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Inspection on 20/04/06 for Newstead Nursing Home

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

This inspection was carried out on 20th April 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service users needs are well assessed and their care plans regularly monitored. The medicines policy and procedures are well written and staff adherence to them is good. Service users health care needs are met in the processes of care planning and review. Service users can be confident of receiving a balanced and healthy diet, and that their complaints will be listened to and acted upon.

What has improved since the last inspection?

There is a clear management structure in place, and improvements in the support and training of staff have had a positive impact on the quality of care provided in the home. Tensions between different groups of staff evident at the previous two inspections are no longer there, and the quality of the environment is being significantly improved. The development of systems to regularly seek and record the views of service users, relatives and staff are to be welcomed. There have been significant improvements in the day-to-day quality of life for service users following the employment of activities coordinators.

What the care home could do better:

Three requirements from the last inspection have not yet been met and have been restated in this report, with a new timescale for compliance. 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. These outstanding requirements are in relation to the storage of medication, the undertaking of a staff review and the provision of supervision for all staff.New requirements are that the manager apply for registration to the Commission for Social Care Inspection, the undertaking of a number of repairs and the drafting of an annual development plan.

CARE HOMES FOR OLDER PEOPLE Newstead Nursing Home Denewood Road Highgate London N6 4AL Lead Inspector Peter Allcock Key Unannounced Inspection 20th April 2006 10:00 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.V290294.R01.S.doc Version 5.1 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.V290294.R01.S.doc Version 5.1 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 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.V290294.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One specified service user who is under 65 years of age may be accommodated in the home. The home must advise the registering authority at such times as the specified service user attains 65 years of age or vacates the home. 16th December 2005 Date of last inspection 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. There are display shelves in the reception area accessible to service users, relatives and staff, which hold information such as previous inspection reports The current weekly fees for accommodation in the home range from £ 528 to £ 850. Newstead Nursing Home DS0000064195.V290294.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day. The Manager was present throughout and assisted with the inspection. Two service users, two nursing staff, one care staff and one kitchen staff were spoken to during the inspection. The inspector read the two previous inspection reports and reviewed current information held on the home. An inspection of service users and staff files, general home records and a tour of the building and grounds completed the inspection. What the service does well: What has improved since the last inspection? What they could do better: Three requirements from the last inspection have not yet been met and have been restated in this report, with a new timescale for compliance. 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. These outstanding requirements are in relation to the storage of medication, the undertaking of a staff review and the provision of supervision for all staff. Newstead Nursing Home DS0000064195.V290294.R01.S.doc Version 5.1 Page 6 New requirements are that the manager apply for registration to the Commission for Social Care Inspection, the undertaking of a number of repairs and the drafting of an annual development plan. 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.V290294.R01.S.doc Version 5.1 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.V290294.R01.S.doc Version 5.1 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): 3, 6 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service.Service users are reassured by the knowledge that their needs are assessed and can be met by the home. EVIDENCE: NMS 3 Service users files seen during this inspection contained assessments undertaken by social workers from the placing authorities which included all the required information as set out under national minimum standard 2.3. Most service users are placed by the London Boroughs of Islington, Haringey and Barnet. Where prospective service users are privately funded, the manager of the home undertakes the assessment. NMS 6 The home does not provide an intermediate care service, and therefore national minimum standard six is not applicable. Newstead Nursing Home DS0000064195.V290294.R01.S.doc Version 5.1 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): 7, 8, 9, 10, 11 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users know that their health care needs are met in the processes of care planning and review. Service users are protected by the homes systems for the administration of medicines, but the inappropriate temperature at which medication is stored may compromise their well being. EVIDENCE: NMS 7 Four care plans were examined during this inspection, and contained the relevant information to ensure that service users health care needs are met. The care plans are reviewed on a monthly basis. As noted at the previous inspection, where appropriate there are risk assessments in place with regard to the