Inspection on 18/12/06 for Howard Court Nursing Home

This inspection was carried out on 18th December 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Howard Court Nursing Home 26/03/09

Howard Court Nursing Home 05/11/07

Howard Court Nursing Home 05/10/05

Howard Court Nursing Home 28/07/05

Howard Court Nursing Home 20/01/05

Howard Court Nursing Home 15/07/04

Howard Court Nursing Home 11/02/04

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

CARE HOMES FOR OLDER PEOPLE Howard Court Nursing Home 9 Burlington Road Ipswich Suffolk IP1 2EU Lead Inspector Jane Higham Unannounced Inspection 18th December 2006 11:45 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 Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Howard Court Nursing Home Address 9 Burlington Road Ipswich Suffolk IP1 2EU 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) 01473 210787 01473 233619 www.bupa.co.uk BUPA Care Homes (CFCHomes) Limited Mrs Audrey Sayers Care Home 40 Category(ies) of Dementia (40) registration, with number of places Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 5th October 2005 Brief Description of the Service: Howard Court is a forty-bedded nursing home for older people suffering from severe mental infirmity and is located with a residential area of Ipswich, close to the town centre and all its facilities and resources. Originally owned by the local authority, the home now forms part of the BUPA care group and was registered under the name of this organisation in December 1994. The home has twenty-six single bedrooms and a further seven shared rooms. Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of Howard Court, a forty bedded care home with nursing for people over the age of 65 suffering from severe mental infirmity. The home is owned and administered by BUPA Care Homes Ltd and is situated in a residential area of Ipswich, close to town centre resources and facilities. The inspection was carried out on 18 December 2006 over a period of six hours. The key inspection focused on the care standards relating to care homes for older people. The report has been written using accumulated evidence gathered prior to and during the inspection. In advance of the inspection, the home was provided with relative/visitor questionnaires for distribution. At the time of writing twenty-two questionnaires were returned to the Commission. A range of comments contained within the questionnaires are included in this report as are those obtained during the inspection. The National Minimum Standards and Care Homes Regulations 2001 are referred to throughout this report and any non-compliance identified. All key standards were assessed as part of this inspection. The Manager was present throughout the inspection and the inspector had the opportunity to talk to residents, visitors to the home and staff members. At the time of the inspection, fees charged ranged from £492 - £720. What the service does well: The home ensures that prospective residents and their families/representatives receive comprehensive information about the home on which they can base a decision as to whether they wish to use the service. Each resident is provided with a detailed plan of care which provide staff with clear guidelines as to the individual levels of intervention and support required. The needs of residents are both complex and at times challenging but they are supported by staff, wherever possible, to make decisions about their everyday lives. Residents are offered activities which are appropriate to their needs and abilities. The home offers a very unrestricted environment where residents are free to access all areas of the building. Residents are supported by dedicated and well trained staff, in sufficient numbers to ensure that individual care needs are met. Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives can expect to be provided with detailed information on which they can base a decision as to whether they wish to live at the home. All residents can expect to be issued with a contract and written details on the terms and conditions of placement and can be assured that their individual needs will be assessed prior to any admission taking place. EVIDENCE: During the inspection, the home was able to evidence that all prospective service users and their representatives are provided with a very comprehensive Statement of Purpose and Service User Guide. The Statement of Purpose includes all information as required by Schedule 1 of the Care Homes Regulations 2001. The Service User Guide provides detailed information in relation to the services and facilities provided, including a sample menu of Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 9 meals and plan of daily activities. Additionally the owning organisation provides a useful leaflet on the financing of residential and nursing care and a brochure on the provision of specialist care for service users suffering from dementia. A tour of the premises evidenced that a copy of the Service User Guide is provided in each resident bedroom. The inspector examined the admission information held by the home for the four most recently admitted service users. The home was able to evidence that two of the residents had been provided with a placement contract and a terms and conditions document. The other two residents, who had been living at the home for a period of two weeks, had not as yet been issued with a placement contract or a terms and conditions document as they were still placed on a trial period. The home was able to evidence that regardless of whether residents are placed privately or via the local authority, they are all provided