Inspection on 25/04/06 for Homelands Nursing Home

This inspection was carried out on 25th April 2006.

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

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

Other inspections for this house

Homelands Nursing Home 08/07/08

Homelands Nursing Home 17/07/07

Homelands Nursing Home 21/09/05

Homelands Nursing Home 07/06/05

Homelands Nursing Home 24/11/04

Homelands Nursing Home 12/07/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Homelands Nursing Home Horsham Road Cowfold West Sussex RH13 8AJ Lead Inspector Mr D Bannier Key Unannounced Inspection 25th April 2006 11:00 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 Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 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. Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Homelands Nursing Home Address Horsham Road Cowfold West Sussex RH13 8AJ 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) 01403 864581 Medicrest Limited Mr Kamta Prasad Fakun Care Home 43 Category(ies) of Dementia - over 65 years of age (17), Old age, registration, with number not falling within any other category (26) of places Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st September 2005 Brief Description of the Service: Homelands is a care home, which is registered to provide nursing care. It has two separate buildings known as the Main House and the Coach House and is located in the village of Cowfold. The Main House accommodates up to 26 service users in the category old age not falling within any other category (OP). The Coach House accommodates up to 17 service users in the category dementia, over the age of 65 years (DE(E)). Private accommodation provided in each house includes single and double bedrooms, some of which also include en-suite facilities. Communal accommodation includes two lounges and a dining room in the Main House and a lounge/dining room in the Coach House. The fees for this care home currently range from £485 to £575 per week. The registered provider is Medicrest Ltd who has appointed Mr S Alagaratnam as the Responsible Individual who is responsible for supervising the management of the care home. The Registered Manager is Mr K Fakun who is responsible for the day to day running of the care home. Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection report has been written using new methods introduced on 1st April 2006. Some evidence used to assess standards has been gathered before this visit took place. For example, information has been used from the registered provider’s action plan that sets out how the requirements from the last inspection will be met; information has also been used from written reports of visits to the care home made by representatives of the registered provider. This visit was unannounced and started at 11am. It took place over five and a half hours and was conducted by Mr David Bannier and Mrs Kerry Leppard. The inspectors looked at those standards that are about how new residents are admitted to the care home; how residents are cared for; the daily life and social activities provided for residents; how the care home deals with complaints and how they protect residents from abuse; the environment in which residents live; how staff are recruited and trained; and how the care home is managed. Six residents were spoken to, along with two relatives who were visiting. Inspectors also spoke to the deputy manager and five staff who were on duty. The communal areas in the Main House and in the Coach House were viewed along with a number of residents’ bedrooms. Inspectors also saw the kitchen, and sluice rooms. A selection of records was also seen. Mr Kamta Fakun was also present throughout the inspection and kindly assisted the inspectors with his enquiries. The overall quality of this service is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. What the service does well: Residents who were spoken said they were well cared for and staff ensure their dignity and privacy has been maintained. Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 Page 6 Residents have been enabled to maintain contact with family and friends as they wish. Residents have also been helped to exercise choice and control over their lives. The registered provider has ensured residents receive a wholesome appealing and balanced diet. The registered provider has ensured residents live in a safe, well-maintained environment. Appropriate steps have been taken to ensure good levels of hygiene are maintained. Sufficient numbers of staff, which have been appropriately trained, have been recruited to work in the home. The registered provider has ensured residents are supported and protected by the home’s recruitment policy and practices. This will mean residents are in safe hands at all times. The registered provider has ensured to way the home is managed is in the best interests of the residents who live there. What has improved since the last inspection? What they could do better: The manager needs to ensure prospective residents are consulted as part of the process of assessing care needs. The manager also needs to ensure Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 Page 7 prospective residents are written to and the way it is proposed their care needs will be met explained to them. This will ensure residents are fully consulted and any individual needs and wishes taken into account. This will also ensure residents, or their representatives, have all the necessary information available to them before deciding to move into the care home. The manager needs to ensure care plans include information and guidance to staff about how each individual’s care social and health care needs are to be met. This will mean residents’ care needs will be met in a consistent and continuous way. This will also ensure all staff will provide care to individual residents in a manner acceptable to them and taking into account, where possible, individual preferences. 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. Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 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 Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 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): 3 and 6 The registered provider has ensured that no resident moves into the care home without having had his or her care needs assessed. The registered provider has been unable to confirm that residents have been consulted as part of the assessment process and that they have been assured their care needs will be met. This care home does not provide intermediate care. Quality in this outcome area is adequate. EVIDENCE: Following the last inspection a representative of the registered provider has reviewed the assessment process. As a result a new pre – admission assessment form is now in use. This means that the registered manager is able to gather information about the needs of prospective residents in order to determine if the care home can meet them. Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 Page 10 The inspectors looked at the records of six residents who had been admitted since the last inspection. It was noted that information gathered was inconsistent. Some forms were well -used and provided good information others were incomplete and provided very minimal information. The manager was advised to devise in house training for staff that are involved in this process. This will ensure staff understand the level of information, which should be gathered, and the purpose of the process. Six residents were spoken to, along with two relatives who were visiting. Four residents confirmed they were satisfied with the care provided. One resident told the inspector “The staff are very kind to me”. Two residents said that, whilst staff were kind and caring, they did not think staff understood their individual care needs. One resident said, “ The nursing care is no existent”. Another resident said, “Staff don’t know what to do to help me.” There was no evidence to confirm that residents had been consulted during the assessment process. This means that resident’s individual wishes about how they want to be cared for have not been taken into account. Nor was their evidence to confirm that the registered person had written to each prospective resident, or their representative, to confirm that the care home is able to meet assessed needs. This means that the registered person has not provided residents with information about how it proposed to meets identified needs before they decide to move in. Neither residents nor relatives were able to confirm they had been consulted during the assessment process to ensure individual choices have been taken in to account. Relatives who spoke with the inspectors also said they had been to the home to look around before their relative came to live at Homelands. Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 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, and 10 Whilst care plans have been drawn up for each resident, they do not appear to form the basis on which care is provided. Whilst residents’ health care needs have been met, this has not been done in a planned way and in accordance with residents’ wishes. Residents, where appropriate, have not been encouraged and supported in taking responsibility for their own medication. Prescribed medicines have been dealt with safely. Residents have been treated with respect and their right to privacy has been upheld. Quality in this outcome area is adequate. EVIDENCE: Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 Page 12 There was evidence to confirm care plans had been generated as a result of the assessment process. Care plans provided staff with clear information regarding the identified care needs of each resident. However, records did not provide clear instructions to staff regarding how they should be met. As a result it was not clear that staff are provided with information and directions to ensure consistency and continuity of care provided and in accordance with the wishes of individual residents. A senior nurse reviews care plans at least once a month. However, the information did not provide clear evidence regarding how they were reviewed and whether each resident and their relatives had been consulted. Entries seen, that were also dated, simply stated that the care plan had been reviewed. Neither residents nor relatives who were spoken to were able to confirm they had been consulted with regard to care plans and when they have been reviewed. It was, therefore, not clear if the care provided has been agreed with residents and had taken into account their personal wishes. There was evidence that indicated that residents’ health care needs have been met. Residents said they have visits from their GP and from a chiropodist should it be necessary. These visits have been clearly documented in residents’ care notes. Nursing interventions have also been documented. However, there were instances when they had not been kept up to date. For example a resident had an indwelling catheter that had been removed. There was no entry to confirm when this had been done and by whom. The care plan had not been updated to include directions to staff regarding what they should do to assist with the management of this resident’s continence. Staff who were spoken to appeared to understand the needs of residents. Whilst there is no evidence of negligence by staff, it appears as if care is provided instinctively by staff rather than in a planned manner following consultation with residents or their relatives. Care records and assessment records examined provided no evidence to confirm that where possible, residents are supported in administering their own medication. It appears as if it is the practice for this care home to take responsibility for all residents’ medication without taking in to consideration residents’ abilities or wishes. The manager was advised that this matter should be included within the initial assessment of residents’ care needs before admission. He should also undertake a review of all current residents to ensure they are satisfied with the current arrangements to administer their medicines to them. Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 Page 13 The inspectors observed the nurse in charge administer lunchtime medication from a lockable box that is easy to transport around the home, the nurse’s practise involved administering from a blister pack and signing a Medication Administration Records when each resident had taken their tablets. Medication records seen were up to date and demonstrated that residents had been given all prescribed medication appropriately. The care home has also kept a record of the disposal of unused medication. Such medication has been disposed of safely and appropriately. Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 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, 13, 14 and 15 The registered provider has ensured the lifestyle residents experience in the care home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Residents are able to maintain contact with family and friends as they wish. Residents are helped to exercise choice and control over their lives. The registered provider has ensured residents receive a wholesome appealing and balanced diet. Quality in this outcome area is good. However, the outcome for each of the above standards can be further improved by ensuring residents and their relatives are consulted wherever possible when individual care needs are assessed and care plans are reviewed. EVIDENCE: Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 Page 15 Relatives visiting the Coach House, who spoke to the inspectors expressed satisfaction with the levels of stimulation provided to residents. The inspectors observed that music was playing to which some residents were singing along and one resident was supported to dance. Staff told the inspectors that an activity organiser works full time including some weekends. According to information provided in reports of visits made by a representative or the registered provider, residents told the representative they were satisfied with the care and services provided. One resident told the representative