Inspection on 04/11/05 for Homefield Nursing Home

This inspection was carried out on 4th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Homefield Nursing Home 13/06/07

Homefield Nursing Home 15/06/06

Homefield Nursing Home 11/05/05

Homefield Nursing Home 11/10/04

Homefield Nursing Home 23/04/04

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

CARE HOMES FOR OLDER PEOPLE Homefield Nursing Home 1 Lime Close, Southborough Road Bickley Bromley Kent BR1 2EF Lead Inspector Lorraine Pumford Announced Inspection 4th November 2005 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 Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 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. Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Homefield Nursing Home Address 1 Lime Close, Southborough Road Bickley Bromley Kent BR1 2EF 020 8289 7932 020 8289 7928 moise@mnssicare.org.uk 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) Mission Care Mr Moise Jennah Care Home 44 Category(ies) of Dementia - over 65 years of age (44) registration, with number of places Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Staffing Notice issued 1 July 1994 Staffing levels for the home are as follows on the basis that the manager of the home holds a RMN qualification: AM: 2 RMN`s or RGN`s with 6 Care Assistants PM: 2 RMN`s or RGN`s with 6 Care Assistants NIGHTS: 2 RMN`s or 1 RMN and 1 RGN with 4 Care Assistants RGN`s working in the home do so on the basis that they have substantial exprience or relevant training specific to dementia. Date of last inspection 11th May 2005 Brief Description of the Service: Homefield is registered to accommodate up to 44 service users who have been assessed as having dementia and also as requiring nursing care. The home has 12 bedrooms on the ground floor, 22 bedrooms on the first floor and 10 bedrooms on the top floor. All bedrooms have ensuite facilities. There is a dining room and lounge situated on the ground floor. There is a small garden situated to the side of the property and car parking to the front of the building. The home is conveniently situated to the local bus route and Bickley train station. Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors spent a period of time in the home, both were present from 10am until 1pm and then one inspector remained until 4 p.m. During this time the acting manager and members of staff on duty assisted with the inspection. Two relatives spoke with the inspectors and some completed written comment cards to the CSCI, their comments have been incorporated in to this report. During the course of the inspection a number of documents were examined and parts of the premises inspected. The home is registered to accommodate service users who have been assessed as needing nursing care and who have also been diagnosed with dementia therefore their ability to verbally contribute to this inspection was limited. All Registered Care Homes receive a minimum of two inspections within a 12 months period, as this inspection may not have covered all the National Minimum Standard on this occasion if further information is required it is recommended that a copy of the last inspection report also be obtained. What the service does well: What has improved since the last inspection? Since the last inspection a number of staff have attended training courses relating to Dementia. Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 6 Mission Care has developed its Whistle Blowing Policy and staff have attended Adult protection training. The homes Statement of Purpose and Service Users Guide have been developed and are now ready for printing. The home has improved its storage facilities and hoists, wheelchairs and zimmers are now less of a hazard. What they could do better: Issues in relation to the recording of medication need to be addressed urgently this is of particular concern as the home have failed to act on the requirement made at the previous inspection. The acting manager must ensure that the CSCI are informed of any, accident or incident that may effect the wellbeing of service users. This is to include any service users who are diagnosed with MRSA. The acting manager must ensure that records of any complaints received are kept in the home and available for inspection. The sample of care plans seen indicated key information was out of date, action is required to review care plans and commence use of the new format as soon as possible. Service users who do not have relatives or friends require assistance to personalise their rooms. If staff need to physically restrain service users from harming other service users or member of staff. appropriate training needs to be provided to reduce the risk of harm to both parties. The acting manager needs to develop a system of auditing to review the quality of service and nursing care provided in the home. The acting manager and all staff working in the home need to ensure that sound practises are in place regarding infection control. All staff need to ensure safe moving and handling procedures are used when moving service users. Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 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 Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 Since the last inspection action has been taken to produce a Statement of Purpose and Service User Guide. This provides service users or their advocates with the necessary information needed to make an informed decision to live at Homefield. EVIDENCE: Since the last inspection progress has been made in relation to the production of the Homes Statement of Purpose and Service User Guide with draft copies now ready for printing. A copy of the final document needs to distributed to service users or their advocates as well as the CSCI. The manager stated that service users or their advocates are provided with written information regarding their terms and conditions of residency and both parties rights and responsibilities. Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 10 Prospective service users are given the opportunity to visit the home prior to admission although the process has to vary depending on each persons ability to comprehend the process. Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 11 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, 11 Service users are spoken to and treated respectfully by staff. There has been no progress made to address the issues around poor medication practises as highlighted in this and the previous inspection report. Poor practise can be detrimental to the health and well being of the service users. EVIDENCE: Each service users has a written care plan. The format is currently changing, however at the time of the inspection only one new style care plan was in use, this was not examined on this occasion. Factual inaccuracies seen on two old style care plans mean the task of reviewing and transferring relevant information from the old care plan to the new needs to be addressed as a priority. A relative spoken with stated that on one occasion he had been denied access to his mothers care plan and the issue was only resolved by the intervention of the Acting manager. Senior staff that attended part of the inspection stated this would not happen in the future and that relatives will be involved in the care planning and review process. Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 12 Service users were seen to be appropriately dressed in clean well-laundered clothing. One relative spoken with who visits daily felt that her husband was well cared for and always well dressed. Staff demonstrated a caring approach and one male staff member was seen to be particularly helpful and very pleasant to residents and visitors. Records seen at the time of the inspection indicate service users health care needs are addressed. The home has a GP who attends the home on a regular basis, additional services are provided by chiropodists, opticians and dentist etc. The manager stated service users are referred to additional specialised such as physiotherapists and occupational therapists by the GP as and when required. Records seen indicated service users wishes in relation to action to be taken by staff following death have been recorded in their care plan. The manager stated that they endeavour to care and support seriously ill service users in the home for as long as it is safe and appropriate to do. When a local community hospice team provides needed specialised support and intervention. A requirement was made at the time of the last inspection in relation to the recording of medication. Evidence seen on this occasion indicates insufficient action has been taken to address these issues. The medications were inspected in unit three. Medication is supplied through Boots monitored dose system. The medication administration charts had photographs in place for identification purposes. The allergies section was incomplete on many charts. Hand transcriptions of medications had been used on several charts. Some were without staff signatures. One resident’s chart had three hand transcriptions but no staff signatures in place. Quantities received in to the home were generally not recorded when hand transcriptions were used. Two staff signatures should be in place for all hand transcriptions to ensure that the information recorded is accurate. On one chart the abbreviation “ R” had been used to denote that the residents had refused her medication. This was evident on many other charts, residents were said to have refused their medication, and one gentleman had refused for months”. In the event that residents are refusing their medications then this must be referred to the GP and multi disciplinary team for discussion and review. If the medications need to be administered then alternatives should be investigated such as covert administration. The home should devise a policy in Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 13 line with current guidance; the covert administration of any medication must be kept under review. Records were available showing that fridge temperatures are being monitored, however, the inspector was advised that in the summer this room becomes very hot, in this case the room temperature should be monitored to ensure the medication storage is at an optimum temperature, at present this is not happening. A number of service users were seen to be asleep in the lounge during the morning. One relative said that her husband was sleepy every time she visited as he slept poorly. Staff should investigate ways to re establish the night time sleeping routine and review the use of sedative medications with service users GP`s. Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 14 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): 12,14,15 The home provides an activities coordinator, however service users would benefit from more age appropriate activities. EVIDENCE: The home employs an activity co-ordinator, service users art and craftwork was displayed in the dining room. Discussion took place regarding the need to offer age appropriate activities; senior staff stated this was currently being addressed. Ten residents were enjoying a group activity with two staff members. The residents were seen to interact with one another and contact by staff was caring and spontaneous. Old time music was playing in the communal area and staff were seen to be in the area supervising residents. Refreshments were served from the trolley. Biscuits and fruit were available, although the fruit was on the bottom shelf and not offered; hence all of the fruit was returned to the kitchen from the ground floor unit. Service users are able to bring in small items of furniture, pictures and mementos to help personalise their bedroom. Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 15 Records seen indicate that a number of service users have support from relatives who have legal Power of Attorney designed to support the service user in managing their affairs when they are no longer able to act in their own best interest. Lunch was seen to be served. It was well presented and in good sized portions. The tables were laid with cutlery, serviettes and juice was provided with the meal. Plate guards were observed to be used appropriately. Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 16 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): 16,17,18 Mission care has been seen to respond to a complaint brought to their attention. Action has been taken with staff receiving training relating to whistle blowing and issues around adult protection, these need to be developed further if staff are expected to physically manage aggression from service users. EVIDENCE: A relative provided a copy of correspondence regarding a complaint he made to Mission Care. This contained a number of points, some had already been addressed by the organisation before this inspection, and some are still ongoing. The complaint was discussed with Mission care during the course of the inspection, with action being required on some of the issues by the CSCI. These issues are addressed in relation to the relevant standards within this report. Senior staff stated action was being taken by Mission Care to address the concerns made to them, however, at the time of the inspection there was no copy of the complaint in the home or record of action taken by Mission Care to address the concerns. Copies of any complaints made must be kept in the home and available for inspection. The acting manager stated he had taken action to ensure that all service users names are on electoral roll. However to date no one has chosen to vote. Since the last inspection action has been taken by Mission Care to address issues regarding adult protection, staff have received training provided by Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 17 Social Services and the homes policy regarding Whistle Blowing has been updated. Discussion took place around aggression exhibited by some service users toward each other and towards staff. The acting manager stated it had been necessary in one instance to physically restrain a service user who was assaulting another service user. If staff have no alternative but to take this action training is required in safe break away technique. In the event of a service user being assaulted the home is advised to liaise with social services to ascertain if adult protection procedures need to be instigated. Further a review of the service users care needs should take place with relevant health and social care professionals to explore ways of reducing the instances and ascertain if the home is able to continue to meet the service users needs. Information provided by the acting manager on the pre- inspection questionnaire indicated an instance when it had been necessary for staff to restrain a service user to prevent an assault on another person, discussion took place with the acting manager to ensure that any such incident should be fully documented, including the nature of the restraint. Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 18 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): 19,22,24,26, Service users live in a pleasant suitable environment designed to meet their needs. The home is appropriately equipped with aids and adaptations. Sound practises must be developed to reduce the risk and spread of any infection in the home. In the absence of family or friends staff should assist service users with the personalising of their rooms. EVIDENCE: The home was clean and tidy, and free from unpleasant odours; communal areas were appropriately decorated maintained and homely. It was apparent the some service users had received assistance with personalising their bedrooms and these people have benefited from the addition of TVs, photos, pictures and personal mementos. This is also addressed in the homes service users guide. Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 19 However some peoples rooms remain quite stark and unpersonalised this is particularly noticeable as all the rooms are painted magnolia. In the absence of family members or friends staff need to take on the responsibly of assisting service users to personalise their own room. It was noted that clocks and calendars were generally absent or in one instance inaccurate. Residents who suffer from dementia benefit from visual prompts and domestic type signs should be investigated. Since the last inspection steps have been taken to improve the homes storage, which has reduced the number of hoists, wheelchairs and zimmers which were potential hazardous stored in corridors and bathrooms. Other areas have been identified for the purpose. Major work is planned to the lift to upgrade its efficiency. A toilet and bathroom on the first floor still contained laundry bins and other items; discussion took place regarding the need to keep these areas clear, easily accessible and visible to all service users. The acting manager stated the home was provided with appropriate hoists and aids to assist physically frail service users. Plans to change the current office space on the top floor to lounge space for service users benefit were discussed, with the removal of a photocopier from out side service users bedrooms to a more appropriate position. A number of small bolts have been fitted to various doors to restrict service users access for safety reasons i.e. the staff room, kitchen. These detract from a ‘home like’ appearance; discussion took place regarding the need for any lock to be operable from the inside. Discussion took place regarding the possibility of installing a keypad to the staff kitchen and reviewing the practise of bolts else were. Some issues arose in relation to infection control, which must be addressed. Bottles of alcohol hand gel used to reduce the spread of infection were seen to be appropriately installed in dispensers, however, bottles of Hibie Scrub also used for the same purpose were seen in a number of rooms and were not fixed, meaning staff need to hold the bottle to unscrew the lid therefore leading to the possibility of infection being transferred. Yellow bags in a service users bedroom used to store clinical waste were tied to the grab rails of the toilet. This is not appropriate and specific clinical waste bag holders should be sited, senior staff stated these had been purchased and would be installed. Gloves and disposable aprons were available. Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 20 The issue of infection control was discussed with care staff. A member of staff stated he would seek advise from the nurse on duty regarding infection control. However all staff working in the home need to have training relating to standard universal safety precautions. Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 21 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 Appropriate numbers of staff need to be employed to meet the increasing dependency of service users. Service users are cared for by suitable competent and qualified staff, and will benefit from the ongoing training staff are receiving. EVIDENCE: Relatives and care staff spoken with stated they felt there were occasions when there are an inadequate number of care staff to meet the needs of service users. Senior staff stated that the needs and dependency levels of some service users had increased significantly and discussion is currently taking place with local authority purchasers to provide additional funding for staffing. The inspector interviewed two unqualified staff and a number of qualified staff including one RGN and one, RGN/RMN. The interview focused on their knowledge in respect of dementia, its treatment and commonly used therapeutic approaches. The staff demonstrated a reasonable level of knowledge in respect of dementia, however for