Inspection on 04/08/06 for Nettlestead

This inspection was carried out on 4th August 2006.

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

Nettlestead 27/10/09

Nettlestead 27/09/07

Nettlestead 28/12/05

Nettlestead 16/08/05

Nettlestead 21/02/05

Nettlestead 21/05/04

Nettlestead 16/12/03

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Nettlestead Nettlestead 19 Sundridge Avenue Bromley Kent BR1 2PU Lead Inspector Wendy Owen Key Unannounced Inspection 4th August 2006 09:30 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 Nettlestead DS0000006959.V297841.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. Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Nettlestead Address Nettlestead 19 Sundridge Avenue Bromley Kent BR1 2PU 020 8460 2279 020 8464 3683 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) Nightingale Retirement Care Limited Mrs Kim Thomas Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 22 Elderly Men and Women Date of last inspection 28th December 2005 Brief Description of the Service: Nettlestead is a large, detached three-storey Victorian house, converted for residential living, providing care and accommodation for twenty-two older people. The house is set within its own well-kept grounds, with a secluded rear garden. Off-road parking is located to the front of the property, with an “in and out” drive. The home is situated in a quiet residential area within walking distance of local shops and public transport links. The house has retained some of its original features, particularly the wood panelling in the lounge. Service users accommodation is on all three floors, accessed by stairs or lift. There are fourteen single and four double rooms. Central heating is provided to all areas of the home. Specialist bathing equipment and lifting aids are also available. There are telephones accessible to service users. There is one pay phone and one mobile phone for incoming calls to allow privacy. A few service users have a phone in their own room at their own expense. The residents are cared for 24 hours a day by a team of care staff, ancillary staff and a management team. Current scale of charges range between £643-£432. This includes accommodation, food and staffing. It does not include hairdressing; private healthcare; newspapers, clothing; toiletries and other personal expenditure. The home has a Statement of Purpose and Service Users Guide providing information on the home and copies of inspection reports are available directly from the home. Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one and a half days with one inspector undertaking the inspection. The inspection included written feedback from six relatives, one GP and six residents; discussions with staff, residents and the Manager; viewing of records, observations of practice and a tour of the home. What the service does well: What has improved since the last inspection? Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 6 Since the last inspection the temperatures of individuals’ rooms have been resolved. Staff have also undertaken moving and handling training, although this is not evident for all staff. Receipts for all residents’ monies spent are now in place so that there is an audit trail to check individual monies spent. The home has also developed risk assessments to ensure that risks to residents are identified and action noted on how the risks are to be minimised. What they could do better: The home ensures residents are assessed prior to admission to the home. However, the assessments could be more comprehensive and specific to the actual needs of the individual. Whilst there has been improvement in the care planning records there is still a need to ensure they reflect all areas of health, personal and social care needs. There was also a lack of moving and handling risk assessments for residents who require such assistance. There was evidence of contracts for residents who are privately funded and for those who had been agreed placement through the Local Authority, a placement agreement had been obtained. However, these residents should also be provided with a copy of the home’s terms and conditions of residency. Residents’ safety is compromised by the water discharging in the ground floor bathroom at too hot a temperature. Feedback and observations from the inspection process identified that there is a lack of activities with residents not being stimulated to any great extent. One relative said that, “more should be done if possible to make old people’s lives less boring and more enjoyable.” Adult protection procedures must be reviewed and provide more comprehensive guidance for staff. Staff must be provided with training in these procedures. The recruitment procedures have improved since the last inspection although there is still further improvement required. The bathroom on the first floor is currently out of use. The work must be completed to enable it to be used in the near future. The home must ensure residents have the equipment identified in their individual care plans. All equipment must be kept well maintained for safe use. Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 7 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. Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,5 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admission procedures ensure residents have the information they require about the home to enable them to make a decision about entering the home. Whilst all residents are assessed prior to admission, this must be more comprehensive to ensure staff have the full information they require to meet the individuals needs. EVIDENCE: Prior to any resident being admitted to the home prospective residents are assessed and, where the resident is funded by the Local Authority, a Care Manager’s assessment is obtained. The files of the last two residents admitted were viewed; one contained the home’s assessment and the other contained the home’s assessment and the Care Manager’s assessment. Whilst the home’s assessment covers many of the areas required by standard 2 the information recorded is basic and further guidance would give staff the information they require to care for all identified needs. For example: where the person needed assistance with mobility there Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 10 were no details of what assistance or aids were needed when it was clear that the resident used a Zimmer-frame. One