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Inspection on 17/09/07 for Linthorpe Nursing Home

Also see our care home review for Linthorpe Nursing Home for more information

This inspection was carried out on 17th September 2007.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

A good standard of care is provided and residents are happy. Residents are treated with respect and their privacy and dignity is maintained. Care staff spoken to during the visit were able to give examples of how they treated residents with respect whilst ensuring privacy and dignity. Care staff demonstrated an in depth knowledge of the people they were caring for. Residents spoken to during the inspection and surveys completed by resident and relatives said, The service is better than one would expect" "All the staff are excellent. The staff take time to sit and communicate with residents" " The home has genuinely caring staff" "Lovely nurses, lovely carers" "Staff at the home have provided personal, almost loving care to my mother and have helped her to feel at home" 68% of Care Assistants working at the home have now achieved an NVQ level 2 in care. The homes recruitment procedure is robust, appropriate checks are carried out on staff before they start working at the home to ensure protection of residents.

What has improved since the last inspection?

A number of bedrooms have benefited from new wardrobes, drawers and a lockable bedside table. Lots of new bedding has also been purchased, this has enhanced the environment in which residents live. All requirements identified at the last inspection have been addressed. The home has received a grant and is spending the majority of money to improve the garden/seating area for residents at the back of the home. Work was in the process of being carried out on the garden area at the time of the inspection visit. A lovely patio/seating area was underway which will make a big improvement externally.

What the care home could do better:

In general good procedures are in place in respect of medication, however It was noticed that if more than one resident was on the same pain control then staff would not use dispensed medication for each individual resident but use one packet/bottle for all and when that ran out use another residents. Each resident must receive the individual medication that is dispensed for them. The broken lock on the medication fridge needs fixing to ensure safe storage of medication. Activities and outings provided by the home are limited and as such do not ensure that resident`s lives are lived to the full. The Manager and staff should discuss with residents and plan a varied range of activities. Bathrooms in the home environment need refurbishment to make the environment a more enjoyable place for residents to bathe. A window on the first floor of the home opens too far and requires restricting to ensure residents safety. Staff must receive moving and handling training on a regular basis to ensure that resident comfort is maintained and safety promoted.

CARE HOMES FOR OLDER PEOPLE Linthorpe Nursing Home 36 Eastbourne Road Linthorpe Middlesbrough TS5 6QW Lead Inspector Katherine Acheson Key Unannounced Inspection 17th September 2007 09:30 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 Linthorpe Nursing Home DS0000000184.V350935.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. Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Linthorpe Nursing Home Address 36 Eastbourne Road Linthorpe Middlesbrough TS5 6QW 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) 01642 850032 01642 824092 Linthorpe Private Nursing Home Mrs Carol Breeze Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability (0) of places Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum number of 5 service users aged 55 years and above can be accommodated within the home. 31st August 2006 Date of last inspection Brief Description of the Service: Linthorpe Nursing Home is registered to provide personal and nursing care to thirty older people. The home is situated on Eastbourne Road, Middlesbrough, and is close to Linthorpe Village and other local amenities. The home is set in its own grounds with gardens to the front and rear of the building. Internally, there are three lounge areas on the ground floor, one lounge on the first floor and two dining areas. There are twenty-two single bedrooms and four double bedrooms. Nine of the bedrooms have ensuite facilities, which comprise of a sink and a toilet. All bedrooms meet with size requirements of National Minimum Standards. The cost of care at the time of the inspection visit (depending on the category of care) ranged from £355 to £494 per week. Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was carried out on 17th September 2007 and lasted for seven hours. The reason for the inspection was to see how good a job the home does in meeting the National Minimum Standards set by the government for Care Homes. Five residents, two Care Assistants and the Office Administrator were spoken to during the visit. Lengthy discussions also took place with the Manager. Numerous records including care plans, menus, complaints and staff recruitment and training records were examined. The Inspector walked around the home with the Manager. The details of any issues identified at this inspection requiring action are to be found at the back of this report. Before the inspection fifteen surveys for residents and fifteen surveys for relatives were sent to the home for the Manager to distribute accordingly. Surveys