Inspection on 12/10/05 for Longmore Nursing Home

This inspection was carried out on 12th October 2005.

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

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

Other inspections for this house

Longmore Nursing Home 24/09/08

Longmore Nursing Home 16/10/06

Longmore Nursing Home 17/02/06

Longmore Nursing Home 17/02/05

Longmore Nursing Home 17/08/04

Longmore Nursing Home 03/12/03

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Longmore Nursing Home 118 Longmore Road Shirley Solihull West Midlands B90 3EE Lead Inspector Sandra Wade Unannounced Inspection 12th October 2005 07:50 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 Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 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. Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Longmore Nursing Home Address 118 Longmore Road Shirley Solihull West Midlands B90 3EE 0121 733 6595 0121 733 3159 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) Mr & Mrs Grant Mrs Lynne Margaret Buckle Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May provide day care for up to 5 older people. May provide accomodation for up to 22 service users in 14 single bedrooms and 4 double bedrooms, (increased from 20) The exisiting staffing must be increased to provide the following minimum staffing levels over a 24-hour period: RGN 7am - 2pm 1 staff 2pm - 8pm 1 Staff 8pm-8am 1 Staff Care Assistant 7am - 2pm 4 staff 2pm - 8pm 3 Staff 8pm-8am 2 Staff Catering, laundry and other ancilliary tasks are in addition to the care / nursing staff hours and must be reflected as such on the staffing rota. Staffing levels are continuously reviewed to reflect the changing needs of service users resident in the home. Students are not to be classed as part of the staffing establishment. The manager of the home is contracted to work a minimum of 35 hours per week and is super numerary to the staffing hours. May admit older people requiring personal and nursing care, on a respite care basis, within the overall total of 22 service users. 4. 5. 6. 7. 8. Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 5 Date of last inspection 17th February 2005 Brief Description of the Service: Longmore is a purpose built, two story, detached building, set in a residential area of Shirley. Located close to all local amenities and with a good public transport system, which services the area. There is a large garden to the rear of the property with patio areas and designated car parking spaces at the front of the building. The home provides accommodation and care for up to twenty elderly and elderly physically disabled people and may make provision for up to five-day care residents. At the entrance to the home there is a small foyer with a lounge directly opposite. The home has four double bedrooms and twelve single bedrooms, there are no bedrooms providing en-suite facilities. The passenger lift is centrally located and travels to all floors. Accommodation for residents is located on the ground floor and first floor. There is a large lounge on the ground floor, which leads directly into a large conservatory, which is used as a sitting and dining room. Level access is provided for wheelchair users. Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced and was undertaken between the hours of 7.50am and 3.55pm. The inspection process included a tour of the home, talking with the Manager, examining care plan records, discussions with staff and residents and a review of policies and procedures of the home. On arrival to the home residents staff were assisting some of the residents to get up so that they could be taken to the dining area for breakfast. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 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 Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 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): 3,4 All residents are assessed prior to their admission but assessment records are not sufficiently detailed to confirm all needs have been identified. Residents receive written confirmation that the home can meet their needs. EVIDENCE: Assessment records were available in resident care plan files viewed but it was not evident the assessment process included the assessment of all care needs as specified in the care standard relating to assessments. This included the omission of an assessment of oral health, foot care, history of falls, dietary preferences and personal safety and risk. The manager advised that these matters were picked up in the care plans for residents once admitted. Letters written to residents following their assessment were available on files to confirm residents know before their admission that the home can meet their needs. Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 9 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): 7,8,11 The residents health and personal care needs are set out in an individual plan of care but further work is required to ensure these fully address current care needs and to ensure care given can be fully demonstrated. Residents have access to specialist support to address their health care needs. Further work is required to address policies and procedures on dying and death so that residents and their families know this will be handled in a respectful and sensitive manner. EVIDENCE: Through observation, the residents looked comfortable and content. Those who were able to communicate gave positive feedback regarding the care and support provided. It was clear from attempts to talk with some of the residents that they had limited communication and it was therefore difficult to get their opinions of the home and the care provided. Care plans are in place for each resident and contain details of residents needs, staff actions required to meet these needs and a signature section to confirm the staff actions have been carried out. Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 10 One resident care plan stated they were to undertake specific exercises each day and this contained an instruction for staff to encourage them to do these exercises. It was not clear if the resident chose not to do the exercises whether staff would sign the signature section of the care plan or not. The sheets being signed do not contain space for staff to write any notes. There are separate daily care notes, which are completed by the nursing staff, but these are not always directly linked to each care plan need. The manager confirmed that these notes are for the staff to record if anything has changed in regard the residents care needs and it would also be her expectation that staff use these notes to record anything significant relating to the care plans. It was advised that staff instructions are made more specific in the care plans so that it is clear what staff are signing for and staff are clear what other notes need to be completed if for some reason an instruction was not followed due to a residents reluctance or ill health. One care plan indicated that a resident was reluctant to eat and drink. The staff instruction was to offer a choice and assist if necessary and give regular drinks. There was no specific instruction on actions that should be taken if the resident was taking poor nutrition such as to coax this resident with high calorie snacks between meals or to monitor food and fluid intake. The daily records did not report consistently on whether this resident was eating and drinking adequately. The resident said that staff were giving them plenty of drinks through the day. The manager reported that there was now no problems with this resident and they were eating satisfactorily and it was agreed the care plan needed to be updated to reflect this change. Another residents care plan stated that they were particular with food and staff were to coax them with food they liked to ensure they could maintain good nutrition. It was not clear from care plan notes what food this resident liked. Care plan records contained weight charts but one of these had not been completed for September and had not yet been completed for October to demonstrate that staff were closely monitoring any weight loss due to issues relating to limited food intake. Risk assessments were available in care plan records to identify those areas of risk that needed to be managed by staff to ensure the residents care was managed safely. Both care plans viewed contained assessments in regards to the risk of the resident developing pressure areas. These assessments contained an instruction that if the scoring was above 12, then a care plan for pressure relief should be developed. Both residents had scores in excess of 12 and no care plans were available for pressure relief. Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 11 An assessment for bedrails gave an instruction for staff to observe and decide if the resident needed them and was dated July 05. A falls risk assessment in the same care plan file stated, “use bedrails as preventative action”. The resident confirmed that rails were being used on their bed but it was not clear from care plan records that this was the case or that the resident had agreed to them. The manager advised that this resident was being cared for in a special bed, which had bed rails built into it. Pre assessment records indicated that a resident was depressed, it was not evident that the care plans devised upon admission considered the psychological care needs of this resident. The manager advised that as soon as this resident was admitted to the home the depression had lifted. The daily record sheets completed by nurses made references to this residents “mood” demonstrating this was being monitored. On both care plans there were gaps on the signature sheets and it was therefore not clear whether staff had actually carried out the instructions to meet the care needs identified. Care plan records did not indicate the residents preferred term of address and did not have photographs as stipulated in the care standards. Any specialist appointments such as visits by the doctor are recorded on specific sheets in the care plan notes. At the time of this inspection there was one resident with pressure areas to their heels. The manager reported that since the last inspection more pressure cushions have been purchased to provide pressure relief for the residents who need them. The home have their own pressure relief mattresses and the manager reported that she monitors those residents who may need these. The care standards relating to death and dying were discussed. It was acknowledged that currently the home does not have a policy and procedure, which fully reflects the standards. It was advised that the manager take action to address this including for example the homes policy on residents being able to spend their final days in the their own rooms and the homes policy on relatives staying with them. Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 There home supplies three main meals each day and residents are given a choice at each mealtime. EVIDENCE: Meals seen looked appetising and menus viewed confirmed that choices are available for each meal. One of the residents said that the food was “excellent” and “good honest plain food” is being provided. It was clear from the menus that there are hot choices made available for breakfast each day as well as cereals. There are also hot choices available at teatime in addition to the sandwiches available each day. Menus do not currently show that snacks and drinks are available or that a supper menu is offered so that is it is clear these are being provided. One resident did confirm that a variety of drinks are provided throughout the day. The chilled food within the fridge and freezers was labelled and dated and temperatures are being recorded. The temperature of the fridge in the storage room near to the kitchen was tested with the probe provided and after waiting for a period of time this did not reach the temperature recorded. The manager was advised to monitor this. The cook said that the temperature did vary according to the temperature of the room. The fridge in the storage room near to the kitchen was dirty and a cucumber was not appropriately wrapped and had started to decay. The fridge storage Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 13 boxes were broken and in need of replacement and the external area of the fridge door was beginning to show signs of rust. The cleaning schedules were viewed and these had not been completed for the 10 and 11 October to confirm cleaning in the kitchen and food storage room had been done. Items of dried food and glassware were stored on heavily rusted shelves, which would be hard to maintain in a clean and hygienic condition. Since the last inspection two new stainless steel shelves have been fitted into the kitchen area for the storage of crockery etc although these were noted to have been fitted at a high level for staff to be able to easily reach. The food storage area in the main kitchen contained a good stock of foods, it was noted that the potatoes were being stored directly on the floor as opposed to on top of a crate, which the manager confirmed was the usual method of storage. Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 The home has a complaints procedure in place, which indicates an open and positive approach to problem solving. EVIDENCE: A complaints procedure is in place but the manager advised that no complaints had been received since the last inspection. Action has been taken by the manager to devise complaint tracking sheets to use in the event of receiving a complaint. During the inspection process, no concerns or complaints were made by residents and communications with residents was positive. Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 15 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, 21,25,26 Residents live in safe and comfortable surroundings, which have been well maintained with sufficient numbers of toilets and washing facilities. The home was found to be clean but some practices linked to infection control procedures need to be reviewed. EVIDENCE: Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 16 This home has a large lounge on the ground floor, which leads directly into a large conservatory, which is used as a sitting area and dining room. Level access is provided for wheelchair users. The home has four double bedrooms and twelve single bedrooms, there are no bedrooms providing en-suite facilities. The passenger lift is centrally located and travels to all floors. Accommodation for residents is located on the ground floor and first floor. The kitchen is based on the lower ground floor and food is delivered to the dining area and bedrooms via the use of the lift. A brief tour of the building was undertaken and bedroom and communal areas viewed were found to be clean and tidy. No unpleasant odours were noted. The manager advised that since the last inspection new carpets had been fitted in the lounges and some of the bedrooms. One of the residents said that friends had helped them to choose the home and they liked the home and the facilities provided. They stated they did not wish to have a lock on their door. The manager stated that there are only two residents that have locks on their doors and care plans confirm other resident’s wishes in regard to this matter. This was evidenced on care plans seen. There are toilets available on each floor for the residents and on the top floor there are two bathrooms. One of these has a hoist to assist residents into the bath and the other bath does not. Staff confirmed that the hairdresser tended to use this bathroom and it was rarely used for residents. Staff also confirmed that there were usually no more that two residents that would be bathed at the same time. There are no shower facilities in this home. There are wash- hand basins available in the bedrooms and most of the hot water taps tested were operating at safe levels so not to cause any scald risks to the residents. It was noted that the hot water in the toilet next to room 11 was running hotter than it should. Some of the hot water temperatures in the bedrooms felt on the low side and this will need to be monitored to ensure water remains hot enough to wash in. Since the last inspection the manager has employed a Company to undertake all water checks for the home. This company do not check hot water temperatures monthly and the manager was advised to review this matter as it could mean any thermostatic mixing valves not operating effectively may not be picked up in good time to prevent any scald risks to the residents. There are two washing machines and two dryers to undertake the laundry for the home. Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 17 The laundry area was viewed and the design and layout of this does not allow for a good clean to dirty flow of laundry. On entry to the laundry it was noted that the sink was blocked by a dryer and various other equipment such as buckets and cleaning products. Staff stated that the dryer had been bought in initially to use when the main dryer had failed to work. It was not clear where staff were washing their hands and although gloves were seen to be available, disposable aprons were not seen. Various colour baskets were available in the laundry but it was not clear which of these were for clean and which were for dirty laundry. A member of staff spoken to was not able to confirm this. A procedure for staff to follow in dealing with soiled or infected laundry was not on display to confirm how staff were managing this within safe infection control guidelines. A member of staff stated that the ‘red bag’ system is being used so that any heavily soiled items are put into bags before they are transported to the laundry. Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 The home provides sufficient numbers of staff with the skill mix necessary to meet the needs of service users but records do not demonstrate all staff working in the home consistently. An ongoing programme of training is being provided to all staff to ensure residents’ needs are met safely and sufficiently. The homes recruitment policies and procedures are appropriate to support and protect the residents from harm but these are not always being followed. EVIDENCE: The Staffing requirements for the home are four carers between 7am and 2pm, three carers and one nurse between 2pm and 8pm and one nurse and two carers between 8pm and 8am. The homes Registration Certificate confirms this staffing on the Conditions of Registration for the home. Duty rotas show that in the main these hours are being complied with for both nursing and caring staff. During early October there were some days when there were three carers on duty as opposed to four during the day. It was evident that the manager had attempted to cover shifts with agency carers. On the day of inspection one of the carers who was due to come on duty did not arrive until later so initially a nurse and three carers were on duty. One of these carers was on their induction training to the home. Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 19 The manager is supernumerary to the shift and is required to complete a minimum of 35 hours per week. The duty rota did not indicate the hours worked by the manager consistently to demonstrate the hours worked. At the time of inspection the Head Chef was on sick leave and this post was therefore being covered temporarily by a member of staff who usually works as a domestic. It was confirmed this member of staff has completed food hygiene training. The manager advised that the Chef is assisted by an Assistant cook and stated there are specific staff to manage the cleaning in the home. Both the manager and care staff confirmed that they do the laundry. The duty rota for the home does not indicate the names and shifts of staff completing kitchen, laundry and cleaning for the home. The Registration Certificate for the home states that any hours allocated to these duties must be reflected on the staffing rota and be in addition to the care/nursing hours provided. This does not appear to be the case which means the home are not fully compliant in meeting the Conditions of Registration for the home. Duty rotas also do not indicate the designations of staff so that it is clear what role each member of staff undertakes. Most of the care staff have completed a National Vocational Qualification (NVQ) II in Care and the home exceed the care standard relating to training in this respect. Statutory training such as moving and handling, food hygiene are being addressed on an ongoing basis but it was not possible to fully confirm this training as training records are held on individual files as opposed to an ‘at a glance’ training schedule for all staff. Staff spoken to confirmed they had completed training as required with the exception that one member of staff had not completed training in first aid. A review of staff records confirmed that recruitment information is not being closely scrutinized. Reference information is being followed up but it is not always clear whether the last employer has provided the reference or in what capacity a referee has provided the reference in regard to the applicant. One of the files viewed did not contain the identification information such as birth certificate and it was not clear what their commencement date was. Criminal Record Bureau checks (CRB) were either in place or had been applied for, it was noted on one CRB check that the ‘Protection of Vulnerable Adults Register’ (POVA) check had not been requested and no additional POVA First check had been obtained. This must be requested to ensure staff employed have not had their named entered onto the register due to issues relating to abuse. The manager advised that Terms and Conditions are usually given after the first six weeks of employment but it was not evident one of the members of staff had received this after their six week induction period. Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 33,38 EVIDENCE: Staff spoken to were very aware of the residents needs and their individual preferences. The manager advised that staff try to accommodate individual residents choices and preferences in regard to their care and to ensure the home is being run in the best interests of the residents. Meetings are held with residents and relatives and questionnaires are always left in the reception area for relatives and visitors to complete. Various different questionnaires are in use and one was viewed relating to the quality of care being provided. Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 21 The deputy manager was advised that the results of quality questionnaires received should be collated and published with details of any actions taken in response to them. This is so both residents and visitors can see the outcomes of questionnaires and the actions taken in response to these. Since the last inspection action has been taken to ensure there are separate receipts available for residents for any hairdressing undertaken. Health and safety records were viewed and it was evident that appropriate safety checks had been carried out for gas, electricity, the lift, hoists and fire equipment. The fire risk assessment is due for review and the portable appliance testing is due to be completed in October 2005. The manager advised that they undertake weekly alarm tests and fire drills are carried out 6 monthly. All bedroom doors have ‘free swing’ devices which means the doors will stay open where they are left but will close in the event of the fire alarm sounding to ensure fire safety in the home is not compromised. The frequency of hot water temperature checks is an issue raised at the last inspection, which is still to be reviewed to ensure all hot water outlets, are being maintained at safe levels. Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 X 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X 3 X X X 3 2 STAFFING Standard No Score 27 2 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X 2 Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14 (1) Requirement The manager is to review the assessment procedure to ensure all care needs are being identified. Guidance as stipulated in the care standard should be used in this review process. Care plans must be kept up-todate consistently to ensure current care needs identified are relevant. Care plans for residents with poor nutritional intake must be specific in terms of actions required to address this. Daily signature section of the care plans must be signed consistently to demonstrate staff have carried out the care indicated. Where care instructions on care plans have not been carried out for a specific reason, a system is to be agreed as to how this is to be indicated. Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 24 Timescale for action 30/11/05 2 OP7 12(1)(a) 15(1)(2) 30/11/05 The actions identified on the Waterlow Assessments needs to be demonstrated in regard to completion of pressure relief care plans. Evidence is to be maintained on care plan files of the resident/relative agreement to the use of bed rails as appropriate. 3 OP11 12, 15 The manager is to make 31/12/05 arrangements to develop a policy on dying and death with reflects family involvement and staff support that will be given to the resident/family when dealing with a residents increasing infirmity, terminal illness and death. The registered person shall having regard to the size of the care home and the number and needs of service users— provide, in adequate quantities, suitable, wholesome and nutritious food which is varied and properly prepared and available at such time as may reasonably be required by service users. In this regulation “food” includes drink. To demonstrate the above regulation, the manager is to ensure all snacks and drinks available plus the supper menu are detailed on the menu. Action must be taken in regard to the rusty shelves in the food store room to ensure shelves can be maintained in a clean and hygienic condition. Action is to be taken by the manager to monitor kitchen Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 25 4 OP15 16 31/12/05 cleaning to ensure this is being done and kitchen cleaning schedules completed accordingly. 5 OP26 23 16 (j) A review of the laundry is to be undertaken to ensure any unnecessary items are removed and staff can access the sink to wash their hands. Infection control procedures need to be reviewed to ensure there are disposable aprons available in the laundry at all times and there are clear procedures available in the laundry for staff on how laundry is to be managed. This is to include clearly labelled baskets for clean and dirty washing. The manager is to demonstrate compliance with the Water Supply (Water Fittings) Regulations 1999. A copy of the water inspection and outcome is to be forwarded as appropriate. 30/11/05 6 OP27 18 17 Sch 4 (7) The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. To demonstrate the above, the manager is to ensure:- 30/11/05 Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 26 The duty rota for the home includes hours and shifts of all staff working in the home. The designations of staff and details of any staff completing laundry duties. The manager must fully comply with the Conditions of Registration as detailed on the Registration Certificate for the home. This includes catering, laundry and other ancillary tasks being in addition to the care/nursing staff hours. 7 OP29 19(1)(c) Sch 2 Recruitment records must be closely scrutinised to ensure reference information has been sought from last employers and referees have given clear information on how they knew the applicant. Clear identification information is to be maintained on files (issue from last inspection) including clear and recent photo identification. Criminal Record checks obtained must also include a POVA check. 30/11/05 Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 27 8 OP38 13 (4) The hot water outlet in the bathroom near room 11 is to be monitored to ensure this is not operating above safe guidelines i.e. 43°C. The testing of water temperatures is to be undertaken on a more regular basis in service user areas. (Issue outstanding from previous inspection). 30/11/05 Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 28 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 OP15 OP29 Good Practice Recommendations It is recommended that the fridge in the Store Room is replaced as this is showing signs of wear. The manager should ensure the homes own policies and procedures are followed in terms of issuing Terms and Conditions to staff and ensuring commencement dates are indicated on files. It is advised that the manager develop an ‘at a glance’ training schedule for staff so that it is clear what training has been completed and which staff are still required to complete training within the timescales required. 3 OP30 Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 29 Commission for Social Care Inspection Birmingham Local Office 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Longmore Nursing Home DS0000004559.V257744.R01.S.doc Version 5.0 Page 30 - 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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