Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 01/09/05 for Merseybank Nursing Home

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

This inspection was carried out on 1st September 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

There has been a change of manager since the last inspection. The acting manager (not yet registered with the Commission) received encouraging comment from the service users and a relative spoken with at this inspection, in terms of her abilities and professionalism. The staff as a whole are well regarded by the service users and there was an impression gained of a welltrained, friendly and professional group. There is a relaxed atmosphere within the home and service users can retain as much control over their lives as possible. The facilities provided for service users are generally well maintained and there are systems in place to promote service user safety and wellbeing. Management is accessible and responsive to service users needs and staff are committed to providing a good service, which meets the individual needs of the service users

What has improved since the last inspection?

Many of the requirements from the last inspection have been addressed, or are in the process of being addressed. For example, the medication systems have been improved and the systems provide satisfactory levels of safety for the service users. There is also satisfactory evidence of servicing and maintenance of the services.

What the care home could do better:

There are positive signs that this service intends to comply with standards and there are now fewer areas for management to address, compared with the last inspection. An area still in need of attention includes a better partnership approach to care planning, with more involvement from the service users to be encouraged (where appropriate). There are still some maintenance issues to rectify. Potentially one of the most important to service users, and a point that was not raised at the last inspection, is for the home to provide showers in the two units that do not currently have this provision. Service users (and staff) also have the right to clean air, and the smoke room arrangements in one of the units needs to be reviewed. There must also be unrestricted access to the communal areas of the home for service users at all times.

