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Inspection on 29/11/06 for Hill House Nursing Home

Also see our care home review for Hill House Nursing Home for more information

This inspection was carried out on 29th November 2006.

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 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

People are provided with sufficient information about the service to enable them to make an informed decision about admission to this home. The admissions process ensures A full assessment of need is performed this ensures that peoples needs are understood and a decision can be made about if/how those needs will be met by the home following the residents` admission. The registered person promotes and maintains residents` health and ensures access to health care services to meet assessed needs. Residents are treated with respect and their right to privacy is upheld. Residents are able to maintain contact with family and friends and exercise choice and control over their lives. People are aware of the complaints procedure and feel safe living in the home. The environment is clean and hygienic and safe and adequately maintained. There are sufficient numbers of staff with appropriate skills and knowledge to meet the needs of residents in this home. The residents were complimentary about the staff team confirming their needs were met 24 hours a day. Comments received from clients included: `I am really impressed with the care and support that I am given here at Hill House`, `the staff are kind and attentive. The manager/provider shows a real commitment to meeting the needs of residents and the quality off the service is continually assessed.

What has improved since the last inspection?

An extension to the home has been completed; this has meant that the home is now able to admit residents with a wider range of needs including those who use self-propelled mobility aids. Additional en suite facilities are available to bedrooms. The catering department has benefited from a new kitchen with additional dried and chilled storage facilities.

What the care home could do better:

Residents could be given more opportunities for stimulation through leisure and recreational activities in and outside the home. The home should offer a choice of menu at all meals and this should be advertised in written or other formats to suit residents, to ensure they have a choice at all meals.

