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Inspection on 16/08/06 for Lyndhurst Nursing Home

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

This inspection was carried out on 16th August 2006.

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.

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

The home had stable management arrangements. Staff were approachable and friendly and communicated effectively with residents and relatives. 50% of care staff had attained a vocational qualification in care at level two or above. Residents and relatives expressed satisfaction with the standard of care provided and commented that staff were "friendly and kind to residents". Relatives were satisfied with the visiting arrangements and said that they were kept informed about their resident. The home was well-maintained, clean, tidy and odour free. Safety systems and equipment was serviced at regular intervals and fire safety arrangements were mostly satisfactory. The home had an easy to follow complaints procedure and had not received any complaints since the last inspection.

What has improved since the last inspection?

Rotas seen showed that minimum staffing levels were maintained. Improvements had been made to recruitment procedures and the information required by regulation obtained for employees. The extension to the lounge was almost complete and this would enhance the communal space for residents.

What the care home could do better:

Care must be taken not to admit residents outside the home`s category of registration. Written confirmation must be sent to residents confirming that based on assessment the home can meet their needs. Risk assessments must be completed prior to using bedrails and ensure this equipment is properly fitted and the correct height to protect residents. Some improvements were needed to medicine storage and recording of homely remedy medicines. Social care plans must be prepared to show how this need is met for individual residents. Equipment such as the kettle and microwave in the kitchen and the scales used to weigh residents must be well maintained. Liquid soap must be available for staff to ensure they practice infection control. Improvements must be made to the provision of relevant staff training and training records. A quality assurance system must be implemented to review and improve the service.