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Merseybank Nursing Home The Carriage Drive Hadfield, Glossop Derbyshire SK13 1PJ Lead Inspector Andrew Bailey Unannounced Inspection 01 September 2005 at 10:15am 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 and Care Homes for Adults 18 – 65*. 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. Merseybank Nursing Home C52 C02 S25442 Merseybank Nursing Home V247034 010905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Merseybank Nursing Home Address The Carriage Drive, Hadfield, Glossop, Derbyshire, SK13 1PJ 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) 01457 885175 01457 860381 merseybank@craegmoor.co.uk Parkcare Homes (No.2) Limited Awaiting registration Care Home 74 Category(ies) of Dementia (18), Old age, not falling within any registration, with number other category (18), Physical disability (38) of places Merseybank Nursing Home C52 C02 S25442 Merseybank Nursing Home V247034 010905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. 18 elderly mentally ill aged 55 years and over; 1 first level registered nurse throughout 24 hours. 2. 18 elderly physical infirm aged 55 years and over; 1 first level registered nurse throughout 24 hours. 3. 38 younger disabled aged between 18 - 55 years; 1 first level plus 1 first/second level registered nurse over 24 hours. 4. The Home Manager to be supernumerary for 37.5 hours per week. Date of last inspection 25 May 2005 Brief Description of the Service: Merseybank Nursing Home is registered for the care of 74 service users with nursing and personal care needs (including up to 18 service users with dementia and up to 38 youger adults with physical disability). The home is situated in Hadfield, near to the town of Glossop. Service user accommodation is provided on three floors with passenger lift and staircase access provided. The home is divided into four separate units. The units are staffed separately. There are expansive gardens, including a patio area. Support services are in place from local GPs. Other health support services are accessed on request or as required. Merseybank Nursing Home C52 C02 S25442 Merseybank Nursing Home V247034 010905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and the duration of the inspection was approximately 6 hours. A tour of the building took place. The Inspector spoke with six service users, one relative and with several staff. The acting manager was present at this inspection (the registered manager resigned recently and the acting manager is to apply for registration with the Commission). The Area Manager was also present for the majority of the inspection. A number of records were examined, including care plans (as part of the case tracking process, which is used to help determine how the home meets the needs of individual service users). An assessment was made of progress by the registered persons to address requirements made at the previous inspection of this service. The majority of previous requirements had either been dealt with or there were plans to address these in the near future. Many of the ‘key standards’ had been assessed at the last inspection, and where these were met they were not reassessed at this inspection. Overall, feedback from service users and a relative spoken with was very positive with regard to the service provided at this home. What the service does well: There has been a change of manager since the last inspection. The acting manager (not yet registered with the Commission) received encouraging comment from the service users and a relative spoken with at this inspection, in terms of her abilities and professionalism. The staff as a whole are well regarded by the service users and there was an impression gained of a welltrained, friendly and professional group. There is a relaxed atmosphere within the home and service users can retain as much control over their lives as possible. The facilities provided for service users are generally well maintained and there are systems in place to promote service user safety and wellbeing. Management is accessible and responsive to service users needs and staff are committed to providing a good service, which meets the individual needs of the service users. Merseybank Nursing Home C52 C02 S25442 Merseybank Nursing Home V247034 010905 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? 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. Merseybank Nursing Home C52 C02 S25442 Merseybank Nursing Home V247034 010905 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Standards Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Merseybank Nursing Home C52 C02 S25442 Merseybank Nursing Home V247034 010905 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Key standards were met at the last inspection (May 2005). Standard 6 (Older People) is not applicable to this service. (See report from May 2005. Not assessed at this inspection) EVIDENCE: Not assessed at this inspection. Merseybank Nursing Home C52 C02 S25442 Merseybank Nursing Home V247034 010905 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 9 (and 9, 19 & 20 - Adults 18-65) The care plans are detailed and clearly set out the care needs of the service users. There is insufficient evidence of the involvement of service users in the development and review of care plans. Service users are protected by systems that promote safe administration and handling of medicines. EVIDENCE: Six service users were case tracked, which included detailed examination of their care plans. Merseybank Nursing Home C52 C02 S25442 Merseybank Nursing Home V247034 010905 Stage 4.doc Version 1.40 Page 10 Overall, the care plans were comprehensive and contained a range of screening and risk assessment documents that had been reviewed on a regular basis. However, there is not a risk assessment in use with particular attention to the prevention of falls. This was discussed with the acting manager at this inspection and she indicated that this would be explored after the inspection. The National Framework for Older People (DOH 2001) identifies the importance of measures to reduce the incidence and effects of