Inspection on 21/06/06 for Hay House Nursing Home

This inspection was carried out on 21st June 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hay House Nursing Home 02/11/09

Hay House Nursing Home 10/08/09

Hay House Nursing Home 24/06/09

Hay House Nursing Home 01/10/08

Hay House Nursing Home 05/11/07

Hay House Nursing Home 16/12/05

Hay House Nursing Home 26/07/05

Hay House Nursing Home 21/10/04

Hay House Nursing Home 22/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Hay House Nursing Home Hay House Nursing Home Broadclyst Exeter Devon EX5 3JL Lead Inspector Rachel Doyle Unannounced Inspection 21st June 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hay House Nursing Home DS0000043065.V293637.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. Hay House Nursing Home DS0000043065.V293637.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hay House Nursing Home Address Hay House Nursing Home Broadclyst Exeter Devon EX5 3JL 01392 461779 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) Chartbeech Ltd Rachel Somers Care Home 35 Category(ies) of Dementia - over 65 years of age (35), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (35) Hay House Nursing Home DS0000043065.V293637.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Staffing minimum as agreed with the previous registration authority 29/01/2002 and detailed in the variation of registration report of the same date, is observed. The manager, Ms Rachel Somers, must obtain the Registered Managers’ Award by 2005 There is a named Registered Mental Nurse as a lead for mental health care at the home. To admit one named person outside the categories of registration as detailed in the notice dated 5th November 2004 The maximum number of persons accommodated at the home, including the named service user, will remain at 35 On the termination of the placement of the named service user, the registered person will notify the Commission in writing and the particulars and conditions of this registration will revert to those held on the 8th November 2004. 16th December 2005 2. 3. 4. 5. 6. Date of last inspection Brief Description of the Service: Hay House is registered as a care home for 35 people, over the age of 65, with dementia or mental disorder. The building dates back to Georgian times and has beautiful views of the countryside. It is set in an elevated position between Broadclyst and Killerton. There is a 16 bedded extension attached to the home, which provides en-suite bedrooms. There are 11 bedrooms on the ground floor, 1 shared and 19 bedrooms on the first floor, 4 shared. There is a passenger lift and a wide staircase from the hall. There is one main lounge, one dining room, one smaller lounge, which is also used as a dining room, a visitors’ room and a large entrance hall. Care is provided by Registered Nurses and trained carers. The average cost of care is £492-600 per week at the time of inspection. Additional costs, not covered in the fees, include chiropody, hairdressing and personal items such as toiletries and newspapers and personal transport. Current information about the service, including CSCI reports, which are accessible, are given to prospective residents and/or their representatives. Large print format is available on request. The Home currently provides day services for one person once a week. Hay House Nursing Home DS0000043065.V293637.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector undertook this unannounced inspection over a period of approximately 6 hours. There were 33 residents (plus 1 bed being held for a resident in hospital) living at the Home at the time of the inspection. During the inspection the inspector case-tracked 3 residents, which helps us to understand the experiences of people using the service. A number of other residents were met and spoken with during the course of the day, most of these had difficulty communicating due to their mental capacity. The inspector also spent a considerable time observing the care and attention given to residents by staff. Several staff were spoken with during the day, including Registered Nurses, care staff, ancillary staff, and a representative of Chartbeech Ltd. The manager was on annual leave. The inspector was also able to discuss the inspection with the provider over the telephone the following day. Prior to the inspection surveys were sent to relatives to obtain their views of the service provided; 5 were returned. One resident survey was returned. Staff were also sent surveys, 8 were returned. Health and social care professionals were also contacted prior to the inspection including GPs, community psychiatric nurses and community care worker. Three were returned. The inspector toured the premises and a sample number of records were inspected which included care plans, medication records/procedures, staff recruitment files, service and maintenance certificates and fire safety records. The provider had completed a pre-inspection questionnaire and the inspector appreciated the preparation undertaken by them to assist with this inspection and found all staff very helpful on the day. What the service does well: The Home is run by a committed provider who is open and approachable. Residents like the staff who are kind and work hard to provide good care. The building is well maintained and provides a homely environment for residents to live in. Residents like the food provided and are supported to choose what they want to eat. Complaints are well managed and relatives feel that they can use the complaints procedure effectively. Hay House Nursing Home DS0000043065.V293637.R01.S.doc Version 5.2 Page 6 Residents are well protected by systems at the Home relating to Protection of Vulnerable Adults. When activities are provided they are well managed and residents who participate enjoy them. Health and personal care needs are well met and health professionals are accessed appropriately. What has improved since the last inspection? What they could do better: Care plans and associated records could be more informative, to better reflect residents’ needs and ensure that staff know what to do for each resident. Particular consideration must be given to stimulating and meaningful activities for residents who lack capacity to ensure that the lifestyle experienced in the home matches expectations and preferences. Staffing levels should be monitored to ensure residents’ needs are met in a timely way, including their social interests. Attention needs to be paid to some areas of health, hygiene and safety to ensure that residents are cared for in a safe environment. All residents’ rooms should include appropriate equipment such as screening and bedside lamps and tables. The garden should be made accessible to residents. Recruitment procedures and storage of monies must be made robust to protect residents. The management structure should be addressed to ensure that staff have clear leadership and support in their work to ensure consistent care. Hay House Nursing Home DS0000043065.V293637.R01.S.doc Version 5.2 Page 7 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. Hay House Nursing Home DS0000043065.V293637.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hay House Nursing Home DS0000043065.V293637.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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. The admission and assessment process is thorough and ensures that the Home is able to meet residents’ needs prior to admission. EVIDENCE: The Home has a clear and accessible Statement of Purpose and Service Users’ Guide. The manager and/or an RGN visit prospective residents in hospital or home to assess their needs and suitability for admission. The admission procedure and assessment documentation was good and residents/representatives are given enough information to enable them to make an informed choice. Residents are also able to visit the Home prior to admission to spend time there and there is a trial period following admission. The Home does not provide intermediate care. Hay House Nursing Home DS0000043065.V293637.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff have a good understanding of the health and personal care needs of residents although information should be detailed more clearly in care plans to ensure consistency. There is good evidence to show multidisciplinary working on a regular basis. Residents’ privacy and dignity are well maintained and promoted by staff at the Home. Medication administration at the Home is well managed, promoting good health. EVIDENCE: Three residents were case-tracked, which means that their care and documents were inspected fully. Their care plans were looked at. These were generally well written and the Registered General Nurses were continuing to work on improving the format. There were excellent social histories, good discussions with relatives and use of restraint measures such as bed rails. Hay House Nursing Home DS0000043065.V293637.R01.S.doc Version 5.2 Page 11 Health professional referrals were made appropriately and documented. One doctor expressed delight at one resident’s quality of life. Pressure area care and use of equipment was good as was nutritional, weight and skin assessments. Some identified issues were dated 2004/5 and some updates/reviews were not easily followed, however, most care staff were aware of residents’ needs when spoken to, although one carer was not aware of one residents’ mental health diagnosis. There is a key-worker system with staff allocated to named residents but staff said that this had not really been put into practice effectively as yet. The five relatives surveys returned were very positive with comments such as ‘the Home is always lively and friendly’, ‘residents are well looked after by wonderful staff’ and that the nurses are very good and listen’. All were satisfied with the overall care. Two GP surveys were returned. One commented ‘I am favourably impressed by the quality of care given to residents, good patient centred care and respect for individual wishes’. Residents were able to use the Home as they wished and some residents were enjoying time in both the lounges and the hall, popping into the office as they wished. Visitors are able to visit at any time. Staff were at all times seen to treat residents with respect and maintaining their privacy and dignity. Staff were able to discuss how they viewed each residents as an individual and knew their histories and likes and dislikes. Staff were obviously very caring and thoughtful in how they went about attending to residents and there was a lovely rapport between staff and residents when they interacted. Medication was inspected and records, storage and administration were all well managed. Hay House Nursing Home DS0000043065.V293637.R01.S.doc Version 5.2 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, 14, 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Home attempts to meet some residents’ social and leisure needs but improvements are needed to ensure that all residents are included on a regular basis, especially those residents who have difficulty communicating and limited capacity. Meals provide choice and daily variation in a congenial setting. Residents are encouraged to maintain their independence, exercising choice and control as able over their lives. EVIDENCE: The inspector was able to take lunch with residents, spending time in both dining rooms. The Home are now using the small lounge as a dining area for those residents who like to eat in their chairs with lap tables, maintaining independence for others. Staff were always very polite and as attentive as they could be with the current staffing levels. The menus are varied and reflect residents’ likes and dislikes. The food was very appetising and well presented. However, there were issues with the delivery (see Staffing). The Home offers various activities such as drama-therapy sessions, visiting entertainers, visiting Hay House Nursing Home DS0000043065.V293637.R01.S.doc Version 5.2 Page 13 donkey and birds of prey, visits to shows and shopping trips. Residents commented that they liked the singing and the story man, one