with a document which outlines the terms and conditions of residence. The home was able to evidence that it had clear and robust pre-admission assessment procedures in order to ensure that they could appropriately meet the needs of any prospective resident. The inspector examined the preadmission documentation for the four most recently admitted residents and in all four cases the home was able to show that a detailed pre-admission needs assessment had been carried out and considered prior to any admission taking place. In addition to the assessment carried out by the home, residents placed via the local authority are subject to a community care assessment carried out by the named assessor, a copy of which had been submitted to the home before admission took place. In all four cases a behavioural needs assessment had been completed as part of the pre-admission process and detailed information had also been gained as part of the hospital discharge process. The home was able to evidence that it provides long-term nursing care for older people suffering from severe mental infirmity and does not provide an intermediate care facility. Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to be provided with an individual plan of care which identifies their individual needs and the levels of intervention and support required by care staff. Residents can also expect that their physical and mental health care needs will be met and that they will be enabled to access community health services. Generally, systems for the administration and storage of medication were secure, although two minor shortfalls were identified. One minor shortfall was identified in relation to the privacy and dignity of residents. EVIDENCE: The Inspector examined the care plans of the four most recently admitted residents. An individual plan of care had been provided for three of the four Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 11 residents. These were detailed in their content and gave clear guidelines to staff on the interventions and levels of support required by each person. Areas of need covered by care plans included eating and drinking, continence, personal care, maintaining a safe environment and medication. In each case the home was able to evidence that individual care plans had been regularly reviewed. At the time of the inspection, one of the four residents had not been provided with a care plan as they had only been resident for four days. Individual care plans evidenced that an assessment of individual nursing needs was carried out on the day that each person was admitted to the home. Where appropriate, a risk assessment had been completed in relation to pressure areas. The home was able to evidence that it enables residents to access community health services such as GP services, chiropody and dental services. Residents receive private chiropody services every 6 – 8 weeks and an annual eye test. All visits by GPs and other health professionals are recorded as part of the care planning system. Residents are individually assessed for their continence needs and thereafter reviewed every six months. As part of the inspection process, the Inspector examined the systems for the safe storage and administration of resident medication. Since the previous inspection, the home has changed to a monitored dosage blister pack system and three new “fit for purpose” medication storage trolleys had been purchased. The home was able to evidence that resident medication was stored securely and also had appropriate storage for any controlled drugs held. In general the administration of medication was recorded appropriately on the medication administration records. However, it was noted that in some cases where medication was prescribed on an “as required” basis and the dosage was decided by the person administering the medication ie “one or two tablets”, the actual dosage given was not always entered on the MAR sheet and therefore did not provide an accurate audit trail. It was also noted that, in the case of one resident’s medication, where diazepam had been stored as a controlled drug, the balance entered in the CD book did not balance with the amount stored in the CD cupboard. It was latterly identified that further supplies of the medication had been included in the blister pack by the pharmacy but this had not been identified by the two members of nursing staff who had carried out a check of all CDs held on the morning of the inspection. The home was able to evidence that in general, current practices sought to protect the privacy and dignity of residents. Care plans seen evidenced that as far as possible the tastes and preferences of individual residents were documented. Whilst most residents are provided with a single room, the home has seven rooms which are shared. An environmental tour of the home evidenced that shared rooms had been provided with privacy screens. It was identified during the inspection, that a notice for staff, in relation to the Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 12 personal care needs of one resident, had been displayed on the resident’s wardrobe. This did not protect the privacy and dignity of the resident. Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents living at the home can expect to be offered a varied and nutritious menu of meals and to be supported with any nutritional needs they may have. Residents are supported to maintain social contact with family and friends and to make choices in relation to their daily lives. Service users benefit from a programme of activities which are appropriate to their individual needs and abilities. EVIDENCE: The home was able to evidence that it offers residents a range of different activities. Two activities co-ordinators are employed at the home, one providing 30 hours per week and the other 16 hours a week. At the time of the inspection, the full-time activities co-ordinator was on sick leave but a limited programme of activities was still available where individual resident need was the greatest. The Inspector was provided with a copy of the activities programme on offer during December 2006 which included a musical Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 14 entertainer, a Christmas party and a carol service. On the day of the inspection, children from a local primary school were entertaining the residents with a carol performance. Due to the severe mental infirmity of residents, it is not always appropriate to use community facilities, however, residents do manage to use the local park and some attend the local church on a fortnightly basis. Residents families and friends are able to visit at any time of the day and are enabled to receive visitors in the privacy of their bedrooms if so desired. In addition to communal lounge facilities, the home has several more private seating areas around the building. One visitor to the home reported to the inspector that they felt that they were very lucky that their family member was being cared for at Howard Court rather than in a hospital setting. Of the 22 comment cards returned to the Commission by family members/visitors, 20 confirmed that they were welcomed in the home at any time and 21 comment cards confirmed that relatives were kept informed of important matters relating to their family member. Residents living at the home suffer from severe mental infirmity and as such it can be difficult for them to express their opinions or choices. However, the home was able to prove that it places importance on gaining information about individual likes and dislikes from family members and looking at the non-verbal clues and body language shown by individuals. As part of the inspection, the inspector examined the menu of meals provided for service users. The home has a varied menu with a choice of two meals at lunch time. Residents were observed enjoying their mid day meal in the home’s main dining room. Several commented how much they had enjoyed their lunch. Residents were provided with support to eat their meals where appropriate. Care plans seen at the time of the inspection, evidenced that individual nutritional risk assessments were carried out where residents had identified dietary requirements or where eating difficulties were identified. A sample menu is provided to prospective service users as part of the Service User Guide. Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents living at the home and their representatives can expect to be furnished with sufficient information to enable them to make a complaint or raise a concern in relation to the services provided. Service users can expect that the homes policies and reporting procedures, as far as possible, protect them from abuse EVIDENCE: Information on how service users of their representatives can raise any concerns or make a complaint is contained within the home’s Statement of Purpose and Service User Guide. A printed copy of the procedure is also displayed within the home and is therefore accessible to all visitors to the building. Whilst the inspector is aware that this information is available, 48 of respondents to the questionnaire indicated that they were not aware of the home’s complaints procedure. On the day of the inspection, the home was able to evidence that it maintains a very organised log of all complaints received. All complaints or concerns are recorded on the appropriate complaints form which also contains evidence in relation to the investigations undertaken, outcomes reached and documents Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 16 any action taken. No complaints have been received by the Commission in relation to this service since the previous inspection. The home was able to evidence that it had a copy of the local authority procedure in relation to the protection of vulnerable adults. The home was also able to evidence that where a concern regarding the welfare of a resident had arisen, the appropriate reporting procedures were adopted. Whilst information regarding the protection of vulnerable adults was passed to staff members via a written leaflet, at the time of the inspection no formal training package was in place. However training plans for the forthcoming year evidenced that a formal staff training session had been planned for February 2007 as part of the home’s overall training plan. Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate . This judgement has been made using available evidence including a visit to this service. Residents can expect to live in a home which is maintained to a satisfactory standard of repair and appropriate to the needs and abilities of individuals. In some areas of the building, cleanliness and hygiene issues did not afford service users total protection. EVIDENCE: Accommodation within the home is sited on two floors both of which are accessible via a shaft lift which is wheelchair accessible. There are two large resident lounges to the front of the property and a large centrally sited dining room with additional lounge seating. There are also additional seating areas located around the building which offer residents and their families a quiet and more private setting. The home has 26 single bedrooms of which 17 have ensuite facilities and a further seven shared rooms of which 4 have ensuites. Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 18 In addition to the ensuite facilities available in a large proportion of resident rooms, the home has adequate communal assisted bathing and toilet facilities. There is a large centrally sited kitchen where all resident meals are prepared. The home offers a very unrestricted environment for service users who can access the home’s secure gardens via several exits from the main building. On the day of the inspection, Christmas decorations had given a very festive feel to the home. Since the previous inspection, ground floor corridor areas had benefited from redecoration and upper floor corridors were in the process of receiving the same attention. As part of the inspection, the Inspector looked at a selection of resident bedrooms. Some were attractively decorated, well furnished and had been made to look very homely by the occupant with the addition of personal belongings ie photographs and small items of furniture. Some rooms looked rather bare and would benefit from redecoration. One bedroom (room 9) was identified as having an unpleasant odour. Communal lounge areas were very pleasant, attractively decorated and comfortably furnished. The home has a large dining room which allows for easy wheelchair access and provides a pleasant area for residents to come together at meal times. This room has large “floor to ceiling” windows which overlook the home’s gardens. In general the home was maintained to a satisfactory standard of cleanliness and hygiene, however some shortfalls were identified and these are listed below. * The sluice room situated on the first floor was not maintained to a satisfactory standard of cleanliness. * The sluice room situated on the ground floor was not maintained to a good standard of cleanliness. * The kitchen was not maintained to a good standard of cleanliness or decorative order. Areas of paintwork were damaged exposing bare plaster which constituted an infection control hazard. * The kitchen cleaning records did not accurately reflect what cleaning tasks had been completed on a daily basis. * Various members of staff, including nursing staff, ancillary staff and visitors were seen entering and exiting the main kitchen on several occasions without wearing the appropriate protective clothing. The use of the kitchen by staff other than those allocated for the purposes of food preparation, increases the risk of contamination and the spread of infection. The higher the amount of “traffic” entering and leaving the kitchen, the greater the risk. Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 19 Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents living at the home can expect to be supported and cared for by a level of staffing which is sufficient to meet their individual needs. Residents can also expect that staff receive appropriate training in order that they can competently carry out their roles. Recruitment procedures are robust in order to, as far as possible, protect residents. EVIDENCE: The staffing rotas seen on the day of the inspection evidenced that two nursing staff are on duty throughout the day and during the night. Nursing staff are supported by six care staff in the morning, four care staff in the afternoon, decreasing to two care staff at night. The home also employs domestic staff, kitchen staff, maintenance staff and activities co-ordinators. Out of the 22 relatives/visitors who returned questionnaires 63 felt that there were a sufficient number of staff on duty. The Inspector examined the recruitment documentation for two randomly selected staff members. Recruitment files were well presented and organised and the home was able to evidence that in the case of both staff members, Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 21 POVA checks and enhanced disclosures had been obtained prior to either commencing duties, as had two satisfactory written references. Evidence was available to confirm that all newly appointed staff members are provided with a structured four day Induction Training package, which comply with Skills for Care training standards. Training records available evidenced that staff members are provided with all areas of mandatory training , including moving and handling, fire awareness and health and safety. Additionally as the home provides a service for older people suffering from dementia, all staff undertake “Understanding Dementia” training. A detailed and comprehensive staff training plan had been provided for the forthcoming year. At the time of the inspection, two members of care staff had achieved an NVQ Level 2 in care, seven had commenced an NVQ training programme and another three members of care staff were commencing an NVQ programme in January 2007. If care staff members successfully complete the above courses the home will be in excess of the recommended minimum ratio of 50 of trained care staff. During the inspection, interactions between staff and residents were observed to be good. Staff were helpful, warm and supportive and treated residents with respect. One relative who returned a comment card to the Commission stated “We can not praise the care our family member receives enough. The staff are wonderful.” Another returned comment card stated “ Staff do a difficult job tirelessly and with a good heart and are very kind to patients and visitors.” Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): k31, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to live in a home which is effectively managed and administered in their best interests. Service Users financial interests are safeguarded by appropriate procedures and staff are provided with appropriate supervision and guidance. Two identified shortfalls prohibited the home from providing comprehensive protection to service users in relation to their health and safety. EVIDENCE: The current Manager has worked at the home since 1996, initially in a nursing position and as manager since 1996. She is a qualified Registered Nurse and Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 23 since becoming Manager of the home has undergone additional training in the care of older people suffering from dementia. In September 2005, the Manager successfully completed the Registered Manager’s Award. The home is effectively managed and there is a clear staffing structure in place. At the time of the inspection, the Deputy Manager’s post was vacant but a successful appointment had been made. In addition to the monthly quality assurance visits carried out by a representative of the owning organisation in compliance with Regulation 26 of the Care Homes Regulations, the home has a detailed and robust organisational quality assurance system which covers 20 areas of service provision all of which have to be assessed over a one year period. The home was also able to evidence that it distributes a customer satisfaction questionnaire on an annual basis. Information gained from this questionnaire is processed and an action plan produced to ensure that any shortfalls are addressed. When looking at the systems employed for the administration and safe keeping of resident finances , the home was able to evidence that no monies are held for any service users. However, two personal allowance resident accounts are administered by the owning organisation and records were available to evidence the amounts held and transactions carried out. The Inspector noted that these finances were held in a current account and did not accrue any interest. The home was able to evidence that a staff supervision system was in place, although due to the lack of a Deputy Manager, the frequency of these supervisions had lapsed somewhat since the previous inspection. However, there was an organised approach towards the provision of staff supervision which took the format of either one to one or group meetings. In general the home provided a safe environment for service users and aids and adaptations were utilised to aid recognition and orientation. All accidents occurring in the home were recorded in detail and the home was able to evidence the weekly testing of fire alarms and emergency secondary lighting. The home has received an inspection from Suffolk Fire and Rescue Department within the last twelve months and a recently reviewed Fire Risk Assessment was available for inspection. Whilst in general the home provided a safe environment for service users, two shortfalls were identified: * Moving and handling assessments had not been carried out in relation to the two most recently admitted residents. * On the day of the inspection, the door to the first floor sluice room was left unlocked and accessible to service users. The room contained alcohol gel and Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 24 disinfectant which could present a health and safety risk to residents who suffer from dementia. Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 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 4 4 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 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 3 2 3 3 3 3 3 3 2 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 3 x 2 Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No 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 18/12/06 2 OP9 13(2) 3. OP10 12(4)(a) The Registered Persons must ensure that where the dosage of “as required” medication is within a prescribed range and administered at the discretion of a staff member, the dosage must be entered on the Medication Administration Record. The Registered Persons must 18/12/06 ensure that the balance of controlled drugs entered in the CD book is a true reflection of the amount stored within the CD cupboard. The Registered Persons must 18/12/06 ensure that notices to staff relating to the personal care of residents are not displayed openly. The Registered Persons should 28/02/07 ensure that the kitchen is maintained to a good standard of decorative order. The Registered Persons must 31/01/07 ensure that both sluice rooms sited at the home are maintained to a good standard of DS0000024421.V324559.R01.S.doc Version 5.2 4 OP19 23(2)(b)& (d) 23(2)(d) 5 OP26 Howard Court Nursing Home Page 27 6 OP26 13(3) 7 OP38 13(5) 8 OP38 13(4)(a)& (c) cleanliness. The Registered Persons must ensure that the kitchen cleaning records correctly evidences the daily cleaning tasks. The Registered Persons must ensure that that moving and handling risk assessments are completed for all residents as soon after admission to the home as possible. The Registered Persons must ensure that the sluice room sited on the first floor of the building is not accessible by service users. 18/12/06 31/01/07 18/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP16 OP26 Good Practice Recommendations The Registered Persons should ensure that representatives of residents are fully aware of the home’s complaints procedure. The Registered Persons should ensure that the number of persons entering the kitchen is kept to a minimum in order to minimise the risk of the spread of infection and contamination. Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Howard Court Nursing Home DS0000024421.V324559.R01.S.doc Version 5.2 Page 29 - 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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