Inspection on 13/09/05 for Halliwell Nursing Home

This inspection was carried out on 13th September 2005.

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

Halliwell Nursing Home 01/08/06

Halliwell Nursing Home 24/05/05

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

CARE HOMES FOR OLDER PEOPLE Halliwell Nursing Home Kingswood Road Tunbridge Wells Kent TN2 4UN Lead Inspector Ann Block Announced 13 & 14 September 2005 09:30 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 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. Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Halliwell Nursing Home Address Kingswood Road Tunbridge Wells Kent TN2 4UN 01892 525909 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Elizabeth Finn Homes Ltd Mrs Gillian Pollock Forsyth CRH Care Home 50 Category(ies) of Old age (50) registration, with number of places Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24 May 2005 Brief Description of the Service: Halliwell Nursing Home is a purpose built building on three floors dating from the 1970’s with later additions.It is situated in a residential area of Tunbridge Wells a short walk from the Pantiles. There is easy access to public transport including a main line station. There is parking for staff and visitors to the front of the house. The home is in extensive grounds covering an area of up to 6 acres. Six bedrooms have their own access on to a secluded patio area.The home caters for 50 elderly and older frail service users including those who need nursing care.. Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The commission was represented by Regulatory Inspector Ann Block who carried out an announced inspection of Halliwell on Tuesday 13 September between 9.30 am and 5.30 pm and Wednesday 14th September between 9.00 am and 5.30 pm. On Tuesday morning Jane Vaughan, representing the commission, carried out a pharmacy inspection. Residents, visitors, staff and management agreed to speak with the inspector, both in groups and privately. Feedback from the inspection was given to the General Manager and Clinical Care Manager who both assisted the process of inspection. As part of the inspection process comment cards were received from residents, relatives and professionals. Comments about the home included: ‘Excellent home’ ‘The care my mother is receiving from the home is excellent and the staff are very good’ ‘Brings great peace of mind to residents and relatives alike.’ ‘Everyone here is very kind & helpful’ ‘I’ve been here for five years, the longest I’ve worked anywhere, that must say something mustn’t it?’ The inspector is familiar with the service hence some judgements have been made combining information from previous inspections with comments from residents and staff and reflections of practice from this inspection. From speaking with residents and staff it was clear that the service has at its heart the welfare of residents living at Halliwell. Systems are geared to the needs of older with the aim of providing the best quality of life possible within a care setting. What the service does well: Halliwell is run and managed to provide the best possible service to older people. The General Manager and staff are creative and responsive. Residents have the quality and style of life that they expect to receive. They feel staff treat them with respect and dignity. Sound admission processes ensure they have full information before they move in. Residents’ needs and preferences are made known to staff through individual care plans. Health and medical care is well managed and residents consider they have good access to internal and external health care. Residents are supported through all the stages of older age. Residents like the food and the choice of menu. They take pleasure Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 Page 6 in the surroundings of the home which they feel is bright and well maintained. Visitors are made welcome and residents can keep contact with friends and family. Residents consider the activities coordinator is ‘outstanding’ and miss her when she is on leave. There are opportunities to make comment about the service and to be listened to. Staff are well managed and properly recruited. Staff are liked and considered to be a strong team. Good care is underpinned by good record keeping. 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. Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 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 standard(s) 1,2,3,4 & 5 Residents and others have full provision to obtain written and practical information about Halliwell to decide whether they wish to move into the home. EVIDENCE: Residents said they had been able to make a decision whether to come in to Halliwell. One said a relative had visited on his behalf and after looking at a number of homes thought Halliwell would best suit his needs. Following that he had met staff who carried out an assessment of need. The assessment document gave detail of the reason for wishing to stay at Halliwell, health and emotional needs and desired outcomes. Whilst the resident remembered having a contract he had not received a letter confirming that following assessment his needs could be met at Halliwell. Such a letter is provided to permanent placements but had not been drafted for respite care placements. During the inspection such a letter was set up. The contract is very comprehensive and provides residents with greater security of placement detailing rights and responsibilities of both the resident and the home. A resident said that in their view the admission process was sound, he had a Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 Page 9 choice of care home, been given sufficient information about