falls in the elderly, and the introduction of a risk assessment for falls would be a positive development at this home in an attempt to reduce the risk to the elderly service users. As at the last inspection, from examination of care plan records, there was insufficient evidence of service user (and/or representative) involvement in the formulation of care plans. Discussion with service users again confirmed this finding, with none of the service users describing a true partnership approach to care planning. Service users spoken with were also not aware of their right to access their care plans. There is not an open and transparent system in place that encourages meaningful involvement of the service user (or their representative) in determining the care to be provided. The acting manager explained that new documentation was being introduced and that it was intended to encourage service user and/or representative involvement in the compilation and review of care plans to coincide with the introduction of this documentation. The timescale for achieving this has therefore been extended. Requirements from a recent inspection by the CSCI pharmacist had been addressed and there were robust medication systems in place to safeguard the service users. An inspection of the medication systems was undertaken to check compliance with the requirements made by the pharmacist. Merseybank Nursing Home C52 C02 S25442 Merseybank Nursing Home V247034 010905 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with asssistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Key standards were met at the last inspection (May 2005). (See report from May 2005. Not assessed at this inspection) EVIDENCE: Not assessed at this inspection. Merseybank Nursing Home C52 C02 S25442 Merseybank Nursing Home V247034 010905 Stage 4.doc Version 1.40 Page 12 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 (and 23 Adults 18-65) The adult protection systems in place and the training of staff safeguard service users from abuse and neglect. EVIDENCE: There is evidence from the way management handled a recent incident that the systems in place for dealing with adult protection issues are robust. Staff receive training in adult protection and this training is delivered in-house by a member of staff. There was no available information at the time of the inspection to demonstrate that the trainer receives her own periodic update from a creditable source e.g. social services adult protection training. The acting manager agreed to follow this up and to facilitate such arrangements, if necessary. This is to ensure that the information and training that staff receive always reflects best and current practice, to further safeguard the service users. Staff also receive training on dealing with verbal and/or physical aggression (Care and Protection of the Individual). Merseybank Nursing Home C52 C02 S25442 Merseybank Nursing Home V247034 010905 Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) 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, 24, 25 & 26 (and 24, 26, 27, 28 & 30 - Adults 18-65) There are a few environmental issues to address to ensure that the facilities meet service users needs. EVIDENCE: A tour of the premises was made to evaluate the environment. Progress had been made since the last inspection, with many of the environmental requirements addressed. Where these had not been completed, there were Merseybank Nursing Home C52 C02 S25442 Merseybank Nursing Home V247034 010905 Stage 4.doc Version 1.40 Page 14 plans in place to address them in the near future. Overall, the facilities are maintained to a satisfactory standard. The exposed pipework in the dementia unit (dining room) still required either removing or boxing in (health & safety risk). The pipework was covered/guarded by a table at the time of the inspection. A toilet had a rusted handrail (adjacent to the pedestal) in YPD1, which was rough and could not be cleaned adequately (health & safety risk). Several of the rusting metal radiator covers on YPD1 had been restored, but some awaited attention e.g. YPD1 bathroom. The bathroom on YPD1 had been cleared of storage, but waited refurbishment. There were quotations obtained and definite plans to provide locks to bedroom doors (where applicable). The sluice on YPD1 had wall tiles removed, and was awaiting re-tiling (the sluice had been taken out of use temporarily). Further environmental issues were raised at this inspection (many by the service users spoken with). A toilet frame on YPD2 required replacement (rusted metal frame). The activities room on YPD1 (previously service user communal lounge space) was being locked at some times, which denied the service users the use of this facility. The Area Manager and acting manager agreed to ensure that the room was available to service users at all times. The smoke room on YPD2 is small. Whilst it may be difficult to relocate this facility, the registered persons must ensure that adequate ventilation (extraction) is present to prevent the presence of smoky air in the corridor and surrounding areas. It is not satisfactory to use the emergency exit door as a means of ventilation, since this tends to send the smoke down the corridor rather than extracting it. Several service users spoken with at the inspection felt that their needs required the use of a shower. However, on YPD2 (younger adults) and on Kinder (older persons) there was no shower provision. The shower on Kinder had been taken out of commission due to drainage problems (floor slope). Staff also reported challenges in meeting the needs of some of the service users with no shower provision on these units. Merseybank Nursing Home C52 C02 S25442 Merseybank Nursing Home V247034 010905 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 29 and 30 (Older People) and Standards 34 and 35 (Adults 18-65) the key standards to be inspected at leat once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 (and 33 Adults 18-65) Staffing levels correspond to the needs of the service users living at the care home. EVIDENCE: Service users and a relative spoken with felt that the home was adequately