Inspection on 16/12/05 for Newstead Nursing Home

This inspection was carried out on 16th December 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Newstead Nursing Home 27/05/09

Newstead Nursing Home 28/08/08

Newstead Nursing Home 16/08/07

Newstead Nursing Home 14/12/06

Newstead Nursing Home 20/04/06

Newstead Nursing Home 16/08/05

Similar services:

Ashlong House

Norbury Crescent (30)

Henry Nihill House

Birchwood

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

The Infirmary

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

CARE HOMES FOR OLDER PEOPLE Newstead Nursing Home Denewood Road Highgate London N6 4AL Lead Inspector Margaret Flaws Unannounced Inspection 16th December 2005 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 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. Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Newstead Nursing Home Address Denewood Road Highgate London N6 4AL Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8348 4611 020 8341 7459 Gold Care Homes Limited Kaye Lee Care Home 36 Category(ies) of Dementia - over 65 years of age (0), Learning registration, with number disability over 65 years of age (0), Old age, not of places falling within any other category (0), Physical disability over 65 years of age (0), Terminally ill over 65 years of age (0) Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th August 2005 Brief Description of the Service: Newstead Nursing home has recently been sold by Hill Homes and since the 1 August 2005 has been owned by a private company called Gold Care. Newstead can provide residential accommodation and nursing care for up to thirty-six older people. There are nursing staff available both during the daytime and awake throughout the night. There are 5 double bedrooms and 26 single bedrooms. There is a large staffed kitchen and there are facilities for service users and their relatives to make drinks in the garden room. There is a large open reception area that has tables and chairs so that visitors can sit and chat and a large open lounge and dining area. There are four bathrooms providing four assisted baths and one shower.The home is situated in a residential area of Highgate. The areas used by service users are arranged over the ground floor and are wheelchair accessible. There is an area that is used solely by the staff and this is on the first floor. There are two wings, Thompson and Goldsmiths. Thompson wing was converted for service users about 12 years ago.The home is supported by a number of volunteers and a visiting clergyman.The stated aim of the home is to provide long-term nursing care for elderly people with complex needs who require 24-hour supervision, a homely environment which reflects the service users rights of personal choice, dignity and privacy and to implement individualised care plans in-conjunction with service users needs and wishes. Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day. The Registered Manager was present throughout and assisted with the inspection. Four service users, six relatives, nine nursing and care staff and one kitchen staff were spoken to during the inspection. The inspector also spoke to a group of staff at afternoon handover. Inspection of service users and staff files, general home records and a tour of the building and grounds completed the inspection. Nine new requirements were made on this inspection. What the service does well: What has improved since the last inspection? What they could do better: Five requirements from the last inspection have not yet been met and have been restated in this report, with a new timescale for compliance. In the ‘Timescale for Action’ column, the date in ordinary type relates to the timescale given at the last inspection. The date in bold type relates to the new timescale. Further information about unmet requirements can be found in the relevant standard. Unmet requirements impact upon the welfare and safety of service users. Failure to comply by the revised timescale will lead to the Commission for Social Care Inspection considering enforcement action to secure compliance. A programme of activities for the home still needs more work to meet service users’ needs. Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 Page 6 There has been no progress on work to physically upgrade the home. There is no evidence of an action plan for redecoration or replacement of worn furniture. Fly screens still have to fitted in the kitchen and blinds in service users’ rooms still need replacing or repairing. The storage facilities for the storage of medication is cramped and the temperature of the storage areas can reach above 25 oC. Nine new requirements are made from this inspection. A risk management approach should be taken to any changes in infection control policy and procedures, especially in relation to MRSA. Labels on pharmacy bottles should agree with the most recent instruction and date of opening stated on eye drop bottles. Several areas of training require updating: adult and fire protection, foundation training (except manual handling) and dementia care. Staff training also have to be better organised. Some specific repairs and maintenance are required in addition to those restated above – broken toilet seats, dripping taps and sluice room floors repaired; hot water provided to all handbasins and store cupboards tidied. Staffing requirements include the employment of an additional cleaner and a staffing review to be done across the whole home. A copy of this review must be sent to the CSCI. Staff must receive supervision more regularly. Two recommendations are made. The recommendation for staff to receive training in delivering activities is restated and it is also recommended that regular relatives’ meeting take place. 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. Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 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 Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Service users are reassured by the knowledge that their needs are assessed and that their needs can be met by the home. EVIDENCE: Four service users’ files were inspected. They all contained a full assessment undertaken by a social worker from the placing authority and included all the information required as set out in national minimum standard 2.3. Local authorities fund all but three of the service users resident in the home. Most contracts are held with Islington, Haringey and Barnet local authorities. The registered manager undertakes the assessments of prospective service users who are privately funded. The home does not provide an intermediate care service. Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Service users know that their health care needs are met in the processes of care planning and review. They can know that they are protected by the homes systems for the administration of medicines but the inappropriate temperature at which medication is stored may compromise service users well being. EVIDENCE: There were thirty three service users on the day of the inspection, with two in hospital. Most service users have dementia. A recent dependency exercise indicated that twenty three residents have a high dependency score. Because of this and because there have been changes in the care staff working pattern, it is required that the registered provider do a staffing review. This is addressed under Standard 27. Four care plans were examined. Agreements and regularly reviewed risk assessments for cot sides were in place, reviewed monthly. Care plans seen on the day contain all relevant information regarding the home meeting the healthcare needs of the service users. Service users and relatives were generally very positive about the quality of care received and said that staff understood their needs. Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 Page 10 The home supports a number of service users who are peg fed, diabetics and who need pressure care mattresses. Two relatives and service users spoken to gave examples of how the home has achieved very good results in the treatment of pressure sores. This was confirmed in the service users’ files. There is regular input from tissue viability nurses and other visiting health professionals. The home also has a significant number of service users with MRSA, partly because they willingly admits people with MRSA. Staff did express concern that the home was considering discontinuing use of antibacterial handwash that protected against the transmission of MRSA and other infectious conditions. It is required that a risk management approach is taken and documented preceding any changes to infection control policy and procedures. It is also required that MRSA policies and procedures are in line with current best practice. Risk assessments and care plans reviews documenting changes in care, are in place. The medicines policy is complete. No service users are taking responsibility for their own medication and no medication is being disguised, according to the deputy matron. The records for the receipt, administration and disposal of medication were satisfactory. The new system for the disposal of unwanted medication has not yet been introduced. The inspector explained that two members of staff would have to sign for medication disposed of into the waste bins to ensure no mishandling. The documentation kept in the home allows a medication history/audit trail to be established. In a few instances the dose of medication and or the times had been altered for service users by their GP when visiting the home but the labels from the pharmacist showed the old dosage. [Requirement made]. Also the date of opening had not been stated on the eye drop bottles. The staff assured the inspector that they were discarded every month. The medication is stored in a medication room which is tidy but small. The room temperature was maintained at 25oC or below except in very hot weather. The temperature of the room where feeds were stored could also exceed 25 oC. The previous requirement to better control the temperature I this room is restated. Temazepam was the only Controlled Drugs being kept on behalf of service users. The entries in the Controlled Drug register were also satisfactory. Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Service users’ leisure and social needs are generally not met, with the exception of the ability to maintain relationships with family and friends. They can be confident of receiving a balanced and healthy diet. EVIDENCE: Observations made at the previous inspection of service users sitting in the main lounge in front of a television with few of them were watching, were confirmed on this inspection. Minimal work has been done to improve stimulation for the service users and the availability of social, cultural and recreational activities. This situation must not be allowed to continue. The vacant Activities Co-ordinator post has been advertised but not recruited to as yet and no other activities put in place. It is also still recommended that there is a programme of training for nursing and care staff so that they are enabled to deliver a programme of meaningful activities. On the day of the inspection, several relatives were visiting. They were all positive about how the home supported their visiting and enabled them to maintain good relationships with the service users. Both relatives and service users said they were able to keep in regular contact, that visiting hours were Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 Page 12 not restricted and that there were good spaces for private interactions. One relative did comment that relatives meetings are not held regularly and it is recommended that this be rectified. Lunch and dinner service was observed during the inspection. The kitchen is just off the main lounge and dining area and the meals are easily served through a hatch and taken to the service users in the dining area. Several service users required assistance with eating. The menus were inspected and discussed with the cook. They are rotated on an eight week cycle. The cook had a good knowledge of service users’ needs and preferences and described how individual choices were supported and feedback obtained. Since Goldcare took over the home, there has been a reduction in the number of kitchen staff and hours and the cook expressed concern that this impacted on the home’s ability to provide meals in a timely manner. This was reiterated by care staff who now have to do additional duties around meal times. It is required that the staffing review required under Standard 27 include kitchen and domestic staffing. Hot food, fridge and freezer temperatures are correctly and regularly recorded. The standard of daily and deep cleaning in the kitchen was very high, unlike the standard of cleaning in the rest of the home. Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 Page 13 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): Service users can have confidence that their complaints will be listened to and acted upon. They could be better protected if staff received more regular adult protection training. EVIDENCE: The home has a sound policy and procedure for managing complaints. There has been one complaint recorded in the home since the last inspection. The complaints record included a description of the complaint and a record of the action taken in response. There is an Adult Protection policy and procedure in place but staff require up to date and regular adult protection training. Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 Page 14 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): Service users live in a generally safe yet rather clinical environment in need of refurbishment. Broken blinds in their rooms intrude upon the privacy of some service users. The standard of hygiene and maintenance is poor, which has the potential negatively on service users’ wellbeing. EVIDENCE: The home presents as somewhat cold and clinical, with vinyl flooring and unpapered painted walls throughout. Attempts have been made to soften this by painting the walls in a number of areas, and the provision of paintings with limited success. The entrance lobby is bright and pleasant and benefits from a number of plants, which create a more homely environment. The overall impression is that the décor of the building is tired and is overdue for refurbishment. The registered provider is still required to supply a written action plan for the upgrading of the decoration of the home, and the replacement of furniture that is worn. Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 Page 15 Bathrooms were in a poor state. One toilet seat was missing, a tap was continuously dripping, paint was peeling off the walls, the floors of one sluice room in a poor state. There was also no toilet paper or paper hand towels. Requirements are given for these to be repaired. The temperature of hot water in the bathrooms was cold and it is required that this be regularly. A equipment storeroom was overstuffed and disordered. Both hoists in the home are now in working order. Previously, there had been only one hoist in the home while one was being repaired for several weeks. The manager understands that this was unacceptable practice and said a contingency plan is in place to replacement hoist in the future should it be required. The handrail to the front steps has been replaced. The bedrooms are equipped with vertical blinds, several of which were noted at the previous inspection to be broken or dirty, have not been repaired, replaced or cleaned and the requirement is restated. The building was not clean on the day of this inspection and the standard of cleaning was poor. This was particularly notable in the sluice rooms, bathrooms and toilets. Relatives also confirmed that the home was often not well cleaned. The manager said that there was regularly only one cleaner on duty per day. An additional cleaner has been recruited for twenty hours per week but this is still insufficient for the home, as it would not increase the number of cleaners on duty daily. It is required that the ratio of cleaning staff on duty is increased to improved cleaning standards. Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 Page 16 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): Service users’ have been disadvantaged by inconsistent and inadequate staffing levels. They are generally protected by the home’s recruitment policy and procedures but lack of staff training in key areas compromises the home’s ability to deliver quality care. EVIDENCE: The rotas are quite clear and well organised. They reflect that there are two registered nurses and seven-care assistants rota’d to be on duty during the morning shift and two nurses and five care assistants for the afternoon and evening. At night there are two qualified nurses and two care assistants. Because of high dependency levels and because there have been changes in the care staff working pattern, it is required that the registered provider do a staffing review. This is addressed under Standard 2. to ensure that the staffing levels match the needs of the service users. This should also include a review of the number of RMN nursing staff employed, as the dependency exercise indicated one third of the service users had advanced dementia. A copy of this review should be sent to the CSCI. Because of this and because there have been changes in the care staff working pattern, it is required that the registered provider do a staffing review. This is addressed under Standard 2. to ensure that the staffing levels match the needs of the service users. This should also include a review of the number of Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 Page 17 RMN nursing staff employed, as the dependency exercise indicated one third of the service users had advanced dementia. A copy of this review should be sent to the CSCI. A prior concern was raised that the level of staffing was not maintained during annual leave or sickness. On the previous inspection, the inspector looked at a random rotas and found that on two occasions, this level had not been maintained following staff calling late to say they are off sick and would not be coming in. This concern was raised again by staff, relatives and service users on this inspection and confirmed by random rota selection. Staffing levels are also an increased concern under the new ownership of Goldcare, because of the additional meal time duties allocated to care staff. It is required that the staffing levels be maintained at the recorded levels to ensure that the home does not compromise the safety and wellbeing of service users, particularly now that the home has identified that so many service users fall into a high dependency category. New staff files were inspected and all pre-employment had been completed and the correct documentation was on file. Details of all enhanced CRB disclosures are now held on file for all agency staff as well as employed staff. The Registered Manager said that the home is not using agency staff anymore, had no permanent vacancies but that there were bank vacancies. The number and availability of ‘as and when’ bank staff should be reviewed as part of the staffing review, given the previously highlighted issues of cover for permanent staff annual leave and sickness. Staff training records were examined. They were not up to date. It is required that staff training records be efficiently recorded, to enable the easy retrieval of information and be kept up to date. A Workforce Development Training Plan was completed by an independent organisation in August 2005. It indicated that 21 staff have completed NVQ2. However, there are significant gaps where staff have not received training in adult protection, all areas of foundation training (except manual handling, which is up to date), fire safety and dementia care, all of which are required. Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 Page 18 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): Service users may be vulnerable if the pending management gap is not quickly and appropriately covered, unless staff are better supported or do not receive regular fire safety training. EVIDENCE: The Registered Manager has resigned and is due to leave in January 2006. At the time of the inspection, no replacement had been appointed. It is of critical importance that appropriate management is put in place as quickly as possible. There are significant outstanding issues in staffing levels, cleanliness, staff training and supervision, that require addressing urgently identified in this report. Supervision files were inspected and indicated that staff are not receiving regular, documented supervision. It is required that staff received supervision a minimum of six times per year. Some relatives and service users commented Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 Page 19 that there appears to be a level of discontent among the staff, partly reflected in their manner with each other. This was also observed by the inspector. Supervision is a necessary tool for providing staff support and addressing concerns and it needs to be better utilised in the home. All health and safety certificates were in place and on file. There are comprehensive environmental risk assessments in place, which assess the level of risk in relation to the probability of the outcome and the seriousness of the outcome. Incident and accident records were inspected, were up to date and in order. Fire records were inspected and were up to date, with regular drills. However, there is a significant gap in fire safety training, which is required for all staff. Kitchen windows still do not have fly screens fitted to aid effective ventilation and the requirement is restated for the second time. The Registered Manager said that the a quote has been obtained but action is overdue. Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 Page 20 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 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 1 X X X 2 X X 1 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X 1 X 2 Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 Page 21 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 OP8 Regulation 12 (1) Requirement Timescale for action 28/02/06 2 OP9 13 3 OP9 13 4 OP12 12 (1) (a) The Registered Person must ensure that a risk management plan is drawn up for any changes to infection control policies and procedures and that any changes put in place are in line with current best practice, particularly in the dealing with MRSA. 28/02/06 The Registered Person must ensure that the labels on the pharmacy bottles and containers agree with the most recent instruction, given by the service user’s GP when visiting the home. The date of opening must be stated on all eye drop bottles to ensure that they are only used for a maximum of a month after opening. The Registered Person must 28/02/06 ensure that the temperature of the area where medication is stored is maintained at 25oC or below and the medication refrigerator is maintained between 2-8oC. Previous timescale of 30/12/05 not met. The Registered Person must 28/02/06 ensure that there is a DS0000064195.V257623.R01.S.doc Version 5.0 Newstead Nursing Home Page 22 6 7 OP18 OP19 13 (6) 23 (2) (d) 8 OP26 12 (1) 9 OP23 23 (2) 10 OP26 12 (1) 10 OP27 18 (1)_ 11 OP30 18 (1) programme of activities which meet the social, cultural and recreational needs of service users. Previous timescale of 30/098/05 not met. The Registered Person must 31/03/06 ensure that all staff receive regular adult protection training. The Registered Person must 28/02/06 supply a written action plan for the upgrading and redecoration of the home and the replacement of furniture that is worn. Previous timescale of 30/09/05 not met. The Registered Person must 28/02/06 ensure that the follow maintenance and repairs are undertaken: • Broken toilet seats replaced • Dripping taps repaired • Sluice room floor repaired • All bathrooms and hand basins receive hot water • Store cupboards be tidied The Registered Person must 28/02/06 ensure that all blinds in service users’ bedrooms are clean and in full working order. Any blinds which cannot be cleaned or repaired must be replaced. Previous timescale of 30/10/05 not met. The Registered Person must 31/01/06 ensure that there are sufficient cleaning staff employed to maintain hygiene standards. The Registered Person must 28/02/06 ensure that staffing levels, including nursing, care and domestic staff levels, are reviewed and staffing always maintained at documented levels. A copy of the review should be sent to CSCI. The Registered Person must 31/03/06 ensure that staff training records DS0000064195.V257623.R01.S.doc Version 5.0 Page 23 Newstead Nursing Home 12 OP30 18 (1) 13 OP36 18 (2) 14 OP38 23 (5) be systematically organised. The Registered Person must ensure that all staff receive foundation, fire safety and dementia care training. The Registered Person must ensure that all staff receive individual documented supervision at least six times per year. The Registered Person must ensure that all opening windows in the kitchen are fitted with fly screens to aid ventilation. Previous timescale of 30 October 2005 not met. 31/03/06 28/02/06 28/02/06 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. 2. Refer to Standard OP12 OP14 Good Practice Recommendations The Registered Person should ensure that there is a programme of training for nursing and care staff to enable them to deliver a programme of meaningful activities. The Registered Person should ensure that regular relatives meetings take place. Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Newstead Nursing Home DS0000064195.V257623.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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