liked everything at the Home and enjoyed getting their hair done although it was a bit noisy at times. However, activities do not always meet all residents’ social needs. Records showed that some residents did not receive effective stimulation on a regular basis, especially those residents who had difficulty communicating and were not related to information obtained in their social histories. Staff had done the best they could with current staffing levels and the lack of an organised activity plan. One staff member had been particularly pro-active in fund raising to offer various activities in the past. There are lovely views from the Home and a lovely garden and summerhouse. This is not easily accessible for residents from the house unless they are able to make their wishes known or be able to wander to the rear door some way from the living space. The Home has plans to open up a doorway from the dining room, which will allow residents to get outside or more easily make their wishes known. At present residents need to be pro-actively assisted to go outside by staff, as indicated by residents’ falls risk assessments, which means that there needs to be enough staff able to facilitate this activity. Hay House Nursing Home DS0000043065.V293637.R01.S.doc Version 5.2 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, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a robust complaints procedure and relatives feel that they can raise any issue of concern, which will be listened to and acted upon. Residents are protected from abuse as sound procedures and practice are in place. EVIDENCE: Staff were aware of Protection of Vulnerable Adult procedures and there was a clear process posted in the office for staff to follow. Regular training in this topic is undertaken by staff. Recent incidents had been well managed and communicated to the appropriate agencies and followed up well. Consent relating to any restraint measures was discussed with the multidisciplinary team and relatives. Complaints were well recorded and actioned and all relatives who responded said that they were aware of the complaints’ procedure. Hay House Nursing Home DS0000043065.V293637.R01.S.doc Version 5.2 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): 19, 24, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment is good providing residents with an attractive and homely place to live. The cleanliness and standard of hygiene is good and provides a safe environment. EVIDENCE: The environment including the large, older style building was well maintained and clean. One relative commented that the Home was kept as clean as their relative would have kept their own house. Soap, gloves and paper towels were readily available. The Home was seen to be clean and hygienic throughout and domestics deep clean residents’ rooms every 3 months. However, during the inspection a dog escaped from the office to the dining room for the latter end of lunch-time eating scraps, which is not good practice. The Home has recently bought new furniture, kitchen equipment and a re-decoration programme Hay House Nursing Home DS0000043065.V293637.R01.S.doc Version 5.2 Page 16 continues with some residents’ rooms, shower room, hall and staff toilet. Some rooms have also had new carpets. There is a homely feel. Residents’ rooms are well personalised and their property well cared for. The Provider said that privacy screening was available in all double rooms. Many rooms do not have a bedside light and some no bedside table. The Provider said that this is due to residents’ preferences or related to risk assessments but this was not recorded in care plans to indicate the reasons why not. Hay House Nursing Home DS0000043065.V293637.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The procedures for the recruitment of staff are not robust and do not consistently protect residents. Staff are not always employed in sufficient numbers to meet the needs of residents. Residents generally benefit from skilled, experienced and friendly staff who have a good understanding of their needs. EVIDENCE: Relatives commented that staff gave them a warm welcome, were knowledgeable and that staff communication with them and each other had improved. A Health Professional commented that communication with staff and themselves was good. During the inspection there were 2 Registered Nurses and 5 carers on duty, one carer had phoned in sick that morning. All staff on duty said that staff sickness, especially staff communicating this just before a shift, was an ongoing problem, sometimes leaving only 3 carers. This was said to be affecting staff morale as nurses had no time to organise last minute agency staff and lower staffing levels affected residents’ care. Staff said that when this happened, as during the inspection, residents may not all be offered elevenses or be assisted with meals in a timely way. Five residents in the small dining Hay House Nursing Home DS0000043065.V293637.R01.S.doc Version 5.2 Page 18 room had to wait for 40 minutes to be fed, whilst watching others eating at the table. Some assistance given by staff was hurried, one staff member standing over the resident, saying ‘come on’. Staff said that they had little time to sit with residents on a one to one basis or enable residents to access the garden safely but they do the best they can. One staff member did not use an effective approach to alleviate one residents’ anxiety possibly due to time. Quality and effective staff time with residents was not seen during the inspection other than task related and staff were frustrated by this and tried to organise activities when they could. Staff said that they do not have time to facilitate activities/individual time with residents on a regular basis and the Home does not have a designated activity organiser. One resident, who did not use a call bell, said that they did not see anyone for hours and the inspector observed at least 2 hours. Eight staff surveys also reflected this view. Of the 17 care staff, 12 have NVQ level 2 or above qualifications. 