Inspection on 17/12/07 for Guardian House Nursing & Residential Home

This inspection was carried out on 17th December 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

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

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

Guardian House Nursing &... 11/02/06

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 Yvonne Allen Unannounced Inspection 17th December 2007 10:00 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.V351173.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. Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 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 Alexandra Jade Sargeant 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.V351173.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th July 2006 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, and 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. The fees charged are outlined in the Statement Of Purpose and can be obtained from the Manager of the home. There are additional charges for hairdressing. Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced Key inspection visit took place over five hours and was carried out by one inspector. Prior to the visit the Providers had completed a self-assessment document entitled Annual Quality Assurance Assessment (AQAA). This assessment outlined how the Providers had assessed themselves as meeting the standards of the Care Standards Act and how they achieve the outcomes for the people who live at the home. During this inspection process all of the Key standards and outcomes for residents were assessed. The ways in which we gathered evidence to formulate our judgements were as follows – Analysis of the AQAA Discussions with the people who live in the home Discussions with visitors, staff and managers Examination of relevant records and documentation A tour of the home including a sample of bedrooms, the lounge, kitchen and laundry Observations of care practices and interaction of staff with residents We were made to feel welcome by all the staff and residents and the managers were helpful in assisting CSCI. Improvements had been made since the last inspection and all previous requirements had been addressed. Most of the key inspections were fully met with others almost met. Two Requirements and recommendations with timescales were made as a result of this inspection. There were no immediate requirements. What the service does well: The home has very good health care support from the local health centre. There is a matron attached to the centre and she will visit the home whenever needed to give help, advice and training to staff. This means that the residents benefit from regular health screening and reviews and that staff have up to date clinical knowledge so that residents receive the best possible nursing and health care. Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 Page 6 Just prior to the inspection visit, it was pleasing to note that for a trial period the Tissue Viability Nurse Specialist team is able to visit individuals living in the home in order to offer advice and support and prescribe treatment. This is an improvement on the previous service, which was via telephone only and will undoubtedly help the nurses in the home to improve in the prevention and treatment of pressure sores. Staff recruitment, training and development at the home are good. Some positive comments were received from residents – one lady stated – “Oh its wonderful here”. What has improved since the last inspection? What they could do better: There has been another change in manager since the last inspection and this is concerning to relatives who visit the home. This needs to improve so that consistency can be achieved and the home is run in the best interests of the people who live there. Comments from a visitor and some residents identified that there is a problem with the delivery of personal care at the home. Individuals do not always receive the care, which is planned for them. A complaint received by the CSCI since the last Key inspection, and investigated by the Provider also highlighted failings in the delivery of care. This was disappointing as staff training is good and staff have the knowledge and skills to deliver this care. Comments from a visitor included - “Quite a lot needs changing here” – she went on to say –“small things aren’t always done – such as leaving the call bell within easy reach and the table on the side where residents can use it.” The visitor went on to say that attention to personal care needs is not always given. One of the residents spoken to was also unhappy – she stated, “Its alright, not like home though and things aren’t always done.” When the above is improved then promotion of individual autonomy and dignity should also be achieved. The hours devoted to activities and entertainment within the home should be increased. There are some activities taking place in the home but these are not geared around individual needs and abilities, are not enough to be effective and social and therapeutic needs are not fully met. Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 Page 7 The menus need to be reviewed so that the evening meal offers more choice and to ensure that those individuals requiring a soft diet are catered for. A suitably trained individual should assess the nutritional content of meals in order to ensure that residents are receiving a well-balanced nutritious diet. The home would benefit from an ongoing redecoration and refurbishment programme, as some areas of the environment are now looking very tired. 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. Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 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 Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Individuals undergo an assessment of their needs before being offered a place at the home and can be assured that their overall needs will be met, although the people who live there have highlighted areas for improvement. EVIDENCE: Standards 3 and 4 were assessed. 