they were looking forward to the summer and a chance to sit out in the sunshine and walk in the grounds. Another resident told the representative about an encyclopaedia specifically designed for crosswords. The representative observed that residents had been provided with selection of activities such as playing cards, feeding the wild birds, walking in the garden and in the grounds. Visitors told the inspectors they are welcomed at various times and the inspectors observed that refreshments were offered. According to written reports sent to the Commission the representative spoke to a relative of one resident who confirmed their satisfaction with the care provided. One inspector sat in the lounge/dining area of the Coach House during lunch and saw the meal of chicken curry that was served with rice and vegetables, which smelt and looked appetising. Most residents appeared to enjoy the meal and one who did not was provided with an alternative that was freshly cooked. One resident told the inspectors “ I am a good eater. The food is very good”. Staff were available to support residents and it was brought to the registered manager’s attention that staff may need reminding of the importance of communication when providing support to residents. Residents have told the representative how much they enjoy the food. Two residents provided with special meals of roast chicken and scampi instead roast beef, which was on the menu. Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 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 and 18 The registered provider has taken appropriate steps to ensure complaints made by residents and their relatives are listened to, taken seriously and acted upon. All staff have received training to ensure residents are protected from abuse. Quality in this outcome area is good. EVIDENCE: During the last inspection evidence was available to confirm that appropriate records have been kept of complaints received, including how they have been investigated and what action, if any has been taken to resolve them. The manager informed the inspectors that no complaints have been received since the last inspection. It was noted that the home’s complaint procedure was on display in the hallway of the Main House and in a similar area in the Coach House. The inspectors spoke to two care staff that were on duty in the Main House. They were able to confirm that they would report any incident of suspected abuse to the manager or the nurse in charge. They were also, after prompting, able to describe some instances of possible abuse. Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 Page 17 However it was of concern to note that the nurse in charge was unable to confirm she knew the contents of the local Adult Protection procedures. This is with particular reference to notifying and alerting the local Social Services office of such an incident. It is recommended that the registered manager ensures all senior staff who are left in charge of the care home are aware of their responsibilities, particularly when he is not available. Staff working in the Coach House said they had received training in abuse awareness and understood their responsibility to whistle blow. The manager confirmed that all staff have received training with regard to identifying and reporting incidents of abuse to residents. Records were also available which confirmed the training provided. One inspector observed staff, who were on duty in the Coach House, deal sensitively and appropriately with agitation expressed by one resident. It was noted that the limited communal space in the Coach House does not facilitate residents to spend time alone or with a select group of residents easily and this could increase the risk of challenging and/or aggressive behaviour. Following discussion, the registered manager confirmed that the registered provider is giving consideration to building a conservatory in this part of the care home in order to provide additional communal space. Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 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 and 26. The registered provider has ensured residents live in a safe, well-maintained environment. The registered provider has taken appropriate steps to ensure good levels of hygiene are maintained. Quality in this outcome area is good. EVIDENCE: During the last inspection there was evidence, which confirmed that the registered provider had ensured residents accommodated in both the Main House and the Coach House were living in a safe and well-maintained environment. Information supplied by a representative of the provider has indicated that appropriate action has been taken to ensure the premises are satisfactory. Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 Page 19 The inspectors were informed that one resident was unable to have a bath. This is because the resident’s bedroom is located on a small mezzanine floor between the ground and the first floor. The resident is unable to walk up a small flight of stairs to the first floor where the bathroom is located. Staff are unable to take a hoist down the flight of stairs to the bedroom. An inspector spoke to the relative of the resident who said that this was pointed out to them before the resident was admitted. However, as the resident wanted to move into this particular room, the admission took place. It was also confirmed that, when another room becomes available, the resident would be moved. In the mean time staff ensure the resident is helped to wash thoroughly on a regular basis. From direct observation, the inspector noted that the resident appeared to be well cared for. The resident told the inspector “The staff are very kind to me”. The inspectors noted that two rooms in the Coach House have been refurbished with new curtains, bed covers and chairs in matching upholstery that looked smart. The inspectors saw that the sluice room in the Main House had been refitted with stainless steel equipment that is readily cleanable. The floor covering had also been replaced. However, further work is needed to ensure wall surfaces, including tiling, are sound, impermeable and easily cleanable. The sluice area in the Coach House is also in need of some work to ensure the surfaces and floor covering are easy to clean. The manager confirmed that this would be done as part of the ongoing maintenance of the premises. The inspectors were advised of an ongoing problem with regard to the plumbing. This means that, on occasion, there is no hot water. The inspectors were also advised that that this is in hand. Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 Page 20 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, and 30 The registered provider has ensured residents’ needs are met by an appropriate number and skills mix of staff. The registered provider has ensured residents are in safe hands at all times. The registered provider has ensured residents are supported and protected by the home’s recruitment policy and practices. The registered provider has taken appropriate steps to ensure all staff are trained and competent to do their jobs. Negative comments made by residents are considered to be due to the lack of effective consultation with residents and their relatives about care assessments, care plans and how it is proposed care is to be provided. Quality in this outcome area is good. EVIDENCE: During the last inspection there was evidence that confirmed that this care home has been provided with staffing levels adequate to meet the needs of residents accommodated. Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 Page 21 The inspectors observed three care assistants and one trained nurse were on duty during the morning shift in the Main House, providing care and support to twenty residents. Domestic staff including a cleaner and laundry person supported them. Staffing levels in the Coach House included three care staff and one nurse to support fifteen residents during the morning shift. Domestic staff are also employed. Feedback from relatives also indicates that staffing levels are satisfactory. There was also evidence to confirm that the recruitment procedures and practices were sufficiently robust to protect residents from possible abuse. During regularly monthly visits to the care home a representative of the registered provider reviewed files on newly appointed staff during his visit in April and confirmed that CRB/POVA checks were in place. The inspectors spoke to three staff that were on duty in the Main House, including the nurse in charge of the shift. One member of staff had been working in the care home for about 1 month and was currently undertaking her induction training. The care needs of three residents were discussed with them. They appeared to understand the care needs of residents and were aware of the contents of individual care plans. The inspectors saw the induction record of the member of staff who is currently receiving this training. The manager has also provided evidence to confirm a training programme that is planned for all staff over the next few months Staff who were spoken to, including the person who is undertaking induction training, confirmed the training they had received and the training, which was planned. One resident said, “The nursing care is non existent! One or two staff are very good, but their English is a bit limited.” Another resident said, “ Some carers are alright. When asked about the ability of staff to look after them, the same resident said, “Staff don’t know what to do!” Other residents and relatives confirmed they were satisfied with the care provided. Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 Page 22 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 and 38 Mr Kam Fakun manages Homelands Nursing Home. He is registered with the Commission and is therefore, considered fit to be in charge, of good character and is able to discharge his responsibilities fully. The registered provider has demonstrated the home is being run in the best interests of the residents. The registered provider has ensured that residents’ financial interests have been safeguarded Appropriate action has been taken to ensure the health, safety sand welfare of residents and staff. Quality in this outcome area is good. Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 Page 23 EVIDENCE: The registered manager is Mr Kam Fakun. He is a Level 1 registered nurse. The Responsible Individual is Mr Alagaratnam, who represents the registered provider, and conducts visits to the care home each month. According to reports of his visits provided to the Commission, the RI uses these visits to talk to residents and their relatives; speak to the manager and his staff; review records and inspect the premises. This provides Mr Alagaratnam opportunities to supervise and monitor the management of the care home to ensure it is being run in the best interests of the residents. During the last inspection there was evidence that confirmed that the manager has started a programme by which all staff receive supervision on a regular basis. Mr Fakun informed the inspectors that it is not policy of the care home for staff to be involved in the financial affairs of residents. It is expected that residents, the relatives or an independent agent take responsibility for this. The manager also informed the inspectors that residents might deposit money or valuables with him for safe keeping. A safe is available for this purpose. At this time no residents are making use of this facility. Staff working in the Coach House told the inspectors they attend regular fire training sessions. Fire and moving and handling equipment servicing are maintained. Accidents are recorded although no evidence was available that they are audited and linked to care plans and the risk assessment process. This will ensure any possible risks to residents are identified and, so far as possible, eliminated. Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 Page 24 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 2 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 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 3 x 3 x 3 x x 3 Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 Page 25 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14(1)(c) Requirement Timescale for action 25/07/06 2 OP3 14(1)(d) 3 OP7 15(1) The registered person shall not provide accommodation to a service user at the care home unless, so far as it shall have been practicable to do so, there has been appropriate consultation regarding the assessment with the service user or a representative of the service user. 25/07/06 The registered person shall not provide accommodation to a service user at the care home unless, so far as it shall have been practicable to do so, the registered person has confirmed in writing to the service user that having regard to the assessment the care home is suitable for the purpose of meeting the service user’s needs in respect of their health and welfare. Care plans should be amended 25/07/06 to include information and directions to staff with regard to how the service user’s needs in respect of their health and welfare are to be met. Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 Page 26 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 OP3 Good Practice Recommendations It is recommended that the manager provides staff that are responsible for the assessment of prospective residents’ care needs with training. Training should include clarifying the purpose of the assessment process and the information required to determine if the care home is able to meet prospective residents’ care needs. It is recommended that the manager ensures all senior staff who are left in charge in his absence understand what they should do if an allegation of abuse is reported to them. It is recommended that accidents to residents are audited and reviewed. Where necessary individual care plans should be amended to ensure they reflect the actual needs of residents. 2 OP18 3 OP38 Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Homelands Nursing Home DS0000024155.V289108.R01.S.doc Version 5.1 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. 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