provision of cot sides to service users’ beds. Relative’s surveys recently organised by the manager, and seen by the inspector were generally positive about the quality of care provided in the home. Newstead Nursing Home DS0000064195.V290294.R01.S.doc Version 5.1 Page 10 NMS 8 The home supports a number of service users who are diabetic, six who are peg fed and a number who require a pressure care mattress. Care notes of one service user admitted to the home with a pressure ulcer indicated that they have made some positive progress in relation to the severity of the pressure ulcer since their admission to the home. There is regular input from the local tissue viability nurse and other visiting health professionals. A significant number of service users are admitted to the home with MRSA. Since the last inspection, the manager has ensured that in conjunction with their GP, all service users with MRSA have been screened and an appropriate form of treatment commenced. Paper towels and soap dispensers have been installed in each room, and dispensers of anti-bacterial gel placed at strategic locations throughout the home, which can be accessed by visitors to the home in addition to the staff team. NMS 9 The home has a clear policy and procedures for the receipt, administration and disposal of medication. There are currently no service users who are responsible for their own medication. The records for the receipt, administration and disposal of medication were seen during this inspection to be satisfactory, and allows a medication history/audit trail to be established. Following a requirement made at the last inspection, all eye drop bottles had a small sticker stating the date on which the bottle was opened. As noted at previous inspections, the room in which medication is stored is small, and it is not always possible to store medication at 25oC or below, particularly during hot weather. The manager has installed a small fan, which has not had a significant effect on the room’s temperature. The manager told the inspector that she would be purchasing a portable air conditioning unit in an attempt to regulate the rooms’ temperature to the required level. The requirement that medication is stored is maintained at 25oC or below is restated, for the second time with the expectation of compliance by the notified date. The record of controlled drugs was in order and a random check of one service user’s medication demonstrated that the record was in accordance with the amount of medication held in the home. NMS 10 Observation of practice in the home demonstrated that the arrangements for service users personal care are respected. The manager has changed the Newstead Nursing Home DS0000064195.V290294.R01.S.doc Version 5.1 Page 11 location of the nurse’s station and removed the board containing service users details to enhance their privacy. NMS 11 The manager showed the inspector a number of forms, which had been completed by service users relatives, which recorded the service users wishes in the event of their death in the home. The manager told the inspector that she was in the process of ensuring that all service users resident in the home had their wishes recorded. Newstead Nursing Home DS0000064195.V290294.R01.S.doc Version 5.1 Page 12 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 good. This judgement has been made from evidence gathered both during and before the visit to this service. The ability of the home to meet service users leisure and social needs is improving, whilst the maintenance of relationships with family and friends is well managed. Service users can be confident of receiving a balanced and healthy diet. EVIDENCE: NMS 12 Since the last inspection, the home has recruited to the vacant activities coordinator post and two staff now undertake this role. During the inspection, it was a pleasure to see a number of service users participating in a game of skittles in the morning, and in the afternoon a being entertained by a singer. There is now a programme of activities on four days of the week, and a cinema club is due to start on a Monday evening. This programme represents a significant improvement in the quality of service users lives, especially when contrasted with observations from the two previous inspections when they were observed to be sitting in the main lounge in front of a television, which few of them were watching. Care staff have received some training in appropriate activities as part of a recent dementia awareness course. It is recommended that this training is built on by a formal programme involving Newstead Nursing Home DS0000064195.V290294.R01.S.doc Version 5.1 Page 13 care staff and nursing staff in the provision of an activities programme when the activities co-ordinators are not available. NMS 13 A number of relatives questionnaires seen by the inspector commented positively on the support offered to relatives to visit the home, which enabled them to maintain good relationships with the service users. Visiting hours are not restricted and there are a number of places where visitors and service users can enjoy privacy. The home also makes facilities available for visitors to make hot drinks should they wish to do so. The home has recently held a relatives survey and a meeting for service users relatives to give their views on the operation of the home. The manager told the inspector that these meetings would take place on a quarterly basis. NMS 14 The manager described the difficulties experienced by staff in understanding the wishes of people with significant levels of confusion. The home has undertaken surveys via service users relatives, and it is recommended that specialist training on communication with service users with dementia be provided for all staff. NMS 15 Lunch 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 manager has encouraged more service users to take their lunch at dining tables