resident wrote that “they (staff) came to visit me in my home and I visited the home”. Another resident who had been admitted for a short stay had visited the home previously and made arrangements for the stay himself. Two of the most recently admitted residents said they felt the care was good and that staff are personable and cared for you. “I feel spoilt” said one resident. (See requirement 1 & recommendation 1) Private residents benefit from the home’s contract detailing terms and conditions of residency, whilst those residents placed in the home by the Local Authority are provided with the Local Authority placement agreement. There was evidence of contracts and agreements in place, although some contracts were still with the family member for perusal. The inspector recommends that all residents, whether private or authority funded, are provided with the home’s terms and conditions. (See recommendation 7) The written feedback from residents all stated they have received contracts and that they had the information they require before entering the home. Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 & 11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff provided good care to residents to ensure they meet their health and social care needs. However, the written information must be more detailed to ensure residents’ needs are fully met. EVIDENCE: Three care plans were viewed. They all contained general information on the needs of the residents and included the daily routines. This is good practice. Core areas were covered, although they still need to contain more specific information on how staff are to meet the residents’ needs. For instance, where diet is mentioned this needs to be made clear as to whether this is a normal diet, the dislikes, ability to eat without support or assistance. This is also true of the personal care. The home must also ensure that where they have identified a risk of pressure sores the areas identified as a concern are entered onto the care plan for appropriate intervention. Physical health needs must also be more fully recorded in the form of a care plan, with more detail on the intervention proposed, such as how to meet chiropody and optical requirements. One resident, who is very poorly, had a care plan which Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 12 highlighted some areas of care but did not provide details of the involvement of other agencies, current dietary and medication needs, or palliative care. Special equipment was in place and the inspector observed the hospice nurse on premises. There was also evidence of District Nurses visiting the home. The care plans had been reviewed regularly and updated where necessary. There was evidence of residents signing the care plan but little evidence of relatives’ involvement in the reviews. (See requirement 2 & recommendation 2) The home ensures residents are weighed regularly and a record made. Falls risk assessments were also in place. However, the files lacked moving and handling assessments. This is required, especially where residents are nursed in bed or require specific equipment etc. Records were in place detailing health care visits by the chiropodist, GP and DN. It is clear from observations and feedback that the home provided good care to residents and that they ensure access to the appropriate healthcare referral. Residents generally looked well groomed and presented. The inspector observed the medication administered during the lunch-time period. This was generally satisfactory. There were good records of receipt of medication with two signatures in place for hand transcriptions. However, oromorph had not been clearly signed as received as it was on the same line as the medication administered. This must be made clear, especially as it is a controlled drug. Most, but not all, administration records contained details of allergies with photographs in place. Records of administration were good with codes in place where medication had not been administered. Variable doses showed a mixed recording on the number of tablets administered. During the course of the inspection the medication ready for disposal was collected by a pharmacy representative with records competed and signed. A number of staff have undertaken Level 2 medication administration with Croydon college. (See requirement 3 and recommendation 3) There was evidence of staff treating residents with respect and dignity. Privacy was also respected with staff undertaking personal care in private and knocking on doors before entering private rooms or bathrooms etc. Where residents are poorly the home ensures that there is a multi disciplinary approach as to how best care for the individual. Residents can spend their last days in the home with the appropriate care and support and relatives are treated sensitively during this time. Staff try and make the relatives’ time in the home comfortable and ensure that privacy is respected. Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 13 Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Routines in the home are flexible enabling residents to spend their day as they wish. There is not enough activity and stimulation to ensure the individual’s emotional and mental wellbeing. EVIDENCE: The individual care plans include a summary of the care required day and night. This is beneficial as it gives the staff an idea of the resident’s normal routine. Much of the feedback, written, verbal, and from the minutes of meetings viewed, show that the provision of activities and stimulation could be improved upon. Currently the home has an activity co-ordinator who works two afternoons each week. The Manager stated that she will soon be leaving and she is hoping to increase the hours for this post. This would benefit the residents. On both days of the inspection the residents were either in their rooms or the main lounge sleeping. There were no activities or stimulation. The home should investigate how they can provide activities inside and out of the home, ensuring consultation with residents. There is a local arts centre close by; pub lunches were asked for by another resident, as well as attending musical evenings. Residents would also benefit from regular entertainment brought into the home. There have been very few trips this summer due to the Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 15 extreme hot weather. The provision of more activities and a stimulating environment would