Inspection on 12/01/07 for Hanbury Court Nursing Home

This inspection was carried out on 12th January 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

Hanbury Court Nursing Home 05/10/05

Hanbury Court Nursing Home 20/05/05

Hanbury Court Nursing Home 23/11/04

Hanbury Court Nursing Home 07/10/04

Hanbury Court Nursing Home 24/03/04

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

CARE HOMES FOR OLDER PEOPLE Hanbury Court Nursing Home Dagmar Road Dagenham Essex RM10 8XP Lead Inspector Ms Gwen Lording Key Unannounced Inspection 12th January 2007 10:15 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 Hanbury Court Nursing Home DS0000015592.V326750.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. Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hanbury Court Nursing Home Address Dagmar Road Dagenham Essex RM10 8XP 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) 020 8593 8000 020 8984 8914 angelcare@btinternet.com MNS Care PLC Mrs Mandy Leggate Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (41), Terminally ill (1) of places Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th October 2005 Brief Description of the Service: Hanbury Court is a purpose built care home registered to provide nursing care for 42 older people. The home is operated by MNS Care PLC. The home is in a residential area of Dagenham close to shops and public transport –buses and underground. The majority of the bedrooms are single occupancy (26 of these have en-suite facilities). There are 8 shared bedrooms. The home is wheelchair accessible and there is a passenger lift to the first floor. Eight of the beds are for people requiring intermediate care and these beds are commissioned by the London Borough of Barking and Dagenham. On the day of the inspection the range of fees for the home was between £545.00 and £583.00 per week. A copy of the Statement of Purpose and service user guide is made available to both the resident and the family. A copy of the most recent inspection report is available on request. Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken by the lead inspector, Gwen Lording. It started at 10.15am and took place over six hours. The registered manager was available throughout the visit to aid the inspection process. This was a key inspection visit in the inspection programme for 2006/2007. Discussion took place with the registered manager, several members of nursing and care staff; the cook; maintenance person; activities co-ordinator and person in charge of the laundry. Nursing and care staff were asked about the care that residents receive, and were also observed carrying out their duties. The inspector spoke to a number of residents and visiting relatives. Where possible residents were asked to give their views on the service and their experience of living in the home. A tour of the premises, including the laundry and the kitchen, was undertaken and all rooms were clean and tidy with no offensive odours present throughout. A random sample of residents’ files were case tracked, together with the examination of other staff and home records; including medication administration, staff rotas, training schedules, activity programmes, maintenance records, complaints, fire safety, accident/ incident records and staff recruitment procedures and files. Information was also taken from a preinspection questionnaire, which was completed and returned by the manager. In order to gain additional information about the quality of the service the previous lead inspector was able to attend a residents’ meeting earlier in the inspection year. More information about this meeting can be found in the main report. The inspector would like to thank the staff and residents for their input and assistance during the inspection. What the service does well: There is a relaxed atmosphere in the home and residents appeared unhurried and are given sufficient time and support in their everyday lives. The attitude and practice of the service and that of the staff working in the home, promote opportunities for residents to remain independent, exercise choice and express their wishes and needs. A great deal of consideration is given to arranging the social life of residents, including opportunities to take part in a variety of activities. The views of Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 6 residents are actively sought and considered when planning the routines of daily living and arranging activities. There is a well-developed training programme and the manager prioritises training so that staff have skills and competencies beyond basic requirements. The manager works collaboratively with outside agencies, health care professionals and local community health services to provide an increased quality of life for residents. 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. The summary of this inspection report can be made available in other formats on request. Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 3, 4, 5 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Comprehensive assessments are being undertaken for all residents prior to them moving into the home. Care Plans are drawn up from the information in this assessment, ensuring that the needs of the residents are identified, understood and met. EVIDENCE: Individual records are kept for each residents and a total of six files were examined. All records inspected have assessment information recorded and the information had been used to continue assessment following admission to the home, and develop written care plans. The records showed that residents, where capable and their relatives are involved in the assessment process. Prospective residents and their relatives/ representatives are provided with information about the home and there is always the opportunity to visit the home prior to making any decision to move in. Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 9 The Care Homes Regulations 2001 have been amended with effect from the 1st September 2006, for new residents, and for existing residents with effect from the 1st October 2006, so that more comprehensive information is to be included in the service users’ guide. Details of information to be included are contained within the amended regulations. Therefore, the service user guide must be reviewed and amended by the stated timescales. The manager was also provided with a copy of the Commission’s ‘Policy and Guidance on Provision of Fees Information by Care Homes’. The London Borough of Barking and Dagenham currently commissions eight beds in the home for the provision of intermediate care. There are specific facilities and staff to provide input into the rehabilitation of these service users, and a community Consultant Psycho-Geriatrician oversees the rehabilitation process. The maximum placement is six weeks but the majority of service users stay is between 3-4 weeks. Approximately 85 of service users placed for intermediate care are discharged back to their own homes. Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9, 10 & 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health, personal care and social care needs are set out in individual care plans and provide staff with the information they need to satisfactorily identify and meet residents’ needs. All residents could be assured that at the time of their death, staff would treat them and their family with care, sensitivity and respect. There are clear medication policies and procedures to follow. However, there are some inconsistencies in the management of medication, which may result in unsafe practices. EVIDENCE: A total of six residents were case tracked, three on each floor, and their care plans and related documentation inspected. Care plans are being used as working tools. All residents had comprehensive care plans, which covered health and personal care needs, including control of infection and care of indwelling catheters. There was evidence that care plans were being reviewed Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 11 at least monthly and updated to reflect changing needs. As far as possible, residents’ and/ or their relatives are involved in the drawing up of their care plan. The documentation/ health records relating to wound management; a resident with diabetes; and a recently admitted resident, were examined. The records for these residents were found to be detailed and being adequately maintained. Risk assessments are routinely undertaken on admission for all residents around nutrition, manual handling, continence, falls and pressure sore prevention; and reviewed on a regular basis. Records are maintained of nutrition, including weight gain or loss with appropriate action being taken where necessary. Records indicated that residents are seen by other health professionals such as tissue viability nurse and diabetic nurse specialists; speech and language therapist; optical, dental and chiropody services. The home is able to meet the needs of people requiring palliative care and works closely with a nearby Hospice. The registered manager has expressed an interest in implementing the Liverpool Care Pathway (LCP) for the Dying Patient and has arranged a meeting with the co-ordinator for the North East London Cancer Network. This transfers the hospice model of care into other settings and has been used effectively in care homes. There was no evidence of ‘End of Life’ care plans and the importance of developing these was discussed with the manager, during the inspection. However, from discussions with staff and viewing letters received from relatives, it was apparent that staff dealt with a person’s dying and death in a sensitive and understanding manner, both for the individual and relatives. One relative had written: “Thank you for making our Mum’s last days as comfortable as possible”. Another had written: “We know Mum could be difficult at times, but she appreciated all the help and care and was so well looked after for many years”. Nutritional screening is routinely undertaken and records are maintained of nutrition including weight loss or gain with appropriate action being taken where necessary. A number of monitoring charts were examined including blood sugar monitoring, turning charts and fluid intake/ output monitoring charts. The majority of these were found to be in good order. However, a small number of fluid charts were being completed retrospectively by care staff. For example, at 12.00 hours on the day of the inspection the last recorded entry on some charts was 08.00 hours. It is essential that all monitoring charts are maintained accurately and up to date. There are policies and procedures for the handling and recording of medicines. An audit was undertaken of the management of medicines within the home Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 12 and a random sample of Medication Administration Records (MAR) charts were examined. The following issues were discussed with the manager: • All hand written entries on MAR charts must be signed and dated by the person making the entry. The entry must also include the source of the information. It was noted that insulin in current use was being stored in the medicine fridge. In accordance with directions and the product licence, some insulin preparations in current use must be stored at room temperature. This was confirmed by the inspector and the nurse in charge reading the ‘pharmaceutical information’ regarding storage as included with the product. • The registered manager was given a copy of the Medical Advice Alert (MDA/2006/066) issued by the Medicines and Healthcare Products Regulatory Agency (MHRA) on Lancing Devices used in nursing and care homes for blood glucose monitoring. She confirmed that she had already received a copy of this alert and had taken the appropriate action. Staff talked about and were observed to treat residents in a respectful and sensitive manner. They were seen to be very gentle when undertaking moving and handling tasks and offered explanation and reassurance throughout the activity. Several residents were asked about the care they receive in the home. Comments included: “ There is a lovely atmosphere and everyone is so friendly”. Another said: “Kind and caring staff- nothing’s too much trouble”. Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 13 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): Standards 12, 13, 14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The lifestyle within the home matches the expectations and preferences of residents. The attitude and practice of the service and that of the staff working in the home, promote opportunities for residents to remain independent, exercise choice and express their wishes and needs. Visiting times are flexible and people are made to feel welcome in the home so that residents are able to maintain contact with their family and friends. EVIDENCE: The home employs a full time activity co-ordinator and she is viewed as a valued member of the staff team. There is a general programme of planned activities available for all residents and regular visits by professional entertainers. There is a variety of small and large group activities and the activity co-ordinator takes into account the needs, preferences, expectations and capabilities of all residents in the home by arranging activities suited to individual’s interests. Quizzes are very popular as are the cooking sessions were residents are able to help prepare cakes and other baked items. Relatives and friends are encouraged and welcomed to be involved in special events in Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 14 the home such as the annual summer barbeque and Christmas party, so that residents are able to maintain contact with their family and friends. Each resident has a social care plan, which details their interests/ hobbies, and this is reviewed monthly. Recent successful activities have included a Christmas quiz with buffet, involving teams of staff, relatives and residents. A fashion show was put on by staff dressing up in appropriate fashions dating from 1920’s through to 1990’s, which was accompanied by a piece of music relevant to the era. Relatives/ friends are encouraged to visit the home and there are no restrictions on when people can visit. Visiting can be undertaken in the lounges or in the privacy of the resident’s room. The inspector observed members of staff allowing time for residents to express their wishes and supporting individuals to make choices in their daily lives, for example choosing a drink, newspaper, or where they wished to eat their meal. The serving of the lunchtime meal was observed and provided residents with an appealing, varied and nutritious meal. Residents can choose to eat in a dining room, lounge/ dining room or in their rooms. Staff were seen to offer assistance where necessary and this was done discreetly and individually. Pureed meals were presented in an attractive and appealing manner and residents who required assistance were not hurried. A visit was made to the kitchen and the inspector discussed the storage and preparation of food and menus with the cook. She was aware of those residents requiring special diets for example, diabetic and gluten free diets; and was very much aware of individual’s preferences. There was a range of choices available each day, for example at breakfast and included cooked breakfast, porridge, cereals and grapefruit. There is little reliance on tinned, processed or frozen foods and fresh fruit is available each day. Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 15 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): Standards 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and staff make every effort to sort out any problems or concerns and make sure that residents and their relatives feel confident that their complaints and concerns are listened to and will be acted upon. Staff working in the home have received training in adult protection/ abuse awareness to ensure that there is a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has a written complaints policy/ procedure and the complaints log inspected indicated the number of complaints and issues of concern received and included details of investigation, action taken to resolve them and the outcome for the complainant. All complaints are recorded whether formal written or verbal expressions of concern. Those residents spoken to were aware of how to complain and to whom. There is an in house training programme for all staff in adult protection/ abuse awareness and this is included in the induction programme. Those staff spoken to during the inspection were aware of the action to be taken if they had concerns about the safety and welfare of residents. Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 16 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): Standards 19, 20, 22, 24 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The concerns around the storage of aids and equipment, including wheelchairs impacts upon the assessed judgement on this group of standards. The overall atmosphere in the home is very welcoming and the communal areas of the home are comfortable and clean. There is an ongoing refurbishment programme for the home and this must be progressed to ensure that all parts of the home are well maintained. However, storage within the home is a major problem which could impact upon on staff and residents if the manager does not continually review storage arrangements. EVIDENCE: The building was toured by the inspector, accompanied by the manager, at the start of the visit, and all areas were visited later during the day. Some bedrooms were seen either by invitation of the residents, whilst others were seen because the doors were open or being cleaned. All of the bedrooms seen Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 17 were very personalised and were representative of the occupant’s interests. There is a call alarm system fitted to each bedroom, and is located within easy reach of each resident’s bed. There were no offensive odours and the home was clean and tidy. Whilst the standard of the décor, furnishings and fittings are generally being maintained to a good standard, some of the carpets in the communal areas, including hallways and stairs, need deep cleaning or replacing. In discussion with the manager it was evident that there is a planned refurbishment programme for the home, which includes replacement of carpets and lounge chairs. This must be progressed to ensure that all parts of the home are well maintained and provide people living in the home with comfortable surroundings that meet their needs. Storage is a major problem throughout the home and this was discussed with the manager who has since made arrangements for the storage of nutritional supplements and enteral feeds to be re-located to a storage cupboard near the kitchen. Aids and equipment that are surplus to requirements have also been returned to medical loans. This will now free up space in individual bedrooms and communal areas. The registered manager must continue to ensure that the issue of storage is kept under review. The laundry area was visited and this was found to be clean, with soiled articles, clothing and foul linen being appropriately stored, pending washing. Laundry staff were aware of health and safety regulations with regard to handling and storage of chemicals. Personal Protective Equipment (PPE) such as clothing, gloves, mask and goggles were available and in use. Hand washing facilities are prominently sited and staff were observed to be practising an adequate standard of hand hygiene. Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staffing levels are satisfactory and residents benefit from a committed staff team who have the skills, training and competence to meet the individual assessed needs of residents. The procedures for the recruitment of staff are robust and provide safeguards for the protection of residents. EVIDENCE: Staff rotas were inspected and the staffing levels and skill mix of qualified nurses and care staff was sufficient to meet the assessed nursing and personal care needs of residents. Care workers were being effectively deployed to ensure that residents’ choosing, or needing to remain in their bedrooms were being cared for appropriately. Hanbury Court has a relatively stable workforce and effective team working was observed and evidenced throughout the inspection. Staff interacted well, both with each other and the residents. A random sample of the files of the three most recently appointed staff were examined. These were found to be in good order with necessary references, Criminal Record Bureau (CRB) disclosures, and application forms duly Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 19 completed. It was evident that the recruitment procedures are robust and in accordance with the Care Homes Regulations. From talking to staff and inspecting training records it was evident that nurses and care staff have undertaken a wide variety of training, and that such training is then put into practice within the home to the benefit of residents. Records showed that staff had undertaken training in essential areas such as fire safety, manual handling, protection of vulnerable adults and first aid. Other staff have undertaken training in understanding dementia, principles of care and bereavement. A number of key staff have undertaken a course in Palliative Care run by St Francis Hospice, and qualified nursing staff have undertaken, and been assessed as competent to undertaken intravenous cannulation and phlebotomy. This means that where appropriate, residents can have blood samples taken by nurses qualified to do so, and avoid unnecessary trips to hospital. In addition qualified nurse are able to manage the administration of sub-cutaneous fluids to residents, when prescribed and monitored by the GP. The pre-inspection questionnaire completed by the manager states that 67 of care staff are qualified to NVQ level 2 or above. Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33, 35, 36, 37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager of the home is a well qualified and experienced person and residents benefit as the home is run in their best interests. Monitoring visits are undertaken regularly by the responsible individual to monitor and report on the quality of the service being provided in the home. EVIDENCE: All staff spoken to throughout the visit, both care and departmental staff, spoke positively about how well supported they felt by the manager. Staff receive regular 1:1 supervision, direct observation of care practices and staff group meetings. Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 21 Mrs Leggate has developed positive contacts with external agencies and works collaboratively with healthcare professionals and local community health services. This has enabled residents with changing and increased health care needs to remain living at Hanbury Court, and this is avoiding uneccessary hospital admissions. The responsible individual undertakes Regulation 26 monitoring visits on a monthly basis to monitor and report on the quality of the service being provided in the home. A copy of the report is sent to the Commission. As part of the inspection process the previous lead inspector was able to attend a residents meeting. Meetings are held regularly and this meeting was chaired by the activities co-ordinator. Several residents did not wish to attend the meeting, as they wished to remain in their rooms. However, they like to hear what has been discussed and the activity co-ordinator feedbacks to them after the meeting. The main focus of discussions was around food and suggestions for planned activities, such as outside trips. Currently the manager does not act as an appointed agent for any resident. Residents’ financial affairs are managed by their relatives/ representatives. The home has responsibility for the personal allowance of several residents. Through discussion with the administrator and records inspected, there was evidence to show that residents’ financial interests are safeguarded. Secure facilities are provided for the safekeeping of money and valuables held on behalf of residents. A wide range of records looked at including, fire safety, emergency lighting, water temperatures checks, accident/ incident records, and lift/ hoist maintenance. These records were found to be detailed, up to date and accurate. Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X 3 3 3 3 Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP8 Regulation 12 Requirement Timescale for action 12/01/07 2. OP9 13 3. OP9 13 4. OP19 16 & 23 The registered manager must ensure that where the record of fluid intake/ output is indicated for a resident, that these recordings are accurately maintained and up to date. The registered manager must 12/01/07 ensure that all hand written entries on Medication Administration Record (MAR) charts are signed and dated by the person making the entry and include the source of the information. The registered manager must 12/01/07 ensure that where indicated, insulin in current use is stored at room temperature, in accordance with the product license. The registered persons must 31/03/07 ensure that the refurbishment programme for the home is progressed to ensure that all parts of the home are well maintained. Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 24 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 Standard Good Practice Recommendations Hanbury Court Nursing Home DS0000015592.V326750.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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. 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