Inspection on 23/10/08 for Meadbank Nursing Home

This inspection was carried out on 23rd October 2008.

CSCI found this care home to be providing an Adequate service.

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

Meadbank Nursing Home 28/04/08

Meadbank Nursing Home 23/07/07

Meadbank Nursing Home 19/05/06

Meadbank Nursing Home 25/01/06

Meadbank Nursing Home 14/09/05

Meadbank Nursing Home 24/02/05

Meadbank Nursing Home 26/07/04

Meadbank Nursing Home 24/02/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

CARE HOMES FOR OLDER PEOPLE Meadbank Nursing Home 12 Parkgate Road Battersea London SW11 4NN Lead Inspector Simon Smith Unannounced Inspection 23rd October 2008 11:00 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 Meadbank Nursing Home DS0000019107.V373230.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. Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadbank Nursing Home Address 12 Parkgate Road Battersea London SW11 4NN 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) 020 7801 6000 020 7978 5726 www.bupa.co.uk BUPA Care Homes (ANS) Ltd No Manager currently registered Care Home 176 Category(ies) of Dementia (176), Mental disorder, excluding registration, with number learning disability or dementia (10), Old age, of places not falling within any other category (176), Physical disability (176), Terminally ill (176) Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28 April 2008 Brief Description of the Service: Meadbank Care Centre provides accommodation for a maximum of 176 residents. The home is situated in Battersea, close to local shops and services. Battersea Park and the River Thames are nearby. Weekly fees range from £900 to £1175 for permanent care and £1275 for respite care. The home is well decorated and there is a small but well-maintained garden. Each resident has a single room. Communal lounges and dining areas are provided on each floor. The home is divided into units, each of which has an allocated manager. There is a dedicated dementia unit on the third floor. Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. We used evidence from a number of sources to make this judgement about the home. These included visiting the home unannounced on two occasions and talking to residents, relatives, the manager and staff. One inspector joined residents for a meal. We checked a sample of records, including staff and residents’ files. Surveys were available to residents, relatives, staff and healthcare professionals who visit the home. Four residents, eight relatives, two healthcare professionals and five staff returned surveys. Feedback and comments from these surveys are included in the relevant sections of this report. The home met 22 of 29 National Minimum Standards assessed at this inspection. Seven standards were almost met. What the service does well: What has improved since the last inspection? An improvement plan has been drawn up to address the areas identified for improvement at the last key inspection. Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 6 Bupa has input support from the Quality and Compliance Team, which was ongoing at the time of inspection. There is an action plan for each unit and a ‘responsible person’ has been assigned to each floor to oversee the plan’s implementation. The service manager has worked hard to get to know residents and to establish consistency amongst the staff team. The first floor has been split into two units due to its size and thus has two managers. Staff said that they now receive good information about the needs of the people they care for. Staff interaction with residents was more positive and promoted dignity and choice. Relatives said that they feel more confident about the home’s ability to meet residents’ health needs than at previous inspections. The volume of complaints has fallen. The volume of Safeguarding alerts has fallen. There has been some improvement in activities provision but residents would benefit from a wider range of activities. The support provided by staff at mealtimes was much improved, ensuring that residents’ experience was enhanced. Staff engagement with residents was much improved from the last inspection. Relatives said that staff availability has improved although identified the period after lunch as a problem. The management support provided to staff has improved. The communication with medical staff has improved. The manager now meets the home’s medical advisors regularly. New guidance has been issued to staff to ensure they know how to contact general practitioners out of hours. The home has appointed link nurses with special responsibility for infection control, tissue viability, continence and diabetes to ensure that practice is up to date in these areas. Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 3, 4 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a range of information available about the home for present and prospective residents. The information available to staff about the people they care for has improved. Residents’ need are appropriately assessed when they move to the home. The quality of care for residents with dementia has improved. EVIDENCE: Bupa has produced a range of information about the home and there is a Statement of Purpose. This information is available in brochure form or via the Bupa website. The Complaints procedure is accessible and the latest CSCI Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 10 inspection report is available in the home. The manager said that the Residents’ Information Pack had recently been updated and the draft copy given to a sample of residents for consultation and comment. Prospective new residents are able to visit the home and move in on a trial basis before deciding to stay there. One resident’s friend said, “When looking to place my friend we visited lots of homes and decided this was the one for us”. Staff surveyed for the last key inspection said that they did not always get sufficient information about new residents to enable them to provide good care. The improvement plan submitted by the home following the last inspection outlined the measures planned to improve the home’s assessment process and the information provided to staff about new residents. The Business Development Manager reviews all assessments prior to a new resident’s arrival. The unit manager briefs care staff on all new admissions and audits the assessment documentation within 72 hours of a resident’s arrival. Staff returning surveys for this inspection noted improvements in this area, reporting that they are now given good, up to date information about the people they care for. The last key inspection identified concerns about the quality of care available on the dementia unit. This visit found evidence that much effort has been invested in improving the quality of care for residents with dementia. The manager has visited other care services providing dementia care to observe practice and share ideas. Staff have attended dementia training provided in the home by the London Borough of Wandsworth. This training programme will run until January 2009. A ‘night bites’ menu has been introduced so that residents have access to food and drinks outside traditional mealtimes. In addition, the Head of Mental Health for Bupa has visited the unit and made recommendations for improvements to the environment, such as colour coding certain areas to aid recognition, dividing large communal areas and establishing reminiscence areas, although these recommendations had yet to be implemented at the time of inspection. Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The quality of information on residents’ care plans continues to improve. Some relatives and professionals feel that residents’ care needs to be more person-centred. The home has issued new guidance for staff who need to contact medical staff for out of hours advice. Friends and family members who returned surveys felt confident about the home’s ability to meet their relative’s health needs. Storage and administration of medication was generally good but medication was not stored securely on one unit. Staff interaction with residents was positive and promoted dignity and choice. Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 12 EVIDENCE: The home uses the Quest care planning system to record residents’ needs across a range of areas, including communication, lifestyle and preferences about the care they receive. There are useful tools to record important information about residents’ personal history, identifying important events, relationships, hobbies and interests. The quality of information on residents’ care plans continues to improve as the Quest system is established in the home and the majority of plans checked provided a good insight into the needs, wishes and preferences of the individual concerned. However some comments indicated that the home needs to work towards the provision of person centred care. Following reviews of all their clients, the London Borough of Wandsworth said that their reviews identified few concerns about the quality of care but that care provided was not sufficiently individualised. One relative said that she has to remind staff about her husband’s preferred ways of dressing, washing, seating position and food preferences. The relative also said that she would like her husband’s keyworker to have a more in-depth understanding of his needs. See Requirement 1. Some healthcare professionals and relatives expressed concern at the last key inspection about the effectiveness of communication between care and medical staff, particularly when urgent medical assistance was needed. The home has clarified procedures for staff who need to contact medical staff for out of hours advice and the manager now meets the home’s general practitioners on a quarterly basis to ensure that any issues around communication are addressed. The home’s improvement plan states that all hospital admissions are reviewed within 48 hours of admission to ensure that appropriate policies and procedures were followed. Comments received from relatives suggested that they feel more confident about the home’s ability to meet residents’ health needs than at previous inspections. One relative said, “Her needs are met very well… We have no worries about her care” and “The Sisters know how to deal with whatever arises”. Another relative said, “Staff are conscientious. When she has been unwell or fallen my mother’s care has always been of a good standard. Staff have been quick to help her, including hospital referral when necessary”. The recording of receipts, administration and disposal of medication was inspected in two units of the home. Medicines are checked when received into the home and records of administration were accurate. A number of residents choose to retain control of their medication and risk assessments had been carried out to enable this to take place safely. Storage of medication was generally secure in the home but the medication room on one unit was left unlocked whilst the nurse was completing the medicine round. See Requirement 2. Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 13 The last key inspection identified concerns about residents’ privacy and dignity being compromised by the actions of staff. The manager has introduced tools to focus on individual accountability and to develop staff understanding of the consequences of inappropriate or negative behaviour, which has resulted in improvements in this area. Staff engaged positively with residents during their interaction with them during the inspection and delivered care in a manner that maintained residents’ privacy and dignity. Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There has been improvement in activities provision since the last inspection but residents would benefit from a wider range of activities. Staff promoted residents’ choice and decision making in their interaction with them. Relatives returning surveys said that staff are welcoming and friendly when they visit. Staff provided good support to those residents who needed it at mealtimes. EVIDENCE: The last inspection found that the activities programme offered residents a limited range of activities and few opportunities to go out. There was evidence that the home has tried to address this area. Activities co-ordinators have visited other services to exchange ideas and a Bupa activities manager visited Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 15 the home during the inspection visited to work with the home’s activities coordinators. Whilst this is encouraging, further development of the programme is needed to ensure that residents have access to a suitably varied range of activities. See Requirement 3. Activities staff spend a good deal of their time working on a one to one basis with residents and were observed spending time with residents who choose to remain in their rooms for much of the day, talking about interests or playing games such as Scrabble. There has also been a drive to involve care staff in delivering activities and to develop an awareness that an activity can involve any interaction with residents that is meaningful to them rather than necessarily a planned and structured activity. For example care staff spent time with residents in the lounges and were attentive to their needs, reading a newspaper with one resident and helping another with her knitting. The experience of residents at mealtimes had also improved since the last inspection. One inspector had lunch with residents on the first floor. The meal was a relaxed, unhurried occasion that was enjoyed by the residents present. Staff provided good support to those residents who needed it during the meal, including one-to-one where necessary, delivered at an appropriate pace. Staff were observed to promote residents’ choice and decision making in their interaction with them. Relatives returning surveys said that staff are welcoming and friendly when they visit. One relative said, “Visitors are welcomed at any time of day and always offered a cup of tea or coffee”, whilst another said, “They make friends and relatives feel very welcome”. Relatives also said that residents’ cultural and spiritual needs are met. One relative said, “My mother has the opportunity to see the Roman Catholic priest each week. Visitors from her parish are welcomed”. Some relatives felt that more in-house entertainment would benefit residents. One relative said, “The residents would very much enjoy the opportunity for more visits from musicians, theatre groups etc.” Meadbank Nursing Home DS0000019107.V373230.