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Inspection on 29/06/06 for Highfield Nursing and Residential Home

Also see our care home review for Highfield Nursing and Residential Home for more information

This inspection was carried out on 29th 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The residents and staff report that the food offered is of good quality and well balanced. The handling of complaints within this home is good; the acting manager uses company policies and procedures to ensure that the complainant is happy with the outcome and that the staff learn by the issues raised. Recruitment policies are good, ensuring that residents are cared for safely by the staff employed.

What has improved since the last inspection?

A number of changes to the way, in which the staff hours are organised, has ensured that there is appropriate coverage is available at the busiest times of day. The change also offers better continuity following shift changes. The layout and usability of recruitment files had improved since the last inspection; they are now sections so that you can find the information you want easily. Since the previous permanent manager left, there has been an acting manager in post who has stabilised the staffing and staff spoken to were pleased with the way in which she is arranging care. All records indicating that equipment/utilities were serviced and maintained regularly are now being kept in a separate file ensuring that it is easy to see when they need updating.

What the care home could do better:

Care planning still needs to improve throughout home. The files themselves are not easy to follow and information is not clear enough for quick reference. Medication policies and procedures are being followed, however a number of documentation problems were highlighted during this site visit. Staff were made aware of this and were clear about how to rectify the problem. The staff should ensure that all CoSHH products are stored safely and legally throughout the home. More care staff need to attend NVQ training to ensure that residents are offered a high level of care by appropriately trained staff. A quality assurance plan needs to be formulated for this home to insure that there is ongoing progress and up to date care offered. Staff should be offered regular supervision and performance appraisals, to help them understand the care needed and being given to the residents.