Halliwell and had been able to make a decision based on that knowledge. He was aware of the fees that would be charged and what services he could expect. Permanent residents are aware that there is a trial period after admission to make sure both they and Halliwell are happy with the care and service being provided. A statement of purpose and service users guide is readily available to any interested person with copies placed in the entrance hall. The documents have been updated to reflect recent organisational changes. The General Manager feels that these documents do not offer the most user friendly introduction to Halliwell and is in the later stages of setting up a ‘Welcome to Halliwell’ folder which can be updated and amended as necessary. A folder will be placed in each bedroom. Respite care is offered as it is felt that this is a valuable service both to the older person and carers. There are no specific short stay rooms allocated, residents join in with the group and in many cases have used respite stays as a gentle introduction to a permanent stay. Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 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 standard(s) 7,8,9,10 & 11 Residents’ health and care needs are well managed, tracking of daily notes would ensure continuity of care. EVIDENCE: Each resident has a plan of care which sets out a range of activities of daily living. The care plan is the underpinning documentation to promote consistent, personalised care to meet the current needs of each resident. A resident was aware that a care plan had been set up and had been able to make his own amendments to it. Care plans are audited regularly. A computer package is used as the basis for recording care detail. Staff have found it more useful to maintain printouts of the actual care plan and consideration is being given to the best place to ensure staff have easy access to them. Daily notes are recorded directly onto the computer database. The layout of the database makes tracking of care for individuals difficult and time consuming. When looking at notes for a number of residents tracked as part of the inspection process, incidents affecting wellbeing had been recorded but not followed through. As further development to ensure personal and consistent care is provided, greater use of how care is to provided, better personalisation of care directives and reliably incorporating information from Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 Page 11 diary notes should be carried out. The events coordinator is starting to record social and personal histories to include in the care plans. Residents felt that health care provision was excellent, both in house and in obtaining further medical treatment, both private and NHS. The home has the full support of General Practitioner’s, Consultants and general health care services. Records of medical care confirmed that relevant risk assessments such as nutrition, tissue viability, pressure wound and falls monitoring and mobility were actively addressed. Other areas of risk remain not so well recorded. Staff work with residents to maintain mental and physical abilities. Medication management within the home was satisfactory. Residents wishing to self-administer medication do so with the support of the staff within a risk management framework. The risk management tool would benefit from more detail than is being carried out at present. Residents requiring the administration of “when required” medication risk inconsistent and ineffective treatment due to the lack of guidelines and clear recording of administration. Residents considered that staff respected them as people with the right to privacy and dignity. Staff were seen to knock on doors. Residents said that they were asked how they wished to be addressed and this was normally followed in practice. Care was taken to ensure residents continued to present themselves as they would wish. Residents are aware that they will be able to remain in Halliwell throughout all stages of older age, providing their needs can continue to be met. A family member said that pain relief was being very well controlled and staff liaised with the hospice nurse who visited regularly. Relatives are welcome to remain with the resident through the last stages of life if the resident wishes. Staff are on hand to offer both physical and emotional support. Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 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 standard(s) 12,13,14 & 15 Residents lead a life which as closely as possible matches their preferences, beliefs and social aspirations. EVIDENCE: The statement of purpose for Halliwell clearly states the status of persons who may be accommodated there. From this there follows an expectation from residents that certain social and cultural principles will be met. From speaking with residents and from previous experience of the home, this is fully acknowledged and excellently managed. Activities and social events are arranged by a designated social and events coordinator who again demonstrated her boundless enthusiasm for the role and a genuine interest in quality of life for older people. Activities are provided both on a group basis and where time allows on a one to one basis. Residents have opportunities to be mentally and physically stimulated. A very successful tea party was held in the neighbouring park which was attended by 30 residents together with family, friends and staff. A few residents made comment that they would like to be able to go for a walk or drive, although mentioning that often family would take them out. Religious preferences are identified with external and internal contacts supported. Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 Page 13 As noted during both days of the inspection and as recorded in the visitors book, visitors are welcomed to the home. There are areas where meetings can take place in private. Family and friends are welcome to stay for a meal for which a small charge is made. Currently a flat can be booked for overnight stays. Residents commented how much they appreciated being able to maintain contact with family, old friends and associates. Where there is limited access to personal support, the house committee can provide friendship and advocacy. Residents felt they were able to direct their lives but as one resident pointed out there would inevitably be restrictions in any group living situation. As has been previously mentioned residents believed that call buzzers could take some time to be answered, this is likely to be addressed with the new call system. Staff were aware of individual preferences and built these into daily routines as far as possible. The home uses an external contract company which covers all catering and domestic responsibilities. Food provision is based on promoting interesting, well presented, varied and seasonal foods which meets dietary needs. Choice is offered and made known each day through the ‘Halliwell Times’. Residents and staff agreed that at times the food actually available on the day was occasionally slightly different to that on the menu. Residents have use of a large dining room with areas for use by visitors and for those needing assistance. Any assistance needed with eating is provided discreetly and on a one to one basis by care staff. Dining room staff serve and clear tables. Breakfast, tea and additional drinks are taken to individual rooms. Residents considered the food was usually very good. Encouragement is given to maintain a sound nutritional intake with records of weight maintained. Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 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 standard(s) 16,17 & 18 Residents have good systems to make comment about life at Halliwell to people who can effect change and to ensure their wellbeing is protected. EVIDENCE: Residents are aware they have the right to make complaint, to be listened to and for action to be taken. How to make complaint is presented in a clear, accessible policy with contact detail, copies will shortly be placed in each room. Copies of complaint forms are also available in the hallway. Management take complaints seriously, including talking with relatives where necessary, and will ensure that their concerns are addressed with records held of the stages of the process. Residents have the opportunity to vote in local and national elections in person or by postal vote. All staff are required to sign that they have read the homes adult protection policy and that they will abide by principles of protecting vulnerable adults. Residents felt safe in the home and had internal and external contacts to monitor their wellbeing. Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 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 standard(s) 19,20,21,22,23,24,25 & 26 Residents have a well maintained and decorated environment which meets their nursing and social needs. EVIDENCE: Residents felt overall the home was well maintained both mechanically and in décor. Redecoration and repairs are carried out on a planned and responsive basis. Residents again commented on the lovely personality, helpfulness and efficiency of the maintenance man. Lounges are well decorated and furnished to meet the expectations and needs of residents living at Halliwell. The ‘panelled’ room, a large meeting room, has recently been redecorated and recarpeted. Other communal areas are scheduled for redecoration shortly. Taking into account the range of small and larger lounges and dining spaces there is ample room for residents to meet in small or larger groups and privately with family. A resident spoke of ‘her’ group in the dining room and how she found it stimulating to have a chat and keep up with the news. Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 Page 16 Plans are at the discussion stage regarding general upgrading of the building to offer a more suitable environment for the generation of older people now coming into care. Residents who require a wheelchair to mobilise find the size of the smaller rooms restrict full use. The main house is sited in grounds which offers access to smaller patios and a grassed area. The slope of the site offers good views over Dunorlan Park and the surrounding countryside. Each resident has their own bedroom, which whilst in the main is not large, has an en-suite, bed, clothes storage and easy chair. Residents may bring with them small personal items, there is limited room for larger items of furniture. Most permanent residents have rooms which are well personalised, many mentioned how much they appreciated this. A room key can be provided on request, each room has a lockable unit. Over the past few years improved bath and shower arrangements have been made giving a range of facilities to meet individual needs and choices. Each room has its own ensuite, the majority have a washbasin in the ensuite, others have the basin in the sleeping area. Additional toilets are provided on each floor and accessible from communal areas. Staff have their own designated area and facilities. At some significant expense each room has been provided with an adjustable bed and pressure relieving mattress. Additional aids and equipment as required is either provided by the home or obtained through local health sources. Hoists have been purchased which are easier to use and which can weigh residents whilst being hoisted. A good sized lift gives access to all areas used by residents. The