Inspection on 15/10/07 for Lound Hall Nursing Home

This inspection was carried out on 15th October 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.

Other inspections for this house

Lound Hall Nursing Home 15/10/08

Lound Hall Nursing Home 02/10/06

Lound Hall Nursing Home 26/02/06

Lound Hall Nursing Home 11/08/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Lound Hall Nursing Home Town Street Lound Retford Nottinghamshire DN22 8RS Lead Inspector Linda Hirst Key Unannounced Inspection 10:30 15th October 2007 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 Lound Hall Nursing Home DS0000063130.V342100.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. Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lound Hall Nursing Home Address Town Street Lound Retford Nottinghamshire DN22 8RS 01777 818082 01777 818084 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) MPS Care Homes Ltd Monica Elizabeth Kewarth Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30)Physical disability (30) of places Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The Registered Provider will provide external support from within the organisation to the home Service users shall be within categories OP or PD (over 50 Years) Date of last inspection 2nd October 2006 Brief Description of the Service: Lound Hall Care Home is situated in the village of Lound close to Retford. The home provides Nursing and Residential Care for up to 30 older people or people who have a physical disability. The accommodation comprises two lounges and a dining room and both single and double rooms are available, all with ensuite facilities. The home is suitable for people with mobility problems, provides a passenger lift and level access. The gardens are accessible to wheelchairs and provide a range of seating within a mature well-maintained garden. The range of fees is: £315.00 to £748.00 per week, and these do not include hairdressing, chiropody or toiletries. If a staff escort is required for Hospital appointments a charge of £25 is applied. A copy of the last report is available on the wall in the reception area, and every service user is given an admission pack which contains the service user guide. Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This inspection involved one inspector; it was unannounced and took place in the day, including lunchtime. The main method of inspection used is called ‘case tracking’ which involves selecting three residents and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. There is only one person living at the service currently from a minority ethnic groups who was case tracked to check their needs are being met appropriately. All of the residents have English as their first language, although there are staff who can speak both Romanian if this were the first language of any resident. We observed some residents receiving help from the staff over lunchtime and some judgements in this report come from these observations. We sent out staff surveys to five members of staff, and two were received back. We also asked for the views of another resident who was not part of the “case tracking” to form an opinion about the quality of the service provided. We read documents as part of this visit and medication was inspected to form an opinion about the health and safety of residents at the home. We did a partial tour of the building, including all communal areas and a sample of bedrooms to make sure that the environment is safe and homely. We have reviewed of all the information we have received about the home since the last inspection and considered this in planning the visit and deciding what areas to look at. Five surveys were sent out to relatives and two were returned, both commented on how happy they are with the staff and the care provided but suggestions for improvements to activities, the garden and staffing levels were raised and further comments will be included in the relevant parts of this report. We also looked at the quality assurance questionnaires completed by residents, relatives and visiting professionals and the comments have been added in to this report. Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? We “case tracked” the last person to be admitted to the service and found that he had a full assessment before he was admitted to make sure the home could meet his needs. Although the admission had been an emergency there was already a care plan in place to guide staff on how to meet his needs. Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 7 We found that the policies and procedures on medication have been updated and more detail has been added to make sure all staff are clear about how to administer medicines safely. We found that the arrangements for medication are safe and well managed, and the residents receive their medication as prescribed by their GP. All of the records we needed to see were available to us during the inspection meaning we could check on essential information to make sure service users are cared for safely. We found that the fire safety arrangements were in order and protect residents from risk as far as possible. We checked the hot water supply in residents’ bedrooms randomly and we found the temperature was safe. We found evidence that the service has had full legionella checks to make sure the residents are safe from infection. What they could do better: We found that the nurses needed to review one of the care plans more often to make sure that it is up to date and reflects the current needs of the resident so that the staff can provide the care that is needed. We found that the nurses need to take extra care to count in the Controlled Drugs, to take account of any stocks which still exist and to make sure that the records and the amounts held tally. Relatives who completed questionnaires said that the provision of activities could be better to keep the minds of the residents more active. We found the staff could benefit from training on safeguarding issues to make sure that they know when and how to report abuse so they can keep the residents safe. We found that a sluicing disinfector could improve the current arrangements to prevent any spread of resistant infections between the residents, keeping them well and healthy. The arrangements for covering staff holidays and sickness need to be changed to ensure there are enough staff available to meet the needs of the residents at the home. The recruitment procedures and checks are not good enough and this means that residents are not properly protected from staff who may harm or abuse them. The owners could make sure they check that the service is being audited through the year to make sure the best care is being provided to residents. Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 8 We found more stringent checks are needed on the records and cash amounts held for residents to make sure that these are accurate. 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. Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 9 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 Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 10 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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are fully assessed before they are admitted so that they know that these can be met at the service. EVIDENCE: We “case tracked” the last person who was admitted to the home. We saw evidence that the person was properly assessed before admission. There was a copy of the assessment undertaken at the Rehabilitation unit as well as a copy of the assessment by the nurse. Although the resident was admitted in an emergency, we found that a care plan was already in place which contained good person centred detail about likes, dislikes and routines. The residents we interviewed had not visited the home before admission, but they said the nurse had asked about their needs before they came. They both Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 11 feel they have settled well at the service and feel quite happy with the service they receive. We were told by relatives completing surveys that the staff at the care home are very good at meeting the care needs of residents but they both said that the home should provide more activities. (See OP12). A staff member said that they are kept up to date with the current needs of the residents. The standard about intermediate care was not assessed during our visit. It will be considered during our next inspection. Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health and personal care needs are properly assessed and provided for in a safe way, which takes account of their preferences and personal dignity. EVIDENCE: We looked at the care plans of “case tracked” residents and found them to contain good information about the likes, dislikes and preferences of the residents. There is a valid restriction in place for one resident and this has been discussed with Social and Health Care staff and was fully and properly recorded. We found that residents and their relatives are involved in care planning, although the people who we interviewed said that they left this to their relatives. One plan we saw needed to be updated so it reflected the changing need of the resident concerned. The staff said the care plans have enough detail to guide them about meeting the residents’ needs. Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 13 We found in general that the nursing plans in place were good and up to date; in most cases the risks which were highlighted had a care plan in place to meet residents’ needs. The residents we spoke to and relatives’ comments indicate that the attention to health care needs is good. There is specialist equipment in place to prevent the development of pressure sores and the staff said that they receive training to keep them up to date with new ways of working. We observed the lunchtime medication round which was done by the qualified Nurse. She administered the medicines safely and we saw her take her time to help residents take their tablets. We found that all of the medication is stored safely and correctly to make sure that the correct potency is maintained. We looked at the policies and procedures and found that these have all been updated and that they provide clear guidance to staff. We found an anomaly between the amount of Temazepam in stock for one resident and the amount the records said should be available. There were two more tablets than the records indicated there should have been, but the Medication Administration Record sheets indicated that the tablets had been given on every occasion. We asked the manager to investigate this and report back to us on her findings. The residents we interviewed said that they get their tablets on time and that the staff bring them a drink to take their tablets and check they have taken them before leaving. One resident told us he was in pain and needed some tablets, and the nurse attended to this immediately. The policy on privacy and dignity is in the statement of purpose which is given to every resident and their rights are on display in reception. The residents we spoke to said the staff always treat them with dignity and respect and we saw many examples of the staff showing great respect for the dignity of residents throughout this inspection (see also comments on OP15). Lound Hall Nursing Home DS0000063130.V342100.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): 12, 13, 14, 15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents enjoy a flexible lifestyle in accordance with their needs, choices and wishes. EVIDENCE: We were told that the activities organiser works from 14.00 – 16.00 Monday to Friday. Neither of the residents we spoke with had a particular interest in joining in activities; although one said she had joined in a recent trip to Robin Hood Airport. They both said they enjoy visits from their family more. The relatives who returned questionnaires to us both raised concerns about activities, “ I feel more could be done to keep bodies and minds active. Perhaps cross stitch, basket making or other creative activities. Keep fit for the more able bodied?” Another commented, “the care staff do not appear to have time to sit and chat…my mother is very keen to sit outside but staff need to monitor (her) and bring her in quickly if it is not warm enough. Perhaps a Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 15 more sheltered outdoor sitting area could be provided?” Staff members had no comments to make about activities. The residents who we spoke with said that they enjoy regular visits from their family and friends. There is one visiting restriction in place; a decision which has been reached following discussion and agreement with other agencies and this is fully documented. The staff said they welcome relatives into the home. Relatives who returned questionnaires to us said they are always kept up to date on important issues affecting their loved ones. The residents we spoke with said that they can get up and go to bed when they like and they can spend their day as they wish. Both prefer to spend time in their room; preferring privacy to communal life, they said this is respected. One relative who returned a questionnaire to us commented that there could be more flexibility around mealtimes, and that breakfast could be served earlier to prevent long gaps between meals. The staff we spoke to said that this can be difficult given the current staffing levels, as staff do not hurry the residents it can take longer to do things. We observed the lunch being served. There are two sittings for lunch, and those who need the most assistance are helped to eat first so that they can have more time and attention and to help preserve their dignity. We saw four residents being supported to eat. The staff sat beside residents and there was good communication between them, the staff told the residents what they were eating and checked if they were ready for more to eat. We saw good, polite and respectful interactions between staff and residents. There was a pleasant and calm atmosphere in the dining room. The food looked and smelled appetising, and all food is blended separately for those needing a soft diet to make sure their appetite is stimulated as much as possible. We saw good stocks of food in the home and plenty of evidence of home cooking and baking. Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints and safeguarding issues are investigated and responded to in accordance with policies and local procedures and the residents are safe and protected from harm and abuse at the home. EVIDENCE: We saw the complaints procedure (which was in a large font for people with visual impairment) displayed in the reception area. It is also included in the information pack which is given to all prospective residents. There have been two complaints since the last inspection and we saw full and detailed records of the complaints, along with the investigation into these and outcomes (one was partially substantiated, the other was not substantiated.) We found no ongoing legal issues in relation to these complaints. The residents we interviewed said they would feel confident to report any concerns to the manager and they were certain that concerns would be acted upon and addressed. Neither had made a complaint. One of the relatives who filled in a questionnaire said she had raised concerns rather than complaints, the other had not. The person who had raised concerns said, “there was a response, but excuses are made rather than an honest admission of shortcomings – a very Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 17 human response.” Staff knew what to do in the event of concerns being raised about the service provided. There has been one safeguarding alert since the last inspection concerning an assault by one resident on another. We found that this was referred under the local reporting procedures and the records are full and complete with details of the action taken and the reasons for this. There are no outstanding issues about this incident. We saw a copy of the updated and amended local safeguarding procedures in the office, though the staff have not yet received training on this subject. The residents we spoke with said that they feel safe and well cared for at the home. One relative commented to us, “I have not seen any staff deal with or speak inappropriately to any resident.” Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 18 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): 19, 20, 24, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is comfortable, clean and well maintained and provides a good standard of accommodation to the people who live there. EVIDENCE: A new office has been created to provide a place for storage, meetings and recording. There are two lounges and a dining room, these are comfortable and warm and there are televisions in all three areas. Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 19 All of the bedrooms have en suite facilities and people can bring in their own personal belongings, some of those we saw were highly personalised and have phone points in the bedroom. The kitchen is clean and well organised as is the laundry. Some of the staff we spoke with told us that they have concerns about the lack of a sluicing disinfector given the prevalence of “super bugs” in Hospitals, and they feel one is needed to prevent the spread of resistant infections between residents. There were some unattended power tools in a room which is being upgraded, but these were removed immediately and made safe as soon as the error was noted. The residents we spoke with said the home is clean, warm, comfortable and homely, they said they like their bedrooms and have everything they need. Relatives commented that the atmosphere at the home is always calm and cheerful, but one said, “in an ideal world there would be a small seating area for those who are mentally sound who might enjoy conversation, reading or being in a room without television.” Staff who we spoke to said the office has made meetings easier, but they would like to have a quiet area for residents who do not like the television. Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff are competent and caring and provide good care to the residents but the arrangements for covering staff holidays and sickness are not sufficient to ensure the residents receive the care that they need. The recruitment procedures are not adequate to ensure that residents are being supported by staff who will not harm or abuse them. EVIDENCE: We looked at the staff rota which indicates that each day shift is covered by a qualified nurse and three care staff. Where this would appear to be adequate for the needs of the residents at the home, the relatives who completed questionnaires made comments about the numbers of staff on duty. One said, “I have often visited and not seen, or been seen my a member of staff.” Two staff also commented to us that staff shortages can be an issue of concern, “the service could provide more staff when there are staff holidays or to cover illness so the residents can still get good care all of the time. It would be helpful if agency staff were used in cases of unexpected illness for example.” The residents who were interviewed said they sometimes do have to wait but that the staff do their best. Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 21 The service has already achieved the target of 50 of care staff having achieved National Vocational Qualification Level 2, and the staff we observed during the course of this inspection were competent and caring. We were told that the qualified staff do not get any time off to do training to maintain their Nursing registration. The records we saw indicate that training has been provided on Moving and Handling, Diabetes and Diet and Fire Safety. All of the new staff now complete a Skills for Care competence–based induction. There is evidence that Health and Safety and falls awareness and prevention training is pending. Future training plans include; Safeguarding, Fire Training and Basic Food Hygiene, but there is no evidence that these have been booked. The residents we interviewed said the staff are good and very caring and staff commented to us that they have access to the training they need to do their job well. We looked at four staff files but found that there were key documents and pieces of information missing which are required to be there by Law. We have issued an urgent action letter about this to make sure that residents are properly protected from those who may harm or abuse them. We also issued an immediate requirement because one person was working at the home without any evidence that written references had been obtained on her and the staff member was sent home until her references were received. The residents and relatives praised the staff highly as “dedicated” and caring. Other comments from our questionnaires and the Quality Assurance replies included, “Mum is always clean and well cared for. All of the staff are friendly, approachable and do anything asked of them efficiently and with a smile.” “The staff work efficiently together as a team, they are happy and enjoy their work and don’t seem to want to leave.” “The general standard of care is very satisfactory.” “ All members of staff are very good.” “The staff are courteous and smart, service users are comfortable and well cared for.” Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is well managed and is run taking into account the views, wishes and best interests of the residents who live there. EVIDENCE: There is a system for internal auditing in place which covers of the areas of the National Minimum Standards, we looked at the audit on care planning which was done in February 2007, this highlighted a list of actions needed to being care plans up to the required standard, but this was the only area of auditing that has been completed this year. Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 23 We looked at the monthly reports on the conduct of the home by the Responsible Individual, but there is no evidence that the auditing is being checked as part of this visit. The manager has given out questionnaires to residents, relatives and visiting professionals to give them the chance to comment on the quality of the care provided, but these responses have not yet been collated, however the results are very positive indeed. Nine Doctors, the Pharmacist, a Social Worker, a Nursing Assessor, a specialist Nurse, a Continence Advisor and an National Vocational Qualification Tutor all gave very positive comments about the service. “I have attended this home as a chiropodist for over eight years now and in that time have only seen continuous improvement in care and standards from both management and staff.” “Excellent, it feels like a home not an institute and the care for the residents is outstanding.” The home “is of a very high standard. I visit several residential and nursing homes as a GP and Lound Hall clearly offers well above the care offered in many other places.” “ I visit lots of different homes and consider this one of the best.” “I feel any queries re: my mum have been dealt with promptly… I feel confident that she is receiving the best care at Lound Hall.” “Laundry service outstanding.” We looked at the arrangements for looking after residents’ finances. Only small cash amounts are held for residents. Good records of financial transactions are maintained and all but one person’s records tallied with the amount held at the home. This was rectified on the day and we received assurances that the checks would improve to make sure there is no repetition of the incident. The residents we spoke with said their relatives handled their money, or they did this for themselves and the staff were not involved in handling residents’ money. We looked at the records of servicing and Health and Safety checks and found these were all in order and the wellbeing of staff and residents is properly protected. Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 24 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 X 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 3 3 X X X 3 X 2 STAFFING Standard No Score 27 2 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 X X 3 Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13(2) Requirement Timescale for action 2. OP27 18(1)(a) 3. OP29 19, Sch 2 You must undertake an 20/11/07 investigation into the excess Temazepam for the resident identified and send a copy of this to the Commission for Social Care Inspection to make sure the residents are receiving their tablets as prescribed by their Doctor. You must review the staffing 20/01/08 arrangements, and put contingency plans in place to ensure there are enough staff to meet the dependency levels of the residents in the event of staff holidays and sickness. You must ensure that all of the 20/12/07 information and documentation required by Regulation 19 and Schedule 2 is available in the staff files and you must not employ anyone to work at the care home until these documents and this information is obtained so that residents are properly protected from harm. Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 26 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. 3. 4. 5. 6. 7. Refer to Standard OP7 OP12 OP12 OP16 OP18 OP20 OP33 Good Practice Recommendations The care plans should reflect the current needs of all residents to make sure the staff fully understand their needs and can support them with these. The provision of activities should be reviewed to make sure it meets the needs and expectations of the residents. The social needs of the residents should be recorded in their care plans to ensure that their wishes are taken account of in planning activities. Review the timings of meals to ensure that residents are not going for long periods without food. Provide training for all staff on local safeguarding procedures to ensure they are clear about their obligations to report abuse and protect the residents. Review the accommodation to see if provision can be made for a quieter area for residents who do not enjoy the television. The responsible individual should ensure that the Quality Audit tool is being completed in line with the policy of the company through his monthly visits to ensure the service runs in the best interests of residents. More stringent checks should be made to make sure recorded balances tally with the cash amounts held on behalf of residents to ensure their interests are protected. A sluicing disinfector should be provided to ensure the residents are protected from the risk of contracting resistant infections. 8. 9. OP35 OP38 Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Lound Hall Nursing Home DS0000063130.V342100.R01.S.doc Version 5.2 Page 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!