Inspection on 03/01/07 for Heathfield House Nursing Home

This inspection was carried out on 3rd 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

Heathfield House Nursing Home 16/08/06

Heathfield House Nursing Home 08/11/05

Heathfield House Nursing Home 26/04/05

Heathfield House Nursing Home 07/01/05

Heathfield House Nursing Home 01/09/04

Heathfield House Nursing Home 10/02/04

Similar services:

St Vincents

The Cotswold Home

Winton House

Newbeech House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Heathfield House Nursing Home Bicester Road Bletchingdon Oxfordshire OX5 3DX Lead Inspector Philippa MacMahon Unannounced Inspection 3rd January 2007 09.50 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 Heathfield House Nursing Home DS0000027155.V322636.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. Heathfield House Nursing Home DS0000027155.V322636.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heathfield House Nursing Home Address Bicester Road Bletchingdon Oxfordshire OX5 3DX 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) 01869 350940 01869 350251 info@heathfield-house.co.uk Heathfield House Nursing Homes Limited Vacant Care Home 48 Category(ies) of Dementia (20), Old age, not falling within any registration, with number other category (40) of places Heathfield House Nursing Home DS0000027155.V322636.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. On admission persons should be aged 60 years and over. Date of last inspection 16th August 2006 Brief Description of the Service: Heathfield House is a privately owned care home for older people registered with the Commission for Social Care Inspection to provide nursing care for up to 40 people, including up to 20 with dementia. The home has been established since 1986 and is situated north east of Oxford City, surrounded by open countryside. Accommodation is provided in a mixture of single and double rooms over two floors. There is a sitting room, dining room and conservatory, with a patio area and grounds with seating and a walkway. There are 2 communal bathrooms and some rooms have en-suite facilities. Nurses and care assistants provide care. There is a housekeeping and kitchen team. The home’s proprietor also works as the administrator in the home. An extension providing 12 single bedrooms has recently been completed. A further extension is nearing completion and will provide a new dining room, and a further single room. The fees range from £650.00 - £800.00 per week. Heathfield House Nursing Home DS0000027155.V322636.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 09:50 hours and was in the service for 7.hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. The inspection included a thorough examination of a sample of the residents individual care plans, and this was followed up by meeting with the resident and discussing their care with the staff. The homes medication system was examined, and the records required by regulation. Lunch was taken with the residents in the dining room in order to observe the service of the meal and to take time to talk with the residents. The inspector took time to meet with the staff to discuss the day to day running of the home. A tour of the building took place and the inspector examined staff rosters, a sample of staff files, and discussed the recruitment process within the home with the registered provider. Visitors and relatives were spoken during the inspection. The inspector was afforded a warm welcome by the staff and all cooperation was given thoughout the inspection. What the service does well: Heathfield House Nursing Home DS0000027155.V322636.R01.S.doc Version 5.2 Page 6 The home provides a comfortable, homely, environment set it in most attractive grounds and gardens. Furniture and fittings are of a good quality and the refurbishment programme is ongoing. The residents are treated with dignity and respect, and a relative spoken to said how kind and attentive the staff is. Every effort is made to ascertain the residents wishes about the time of their death. The Registered Provider is involved in the day-to-day management of the home and in the absence of a registered manager has been supporting the Deputy manager in ensuring the care provision remains of a good standard. The Registered Provider is committed to staff training and development. There is good evidence of staff working as a team. There is good communication between the GP’s, and the Registered Nurse’s. The Registered Nurse’s have ready access to specialist nurses and other Health Care Professionals. Meals and mealtimes are much appreciated by the residents. The activities programme is well planned to provide for the residents collective and individual interest. What has improved since the last inspection? The information given to prospective residents has been reviewed and updated. The assessment process has also been reviewed and changed. All staff has undertaken training in the protection of vulnerable adults. Staff recruitment files contain the necessary information and checks. The administration of medicines has improved. The induction training now meets the Skills for Care national guidelines. Heathfield House Nursing Home DS0000027155.V322636.R01.S.doc Version 5.2 Page 7 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. Heathfield House Nursing Home DS0000027155.V322636.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 Heathfield House Nursing Home DS0000027155.V322636.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home does not provide an intermediate care service. Every residents has an assessment of their individual care needs prior to being admitted to the home. Confirmation of the agreement for admission is sent to the prospective residents prior to admission. EVIDENCE: The inspector examined a sample of the residents individual care plans and administration files, and found that each resident had an assessment of their care needs prior to being admitted to the home. Relevant information had also been obtained from other care professionals who had been involved in their care before admission to the home. These assessments formed the basis of the residents individual care plan. Each resident had a contract and a service users guide with accompanying letter prior to admission. The inspector was given a copy of the service users guide and statement of purpose that are sent out. Heathfield House Nursing Home DS0000027155.V322636.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): 7,8,9,10,11. