Inspection on 06/09/06 for Lauriston House Nursing Home

This inspection was carried out on 6th September 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

Lauriston House Nursing Home 15/11/05

Lauriston House Nursing Home 05/08/05

Lauriston House Nursing Home 14/12/04

Lauriston House Nursing Home 29/06/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Lauriston House Nursing Home Bickley Park Road Bickley Kent BR1 2AZ Lead Inspector Miss Rosemary Blenkinsopp Unannounced Inspection 09:00 6 September 2006 th 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 Lauriston House Nursing Home DS0000010139.V303107.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. Lauriston House Nursing Home DS0000010139.V303107.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lauriston House Nursing Home Address Bickley Park Road Bickley Kent BR1 2AZ 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) 020 8295 3000 020 8295 3674 Southern Cross Health Care. Ms Penny Hammond Care Home 100 Category(ies) of Learning disability (1), Old age, not falling registration, with number within any other category (97), Physical of places disability (2), Terminally ill (3) Lauriston House Nursing Home DS0000010139.V303107.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. Staffing Notice issued 10 January 1995 12 beds designated for intermediate care 2 places registered for service user category PD for named service users only. 1 place registered for service user category TI for named service user only. As agreed on the 19th April 2006, one named service user (male) with Learning Disabilities can be accommodated within the home. As agreed on 5th May 2006, one named service user (female), aged 63 years, with Terminal Illness can be accommodated in the home. 1 service user aged 59 years with Terminal Illness can be accommodated within the home. 15th November 2005 Date of last inspection Brief Description of the Service: Lauriston House is a purpose-built care home for the nursing care of older people. Ninety-eight beds are currently being used. At the time of the inspection the home had eighty-two residents on site. The accommodation for residents is on three floors, all accessed by two passenger lifts. There is a large garden at the back of the home and parking at the front. The home is two miles from Bromley town centre and within walking distance of Bickley rail station for those with full mobility. The home is on a bus route. Several of the above conditions of registration are now not applicable. The Manager will apply to have these removed in conjunction with the new registration of physically disabled which is proposed for the first floor. Lauriston House Nursing Home DS0000010139.V303107.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Since the last inspection the Registered Company has changed from Ashbourne to Southern Cross. Lauriston itself is in a period of transition with regards to the paperwork and documentation, as all of this has changed. Senior personnel and lines of management have also been subject to change. The inspection was conducted unannounced by two inspectors over a period of one and a half days. In preparation for the inspection the Manger had completed the pre-inspection questionnaire and returned this to the CSCI. Seven comment cards were returned, three from relatives, two from residents, one from a care Manager and one from the GP. The two inspectors visited different floors during the inspection one concentrated on the Garden Suite the other on the ground floor. A limited period was spent on the first floor. There is no longer an Intermediate Care Unit on the first floor. This floor now had elderly residents plus a younger physically disabled resident for whom the home has a variation. On the day of the inspection there were eighty-two residents in the home. Generally positive feedback was received regarding the care provided and staff working within the home. This is a large facility, that has gone through significant change in the last year, which can adversely affect residents or staff however this seems to have had little negative impact on either, probably due to the consistency an support provided by the Management Team. What the service does well: The Management Team provides strong leadership in this large facility. All staff with whom the inspectors met confirmed this. Lauriston House manages some very dependant residents and is particularly skilled in wound and pressure area care, good results have been achieved in these areas. More recently the home has started to provide care for younger terminally ill residents – of which variations have been approved. Again the care provided in the latter stages of life has been to a good standard. Systems are in place to ensure records are accessible and available to staff. This was evidenced on the two days of the inspection. Documentation, including care plans and risk assessments, are kept up to date by staff with internal management audits to ensure this is the case. Staff themselves said that they felt supported by input from Management who were available, knowledgeable and good at providing advise. Lauriston House Nursing Home DS0000010139.V303107.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. Lauriston House Nursing Home DS0000010139.V303107.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 Lauriston House Nursing Home DS0000010139.V303107.