requested feedback on the service and staff provided. Four resident and four relative surveys were returned to the Commission for Social Care Inspection. Comments received can be read within the report. The findings from the inspection were that the home provides a good service with most of the National Minimum Standards being met. What the service does well: A good standard of care is provided and residents are happy. Residents are treated with respect and their privacy and dignity is maintained. Care staff spoken to during the visit were able to give examples of how they treated residents with respect whilst ensuring privacy and dignity. Care staff demonstrated an in depth knowledge of the people they were caring for. Residents spoken to during the inspection and surveys completed by resident and relatives said, The service is better than one would expect” “All the staff are excellent. The staff take time to sit and communicate with residents” “ The home has genuinely caring staff” “Lovely nurses, lovely carers” Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 6 “Staff at the home have provided personal, almost loving care to my mother and have helped her to feel at home” 68 of Care Assistants working at the home have now achieved an NVQ level 2 in care. The homes recruitment procedure is robust, appropriate checks are carried out on staff before they start working at the home to ensure protection of residents. What has improved since the last inspection? What they could do better: In general good procedures are in place in respect of medication, however It was noticed that if more than one resident was on the same pain control then staff would not use dispensed medication for each individual resident but use one packet/bottle for all and when that ran out use another residents. Each resident must receive the individual medication that is dispensed for them. The broken lock on the medication fridge needs fixing to ensure safe storage of medication. Activities and outings provided by the home are limited and as such do not ensure that resident’s lives are lived to the full. The Manager and staff should discuss with residents and plan a varied range of activities. Bathrooms in the home environment need refurbishment to make the environment a more enjoyable place for residents to bathe. A window on the first floor of the home opens too far and requires restricting to ensure residents safety. Staff must receive moving and handling training on a regular basis to ensure that resident comfort is maintained and safety promoted. Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards assessed 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments of prospective residents are carried out to ensure the needs of residents can be met. EVIDENCE: Before going into Linthorpe Nursing Home, residents are assessed by a Social Worker or health care professional. A copy of this assessment is forwarded to the management of the home so that a judgement can be made to see if needs can be met. The Manager said that staff at the home do not routinely carry out their own pre-admission assessment of a prospective resident before admission unless the resident is self-funding or has complex care needs. Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 10 The Manager advised that an assessment of the resident is done soon after admission with a plan of care being developed there after. Surveys, received by the Commission for Social Care Inspection, and residents who spoke with us confirmed residents had enough information about the home before they moved in. The home does not provide intermediate care so standard 6 is not applicable to this home Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards assessed 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. Resident’s health, personal and social care needs are met. The home provides a good standard of care. Care plans are detailed, which will help to ensure that resident’s needs are met. Some improvements are needed in respect of medication practice to reduce/prevent errors. EVIDENCE: Two plans of care were looked at during this visit both of which contained detailed information about the resident and the help they needed. One plan of care was that of a resident who needed a lot of support and help from nurses and care staff working at the home. Care plans were individual to the resident an example being how the resident needed help at mealtime and with feeding. The plan of care described how food needed to be chopped into small pieces to help with swallowing. Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 12 Care plans were reviewed on a monthly basis and detailed any deteriorations or improvements made. Resident’s files included healthcare visits and appointments. The records showed the regularity of visits for treatment from: doctors and district nurses, opticians, chiropodists, dentists and other healthcare specialists. The home had equipment, to assist staff when they were moving residents. Residents are treated with respect and their privacy and dignity is maintained. Care staff spoken to during the visit were able to give examples of how they treated residents with respect whilst ensuring privacy and dignity. Care staff demonstrated an in depth knowledge of the people they were caring for. Five residents were spoken to during the inspection comments made included, “I am quite content I have no complaints and the staff are very nice” “The staff are fine all of them, I couldn’t fault anyone” “The staff are very kind they