Inspection on 09/12/05 for Harnham Croft Nursing Home

This inspection was carried out on 9th December 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

Harnham Croft Nursing Home 14/09/07

Harnham Croft Nursing Home 24/06/05

Harnham Croft Nursing Home 10/01/05

Harnham Croft Nursing Home 13/07/04

Harnham Croft Nursing Home 12/03/04

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

CARE HOMES FOR OLDER PEOPLE Harnham Croft Nursing Home 76 Harnham Road Salisbury Wiltshire SP2 8JN Lead Inspector Susie Stratton Unannounced Inspection 9:15 9 December 2005 th 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 Harnham Croft Nursing Home DS0000015915.V269007.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. Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Harnham Croft Nursing Home Address 76 Harnham Road Salisbury Wiltshire SP2 8JN 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) 01722 327623 01722 334983 BUPA Care Homes (CFC Homes) Limited Mrs Nicola Maguire Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44), Physical disability (4), Terminally ill (4), of places Terminally ill over 65 years of age (4) Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The maximum number of service users who may be accommodated in the home at any one time is 44. No more than 4 service users between the ages of 18 - 65 years with a physical disability may be accommodated at any one time. No more than 4 service users with a terminal illness may be accommodated at any one time The staffing levels set out in the Notice of Decision dated 31 March 2005 must be met at all times. 24th June 2005 Date of last inspection Brief Description of the Service: Harnham Croft Nursing Home was first registered as a nursing home in 1947; it was renovated and extended in 1978, 1989, 1993 and a further extensive renovation was completed in 2003. The original building was built in 1898. Accommodation is provided over 3 floors and the grounds extend down to the River Nadder, with views looking towards Salisbury Cathedral. The home is registered to care for 44 persons. At the time of the inspection, there were 32 persons resident in the home. The home is owned by BUPA, a national provider of care homes. The manager of Harnham Croft is Mrs Nicky Maguire, she is supported by a deputy and leads a team of registered nursing and care staff. An activities organiser and a team of ancillary and administrative staff are also employed. The home is situated on the main road in Harnham, which is on the outskirts of the city of Salisbury, about a mile from the city centre and three quarters of a mile from Salisbury District Hospital. There is a bus stop immediately outside the entrance and ample parking is available on site. Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on Friday, 9th December 2005 between 9:15am and 3:30pm, in the presence of Mrs Niccy Maguire, registered manager. During the inspection, the Inspector met with thirteen residents and observed care for eleven residents who were unable to communicate. The Inspector met with the deputy manager, the activities coordinator, the administrator, two registered nurses, four carers, the senior housekeeper and a domestic, as well as touring the building. The Inspector reviewed among other areas, documentation relating to nine residents, including one newly admitted resident, three newly appointed staff files, medication records and storage, the fire log book, training records and complaints records. What the service does well: What has improved since the last inspection? The one requirement has been addressed and the four good practice recommendations are addressed or in progress. Where residents are prescribed oxygen, relevant signage is placed on the door of their room and the cylinders are always fully secured. All nursing and care assessments are made in writing and dated and signed by the person drawing up the assessment. BUPA is reported to be reviewing its falls risk assessment, to include an assessment of the resident’s footwear. A procedure on crossgender care has been drawn up. A copy of the up-dated Health Protection Agency guidelines had been ordered. Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 Page 6 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. Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 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 Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4 & 5. Harnham Croft does not offer intermediate care. All residents are issued with a contract and terms and conditions. Residents have full nursing and care assessments performed prior to admission. The home were able to meet the needs of persons resident in the home. Preadmission visiting is supported. EVIDENCE: The recently admitted resident had been issued with terms and conditions and a contract, which their representative had signed. Harnham Croft uses a standard contract and terms and conditions which is used across all BUPA homes. One person recently admitted to the home had a very detailed preadmission assessment performed by the manager. The assessment was clear and included all relevant matters relating to the individual’s nursing and care had been included. The resident reported that they had found it helpful to meet with Mrs Maguire and ask questions about the home before deciding to be admitted. Many of the residents said that they had been too unwell to visit the home prior to admission but that one of their relatives had visited on their behalf. One person said that they had lived close to the home for many years and knew it well and so it seemed the obvious choice when they needed to go into a home. Discussions with residents, observations of care, discussions with Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 Page 9 staff and reviews of notes showed that the home were able to meet the nursing and care needs of residents. Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 11 Residents are generally protected by clear care plans. Residents who are at risk of pressure damage may be put at risk by not having care plans in place to direct staff on how to reduce risk. Some residents may also be put at risk by not having their assessments reviewed promptly when their conditions change. Residents need to have their bowel habits monitored properly, to ensure that their individual needs are being met. Frail and dying residents have their nursing and care needs met. There are safe systems in place for the management of medicines. EVIDENCE: All residents have full and detailed care plans completed. Senior care staff are now involved in completing daily records of care and will become involved in evaluating care plans. All residents have very clear and detailed night care plans, these direct nursing and care individually for each resident. All residents are assessed for manual handling needs and care plans are put in place to direct staff on how to meet these needs. Where residents are assessed as being at nutritional risk, they have care plans in place to direct staff on how risk is to be reduced. Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 Page 11 Residents are assessed for risk of pressure damage, however they do not have care plans in place to direct staff on how risk of pressure damage is to be reduced and although equipment and systems were available in the home to prevent risk of pressure damage to residents, the home cannot show that they were meeting residents’ needs in an individualised and consistent manner. Some care plans had been up-dated when the residents’ condition changed, but this was not happening for all residents. One resident’s condition had deteriorated recently and they now spent most of their time in bed, their assessments and care plans did not reflect this. This was particularly in relation to assessments for risk of pressure damage, where their risk was documented as being much lower than it actually was, now they were much frailer. Residents who have wounds have very clear records relating to their management. Progress of the wounds to treatment programmes is fully documented. Where residents have minor wounds, staff showed a good verbal knowledge of the wound, however they were not documented in the same manner as more complex wounds. Several residents have care plans in place relating to the management of their bowel care. The home has a system for documenting residents’ bowel movements, but the records are not consistently completed and as many of the residents would not be able to inform staff of their bowel movements, where residents have care plans relating to bowel care, these records must be completed, so that staff can ensure that residents are comfortable. Residents had clear care plans about meeting their continence needs, which are easy for staff to follow and review the residents’ progress. One resident has a care plan relating to intermittent catheterisation which would benefit from more detail relating to how often the procedure is needed and the type of catheter to be used. One resident had recently been catheterised and while the consent of the resident and GP had been obtained, the clinical indicator for catheterisation was not clearly documented in their notes. Frail residents looked comfortable, with clean fingernails, brushed hair and clean bed linen. Frequent care charts were used to ensure that they were turned and offered fluids and meals regularly. These charts were all regularly completed in full. One frail resident’s care plan stated the position which they needed to be placed in their bed in technical language and the care plan would be more approachable to their representative if standard, non medical language was used. Staff were observed to chat supportively to one of the very frail residents, calling them by their own name and encouraging them to answer simple questions and chat. It was discussed that frail and dying residents would be further supported by the drawing up of end of life care plans with them and their representatives. Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 Page 12 All medicines were safely stored and full records maintained. The home has set up a system for disposal of medicines, which conforms to recent legislative changes. Some residents have care plans in place which assist in monitoring the effectiveness of their medication regimes, this is particularly for night care plans which document night sedation used. Some residents, including those prescribed mood altering drugs, did not have care plans about their medication and it is advisable that such care plans are introduced so as to assist staff in monitoring the effectiveness of such medication. Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 14 & 15 Residents are offered a flexible activities programme. Residents are supported in remaining contact with relatives and others in the local community. Choice is encouraged, to ensure that residents have as much control over their lives as possible. Residents are offered a well-balanced diet in pleasing surroundings, with support available for frail residents. EVIDENCE: Harnham Croft has an activities programme in place, which residents can attend if they want to. A range of activities had been planned for the Christmas period. An external group had recently put on a pantomime of Cinderella in the main sitting room, which several residents said they had enjoyed. The activities coordinator also visits frail residents in their rooms to provide individual support. She showed a flexible approach to activities provision and was prepared to change the schedule of activities to meet the individual and changing needs of residents. Residents all said how their relatives were able to visit the home at any time. They also said that the home supported them in going out with their relatives when they wanted to. Some residents said that they knew their relatives would be welcomed into the home at Christmas time, others said that they would be going out with their relatives for the day. Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 Page 14 Relatives are supported in making choices. On a cold winters day it was observed that all residents, apart from one who had decided to get up, had decided to remain in bed on the top floor of the home and that this had been respected by staff. One frail resident said that they regarded getting up before 10:00am as “far too early” and that staff understood this. Residents said that they could choose when they went to bed, one said “I like to go early in this cold weather and staff always let me.” Residents said it was up to them whether they go down to meals or ate in their own rooms. One resident said that they were aware that staff came in regularly to check on them during the night and that they appreciated how quiet and careful staff were, to ensure that they were not disturbed in their sleep. Less frail residents who did not want to have their condition checked during the night said that this was respected by staff. Mealtimes are well organised. The chef is happy to meet with residents to discuss their individual needs and preferences, many of the residents spoken with knew him by his first name. One resident said that the home made “lovely” porridge, another said “I very much like the breakfasts”, another described the food as “very, very good” and another as “absolutely first class”. The atmosphere in the dining room was similar to that of a hotel, with attractive tablecloths, napkins, cutlery and crockery. A choice of drinks is provided, including beer and wine, all are offered in attractive glasses. The mealtime was leisurely, with residents being supported in taking their time and making it a social occasion. Residents who do not wish to eat in the dining room are provided with their meals in a timely manner and the kitchen assistant was observed to help residents with cutting up meals and describing what was where on the plate for residents who had visual problems. Staff were available to support residents who needed assistance to eat their meals. Staff were observed to sit with such residents, helping them and encouraging them to eat. Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Harnham Croft has a complaints procedure, which works in practice. The home has systems in place to ensure that vulnerable adults are protected from abuse. EVIDENCE: Harnham Croft has a complaints policy, which is displayed and made available to all residents in the service users’ guide. A central complaints file is maintained, this is analysed monthly. A review of the file showed that all matters, including small concerns are documented. Records show that all issues raised are fully investigated, in accordance with BUPA’s polices and procedures. Residents said that they knew who to raise issues with. One resident said that they spoke to the “older ones” and that they were “very good” at sorting things out. Another said that they would not raise any concerns directly themselves, but that their family were always happy to do so on their behalf and that they knew that they were always listened to. The deputy manager had recently attended vulnerable adults training and had then cascaded it on to all the staff during daily report. A review of the home’s file showed that they had recently taken action to protect a resident in relation to issues not directly relating to the home. All residents who need restraints such as safety rails have documentation, which is regularly reviewed, in relation to this. Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 29, 21, 22, 23, 24 & 26 Harnham Croft is well maintained. There are spacious communal rooms and bedrooms. A range of sanitary facilities are provided on each floor. Equipment to support disabled persons is provided. All rooms are clean, attractive and fully furnished. EVIDENCE: Harnham Croft is well-maintained. The maintenance man is on site during the day and able to respond quickly when issues are identified. There is a large lounge on the ground floor, this offers access onto a terrace, with views over the river Nadder and Salisbury Cathedral. The dining room is also spacious. The front entrance is provided with seating and some residents and visitors like to sit there too. The grounds are well maintained. A range of wcs and bathrooms are provided for residents, all have relevant equipment to support disabled persons. Most rooms are large and all have en-suite facilities. Some rooms have views looking towards the water meadows and Salisbury Cathedral, the rooms which look towards the main road are screened by trees. Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 Page 17 All relevant equipment for disabled persons is in place. A range of hoists to support staff in moving disabled persons are provided. All residents with complex manual handling care needs are nursed in foot-pedal or electrically operated variable height beds. All residents had been left with access to the call bell system. One resident said staff were “very prompt” when they rang their bell, another said that staff were “variable” in their response according to how many other residents had called at the time, but that they were always “very helpful” when they came. Staff response times when call balls are activated are monitored, to ensure that staff attend in a timely manner. Low airloss mattresses are provided to residents who are at risk of pressure damage. The dial on one resident’s low airloss mattress did not relate to their weight. The dials of all electrically operated mattresses should be regularly checked to ensure that they remain set at the correct position for that resident. The home was clean throughout. Clinical waste was properly disposed of. There are safe systems for the laundering of potentially infected laundry, which the laundress reported that staff conform to. There is an ample supply of gloves and dressing packs for aseptic procedure, which staff said that they used, when performing clinical dressings and catheterisations. Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 & 30 Harnham Croft are generally staffing the home as required by the Commission. Training is supported and residents are protected by a safe staff recruitment system. EVIDENCE: Harnham Croft is required to staff the home in accordance with a Condition of Registration set out by the Commission. They were meeting the requirements of this Condition. On occasions since the last inspection, where the home have had problems with complying with their minimum staffing levels, due to sudden sickness, the home always informs the Commission and outlines how residents have been protected. A range of nursing, care and ancillary staff are in post. Some staff have been in post for a considerable period of time and form a core of staff who know the home and its systems well, this supports newer staff. The home continues to use agency staff to cover some shifts, the deputy manager reported that as much as possible they book the same agency staff. On the day of the inspection, there was one agency staff on the late shift, they had worked in the home previously. One member of staff had also phoned in off sick at short notice and another member of staff had volunteered to work additional hours to cover the shift. Mrs Maguire reported that recruitment drives continue and that she anticipates that a registered nurse will be returning to the home, once they have completed an adaptation course. She also reported that recently the home had recently had several applications from persons who live locally and so hoped that the staffing situation would improve shortly. Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 Page 19 The deputy manager is responsible for staff training. She supports new staff through a standard induction programme which has been set up across all BUPA homes. Staff work supernumerary for their first few shifts, the amount of time they spend supernumerary depends on their past experience and individual progress while in post. A new member of staff was undertaking an induction programme on the day of the inspection, they were working supernumerary and shadowing a more senior member of staff, who was observed to be supportive to them. The deputy manager reported that she ensures that all agency registered nurses also undertake a specific induction programme, when they are to be in charge of a shift. Staff are supported in taking NVQs and additional training programmes have been put on, to support staff in caring for residents who have specific individual nursing and care needs. A training matrix is on display in the manager’s office so that she can see at a glance staff progress in meeting targets for mandatory training. The files of three recently employed staff were reviewed, these showed that standard recruitment procedures had taken place, including cv/application form, two references, a heath status check, pova and CRB check. All potential staff are interviewed using an interview assessment tool and heads of department are involved, for example a new assistant chef had recently been appointed and the senior chef had been fully involved in the interview process. Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 & 38 Harnham Croft is managed by a qualified, experienced manager who works hard to manage the home in an open manner, responding to residents, visitors and staff. BUPA regularly reviews quality of care and makes findings known to residents. Safe systems are in place for management of residents’ moneys and health and safety. EVIDENCE: Mrs Maguire is an experienced registered nurse and manager. She has completed the Managers’ award. Mrs Maguire is supported by a deputy manager. Regular staff meetings are held, these are minuted. Mrs Maguire reported that now this inspection had taken place, she would cascade the findings to all staff during the next meetings. Residents said that they met with either Mrs Maguire or her deputy regularly. Both managers reported that they tried to see all residents every day at some point. BUPA perform regular quality audits and findings are made available to residents in the service users’ guide. A satisfaction survey has recently been performed and the results of Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 Page 21 these surveys are awaited. The home will then be scored by BUPA against various performance targets and if are areas are identified, they will be asked to respond to state how these areas will be addressed. Individual managers, such as the catering manager also regularly perform their own audits. The home is visited regularly by representatives from the proprietors and reports completed. The home uses the standard BUPA invoicing system for services such as hairdressing and chiropody, all accounts are regularly audited by qualified auditors. Staff are regularly trained in all areas relating to health and safety. If staff do not attend mandatory courses, there are systems in place to ensure that they do attend in future. The fire log book is fully maintained. All equipment is regularly serviced. Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 x x 3 Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 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 13(4)(c) 15(1) Requirement Timescale for action 31/01/06 2. OP8 12(1)(a), 17(1)(a) 14(2)(b), 15(2)(c) 3. OP8 All residents who are assessed as being at risk of pressure damage must have a care plan in place to direct staff on how risk is to be reduced. Where a service user has a care 31/01/06 plan relating to bowel care needs, a record of their bowel movements must be maintained. Where a residents nursing and 31/01/06 care needs have changed, a revised assessment and care plan must be promptly completed, to reflect their changed needs. 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 OP8 Good Practice Recommendations Assessments, care plans and monitoring systems for minor wounds should be completed in the same way as for complex wounds. DS0000015915.V269007.R01.S.doc Version 5.0 Page 24 Harnham Croft Nursing Home 2. OP8 3. 4. 5. OP8 OP8 OP9 6. 7 OP11 OP22 Residents who need intermittent catheterisation should have clear details in their care plan relating to the frequency of the procedure and type(s) of catheter to be used. The actual clinical indicator for urinary catheterisation should always be documented. Non technical language should always be used in care plans. The home should develop care plans relating to residents’ medication, particularly where mood altering drugs are prescribed, so that the effectiveness of the drug treatment can be assessed. The home should develop end of life care plans for frail and dying service users. All electrically operated pressure relieving mattresses should be regularly checked to ensure that the pressure indicated on the dial relates to the service user’s weight. Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Harnham Croft Nursing Home DS0000015915.V269007.R01.S.doc Version 5.0 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. 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