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The quality rating in this section is adequate. This is based on all information including the site visit. All residents are assessed prior to admission by suitably qualified staff. Pre-admission information is provided with contracts terms and conditions issued on admission. EVIDENCE: Intermediate care is not provided in this home. This ceased December 2005. The two Managers assess all prospective residents. This has included, within the last year, a resident who was hospitalised in France. The two Managers went to France to assess him to ensure that they were able to meet his needs and did not simply accept the paperwork provided. There is a standard assessment tool in use, which identifies areas of need including physical, mental and social aspects of health. There is space for additional problem areas to be included. Due to the change of company, all of the documentation is due to be replaced including assessment and care planning records. Lauriston House Nursing Home DS0000010139.V303107.R01.S.doc Version 5.2 Page 9 The inspectors viewed several of the admission assessments of those residents on the ground floor and those in the Garden Suite. In addition the information relating to a resident who was due to be admitted on the first day of the inspection was viewed. This pre-admission information was recorded on the Southern Cross paperwork, which staff found more difficult and not as comprehensive as previously used. The format covered all health needs although allowed a limited space for information and the inspector was unable to find the diagnosis. Included within the paperwork was an assessment for specialised equipment required for prospective residents. The inspectors were advised that rarely do residents visit prior to placement although relatives do. Relatives, with whom the inspectors met, confirmed this. Contracts, terms and conditions were in place for all residents, including privately funded residents. The contracts detailed the fee payable and stated all additional costs. On the Garden Suite, the inspector also viewed pre-assessment information. Again, it was evident that prior to admission senior staff assess all residents. The home obtains written information from Care Managers or health professionals involved in residents’ care. Two residents’ files were viewed. These contained the home’s written referral and assessment details with information from the relevant professional involved in their care at that time. The assessments contained the basic information on a number of areas. It was also evident from this information that residents may have confusion or a form of Dementia, as well as the physical nursing care needs which prompted their admission. This was detailed in the paperwork. The home must ensure that all residents admitted are within their registration categories. There was confirmation in the files that, upon assessment, they (the home), are able to meet the residents’ needs. The Statement of Purpose and Service Users Guide were available and these were obtainable in audio form. These are issued to all residents. Lauriston House Nursing Home DS0000010139.V303107.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. The quality rating in this section is good. This is based on all information including the site visit. Heath care is well provided for with specialist equipment available and used. Care plans are in use with supporting risk assessments. These are reflective of needs, updated and kept under review. Medications are well managed and records completed. EVIDENCE: On the ground floor three residents with whom the inspector met had their care plan documentation selected for case tracking. The home uses a standard care plan format, which outlines activities of daily living with supporting risk assessments in place. These were reviewed regularly usually on a monthly basis. Risk assessment covered nutrition, manual handling falls and skin integrity. Residents’ photographs were on file and next of kin details were recorded. One female resident was in her bedroom, classical music was playing and she looked well care for. This resident’s care plan did not totally reflect her needs Lauriston House Nursing Home DS0000010139.V303107.R01.S.doc Version 5.2 Page 11 as she was seen to be verbally uncommunicative, however this was not noted nor a care plan regarding alternative communication methods developed. The named nurse for this resident had a good knowledge of her needs. Equipment was seen to be used correctly and appropriately for residents needs. Multi-disciplinary input, hospital appointments and social worker reviews were on file. Residents on the Garden Suite appeared to be well presented and nicely groomed. The three files viewed contained an assessment and care plans developed to show the support or interventions required to meet the individuals’ needs. There were some gaps in the information, including one assessment where the personal care needs had not been fully completed. In addition risk assessments had not been completed in respect of one resident’s behaviour. The interventions information in respect of a recent increase in falls was limited. One care plan did not reflect the very recent change in needs. Where a resident is confused or has Dementia more detail should be given, as to how these specific needs are to be addressed. In general risk assessments had been completed and reviewed regularly. The information in relation to the use of bedrails was adequate. Bedrails were observed to be in place in a number of