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Every resident has a care plan in which their individual care needs are identified and the action required to meet them. Risk assessments are poor, and the reviews of care are superficial. The medication system is clear and auditable. Issues around the disposal of waste medication need to be addressed. Residents are treated with dignity and respect at all times. Every effort is made to ensure that at the time of their death residents wishes are respected. EVIDENCE: The inspector examined a sample of individual residents care plans including the most recent person to be admitted and a person who is on short stay. Each of the residents had a care plan in place that reflects their care needs and how these would be met. One of the care plans examined had a very comprehensive and clear plan of care that the residents had had in place at home prior to admission. It is commendable that this is used as the basis for the care plan being developed for that individual. There was evidence of the care plans being reviewed by a monthly signature and date. However in some Heathfield House Nursing Home DS0000027155.V322636.R01.S.doc Version 5.2 Page 11 instances there appeared to be no change when the daily record indicated that the care needs had changed. In one instance the daily record indicated that a resident had developed a pressure ulcer and that a dressing had been applied. The wound assessment tool and action required to heal the wound was implemented four weeks after the first sign was identified. Risk assessments are not being routinely carried out and followed through, to ensure the early identification of changes in care needs. The Registered Provider showed the inspector an audit tool that they are about to implement that covers all aspects of care planning. It is recommended that the internal audit of residents records should be commenced at the earliest opportunity, and that risk assessments in moving and handling, nutrition, and the prevention of pressure ulcers should be in place for each resident. The inspector found good evidence of cooperative working with GP’s, Dieticians, and Speech and Language therapist, in order to meet the residents needs. The Registered Nurses spoken to say that they had ready access to Macmillan Nurses, Continence, and infection control specialist nurses. The medication system in place was examined by the inspector and overall found to be in good order. However the disposal of unused medication was not being carried out in accordance with the Environment Agency legislation around the disposal of waste medication. The inspector advised the Registered Provider of where to access the guidance in relation to the disposal of waste from care homes with nursing. It is a requirement that the safe disposal of waste medication must be carried as required by the Environment Agency legislation. The inspector noted that there were two vials and two pre filled syringes of flu vaccination unlabelled in the medicine refrigerator. Discussion with the Registered Nurse’s on duty about the vaccination process in the home revealed that the GP supplies the vaccine and the nurses give them. The Registered Nurse said that they did not have a procedure or training in the administration of vaccines and the necessary emergency medication that needs to be available at the time of administration. It is recommended that the Registered Provider should obtain guidelines from the commissions website on the administration of vaccinations by Registered Nurse’s in care homes with nursing. The inspector observed that the residents were treated with dignity and respect by the staff. The residents were called by their preferred term of address and staff always knocked on the doors of residents private rooms and the toilets and bathrooms before entering. Residents spoken to also said that the staff always treated them in a kindly and appropriate manner. Information about the residents wishes about arrangements at the time of their death were found in the care plans, and discussion with the Registered Provider revealed that they are looking into being involved in the NHS End of Life Care project being implemented in Oxfordshire. Heathfield House Nursing Home DS0000027155.V322636.R01.S.doc Version 5.2 Page 12 Heathfield House Nursing Home DS0000027155.V322636.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): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The provision of activities is varied and suitable to meet the needs of the present group of residents. Residents are given the opportunity to make choices and take control over their lives. From the evidence seen by the inspector and comments received, the inspector considers that this home would be able to provide a service to meet the needs of individuals of various religions, race and culture. The residents receive a wholesome and nutritious diet. The dining room needs to be made more homely. EVIDENCE: The inspector noted copies of the programme of activities for January placed around the home and in the residents individual rooms. This programme includes beauty therapy such as hair dressing, aromatherapy, manicures, musical entertainment, exercise, cookery, and church services. Birthday celebrations are also noted. The inspector met with the activities co-ordinator who visits the home 5 days a week, and discussed how she gets to know the individual residents their chosen lifestyle and tailors the programme to try to meet these. An individual record is kept for each resident describing how they respond to the activities provided. There was musical entertainment provided Heathfield House Nursing Home DS0000027155.V322636.R01.S.doc Version 5.2 Page 14 on the day of inspection from a group who tour the country visiting care homes, and they tailor the programme to each home as they get to know the residents and the kind of music they enjoy most. A number of relatives were visiting the home at the time of the inspection and in each case were made very welcome by the staff. Relatives are offered beverages, and are able to join in at mealtimes given prior warning to the cook. Most of the resident’s individual rooms had been personalised with their own possessions around them. None of the present group of residents is able to manage their own affairs and their families or representatives support them. The inspector joined the residents for lunch in the dining room and observed the staff assisting the residents in a kindly, unhurried and appropriate manner. The food was individually plated up in an appealing manner and was much enjoyed by the residents. The menus have just been altered to include more fresh vegetables and fresh fruit as a result of a survey carried out recently. The dining room is in need of refurbishment and this is programmed to commence as soon as the new extension is complete and the residents will be able to use the new dining room. The dining room tables are covered in wipe able cloths that are rather institutional in appearance, and white paper napkins. It is recommended that the Registered Provider should consider providing cloth tablecloths and napkins to make the dining experience more homely. Heathfield House Nursing Home DS0000027155.V322636.