CARE HOMES FOR OLDER PEOPLE Lyndhurst Nursing Home 238 Upton Road South Bexley Kent DA5 1QS Lead Inspector Ms Pauline Lambe Key Unannounced Inspection 16th August 2006 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 Lyndhurst Nursing Home DS0000006765.V297304.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. Lyndhurst Nursing Home DS0000006765.V297304.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lyndhurst Nursing Home Address 238 Upton Road South Bexley Kent DA5 1QS 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) 01322 523821 01322 523821 Mr Richard Mahomed Mrs Rookaya Mahomed Mr Richard Mahomed Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Lyndhurst Nursing Home DS0000006765.V297304.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 16 beds Elderly and infirm Date of last inspection 16th December 2005 Brief Description of the Service: This home is located in a residential area of Bexley, within walking distance of local shops, a railway station and bus routes. There are five double, one triple and three single bedrooms in the home. Communal space consists of a lounge/ dining room. This room has been extended to provide a large sunny space for residents to enjoy and participate in activities. At the rear of the property there is a spacious garden for residents use. Parking is restricted in the roads surrounding the home and limited off street parking is provided on the driveway. The current fees ranged from £540.18 - £560 per week. Residents paid privately for hairdressing, chiropody and personal items. Lyndhurst Nursing Home DS0000006765.V297304.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit for this unannounced inspection was completed on 16th August 2006 over 7.5 hours. Staff assisted with the inspection and the registered person joined for the afternoon. Fifteen residents were in home and one resident was in hospital. The service was last inspected on the 16th December 2005. The inspection included a review of information held on the service file, a tour of the premises, and inspection of records, talking to residents, staff and the registered person and reviewing compliance with previous requirements. Prior to the inspection fifteen completed comment cards were received from or on behalf of residents and thirteen from relatives. Feedback on the service from residents and relatives was generally positive and indicated overall satisfaction with the quality of care provided. What the service does well: What has improved since the last inspection? Rotas seen showed that minimum staffing levels were maintained. Improvements had been made to recruitment procedures and the information required by regulation obtained for employees. The extension to the lounge was almost complete and this would enhance the communal space for residents. Lyndhurst Nursing Home DS0000006765.V297304.R01.S.doc Version 5.2 Page 6 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. Lyndhurst Nursing Home DS0000006765.V297304.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lyndhurst Nursing Home DS0000006765.V297304.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and standard 6 did not apply to the service. Quality in this outcome area was adequate. This judgement has been made using available evidence including a visit to the service. Adequate information was provided for residents. Residents were admitted based a pre-admission assessment of need. Resident records viewed did not include evidence that the registered person had confirmed in writing that the home could meet their assessed care needs. EVIDENCE: Adequate information was available in the statement of purpose and service user guide for residents on the property and the service provided. Residents were admitted to the home based a pre-admission of assessment. Since the last inspection a resident with dementia had been admitted. The registered person must ensure residents are not admitted who are outside the home’s category of registration without applying to the Commission for a variation to registration. There was no evidence to show that residents admitted to the home had received written confirmation that the home could meet their assessed care needs. Requirement 1. Lyndhurst Nursing Home DS0000006765.V297304.R01.S.doc Version 5.2 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 – 10. Quality in this outcome area was adequate. This judgement has been made using available evidence including a visit to the service. Care plans seen required some improvements in relation to the use of bedrails and wound care records. Medicine management was satisfactory but improvements were needed to recording of homely remedies. Attention was given to ensuring residents had access to health care and no concerns were noted as to resident dignity. EVIDENCE: Three care plans were viewed. These included pre-admission assessment and some risk assessments with care plans prepared to show how needs were to be met. There was evidence to show that residents or relatives had been consulted about care plans. However some concerns were noted with the care plans in relation to the use of bedrails and wound management records. There were no risk assessments completed for the use of bedrails and with one pressure sore care plan. Some beds seen had only one bedrail fitted and some of the bedrails fitted, when the bed had an additional pressure relief mattress, were not high enough to ensure the residents safety. The issue in relation to the use of bedrails in the home had been raised with the registered person at previous inspections and requirements made were not met. Lyndhurst Nursing Home DS0000006765.V297304.R01.S.doc Version 5.2 Page 10 A resident had been admitted with pressure sores and had care plans, wound management and assessment records prepared but these were not up to date and did not show the current status of the wound or the frequency of dressings. A tissue viability nurse had seen the resident and advised on the management of the wounds. No social care plans were seen in the files viewed. Daily evaluation records were kept to show how care plans were implemented. Requirements 2 and 3. Residents were registered with a GP, staff ensured residents had access to the services of a dentist, optician and tissue viability nurse. Other medical advice was obtained through GP referral. Records seen showed that no accidents had been sustained by residents since the last inspection. Policies and procedures were provided in relation to medicine management. Medicines were stored in the staff office on the ground floor. The temperature of this room was not recorded. Adequate storage space was provided. Receipts were kept for medicines received, administered and returned to the pharmacy. The home did not have a medicine fridge and stored medicines in a locked box in the kitchen fridge when needed. Staff had access to up to date information on medicines. Medicine records for three residents were checked and found to be correct. Administration charts were well maintained. No controlled drugs were in use but systems were in place to safely store and manage these. Homely remedies were agreed with the GP. The system used to record these did not enable an audit trail to be completed. Requirement 4. Staff were observed interacting appropriately with residents. Many of the residents were unable to voice their views of the service. Residents who were spoken with said staff treated them with respect. Feedback received from relatives on the day and in comment cards indicated an overall satisfaction with the quality of care provided and did not indicate concerns with how residents were respected. Lyndhurst Nursing Home DS0000006765.V297304.