which have been attractively decorated with flowers, to encourage more social interaction and a greater sense of occasion at meal times. The menus were inspected and discussed with the cook. They are rotated on an eight-week cycle, and the cook had a good knowledge of service users’ needs and preferences and described how individual choices were supported and feedback obtained. Since Gold care took over the home, there has been a reduction in the number of kitchen staff and their hours, and at the last inspection, the cook expressed concern that this impacted on the home’s ability to provide meals in a timely manner. This was also reiterated by care staff at the last inspection who now have to do additional duties around meal times. The requirement that the management of the home undertake a staffing review as described under national minimum standard 27 include kitchen and domestic staffing is outstanding, and is restated in this report. Newstead Nursing Home DS0000064195.V290294.R01.S.doc Version 5.1 Page 14 Hot food, fridge and freezer temperatures are correctly and regularly recorded, and the standard of daily and deep cleaning in the kitchen was very high. Newstead Nursing Home DS0000064195.V290294.R01.S.doc Version 5.1 Page 15 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 good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users can have confidence that their complaints will be listened to and acted upon, and are better-protected following recent staff training in adult protection. EVIDENCE: NMS 16 The home has a sound policy and procedure for managing complaints. There have been a number of complaints made recently with regard to care in the home, which resulted in two placing authorities placing a temporary embargo on placements in the home. The new management have worked with and been supported by the placing authorities to make the changes which have recently resulted in both placing authorities now being in a position where they can refer clients to the home again. There is one outstanding complaint, which is currently subject to investigation by one of the placing authorities. Records of the management of complaints show a willingness to work towards a positive outcome for service users and their relatives in the management of complaints. One member of staff has resigned prior to a disciplinary hearing as result of complaints made about their practice, and although they are no longer available, it is recommended that Gold Care Homes hold a formal disciplinary hearing into the conduct of this member of staff, and that they provide evidence in writing to the Commission for Social Care Inspection that the matter has been satisfactorily concluded. Newstead Nursing Home DS0000064195.V290294.R01.S.doc Version 5.1 Page 16 NMS 18 There is an Adult Protection policy and procedure in place, and following a requirement made at the last inspection; staff have received training in their responsibilities in the operation of this policy. Newstead Nursing Home DS0000064195.V290294.R01.S.doc Version 5.1 Page 17 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, 23, 26 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The environment in which service users currently live is being improved from one, which was rather clinical, to a more homely setting in which to live. Service users benefit from significant improvements in the standard of cleanliness in the home. EVIDENCE: NMS 19 The current programme of re-decoration is well underway, and new furniture is being purchased which where completed has resulted in a more homely environment for service users. All bathrooms are due to be re-decorated, and one will be equipped as a wet room to assist the bathing of service users with limited mobility. New toilet seats and soap/paper towels have been installed in all the bathrooms. Newstead Nursing Home DS0000064195.V290294.R01.S.doc Version 5.1 Page 18 The flow of hot water around the building is insufficient, and the inspector saw a plumbers report detailing required works to improve the flow of water around the building. The registered persons must ensure that this work is undertaken as a matter of priority. As noted at the last inspection, both hoists in the home are in working order, and a new standing hoist is currently being evaluated by staff in the home, as its use benefits the maintenance of service users independence. The handrail to the front steps has been replaced, but is loose and must be more securely fixed to the floor. NMS 23 The inspector was pleased to note ongoing works to decorate service users bedrooms. One wing of the home is currently being refurbished with improvements to decoration, bedding, and the installation of curtains to replace the dirty and worn out blinds noted at previous inspections. The installation of carpet, upgraded lighting and pictures in the hallway outside the bedrooms has created a more homely environment. NMS 26 In marked contrast to the previous two inspections, standards of cleanliness have shown a significant improvement and the home was seen to be clean, tidy and free of any odours on the day of this inspection. Newstead Nursing Home DS0000064195.V290294.R01.S.doc Version 5.1 Page 19 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 from evidence gathered both during and before the visit to this service. Service users’ are potentially disadvantaged by the homes failure to conduct a review of staffing levels, but are protected by the home’s recruitment policy and procedures. Provision of staff training in key areas will enhance the home’s ability to deliver quality care to the people who live there. EVIDENCE: NMS 27 / NMS 28 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 when the home is fully occupied. At night there are two qualified nurses and two care assistants. The slightly lower staffing ratios seen at this inspection currently reflect the occupancy of just 26 of