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Inspection on 29/11/07 for Holmesley Nursing Home

Also see our care home review for Holmesley Nursing Home for more information

This inspection was carried out on 29th November 2007.

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

Each person who thinks about coming to live here has their needs assessed by a Registered Nurse. This helps to ensure that staff have a knowledge of their needs and that the home can be sure they can meet those needs. Each person has a plan of care that is understood by staff and which are easy to read and well organised. People living here are treated with respect and have their right to privacy and to make decisions about their daily lives protected. Their views, concerns and complaints are heard and acted upon, through both formal and informal processes. People are kept safe from harm by staff who are kind and trained generally and in safeguarding issues. Staff are recruited using robust methods to ensure that unsuitable people do not work at the home. This home is particularly well cared for and maintained. It is furnished and decorated to a high standard and systems are in place to ensure that the building and equipment is safe. Good management systems are in place.

What has improved since the last inspection?

Since the last inspection the management team have worked hard to bring about improvements. Pre admission assessments have been revised to ensure that the information collected is comprehensive and helpful to staff and to the person being admitted. Care planning has been reviewed and work is ongoing to help make these more meaningful and person centred. The system for managing medicines has been changed as a way of reducing potential errors. The temperature of the fridge where medicines are kept is appropriate for that purpose. Work is ongoing to improve the way that peoples` social needs are met and staff responsibilities and roles have been reviewed. The home is more open to hearing concerns and has arranged safeguarding training for all staff. The type of training that staff need is being reviewed. The manager is now back from sick leave and is managing the home full time. Systems for overall management and supervision of staff have improved significantly.

What the care home could do better:

Some care plans are not as person centred as they could be although work in this area is ongoing. The date set by the commission for achieving this has not yet been reached. In general people`s healthcare needs are met. However, staff are not as familiar with the guidance relating to people who have had mini strokes and as such do not follow that guidance. Improvements have been made to the way medicines are managed however individual practices are not as robust as they should be meaning that it cannot be guaranteed that medicines are managed safely. Work continues to help meet the diverse range of social needs and abilities of the people living here. The date set by the commission for achieving this has not yet been reached. Not everyone has easy access to a call bell system meaning that they cannot always easily get the help they need.Although some nurses work as carers on some shifts, the home should continue to work towards ensuring that 50% of care staff hold a National Vocational Qualification in care.