CARE HOMES FOR OLDER PEOPLE Hill House Nursing Home Park Avenue Brixham Devon TQ5 0DT Lead Inspector Fiona Cartlidge Unannounced Inspection 11:30 29 November 2006 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hill House Nursing Home DS0000028683.V301009.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. Hill House Nursing Home DS0000028683.V301009.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hill House Nursing Home Address Park Avenue Brixham Devon TQ5 0DT 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) 01803 853867 01803 854757 Mrs Ann Margaret Stockwell Ann Margaret Stockwell Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38), Physical disability (38) of places Hill House Nursing Home DS0000028683.V301009.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Old Age not falling within any other category (OP) 38 Physical Disability (PD) 38 4 bedrooms (identified and recorded on site visit) not to be used for Service Users until a site visit has been performed by the Commission for Social Care Inspection and confirmation of their fitness for purpose has been agreed 14th December 2005 Date of last inspection Brief Description of the Service: Hill House Nursing Home is set in Higher Brixham; it faces northeast and is built into a hill, thus giving it its name. A former Manor House, it was built in the 14th century and is listed as an important building on the Schedule 11 listing for Torbay. Exposed beams, inglenook fireplaces and uneven floors give part of the home a homely, cottage feeling. Due to the age and construction of this part it is unable to accommodate self-propelled independent wheel chair users. However a two-storey purpose built extension was registered earlier this year, which is designed to cater for persons with or without independent mobility. A passenger lift provides access between floors. The home caters for 38 older people of either gender with physical disabilities and/or frailty. A range of equipment and adaptations are available to Service Users following an assessment of their care needs. A registered nurse is on duty at all times supported by a team of Health Care Assistants. Information about the home was found in the entrance hall and this asks readers to request a copy of the latest inspection reports from the administration office. Information given to the Commission by the provider indicates the current range of fees is from £466 to £580/week. Hill House Nursing Home DS0000028683.V301009.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit took place over 5 hours 15 minutes and was unannounced. A partial tour of the home took place when some bedrooms and all communal areas were viewed. Four residents had their care case tracked this means their records were examined in detail and three of the four residents were spoken to in depth about the care and services they receive. The fourth resident being case tracked was spoken to briefly and their care was observed. Five other residents were spoken with during the visit, as were 3 visitors/relatives one Social services professional and 3 members of staff and the registered manager/provider. Personnel records of 2 members of staff and policies and procedures were also inspected. The Commission received written feedback via surveys from 6 residents, 5 care staff and 2 General Practitioners. As part of this unannounced inspection the quality of information given to people about the care home was looked at. People who use services were also spoken to, to see if they could understand this information and how it helped them to make choices. The information included the service user’s guide (sometimes called a brochure or prospectus), statement of terms and conditions (also known as contracts of care) and the complaints procedure. These findings will be used as part of a wider study that CSCI are carrying out about the information that people get about care homes for older people. This report will be published in May 2007. Further information on this can be found on our website www.csci.org.uk. What the service does well: People are provided with sufficient information about the service to enable them to make an informed decision about admission to this home. The admissions process ensures A full assessment of need is performed this ensures that peoples needs are understood and a decision can be made about if/how those needs will be met by the home following the residents’ admission. The registered person promotes and maintains residents’ health and ensures access to health care services to meet assessed needs. Residents are treated with respect and their right to privacy is upheld. Residents are able to maintain contact with family and friends and exercise choice and control over their lives. People are aware of the complaints procedure and feel safe living in the home. Hill House Nursing Home DS0000028683.V301009.R01.S.doc Version 5.2 Page 6 The environment is clean and hygienic and safe and adequately maintained. There are sufficient numbers of staff with appropriate skills and knowledge to meet the needs of residents in this home. The residents were complimentary about the staff team confirming their needs were met 24 hours a day. Comments received from clients included: ‘I am really impressed with the care and support that I am given here at Hill House’, ‘the staff are kind and attentive. The manager/provider shows a real commitment to meeting the needs of residents and the quality off the service is continually assessed. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hill House Nursing Home DS0000028683.V301009.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 Hill House Nursing Home DS0000028683.V301009.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 using available evidence including a visit to this service. People are provided with sufficient information about the service to enable them to make a decision about admission to the home. The admissions process is safe. This home does not provide intermediate care. EVIDENCE: The home has a service users guide this document sets out the aims and objectives of the home and provides comprehensive information about the service. This booklet was available in the entrance of the home. Four residents were spoken with about the information they received before entering the home; one commented that ‘the booklet was well written’ and a copy was seen in their room, another residents relative said they had a copy of the booklet and had taken it home to read. All of those spoken to said they felt they had received enough information. Hill House Nursing Home DS0000028683.V301009.R01.S.doc Version 5.2 Page 9 Residents spoken to were aware that they had contracts, all of those spoken with said the contracts had been supplied by social services. The home does not provide its own terms and conditions of residency if care management has provided a contract. An assessment of care needs of a prospective service user takes place prior to admission to the home. Records seen included copies of assessments carried out through care management arrangements and hospital/community health care teams where applicable. A full assessment of need is performed by staff employed by the home following the residents’ admission and this information and that from the preadmission care management/health assessments informs the homes care planning process. Hill House Nursing Home DS0000028683.V301009.