rooms. The files viewed showed there to be a risk assessment in place detailing the risks for and against their use. The inspector also noted that, where a bedrail was determined to be unsafe to one resident who was at risk of falls, another aid was used in order to monitor their safety. The home had very good records in respect of multidisciplinary visits and good records of how the residents’ health care needs were being met, including pressure care, nutritional needs and controlling infection. Relatives spoken to were generally satisfied with the care provided with positive feedback on how the home contacts them regarding any issues or concerns. One relative felt that more “attention to detail” is required in the dressing and grooming process otherwise they were satisfied with the care provided. Relatives also felt that their family members were treated with respect. They stated that particular attention was paid to dignity and privacy in relation to personal care. One resident spoken to felt that staff were kind and considerate and that her privacy was respected. She stated that she remained in bed for much of the time and felt that staff addressed her needs well. Lauriston House Nursing Home DS0000010139.V303107.R01.S.doc Version 5.2 Page 12 The medications were inspected on the ground floor. During the lunchtime period, the inspector observed the practice of administrating medications, good procedures were noted. The inspector was assisted with the inspection of the medication systems by one of the qualified staff from the ground floor. The mediation charts were well completed with photographs and allergies recorded. Dates of opening were in place for the sharps bin. Fridge and room temperatures were recorded. A list of homely remedies was available signed by the GP, 6 June 2006, and included the maximum dose of medications to be given. Those medications prescribed, “as required“, had full instructions in place. The staff member demonstrated a good knowledge of the medications she had administered and how to access information on any new drugs. Two controlled drugs records and stock balance were checked and correct. The records were accurate. There was no overstocking noted. Medications were in date with dates of opening on appropriate items. Medications were stored correctly. Drugs for disposal, had the appropriate container for this available, in the clinical room. Please see requirement 1. Lauriston House Nursing Home DS0000010139.V303107.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. The quality rating in this section is good. This is based on all information including the site visit. Some routines do prevail within the home, however choice and flexibility are included as far as possible. This nursing home caters for some heavily dependant residents and personal care takes up the majority of staff time. Activities are provided through the two activities coordinators, either in group or one-to-one sessions. EVIDENCE: The inspectors observed some of the routines on the two periods of the inspection. The inspectors met with residents, relatives and any other visitors who wished to speak with them. In the main, feedback was positive this was particularly true of the management in the home. Residents were seen to spend time in their individual bedrooms or in the communal areas. Those residents in their own bedrooms had TVs, music, and newspapers available. One younger resident on the first floor had a computer, flat screen TV and a number of other items for entertainment. He related very positive comments regarding his stay. He stated that the staff were professional although friendly which made his stay more enjoyable. He felt his needs were well addressed. He received frequent visitors and had been out of the home on various occasions. Lauriston House Nursing Home DS0000010139.V303107.R01.S.doc Version 5.2 Page 14 Some of those residents who were in the ground floor lounge remained seated in their wheelchairs for the morning period. Staff advised this was due to the difficulties with using the hoists for frequent transfers and the fact that residents themselves did not like it and preferred to stay in their wheelchairs. This situation must be kept under review and residents’ wishes addressed. Another resident on the first floor was interviewed and again she was complimentary regarding the care provided and the staff. She did however request that a pedicure be organised, as her toenails were she felt in need of it. The two activities staff organise various group and individual events. The activities programme included nail manicures, bread making, armchair aerobics and knitting. There is also a visiting library for residents. Relatives were seen to come and go throughout the day. Two relatives with whom the inspector met visited very frequently and were very satisfied with the care provided. The lunch was observed. Tables were nicely presented with fluids offered, and those who required such were assisted to eat and drink. A choice of main course was available and special requests provided as needed. Comments regarding food were all favourable. One resident enjoyed being served his breakfast in bed he said. One resident did state that the menu was not always what was actually served. After lunch some of the residents were assisted back to their bedrooms to rest or remained in the communal areas. Lauriston House Nursing Home DS0000010139.V303107.