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Inspection on 24/08/05 for Meadow View Nursing Home

Also see our care home review for Meadow View Nursing Home for more information

This inspection was carried out on 24th August 2005.

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

The inspector 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

Residents at Meadow View appeared settled and contented. It was clear that there were good relationships between residents and staff. The care plans seen were detailed and comprehensive to ensure staff were fully aware of all the actions required to meet residents` needs. Staff spoken with were knowledgeable about the care needs of residents. Residents` bedrooms were individual and personal, reflecting residents` characters and preferences.

What has improved since the last inspection?

The home had met some of the requirements made at the last inspection, resulting in improvements to the environment of the home and in the information provided to, and collected about residents. The home had employed a housekeeper to ensure a good standard of cleanliness throughout the home and to relieve care staff from some of the cleaning tasks. A new bath had been installed in one bungalow, improving the facilities available to residents. The home had employed an activities coordinator to improve the service offered to residents.

CARE HOME ADULTS 18-65 Meadow View Nursing Home Church Lane Calow Chesterfield S44 5AG Lead Inspector Rose Veale Unannounced Inspection 24 August 2005 at 10:00am th 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Meadow View Nursing Home Address Church Lane, Calow, Chesterfield, Derbyshire, S44 5AG 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) 01246 270235 Derbyshire Care & Home Support Limited Neil Blake Care Home with nursing 24 Category(ies) of Learning Disability (24) registration, with number of places Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 31/01/2005 Brief Description of the Service: Meadow View is situated approximately two miles from the centre of Chesterfield in a residential area near to local amenities and public transport. Meadow View provides personal and nursing care and accommodation for 24 adults with learning disabilities. The home comprises four bungalows, each accommodating six residents. The bungalows are linked, although each has its own separate facilities. All the residents have single, ground floor bedrooms and shared lounge / dining rooms. There are garden and patio areas to the rear of the bungalows. Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over 5 hours on one day. Twenty four residents were accommodated in the home on the day of the inspection. The care records of 4 residents were examined, plus other records relating to the staffing and management of the home. A tour of the building was undertaken. The home’s manager had completed a pre-inspection questionnaire which had been returned to CSCI before the inspection. The manager was on annual leave on the day of the inspection. The two staff nurses in charge of the home were very helpful throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: Although the care records were generally good, there were some gaps identified which needed attention to ensure residents needs were fully met. Despite the best efforts of staff, there was not a sufficient range of activities offered to residents, in particular, access to relevant day services, to meet the assessed needs of residents. Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 6 Staff needed to undertake training in managing challenging behaviour and in infection control to ensure they had the necessary skills and competence to meet residents’ needs. Staffing levels at the home needed reviewing to ensure that there were sufficient staff on duty to meet residents’ needs, particularly with regard to social and therapeutic activities. Although the home was generally well maintained, there were several issues to be addressed to ensure a safe and pleasant environment for residents. 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. Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3, 4 and 5 Detailed assessment was obtained prior to the admission of residents for the home to use to judge whether they could meet residents’ needs. However, some assessment information collected following admission was insufficient and had not been reviewed regularly. Encouraging residents to visit the home prior to admission, and information provided in the terms and conditions ensured that residents / their representatives could make an informed decision about living at the home. EVIDENCE: The care records of four residents were examined, including the assessment information for two residents recently admitted. The Community Care Assessment was available, plus assessments from other healthcare professionals, such as learning disabilities nurse and speech and language therapist. The assessment information was detailed and comprehensive, enabling the home to make a decision about whether Meadow View could meet the needs of the residents. However, none of the records seen had a copy of a letter to the resident / their representative confirming that the home was able to meet the needs of the resident. This was part of a requirement made at the last inspection and has been carried forward in this report. The home had made assessments of the residents’ needs following admission and each resident had an individual care plan. Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 9 There were some gaps in the assessment records. One record did not contain an assessment of the risk of developing pressure sores, and other assessments in the same record had not been updated for over a year. One resident’s assessment of the risk of developing pressure sores had not been updated since January 2004, even though the resident had been assessed as being at risk and had recently had a change in condition. Two residents had moving and handling assessments which were not fully completed. From the records seen and discussion with staff, there was evidence that residents had been able to visit the home before admission to meet other residents and staff. One resident’s relatives had been closely involved with the pre-admission process and had helped prepare the resident’s bedroom so that it would be ‘like home’. Three of the records seen contained a copy of the terms and conditions between the resident and the home, and a breakdown of the fees to be paid, including the Registered Nursing Care Contribution. It was a requirement at previous inspections that this information must be provided and this had therefore been met. Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9 Individual care plans and risk assessments were clear and detailed, ensuring staff were aware of the action required to meet the needs of residents. However, some care plans and risk assessments had not been regularly reviewed or updated. EVIDENCE: Each of the residents’ records seen contained individual care plans. There was also a Personal Planning book for each resident which included detailed information about the residents preferred daily routines, likes and dislikes, family and social history and contacts. This book had been recently introduced and so had not been fully completed for every resident. The care plans seen were detailed and comprehensive, covering all aspects of each resident’s daily life. The care plans clearly described the action needed by staff to ensure resident’s needs were fully met. In one record, the care plans were disorganised as old information had not been removed when care plans had been reviewed and updated. In three of the records the care plans had been regularly reviewed and updated. One care plan had not been reviewed for over a year. All the records seen had notes of six monthly care reviews held regularly up to date. Not all the care plans seen were signed and dated. This Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 11 was a recommendation at the last inspection and has been repeated in this report. There were risk assessments in each of the records seen appropriate to individual residents. Risk assessments included going out on trips, use of bed rails, choking on food, and falls. Some of the risk assessments seen had not been reviewed or updated for over a year. Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14, 15 and 16 Despite the best efforts of staff, little progress had been made in providing appropriate activities, in and out of the home, to ensure fulfilling lifestyles for residents. EVIDENCE: Records were kept of activities residents had taken part in. These included trips out of the home and activities in the home appropriate to the needs and abilities of residents, such as manicures and use of the Snoezelen room. Staff were observed to be sitting and talking with residents, assisting residents to use the Snoezelen room, and helping residents to listen to music. Some residents were able to attend local day centres. One resident whose records were seen did not attend any day care outside the home even though it was felt that the resident would clearly benefit from this. This issue had been raised at previous inspections but it appeared that no progress had been made. It was reported that two residents should have gone out bowling on the day of the inspection, but there were no staff available to provide the escort required. It was felt that staffing levels in the home were not sufficient to allow staff enough time for social / leisure activities with residents. The home had recently employed an activities coordinator but it appeared that this was only for one day per week. Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 13 Residents’ families and friends were encouraged to visit and records were kept of the contact maintained. It was clear from the care records seen that some families were involved in the care of residents. The manager’s office was also used as a visitors room if residents and their visitors wanted privacy. Because of their needs and abilities, residents in the home could not express opinions about whether staff respected their rights, privacy and dignity. The records seen detailed residents’ preferred routines, like and dislikes. Staff spoken with were very aware of residents’ individual needs and preferences. It was observed that when staff assisted residents, their privacy and dignity were maintained. For example, residents were dressed appropriately, addressed by their preferred names, and personal care was carried out in private. Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 19 There was an emphasis in the home on the choices and preferences of residents, demonstrated through the attitudes and awareness of staff. EVIDENCE: Residents’ preferences were clearly detailed in their records. Staff spoken with were knowledgeable about the needs and preferences of residents. Staff were well aware of the importance of assisting residents in the way preferred. Records showed that residents and staff had received specialist support and advice from other healthcare professionals, such as physiotherapists, speech and language therapists, and moving and handling staff. The records seen showed that residents’ healthcare needs were met and records were kept of the input of other healthcare professionals, such as GP, dentist, optician, and learning disabilities consultant. It was clear that residents’ health was monitored and appropriate action was taken. For example, one resident had been referred for a medication review following reports by staff of possible side effects. Although standard 20 was not specifically assessed at this inspection, the Medication Administration Records, (MARs), and medicines fridge were checked to follow up requirements made at previous inspections. Although the medicine fridge temperature was checked daily and records kept, the maximum and minimum temperatures had not been recorded. Items were Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 15 stored appropriately in the fridge. The MARs were examined and found to have some gaps where there was no signature or code recorded. The relevant requirements have been carried forward in this report. Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The complaints procedure was clear and robust to ensure effective use. Residents were generally safeguarded by the home’s policies and procedures, however, relevant staff training was needed to ensure full protection. EVIDENCE: There was a suitable complaints procedure in place in the home. No formal complaints had been made to the home or to CSCI since the last inspection. The home’s complaints book recorded one recent verbal complaint from a relative with a note of the action taken. The home’s adult protection policy and procedures had been seen at previous inspections and found to be satisfactory and so were not examined at this inspection. It was a requirement at a previous inspection that staff must have training in respect of physical and non-physical interventions for dealing with challenging behaviours. It was reported by staff that this training had not taken place. The requirement is therefore carried forward in this report. Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26, 28 and 30 The home was generally clean, reasonably well maintained and free from unpleasant odours on the day of the inspection. However, there were several maintenance issues to be addressed to ensure a safe and pleasant environment for residents. EVIDENCE: It was reported that the bedrooms and lounge / dining area in bungalow 3 were waiting to be decorated. There were several maintenance issues identified. The dishwasher for the kitchen of bungalow 1 was waiting to be fitted. The grille to the extractor fan in the kitchen of bungalow 2 was very dirty and there were greasy splashes to the wall and ceiling above the cooker. Some of the cupboard doors and drawer fronts in the kitchens of bungalows 3 and 4 were loose. It was reported that repairs had been carried out, but the problems kept reoccurring. The kitchen in bungalow 4 had a torn flyscreen to the back door and the flooring was ripped between the fridge and dishwasher. The worktops were very worn. The floor in the bathroom in bungalow 3 was very stained around the toilet and coming away around the toilet and near to the door. Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 18 The floor in the dining areas of bungalows 3 and 4 was wooden and it was felt that this was a safety issue. Staff reported that there had been several accidents due to fluids spilt on this floor making it very slippery. Staff also felt that the wooden floor in the corridor outside the bathroom on bungalow 3 was unsafe when the bathroom was in use as it was impossible to prevent it getting wet. The corridor outside the bathroom on bungalow 4 had been fitted with an inset mat to address the same problem. Staff said that these issues had been raised with the manager. The home was accessible to residents throughout. There was an outdoor area for each bungalow, each with a patio area and suitable furniture. The patio outside bungalow 1 was sloping on either side of the ramp to the door and needed handrails fitting to ensure safe use by residents and visitors. The area outside bungalow 2 was not secure and so staff felt it was unsafe to allow residents to be in this area without continual supervision. This was not possible due to staffing levels. It was reported that this area had been scheduled for improvement by the providers some time ago. The bedrooms seen were all bright, clean and well personalised with residents’ photographs and possessions. Staff said that, as residents were mostly unable to indicate a choice of décor and furnishings, the rooms had been decorated to reflect the personality and known preferences of each resident. The laundries were well equipped, clean and tidy on the day of the inspection. Sluicing disinfectors were provided in three of the bungalows. According to the staff training records seen, some staff had undertaken infection control training, but the majority had not. Staff said that relevant training was available and they had applied, but had not been successful in securing places. It was a requirement at a previous inspection that staff must have infection control training and this has been carried forward in this report. Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 36 Staffing levels needed to be reviewed, in consultation with staff, to ensure that residents’ needs were fully met. EVIDENCE: Some progress had been made since the last inspection with regard to staffing hours as a housekeeper had been appointed. However, it was felt that there were not enough hours provided for housekeeping as the housekeeper was able to spend one day per week in each bungalow and other staff continued cleaning on the other days. Staffing levels were clearly an issue to the staff spoken with. It was felt that staffing levels were too low to allow staff to be able to fully meet the needs of residents, particularly regarding social and therapeutic activities. Staff were carrying out cleaning, cooking and laundry tasks in addition to the care of residents and it was felt that this had not been taken into account in the calculation of staff hours needed. From the duty rotas and other information provided with the pre-inspection questionnaire, and from information obtained during the inspection, it appeared that the care hours provided were not always sufficient to fully meet the needs of the residents. However, a full discussion and exploration of the issue was not possible as the manager was on annual leave. A requirement has been made in this report for the home to provide further information regarding the dependency level of residents and the staffing hours provided. Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 20 Staff spoken with said that the care assistants had regular supervision sessions with the nurses, but the nurses had not had regular supervision or annual appraisals. It was not possible to examine staff supervision records as the staff on duty did not have access to them. This will be followed up at the next inspection. Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: No standards in this section were assessed at this inspection because the manager was on annual leave and the staff on duty did not have access to all the information required. Although the next inspection will also be unannounced, efforts will be made to ensure the availability of the manager. Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 2 3 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 3 x 3 x 2 Standard No 11 12 13 14 15 16 17 x x x 2 3 3 x Standard No 31 32 33 34 35 36 Score x x 2 x 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Meadow View Nursing Home Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 23 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 2 Regulation 14(1)(d) Requirement The Registered Person shall not provide accommodation to any service user at the home unless it has been confirmed in writing to the service user that, having regard to assessment, the care home is suitable for the purpose of meeting the service users needs in respect of their health and welfare. Original timescale 31/03/2005 The home must not offer a place to someone whose needs it cannot meet. In this instance, action must be taken to ensure that the identified service user is able to access relevant day care, educational / occupational activities outside the home in accordance with their assesed needs. Original timescale 31/03/05 Care plans, including risk assessments, must be kept under review Staff must sign for medicines which must be administered in accordance with instructions on service users medicines administration record (MAR) sheets. If they are not given a Timescale for action 31/10/05 2. 2 14(1) 31/10/05 3. 4. 6 20 15(2)(b) (c) 13(2) 17(1) (a) Schedule 3 31/10/05 31/10/05 Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 24 5. 20 13(2) 6. 7. 8. 24 24 24 23(2) (b) (d) 23(2)(b) (c) 23(2)(b) (c) 23(2)(b) 13(4)(a) (c) 9. 10. 24 24 11. 24 23(2)(o) 12. 30 13(3) 18(1) 13. 32 13(4) 18(1) 14. 15. 32 33 18(1)(a) (c) (i) 18(1) (a) coded reason must be recorded. Original timescale 28/02/05 The maximum and minimum temperatures of the medicines fridge must be checked and recorded daily when in use and lie between 2 and 8 degrees centigrade. Original timescale 30/11/04 The extractor fan grille and the walls and ceiling in the kitchen in bungalow 2 must be kept clean The torn fly screen and flooring in the kitchen of bungalow 4 must be repaired or replaced The cupboard doors and drawer fronts in the kitchens of bungalows 3 and 4 must be repaired or replaced The flooring in the bathroom of bungalow 3 must be repaired or replaced A risk assessment must be made regarding the wooden flooring in bungalows 3 and 4, including the action to be taken to prevent slips and falls The patio areas outside bungalows 1 and 2 must be suitable for, and safe for use by service users Infection control training must be provided for staff by way of the rolling training programme arrangements to ensure that staff receive periodic updates. Original timescale 01/12/04 Staff who require must undertake relevant and recognised training in respect of non-physical and physical interventions for dealing with challenging behaviours. Original timescale 28/02/04 At least 50 of care staff must have NVQ Level 2 The Registered Person must provide details to CSCI of the 31/10/05 31/10/05 30/11/05 30/11/05 30/11/05 31/10/05 31/12/05 30/11/05 30/11/05 31/12/05 31/10/05 Page 25 Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 dependency levels of all service users at the home, and details of the care hours provided 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 6 6 6 24 Good Practice Recommendations Care plans, assessments and risk assessments should be signed and dated by the member of staff writing them The date of admission should be included on the front sheet of service users files Care plans and risk assessments should be reviewed and updated at least every six months A general upgrade and refurbishment of the kitchen areas should be considered to improve the facilities Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection South Point Cardinal Square Nottingham Road Derby, DE1 3QT 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 Meadow View Nursing Home C52 C02 S2064 Meadow View V243491 160805 Stage 4.doc Version 1.40 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. 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!