Inspection on 07/06/05 for Homelands Nursing Home

This inspection was carried out on 7th June 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

Homelands Nursing Home 08/07/08

Homelands Nursing Home 17/07/07

Homelands Nursing Home 25/04/06

Homelands Nursing Home 21/09/05

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 David Bannier Announced 7 June 2005, 09:00 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 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 H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 0.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Homelands Nursing Home Address Horsham Road, Cowfold, West Sussex, RH13 8AJ Telephone number Fax number Email 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 01403 865066 Medicrest Limited Mr Kamta Prasad Fakun Care Home (CRH) 43 Category(ies) of Old age, not falling within any other category registration, with number (OP),(26) of places Dementia-over 65 years of age (DE(E)),(17) Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 0.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24 November 2004 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 ensuite facilties. Communal accommodation includes two lounges and a dining room in the Main House and a lounge/dining room in the Coach House. The registered provider is Medicrest Ltd who have 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 H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 0.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and started at 9am. It took place over eight and a half hours on one day and over two hours on the second day. On the first day the inspector spoke separately to five residents and to seven staff who were on duty. The inspector also looked around most areas of the Main House and the lounge/dining room in the Coach House. The inspector observed a mealtime in the Main House and also observed an activity involving six residents in the Coach House that had been organised and led by a member of staff. Some records were also examined. The inspector returned on the second day to look at staff records including recruitment, induction and training records and to tell Mr Alagaratnam and Mr Fakun what the inspector had discovered about the way residents were being cared for and how well the home was being run. Before the inspection started Mr Fakun had sent the Inspector general information about the way the home was being run. This included the number of residents who have been admitted and who have died since the last inspection and if any residents have been involved in accidents or falls. The information also included the number of staff who had started to work at the care home and the type of training they have received. The inspector also received completed comment cards from seven residents and from seven relatives or visitors to the care home, which gave their views about the way the home was being run. During the last inspection there were some concerns about the way the care home has employed staff. An anonymous complaint was also received about this as well. As a result a meeting was held between inspectors, Mr Alagratnam, Mr Fakun and their legal advisor. The inspectors explained why they were concerned and also explained what must be done to make sure residents are safe. At this meeting Mr Alagaratnam and Mr Fakun agreed to ensure that, from the date of the meeting, no member of staff would be employed to work at the care home without having obtained all necessary checks in respect of each person employed. It was also agreed that information about the management of the care home, which is must be supplied on a monthly basis, would be provided in a more suitable and comprehensive format than has been provided until now. Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 0.doc Version 1.30 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 6 Before moving into the care home, the manager ensures he obtains the care assessment made by the resident’s social worker. If a resident does not have a social worker the manager finds out information about the resident from either hospital staff or relatives before the resident is admitted. A comprehensive assessment of their care needs have not been completed for such residents. The manager told the inspector that he does not admit residents who require intermediate care. EVIDENCE: The records of four residents were examined. These included two residents who live in the Main House and two residents who live in the Coach House. Each record included care assessments, which have been carried out by a social worker before the resident was admitted. The manager was not able to confirm that he has his own way of assessing resident’s needs if the resident does not have a social worker. It was, therefore, not clear how staff will know what they need to do for these residents. Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc Version 1.30 Page 9 One resident told the inspector that they did not want to be at Homelands, as they did not believe their needs were being met. Comment cards, which had been completed by residents, stated that three residents sometimes liked living at the care home. Two residents said they sometimes feel well cared for. A comment card stated that another resident had attacked their relative, who is a resident in the home. They also said that the other resident had not been assessed by the care home as they came from further away. Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8, and 10 A care plan has been drawn up for each resident. Where possible, the resident or their relative has been involved with this. Care plans have focussed only on the long term nursing needs of residents. No consideration has been given to personal and social care needs. EVIDENCE: Records of each resident seen included a care plan, which provided information to staff about what they are expected to do to provide for each residents individual long term nursing needs. Care plans did not include information about any interests or hobbies, which the resident might have. Three residents who live in the Main House were spoken to. One resident told the inspector that they did not want to be at Homelands, as they did not believe their needs were being met. When asked, the resident explained that there was not enough for them to do in terms of social activities. The resident also felt restricted as, due to the location of Homelands, it was not possible to go out to the local village without being accompanied by a member of staff. They were unable to socialise with other residents, as they were too frail or too Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc Version 1.30 Page 11 poorly to communicate. Although activities have been organised twice a week, there was not enough social