staffed. They also praised the staff and the manager for their hard work and commented that the staff are friendly and professional in their approach with the service users. The staffing roster was examined and it was apparent that the Conditions of Registration (Registration Certificate) were being complied with. There is a bank system in place to provide cover for sickness etc and this provides some continuity for the service users in that these staff are familiar with the home. Merseybank Nursing Home C52 C02 S25442 Merseybank Nursing Home V247034 010905 Stage 4.doc Version 1.40 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s polies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 33, 35 and 38 (Older People) and Standards 23, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 & 38 (and 39 & 42 - Adults 18-65) There is effective management of this care home and management is accessible and responsive to service users and their representatives. The systems in place promote the health and safety of service users. Merseybank Nursing Home C52 C02 S25442 Merseybank Nursing Home V247034 010905 Stage 4.doc Version 1.40 Page 17 EVIDENCE: The management undertake audits as part of the quality systems in place. These include Health & Safety audits and maintenance audits and take place on a six-monthly basis. This helps assure the quality of the service for the service users. There have been service user satisfaction surveys on an annual basis, but there is no evidence of a clear feedback mechanism for the service users e.g. summarised feedback for inclusion in the Service User Guide, or displayed feedback within the home. However, residents’ meeting are held regularly and these provide opportunity for management to get feedback from the service users about how the service is perceived by service users. There is evidence of visits to the home on behalf of the registered providers (by the Area Manager) in accordance with Regulation 26, to provide an ongoing assessment of the running of the home. This is one of the quality monitoring measures that contributes to the home being run in the best interests of the service users. There has been a change of manager since the last inspection. The acting manager (not yet registered with CSCI) received praise from the service users and a relative who spoke to the Inspector, about her abilities and the manner in which she undertakes her role. Staff had received training in safe working practices. There was evidence that equipment and services had been serviced/inspected, including evidence that previous requirements had been met (the sample of records examined at this visit, included gas and electric services). The approach to safe working practices provides assurance that satisfactory efforts are being made to promote the health, safety and welfare of service users, staff and other persons entering the premises. Merseybank Nursing Home C52 C02 S25442 Merseybank Nursing Home V247034 010905 Stage 4.doc Version 1.40 Page 18 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 x 2 x 3 x 4 x 5 x 6 x HEALTH AND PERSONAL CARE ENVIRONMENT Standard No 19 20 21 22 23 24 25 26 STAFFING Score 2 2 2 3 x 2 2 2 Score Standard No 7 8 9 10 11 Score 2 3 3 x x Standard No 27 28 29 30 3 x x x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No 16 17 18 Score x x 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 x 32 x 33 3 34 x 35 x 36 x 37 x 38 3 Merseybank Nursing Home C52 C02 S25442 Merseybank Nursing Home V247034 010905 Stage 4.doc Version 1.40 Page 19 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 op7 Regulation 15 (1,2) Requirement There must be evidence of service user/representative involvement in the drawing up of and review of care plans (previous requirement not met timescale of 31 July 2005) The rusting toilet frame in YPD2 must be replaced Rusting radiator covers must be replaced or repainted (previous requirement not met in full timescale of 31 July 2005) Locks must be provided to bedroom doors (previous requirement not met - timescale of 31 July 2005) There must be adequate ventilation (extraction to the outside) in the smoke room on YPD2 A shower must be provided for service users on YPD2 A shower must be provided for service users on Kinder The communal lounge space on YPD1 (activities room) must be available to service users at all times The wall tiles in the sluice on YPD1 must be replaced or an Timescale for action 31 October 2005 2. 3. ya24 ya24 23 (2) 23 (2) 31 October 2005 31 October 2005 31 October 2005 31 October 2005 30 January 2006 30 January 2006 30 September 2005 31 October 2005 Page 20 4. ya26/op24 23 (2) 5. ya24 23 (2) 6. 7. 8. ya27 op21 ya28 23 (2) 23 (2) 23 (2) 9. ya30 23 (2) Merseybank Nursing Home C52 C02 S25442 Merseybank Nursing Home V247034 010905 Stage 4.doc Version 1.40 alternative washable surface must be provided (infection control risk) (previous requirement not met - timescale of 31 July 2005, but sluice taken out of service pending repair) 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 op7 op9 op9 op18 Good Practice Recommendations A risk assessment for falls should be introduced for use with service users (particularly the over 65s, as per the National Service Framework for Older People (DOH 2001)) A written procedure should be produced for the disposal of medicines to reflect the recent change in procedure The maximum and minimum temperatures of the medication refrigerators should be recorded daily and lie between two and eight degrees Centigrade The manager should ensure that the in-house adult protection trainer has frequent updates on this subject from a creditable source e.g. social services adult protection training There should be a formal mechanism for feedback to service users on the results of service user satisfaction surveys 5. op33/ya39 Merseybank Nursing Home C52 C02 S25442 Merseybank Nursing Home V247034 010905 Stage 4.doc Version 1.40 Page 21 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. Merseybank Nursing Home C52 C02 S25442 Merseybank Nursing Home V247034 010905 Stage 4.doc Version 1.40 Page 22 - 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!