Inspection on 25/07/07 for Minshull Court Nursing Home

This inspection was carried out on 25th July 2007.

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.

Other inspections for this house

Minshull Court Nursing Home 22/01/07

Minshull Court Nursing Home 20/11/05

Minshull Court Nursing Home 08/08/05

Minshull Court Nursing Home 15/11/04

Minshull Court Nursing Home 12/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Minshull Court Nursing Home Minshull New Road Crewe Cheshire CW1 3PP Lead Inspector Anthony Cliffe Unannounced Inspection 09:30 25 and 27th July 2007 th 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 Minshull Court Nursing Home DS0000018755.V340405.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. Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Minshull Court Nursing Home Address Minshull New Road Crewe Cheshire CW1 3PP 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) 01270 257917 01270 500614 Mr Christopher Chawner Manager not registered Care Home 34 Category(ies) of Dementia (34) registration, with number of places Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 34 service users to include: * Up to 34 service users in the category of DE(E) (dementia over the age of 65) 22nd January 2007 Date of last inspection Brief Description of the Service: Minshull Court care home is a converted detached two-storey property situated in its own grounds approximately two miles from the centre of Crewe. The home provides care with nursing for adults aged over 65 years of age diagnosed with dementia. There is a passenger lift and internal staircases and wheelchair access throughout the home. The home has two lounges and two dining rooms. Bedroom accommodation comprises of 34 single rooms all with hand-wash basins. There are no en-suite facilities. There is an enclosed garden and patio area to the rear and with ample car parking at the front. The home is on a bus route and the main railway at Crewe town centre. Fees range from £350 t0 £550. Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on the 25th and 27th July 2007 and lasted Twelve and a half hours. A Regulatory Inspector carried out the visit. This visit was just one part of the inspection. Other information received was also looked at. Before the visit the home manager was also asked to complete a questionnaire to provide up to date information about services provided. Questionnaires were provided for residents, families, and health and social care professionals to find out their views. During the visit various records and the premises were looked at. A number of residents and staff were also spoken with and they gave their views about the service. What the service does well: What has improved since the last inspection? The recruitment of staff had improved so residents were protected from harm. Fire training and fire drills had improved so residents and staff were protected from the risk of fire. The opportunities for staff to undertake NVQ level 2 training and training appropriate to their role had improved to provided a more skilled workforce. Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are assessed prior to moving in. EVIDENCE: Minshull Court accommodates mainly people from the Crewe area and is welcoming to anyone from outside the area or with a disability, different ethnic or cultural needs or sexual orientation. Records were examined of two residents who recently moved into Minshull Court. The manager had and met with them and gathered information about their needs. Personal support plans and risk assessments were in place for both residents. Additional information had been obtained from the local council social services department and Partnership Care Trust (PCT), which placed the residents at Minshull Court. The two residents had pre admission assessments and copies of the local council and PCT assessment of need. Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Detailed records of care, liaison with health and social care professionals and good medicine management ensures residents’ health and welfare needs are met. EVIDENCE: The care records of three residents were examined. They all contained information with regard to continence, safe moving and handling, nutrition, and skin integrity. Personal support plans had been devised for the needs of the residents that identified the problem, the help and support needed and the desired outcome. Each support plan had information from the social worker or from the NHS hospital from where the resident moved. From looking at support plans, watching staff working practices and talking with residents, staff and a visiting General Practitioner (GP) the health of residents was cared for. There were good examples of records in place that monitored residents’ health. Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 10 Support plans showed further improvement and guided staff on how to support and provide care for residents. Records recorded residents` physical and mental health needs. There were good examples of personal plans reflecting positive outcomes for residents. A support plan to reduce the number of falls for a resident had recorded she had not had any since September 2006. Her support plan regarding her personal care had been re written as she only needed one staff member to provide assistance. Another resident’s support plan identified that problems with continence had improved during the day but did not refer to the use of continence aids at night. Care staff kept separate records of the care they provided to residents. These were positive in their use as it allowed them to record the care and support they provided. However they mainly recorded information that residents had eaten or drank and had help with personal care. Personal plans described where residents were independent and could help with their care or informed staff of the level of support and care residents needed but did not always reflect residents’ choices or decisions about their care. Residents could choose to have a male or female carer. All of the residents were registered with a general practitioner and had access to NHS facilities. Records were maintained in the residents’ personal files showing that other healthcare professionals were involved in the care of the residents. Information from General Practitioners and social and healthcare professionals was included in the monthly reviews of person al plans. Medicines management and administration was examined. No errors were seen on medicine administration records. A monitored dosage system was used throughout the care home. The manager had commenced checks on medicine management as part of the quality assurance system. During the checks the manager had found errors with the monitored dosage system. The wrong medicines had been supplied and the pharmacist had lost prescriptions. The manager had addressed the matter with the pharmacy. The checks highlighted problems but did not record who was accountable and responsible for addressing them. The manager and deputy said that the staff’s approach to residents had greatly improved but there was room for improvement. They were aware that some staff addressed residents as love, mate, darling and gorgeous. They said staff addressing residents using such terms was not meant to cause disrespect and were terms of endearment. Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents need more support in making choices in their lifestyle and the coordination and recording of activities could improve so residents have regular activities based on their choice and preferences. EVIDENCE: Three residents’ support plans were looked at how social and recreational choices were planned. The recording of residents’ preferences on their social life had improved with the introduction of an activity care plan and carer diaries. Support plans had been written with the aim of preventing residents becoming withdrawn through loneliness and memory problems. The records advised care staff to offer and include residents in activities they were able to join in and that they could choose. Staff had recorded information on the social and recreational choices of residents. The carer diaries and activity profiles still recorded limited information some of which was inaccurate. The family member of one resident had updated the activity profile of one of the resident’s records examined to give accurate information on his recreational and work life but this information was not used to provide individual information for staff to use to promote his memory or plan recreational or social activities. Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 12 The activities coordinator was on sick leave. There were no organised activities at the time of the site visit. Staff said they did get involved in activities and had held a garden party the previous weekend and raised £350. They said the money raised would be used for the benefit of residents. The manager confirmed there was no dedicated activity budget. Carer diaries recorded activities residents were involved in and it was evident residents spent most of the time sat in lounges watching TV or listening to music. Individual’s involvement in activities was recorded for example nail care, dominoes and bingo. Staff had time to sit and talk to residents to provide social interaction but didn’t use their initiative and provide alternative social stimulation. A fourweek activity programme was in place but activities were not seen taking place. There were details of a party to celebrate the 50th wedding anniversary for a resident. The manager had further developed the role and responsibilities of the key worker and how staff were organised to provide support for residents. Staff spoke to were aware of their responsibilities as key workers. They highlighted that having a detailed knowledge of resident’s life histories was important, but this was difficult if residents did not have families or they did not provide information when requested. Key worker said they worked with a registered nurse as the named nurse and they met regularly to discuss residents’ care and support. Visitors were seen throughout the visit and were welcomed by staff. Visitors were at ease in approaching staff for information. A visiting GP said, “I think there has been a lot of change here. It’s calmer than a lot of the dementia care homes I visit locally. I think there is a calmer atmosphere and a calmer approach from the staff. I visit here regularly but am never called out unnecessarily. The staff here doesn’t just call a GP out to cover their backs it’s when we’re needed. I find the registered nurses very knowledgeable and know the residents’ conditions. The care is of a good standard as I have said. If staff ask for a referral or think one is needed they will say so as they are confident in their knowledge. The real change is in how open people are. Staff are always around caring for residents. It’s transparent to see how people are. Staff are approachable and will answer questions. Everything isn’t as controlled or have to go through the manager. If I had a relative who needed dementia care I wouldn’t hesitate in placing them here. That’s how much it’s improved. Its’ a nice place but needs updating. It’s not purpose built but it’s not bedlam either like many of the dementia care homes I visit locally that are”. Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 13 The menu was available in a large print format in bright colours. This had been laminated and was displayed in the foyer on the information board. The chef had continued residents’ ordering their meals from the menu and keeping a record of this. This included choices of alternative not on the menu. Residents were seen having breakfast and lunch. Pureed meals were appropriately presented in individual portions. Information about meal choice was given to residents by staff assisting them to order meals and residents chose from the menu. One resident was given a meal without choice and was angry with this. The resident was brought liver and onions. She said, “I don like that I’ve never liked it. My mother used to give it to me as a baby and the smell makes me physically sick. The carer didn’t ask me she just brought it”. Another carer asked her what she wanted and she said a sandwich which was brought to her. Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 14 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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints or concerns are consistently acted upon to safeguard residents from abuse but the complaints system needs to be revised so concerns are acknowledged so residents and relatives are confident they are listened to and acted upon. EVIDENCE: No complaints had been recorded since the lasts site visit. A quality assurance survey returned by a relative highlighted an issue about the laundry boiling their relatives clothes. This was not recorded as a complaint. The deputy manager said the manager had dealt with this at a local level, spoke to the laundry staff and let the relative know this. Any clothing would have been replaced. It was not seen as a complaint as the complaint’s procedure had not been used. There were no records of how it was dealt with or if a satisfactory outcome had been achieved. The CSCI had asked the owner to investigate a complaint received. The owner investigated this and provided evidence that the complaint could not be substantiated. Again there was no record of this Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 15 Training on protection of vulnerable adults had taken place in November 2006. Some recently recruited care staff needed to complete this as well as two of the registered nurses. The training coordinator had been on sick leave and the manager had looked at staff training programmes and highlighted that training was planned but hadn’t taken place due to sickness. She said the training would take place within one month. The deputy manager and a registered nurses spoken with about the adult protection procedure were aware of the procedure to follow if an allegation of abuse was reported and had the contact numbers of the local council adult protection team. Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 16 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): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a safe environment but equipment to protect then from fire, aid their independence and protect them from harm needs to be provided so they remain safe and independent of need. EVIDENCE: A programme of maintenance was in place. The handyman had two and a half days a week on site for routine maintenance and repairs. The décor is good. Externally the paintwork of the building had not been improved as agreed by the owner at the last site visit. The radiators were on during the site visit and hot to touch. At the last site visit the owner agreed to consult a plumber and fit temperature control valves to the radiators if possible or fit radiator guards. A fixed bath hoist was still not in use following visit from the service engineer in January 2007. At the last site visit owner had also agreed to replace the fixed bath hoist, as the parts could not be obtained for the broken one. The bathroom had a shower in that residents could use. The building was clean and hygienic. Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 17 The fire and rescue authority had raised concern over the fire detection equipment and risk assessment within Minshull Court and were dealing with the owner directly about this. An enforcement notice had been issued under Regulatory Reform (fire Safety) Order 2005 by Cheshire Fire Authority. Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of staff are adequate to meet residents’ needs. Staff recruitment ensures that residents are protected. The training programme provides a skilled workforce that protects residents’ welfare. EVIDENCE: There were sufficient numbers of staff on duty to meet the needs of residents and residents were supervised at all times. The manager provided information that nineteen care staff was employed. Six staff held and NVQ level 2 qualifications and six were registered to commence an NVQ level 2 qualification. Four staff recruitment files were looked at. All contained appropriate identification documentation and completed POVA checks and Criminal Record Bureau (CRB) disclosures. All files had two written references. There were copies of a new induction programme being used and two recently appointed staff had commenced this. Staff files contained a draft contract of employment, job description, training certificates and confirmation of identity. A staff member that had been reemployed as the last visit had a POVA First and CRB disclosure completed. Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 19 Details of staff training were provided during the site visit. The registered nurses had undertaken training in dementia care, bereavement, Fire, promotion of continence, venapuncture, medicine administration, immunisation vaccination, catheterisation first aid and moving and handling. Care staff had undertaking training in fire, moving and handling, bereavement, management of continence and protection of vulnerable adults. Staff spoke to said training, development and supervision was good. No training in dementia care had taken place for care staff. A staff member said, “I’ve never worked anywhere like this. In the short space of time I’ve worked here I’ve learned so much. I’ve had more training including; moving and handling, fire safety, bereavement and two continence courses. I did the protection of vulnerable adults before I left my last job but have been told I will have to repeat it here. I have my NVQ 2 and have been asked if I want to do NVQ 3. I have had supervision with the manager and been supported by the nurses and owners”. Another staff member said, “The key worker system means that I am responsible for keeping carer diaries, asking for monies or anything residents need. We work with the primary nurse and I see her every fortnight and we discuss care plans and residents’ care. We are allocated a group of residents during the morning or afternoon that need either a lot or little assistance. It’s really good that we don’t have routines of putting them to bed and getting them up. Like one resident said he didn’t want to get up today so we left him in bed. Choices could be improved upon if we had the right information. Staff meetings were not held regularly and the minutes of the last staff meetings were for the registered nurses in April 2007 when the last inspection report was discussed. Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An experienced manager has improved quality assurance, training and supervision of the staff team but an application to register, as manager needs to be made so residents’ quality of life is enhanced and they are protected. EVIDENCE: The home manager has been in post for ten months but had not made an application to the CSCI to register as manager. She was a registered mental nurse and had applied to do the NVQ level 4 registered managers’ award. A deputy manager had also been appointed to support the manager. Continued improvement in the management of the home and staff was noted. Prior to the site visit the CSCI were notified that a number of staff had been suspended and disciplinary action had been taken. The outcome of this action was not known to the CSCI. A number of new staff had been recruited and staff spoke positively about the changes in how Minshull Court was managed. Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 21 A registered nurse said, ““We have come a long way as a management team. We have had to manage change in a difficult environment and have made progress. Staff were very resistive at first. We had to challenge them about their practice, the way they spoke to residents and their understanding of residents’ conditions. These are not just a group of old people who have things done to them. Some staff treated residents, as they had no value. We have worked hard to change the culture. We have offered support and training and challenge when necessary. We need to challenge ourselves further as we want to provide the best and you can’t do that by standing still. We now have a really good staff team that have worked together to improve how we work as a team. It’s been hard but we feel we have improved”. A care assistant said, “I feel part of a team and there are no them, and us the nurses explain things to you and don’t use a different language. I am involved in care plans and write in the carer diaries. I am asked about the care plans to see if we have missed anything or if anything can be done better. I am asked for my ideas and opinions on resident’s care. I’ve had two supervisions since I’ve worked here and talked about my training and development and you feel like you’re valued. The atmosphere has changed there more of a team spirit. I am a key worker and have just changed my key residents and am getting to know about them and their family histories”. Another care assistant said, “The manager here is excellent, she listens to you and is very supportive. She is one of the team and will role her sleeves up and does care or can be the manager if she needs to be. If she needs to speak to you it’s done in private and it’s a learning experience and she supports you, It’s not a telling off or you’ve done wrong. The atmosphere has improved. I wouldn’t be afraid to take any problems to the manager as she listens and acts”. The manager had introduced more quality monitoring of the standard of care and monitoring of staff practice. There was a quality assurance system in place. The manager has a routine for monitoring quality of the health and safety of the building, care of residents and record keeping. For example the risk of pressure ulcer developing was monitored weekly. Records of the audits form January to July 2007 recorded no pressure ulcers within Minshull Court. The use of bedrails was monitored to check they were fitted properly; risk assessments up to date and that consent had been given by the resident or their family. Medicine audits were completed fortnightly and the June and July 2007 audits highlighted problems with the pharmacist supplying medicines. The monitored dosage system was not adequate. Prescriptions had gone missing and medication sent for a resident that was not prescribed. The medicine audit did not identify that when errors were found who was responsible for them and who was responsible and accountable for addressing them. Support plan were audited and the records for residents whose support plane were examined were looked at. These were seen for February, April and July 2007. These highlighted where concerns over the recording in support Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 22 plans around reviewing and revising them were highlighted. Where risk assessments needed updating and permission for the use of bed rails needed. Some personal support plans were more than 12 months old and needed an annual review. The audits did not set timescales for records to be revised. A health and safety audit July 2007 highlighted need for mandatory training on the Control of Substances Hazardous to Health for all staff. The carpet in the main lounge was becoming frayed and radiator covers had not been fitted. The manager did not complete an action plan for the provider to address the matters. Eight satisfaction surveys had been returned by relatives. Overall the comments were positive with standards of care rated as good and excellent. Staffing was seen as good throughout the day and the staff team as good. Improvements in the building and décor were highlighted and two said that social and recreational activities could be improved. No monies were held on behalf of residents at Minshull Court Families were responsible for them. One resident manages their own finances. Information provided by the provider in a data set and records held on site were examined. All the required maintenance and health and safety checks of the building and equipment had been completed except for the replacement of a bath hoist in the first floor bathroom and issued raised by Cheshire Fire Authority. Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 X X 2 X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP19 Regulation 23(4a)(b) Requirement The registered person must ensure the requirements of that Order and any regulations made under it are complied with in respect of the care home and comply with the enforcement notice issued by Cheshire Fire Authority 3rd July 2007 so residents’ safety is protected. The registered person must replace the broken assisted bath hoist in the first floor bathroom so residents who are old, infirm or physically disabled have access to bathing facilities of their choice. The registered person must ensure that an application for a suitably qualified and experienced manager is submitted to the Commission for Social Care Inspection so residents’ quality of life is enhanced and they are protected. Timescale for action 01/12/07 2. OP22 23(2)(n) 01/10/07 3. OP31 8(1) 01/11/07 Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP12 Good Practice Recommendations Residents’ carer diaries should contain more details on residents’ social preferences and what they enjoyed doing and the social interactions that took place. This information should be used to further develop the activities offered to residents. All expressions of dissatisfaction and complaints received should be recorded and dealt with under the complaints procedure. Radiators in the lounges and corridors should be fitted with guards. The exterior paintwork of the building should be repainted. Staff meetings should be held more regularly. Staff should be provided with training on dementia care and activity based care. 2. 3. 4. 5. 6. OP16 OP19 OP19 OP30 OP30 Minshull Court Nursing Home DS0000018755.V340405.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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. 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