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): 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s complaints procedure is in place and accessible to the residents, relatives, and visitors. The home makes every best effort to ensure the residents are protected from any form of abuse. EVIDENCE: The inspector examined the homes revised complaints procedure and found it to be in accordance with the National Minimum Standards, and regulations. A copy was posted on the notice board and contained in the service users guide. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. All staff receives training in the protection of vulnerable adults, and staff spoken to had a clear understanding of the issues around all forms of abuse. Heathfield House Nursing Home DS0000027155.V322636.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): 19,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall the home provides a comfortable, safe and homely environment and the standard of cleanliness is high. EVIDENCE: The inspector toured the building and looked at all areas of the home including the new development. Overall the home was found to be clean and hygienic throughout, and the domestic staff are to be congratulated on maintaining such a high standard. The new wing has now been commissioned and the residents in those rooms are very pleased and comfortable. The beds provided are high quality specialist beds designed for the provision of nursing care, but are domestic in appearance. The décor and furnishings are also of a high standard. There is still the completion of the remaining development to be made that includes a new dining room and this is expected to be in the next couple of months. Heathfield House Nursing Home DS0000027155.V322636.R01.S.doc Version 5.2 Page 17 The Registered Provider told that inspector that the plan is to reduce the number of shared rooms and provide more single accommodation. Some of the rooms on the ground floor of the new wing have had gates fitted to the doorways. This is at the residents request because they do not want people wandering into their private rooms but they also do not wish to have the door closed. The sitting rooms provide a choice of space for the residents to enjoy and these are well appointed with lovely views of the surrounding gardens and countryside from each of them. Residents spoken to said that it was very pleasant and homely to sit in the sitting room, and they really preferred this and being in company, to sitting in their own room. There is an ongoing maintenance programme of refurbishment and renewal, and evidence of this was in place. The home now employs a person to carry out the maintenance in the home, and part of his duties are to check the hot water outlets temperatures on a regular basis and record these. Random checks of the hot water outlets by the inspector found the temperatures to be of an acceptable level. The en-suite facility in one of the residents rooms in the old wing of the house had boxing in of pipes at the side of the toilet that had not been painted or stained to provide a non-porous surface for cleaning purposes. There was also no toilet roll holder provided, and a cupboard to the side of the en-suite was found to house the macerator and pipe work for the toilet. An unpainted shelf above these was being used by the resident to store belongings, such as hairbrushes and toiletries. It is recommended that the cupboard housing the pipes and macerator from the en suite toilet should be made inaccessible to the resident and an alternative storage facility be provided for the storage of toiletries. It is further recommended that the box work covering the pipes at the side of the toilet in the one of the residents en-suite facility should be painted in order to maintain a hygienic environment, and that a toilet roll holder should be fitted. The inspector noted in a further room that there was a chart propped up in full view of anybody visiting the resident with details of a very personal nature on it. This is in the inspectors view very demeaning and poor practice. It is a good practice recommendation that any chart or information about a resident in their private room should be placed in a discrete place out of view of any visitors. The laundry and sluices were found to be clean and orderly. The grounds and gardens are kept in good order and are accessible to the residents. The reconfiguring of the new entrance to the home on completion of the new build will provide a most attractive feature. Heathfield House Nursing Home DS0000027155.V322636.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): 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 home is adequately staffed with care assistants but it is unclear as to whether there are always sufficient numbers of Registered Nurse on duty to care for 40 plus residents. The recruitment process is satisfactory but clarification needs to be sort on the Criminal Records Bureau process. The Registered Provider is committed to the training and development of all staff. EVIDENCE: The inspector examined the staff rosters and found that from Monday to Friday there are sufficient numbers and skill mix of staff on duty most of the time. However some of the late and weekend shifts show there is only one nurse on duty to care for 40 residents. There are always good numbers of care assistants on duty and a relative commented that the number of care staff always available was good. The inspector recommends that the Registered Nurse’s look at the dependency levels of the present group of residents and the amount of nursing care they require and the geography of the building and assess an appropriate level of nursing requirement. This was discussed at the last key inspection but no further action has been taken by the home at this time. At the present time the home does not have a registered manager in post, and is in a period of limbo awaiting completion of the recruitment process. Heathfield House Nursing Home DS0000027155.V322636.R01.S.doc Version 5.2 Page 19 The deputy manager is on sick leave, and the remaining nurses are doing and excellent job in