enhance the quality of life for many of the residents. (See requirement 4) It was evident from the written feedback that visitors are welcomed into the home and there is good interaction and communication links between the home and the relatives. The home also arranges residents meetings each month. Whilst these are limited in their content they do highlight some of the issues around activities. The written feedback from residents showed that they were satisfied with the quality of the food. Of the six comment cards received, four said that they usually liked the food and two stated they always enjoyed the meals. The two residents spoken to told the inspector that the food was good and varied with choices on offer. This was apparent from the observation of the lunch-time meal, where residents were seen to have choices and to be enjoying the food offered with seconds offered. Meals are usually taken in the dining room, although some residents preferred their bedrooms. Special crockery was used for those that needed it. Hot and cold drinks and snacks were available throughout the day. Kitchen staff have food hygiene certificates, as do a number of care staff. The Manager should ensure that all staff involved in preparing meals undertake this training. (See recommendation) The kitchen was clean and records viewed showed regular checks were made of the fridge and freezer temperatures. The temperature of the cooked meats is also taken. Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents and relatives are listened to and any concerns acted upon. Systems in place for the protection of individuals from abuse must be more robust. EVIDENCE: Complaints procedures are in place with a copy of the procedure on display in the hallway. This meets with the requirements of the regulations. All complaints whether verbal or written are recorded into a log-book. There have been no complaints to date nor has social services or the Commission received any complaints regarding the home. The Manager demonstrated appropriate knowledge and understanding of how to investigate complaints, although there is no written evidence of this due to lack of complaints made. The majority of residents who provided feedback said that they knew who to talk to if they were not happy and who they would make a complaint to. Adult protection procedures are also in place, although there is a need for them to be more comprehensive to ensure there is clarity about the role of the organisation; social services, as lead agency and CSCI. Staff spoken to had a basic understanding of adult abuse and types of abuse and that if there were any such incidents, they would refer on. No member of staff had received training on adult protection, although it is reportedly included as part of induction training. There is a need for staff to undertake training and to ensure they are aware of the role of different agencies in the protection of Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 17 adults from abuse. There have been no adult protection investigations. (See requirement 5) Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,23,24 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Nettlestead provides a well decorated, comfortable and homely environment. It is kept clean and fresh to minimise the risk of cross infection. EVIDENCE: Nettlestead provides a comfortable, well-decorated, well-furnished and reasonably maintained environment for the residents living there. Communal areas comprise of a lounge, dining room, conservatory and pleasant gardens with patio decking and garden furniture. Bathrooms and toilets are located on all floors, as are individual bedrooms. Bedrooms were nicely decorated with matching furnishings and appropriate furniture is in place to meet the needs of the residents. The rooms viewed were personalised for each individual with mementoes and photos, with TVs and radios in rooms, and some with telephones. One of the bathrooms was out of use due to a faulty hoist. The home is looking in the near future to change this into a shower room. With the current Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 19 numbers the two bathrooms provide adequate facility. However, with further admissions there is a need to ensure this work is undertaken without delay (See requirement 7) All areas viewed were clean and fresh with hand-washing facilities in a number of areas. Gloves and aprons were available for staff, and appropriate infection control procedures were in place. Staff had an understanding of the need for hand washing etc in the control of infection. Residents and relatives mentioned the lack of wheelchairs for residents who require them, and those that the home has are in need of an overhaul and some maintenance. The Manager has agreed to investigate this and make referrals where appropriate. (See requirement 8) A call bell system is located in private and communal areas. These are serviced regularly. Two residents spoken to said that they are able to use these and staff respond appropriately. Hoists are serviced regularly. Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff receive regular training and are competent. The recruitment procedures must be more robust to ensure individuals are protected from potential harm. EVIDENCE: The home has seventeen care staff and four ancillary members of staff. Five care staff have fully completed NVQ 2 in Care with seven pending imminent completion. The home is working well towards 50 of staff with this qualification. The Deputy Manager is due to commence NVQ 3 this year. There are currently sixteen residents, with four care staff working during the morning and three during the evening, including the Deputy Manager. The home should consider carefully the staffing levels with the increased frailty and confusion of a number of residents leading to increased care, especially when full. However, the number of staff with the current number of residents was adequate. On the day of the inspection the Deputy Manager was acting as cook with a supernumerary member of staff in place undertaking management duties All new staff are provided with induction training which is recorded. The home now belongs to Bromley Training consortium which provides training in a number of care areas. Staff spoken to demonstrated an appropriate Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 21 knowledge of what to do in the event of an emergency such as accidents and fire. Training over