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): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The volume of complaints and Safeguarding alerts has reduced since the last inspection. Those who had made complaints said that their concerns were dealt with appropriately when raised. The home co-operates with the local authority in investigating Safeguarding alerts where necessary. EVIDENCE: The volume of complaints has reduced since the last inspection. There was evidence from the complaints record that complainants receive an appropriate response in writing following investigation. Those who had made complaints said that their concerns were dealt with appropriately when raised. One relative said, “I feel that I can approach the sister in charge with any problem. My requests have always been dealt with promptly”. However some issues remain problematic. For example several people said that items of clothing are sometimes not returned from the home’s laundry. Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 17 The improvement plan submitted by the home following the last inspection advised that a review of safeguarding alerts had been carried out. The volume of Safeguarding alerts has reduced since the last inspection. The home continues to co-operate with the local authority in investigating Safeguarding alerts where necessary. Staff spoken to during the inspection had an improved awareness of Safeguarding issues and said that they had attended training in the Protection of Vulnerable Adults. Meadbank Nursing Home DS0000019107.V373230.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): Standards 19, 20, 21, 22, 24 and 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 attractively decorated and communal rooms are well furnished. Residents’ bedrooms reflect their individual tastes and interests. Residents have access to specialist equipment if they need it. Residents’ and relatives’ opinions about cleanliness were divided. EVIDENCE: The home is situated close to local shops and services and Battersea Park and the River Thames are nearby. A good standard of decoration has been Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 19 achieved throughout the home and there is a small but well-maintained garden, which was being landscaped at the time of inspection. Communal lounges and dining areas are provided on each floor. The home is divided into units, each of which has an allocated manager. Residents’ bedrooms have en suite bathroom facilities and reflect individual tastes and preferences. Residents are able to bring personal items with them when they move in and to install a private telephone line should they wish. The home provides specialist equipment and adaptations where necessary to meet residents’ needs. Adapted bath and shower facilities are available and hoists are available to assist transfer. Residents’ opinions about cleanliness were divided. When asked whether the home is fresh and clean, three residents said “usually” and one resident said, “sometimes”. Other opinions about cleanliness were also mixed. A visiting healthcare professional said that the home provides a “warm, clean, comfortable environment”, whilst a relative said, “Cleanliness is variable – there’s room for improvement”. Meadbank Nursing Home DS0000019107.V373230.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): Standards 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Relatives said that staff availability has improved although identified the period after lunch as a problem. Residents and relatives were positive about staff skills and approach. Residents are protected by the home’s recruitment practices but one staff file did not contain a Criminal Records Bureau Disclosure. The support provided to staff has improved. Unit meetings are now taking place but some units do not hold these meetings as frequently as others. EVIDENCE: Some relatives said at the last inspection that staff numbers were not sufficient to provide good care at all times. Comments made by relatives at this inspection indicated that this has improved in recent months, although two people identified the period after lunch as problematic. One relative said, “Staffing levels on the floor in the afternoon is low especially the period after Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 21 lunch so if Mum needs help she has to wait” and another said, “Staffing levels seem to take a sharp downward turn after lunch”. This should be monitored by the management team to ensure that sufficient staff are available to meet residents’ needs at all times. Residents and relatives’ comments were positive about staff skills and approach. One relative said, “Staff are well trained, conscientious and communicate well with relatives”. Other relatives described staff as “Well trained, friendly and hard working” and “Obliging and helpful to friends and relatives, whenever visiting”. A visiting healthcare professional also noted improvements in staff skills and experience, saying, “Recent training innovations and staff selection has produced good results in this field”. The minutes of unit meetings demonstrated that these are used by managers to share important information with staff and to maintain good communication amongst the team. However some units do not hold these meetings as frequently as others. All units should have regular team meetings to ensure that staff are briefed about issues affecting residents and other important information. Ten staff files were checked. All but one contained two references, proof of identity and a Criminal Records Bureau Disclosure. One member of staff’s file did not contain a Criminal Records Bureau Disclosure. See Requirement 4. Training records demonstrated that staff attend training and regular updates in mandatory areas including moving and handling, health and safety, infection control and the Protection of Vulnerable Adults. Some staff at the last inspection said that they did not get good support from their managers. Staff returning surveys for this inspection said that the support available to them had improved. Staff also said that they have better access to training than previously and that communication from the home’s management team has improved. Meadbank Nursing Home DS0000019107.V373230.