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. Resident’s needs are set out in an individual plan of care. The registered person promotes and maintains residents’ health and ensures access to health care services to meet assessed needs. The majority of medicines in the home are handled safely, however some aspects of the use of hand written entries and “when required” medicines have the potential to place service users at risk. Residents are treated with respect and their right to privacy is upheld. EVIDENCE: Personal records held on behalf of 4 residents were examined; in all of those seen there were documented assessments which provided information about skin integrity, moving and handling, safety - including risk of falls, nutritional screening and 2 contained information about social needs. The information generates the plans of care, which provide the basis for the care to be delivered. The care plans were clear and easy to understand and had been regularly reviewed with input from the residents and/or their representatives. Hill House Nursing Home DS0000028683.V301009.R01.S.doc Version 5.2 Page 11 These care records are held in the residents rooms and all were aware they contained personal information about them. Records are maintained for all visits to the home by social or health care professionals, all residents are registered with a GP. Records provided evidence that as well as visits from General Practitioners, district and specialist nurses, chiropodists, physiotherapists and dentist’s visit. Records of outpatient appointments show that visits to community and hospital health resources are enabled. Each service users medicine is stored in a lockable cupboard in their rooms. This demonstrates the homes commitment to supporting service users to look after their own medicines following risk assessment. For those service users looking after their medicine a risk assessment must be in place and the care plan should reflect the level of support that may be needed. This should also be reflected In the homes policy on self-administration. The Medication Administration Record (MAR) charts are kept in the service users rooms. The home has obtained a new metal medicine storage cupboard to store extra medicine stock for service users. The home has also ordered a new fridge for the storage of medicines requiring refrigeration. Until this arrives secure storage within the recommended temperature range must be provided for any medicines requiring this type of storage. Some hand written entries on the MAR charts had not been signed and dated by the person making the entry nor had they been checked and signed by a second person. For some of these entries the hand written directions were not being followed and there was also no guidance in the service users care plan about how these medicines were to be used. The home hold a stock of homely remedies, however the current policy does not reflect the range of products in use nor for how long they are to be given before advice is sought. For medicines prescribed, to be administered with a variable dose it was not always possible to determine from the records the actual dose that had been administered. This means that the care of the individual service user may be compromised. Of the six residents that provided written feedback on surveys returned to the commission all 6 indicated they ‘always’ receive the care and support they need. When asked ‘Do you receive the medical support you need’ five indicated ‘always’ and the other ‘usually’. Two General practitioners provided written feedback both indicated they are satisfied with the overall care provided to the residents in the home one commented ‘ I am particularly impressed with the care and ongoing action of this home which sets standards for the rest of Devon in my view’. Hill House Nursing Home DS0000028683.V301009.R01.S.doc Version 5.2 Page 12 Staff were seen and heard knocking on doors before entering rooms and were carrying out personal tasks in private. Staff observed in 1:1 conversation with residents were heard to be courteous and respectful. Hill House Nursing Home DS0000028683.V301009.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 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. Little effort is made by the home to provide an activities programme and social interaction/stimulation for residents. Residents are able to maintain contact with family and friends and exercise choice and control over their lives. Residents receive a wholesome appealing diet but a choice of meals is not well advertised and residents were unaware of a choice of meals at lunch times. EVIDENCE: During the site visit, some residents were seen sitting in the lounges; in one lounge a television was on, but none of the residents seemed to be aware of or interested in the programme. Other residents were seen spending time in their rooms, reading, listening to music, and watching television. Six residents returned surveys to the Commission when asked ‘Are there activities arranged by the home that you can take part in? 1 indicated ‘always’ 1 ‘usually’, 2 ‘never and the other did not respond. Comments included ‘Not applicable because totally disabled’ another ‘some activities available, but I do not take part’ and ‘have not heard of any as yet’. Hill House Nursing Home DS0000028683.V301009.R01.S.doc Version 5.2 Page 14 The feedback about food was positive all of the residents spoken to said how good it was; on the day of inspection lunch was served, residents were offered Chicken in a cider and mushroom sauce with potatoes and vegetables followed by plums and custard; residents said they were unaware of a choice but said if the main meal doesn’t suit an alternative is found. Some residents ate lunch in the lounge/dining rooms; some residents ate their lunch in their own accommodation. Observation took place at lunch time in the 1st floor lounge/dining room, where residents required assistance this was usually provided appropriately by staff on a 1:1 basis in a relaxed and timely fashion. Records seen provided evidence that it is usual practise for residents to undergo nutritional screening and have a nutritional care plan, which expects resident’s weights to be regularly monitored. A new kitchen has been built within the homes extension programme and a newly employed chef said that they are working closely with the provider to ensure all the equipment needed is available and was aware that residents should be provided with a choice of menu at all meals and indicated this would be developed. The people living in the home said they were happy with the visiting arrangements, visitors said they feel welcomed into the home and are able to visit their relative/friend in private or socially, one visitor was particularly pleased they were able to have lunch in the home with their partner. Hill House Nursing Home DS0000028683.V301009.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 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. Residents and their relatives/friends know how to make a complaint. People are safe living in this home. EVIDENCE: The complaints procedure was found to be included in the document ‘service users guide’ which was situated in the entrance hall, in residents rooms and which relatives confirmed they had at home. Three people who had their care case tracked said they were aware of how to make a complaint but all confirmed they had nothing to complain about. Residents said they feel safe living in the home. There have been no complaints referred to the Commission about this service. Of the 6 resident surveys returned to the Commission 5 indicated they always know how to make a complaint and know who to speak to if they are not happy, with one indicating they would ‘sometimes know how to make a complaint and they would talk to ‘matron or sister’. The policies and procedures seen, included information on adult protection and whistle blowing. Six staff returned surveys; five of these confirmed they are aware of child and adult protection procedures. Hill House Nursing Home DS0000028683.V301009.