nurse call system is currently being replaced by a radio linked system which can indicate where the call is being made and record the time taken to respond. Individual preferences regarding room temperature and fresh air are managed by thermostatically controlled safe surface radiators and windows with restrictors. Residents are further protected from risk by monitoring of hot water at outlet. Residents considered the home was generally clean and mainly odour free. Waste which might present a health and safety risk is removed safely. A large designated laundry room is sited on the ground floor. Great care is taken to reduce any risks of cross infection and to ensure that residents’ clothes are well looked after and returned to them promptly. Dry cleaning can be arranged at additional cost. Residents considered the laundry service was very good. One person commented ‘look at that, all my clothes washed, brought back and piled up neatly on my bed for me’. Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 & 30 Residents are cared for and supported by properly recruited and trained staff. EVIDENCE: Halliwell is staffed by qualified nurses and care staff who work on roster to provide 24 hour care. Both planned and actual hours are recorded on the roster. At all times at least two registered nurses are on duty. The management structure consists of a general manager, clinical care manager, team leaders, registered nurses, nursing assistants and care staff. On each shift, staff are allocated to work on either Constance or Elizabeth floors, many normally work on one or the other floor to provide continuity of care. Comments were made by both residents and staff that the home has been short staffed. All agreed that this had not reduced the quality of care provided but was placing additional pressure on staff who were covering vacant shifts. Management agreed there had been a period where staff had taken planned leave due to school holidays and that this, combined with staff sickness and vacancies, had led to requests for staff to work additional shifts if they chose, or to obtain agency staff. Additional staff have been recruited and are due to start work shortly. Contract staff carry out catering, laundry and cleaning. Halliwell is proactive in ensuring staff obtain NVQ qualifications. One person is responsible for taking staff through their NVQ and to provide supervision. Staff who obtain NVQ qualifications are rewarded in the pay scale, carers who achieve NVQ 3 may apply for a nursing assistant post. Other training is offered including core training, mandatory training, client specific and personal Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 Page 18 development. Qualified staff are supported to maintain their nurses registration. A training matrix is held. All staff follow a recorded induction process which includes time spent shadowing other staff. The General Manager is in the process of introducing a ‘welcome to Halliwell’ book for all staff which will include key information and the induction record. Staff are given responsibility for areas such as health and safety, infection control and moving and handling and are expected to ensure residents are assessed and staff trained in these areas. A designated training room is available. Some staff are due to update their core training and dates were seen for the next courses being held. A minority of staff have not had updated training within the recommended period. As advised in their contract they are aware that this is a requirement of their role and action is taken where there is non compliance. Records show that staff are properly recruited and have the knowledge and attitude necessary to care for older people. Qualification documentation is checked together with evidence of current nursing registration. Evidence from others is obtained to check previous employment history, this needs to be extended to include written verification of the reason for leaving any previous work with vulnerable people. The organisation recently changed the application form with the medical declaration of the applicant’s fitness to work now an attachment, in respect of recent recruitment this attachment had not been included. Staff have contracts of employment and receive copies of the General Social Care Council code of conduct. Staff, volunteers and visiting personnel such as the hairdresser and chiropodist have satisfactory criminal records bureau certificates. Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36,37 & 38 Residents benefit from a clear management and organisational structure which recognises the expectations of older people needing nursing care. EVIDENCE: Residents can be assured that the staff structure of the home provides clear designated responsibilities for overall and task specific management. Those staff in positions of responsibility have the experience and qualifications necessary for their roles including a registered nurse status or NVQ 3. The organisational structure gives upper lines of accountability with the General Manager holding direct day-to-day responsibility for Halliwell. Comment was heard that since her employment commenced, the General Manager has built up a strong team who were working effectively. Staff were clear that the final judgment over day to day matters were those of the Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 Page 20 General Manager, but within this structure held areas of designated responsibility such as heath and safety, tissue viability and falls management.. Staff responded to the opportunities to take these responsibilities and the freedom to use their initiative to provide a good service. All staff are expected to work in a professional manner, action will be taken where