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. The quality rating in this section is good. This is based on all information including the site visit. Information on how to make a complaint is provided to residents and available to relatives. The information details external avenues for referral. Staff are provided with training in respect of adult abuse and whistle blowing and demonstrated an ability to apply this knowledge should the situation arise. Policies, procedures and information regarding this topic are available for staff. EVIDENCE: Residents and relatives spoken with stated that they felt they are able to discuss any concerns or issues. Without exception, the feedback regarding how the Manager and Care Manager responds to these concerns, was excellent. The management has always demonstrated an open, honest approach when dealing with complaints, advising the CSCI and keeping them informed of developments. Complaints are recorded and investigation records maintained together with copies of letters sent. Since the last inspection there has been one complaint made, which was found not to be substantiated. The complaints procedure is on display in the reception area and is also included in the information provided to prospective residents or their relatives. Adult Protection and Whistle Blowing procedures are in place with good guidance on how to manage adult protection issues, including details of POVA. The home also maintains the Local Authority Inter-Agency guidelines in respect of adult protection. Lauriston House Nursing Home DS0000010139.V303107.R01.S.doc Version 5.2 Page 16 Training is provided on these topics. Following the training, a written questionnaire is issued which tests their knowledge on the subject. Two of these were viewed on the staff files. Discussions with three staff showed that their understanding to be variable. This may have been due to lack of knowledge, lack of comprehension or the situation. The second inspector met with two newly appointed staff both of whom demonstrated a good knowledge of procedures and more importantly the reporting of such. They confirmed that during their induction period they had watched a video dealing with abuse and found this very helpful. There have been two recent investigations. The records showed how the allegations were managed, included referral to appropriate agencies and detailed the investigation findings. Whilst there were records of the investigation in place, the inspector recommends there is a record of a clear decision-making process, including dates and individuals involved in this process. The Manager immediately developed a pro-forma to address this. The home has also developed policies and procedures on the protection of staff against violence. Lauriston House Nursing Home DS0000010139.V303107.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 The quality rating in this section is good. This is based on all information including the site visit. The home is a purpose built facility located over three floors. Bedrooms and communal areas were well maintained and afford sufficient space to meet the needs of the residents and the equipment that they require. EVIDENCE: There are twenty-eight single ensuite bedrooms and thirty-two double bedrooms. Bedrooms were personalised, and those residents in shared rooms had divider/privacy curtains in use. The inspectors toured a selection of bedrooms and some communal areas. Areas were generally satisfactory except some corridors and doorframes where paintwork had become marked or damaged due to the amount of equipment in use. Replacement of furniture and refurbishment of bedrooms has recently commenced. There was a lot of equipment seen to be available and used including hoists, pressure relieving beds/mattresses as well as specialised baths and showers. Lauriston House Nursing Home DS0000010139.V303107.R01.S.doc Version 5.2 Page 18 Bedrails were observed to be in place in a number of rooms. The files viewed showed there to be a risk assessment in place detailing the risks for and against their use. The inspector also noted that, where a bedrail was determined to be unsafe to one resident who was at risk of falls, another aid was used in order to monitor their safety. Lounge and dining areas are provided on every floor. There is a pleasant garden, accessed via the Garden Suite. The first floor had a very homely feel more so than the ground floor perhaps because of the reduced occupancy within this floor. On the lower ground floor the main kitchen and laundry are located. The laundry was exceptionally clean tidy and well organised. The inspector met with the staff working in this area. They demonstrated a good knowledge of COSHH, MRSA and infection control measures. The organisation is to be commended in such a large facility where clothing is often an issue of concern. The kitchen is a large area providing sufficient equipment and storage space. All food storage, preparation and cooking is done on site. Meals are transported to individual floors and a member of kitchen staff assist with the serving of the meals . Lauriston House Nursing Home DS0000010139.V303107.