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 at least once during a 12 month period. 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. The environment is safe and adequately maintained and the home is clean and hygienic. EVIDENCE: A partial tour of the home took place, not every bedroom was seen, but those that were looked homely and there was evidence that residents have been able to bring personal belongings with them in to the home. The bedrooms were fitted out to meet individual needs with rooms having adjustable beds, pressure relieving and moving and handling equipment and adaptations to promote independence. Those residents spoken to about their private environment said they like the décor in their own rooms. The furniture, furnishings and equipment in communal rooms appeared to be in good order. Hill House Nursing Home DS0000028683.V301009.R01.S.doc Version 5.2 Page 17 A passenger lift provides access to less mobile residents between 3 floors; The home has recently increased in size to provide accommodation for a maximum of 38 people, the new extension has been build for its purpose and is suitable for people with diverse physical needs. All bedrooms in the new extension have en suite facilities. The environment was found to be clean and odour free and wash hand facilities and disposable gloves were seen through out the home. Hill House Nursing Home DS0000028683.V301009.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 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 good. This judgement has been made using available evidence including a visit to this service. There are sufficient numbers of staff with appropriate skills and knowledge to meet the needs of residents in this home. The homes recruitment practise protects residents from being placed at risk of harm or abuse. EVIDENCE: Five Personnel files were examined, these records showed a commitment to safe recruitment practises, files contained detailed application forms, 2 written references, Criminal Record Bureaux checks, health checks, induction records and training and development records, main terms and conditions of employment. The records also contained policies relating to confidentiality, moving and handling, protection and whistle blowing. Records of training (personal development plans) provided evidence that training is provided and ongoing. Staff spoken to on the day of the site visit confirmed they received sufficient training to enable them to meet the needs of those living in the home. All five staff that completed and returned surveys to the Commission confirmed that the home provides enough support for them to do their job well. Information provided in the pre-inspection questionnaire suggests that 13 care Hill House Nursing Home DS0000028683.V301009.R01.S.doc Version 5.2 Page 19 staff (52 ) have obtained a National Vocational Qualification (NVQ) in care at level 2 or above. The residents were complimentary about the staff team confirming their needs were met 24 hours a day. Comments received from clients included: ‘I am really impressed with the care and support that I am given here at Hill House’, ‘the staff are kind and attentive. 6 residents completed and returned surveys to the Commission, when asked – Do the staff listen and act on what you say? All six answered ‘yes’. When asked – Are the staff available when you need them 4 answered ‘always’ and the other 2 ‘usually’. Staff spoken to during the inspection said that things had been very busy when the new part of the home had opened and that although recruitment had taken place it had also been necessary to employ a number of agency carers. Both staff and residents said that things appeared calmer on the week of the inspection and the manager/provider confirmed recruitment of staff was continuing. Hill House Nursing Home DS0000028683.V301009.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Management arrangements are meeting the needs of the service, and the quality of the service is continually assessed. The registered provider shows a responsible attitude toward promoting and protecting the health, safety and welfare of residents and staff. EVIDENCE: The registered manager/provider is an experienced 1st level registered nurse. Patients, visitors and staff made positive comments about the manager in the home saying they felt comfortable approaching her with Issues. Communication systems are regular through staff handovers and regular staff meetings. Hill House Nursing Home DS0000028683.V301009.R01.S.doc Version 5.2 Page 21 A quality management system is in place and an internal audit of the service took place in June 2006. Each resident has a key worker and resident and relatives meetings are planned for 2007. The manager /provider confirmed that the home does not deal with personal money of residents and it was noted that lockable storage for valuables is available in each residents bedroom. The homes health and safety policy statement was examined and risk assessments had been completed in line with this. Maintenance and associated records provided evidence that the registered provider has a sensible approach towards maintaining the health and safety of residents and staff; the fire precautions logbook indicates that the fire alarm is tested weekly and emergency lights monthly. Records and discussion confirmed that the staff have regular training in fire safety. Information provided to the commission by the provider indicates that gas and central heating systems are checked and serviced by suitably qualified contractors. Hill House Nursing Home DS0000028683.V301009.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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 4 3 N/A X X 3 Hill House Nursing Home DS0000028683.V301009.R01.S.doc Version 5.2 Page 23 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 OP9 Regulation 13(2) Timescale for action The registered person shall make 01/01/07 arrangements for the recording and safe administration of medicines in the care home. This refers to the need to ensure that the actual dose administered is recorded to safeguard the health and well being of the service users. Requirement 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 OP9 Good Practice Recommendations It is recommended that the homes current policies for selfadministration and homely remedies be reviewed to ensure they are reflecting best practice guidance and current practices in the home. It is recommended that directions for the use of “when required” medicines are included in the care plans to Hill House Nursing Home DS0000028683.V301009.R01.S.doc Version 5.2 Page 24 promote consistent use of these medicines. 2 OP12 Service users should be given opportunities for stimulation through leisure and recreational activities in and outside the home, which suit their needs, preferences and capacities. Up to date information about activities available should be circulated to all service users in formats suited to their capacities. The registered person should ensure that there is a menu offering a choice of meals in written or other formats to suit the capacities of all service users, which is given, read or explained to ensure they have a choice of menu at all meals. 3 OP15 Hill House Nursing Home DS0000028683.V301009.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Hill House Nursing Home DS0000028683.V301009.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. Re-publishing this information is in breach of the terms of use of that website. 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