performance does not meet expected standards Quality assurance is taken seriously with formal and informal mechanisms for obtaining the opinion of users of the service, professionals and associated personnel. Monthly visits by a representative of the organisation take place with a report produced. Results of the quality assurance process are published and summarised in information for residents. Regular meetings are held including residents meetings, staff and Heads of Department. Minutes of such meetings are available as necessary. Residents and family are advised of inspections by the commission and aware they can meet with the inspector and make written comment. The General Manager is regularly available, the clinical care manager will hold responsibility to ensure residents and family have a point of contact within the management structure. Organisational changes have recently been made to ensure the continued viability, financial support and investment into services. Systems are in place for residents to have money held safely if they wish with records maintained. As one person holds sole responsibility for overseeing this account it is strongly recommended that the organisation puts audit practices into place. Proper insurance cover is taken out to protect residents and staff, correct detail will be recorded in the welcome handbook. Staff receive regular supervision from the NVQ coordinator. They felt supervision offered an opportunity to express any concerns and for suggestions to be made as to possible action, they considered that supervision was more a supportive rather than directive approach. Staff said they felt well supported by their team leaders but had less confidence in a minority of the ‘sisters’. The administrator has worked hard to update and restructure records to ensure they meet regulatory requirements and are presented in a professional manner. Residents are aware that they have the right to see information held about them, although few choose to do so. Records maintain confidentiality and the principles of data protection. The safety of residents, staff and visitors is respected and promoted through good health and safety practices. Risks from fire are reduced through recorded monitoring of fire safety systems and staff training. A minority of staff, mainly bank staff, have not attended a recent fire drill. As mentioned staff who do not attend mandatory training are subject to management action. The moving and handling coordinator showed enthusiasm for her role and a Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 Page 21 wish to ensure residents are safe, and as far as possible at ease, when using moving and handling equipment. Regular servicing of equipment and a responsive approach to deficits provides residents with a comfortable and safe place to live. Relevant legislation is complied with and policy statements are available to all staff. Accidents and incidents are recorded properly and notified to the appropriate bodies where necessary. An evacuation procedure has been set up with systems to offer protection in situations of high risk. Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 2 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 3 2 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 3 2 3 3 3 Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 Page 23 NO Are there any outstanding requirements from the last inspection? 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 OP3.1 Regulation 14 (1) (d) Requirement As set up during the inspection, a letter to say that following assessment the home can meet need must also be sent to residents on short term placements. When recruiting staff, written verification must be obtained of the reason for leaving any previous work with vulnerable people. All staff must have written declaration that they are mentally and physically fit for the work they are to perform As scheduled, all staff must attend regular fire drills and practices at intervals as recommended by the fire safety officer being 3 months for night staff and six months for day staff. This will include bank staff. Timescale for action From 30 September 2005 and thereafter From 30 September 2005 and thereafter From 30 September 2005 and thereafter By 31 October 2005 and thereafter 2. OP29.1 17 (2) 3. OP29.1 19 (1) Schedule 2 23 (4) (e) 4. OP30.1 OP38.2 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 Page 24 Halliwell Nursing Home 1. Standard OP7 2. 3. OP9.2 OP9.3 4. 5. 6. 7. OP9.4 OP15.7 OP21.5 OP35.1 As further development to ensure personal and consistent care is provided, greater use of how care is to provided, better personalisation of care directives and reliably incorporating information from diary notes should be carried out. A documented risk assessment should be put in place for all service users who undertake to self-administer medication. There should be complete records to ensure that all medication is accountable with clear records of the dose and time “when required” medication is administered and clear guidance for administration to ensure consistent care is provided. All medication in the home should be stored securely. Any changes to the menu should be made known to residents before they are provided with the meal/s. A washbasin should be provided in each en-suite facility. This remains a recommendation from previous inspections. Whilst there is every indication that residents’ monies are maintained accurately, it is strongly recommended that audit procedures be put in place in respect of monies held on behalf of residents. Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 Halliwell Nursing Home H56-H06 S64706 Halliwell V240382 130905 Stage 4.doc Version 1.40 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!