treat you with respect” “It’s wonderful I have been here for four years” “I’m settled here for life” Surveys received stated “The service is better than one would expect” “All the staff are excellent. The staff take time to sit and communicate with residents” “ The home has genuinely caring staff” During the inspection arrangements for receiving, storing, administering, recording and disposing of resident’s medication were observed and examined. Nurses working at the home are responsible for giving residents their medication. During the visit a medication audit of one of the residents files sampled during the inspection was carried out. Medication administration charts had been completed correctly and the stock balance of medication belonging to the residents was correct, matching up with medication ordered, received, administered and remaining in the home. Records showed that one resident was missing a nighttime medication because they were usually asleep; this was pointed out to the Manager who advised Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 13 that she would speak to the GP regarding changing the time of the medication to teatime. The majority of medication prescribed is dispensed by the Pharmacist in blister packs, however some medication in particular tablets to control pain are dispensed in a bottle or packet. It was noticed that if more than one resident was on the same pain control then staff would not use dispensed medication for each individual resident but use one packet/bottle for all and when that ran out use another residents. The Manager was informed that this practice must stop and that residents must get their own medication. The home has a designated fridge for medication that requires cool storage. The lock on this fridge was broken. The Manager said that the temperature of the medication fridge was taken on a daily basis, however records looked at showed that this was not always recorded. Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards assessed 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 are able to make choices about their lifestyle and contact with family and friends is encouraged. Recreational activities do not currently meet all residents’ expectations to ensure residents are fulfilled. EVIDENCE: The home relies on care staff to provide stimulation through leisure and activities when time permits. The Manager identified this as an area of need for improvement. The home does not have a daily plan of activities; care staff advised, “Something usually happens every other day”. Activities mentioned included cards and watching videos. The Manager advised that some residents have been on a recent trip out to Redcar and that residents go out to the local shops with staff. Residents spoken to during the inspection said, Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 15 “There’s plenty going on for me, sometimes we play bingo or do a bit of singing on a night to keep the spirit up” “We’ve been out once to Redcar, sometimes I get a bit bored” “I would like to go out more” “There isn’t a lot to do” “I go to the shops with the carers and sometimes have a coffee” “They used to have someone who called the bingo but she left” “I like my own company I am quite content” Surveys received from residents identified a need for improvement in planned activities. Of the four surveys received one resident stated that they did not want to join in planned activities, two residents said that there were sometimes activities that they could join in and one said that there was never any activities to join in. Residents and staff said, relatives and friends were always made to feel welcome when they visited the home. Staff said the home had regular contact with resident’s families. Residents interviewed spoke of flexibility in routine and freedom of choice The Manager said that the home supports residents to practice their religion. She advised that representatives from the local Church of England Church and Special Ministers from the Roman Catholic Church visit on a weekly basis. The lunchtime of residents was observed. Staff were sitting and helping those residents that required support or feeding at mealtime. The majority of residents were having corned beef stew; one resident was having scrambled egg on toast with spaghetti. It was noted that there were no salt and pepper pots on the table; staff said that they had forgotten to put them out. Residents spoken to during the inspection and surveys received said, “The food is good, you can have what you want. I always have a bacon or egg sandwich for breakfast” “The food is smashing, I’ve put on weight” “The food is good and that’s wonderful for a farmers daughter” Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 16 “They have good wholesome food, plenty of veg and meat. A good menu to choose from” The Food safety Department visited the home for an inspection in August 2007 and identified some areas for improvement. The Manager said that action had been taken to address all areas where improvements were required. It was highlighted at the last inspection that the gas cooker knobs were damaged and needed replacing, this had been addressed. Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 17 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): Standards assessed 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 and relatives are able to express their concerns. Staff are aware of procedures to follow if abuse is suspected which helps to protect residents. EVIDENCE: The home has a complaint procedure, which has been updated to inform residents/relatives of their right to complain to any commissioning authorities such as the Primary Care Trust or Social Services. Residents spoken to during the inspection and comment cards received stated that they would feel comfortable in raising and concern or making a complaint to the staff or management of the home. The home keeps a record of complaints. There have been four complaints in the last twelve months. The home has an adult protection policy and a copy of the Teeswide Guidance regarding the protection of vulnerable adults. Adult protection training is provided to staff working at the home. Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 18 Staff spoken to during the inspection were aware of procedures to follow if abuse is suspected. There has been one referral to adult protection within the last twelve months. Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 19 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): Standards assessed 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. In general the standard of the environment within this home is satisfactory, however refurbishment of bathroom areas would provide residents with improved facilities and a pleasant area to bathe EVIDENCE: The Inspector walked around the home with the Manager. In general Lounge and dining room areas were homely, however the lounge near to the Managers office on the ground floor of the home would benefit from re-decoration. Bedrooms looked at during the visit were personalized. Since last inspection ten resident bedrooms have benefited from a new wardrobe, drawers and bedside table. New bedding has also been purchased. Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 20 It was observed that the window in room 25 on the first floor was not restricted to ensure safety of residents. The Manager said that she would take immediate action to address the situation. The home has received a grant and is spending the majority of money to improve the garden/seating area for residents at the back of the home. Work was in the process of being carried out on the garden area at the time of the inspection visit. A lovely patio/seating area was underway which will make a big improvement externally. It was highlighted at the last inspection of the home that a number of bathroom areas required the flooring to be replaced, this has been carried out, however many of the bathrooms were in need of full refurbishment. Bathroom areas are in need of redecoration to bring them up to standard and to make them a place where residents would enjoy having a bath. The homes laundry is in the external grounds to the back of the home. Since last inspection the flooring has been replaced to ensure it can be readily cleaned to prevent the possible spread of infection. Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards assessed 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. Staff at the home are experienced to meet the needs of residents at the home. Moving and handling training is out of date and as such does not ensure that staff have the knowledge to ensure safe working practices are followed whilst maintaining resident comfort EVIDENCE: At the time of the inspection there were twenty-two residents living at the home, ten of who needed nursing care and twelve residents who needed personal care. The homes duty rota showed that there were four Care Assistants on duty on a morning, three on an afternoon until 7:00pm and two on night duty. In addition there is one trained nurse on duty during the day and night. The Manager of the home, who is also nurse, works three days supernumerary a week and as such works in addition to the staff numbers above. A discussion took place with the Manager about times that residents go to bed. Staffing in the home reduces from 7pm and concerns were that residents might have to go to bed earlier than they wanted to. Residents spoken to Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 22 during the inspection said that they could go to bed when they liked, however one comment card stated that they thought the care home could improve by “Retreating to bed a little later”. Residents, relatives and surveys received in general spoke highly of the Manager and staff team comments made included, “Lovely nurses, lovely carers” “Staff at the home have provided personal, almost loving care to my mother and have helped her to feel at home” 68 of Care Assistants working at the home have now achieved an NVQ level 2 in care. The homes recruitment procedure is robust. The files of four newly appointed staff were looked at during the visit. Evidence was available to confirm that appropriate Criminal Record Bureau checks are carried out before staff start working at the home. Files examined contained all of the required information including, proof of identity and two references. Records were evidenced to confirm that newly appointed staff receive induction training; the Manager said that this meets with current induction standards as set by Skills for Care. The Manager of the home said that she has been on Fire Training and is seen as competent to deliver fire training within the home to staff. The Manager said that day care staff receive fire training twice yearly and night staff receive training four times yearly. Records of training are kept in the home. The home had a Health and Safety inspection earlier this year in which it was identified that moving and handling training for some staff was out of date. The Manager advised that moving and handling training has been arranged for 17th October and 25th October 2007 Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards assessed 31, 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. The home is well managed and run in the best interests of the residents. Resident’s personal monies are safeguarded by the home’s procedures. The health, safety and welfare of residents and staff is promoted and protected. EVIDENCE: The Manager is both experienced and qualified. The Manager is a Registered Nurse who has worked in the nursing and social care environment for many years. Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 24 The Manager has attended a number of training courses during the last twelve months, training courses attended have included, Advanced fire training, Reducing Falls and Catheter care. Residents, relatives and staff said that they thought that the home was well run, comments made included, “The Manager is lovely you couldn’t ask for better. She really helps out” “They deal with the situations they have very well” “The home respond to situations and keep a happy nursing home” “This home is well run. The Manager is nice you can talk to her” The Manager said that quality assurance and quality monitoring practices are in place. Surveys are sent out to residents on a yearly basis to see if they are happy with the home and care that is provided. The Manager advised that if residents are unable to complete questionnaires then relatives are asked to complete on their behalf. The results of the survey are not published and made available to residents a discussion with the Manager took place in respect of this. Staff receive supervision with the Manager or their mentor on a regular basis records were available to confirm that this was the case. The home looks after small amounts of money belonging to some residents. Appropriate records of transactions are kept. A sample of health and safety records were examined and were found to be in order. Records were examined to confirm that the Gas boilers and fire extinguishers had been serviced within the last year. The Manager said that a rolling programme of servicing of appliances and equipment is in place, which includes hoist, and hoist slings which have been serviced and are to be serviced every six months. The Manager said that for all those residents who have bed rails to ensure safety, staff at the home have completed a risk assessment and made sure that health and safety requirements are satisfied. The Manager said that water temperatures in resident areas are taken and recorded on a weekly basis. One average weekly tests of the fire alarm system are carried out to check that the system is in good working order. The Fire Officer visited the home in April 2007 and advised of some fire precautions that must be carried out. The Manager said that all work required had been carried out. Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 25 It was highlighted at the last inspection that the combi boiler in the staff room must be made safe, The Manager said that a cover had been provided to cover exposed wires and pipes. Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 26 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 3 Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 27 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 Requirement The Registered Person must ensure that each resident receives individual medication dispensed for them to avoid any errors The Registered Person must ensure that the lock on the medication fridge is repaired to ensure safe storage The Registered Person must consult with residents to plan a varied range of activities to residents to ensure residents are fulfilled The Registered Person must plan a programme of refurbishment, which includes bathroom and toilet areas in the home. This will improve the facilities and environment from residents to bathe • The Registered Person must ensure that the window on the first floor of the home (room 25) is restricted to ensure safety of residents • The Registered Person must ensure that all DS0000000184.V350935.R01.S.doc Timescale for action 17/09/07 2 OP9 13 17/09/07 3 OP12 16 30/11/07 4 OP19 23 30/04/08 5 OP19 13 17/09/07 Linthorpe Nursing Home Version 5.2 Page 28 6 OP30 13, 18 7 OP33 24 windows on the first floor of the home are restricted to ensure safety of residents. The Registered Person must 30/10/07 ensure that all staff receive moving and handling training on a regular basis to ensure comfort of residents and safe working practices are followed in the home The Registered Person must 30/12/07 ensure that the results of the quality assurance survey are published and made available to residents to give feedback on the service provided. 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 OP1 Good Practice Recommendations The registered person should introduce a new resident guide. The current guide is a small document and may benefit residents more if written in a larger print so it is easier to read. The Registered Person should ensure that assessments of prospective residents are carried out before admission to ensure care needs can be met Staff at the home should record the temperature of the medication fridge to ensure that medications are stored at the correct temperature. 2 3 OP3 OP9 Linthorpe Nursing Home DS0000000184.V350935.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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. 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