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Inspection on 03/05/05 for Manor Barn Nursing Home

Also see our care home review for Manor Barn Nursing Home for more information

This inspection was carried out on 3rd May 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.

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 service is very welcoming to relatives and they are encouraged to visit residents at any time of the day. There are regular relative`s meetings where the senior nurse advises on new issues such as any decoration and any changes to staff. The residents talked about the service and its ability to meet their needs. They talked about the head nurse going to see them in hospital or in their own homes and assessing what care they might need before they enter the home to have a trial period. Once living at the home a care plan is provided so that the resident`s wishes might be recorded. The residents spoken to liked their rooms and the way they are decorated. Residents said the food was very good, well presented and generous in quantity and they made very positive comments about the staff saying they were kind caring and committed.

What has improved since the last inspection?

Decoration and furnishings are being improved and those areas are starting to look, and according to one resident, feel more homely. Residents talked to stated that they are now offered a snack with their evening drink. Staff spoken to advised that they now have training to keep the residents safe and to meet their needs. Care staff now record what care they give in the care plans. This means that care staff who are on duty next can read what has happened to the resident in the previous shift. There are now clear environmental risk assessments regarding the risk of fire and other risks to the residents.

What the care home could do better:

The home was not being managed properly. The staff files at the home were insufficient to make a judgment about the way people are being employed and if they can meet the residents care needs safely. The home needs to employ sufficient staff at all times as the residents, relatives and staff revealed that at times there is not enough staff to meet the basic needs of the residents.The care staff require supervision by trained members of staff to improve the communication between resident and staff. There also needs to be improvement in the safety and quality of the care they provide. The lack of supervision, induction and training records supported staff and residents comments. In the older part of the building some of the radiators still do not have covers on them, which means people, could get burnt if they fell against them. Some of the hot water taps do not have regulators to control the hot water. This could cause scalding if a person left their hand under a running tap for too long. There are however notices up to warn residents. The director who was present at the inspection stated that work would begin on the heating system in July 2005. The recruitment of a manager is essential to ensure that the above areas are improved upon.