stimulation for this person. A second resident was very upset as they were sharing a room with someone who they did not want to do so. This resident was so upset that they wept whilst the inspector was speaking to them. They did not know what they could do to make things better. They told the inspector that their relatives visit them regularly. However, they have nowhere to go to meet with visitors in private. They have used the dining room, but another resident, who smokes, has been told that this room can be used as a smoking room. The resident does not want to go there with visitors any more. The inspector also spoke to the resident who smokes, who is also unhappy. They like to smoke but also know that this makes for being very unpopular with everyone else. Although care plans have been reviewed using a range of different assessment tools including nutritional assessments and assessments relating to skin condition the manager had not used the findings of these assessments to revise and update care plans. For example the care plan for one service user identified the need to ensure their nutrition is maintained. A comment made after a monthly review was that it could be better. The care plan had not been updated as a result of this. Regular assessments also identified an increase in the risk of possible pressure sores of a resident. Again there was no evidence that the care plan had been updated. Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15 Residents at Homelands are not able to make the day-to-day decisions about how they want to live their life. There is a limited range of activities for those who wish to participate. Residents are able maintain contact with all their old friends and family wherever possible. The food is not of a good standard and the choice of menu is limited. People are not able to eat together. They either eat at individual tables or in their own room. Sufficient staff is available to assist those residents who need help and supervision with eating and drinking. EVIDENCE: One resident told the inspector that they did not want to be at Homelands, as they did not believe their needs were being met. When asked, the resident explained that there was not enough for them to do in terms of social activities. The resident also felt restricted as, due to the location of Homelands, it was not possible to go out to the local village without being accompanied by a member of staff. They were unable to socialise with other residents, as they were too frail or too poorly to communicate. Although activities have been organised twice a week, there was not enough social stimulation for this person. Two residents, who completed comment cards, said the home does not provide suitable activities. Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc Version 1.30 Page 13 There was no record kept of residents’ interests or hobbies. As mentioned previously a resident who smokes is using the dining room as a smoking room. Residents in the Main House, therefore take their meals in the lounges or in their own rooms. The main meal was observed during the course of the inspection. Residents were seated at individual tables around the lounge. The television was left on during the meal. When the inspector attempted to make conversation with a resident a member of staff turned the television down. Staff was polite and courteous when serving the meal. However, there was very little or no conversation between the staff and residents, and none whatsoever between residents. Several residents ate one or two mouthfuls of the meal and then lost interest or seemed to find it too much effort. There was no staff present during the meal until one person came in to help a resident with eating. Residents spoken to also said they did not like the food provided. There are too many casseroles and stews, and too many milk puddings and yoghurts. They have spoken to the manager about their concerns. A meeting was held recently, where he asked everyone and noted down comments, which were made to him. No action has been taken since then to deal with the concerns that were raised. Comment cards returned from residents said that three residents do not like the food whilst one resident likes the food sometimes. Residents spoken to said that it was sometimes difficult to speak to some staff because English was not their first language. A comment card received from a relative expressed concern about the limited language skills of some staff and the reduction of English speakers within the staff team. After lunch the inspector visited the Coach House. Six residents were taking part in a bingo session that had been organised by a member of staff. The residents were clearly enjoying the activity. The atmosphere was lively with plenty of banter and chat between the residents and staff on duty. There was a striking difference in atmosphere between the Main House and the Coach House. Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 A written complaint procedure has been drawn up for residents and their relatives to follow. The manager has kept a record of complaints received, but this has not been maintained and kept up to date. Not everyone is aware of how they make a complaint should in be necessary. Complaints, which have been received have not been taken seriously and fully investigated. Staff has received training with regard to identifying different types of abuse. EVIDENCE: A written complaint procedure was on display in the front hallway of Homelands. A comment card received from a relative said that they were not aware of the home’s complaint procedure. Residents told the inspector they have spoken to the manager about concerns they have about the way the home is run. This is about their dissatisfaction with the food provided. One complaint had been recorded since the last inspection, which took place in November 2004. There was no record of the concerns expressed by residents mentioned above. There was no record of two separate complaints made by two Social Workers that had been made directly to the Commission. The Social Workers had been advised to make their complaint to the registered person using Homeland’s own complaint procedure. Three comment cards, completed by relatives or visitors to Homelands included two comments about problems with residents’ personal laundry and one comment about a resident who had been attacked by Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc Version 1.30 Page 15 another resident. None of these had been recorded to demonstrate that each complaint had been properly investigated and any action taken to resolve them. Staff on duty informed the inspector of the range of training that they have had, including how to identify abuse and how to deal with it. Records seen confirmed that staff had received appropriate training. Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 21, 23, 24 and 26 The Main House and the Coach House provides residents with a safe and comfortable environment. Toilets and bathrooms, with appropriate adaptations and equipment have been provided to meet residents’ needs. Not all residents have been provided with rooms which suit their needs. This particularly so with regard to residents who must share a bedroom. EVIDENCE: Most areas of the Main House, including a number of bedrooms, toilets, bathrooms, the downstairs lounge and dining room were visited. The lounge/dining room and one bedroom on the ground floor were seen in the Coach House. All these areas were clean, appropriately equipped and furnished to ensure residents are safe and comfortable. Most residents said they were comfortable and satisfied with their accommodation. However, one resident who shares a bedroom told the Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc Version 1.30 Page 17 inspector they were unhappy with this arrangement as they did not wish to share the room with the other person concerned. The resident also informed the inspector that, apart from the bedroom, they had nowhere else meet with their relatives when they visited. Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 Homelands has adequate numbers of staff to care for the residents who are accommodated there. Staff has been provided with training, including induction training, about the care of elderly people and elderly people with dementia. The home’s recruitment procedure and practices are not sufficiently robust to ensure vulnerable and frail residents are adequately protected. EVIDENCE: Rotas were seen which showed that staffing levels, including trained nurses, catering and domestic staff were sufficient to ensure residents are well cared for. However, the inspector was made aware of some shortcomings with regard to the language skills of some staff, which were considered insufficient to be able to communicate adequately with frail and confused elderly people. The main meal was observed during the course of the inspection. Residents were seated at individual tables around the lounge. Staff was polite and courteous when serving the meal. However, there was very little or no conversation between the staff and residents, and none whatsoever between residents. Several residents ate one or two mouthfuls of the meal and then lost interest or seemed to find it too much effort. There was no staff present during the meal until one person came in to help a resident with eating. Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc Version 1.30 Page 19 Residents spoken to said that it was sometimes difficult to speak to some staff because English was not their first language. A comment card received from a relative expressed concern about the limited language skills of some staff and the reduction of English speakers within the staff team. At a meeting which took place between Inspectors of the Commission, Mr Alagaratnam and his legal advisor on 26th April 2005, Mr Alagaratnam agreed that he would ensure the care home’s recruitment procedures are improved to ensure residents are safe and the way in which staff are employed meets with the requirements of the legislation which governs the way in which care homes must be run. Two staff had been employed since the last inspection. Each person had been appointed before the manager had obtained police checks. This is of concern, as the registered provider has been made aware of this after the last inspection. A letter was sent requiring the registered provider to take immediate action to ensure residents in the care home are safe and are not at risk of abuse. As there has been no change in this a second letter will be sent and the Commission will decide if further action is required to be taken against the registered provider. Homelands provides training for nurses who are on “adaptation” training. This is training for qualified nurses from overseas who have come to Britain to adapt their qualification to the practices of this country. At the moment Homelands is training four adaptation nurses. The manager was able to supply the necessary information that confirmed that training provided is in line with the requirements of the Nursing and Midwifery Council (NMC). However, the registered manager is the only senior staff member who holds the recognised training certificate in assessment. Two other qualified nurses have attended a two-day course in mentoring. One qualified nurse has no training or qualification in assessment or mentoring even though this person has been identified as the mentor of one adaptation nurse. Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc Version 1.30 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 35, 36 and 37 Mr Alagaratnam has not formally supervised Mr Fakun, the registered manager. A system for the regular supervision of all other staff has yet to be set up. Residents’ personal care records have not been securely kept. A number of concerns, regarding the day-to-day management and the administration of the care home have been identified during this inspection. These include the assessment of new residents before they are admitted; dealing with complaints and how staff is recruited. Work is required to ensure residents are well cared for and the home is being run in the best interests of the residents. EVIDENCE: Mr Fakun is the registered manager. He is also a Level 1 nurse and is currently studying for the Registered Manager’s Award (RMA), which he expects to complete by the end of the year. Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc Version 1.30 Page 21 At a meeting which took place between Inspectors of the Commission, Mr Alagaratnam and his legal advisor on 26th April 2005, Mr Alagaratnam agreed that he would keep records of meetings he has with Mr Fakun to ensure the manager meets with the expectations of the owner of the care home and fulfils his responsibilities outlined in current legislation which governs the running of the care home. Mr Fakun has received no formal supervision since his appointment. He meets regularly with Mr Alagaratnam, but there are no formal minutes of their meetings to confirm the matters discussed. Mr Alagaratnam has no way of demonstrating that he has supervised Mr Fakun and that he is satisfied that the manager has discharged his responsibilities fully. At the same meeting Mr Alagaratnam agreed to ensure that appropriate and comprehensive records of monthly visits he, or directors of the company, makes to the care home are kept. Just before this inspection the visit report for May 2005 was sent to the Commission as required. As no improvement had been made to this report it was necessary to write again to Mr