the homes 36 beds Because of high dependency levels and because there have been changes in the care staff working pattern, it was required at the last inspection that the registered provider undertake a staffing review 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. This requirement is outstanding and is restated in this report. Newstead Nursing Home DS0000064195.V290294.R01.S.doc Version 5.1 Page 20 NMS 29 Two staff files were inspected and all pre-employment checks had been completed and the correct documentation was on file, and details of all enhanced CRB disclosures are also held on file for all agency staff. The manager told the inspector that they are not currently using agency staff, and gaps in the rota are filled by bank staff. The number and availability of ‘as and when’ bank staff should be reviewed as part of the staffing review, given the previous issues of cover for permanent staff annual leave and sickness highlighted in the previous inspection. NMS 30 The manager has developed a new system of recording staff training, which links into needs identified in supervision. The manager told the inspector that she would be completing these records in the near future. As noted at the last inspection, a Workforce Development Training Plan was completed by an independent organisation in August 2005. It indicated that 21 staff have completed NVQ Level 2 in Care. Following a requirement at the last inspection, staff have undertaken a number of foundation courses, which have included adult protection, fire safety and dementia care, all of which were required following the last inspection. Newstead Nursing Home DS0000064195.V290294.R01.S.doc Version 5.1 Page 21 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, 33, 36, 38 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Service users are beginning to benefit from the new management of the home, and improvements to the training and supervision of staff. EVIDENCE: NMS 31 The current manager started work in January 2006, having worked at another home operated by Gold Care Homes. The manager has yet to submit her application for registration to the Commission for Social Care Inspection and must do so as a matter of priority. Newstead Nursing Home DS0000064195.V290294.R01.S.doc Version 5.1 Page 22 NMS 33 As stated elsewhere in this report, the home has developed systems to get the views of service users, relatives and staff with regard to the operation of the home. This information must be incorporated into an annual development plan for the home. NMS 36 Supervision files were inspected and indicated that the manager has given individual supervision to approximately half the staff team. The manager is undertaking the initial supervisions personally to ensure that all staff are clear about her expectations as the new manager and the new owners. This has delayed the process, but once this exercise is complete, she will supervise senior nursing staff, who will in turn supervise junior nursing staff and care staff. The requirement made at the last inspection that all staff receive supervision a minimum of six times per year is restated in this report. NMS 38 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 and severity 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, and as required at the last inspection, staff have now received appropriate training in the operation of the homes fire safety procedures. Fly screens have been installed in the kitchen windows. Newstead Nursing Home DS0000064195.V290294.R01.S.doc Version 5.1 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 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X 3 X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X 2 X 3 Newstead Nursing Home DS0000064195.V290294.R01.S.doc Version 5.1 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 OP9 Regulation 13 Timescale for action The Registered Persons must 30/06/06 ensure that the temperature of the area where medication is stored is maintained at 25oC or below and the medication refrigerator is maintained o between 2-8 C. Previous timescales of 30/12/05 and 28/02/06 not met. 2 OP19 12 (1) The Registered Persons must ensure that repairs described in the body of this report are undertaken. 30/06/06 Requirement 3 OP27 18 (1) The Registered Persons must 30/06/06 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. Previous timescale 28/02/06 not met. of Newstead Nursing Home DS0000064195.V290294.R01.S.doc Version 5.1 Page 25 4 OP31 9 The Manager must submit her 30/05/06 application for registration to the Commission for Social Care Inspection as a matter of urgency. The Registered Persons must 30/07/06 draft an annual development plan for the home. The Registered Persons must 30/05/06 ensure that all staff receive individual documented supervision at least six times per year. Previous timescale 28/02/06 not met. of 5 OP33 24(1) 6 OP36 18 (2) Newstead Nursing Home DS0000064195.V290294.R01.S.doc Version 5.1 Page 26 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 It is recommended that the training on appropriate activities recently undertaken by staff on activities for people with dementia be built on by a formal programme involving care staff and nursing staff in the provision of an activities programme when the activities co-ordinators are not available. One member of staff has resigned prior to a disciplinary hearing as result of complaints made about their practice, and although they are no longer available, it is recommended that Gold Care Homes hold a formal disciplinary hearing into the conduct of this member of staff, and that they provide evidence in writing to the Commission for Social Care Inspection that the matter has been satisfactorily concluded. 2 OP16 Newstead Nursing Home DS0000064195.V290294.R01.S.doc Version 5.1 Page 27 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. 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