CARE HOMES FOR OLDER PEOPLE Manor Barn Nursing Home Appledram Lane South Fishbourne Chichester PO20 7PE Lead Inspector Judith Farrell Unannounced 3 May 2005, 09.00am, V221172 rd 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 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. Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Manor Barn Nursing Home Address Appledram Lane South, Fishbourne, Chichester, West Sussex, PO20 7PE Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01243 781490 01243 776881 Rhymecare Ltd Post Vacant CRH 30 Category(ies) of OP - 30 registration, with number of places Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: No conditions of registration Date of last inspection 08/02/05 Brief Description of the Service: Manor Barn is a care establishment that provides nursing care, and is registered to accommodate up to 30 residents in the category of old age, not falling within any other category. Manor Barn was originally conctructed in the sixteenth century, since then it has been extended and converted. The home is situated near the village of fishbourn. The service is owned by Rhymecare Ltd Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a day on the 3rd of May 2005. Three inspectors were involved in the inspection. Mrs Farrell who was the lead Inspector, Mrs Peel who was the second Inspector. Mrs Datoo was the third inspector. Mrs Datoo is a specialised inspector in pharmacy and only looked at the regulations and the standard regarding medication. She spent 2hrs at the home. Both other inspectors spent 5 hours touring the home and talking to residents. A further 3 hours were spent talking to the nurse in charge Mr Bibby and examining records. Two inspectors arrived at the home at 07.15 so they could talk to the night staff about what it is like to care for the people during the night at Manor Barn a tour of the premises took place. Records were examined at random and staff members were spoken with, to gain a sense of what it was like to live in the Manor barn Nursing Home. Residents spoke highly of the establishment, but did have negative comments on the lack of management and that some care staff have poor communication skills. Three night staff, six day staff, sixteen residents and four relatives were spoken to during the day. The residents have different levels of communication abilities and therefore it was difficult to ascertain all their views on how their needs are met. Part of the workforce is from oversees. There has been one additional unannounced visit made since the last inspection. Letters sent to the registered person following this visit can be obtained from the CSCI office on request. Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The home was not being managed properly. The staff files at the home were insufficient to make a judgment about the way people are being employed and if they can meet the residents care needs safely. The home needs to employ sufficient staff at all times as the residents, relatives and staff revealed that at times there is not enough staff to meet the basic needs of the residents. Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 7 The care staff require supervision by trained members of staff to improve the communication between resident and staff. There also needs to be improvement in the safety and quality of the care they provide. The lack of supervision, induction and training records supported staff and residents comments. In the older part of the building some of the radiators still do not have covers on them, which means people, could get burnt if they fell against them. Some of the hot water taps do not have regulators to control the hot water. This could cause scalding if a person left their hand under a running tap for too long. There are however notices up to warn residents. The director who was present at the inspection stated that work would begin on the heating system in July 2005. The recruitment of a manager is essential to ensure that the above areas are improved upon. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5,6 The homes Statement of Purpose and Service Users Guide is inadequate and does not provide sufficient information so that prospective service users are clear about the services the home provides to meet their needs. Arrangements are in place to ensure that the health care needs of residents are identified and recorded. Staff must have sufficient knowledge and abilities to meet the needs of the residents admitted otherwise this could potentially place the resident at risk. Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 10 EVIDENCE: The service is working to improve the Statement of Purpose and Service users guide. A draft copy has been seen but it still requires work to meet the standards. A copy of the terms and conditions (contract) was seen and residents and relatives said that it was clear and that they understood what was in it. Six pre admission assessment documents were looked at and they clearly showed that the admission procedure was thorough and well recorded. This procedure ensures that new residents needs are properly assessed and planned for. Six residents spoken to were able to provide significant information about their care needs, these had all been recorded. The staff members on duty were aware of the assessments but were not all able to fully undertake the care needs due to lack of understanding of the different conditions. This was particularly noted in relation to palliative care. The nurse in charge was aware of some of the staff’s shortcomings and said that staff are having training to improve their knowledge of the service users needs. This home does not provide intermediate care. Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,9,10,11 Progress has been made on improving arrangements to ensure that health care needs of the residents are identified and met, however there are still some shortfalls particularly in relation to communication and training These shortfalls have a potential to place residents at risk. A review of medication handling was undertaken by a CSCI pharmacist inspector. Poor stock control of medicines increases the risk of medicines not being found, or out of date medicines being used. Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 12 EVIDENCE: Six care plans were looked at and clearly identify all aspects of health and social care. These care plans are up to date and well recorded. Risk assessments are complete. Discussion with the six residents concluded that the care matched what was being recorded in the care plans. Discussions with staff and residents suggested that at times there are problems with communication due to cultural and language differences between themselves and some staff members. This could put residents at risk of not having their health care needs met. A recorded assessment was seen for one resident who is able to selfadministered one medicine. Records of disposal were seen but records of receipt of medicines were not available. A nasal spray was in use, without a dispensing label or date of opening, although ten dispensed unopened sprays were in the stock cupboard. One resident said that she had not had her eye drops recently. Records of medicine administration were kept on printed charts, also used to record other health related information such as blood pressure checks. There were handwritten dose changes for two medicines. Staff were observed to respect the service users privacy and to treat them with dignity. However it was noted that there are some bedroom doors with no locks on them. This could lead to resident’s dignity and privacy not being respected. It was also noted that the chiropodist was dealing with resident’s feet in the lounge. He advised one of the inspectors that he would normally undertake this care in the resident’s bedroom, however today they were already in the lounge. The nurse in charge advised that there is a very good working relationship with the residents GPs, the district nurse service and specialist nurses. The resident’s can choose which GP they wish to register with, in the locality. Residents spoken to discussed how they are assisted to attend all hospital outpatients, dentist, eye, and hearing appointments. Though not all staff interviewed had attended training on how to look after people who are dying, they did however show considerable compassion and understanding of the dying process. Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14,15 The home has made progress in providing a balanced and varied diet and some residents are able to exercise choice and control over their diet. Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 14 EVIDENCE: Residents told inspectors that they are able to handle their own finances if they wish. They are also able to bring in personal possessions with them to the home if these can be accommodated. Residents have access to personal records if requested, but the nurse in charge told the Inspectors that the current group of people living at the home have not requested to do so. Currently all the residents, have family or friends to assist them, but if advocacy assistance was required this would be sought from an external agency. Two of the Inspectors enjoyed a meal with the service users. Each resident is offered three full meals each day, all of which may be cooked according to what they choose. The cook compiles 4-weekly rotating menus, which are changed according to season, and which take into account any suggestions made by the residents. Hot and cold drinks and snacks are provided throughout the day and in the evening. Staff take a list of the main meals round to residents the day before so that they can choose from the alternatives offered for the next day. Meals were seen on the menus to be imaginative, varied and well balanced. The resident’s comments about meals were positive and were seen to enjoy their meal. However some residents did have criticisms of the staff that had poor English and were not able to read the menu or describe the food on offer. Meals are enjoyable but not all residents may be able to enjoy all the food, which is on offer. More must be done to improve the level of communication between some staff and service users. Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17,18 Complaints are still not being recorded or handled objectively and residents and relatives are not confident that their concerns are being listened to, or taken seriously. There has been progress on training staff on the correct way to respond to any suspicion or allegation of abuse and this will safeguard the residents. EVIDENCE: The home has a complaints policy. Residents and relatives are provided with information on how to contact external agencies should they wish to complain. Residents and relatives spoken to advised that they had made complaints about a variety of issues, including poor response time to call bells, some staff unable to work in a flexible manner, poor interpersonal skills between staff and residents. The inspector was unable to confirm that these issues had been investigated, as the complaints log was not up to date. The Inspectors were pleased to note that training has now been provided to most staff on the important area of how to identify possible abuse and what to do about it. Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 16 On the day of the inspection it was noted that there were postal votes on the dinning room table. These were being given to the residents to fill in with the help of their relatives or advocates. One relative talked about assisting her husband to vote saying that she knew which party he wanted to vote for and she felt voting was part of staying in the real world. Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25,26 Some improvements to the décor have been made and this provides comfortable surroundings for the people living at the home. However the outstanding matters may constitute a potential risk to the safety for the residents. Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 18 EVIDENCE: Since the last inspection the home has continued with the redecoration and refurbishment programme. There were numerous pleasant floral displays around the building. Residents and visitors were using a pleasant shaded conservatory on the day of the inspection. Outdoor space was easily accessible to residents and a number of residents talked about being taken outside if the weather is fine. The home was clean and tidy and a new resident commented on how often his room was being cleaned. He was pleased with his room, which has french windows opening onto a very pleasant enclosed garden. Staff interviewed were clear on the guidelines for the control of infection. Though it was noted that one member of staff was not following these practice guidelines. A number of areas require attention. A staff call system is provided in every bedroom and in the lounge area. One Inspector monitored the time it took to answer two call bells; one was 15 minutes and the other 10 minutes. A resident commented that it was not uncommon to wait for anything up to 35 minuets for staff to answer a call bell. A director commented that unless one is viewing the control monitors for the alarm call system it is not possible to establish the length of response time as calls are overlaid and the sounder remains “in action” until the last call is answered. At certain times of the day there may be in action for 10 minutes with no single resident waiting more than two minutes. He stated that the response times should be minimised and the intention is to install a system that will record response times and allow improved management of this element of the service. There are still some of the radiators not covered and not all the hot water is regulated. This places vulnerable people at risk. There are however notices up to warn residents. The director who was present at the inspection stated that work would begin on the heating system in July 2005. A director commented that one area of the home is still served by an old heating system. The home is planning to upgrade this system in July. In the meantime notices highlighting the possible danger have been posted. Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 The deployment and number of staff is not sufficient to meet the needs of the residents. The procedures for recruitment of staff may not be robust and therefore the home might not provide the safeguards to offer protection to people living at the home. Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 20 EVIDENCE: At present there are 26 residents at the home. Discussions with night staff spoken to commented that there was sufficient staff on at night duty. Residents confirmed this stating that they never have to wait too long for the bells to be answered. All day staff interviewed stated that at times when staff were on holiday or off sick there is a real problem in giving the care needed. One member of staff described a day when a full complement of staff was present; they could undertake all the tasks needed without rushing the residents. Other staff talked about the problems of using agency staff and how the resident’s care was affected, as they did not know what to do. All residents and the relatives spoken to confirmed that the staffing shortages and the use of agency staff are having a direct impact on the quality of care received by the residents. Two relatives spoken to talked about a recent weekend where the only trained member of staff on duty was an agency nurse, that there should have been three agency care staff, however one agency member of staff did not turn up this meant residents were not able to get up when they wanted to and the cook had to come and help with assisting people with eating. A resident also talked about being put to bed at a very early hour because the home was short of staff. All residents and relatives spoken to said that staff at the home were kind, caring and committed but were always too busy and could spend little time with them. There has been some improvement to the staff files but they still did not hold enough information to prove to the Inspectors that all the checks that should be taken before a person starts working at the home has being carried out. The Inspectors were informed by one of the directors of the care home that all staff have filled in an application form, completed a health declaration, had written references taken up, Criminal Records Bureau checks and Protection of Vulnerable Adults Register checks before they started work. He also stated that full staff files are kept at the main sister home should the Inspectors wish to look at them there. Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,35,36,37,38 There is limited leadership; guidance and direction to staff to ensure residents receive consistent quality care. This results in the residents and their relatives being unsatisfied with some aspects of the care, people who live at Manor Barn receive. The outstanding issues regarding poor communication and lack of supervision of staff can lead to poor practice and potentially put the resident at risk. The lack of management at this home may be affecting the promotion of health, safety and welfare of the people using the service. Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 22 EVIDENCE: There is no registered manager at this time, the last manager, left in February this year. He worked at Manor Barn for four months. Prior to him there was a registered manager in place however he left in June 2004 after a relatively short period of time. Residents and relatives spoken to referred to the fact that that the home had no manager and they felt that at times there was no one to refer problems or complaints to. They also spoke about the lack of leadership and gave examples where they felt that management issues were lacking. Eight staff files randomly selected gave no indications of induction, supervision or any training and development staff had received. One trained nurse interviewed talked about induction as being only two shifts with another trained nurse and then working on their own. Most staff interviewed reported to the Inspectors that they had had their entire mandatory training. The director of the home discussed a recent audit of resident’s opinions and this highlighted the resident’s wishes to have more activities within the home. No action has been taken regarding this issue as yet. It was clear from speaking to staff on the day of inspection that they were aware of the health and safety issues however some poor practices were observed. Staff stated this was due to shortage of staff. While residents, their visitors and staff made positive comments about the staff team, many people gave examples of poor communication, staff being unclear about what is expected of them, and practice being inconsistent between shifts. Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 3 1 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 2 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 2 1 3 STAFFING Standard No Score 27 1 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 3 3 1 x 2 x 3 1 1 1 Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 24 yes Are there any outstanding requirements from the last inspection? 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 1 Regulation 4(1)(c ) & schedule 1 Requirement Timescale for action 01/07/05 2. 4 18(1)(a) 3. 4. 10 & 24 10 & 11 &24 13 13 That all the requirements of Standard 1 and Schedule 1 be included in the of Purpose and that all residents have access to a copy of this document. That the Service Users Guide be amended to include all the requirements of Standard 1.2. (This requirement is now outstanding for the last 3 inspection. The last time scale was 01/04/05) The registered person must 01/07/05 ensure that all the staff have appropriate skills, training, competencies and be able to communicate effectively to meet the care needs of the residents. ( This requirement has been outstanding since the last inspection. The time scale was 01/04/05.) Residents should have chiropody 03/05/05 treatment in their own rooms The Registered Provider must 01/07/05 provide locks on all residents bedroom door, which can be easily opened by residents and which staff can override in an emergency (This requirement is outstanding from the last 4 Version 1.20 Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Page 25 5. 25&38 !3(4)(c) 6. 2 & 27 18(1)(2)( 3)(4) 7. 37 17 8. 9. 10. 0P9 0P36 13(2) 18(a) inspections. The last time scale was 01/05/05. All hot water must be distributed close to 43 degrees centigrade. All hot water pipework and radiators must be guarded or have guaranteed low temperature surfaces. ( This requirement is outstanding from the last 3 inspections The last time scale was 28/05/05. Staff must be employed in sufficent numbers to meet the needs of the residents. This requirement is outstanding from the last inspection. The last time scale was 01/05/05. . The Registered provider must keep staff records in the home as specified in the amended Schedules 2&4 of the Regulations. This requirement is outstanding from the last 4 inspections. The last time scale was 01/03/05 A complete record must be kept of all medication received into the home That all care staff must receive formal supervision at least 6 times a year. 01/07/05 01/07/05 01/07/05 01/06/05 01/07/05 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 OP9.4 Good Practice Recommendations It is good practice to date and initial handwritten dose changes, on the medication administration records and reference to the prescribers instructions. Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 26 Commission for Social Care Inspection Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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 Manor Barn Nursing Home H60-H11 S24175 Manor Barn V221172 030505 Stage 4.doc Version 1.20 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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