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. The quality rating in this section is good. This is based on all information including the site visit. Staff are provided in sufficient numbers to address residents’ needs. Staff receive ongoing training both on mandatory topics and those relating to the residents’ needs. Recruitment procedures reflect that appropriate checks are made prior to employment. EVIDENCE: The home works above the staffing notice issued January 1995. There are fifty-one care staff in post, of which fifteen have NVQ or are registered to do NVQ 2. Twenty-one of the care staff are qualified nurses in their own country. A list of NMC confirmations was received with the pre-inspection questionnaire Staff with whom the inspectors met, confirmed that there was always sufficient staff on duty, although the high dependency of residents was noted as having an impact. The inspectors met with qualified, care and one ancillary staff during the two visits. Discussion revolved around induction, on going training and support. In addition those staff that were key workers to residents, who were case tracked related their knowledge of the residents to the inspectors. Staff who had been in post for some time confirmed ongoing training and support from management. Staff confirmed regular updates in statutory training as well as relevant topics such as wound care catheter care, infection control, and previously courses related to rehabilitation of residents. Lauriston House Nursing Home DS0000010139.V303107.R01.S.doc Version 5.2 Page 20 Supervision was said to take place formally every six weeks as well as daily contact. The Managers confirmed that training was provided both in-house and externally. Training needs would be discussed through supervision sessions. Two newly recruited staff confirmed employment procedures including application forms, interview CRB clearance and two references. They confirmed induction periods covering health and safety fire manual handling, abuse etc. The personnel file were inspected and confirmed robust recruitment checks were undertaken prior to employment. Confirmation of CRB clearance two references, identity checks were in place. Job descriptions, terms and conditions were seen. Two references were without any official company stamp to validate their authenticity. This needs to be addressed. Lauriston House Nursing Home DS0000010139.V303107.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38. The quality rating in this section is good. This is based on all information including the site visit. The home is managed by a competent management team. An open and inclusive atmosphere prevails. Heath and safety aspects are addressed and staff trained on these subjects. Quality assurance measures are in place including Regulation 26 visits. EVIDENCE: The Manager has been in post for approximately six years with her deputy. The Managers provide strong leadership to the home and specialise in different aspects of the day-to-day running whilst working collaboratively for the benefit of residents and staff. Both Managers are qualified nurses on the NMC register. Ms Hammond has completed her registration process through the CSCI. The organisation has a variety of tools to ensure the consistency and quality of care. These include monthly monitoring visits with copies of the report supplied to the Commission. In addition, monthly and three monthly auditing, by the Lauriston House Nursing Home DS0000010139.V303107.R01.S.doc Version 5.2 Page 22 Home Manager and a Senior Manager also takes place. Service user surveys are also conducted. The Manager is aware of the need to collate and analyse the information, with outcomes and shortfalls addressed to improve the quality of care. Regulation 26 visits are conducted and a report on their findings forwarded to the CSCI. Residents’ monies are all pooled together in an interest-bearing account. Any accrued interest is placed into residents’ funds. The home maintains a float for residents’ expenditure with receipts and records made of monies coming into and leaving the accounts. A brief audit was undertaken of the records of those residents case-tracked. These were found to be accurate with receipts in place for all expenditure with the exception of the trolley shop. A number of health and safety service contracts were viewed and found to be well organised and, in the main, up to date with the exception of the portable appliance testing and chlorination of tanks not undertaken within the last year. In the case of the chlorination this was two years. Immediately following the inspection, the CSCI received confirmation that these had been actioned. The Employers Liability insurance was in place with appropriate cover and up to date. Please see recommendation 1. Lauriston House Nursing Home DS0000010139.V303107.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 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 3 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 Lauriston House Nursing Home DS0000010139.V303107.R01.S.doc Version 5.2 Page 24 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 OP7 Regulation 15 Requirement The Registered Manager must ensure that care plans fully reflect the residents’ needs including physical, social and psychological, with sufficiently detailed interventions to provide a framework of care for staff to address. Timescale for action 30/12/06 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. Refer to Standard OP35 Good Practice Recommendations The Registered Manager should ensure receipts are obtained for all purchases including that from the trolley. Lauriston House Nursing Home DS0000010139.V303107.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Lauriston House Nursing Home DS0000010139.V303107.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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