/06. Bathrooms to have hot water thermometers Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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. Extracts may not be used or reproduced without the express permission of CSCI Guardian House Nursing & Residential Home DS0000026947.V282177.R01.S.doc Version 5.1 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!