CARE HOMES FOR OLDER PEOPLE Holmesley Nursing Home Fortescue Road Sidmouth Devon EX10 9QG Lead Inspector Teresa Anderson Unannounced Inspection 29th November 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Holmesley Nursing Home DS0000026664.V353948.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. Holmesley Nursing Home DS0000026664.V353948.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holmesley Nursing Home Address Fortescue Road Sidmouth Devon EX10 9QG 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) 01395 513961 01395 519549 holmesley@btconnect.com Mr Stephen Robert Barber Mr Trevor John Gosling Mrs Margaret Anne Mantle Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Holmesley Nursing Home DS0000026664.V353948.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th July 2007 Brief Description of the Service: Holmesley is a privately owned home that provides accommodation and care (including nursing care) for up to 38 people with needs related to old age. The home is situated approximately half a mile from the town and seaside resort of Sidmouth, and is set in approximately 2 acres of grounds and gardens with views over the Sid Valley and down to the sea. The home has a communal lounge with an area that can be partitioned off to create a second small lounge area, a dining room and a conservatory. Bedrooms are on the ground and first floors and are linked by a 13-person passenger lift and a stair lift. There are two double/twin rooms and the majority of rooms have ensuite facilities. Some rooms have a patio door directly onto a terrace and others have coastal views. The home has ample parking. Access to the town centre is via private transport. The fees charged range from £490.00 to £675.00 per week. There is one room that can accommodate a couple and this is available at £980.00 per week. Information about this home, including reports, is available from the home direct. Holmesley Nursing Home DS0000026664.V353948.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place as part of the normal programme of inspection. The site visit started at 10.30am and finished at 5.00pm. During that time we looked closely at the care and services offered to 3 people as a way of judging the standard of care and services generally. Where possible we spoke with these people in depth. We looked at their care assessments and care plans closely, and spoke with staff about their knowledge and understanding of these plans. We looked at their bedrooms and we looked at the overall environment from their perspective. We also spoke with approximately 12 other people who live here, with 4 visitors, with the manager, with nurses, carers, and with kitchen staff. We looked around the building at all communal areas and saw some of the bedrooms. We looked at other records including medication, staffing, accident and incident reports, training, fire safety and recruitment. Prior to the visit to the home we sent surveys to 18 members of staff and 4 were returned. In addition, and following the last inspection, the owners submitted an ‘improvement plan’ that detailed how they were going to address the improvements that the commission had required them to make. We also met with the owners to discuss this, and the progress they had already made. During this inspection we checked progress against this improvement plan. What the service does well: Each person who thinks about coming to live here has their needs assessed by a Registered Nurse. This helps to ensure that staff have a knowledge of their needs and that the home can be sure they can meet those needs. Each person has a plan of care that is understood by staff and which are easy to read and well organised. People living here are treated with respect and have their right to privacy and to make decisions about their daily lives protected. Their views, concerns and complaints are heard and acted upon, through both formal and informal processes. People are kept safe from harm by staff who are kind and trained generally and in safeguarding issues. Staff are recruited using robust methods to ensure that unsuitable people do not work at the home. This home is particularly well cared for and maintained. It is furnished and decorated to a high standard and systems are in place to ensure that the building and equipment is safe. Good management systems are in place. Holmesley Nursing Home DS0000026664.V353948.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Some care plans are not as person centred as they could be although work in this area is ongoing. The date set by the commission for achieving this has not yet been reached. In general people’s healthcare needs are met. However, staff are not as familiar with the guidance relating to people who have had mini strokes and as such do not follow that guidance. Improvements have been made to the way medicines are managed however individual practices are not as robust as they should be meaning that it cannot be guaranteed that medicines are managed safely. Work continues to help meet the diverse range of social needs and abilities of the people living here. The date set by the commission for achieving this has not yet been reached. Not everyone has easy access to a call bell system meaning that they cannot always easily get the help they need. Holmesley Nursing Home DS0000026664.V353948.R01.S.doc Version 5.2 Page 7 Although some nurses work as carers on some shifts, the home should continue to work towards ensuring that 50 of care staff hold a National Vocational Qualification in care. 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. Holmesley Nursing Home DS0000026664.V353948.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 Holmesley Nursing Home DS0000026664.V353948.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 (standard 6 was not inspected as this home does not provide intermediate care). Quality in this outcome area is good. Improvements in the information collected during peoples’ initial assessment have helped to ensure that their needs can be met when they first come to live here. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the last inspection we recommended that the information collected about people prior to coming to live here needed to be improved. The manager reports that one person has been admitted since that time. We looked at that assessment and found that staff had collected information in enough detail to help ensure that their needs could be met. In addition information had been collected from other healthcare and social care professionals. Holmesley Nursing Home DS0000026664.V353948.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 and 10. Quality in this outcome area is adequate. Improvements are ongoing to the way that care is planned meaning that this service continues to work towards providing person centred care. Whilst the majority of people living here have all their healthcare needs met some improvements are needed. Improvements have been made to the way that medicines are managed, although some risks to people remain because procedures are not always followed as they should be. Peoples’ right to privacy and respect is being upheld. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at three care plans and found them to be well-organised and easy to access and read. All contained assessments carried out by a Registered Nurse detailing each person’s care needs. Peoples risk of falling, developing pressure sores or malnutrition are recorded and appropriate actions taken as a way of helping people to stay healthy. Holmesley Nursing Home DS0000026664.V353948.R01.S.doc Version 5.2 Page 11 People living her and visitors say they are happy with the care that staff provide. Records show that staff are quick to spot if someone is physically unwell or if they might have an infection. Referrals are made to the general practitioner and specialist doctors and nurses as needed. However, the care plan of one person records that staff think this person had a mini stroke (transient ischaemic attack or TIA). According to the Primary Care Trust’s guidelines people who have these should be assessed and investigated within seven days. In this instance, there is no evidence that a doctor was contacted, and staff are not aware of these guidelines. Since the last inspection the manager and staff have started work to make care plans more person centred. Some staff are becoming more skilled at identifying different needs and planning to meet these needs. For example, one care plan records that a person becomes agitated when their incontinence pad becomes wet. Staff have tried to introduce a routine that would prevent this happening. However, this person resists being changed and, although they become agitated when wet, staff report that this person prefers this to being changed more frequently. This is an example of the provision of care that is person centred. However, the same care plan demonstrates that this person gets agitated if the lounge becomes noisy. There is no evidence that staff offer to take this person somewhere quiet before this happens. Although care plans are reviewed regularly, staff have not recorded that they may have recognised this and have not planned to prevent this person from becoming agitated which would have been person centred. Another care plan gives conflicting information about a person’s personality that staff believe contributes to some of their needs. A letter from a relative contradicts this. Another care plan shows that a person has a physical illness for which they should be eating a special diet. This person does not want to follow this. Staff have documented a compromise that has been agreed and which involves restricting this persons fluid intake and diet. However, when we went into this person’s room, there were two jugs of fluid that this person reports they drink as they like. This person has a mental health problem that should have prompted staff towards using the Code of Practice relating to the Mental Capacity Act, but they have not done this. Since the last inspection the home have introduced a system of managing medications (Monitored Dosage System – MDS) that is designed to reduce the margin for error as far as possible. Staff have received training in how to use Holmesley Nursing Home DS0000026664.V353948.R01.S.doc Version 5.2 Page 12 this. However, when we looked at records relating to medication one member of staff had not recorded the quantity of medicines received into the home. In addition, at least one member of staff is signing to say that they have given a medicine, but we saw that they had left it for the person to take later. This person prefers to do this, but staff have not made the appropriate arrangements to ensure this is carried out safely and that all records are accurate. Throughout the inspection we observed staff interacting with the people who live here. All were respectful, discreet and made sure that people’s care was given in private. People say they are asked if they would like a same gender carer for personal care, and that this decision is respected. Holmesley Nursing Home DS0000026664.V353948.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 and 15. Quality in this outcome area is good. Work is ongoing to help ensure that the diverse social needs of the people living here are met. People are assisted to make choices and have easy contact with their visitors and good contact with the local community. People benefit from a diet which is varied and nutritious and which they enjoy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person living at Holmesley is assessed to find out what his or her social needs, interests and abilities are. However, when we looked in care plans we found that some of these had not been fully completed. We found that one person had liked to attend the theatre and to meet with friends, but is now unable to do this. Staff say this person ‘comes alive’ when the home arranges singing sessions and that this is the only activity they can take part in. However, arrangements have not been made to increase the number of times this person can take part in this activity. Holmesley Nursing Home DS0000026664.V353948.R01.S.doc Version 5.2 Page 14 The manager told us she has plans to integrate the work carried out and records kept by the activities coordinator so that meeting people’s social needs is not seen as separate from their overall care. However, this has not yet been achieved. The manager also tells us that there are plans to ensure that staff record people’s memorable dates, such as anniversaries etc, so that staff can help people to either celebrate or commiserate at these times. This is almost completed. We observed staff interacting with people during lunch. We saw staff making a real effort to be sociable and to talk with them. One member of staff talked with someone who has a communication difficulty. They showed real skill in conducting the conversation in a way this person could understand and respond and at a pace that this person was comfortable with. People told us they are assisted to make choices in their daily lives. For example, they choose what clothes to wear, what time to get up and go to bed and where and how to spend their time. Visitors to the home tell us they are always made welcome and offered refreshments. Some visitors choose to have their meals with the person they are visiting and say they are ‘lovely’. People who live here say that on the whole the food is good, that the cook bakes ‘lovely things’ everyday and that if they do not like something that she will always do something different. Some people thought that the meat could be more tender for people with dentures and others said the vegetables are always well cooked ‘not too hard and not too soft’. Holmesley Nursing Home DS0000026664.V353948.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 and 18. Quality in this outcome area is good. People have their concerns and grumbles listened to and acted upon and are safe and protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the home has received one complaint. This was robustly investigated and appropriate actions were taken. The commission have not received any complaints about this service. People say that staff listen to their requests and grumbles and do something about them. People we spoke say they have no complaints. Since the last inspection the home have put procedures into place to better protect people from abuse. The management ensure that any concerns about staff attitude are taken seriously, recorded and actions taken. Training in safeguarding adults has been arranged for all staff and the majority have now received this. When we spoke with staff, they demonstrated a good understanding of what abuse is and what to do if an allegation were made or if they suspected abuse. Holmesley Nursing Home DS0000026664.V353948.R01.S.doc Version 5.2 Page 16 Since the last inspection, the home has appropriately taken advice regarding a safeguarding issue. People living here say they feel safe and well cared for and that staff are kind, gentle and helpful. Holmesley Nursing Home DS0000026664.V353948.R01.S.doc Version 5.2 Page 17 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, 22 and 26. Quality in this outcome area is good. People who live here benefit from a home that is