maintaining the status quo, with the support of the Registered Provider. The inspector examined a sample of staff files and found them to have the necessary documentation in place except for one that had a Criminal Records Bureau enhanced disclosure that had been accessed at the persons previous employment a short period before leaving. It is recommended that the Registered Provider should contact the Criminal Records Bureau for guidance in the validity of previous Criminal Records Bureau disclosures from a previous employer. Training and development is seen by the Registered Provider as being of importance, and the inspector saw evidence of training that has been undertaken and is planned for the next year. Staff spoken to are also keen to develop and know that they need to be continually updated. Some of the training is in-house and the trained staff who have the expertise have been providing this. Progress towards the achievement of 50 of all care staff having NVQ level 2 has been slow due in part to the external assessors. The Registered Provider has now identified a private provider so that they can move forward with completing the training of those already registered on a programme. The induction programme has now changed to the Skills For Care approved course for new staff. Heathfield House Nursing Home DS0000027155.V322636.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is in a period of transition and the Registered Provider supported by the staff is making every best effort to maintain and improve the management of the home. The health, welfare and safety of the residents and staff are being promoted and protected. EVIDENCE: At the present time the home does not have a registered manager in place. The Registered Provider is providing all of the management of the home supported by the Registered Nurse’s and the administration team. Once a new manager is appointed it is the Registered Provider’s intention to withdraw from the day-to-day management and take a more strategic role. The recruitment process is underway to filling the vacancy. Heathfield House Nursing Home DS0000027155.V322636.R01.S.doc Version 5.2 Page 21 The staff were seen to work well together and discussion with the Registered Nurse’s on duty showed that they had pulled together since the last registered manager left and that the deputy had done a lot to help this process. They are apprehensive at the prospect of yet another manager but are looking forward to having clear leadership in place. The Registered Provider explained to the inspector that they are members of the Registered Nursing Homes Association and are using their quality assurance tools. This so far involves internal audits of the various systems involved in running a care home. Customer satisfaction has only involved meals and mealtimes so far, and unfortunately the relative’s forum has folded due to the loss of the chairperson and nobody else wishing to take this on. Letters of commendation are shared with all the staff and the Registered Provider operates an open door style of management and is always accessible to resident’s staff relatives and visitors. The home does not handle any of the residents financial affairs; families or representatives usually deal with this aspect of care. Staff training records show that they have recently received training in fire safety, moving and handling and food hygiene. The inspector examined the fire log and found that appropriate checks had been made and the Registered Provider told the inspector that the new Maintenance person has been given responsibility for ensuring the necessary checks are carried out including the water temperatures. The kitchen was found to be clean and orderly and the dry store had been tiled throughout to ensure that all surfaces are easily cleaned, as required by the environmental health officer. Heathfield House Nursing Home DS0000027155.V322636.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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 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 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score N/A 3 2 X 3 X X 3 Heathfield House Nursing Home DS0000027155.V322636.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13(2) Requirement It is a requirement that the safe disposal of waste medication must be carried as required by the Environment Agency legislation. Timescale for action 26/01/07 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 It is recommended that the internal audit of residents records should be commenced at the earliest opportunity, and that risk assessments in moving and handling, nutrition, and the prevention of pressure ulcers should be in place for each resident. It is recommended that the Registered Provider should obtain guidelines from the commissions website on the administration of vaccines by Registered Nurse’s in care homes with nursing. It is recommended that the Registered Provider should consider providing cloth tablecloths and napkins to make the dining experience more homely. DS0000027155.V322636.R01.S.doc Version 5.2 Page 24 2 OP9 3 OP15 Heathfield House Nursing Home 4 OP24 5 OP10 It is recommended that the cupboard housing the pipes and macerator from the en suite toilet should be made inaccessible to the resident and an alternative storage facility be provided for the storage of toiletries. • It is further recommended that the box work covering the pipes at the side of the toilet in the one of the residents en-suite facility should be painted in order to maintain a hygienic environment, and that a toilet roll holder should be fitted. It is a good practice recommendation that any chart or information about a resident in their private room should be placed in a discrete place out of view of any visitors. The inspector recommends that the Registered Nurse’s look at the dependency levels of the present group of residents and the amount of nursing care they require and the geography of the building and assess an appropriate level of nursing requirement. It is recommended that the Registered Provider should contact the Criminal Records Bureau for guidance in the validity of previous Criminal Records Bureau disclosures from a previous employer. • 6 OP27 7 OP29 Heathfield House Nursing Home DS0000027155.V322636.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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. Extracts may not be used or reproduced without the express permission of CSCI Heathfield House Nursing Home DS0000027155.V322636.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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