Inspection on 20/09/05 for Hamilton Lodge Nursing Home

This inspection was carried out on 20th September 2005.

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

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

Other inspections for this house

Hamilton Lodge Nursing Home 23/08/06

Hamilton Lodge Nursing Home 13/03/06

Hamilton Lodge Nursing Home 01/11/04

Hamilton Lodge Nursing Home 11/06/04

Hamilton Lodge Nursing Home 02/04/04

Hamilton Lodge Nursing Home 16/01/04

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

CARE HOMES FOR OLDER PEOPLE Hamilton Lodge Nursing Home Hamilton Lodge 36 Honor Oak Road Forest Hill London SE23 3RZ Lead Inspector Ms Rehema Russell Unannounced Inspection 09:30 20 & 21 September 2005 th st 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 Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 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. Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hamilton Lodge Nursing Home Address Hamilton Lodge 36 Honor Oak Road Forest Hill London SE23 3RZ 020 8699 6080 020 8699 2074 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) Coles Healthcare Limited Mrs Patricia Jenkins Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (40) of places Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 40 patients, frail elderly persons aged 60 years and above (female) and 65 years and above (male), and chronic sick persons aged 40 years and above 1st November 2004 Date of last inspection Brief Description of the Service: Hamilton Lodge is a care home providing nursing and residential care for up to 40 older men and women. It occupies a nineteenth century building that has four floors. There are 22 single and 9 double bedrooms. The first three floors are used for resident accommodation and are accessible by lift. The top floor is used for office space. There is a large sloping back garden and a large sun terrace which is being updated for resident use. There is off street parking on the forecourt to the front of the building. The home is situated in a residential area. It is on a bus route which is a few stops from a local shopping centre that has library and rail facilities. Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over two days, and was conducted by the lead inspector and the pharmacist inspector. There was a new registered manager at the home and several new nursing staff. At the time of the inspection there were 32 residents at the home and 7 vacancies (one previous double room is now being used as a single only). The inspectors spoke with the manager, nursing and care staff, several residents and visiting relatives, looked at documentation and records and toured the communal areas of the home. What the service does well: 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. Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 Page 6 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 Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 Page 7 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): 1,3 and 6 The Statement of Purpose meets requirements. No resident moves into the home without having had his/her needs assessed by a person qualified to do so. EVIDENCE: There was a requirement from the previous inspection report for the Statement of Purpose to be updated to include all of the items listed in Schedule 1 of The Care Homes Regulations 2001. This had been done. The home’s assessment procedure was checked on four resident files. Each had a health and social care assessment which covered physical conditions as well as awareness orientation, moods/concerns/anxieties, daily living skills, spiritual/religious needs, family and significant relationships, and social and leisure interests. The manager of the home, who is a qualified nurse, usually carries out the assessment or a senior nurse if the manager is not available. Residents are not accepted unless the home is confident that their needs can be met. An example was given of a refused placement due to the need for higher registered nurse cover than the home was able to provide. Evidence was also seen of the home obtaining the placing authorities’ care assessment Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 Page 8 of needs prior to admission or as soon after as possible. It is recommended that at admission, or a later stage, information is also obtained about the resident’s life history so that this can also inform the care and activities provided at the home. One of the front sheets of a resident file listed two medical conditions, neither of which were understood by the inspector. These words had been copied from a hospital discharge notification by previous staff over two years ago, before the current manager and nursing staff were in post. None of the current nurses, the manager or the Pharmacist Inspector understood what these two conditions were. The Pharmacist Inspector subsequently obtained relevant information explaining these two medical terms, which will be sent to the home. The resident was spoken with later in the day and there was no evidence that he was not receiving suitable care at the home. He said that the healthcare at the home was good and that he had no problems. Records showed that the General Practitioner and various other health specialists as appropriate had visited him regularly. However, it is recommended that the home checks through all the residents’ files to ensure that any medical terms used on front sheets and other documents are relevant to the individual concerned and understood by all staff. The home does not accept placements referred solely for intermediate care, therefore Standard 6 is not applicable. Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 Residents’ health, personal and social care needs are set out in an individual plan of care and their health care needs are met. Residents are protected by the home’s policies and procedures for dealing with medicines but more able residents should be encouraged and supported to self-medicate if they wish to. EVIDENCE: Three care plans were seen. Each had between 6 and 9 areas of identified need, each area having a goal/aim, actions to be taken and an evaluation date. Evidence of regular reviews of care plans was seen. However, not all annual statutory reviews by placing authorities had been carried out. Therefore a requirement has been made for the manager to write to the authorities requesting that they fulfil this statutory obligation, retaining a copy of the letter and any responses received. Daily comments sheets are filled in for each resident at the end of both the day and night shifts. Although one comment sheet noted that the resident had had a visitor and a visit from the physiotherapist, the majority of comments related only to residents’ physical condition. Very few commented on the resident’s mood, communication, social activities or visitors on a daily basis. Although some of this information is available elsewhere, such as in the visitors book or activity records, it should Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 Page 10 be included in the comments sheets for each individual. This would ensure that the non-physical care plan needs are also evidenced and monitored, and that a holistic picture of the resident’s daily life at the home is obtained. Documentation demonstrated that the full range of health care services are accessed by the home to meet residents’ assessed needs. This includes the General Practitioner, optician, chiropodist, psychologist, psychiatrist, dentist, physiotherapist, and therapeutic care from hospitals and community health teams. Continence and tissue viability advice is sought as appropriate. It was noted that one resident had been prescribed reading glasses following an optician visit but that this was not recorded in their monthly review. A requirement has therefore been made that all and any changes to the health and social assessment of individual residents is recorded in the monthly reviews. As the home currently has two residents who have no spoken English it is also recommended that there is an interpreter present for healthcare appointments for any residents who cannot communicate in or understand English and have no alternative support. A detailed inspection of medication handling at Hamilton Lodge was conducted in June 2004, and several requirements were made. At that time the home was without a permanent Manager. These requirements were repeated in the inspection report of November 2004. At the beginning of this inspection it was noted that some of the requirements had not been actioned and an immediate requirement was left on the first day regarding Homely Remedies and an out-of-stock medication. However, the new Manager took steps over the two days of the inspections to rectify this and by the end of the inspection these requirements had been met. Medication Administration Record charts were all inspected, and recording was good. All medication items were being stored appropriately. A stock check was carried out on all controlled drugs, both quantities and recording were accurate. Some historic entries did not have the pharmacist’s signature for returns, this must always be obtained. The supplying Pharmacy is currently accepting returns but due to changes in environmental laws, they will no longer be able to do this and the home must make arrangements with their clinical waste company to get unwanted/expired medication returned. No residents were self-administering medication. Some of the more able clients should be asked whether they wish to manage their own medication to increase their independence, especially for respite clients who may have to manage their own medication on leaving the home. Receipts and returns were all recorded accurately. If any items are brought forward from the previous month, the quantities must be added to the MAR chart to enable a stock check to be carried out. This includes quantities of items for respite clients also. Temperature monitoring is carried out on the medication room and fridge. The fridge temperatures were always within limits (2-8C) but the room temperature was consistently above 25C. However, as medication is returned and new supplies obtained every month, this is acceptable. Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 Page 11 The General Practitioner log was inspected for evidence of review and monitoring. It was noted that although staff put residents names down for review the GP does not always carry out the review. This must be addressed as residents are NHS patients and need to be seen promptly whether or not the GP receives a retainer for other services. There have been some occasions where the GP writes an item on the MAR chart but does not provide the prescription on time. In one case, the item was not obtained until 12 days later, which is an unacceptable delay. Prescriptions must be left with the home in order for the exemptions to be completed before being taken to the pharmacy for dispensing. Some of the homely remedies had expired, so expiry dates must be checked at least monthly. Some items did not appear on the list authorised by the GP, one had been prescribed for a client then when no longer needed was kept as a homely remedy, this must not happen so these were removed. The home has recently been successful in its application to the Commission for permission to accept up to four residents with terminal illness. The home has therefore added a section relating to the handling of palliative care medication to the medication policy and staff have been sent on training in the use of specialist equipment for palliative care residents. Following a recent medical alert, all staff must be trained in the use of profiling beds. Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 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 and 15 Residents are supported to satisfy their social, cultural, religious and recreational interests and needs. Residents are encouraged and supported to maintain contact with family and friends. Residents are given a nutritious and balanced diet in pleasant surroundings. EVIDENCE: The home has a full time activities organiser who has devised a schedule of activities for residents. At the time of the inspection the schedule was being changed to accommodate the seasonal change from summer to autumn/winter. During the summer, residents had had the choice of participating in pottery, vegetable growing, gardening, preparing items for the summer fete, shopping trips, free massages, weekly exercise classes and visits to the theatre. The new schedule continued some of these activities and added the choice of bingo, a Halloween party, preparations for the Christmas fete, cooking and indoor games such as dominoes and cards. The activities organiser had also instigated a mobile trolley shop, from which residents can access toiletries, biscuits, chocolates, diabetic sweets and newspapers, and which residents were making good use of on the day of inspection. The home ensures that residents from minority ethnic backgrounds have access to culturally appropriate food, music and any other items of choice. The home has recently admitted a resident with no spoken or understood English Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 Page 13 and so has obtained a communication book of pictures and symbols in her language to aid communication. Her family visits regularly, the home has encouraged friends from her temple to visit and there is also a nurse who can converse to some extent with her in a mutual language. Relatives and friends are encouraged to visit residents in the home, and to take them out into the local community if both parties wish to do this. An example was given of a resident who regularly visits the local pub with relatives. The inspectors spoke with three different sets of relatives who were visiting the home. One relative commented that staff were always in the communal areas interacting with the residents. Another commented that staff treat residents well and that her relative was always well presented. Another said that “my mum gets good care, she gets stimulated by people taking to her. I didn’t want her to come into a care home but they took things slowly in her plan of care and I am impressed with the care she gets.” This relative said that if there were any problems she would speak to the manager, who “is very helpful”. There is a four weekly menu cycle which covers a range of nutritious and wellbalanced meals. The main meal is taken at lunch and is always a cooked meal with cooked options. The evening supper is usually a choice of soup or a light cooked meal. As previously mentioned, ethnic meals are provided daily for minority ethnic residents if this is their choice. This was sampled by one inspector and found to be authentic and tasty. There was evidence that choice is provided at all meals and each resident is provided with a weekly menu for both lunch and supper, on which they can indicated their choice for each meal. The main dining area is on the ground floor in an attractive room which provides a congenial setting in which to eat. Residents spoken with had no complaints about the food provided and one described it as “lovely”. Home made cakes are provided in the afternoon and each resident’s birthday is noted and celebrated. The inspector spoke with the cook and enquired about specialist diets. These are provided as required following a nutritional assessment, and it was explained that measures are taken to ensure that all meals provided at the home are suitable for diabetics. Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 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 There is a clear complaints procedure and staff ensure that complaints are listened to, taken seriously and acted upon. EVIDENCE: The complaints book was seen and evidenced that there had been only one complaint received by the home since the previous inspection (November 2004). This complaint had been suitably responded to and resolved, and no further issues had arisen. Residents and visiting relatives spoken with said that they had no complaints about the home and confirmed that they would approach the manager or a member of staff if they had any problems. A relative spoken with said that any issues raised with the manager were taken seriously and actioned. Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 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): 26 The home is clean, pleasant and hygienic. EVIDENCE: During the course of the inspection the inspectors saw the dining room, lounges, kitchen, laundry, bathrooms and toilets and several resident bedrooms. These, and all of the hallways and stairwells, were found to be clean and hygienic and no unpleasant odours were detected. Laundry facilities are sited on the ground floor off the main corridor so that soiled articles, clothing and infected linen are not carried through food areas and facilities do not intrude on residents. Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Residents’ needs are met by the numbers and skill mix of staff. Residents are protected by the home’s recruitment policies and practices. EVIDENCE: Rotas confirmed that the home has the required level of nurses and healthcare assistants on shift. There were two trained nurses on each morning and afternoon shift and one at night. There were six healthcare assistants on each morning shift, five on each afternoon shift and three at night. This ensures extra staffing at the morning peak period. The manager was quite clear that nurses were expected to undertake hands-on care for all residents, and this was observed on the days of inspection. The home employs ten Registered General Nurses, all first level, of whom two have specialist palliative care training, one has oncology training and a fourth is trained in renal dialysis. Of the current 23 healthcare assistants, seven have NVQ Level 2, two have an equivalent qualification, and nine are in the process of obtaining NVQ Level 2. Although the home has therefore not yet achieved the 50 NVQ Level 2 training target for 2005, it is well on the way to achieving/exceeding it. The staff files of the five staff who had joined the home since the previous inspection were examined and were found to be well laid out an in good order. All necessary checks had been made and required documentation obtained. Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 Page 17 There was also evidence that extra precautions in the form of a risk assessment had been taken in one instance, which is good practice. The manager has checked that the induction training received at the home meets National Training Organisation specification, as is recommended in the National Minimum Standards. She has already begun to implement the home’s training plan for staff for 2005/6 as follows. • • • • • • • eight staff had joined the NVQ programme all staff had undertaken an update on moving and handling training seven staff had begun skills for life literacy and numeracy training three staff had begun distance learning in regard to infection and contamination control three nurses had attended tissue viability training the manager had undertaken challenging behaviour training two nurses and one healthcare assistant had undertaken a palliative care course. In regard to funding and support, staff are given paid time off if the course is free, or attend in their own time if the course is costed. Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 and 38 The Manager of the home is fit to be in charge, is of good character and is able to discharge her responsibilities fully. The health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: The manager is a first level Registered General Nurse and has several years experience as both a deputy and a manager of nursing homes. In addition she is a NVQ Assessor, has a Certificate in Palliative Care and has Wound Care Management training. She is currently undertaking a qualification in management in order to fully comply with NMS guidance. There are clear lines of accountability within the home, and the manager demonstrated a comprehensive knowledge of the conditions and illnesses associated with old age, a sensitive and caring attitude and a strong commitment to meeting the needs of residents of the home. Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 Page 19 Service and maintenance reports were checked. The hoists and lifts had recently been serviced but two items need corrective action as soon as possible. Fire checks are carried out weekly and all staff have had fire safety training. A food hygiene inspection was carried out in August 2005 and all of the requirements identified have been implemented. Electricity and water testing has been carried out, with no problems found. Gas maintenance and lighting protection checks were found to be 3 months overdue at the time of the inspection and must be commissioned as a matter of urgency. An occupational therapist assessment was carried out in June 2004. A copy of the report was not available at the home but had been supplied to the Commission. This report must be located and checked to ensure that all recommendations have been addressed. The waste licence in the maintenance folder was dated 2003-4 and the home must ensure that an up to date licence is obtained. Similarly, there was a sluice/washer/disinfection certificate from 1996. Up to date maintenance certificates must be available for inspection. Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 x X X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 1 Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 Page 21 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 7 Regulation 15(2)(b) Requirement The Registered Manager must write to all appropriate placing authorities requesting that the statutory annual placement reviews are carried out. The Registered Manager must ensure that all changes to the health and social assessment of individual residents are recorded in the monthly reviews. The Registered Provider must ensure that all staff are trained in the use of profiling beds. The Registered Provider must make arrangements with the clinical waste company to accept unwanted/expired medication. The Registered Manager must ensure that the quantities of all items brought forward from the previous month are added to MAR charts to enable a stock check to be carried out. This includes quantities of items for respite clients. The Registered Provider must ensure that (i) requested GP reviews are carried out promptly and (ii) prescriptions are DS0000007023.V253531.R01.S.doc Timescale for action 30/11/05 2 8 15(2)(b) 21/09/05 3 4 8 9 12 (1)(a) 13 (2) 31/03/05 31/12/05 5 9 13 (2) 01/10/05 6 9 13 (2) 21/09/05 Hamilton Lodge Nursing Home Version 5.0 Page 22 7 9 13 (2) 8 38 23(2)(c) 9 38 23(2)(c) 10 38 23(2)(c) 11 38 23(2)(c) provided on time and (iii) prescriptions are left at the home for exemptions to be completed before being taken to the pharmacy. The Registered Manager must ensure that only homely remedies approved by the GP are used and that the expiry dates of all homely remedies are checked monthly. The Registered Provider must ensure that corrective action for the hoists and lift are carried out as a matter of urgency The Registered Provider must ensure that gas maintenance and lighting protection services are carried out as a matter of urgency The Registered Manager must ensure that any recommendations arising from the Occupational Therapy report of June 2004 have been implemented. The Registered Provider must ensure that the waste licence and the sluice/washer/disinfection certificates are up to date and available at the home. 21/09/05 30/11/05 30/11/05 30/11/05 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard 3 Good Practice Recommendations The Registered Manager should ensure that information about a resident’s life history is obtained where possible so that this can inform the care and activities provided at the home. DS0000007023.V253531.R01.S.doc Version 5.0 Page 23 Hamilton Lodge Nursing Home 2 3 The Registered Manager should ensure that any previous medical diagnoses cited for residents on the home’s internal records are still relevant to the individual and are understood by all staff. The Registered Manager should ensure that daily comments sheets record individual resident’s moods/activities/visitors etc. The Registered Manager should ensure that there is an interpreter present for healthcare appointments for any residents who cannot communicate in or understand English. The Registered Manager should ensure that more able clients are asked whether they wish to manage their own medication to increase their independence, including respite clients, and that their wishes are recorded. 3 4 7.2 8 5 9 Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH 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 Hamilton Lodge Nursing Home DS0000007023.V253531.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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