Alagaratnam on 3rd June 2005 to express concerns with regard to his failure to address this despite his assurances that this would be done. Records seen demonstrated that Mr Fakun and the trained staff have attended a course in the supervision and appraisal of staff. This was completed in March 2005. Since then Mr Fakun has supervised one of the ten trained staff. Records seen showed that he has set up a supervision agreement and a form to record what was discussed during the session. Mr Fakun could not confirm when he expected to finish setting this up for all of the trained staff. No other member of staff had received supervision. It is the home’s policy not to be responsible for residents’ financial affairs. It is expected that a relative handles this or an agent such a solicitor appointed by the resident. However, the manager does look after small amounts of money on behalf of four residents. This is kept in a safe and appropriate records with receipts have been kept of any purchases made. Residents’ records of the care they receive are kept in the office of the Main House and the Coach House respectively. As the offices are not locked when they are unattended the manager could not confirm that such records have been kept securely as required. Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 x 15 2 COMPLAINTS AND PROTECTION 3 x 3 x 2 2 x 3 STAFFING Standard No Score 27 2 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 2 x 2 x 3 2 2 x Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc Version 1.30 Page 23 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 3 Regulation 14(1)(a) Requirement The registered person shall not provide accommodation to a service user at the care home unless, so far it shall have been practical to do so, the needs of the service user have been assessed by a suitably qualified or suitably trained person. The registered person shall ensure that the assessment of service users needs is kept under review; and revised at any time when it is necessary to do so having regard to any change of circumstance The registered person shall prepare a written plan as to how the service users needs in respect of his health and welfare are to be met. Care plans should be amended to include short term care needs and social care needs. The registered person shall having regard to the number and needs of the service users ensure that suitable facilities are provided for service users to meet visitors in communal accommodation, and in private accommodation which is Version 1.30 Page 24 Timescale for action 2. 7 14(2)(a) and (b) 3. 7 15(1) 4. 10 23(2)(i) Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc 5. 10 12(2) 6. 10 12(4)(a) 7. 16 22(3) 8. 16 17(2) Schedule 4.11 9. 18 and 29 19(1)(b) as amended 10. 18 and 29 19(9) and (10) (a) and (b) as amended separate from the service users own private rooms. The registered person shall so far as practicable enable service users to make decisions with respect to the care they are to receive and their health and welfare The registered person shall make suitable arrangements to ensure the care home is conducted in a manner which respects the privacy and dignity of service users. The registered person shall ensure that any complaint made under the complaints procedure is fully investigated. The registered person shall maintain in the care home the records specified in Schedule 4, particularly a record of all complaints made by service users or representatives or relatives of service users or by persons working at the care home about the operation of the care home, and the action taken by the registered person in respect of any such complaint. The registered person shall not employ a person to work at the care home unless, subject to paragraphs (6 (8) and (9), he has obtained in respect of that person the information and documents specified in pargraphs 1 to 9 of Schedule 2, and particularly a criminal record certificate issued under section 113 of the Police Act 1997 (Previous timescale of 13/12/04 not met) Where the conditions set out in paragraph (10) are satisfied, the registered person may permit a person (the new worker) to start work at the care home 14th June 2005 14th June 2005 Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc Version 1.30 Page 25 11. 18 and 29 12. 36 13. 37 14. 37 notwithstanding that paragraph (1)(b) has not been complied with in so far as they relate to paragraph 7 of Schedule 2. They conditions are that a criminal record certificate has been applied for in respect of the new worker and full satisfactory information in respect of the new worker has been obtained in relation to paragraph 7 of Schedule 2. 19(11) (a) Where a registered person 14th June (b) and permits a new worker to start 2005 (c) as work persuant to paragraph (9) amended the registered person shall appoint a member of staff (the staff member)who is appropriately qualified and experienced, to supervise the new worker pending receipt of, and satisfying himself with regard to, the outstanding information in relation to a criminal receord certificate; so far as possible, ensure that the staff member is on duty at the same time as the new worker; and ensure the new worker does not escort service users away from the care home premises unless accompanied by the staff member. (Previous timescale of 14/02/05 not met). 18(2) (a) The registered person shall as ensure that persons working at amended the care home are appropriately supervised. 17(1)(a) The registered person shall and (b) maintain in respect of each service user a record which includes the information, documents and other records specified in Schedule 3 relating to the service user; and ensure that the record is kept securely in the care home. 26(4)(a) The person carrying out the visit, H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc Version 1.30 Page 26 Homelands Nursing Home (b) and (c) in accordance with paragraph (2), shall interview with their consent and in private, such of the service users and their representatives and persons working at the care home as appears necessary in order to form an opinion of the standard of care provided at the care home; inspect the premises of the care home, its record of events and records of any complaints; and prepare a written report on the conduct of the care home. (Previous timescale of 28/12/04 not met). 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 Good Practice Recommendations Homelands Nursing Home H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc Version 1.30 Page 27 Commission for Social Care Inspection 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 H60-H11 S24155 Homelands Nursing Home V222240 070605 Stage 4.doc Version 1.30 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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