CARE HOMES FOR OLDER PEOPLE Highfield Nursing and Residential Home Mandeville Road Saffron Walden Essex CB11 4AQ Lead Inspector Lysette Butler Unannounced Inspection 09:00 29th June 2006 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 Highfield Nursing and Residential Home DS0000015401.V302602.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. Highfield Nursing and Residential Home DS0000015401.V302602.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highfield Nursing and Residential Home Address Mandeville Road Saffron Walden Essex CB11 4AQ 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) 01799 524936 01799 526116 Tronicgold Limited Manager post vacant Care Home 60 Category(ies) of Dementia - over 65 years of age (11), Old age, registration, with number not falling within any other category (60), of places Physical disability (3), Physical disability over 65 years of age (25) Highfield Nursing and Residential Home DS0000015401.V302602.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Persons of either sex, aged 50 years and over, who require nursing care by reason of a physical disability (not to exceed 3 persons) Persons of either sex, aged 65 years and over, who require nursing care by reason of a physical disability (not to exceed 25 persons) Persons of either sex, aged 65 years and over, who only fall within the category of old age (not to exceed 60 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 11 persons) The total number of service users accommodated must not exceed 60 persons 6th January 2006 Date of last inspection Brief Description of the Service: Highfield Nursing & Residential Home was opened in 1990 and consists of a two-storey building with newer purpose built single storey accommodation. It is located in a quiet cul-de-sac within walking distance of the centre of the North Essex town of Saffron Walden. Highfield is accessible by road and rail and the nearest station is in Saffron Walden. Parking is available in the visitor’s car park and in the adjacent road. There are 42 single en-suite bedrooms and 9 double bedrooms. 8 of the double rooms are en-suite. There are two passenger lifts. The home has several small courtyard gardens that are attractive and accessible to wheelchair users. All ground floor rooms that face onto the courtyard garden have French windows to give the residents access to the gardens. Highfield Nursing & Residential Home provides nursing and personal care with accommodation for up to 60 residents. This includes provision for 3 adults over 50 years with a physical disability; 25 persons over 65 years who require nursing care for a physical disability; 11 older persons over 65 years who require residential care due to a dementia; and 21 older persons over 65 years who require personal care only. Tronicgold Ltd privately owns Highfield NH, which is part of Carebase Ltd. Highfield Nursing and Residential Home DS0000015401.V302602.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection started on 1st April 2006. The inspection process included: a site visit on 29th June 2006, which lasted eight hours; review of evidence supplied by the proprietor, residents, visitors to the service or the staff; resident, visitor, healthcare professionals and staff surveys; discussions with the acting manager, registered nurses, senior carers, care staff, ancillary staff, residents and relatives. During the site visit the premises were inspected, including inspection of the grounds. Samples of records and residents care plans were also reviewed. The home was clean and well maintained. The overall care and well being of the residents was the focus of the inspection. Staff and residents were welcoming and happy to speak to the inspector at the site visit. This inspection covered all twenty-one key standards and five of the remaining standards. The acting manager and her staff approached the inspection in a positive and cooperative manner that was focused on achieving best practice to meet the needs of the residents. What the service does well: What has improved since the last inspection? A number of changes to the way, in which the staff hours are organised, has ensured that there is appropriate coverage is available at the busiest times of day. The change also offers better continuity following shift changes. The layout and usability of recruitment files had improved since the last inspection; they are now sections so that you can find the information you want easily. Highfield Nursing and Residential Home DS0000015401.V302602.R01.S.doc Version 5.2 Page 6 Since the previous permanent manager left, there has been an acting manager in post who has stabilised the staffing and staff spoken to were pleased with the way in which she is arranging care. All records indicating that equipment/utilities were serviced and maintained regularly are now being kept in a separate file ensuring that it is easy to see when they need updating. 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. Highfield Nursing and Residential Home DS0000015401.V302602.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Highfield Nursing and Residential Home DS0000015401.V302602.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 6 - Quality in this outcome area is good; this judgement has been made from evidence gathered both during and before the visit to this service. Documentation reviewed during this inspection demonstrated that prospective residents/relatives were supplied with information to enable them to make an appropriate choice of home. EVIDENCE: The statements of purpose and service users guide had been recently reviewed/updated and were reviewed by the inspector following the site visit. They were both up to date, including all elements required by Schedule 1 of the CSA. The acting managers information was included. Both documents were stored on the homes computer and were individually printed off as needed, so that changes could be made instantly. The resident files reviewed during the site visit contained copies of their up-todate contracts that contained all elements required by national minimum standards. The acting manager undertook all assessments of prospective residents. The assessment package used was detailed and appropriate for this group of residents. Since the last inspection a pre-admission assessment undertaken by Highfield Nursing and Residential Home DS0000015401.V302602.R01.S.doc Version 5.2 Page 9 another member of staff had resulted in an inappropriate admission and a subsequent complaint. The resident had been placed elsewhere when it became apparent that Highfield NH could not meet the needs of this resident. The evidence reviewed during the site visit demonstrated that the acting manager had dealt with the complaint well. Intermediate care is not offered at this home and there are no plans to offer it in the near future. Highfield Nursing and Residential Home DS0000015401.V302602.