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 – 15. Quality in this outcome area was adequate. This judgement has been made using available evidence including a visit to the service. No social care plans were prepared and a limited amount of social activity time was provided. Residents were supported to maintain contact with family and friends. Efforts were made to involve residents and relatives in making decisions relevant to the resident’s lifestyle. Although food provision seemed satisfactory some concerns were noted in relation to addressing residents weight loss. EVIDENCE: The ability of residents to participate in organised activities varied. Residents who could participate said they enjoyed these but felt more could be provided. This comment was also made in some of the relative comment cards returned to the Commission. An activity organiser was employed and worked for two hours on Wednesday and Friday mornings. During the inspection a number of residents were observed enjoying a game of dominoes while others were encouraged by the activity organiser to participate in some old time music. No social care plans were prepared to show how individual needs were to be met and a number of residents required one to one social interaction. Records were kept of the activities provided and the names of the participants. The records for July 2006 showed that eight activity sessions had been held including dominoes, sing-along, quiz and one to one time. Requirement 5 and recommendation 1. Lyndhurst Nursing Home DS0000006765.V297304.R01.S.doc Version 5.2 Page 12 No concerns were noted in relation to residents maintaining contact with family and friends. Verbal and written feedback received from relatives indicated they were made to feel welcome when visiting the home and kept informed of issues relating to their resident. From records seen, talking to residents, and observation, residents who could make decisions were encouraged to do so. It was not possible to assess how this standard was met from the perspective of the less able residents. However feedback received from relatives indicated staff involved them in making decision on behalf of residents. A menu seen indicated residents were provided with a varied diet and a choice of meal. Staff views on the quality and quantity of meals provided varied. The cook’s view was that meal portions were small and food provided was not the best quality. Care staff felt residents had adequate portions of food provided and that the food was of a satisfactory standard. No concerns about the food was raised by residents or on the relative feedback received. However one resident described the food as ‘passable’. Lunch was observed and residents indicated they enjoyed the meal, had a choice of meal and had adequate portions. Staff assisted and fed residents where needed. From observation of staff feeding residents the inspector was of the view that the amount of food on the spoon was rather large. Several residents required assistance with feeding. In view of the comments made about the food the residents weight was viewed. Residents were weighed monthly and the records showed that over the last 6 months seven residents had lost varying amounts of weight. Apart from one resident who had spent time in hospital there was no evidence to show what action had been taken about this or whether the residents had been referred to the GP or dietician for advice. When this was discussed with the registered person he questioned the accuracy of the scales. If the scales are inaccurate then action must be taken to rectify this to ensure accurate records are kept of resident’s weight. The kitchen was clean and tidy. Records were kept of fridge, freezer and food temperatures. The cleaning schedule was not up to date as the cook said she was short of cleaning materials. The kettle was broken as it would not switch off automatically and the microwave required attention. Requirements 6, 7 and 8. Lyndhurst Nursing Home DS0000006765.V297304.R01.S.doc Version 5.2 Page 13 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 and 18. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Satisfactory systems were in place to manage complaints and allegations or suspicions of abuse. EVIDENCE: Policies and procedures were provided in relation to management of complaints and adult protection. Since the last inspection records seen showed that no complaints had been made about the service. Residents spoken with and feedback received from relatives indicated they were aware of the home’s complaint procedure and how to make a complaint. No allegations or suspicions of abuse had been reported to the home or the Commission since the last inspection. Staff spoken with displayed an awareness of adult protection. No training had been provided for staff on adult protection for some time. (See comments under staffing standards.) Lyndhurst Nursing Home DS0000006765.V297304.R01.S.doc Version 5.2 Page 14 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, 24 and 26. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. The home was clean, tidy and satisfactorily decorated. Bedrooms, bathing and toilet facilities seen were satisfactory. To ensure infection control is practiced staff must use liquid and not bars of soap for hand washing. EVIDENCE: The home was clean, tidy and free of offensive odours. The home was decorated, furnished and fitted to a satisfactory standard. Since the last inspection an extension to the lounge was completed. This will provide a sunny pleasant area for residents to sit in and to undertake activities. The lounge carpet needed cleaning and the registered person said that plans were in place to redecorate the older part of the lounge, fit new carpets and provide new lounge and dining furniture once the builders had completed their work. Combustible materials were stored under one staircase, which could pose a fire risk. Lyndhurst Nursing Home DS0000006765.V297304.R01.S.doc Version 5.2 Page 15 Adequate bathing and toilet facilities were provided for residents. Bathrooms and toilets seen were clean and tidy. A number of bedrooms were viewed. These were clean, tidy, satisfactorily decorated and included residents’ personal items. Screening was provided in shared rooms and the registered person had agreed with the Commission to use the triple bedroom as a double from December 2006. No maintenance issues were noted in the bedrooms seen. As mentioned the home was clean. Hand washing facilities were provided where waste was handled; however a number of the liquid soap containers were empty and bars of soap were left on the basins. Staff had access to protective clothing. Requirement 9. Lyndhurst Nursing Home DS0000006765.V297304.R01.S.doc Version 5.2 Page 16 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 – 30. Quality in this outcome area was adequate. This judgement has been made using available evidence including a visit to the service. Minimum staffing levels were maintained and 50 of care staff had NVQ 2 qualification or above. Recruitment procedures were good but the induction programme must be improved. There was no evidence to show that staff received adequate training relevant to the work they perform. EVIDENCE: The staff team comprised of a manager, trained nurses, care assistants and ancillary staff. Staff rotas were viewed for a three-week period. These showed that the home adhered to minimum staffing levels agreed prior to the introduction of the national minimum standards. Residents gave positive feedback on staff and comments made by relatives included ‘it is an excellent home’, ‘staff are caring and pleasant but hard to understand’ and ‘staff are friendly and kind to residents’. Ten care assistants were employed and four of these had achieved NVQ 2 qualification or above. The home had therefore had met the standard to have 50 of care staff with this level of qualification. Five employee files were viewed. All but one file included the information required by regulation. One file for a domestic did not include a CRB check and it was unclear what level of supervision this employee