homely and well adapted for older people with physical disabilities. Recommendations relating to minor improvements have not been made which would help the people who live here to always get help when it is needed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Successive inspections of this home show that it is consistently clean, hygienic and homely. Contracts are in place to ensure that maintenance and repairs are carried out. The home has a handy man who is much praised for helping people to make their bedrooms homely by for example putting up shelves and pictures. Holmesley Nursing Home DS0000026664.V353948.R01.S.doc Version 5.2 Page 18 The home is decorated and furnished to a very high standard with a variety of furniture and equipment for people of different physical abilities. Throughout the home there are many homely touches such as paintings, pictures, plants and flowers. Staff demonstrate a good knowledge of how to prevent the spread of infection and washing machines have a very hot cycle to deal with heavily soiled linen. We looked at the fire log and found that all checks and drills are undertaken and that fire equipment is checked regularly. At the last two inspections we recommended that all people have easy access to call bells. Whilst this is the case in bedrooms, the lounge does not provide easy access for people to call for help. We saw and heard people looking around for someone, waving and calling out. The manager reports that the system is due to be upgraded and meantime will try some individual door bell type units. Holmesley Nursing Home DS0000026664.V353948.R01.S.doc Version 5.2 Page 19 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 and 30. Quality in this outcome area is good. People who live here are supported by staff who are employed in sufficient numbers and who receive training. Recruitment processes have improved meaning that people are safe from being cared for by unsuitable people. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The duty rota shows that there is always at least one Registered Nurse on duty. In the morning there are 6 carers, in the afternoon and evening there are 4 and at night there are 2. In addition, there is ancillary staff including a cook, kitchen assistant, housekeeper, activities co-ordinator and a handy man. The manager is supernumerary. Although less than the recommended 50 of care staff hold a National Vocational Qualification (NVQ) in care, some nurses work as carers on some shifts. The manager is developing training in accordance with staff’s needs and the needs of the people living here. Holmesley Nursing Home DS0000026664.V353948.R01.S.doc Version 5.2 Page 20 We looked at the induction records of one person who has been newly appointed. Although the manager says these are based on ‘Skills for Care’, the content needs updating. We looked at the recruitment file of the only person recruited since the last inspection. We found that robust checks had been carried out including obtaining proof of identity, getting written references and obtaining a police check before this person started work. Holmesley Nursing Home DS0000026664.V353948.R01.S.doc Version 5.2 Page 21 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 good. Improvements to the overall management of this home mean that people live in a well managed home where safe working practices are implemented. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the manager has returned from sick leave. She has met with the owners and together they have agreed a plan of action to bring about the improvements required. In addition the owners met with the commission to discuss their improvement plan and this was accepted. We have seen during this inspection that improvements have been made in line with the improvement plan submitted to the commission, and that progress is ongoing. Holmesley Nursing Home DS0000026664.V353948.R01.S.doc Version 5.2 Page 22 The owners carry out their own ‘inspection’ on a monthly basis when they talk with people and assess the extent to which improvements are being achieved. They send a copy of their report to the commission. Annual quality assurance surveys are sent to people who live here and other stakeholders. People living here say they like it and that the home is homely and yet efficient. The kitchen is clean and well equipped, as is the laundry. Maintenance and testing contracts are in place meaning the home and equipment are kept safe. We checked the account of one person living here whom staff support to manage their money. Access to this is restricted and monies are kept safely and securely. All records are up to date and receipts are kept to ensure a clear audit trail of monies spent. Staff receive mandatory training which includes infection control, moving and handling and fire safety. Records seen are easy to read and understand, and are up to date. Holmesley Nursing Home DS0000026664.V353948.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x 2 x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Holmesley Nursing Home DS0000026664.V353948.R01.S.doc Version 5.2 Page 24 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 OP7 Regulation 15 (1) Requirement All the people who live here should have a care plan that details how their health and welfare needs are to be met. They must be supported to contribute to this plan so that care can be delivered in a person centred way. Previous timescale of 28/02/07 partially met. 2. OP7 15 (2) Senior staff should review all the care given, together with the consequences of that care. This will ensure that each plan of care is person centred and is based on all the relevant and available information. When a person has a mental health condition, and may not have capacity for making certain healthcare decisions, the Code of Practice relating to The Mental Capacity Act 2005 must be followed. People living here must have DS0000026664.V353948.R01.S.doc Timescale for action 31/01/08 31/03/08 3. OP7 15 (1) (2) (a) (c) (d) 31/01/08 4. OP8 12 (1) (a) 31/01/08 Version 5.2 Page 25 Holmesley Nursing Home (b) access to appropriate health care treatment so that their health can maintained. This refers to following the Primary Care Trust guidelines relating to TIA’s. The risk to the people who come to live here posed by the handling of medications by staff must be reduced. This includes: Ensuring that medication records are accurate and up to date. Ensuring that all staff record all medicines coming into the home. Ensuring that staff only sign for medications that they have given. 31/01/08 5. OP9 13 (2) 6. OP12 16 (2) (m) People who live here must be consulted about their social preferences and they should be supported to have their social needs met in a way that suits them. (Previous timescale of 10/02/07 partially met). 31/01/08 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. Refer to Standard OP22 OP28 Good Practice Recommendations People should have access to a call bell that they can reach easily. The manager should continue to work towards ensuring that 50 of care staff hold a National Vocational DS0000026664.V353948.R01.S.doc Version 5.2 Page 26 Holmesley Nursing Home Qualification (NVQ) in care to level 2 or above to ensure that the people who live here will have their needs met. 3. OP30 Newly appointed staff should receive induction training that meets the standards set by Skills for Care. Holmesley Nursing Home DS0000026664.V353948.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Holmesley Nursing Home DS0000026664.V353948.R01.S.doc Version 5.2 Page 28 - 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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