3 care plans were examined, including that of a recent admission, where it was identified that an assessment of needs had been carried out prior to the individual being offered a placement. As well as this – evidence was seen of assessments carried out by Social Services. Discussions with the prospective manager and current registered manager were held and identified that a suitably trained nurse goes out to assess Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 Page 10 individuals prior to admission. This is usually the manager of the home or another senior nurse. Further examination of the care plans, examination of staff training records and discussions with residents and visitors identified that nursing and health care needs are being met well at the home. Residents and visitors feel that health care and nursing needs are met at the home but some areas of personal and social care could be improved upon and these needs are not always fully met. This has been highlighted in the other outcomes throughout the report. Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Individual nursing and healthcare needs are met very well. Personal care needs are not always met as planned and this needs improving so that individual assessed needs are met. EVIDENCE: Standards 7, 8, 9 and 10 were assessed. 3 care plans were examined including records of nursing care, health care and personal care. Each individual has a plan of care in place based on his or her assessment of needs. One of the care plans had not been reviewed since September 2007. The other 2 plans had been reviewed monthly. Two visitors are happy with the care provided to their relative but are not happy to see yet another change in manager. Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 Page 12 Another visitor was spoken to and commented – “Quite a lot needs changing here” – she went on to say –“small things aren’t always done – such as leaving the call bell within easy reach and the table on the side where residents can use it.” The visitor went on to say that attention to personal care needs is not always given. A resident stated, “Its alright, not like home though and things aren’t always done.” Since the last Key inspection the CSCI had received copies of 2 complaints about the home in respect of poor care practices. The issues contained in these complaints had been partially substantiated by the Provider. During the tour of the bedrooms we met with a resident who is nursed in bed and has specific nursing and personal care needs. She commented that she is happy with the care provided. She appeared very comfortable and had all her personal effects around her at hand, including her call bell. There were charts in place to evidence personal and nursing care carried out. This included pressure area care and changes of position. There was evidence, contained in care plans, of visits by healthcare professionals - such as GP visits, Opticians, Chiropody, and healthcare reviews organised by the community matron based at the local health centre. The registered manager confirmed that this support for the home is very good and that the matron is always available for help and advice and will come in and give talks and training sessions for the staff. The trained nurse on duty was observed administering medication at the lunchtime medication round. This was carried out according to policies and procedures. Examination of the Medication Administration Record (MAR) charts identified that these had also been completed as required. The procedures for receipt, storage and disposal of medication was also found to be correct at the time of the visit. Staff were observed carrying out direct care to residents and were attentive to their needs – especially the trained nurse on duty – who was observed helping individuals with their drinks and medication. A visitor commented, “Residents aren’t always spoken to how they should be” and suggested that dignity and respect are not always promoted at the home. Staff were observed to be polite and respectful towards residents during the visit. At the time of the inspection visit three residents were spoken with – one resident stated that she is “quite happy with the home but its not like my home”. Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 Page 13 Another resident nodded when asked if he felt safe and well cared for and another resident stated –“Oh its marvellous here.” Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Activities and entertainment are organised but the current programme is only partly meeting the social and therapeutic needs of individuals. The menus rotate 4 weekly but require reviewing and amending in order to ensure that individual needs and preferences are catered for. EVIDENCE: Discussions with a visitor were held in relation to social and therapeutic needs. She commented that the current arrangements were inadequate, and that, again, attention to detail is overlooked. She stated that not all residents are able to join in activities and that staff do not appear to have the time to sit and talk – which is what most residents would like. She pointed out that the lounge had been redecorated several weeks ago but that staff had not bothered to put the clock back on the wall – so that residents were unable to see the time – This was noted during the tour of the home and brought to the attention of the manager. Examination of the care plans identified that there is a social/spiritual care plan in place and that individual interests, hobbies and religious persuasion are documented. Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 Page 15 There is a programme of activities and entertainment in place, which is overseen by the activities co-ordinator. It was noted that although the above are in place – the current system and dedicated activity hours are insufficient to be effective. This has been of concern on previous inspections and has improved little since the last Key inspection. Residents and visitors were asked about the meals provided at the home and there were mixed feelings, although on the whole they feel that the meals have improved. A comment received from a visitor was – “meals are limited in choice – especially the sandwiches at teatime”. Examination of the menus identified that choices at teatime are limited – especially for individuals requiring soft diet with some teas not providing anything soft. It is recommended that these menus are reviewed by a dietician/nutritionalist and that more is provided at teatime for individuals requiring soft diet. Staff were observed assisting some individuals with their lunch during the inspection visit. There is still a vacancy for a head Cook and there was a Agency Cook on duty at the time. Discussions with her identified that she comes regularly to the home to work and is quite confident in the job role. Meals could be taken in the privacy of individual bedrooms if so wished and the lady who we visited in her room confirmed this. Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents and their families can be assured that the systems in place at the home will help to keep them safe. Any concerns that individuals might have about the home will be listened to and taken seriously but consistency in management would help improve this. EVIDENCE: The newly appointed acting manager confirmed that she would be dealing with concerns and complaints as they arose and would keep these documented. CSCI had received 2 complaints directly – one from the Tissue Viability Nurse Specialist and a copy of another complaint from a Student Nurse who had worked at the home. This complaint had been sent to and investigated by the Provider. The issues contained in both complaints were in relation to poor care practices and some issues in the complaint from the Student Nurse had been partly substantiated by the Provider. Discussions with the residents and the 2 visitors identified that they knew whom to approach should they have any concerns but that that consistency of manager in the home would help with this. There had been no Safeguarding Referrals to CSCI since the last inspection. Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 Page 17 Examination of staff training records identified that all new staff receive instructions in the Vulnerable Adults process and all staff receive training sessions in Protection Of Vulnerable Adults. Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides individuals with a safe and homely environment, which has been adapted to meet their needs. With exception of the lounge area, which has been done, the home would be further improved by continued redecoration and refurbishment throughout. EVIDENCE: A tour of the home was completed where all the communal areas, a sample of bedrooms, the kitchen and laundry were inspected. Most of the residents were sitting in the lounge, some watching the television and others sitting in the area leading to the dining room. These residents were unable to see the television from this area and the ones who were awake were asked if this bothered them – to which they replied that they did not want to watch television and preferred to sit there. Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 Page 19 This lounge and dining area had been pleasantly redecorated since the last inspection. We were informed that there were plans in place to progress this through to the corridor area next. At the top of the stairs it was noted that there was a mal odour. It was identified that this was coming from room 10 and that the carpet required replacing in this room. In the corridor outside room 7 the carpet was ruttled and the floor uneven thus posing a tripping hazard. It is a requirement that this is levelled and made safe. In room 8 the wardrobe was not attached to the bedroom wall and it is required that this is attached and made safe to prevent it toppling over. The manager stated that the maintenance person would address this immediately. It was noted that room 14 had been pleasantly redecorated since the last inspection. There were no wall thermometers in the bathrooms and these felt cool on entry. It is recommended that thermometers be put into place in order to monitor the ambient air temperature where personal care is carried out. Bedrooms were personalised and adapted to meet individual needs and preferences. The laundry and kitchen were found to be clean and tidy and met the requirements relating to infection control. There were sluices and hand washing facilities (including hand gel) provided for staff. The home was generally clean and well presented but would benefit from redecoration and some refurbishment and this programme should continue throughout. Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people who live in the home can be assured that the staff are provided in sufficient numbers and are trained and equipped with the skills and expertise to meet their assessed needs however evidence in other outcome areas identifies that individual needs are not always fully met. EVIDENCE: At the time of the visit there were 2 managers on duty – 1 who was the existing RM and the other who was the newly appointed acting manager. As this was her first day – the acting manager was being supervised by the existing Registered Manager as part of her induction. There was another trained nurse on duty plus 4 care assistants – for 17 residents –all with nursing needs. There was a good skill mix of staff – NVQ training is ongoing at the home and there is a good staff training and development programme in place. Training sessions are held regularly and include training in all areas covering the needs of residents. Discussions with two staff members and the existing and newly appointed managers confirmed that they felt that their training needs are met and that they are supported to attend training sessions. Examination