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 poor; this judgement has been made from evidence gathered both during and before the visit to this service. The indicators examined during this inspection suggested that the residents’ health and personal care needs were well catered for at this home. However care documentation and some medication procedures were poor. EVIDENCE: Three care files were reviewed during the site visit, all were incomplete and there had been no improvement since the last inspection. Monthly reviews were not being carried out and were not subsequently being updated in response to changes in the care of the residents. Care plans were generally brief and one reviewed had not been changed since the residents’ admission in 2002. Other health care visits to the individual residents were not always clear or documented appropriately. Risk assessments were sparse and in some cases non-existent. A number of charts were contained in the files, such as weight and nutrition, that had either not been used at all, or were only partially completed. The files were difficult to follow because all documentation had been kept in the file without being achieved. Staff mix ensured that the health care needs of the residents were being met. A retained GP still visited the home regularly and residents were registered Highfield Nursing and Residential Home DS0000015401.V302602.R01.S.doc Version 5.2 Page 11 with a number of local GPs. There were regular chiropodist and optician visits to the home. The staff were observed ensuring that health needs were being met. Some medication procedures were poor and there was the potential for errors to be made. Medications that had been discontinued were still printed on the administration sheets, with lines crossed through them, unsigned or dated. On speaking to the trained staff some of the medications had been discontinued for some time but had not been removed from the pharmacist system. There was evidence that there had not been medication reviews for a number of the residents even though the individuals were refusing or did not need medications they were boarded for. There were no records of medications passed to residents who were self medicating. The administration records were complete and there were no signature omissions. Night sedation was being stored in the controlled drug cupboard and was being recorded appropriately. The MDS administration system was in use throughout the home and a new delivery had been made that day with the following months supplies. The pharmacy sent a number of medications in there original boxes with no explanation as to why they were not in the MDS cassettes. The medication room is very small and is in need of rearrangement or expansion to ease the health & safety risks it poses. Procedures to ensure the privacy and dignity of the residents were observed to be good throughout the home. Highfield Nursing and Residential Home DS0000015401.V302602.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 good; this judgement has been made from evidence gathered both during and before the visit to this service. The amount and variety of activities need to be increased to ensure the residents are stimulated in their day-to-day lives. However the food offered is varied and nutritionally balanced to cater for the dietary needs of the current residents. EVIDENCE: Activities in the home have increased and are more varied, however the reliance is still mainly based on entertainment coming into the home, as the coordinator works only four hours each weekday. The coordinator tries to do one to ones with all residents in rotation, there is a chart to ensure that all are offered a session regularly. What the chart does not show is when a resident is offered their own session, but has refused, it is however documented in their care plan so there is a record of it being offered. Copies of the last four months activities were reviewed during the site visit. All residents are on the electoral register and they are consulted on how and if they wish to vote at each election. The residents spoken to felt that they had all the day-to-day choices that they required and were happy that the home Highfield Nursing and Residential Home DS0000015401.V302602.R01.S.doc Version 5.2 Page 13 staff were open to suggestions. No residents were looking after there own finances at the time of the site visit. The inspector arrived at the home for the site visit during breakfast time. It was clear that the residents were having breakfast at a time suited to them and their morning routine. There was a mixture of food being offered including cereals, toast and cooked food. Breakfast and lunch looked appetising and well presented. There was evidence that residents chose what and how much food they were given. Care staff were witnessed interacting well with residents and helped where needed. There were a number of different areas in which residents could eat, including in their own room if they wished. During the site visit the inspector spoke to the chef who appeared to have a good knowledge of different types of diet as required by this group of residents. The cook was happy with the level of autonomy he was given and tried to talk to all residents on a regular basis to gauge their likes and dislikes when altering menus. He ensured that there was a cooked option at every meal. The kitchen itself is in need of upgrading, but the last EHO visit had been about 15-18 months before this site visit, so the home were expecting the next one soon. This would highlight any urgent matters that need correcting. However the fly screen door to the rear of the kitchen was in a very poor state of repair and needed replacing before the EHO visit. Highfield Nursing and Residential Home DS0000015401.V302602.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 from evidence gathered both during and before the visit to this service. The policies and procedures regarding complaint and PoVA issues are followed ensuring the protection and safety of the residents in this home. EVIDENCE: There had been three complaints to the home since the last inspection. All were reviewed at this site visit and had been handled well within the company policies and procedures. There had been no complaints forwarded to the Commission for Social Care Inspection directly. There had been no PoVA issues raised since the last inspection and all staff training was up-to-date. The acting manager was very clear about her responsibilities with regard to Protection of Vulnerable Adults reporting and handling. Highfield Nursing and Residential Home DS0000015401.V302602.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): Quality in this outcome area is good; this judgement has been made from evidence gathered both during and before the visit to this service. The general environment in this home is good, however staff need training to ensure that they are aware of the current legislation to ensure the residents safety. EVIDENCE: There had been no change to the fabric of the building since the last inspection. The whole home was toured at the time of the site visit. there were no unpleasant odours throughout the home and it was clean. However it was rather untidy, this was mainly due to the laying of new carpets throughout the home and one member of staff had been brought in on the day to ensure that all the furniture and equipment that had been moved during the laying of the carpets was restored to its right place. This had been most by the end of the site visit. Highfield Nursing and Residential Home DS0000015401.V302602.R01.S.doc Version 5.2 Page 16 During the tour of the home two housekeeping trolleys containing CoSHH products, were sited in the doorways of residents rooms unmanned. The inspector asked for this to be rectified immediately and the manager was informed of the problem. There appeared to be a lack of knowledge about the requirements of the law regarding the storage and handling of CoSHH products generally. The inspector spoke to the laundry person who has worked at the home for a number of years. The laundry is small for the size of the home but it is tidy and well run ensuring that dirty laundry does not come into contact with clean laundry. Disintegrating red bags are now used for fouled laundry to help reduce infection risks in the home. Highfield Nursing and Residential Home DS0000015401.V302602.