had while waiting for the result of the CRB check. During the inspection the employee confirmed that they had received their copy of the CRB check and would show this to the Lyndhurst Nursing Home DS0000006765.V297304.R01.S.doc Version 5.2 Page 17 registered person as soon as possible. The files contained some evidence of induction but the induction programme could be improved. One feedback comment received from a relative said that ‘staff turnover is excessive’ and two commented on difficulty communicating with staff when English was not their first language. From the information provided by the registered person in the pre-inspection questionnaire of the nineteen employees included on the staff list eleven had commenced employment in the last year. Recommendation 2. Staff spoken with said they received training relevant to their role. Training records seen showed that some staff had access to moving & handling training and fire safety training only since the last inspection. Individual training records were not kept for staff and there was no evidence to show that staff had received 3 days training in the last year. Requirement 10. Lyndhurst Nursing Home DS0000006765.V297304.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area was adequate. This judgement has been made using available evidence including a visit to the service. The home was managed satisfactorily and attention was given to providing a safe environment. The registered person did not manage personal finances for residents. There was no quality assurance or audit system in place to review and monitor the quality of the service. EVIDENCE: The registered manager is also the registered provider. He is registered with the Commission and divides his time between working shifts and management days. Since the last inspection he had employed an administrator for half a day a week to assist with paperwork. As the registered provider was also the manager compliance with regulation 26 was not applicable. The registered person said that he held staff meetings but minutes of these were not available to view. However the agenda for the last Lyndhurst Nursing Home DS0000006765.V297304.R01.S.doc Version 5.2 Page 19 meeting held on 7th July 2006 was seen. Formal resident meetings were not held as the registered person was in regular contact with them. One relative meeting was held each year but the minutes of this were not available to view. The registered person was developing a satisfaction questionnaire to send to residents, relatives and others but there was currently no quality assurance system or internal auditing systems in place. Requirement 11. The registered person had taken the decision not to manage personal allowances for residents and had arranged for relatives to do this. Residents requiring money could access this from petty cash and the registered person invoiced the resident or relative. Receipts were obtained for services such as hairdressing and chiropody and the resident or relatives invoiced for the money. A maintenance book was kept and staff recorded repairs needed in this. A handyman visited and completed repairs identified. Safety records for the lift, moving & handling equipment, fire alarm, electricity supply and portable appliance testing were up to date. The gas boilers were serviced on 20th June 2006 but an up to date landlords safety certificate was not available. This was discussed with the registered person who agreed to have this done as soon as possible. The fire alarm was to be checked weekly but records seen showed this had not been done since 27th July 2006. Only one fire drill was recorded since the last inspection and must be held more regularly to meet the guidance of the fire safety department. A fire officer visited the home on 11th April 2006 who said that fire safety precautions were satisfactory. Requirement 12. Lyndhurst Nursing Home DS0000006765.V297304.R01.S.doc Version 5.2 Page 20 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 3 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 X X 3 X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 1 X 3 X X 2 Lyndhurst Nursing Home DS0000006765.V297304.R01.S.doc Version 5.2 Page 21 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 Requirement The registered person must ensure residents outside the home’s category of registration are not admitted to the home. Residents must receive confirmation in writing that the home can meet their assessed needs in respect of health and welfare. The registered person must ensure that potential risks are assessed prior to using bedrails. If bedrails are required for safety of a resident then these must be fitted to both sides of the bed. Bedrails fitted must be of a height that ensures the safety of the resident. (Previous timescales in relation to risk assessments prior to using bedrails had not been met). The registered person must ensure wound management records are kept up to date and show the current treatment and status of the wound. The registered person must ensure medicines are safely stored. The temperature of the DS0000006765.V297304.R01.S.doc Timescale for action 25/09/06 2. OP7 15 18/09/06 3. OP7 15 25/09/06 4. OP9 13 25/09/06 Lyndhurst Nursing Home Version 5.2 Page 22 5. OP12 16 6. OP15 16 7. OP15 23 8. OP15 23 9. OP26 13 10. OP30 18 11. OP33 24 medicine storage area must be recorded. Records for homely remedy medicines must be kept so that an audit trail can be completed. The registered person must ensure social care plans are prepared for residents to reflect their interests and show how these will be met. The registered person must ensure residents noted to be losing weight are referred to a GP or dietician. The registered person must ensure equipment provided for resident use is well maintained. The scales used to monitor residents weight must be as accurate as possible. The registered person must ensure equipment provided is well maintained. The electric kettle and microwave in the kitchen must be repaired or replaced. The registered person must ensure staff practice infection control and do not use bars of soap for hand washing. The registered person must ensure staff have access to training relevant to the work they perform. Training records must be kept for employees. New employees must have a structured induction programme that meets the National Training Organisation specification. The registered person must establish a system for reviewing the quality of care and nursing provided in the care home. This system must include consultation with residents, relatives and stakeholders. A report of the review must be sent to the Commission with an action plan DS0000006765.V297304.R01.S.doc 25/09/06 25/09/06 25/09/06 25/09/06 25/09/06 25/09/06 25/09/06 Lyndhurst Nursing Home Version 5.2 Page 23 12. OP38 23 to address any issues identified. The registered person must 25/09/06 ensure adequate systems are in place for the safety of residents and others. The fire alarm must be tested weekly. Fire drill must be held at regular intervals as recommended by the fire safety department. An up to date landlord’s gas safety certificate must be provided and a copy sent to the Commission. 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 OP12 Good Practice Recommendations The registered person should seriously consider increasing the hours of activity employee time provided to ensure residents have access to regular social activity and stimulation. The registered person should look at ways to improve staff retention and ensure that staff employed have the ability to communicate satisfactorily with residents and relatives. 2. OP29 Lyndhurst Nursing Home DS0000006765.V297304.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Lyndhurst Nursing Home DS0000006765.V297304.R01.S.doc Version 5.2 Page 25 - 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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