7 carers are currently working towards the qualifications, which will meet the required 50 when finished. However, evidence did not suggest that staff were fully committed to achieving this target. All staff had undergone induction training and mandatory training was up to date including fire, health and safety and manual handling as well as other related training such as dementia, first aid, epilepsy awareness and person centred care. It is suggested that there are individual staff training files, which would make it easier to assess training needs and skill mix. Other training is planned. Staff do receive supervision sessions with management, which are one to one sessions to check on progress, competency and any issues but these are not always regular, some staff having little over the last 2 years. Four recruitment files were looked at. These did not show a robust recruitment procedure in all areas such as lack of discussion/follow relating to negative comments in 2 separate staff references or discussions of CRB disclosures necessary. Hay House Nursing Home DS0000043065.V293637.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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, 36, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ financial interests are generally safeguarded, although safe deposit systems need organising. Management does not always ensure that there is clear leadership and guidance to staff to ensure that residents receive consistent care on a safe environment. EVIDENCE: Maintenance records were up to date and the provider is responding to requirements from the fire officers’ visit and sourcing components. Several fire doors were propped open during the inspection, including the dining room doors. This practice must stop. Cleaning fluid was stored unlocked in the sluice and the water from the sink was excessively hot. Radiators were covered Hay House Nursing Home DS0000043065.V293637.R01.S.doc Version 5.2 Page 20 safely and window restrictors in place. Policies were up to date and accessible to staff to ensure consistency. Four residents manager their own monies otherwise there is an excellent computerised invoicing system and audit trail including receipts. However, some residents keep monies in the safe over long periods of time. The system for checking and storing this is not very organised and could result in inaccuracies. Staff did not think that proper time was made for one to one time with management although they felt that they could go to the provider, who is at the Home the majority of the time. However, the general view from staff was that they would like to feel more valued and that any suggestions they make are not considered. They would like to feel more supported by the manager, who they feel at present has not been very approachable. The manager has not yet completed the Registered Managers’ Award, which is condition of their registration. Hay House Nursing Home DS0000043065.V293637.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x 2 x 2 STAFFING Standard No Score 27 1 28 2 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 2 3 x 2 2 x 1 Hay House Nursing Home DS0000043065.V293637.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? yes 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 OP12 Regulation 16 Requirement You must ensure that the social and leisure needs of residents are met especially those with difficulty communicating. (This refers to meaningful and appropriate activities and stimulation for residents.) You must ensure that there are at all times suitably qualified, competent and experienced persons working at the Home in such numbers as are appropriate for the health and welfare of residents. (This refers especially to maintaining staffing levels to ensure that residents’ needs are met at mealtimes and that their social and mental health needs are met on a regular basis.) This was previously a recommendation. You must ensure that you have obtained all the documentation as specified in Schedule 2. (This refers to follow up of references and CRB disclosures.) You must ensure that the manager has the qualifications, skills and experience necessary DS0000043065.V293637.R01.S.doc Timescale for action 16/08/06 2. OP27 18 16/08/06 3. OP29 19 Schedule 2 9 (1) (2) (i) 16/07/06 4. OP31 16/12/06 Hay House Nursing Home Version 5.2 Page 23 5. OP38 13 (4) c for managing the Home. (This refers to the completion of the Registered Managers’ Award, which is a condition of registration.) You must ensure that unnecessary risks to the health and safety of residents are identified and so far as possible eliminated. (This refers to the practice of propping open fire doors, hot water in the sluice sink and that COSHH substances are stored safely (cleaning fluid in the sluice.) 16/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard OP7 OP12 OP26 OP28 OP32 Good Practice Recommendations It is recommended that care plans clearly document all identified needs, actions taken and reviews. It is recommended that the garden is made more accessible for residents. It is recommended that any Home pets are not permitted in the dining rooms during lunch times. It is recommended that staff are motivated and supported to achieve NVQ qualifications in order to meet the 50 of overall care staff target. It is recommended that the management planning and practice encourages staff innovation, creativity and development and that there is a clear sense of leadership that promotes positive staff morale. It is recommended that the system for regularly checking and storing residents’ monies in the Home safe is robust. It is recommended that care staff should receive regular formal one to one supervision covering all aspects of practice, philosophy of care within the home and career development needs at least 6 times a year. This is carried over from the previous inspection. 6. 7. OP35 OP36 Hay House Nursing Home DS0000043065.V293637.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Hay House Nursing Home DS0000043065.V293637.R01.S.doc Version 5.2 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!