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): Quality in this outcome area is adequate; this judgement has been made from evidence gathered both during and before the visit to this service. Staffing numbers, recruitment and planned training is good throughout ensuring the safety of the residents. EVIDENCE: Staffing numbers were in line with the number of residents and their dependency needs. A number of changes to the way in which the staff hours are organised, has ensured that there is appropriate coverage is available at the busiest times of day. The change also offers better continuity following shift changes. The acting manager was also in the process of developing a twoweek rolling rota for all staff that still has a good amount of flexibility. There were a number of staff changes about to happen following this site visit including the new manager who was due to start at the home during July. New staff stated that they had undertaken induction programmes appropriate to their job descriptions. Ancillary staff were in sufficient numbers to ensure that the home was clean, tidy, mal odour free and well maintained. No care staff had National Vocational Qualifications at the time of the site visit but two were due to finish the course and three further carers were due to finish the course in three to six months. More courses were being accessed as soon as possible for the remaining care staff. Highfield Nursing and Residential Home DS0000015401.V302602.R01.S.doc Version 5.2 Page 18 Three personnel files were reviewed during the site visit and all contained the required elements. All Criminal Records Bureau declarations on site at the time of the visit were signed off. They were logged and kept separately from the personnel files in a locked draw, with the registered nurse Personal Identification Numbers. Staff commence work in a supervised capacity until their Criminal Records Bureau declaration is returned to the home. Evidence observed during the visit demonstrated a commitment to good recruitment procedures. Staff training records were kept in individual files and showed that statutory training was up to date in all cases. The variety of training offered and recording of training undertaken by staff has improved for all levels of staff. There was a number of additional training sessions booked over the following two months. A matrix was supplied to the inspector. However any further planning of training sessions was being left until the new manager was in post. Highfield Nursing and Residential Home DS0000015401.V302602.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): Quality in this outcome area is adequate; this judgement has been made from evidence gathered both during and before the visit to this service. Management arrangements have been sporadic but are improving. Quality assurance and supervision arrangements need improving to ensure staff have the skills to offer appropriate care to individual residents. EVIDENCE: Since the previous manager left there has been a temporary acting manager in post. Whilst in post a number of the homes basic systems have failed needing replacement and have been project managed by the acting manager. This includes replacement of the electric and water/boiler systems. There was no ongoing quality assurance plan for the home, but it is planned that the new manager would look at this when she is in post. The last residents meeting had been in June; minutes were reviewed at the site visit. Regular staff meetings were undertaken and staff felt that the meetings were useful to Highfield Nursing and Residential Home DS0000015401.V302602.R01.S.doc Version 5.2 Page 20 discuss problems and make changes to the care procedures as needed. Meetings are planned ahead but extra meetings were called as needed and frequency has increased because of the numerous changes that were taking place. Resident money is not kept in the home, all payments are invoiced to the relative/guardian nominated and agreed as the payee. The home or its employees are not appointees for any of the residents and none of the residents were dealing with their own finances. The inspector, administrator and acting manager discussed the procedures to follow if there were any problems with access to resident funds as needed. Supervision had only recently been recommenced in an organised fashion and not all staff had recent sessions. Records reviewed during the site visit indicated that equipment and utilities that needed it had been serviced in accordance with requirements. Evidence of fire drills was not inspected on this occasion. Records also showed the regular internal checking of relevant areas, including fire alarms and fire doors, and hot tap water temperatures. Some staff spoken to were unaware of some current guidelines regarding safe working practices. Highfield Nursing and Residential Home DS0000015401.V302602.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 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 2 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 2 X 2 Highfield Nursing and Residential Home DS0000015401.V302602.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. Standard 1. OP7 Regulati on 13(4c) Requirement Timescale for action 30/09/06 2. OP7 3. OP7 4. OP9 5. OP9 6. OP9 7. OP19 Care plans must contain appropriate risk assessments to ensure the safety of the residents. (Timescale of 30/03/06 not met. This is a second repeat requirement.) 15(2b- Care plans should be reviewed c) regularly and appropriate changes made. (Timescale of 30/03/06 not met. This is a second repeat requirement.) 15 Care plans must contain details of the actions needed to care for all the residents’ care and nursing needs. (Timescale of 30/03/06 not met.) 13 (2), The registered person must ensure 17 (1a), medication administration records Schedule only contain current medications. 3 (i) 13 (2), The registered person must ensure 17 (1a), that all changes made to medication Schedule administration records are signed and 3 (i) dated. 12(4), The registered person must ensure 13 (2), that all medications given to residents Schedule for self-medication purposes are 3 (i) appropriately documented. 13 (3) The registered person must ensure (4c), 23 that all areas of the home are well (2b) maintained and are fit for purpose. DS0000015401.V302602.R01.S.doc 30/09/06 30/09/06 31/08/06 31/08/06 31/08/06 30/09/06 Highfield Nursing and Residential Home Version 5.2 Page 23 8. OP26 OP38 13 (4a, 4c & 6), 9. OP28 18(1a& c) 10. OP33 24(1ab) & (23) 18(13a&b) 11. OP36 (This specifically refers to the back door of the kitchen area.) The registered person must ensure that all staff understand and adhere to the requirements of safe working practices. (This is in specific reference to CoSHH requirements.) The manager must arrange for further care staff to commence National Vocational Qualifications at level 2 or above, to meet the 50 trained care assistants, requirement (Timescale of 30/06/06 not met.) The registered person must ensure that an annual development plan for the home is compiled and is completed. All staff must receive regular supervision. (This will usually be on at least 6 occasions each year.) (Timescale of 30/03/06 not met.) 30/09/06 31/12/06 30/09/06 30/09/06 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. 6. Refer to Standard OP7 OP9 OP12 OP27 OP36 OP38 Good Practice Recommendations The manager should ensure that care plan files are tidied and old documentation is archived. The registered person should consider reorganising or extending the medications room. The registered person should consider making more activities coordinator hours available for the residents. The manager should consider reviewing the night staffing numbers and skill mix. (This is a repeat recommendation.) All staff should have regular appraisals of their work. (This is a repeat recommendation.) The manager should ensure that all CoSHH products remain locked up at all times. Highfield Nursing and Residential Home DS0000015401.V302602.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Highfield Nursing and Residential Home DS0000015401.V302602.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. 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