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): Standards 31, 32, 33, 35, 37 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home manager has contributed much to the improvements achieved since the last inspection. Bupa must submit an application to register a manager and responsible individual with the CSCI. All staff should sign to record their reading of operational policies and procedures. The call bell system must be improved to ensure that all calls are responded to in good time. Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 23 The home should implement the recommendations made by the alarm system engineer in October 2008. EVIDENCE: The home manager has contributed much to the improvements achieved since the last inspection. She has introduced a number of systems and approaches that have improved practice, communication and morale. Residents said that they like to see the manager on her regular visits to the units and staff said they feel the manager appreciates their efforts. The manager’s efforts have been supplemented by the work of the Bupa Quality and Compliance team, who have been supporting operational staff since the last inspection. The contribution of the manager was highlighted by the healthcare professionals who submitted comments. One said, “I am impressed with the changes made over the last six months”, whilst another commented, “Management changes in the last 12 months have led to… improvements in the relationship between staff and residents and the handling of residents’ needs”. Whilst the support to the service from the manager and the Quality and Compliance team has been very good, the manager plans to leave the service in the near future. As a result the registration certificate is out of date and the home does not have a manager or a responsible individual registered with the CSCI. Bupa must submit an application to register a manager and responsible individual with the Commission. See Requirement 5. Residents said that they are encouraged to contribute to their care plans and that their relatives are invited to reviews. Some relatives said they would like the opportunity to attend regular Relatives’ Meetings with the home manager. The home should give consideration to this proposal. As highlighted earlier in this report a number of residents and relatives said that items of clothing are sometimes not returned from the home’s laundry, often despite being clearly labelled. The home must ensure that the laundry system is improved so that residents’ items are returned to them. See Requirement 6. Where the home holds residents’ money, there are secure computerised records of all transactions and balances. Statements are produced regularly and provided to residents and their next of kin. Each unit has a file containing current operational policies and procedures and a signature sheet for staff to sign when they have read each document. However these signature sheets contained only a handful of signatures. Unit Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 24 managers should ensure that all staff sign to record their reading of policies and procedures. Call bell response times are recorded and these were checked on several units. These records gave cause for concern, several showing response times in excess of 30 minutes and some in excess of an hour. Some staff said that response times are affected by the bleeps they hold, which do not give clear information about where the call bell has been activated. This issue must be addressed by the home to ensure that call bells are responded to in good time. See Requirement 7. The home has an appropriate emergency lighting and fire alarm system, which was serviced in July 2008. Records of fire drills and fire alarm tests were up to date. An engineer was called out in October 2008 and identified recommendations including a survey of the fire alarm system to identify any necessary improvements and the replacement of smoke detectors due to their age. The home should implement the recommendations made by the alarm system engineer. See Requirement 8. Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 25 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 3 3 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 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 2 X 3 X 3 2 Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 26 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 OP7 Regulation 12 Requirement The Registered Person must ensure that residents receive care that is individualised and tailored to their needs and preferences. The Registered Person must ensure that medication is stored securely at all times. The Registered Person must further develop the activities programme to ensure that residents have access to a suitably varied range of activities. The Registered Person must ensure that a Criminal Records Bureau Disclosure is obtained for all staff when they start work at the home. The Registered Person must submit an application to register a manager and responsible individual with the CSCI. The Registered Person must improve the laundry system so that residents’ items are returned to them. The Registered Person must ensure that all calls to the call DS0000019107.V373230.R01.S.doc Timescale for action 30/12/08 2 3 OP9 OP12 13(2) 16 30/11/08 30/12/08 4 OP29 19 30/11/08 5 OP31 8 30/12/08 6 OP33 16 30/12/08 7 OP38 23 30/12/08 Meadbank Nursing Home Version 5.2 Page 27 8 OP38 23 bell system are responded to in good time. The Registered Person must implement the recommendations made by the fire alarm system engineer in October 2008. 30/12/08 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 Refer to Standard OP27 OP28 OP33 OP37 Good Practice Recommendations Staffing levels should be monitored by the management team to ensure that sufficient staff are available to meet residents’ needs at all times. All units should have regular team meetings to ensure that staff are briefed about issues affecting residents and other important information. Consider holding regular Relatives’ Meetings. All staff should sign to record their reading of policies and procedures. Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Meadbank Nursing Home DS0000019107.V373230.R01.S.doc Version 5.2 Page 29 - 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!