qualified staff who are directing care, managing challenging behaviour, leading and supervising unskilled staff a greater emphasis should be placed on the training in this field. Both staff Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 22 discussed training topics including statutory training and those specifically related to the residents. A requirement was made at the last inspection for where appropriate qualified staff and care staff to receive training specifically in relation to meeting the additional needs of service users with dementia. Both senior staff and care staff interviewed stated this had taken place. Care staff interviewed confirmed they received induction training at the time of appointment to the post. In addition to qualified nurses 20 of care staff have attained NVQ2. All staff have been provided with copies of the GSCC code of conduct and practise. The file of one member of staff who recently commenced work in the home was examined, this raised issues regarding the interview process, this issue will be addressed in more detail separately with Mission Care following this inspection. Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 23 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 Continuity of management is required to address the ongoing issues in this home, to supervise staff practise appropriately and ensure that service users health, safety and well being are maintained. Although their are quality assurance mechanisms these need to be fully developed to safeguard the wellbeing of the service users. EVIDENCE: The acting manager is due to leave having been in post for six months and the inspector was informed that a further temporary manager would be in post whilst action was taken to recruit on a permanent basis. In the interim Mission Care have been asked to provide written details to the CSCI regarding the acting persons qualifications, skills and experience to fulfil the role. Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 24 Discussion took place regarding the homes Quality Assurance mechanisms. At present regular visits take place by a member of the Board of Trustees who completes a comprehensive report on their findings and areas that need to be improved upon. Discussion took place with the manager that a regular audit of the care and service provided to meet the requirements of Regulation 24 CSA 2000 must be carried out. Laing and Boussion have also recently been commissioned to undertake a survey of Mission Cares service users and other relevant parties views. Discussion took place regarding making this information available to the public. Staff do not assist service users with their finances. A monthly account is sent to relatives for any cost incurred i.e. in relation to hairdressing etc. Records seen indicate that the home currently has 6 members of staff who hold first aid qualifications. Although staff stated they had received moving and handling training the inspector noted on two occasions staff were observed to drag residents feet whilst transporting them in their easy chairs. Manual handling practices need to be reiterated to staff as this type of manoeuvre could cause friction, which may lead to the development of pressure sores. Discussion took place regarding the need for the CSCI to be informed of any accident or incident that may effect the well being of service users, this needs to include any service user being diagnosed with MRSA. Records seen indicate that maintenance and safety checks are regularly undertaken to all electrical, gas and equipment used in the home. Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 25 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 3 18 2 3 x x 3 x x x 2 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 3 x x 2 Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 26 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) Requirement Timescale for action 31/12/05 2 OP16 Schedule 4 .11 3 OP18 13(7) 4 OP18 13(8) Make arrangements for the recording, handling, safekeeping, safe administration and disposal of medication. (Previous timescale of 30th may 2005 not met) Records to be kept in the care 30/11/05 home. A record of all complaints made by service users or their representatives or relatives of service users or by any persons working at the home about the operation of the home, and the action taken by the registered person in respect of any such complaint. The registered person must 30/11/05 ensure that no service user is subject to physical restraints unless restraint of the kind employed is the only practical means of securing the welfare of that or any other service user and there are exceptional circumstances. On any occasion on which a 30/11/05 service user is subject to physical restraint, the registered person shall record the DS0000010136.V256271.R01.S.doc Version 5.0 Homefield Nursing Home Page 27 5 OP30 18(1)(C) 6 OP27 18(1)(a) 7 OP26 13(3) 8 9 OP31 OP33 8 24 circumstances, including the nature of the restraint. Staff are provided with appropriate training regarding the work they are to perform in this instance safe and appropriate means of managing physical aggression by service users The registered person must, having regard to the size of the care homes, the Statement of Purpose and the number and needs of service users. Ensure that at all times suitably qualified, competent and experienced persons are working in the care home in such numbers as are appropriate for the health and welfare of service users. The registered person must make suitable arrangements to prevent infection, toxic conditions and the spreading of infection in the care home. The registered provider shall appoint an individual to manage the care home. The registered person must establish and maintain a system for reviewing at appropriate intervals and improving the quality of care provided at the care home, including the quality of nursing when nursing is provided at the care home. 30/11/05 01/03/06 30/11/05 01/03/05 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 28 No. 1 2 3 Refer to Standard OP7 OP12 OP24 Good Practice Recommendations Service users care plans need to be reviewed and information transferred and updated on to the new format. Activities arranged for the service users need to be more age appropriate. All service users bedrooms should be individually personalised and meet their assessed needs. Homefield Nursing Home DS0000010136.V256271.R01.S.doc Version 5.0 Page 29 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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. 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