of the staff rota confirmed that the minimum number of staff are provided for the current occupancy. Dependencies of residents may fluctuate Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 Page 21 and it is the responsibility of the manager to ensure that staff numbers are provided according to the needs of individuals in the home. Other staff are provided – domestic staff, kitchen staff and part time maintenance. Administration is covered by the staff at Guardian Care Centre. Staff are carefully selected to work at the home and examination of two staff files confirmed that the recruitment procedure is robust. All the necessary checks are carried out on staff before they are offered employment. The evidence gathered identifies that staff recruitment and training at the home are good. However evidence seen in respect of the delivery of personal care suggests that staff are not always putting into practice what they have learned. Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although general health and safety is maintained, the home is not always run in the best interests of the people who live there. This outcome would be further improved by ensuring that there is consistency and effective management. EVIDENCE: The CSCI has been informed that the existing manager is moving on in the Company and there is a newly appointed manager in the home who will be applying for registration. Discussions with the acting manager identified that she is experienced and possesses the necessary skills and expertise to run the home. Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 Page 23 There has been a lack of consistency in management of this home and residents, staff and relatives are all feeling that this now needs to settle down. Both sets of visitors spoken to raised this as a concern – as one of them stated “The management of the home is very important and has a knock-on effect over everything”. Evidence gathered in other outcome areas suggest that the lack of consistency of effective management of this home has had a negative impact on outcomes for the people who live there. There is a Quality Assurance programme in place with various audits carried out on a regular basis. These audits included the following – Infection Control, Health and Safety, Clinical Audit and Care Plan Audit. There are also regular residents and relatives meetings held and minutes of these were seen. Staff spoken to also confirmed that they attend regular staff meetings and that their suggestions and opinions are listened to. The manager confirmed that usually representatives deal with personal allowances and that no staff members are appointees or agents for personal allowances. Records relating to health and safety were examined. It was identified that the required regular checks had been carried out such as fire alarms, emergency lighting, hot water temperature checks, servicing of equipment and portable appliance testing. Staff records identified that regular fire drills were carried out both for staff working days shifts and night shifts. Staff had also received training and instruction in fire safety and evacuation. The manager confirmed that Fire Safety risk assessments had been carried out in relation to individual residents. Accidents are recorded and reported to CSCI and RIDDOR as required. Staff confirmed that they have regular training session updates in mandatory training such as moving and handling, food hygiene, infection control and fire safety. Domestic and kitchen staff have received training in COSHH. Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 Page 24 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 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 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 2 x 3 x 3 x x 3 Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 Page 25 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 OP31 Regulation 8 and 9 Requirement The Provider must ensure consistency of management at the home in order to help improve all the outcomes for the people who live there Personal care must be improved and delivered as documented in care plans and delivered with dignity so that individual assessed needs are fully met. The Provider must ensure that the social and therapeutic activities are geared around the needs of individuals. This will ensure that autonomy is promoted and assessed needs are met. The Provider must ensure that menus are reviewed by a dietician/nutritionalist and that more choice is provided, especially at teatime for individuals requiring soft diet. This is to ensure that the people who live in the home receive a well-balanced nutritional diet. The Provider must replace the carpet inside room 10, as this was mal odorous. This will DS0000026947.V351173.R01.S.doc Timescale for action 04/02/08 2. OP7 15(1) and 12(4) a 04/02/08 3. OP12 16(2) m n 04/02/08 4. OP15 16(2) i 04/02/08 5. OP19 16(2) k 15/02/08 Guardian House Nursing & Residential Home Version 5.2 Page 26 6. OP38 13(4) 7. OP7 15(2) improve the environment for the individual living in this bedroom. The Provider must make safe the carpet and flooring in the corridor outside room 7 as this was ruttled and the floor uneven thus posing a tripping hazard. The provider must ensure that individual care plans are reviewed at least monthly so that care needs can be monitored. 15/02/08 04/02/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP19 Good Practice Recommendations The Provider should ensure that the programme of redecoration and refurbishment is on going at the home in order to improve the environment. The Provider should provide wall thermometers in bathrooms and other areas where personal care is carried out so that ambient air temperature can be monitored and kept comfortable for the residents. OP25 Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Guardian House Nursing & Residential Home DS0000026947.V351173.R01.S.doc Version 5.2 Page 28 - 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!