the last year includes stoma care, medication, infection control, moving and handling, and first aid. The Manager was advised of the need to ensure new staff are provided with appropriate moving and handling training before they commence work as part of the team, especially where they are new to care or have not been recently updated in the training. The Manager was advised of the Skills Sector website which provides details of the three core modules for staff- infection control, medication and dementia. The Manager was also made aware of the need to ensure staff are provided with dementia training as a number of residents are becoming increasingly confused. (See recommendation 5) The inspector viewed the files of four recently recruited members of staff. Each contained a completed application form. Generally the home had completed a number of checks including Criminal Records Bureau Checks, although there were some gaps such as employment history, lack of authenticated references and verification of reasons for leaving last employment in care. Interview schedules and contracts were in place for each applicant. The inspector raised concerns that a reference obtained from one home had been written by the administrator in the home, not by a member of the management team. (See requirement 6 and recommendation 4) Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32, 33,35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed with the health and safety of residents maintained with the home looking to continually improve the quality of care. EVIDENCE: The Manager is experienced in the management care and has an NVQ 4 in Management. She leads staff from the floor and monitors care practice by being part of the care team. She is currently awaiting registration to undertake NVQ 4 in Care. (See requirement 9) Residents and relatives’ feedback show that she is approachable and open to ideas about how care could be improved. The home is also well run and well organised. Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 23 The home is accredited to the ISO 9002 quality assurance system and has recently been audited. Only one minor non compliance was recorded. The system also required regular monthly audits of the procedures by the management team. The records of recent audits were viewed and found to be satisfactory. Nettlestead is also part of the National Care Homes Association. Residents’ questionnaires are sent out every six months with the information obtained collated with percentages showing how well they meet that particular area. The Area Manager has been advised to evaluate the information and report on the strengths and weaknesses and what action needs to be taken to improve the service. Three residents’ monies were audited and found to be satisfactory. The last inspection required the home to maintain receipts for all expenditure. This has now been done. The home should also ensure receipt are provided for all monies brought into the home. It is also good practice to ensure there is an accurate description of all valuables kept by the home. (See recommendation 6) A number of health and safety service contracts were viewed and found to be in date and satisfactory. Plant and equipment had been serviced according to the regulations. Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 24 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 2 3 X 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 2 X 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 X X 3 Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 25 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 OP3 Regulation 14 Requirement The Registered Person must ensure after assessment, they confirm in writing that they are able to meet the needs of the prospective service user. This is a repeated requirement. The previous timescale of 1/3/06 has expired. The Registered Person must ensure care plans reflect the current needs of residents with all areas of need identified in the individual plans. This is a repeated requirement. The previous timescale of 1/3/06 has expired. The Registered Person must ensure medication received by the home is clearly recorded. Variable doses must be clearly recorded with the number of tablets administered. The Registered Person must ensure that appropriate internal and external activities are provided in consultation with DS0000006959.V297841.R01.S.doc Timescale for action 01/10/06 2. OP7 15 01/10/06 3 OP9 13 01/09/06 4 OP12 16 01/12/06 Nettlestead Version 5.2 Page 26 5 OP18 13 6. OP29 17 & 19 residents. The Registered Person must ensure adult protection procedures are reviewed and staff are trained in these procedures. The Registered Person must ensure that recruitment procedures are more robust. Specifically, gaps in application forms must be explored fully and two references must be provided. This requirement has been partly met. Previous timescale 01/02/06 The Registered Person must provide an action plan for work to be completed on the first floor bathroom. The Registered Person must ensure wheelchairs are provided for those with identified needs and that all wheelchairs are checked regularly to ensure their continued safe use. The Registered Manager must provide the Commission with an action plan as to how they are likely to achieve the care qualification required as a Manager. This is a repeated requirement with previous timescale of 1/3/06 expired. 01/10/06 01/09/06 7 OP21 23 01/09/06 8 OP22 16 01/10/06 9 OP31 7 01/09/06 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 OP3 Good Practice Recommendations Assessments should include more detailed information on DS0000006959.V297841.R01.S.doc Version 5.2 Page 27 Nettlestead 2 3 4 5 6 7 OP7 OP9 OP29 OP30 OP35 OP2 the specific needs of the individual. Where appropriate residents and relatives should be involved in the development of care plans and in their subsequent review. Medication administration records should detail allergies or where none are known this is also recorded. References should be supplied on headed notepaper, be stamped or be provided with a compliment slip. Dementia training for staff is strongly recommended. Receipts should be provided for any personal monies received into the home. Every resident should be provided with a copy of the home’s terms and conditions of residency. Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Nettlestead DS0000006959.V297841.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!