Inspection on 07/11/05 for Newtown House

This inspection was carried out on 7th November 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

Newtown House 26/07/07

Newtown House 02/06/06

Newtown House 20/05/05

Newtown House 06/07/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Newtown House Waterford Road Highcliffe Christchurch Dorset BH23 5JW Lead Inspector Jo Palmer Unannounced Inspection 7th November 2005 11.30 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 Newtown House DS0000060895.V260894.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. Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Newtown House Address Waterford Road Highcliffe Christchurch Dorset BH23 5JW 01425 272073 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) Highcliffe Nursing Services Ltd Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. A minimum of 30 hours per week of the registered manager hours to be supernumerary to the staffing rota. 20th May 2005 Date of last inspection Brief Description of the Service: Newtown House is a large detached older style property set in its own grounds in a residential road. The home is within walking distance of Highcliffe High Street and sea front/cliff top. The home offers accommodation to a maximum of 26 service users in the category OP (old age) and provides nursing care. Highcliffe Nursing Services Limited owns the home; the directors are Mr & Mrs Harris and Mr Harris is the Responsible Individual for the organisation. There is currently no registered manager although at the time of inspection, an application was pending. Highcliffe Nursing Services employ the services of an organisation called Personnel Solutions who undertake the homes administrative tasks and policy reviews; Personnel Solutions are not part of the registered service. Accommodation is on two floors with a lounge area, kitchen, nurse’s station and communal open plan area on the ground floor with nine single bedrooms and two bathrooms. There are eleven single bedrooms and three double rooms on the first floor and two bathrooms. All bathrooms are fitted with equipment for assistance. There is a passenger lift between floors. There are pleasant gardens to the rear of the property and the front of the home provides off road parking. Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection on 7th November 2005 lasted for three and half hours. There is currently no registered manager for Newtown House although Ms Karen Watts has been appointed by the provider to manager the home and has an application pending with the Commission for registration. Ms Watts was on leave at the time of this visit; during the first part of the inspection, the morning, a trained nurse was in charge of the home, the deputy manager arrived to take charge for the afternoon shift. Both the nurse and deputy manager assisted with the inspection process. The purpose of this inspection visit was to monitor progress in addressing requirements and recommendations of the last inspection and to review practices in relation to some of the National Minimum Standards. This inspection concentrated on the outcomes of care and services for residents, measuring against some of the standards. The inspector spoke with ten residents, three care assistants, a trained nurse, and the deputy manager, took a tour of the home and examined relevant records. What the service does well: Resident’s needs are assessed before they move to Newtown House to ensure they know, and the home knows that the home is suitable and able to meet those needs. The admissions process evidenced that residents and where applicable, their relatives had been involved in the assessment process and had been informed in writing of the outcome. Similarly, there was evidence that residents had been involved in the care planning process and had been consulted with regard to how their would prefer their needs to be met. Residents spoken with confirmed that a kind and caring staff group treat them respectfully. Social care is limited although most residents confirmed they are happy in organising their own time in the home, care planning practices identify people’s social and recreational needs and family and friends are able to visit at any time with no restrictions. Residents confirmed that in the main, they are able to make decisions regarding their daily routines and life in the home although there are some obvious limitations for people with very high needs and levels of dependency. Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 Page 6 Accommodation is provided in a clean, safe, well-maintained environment where each resident is are able to personalise their own rooms and spend as much time there as they please. Residents are provided with appropriate facilities for washing and bathing and there is pleasant communal space available. With an application pending to register, Karen Watts has been developing management and recording systems in the home and staff and residents spoken with confirmed that the home’s organisational arrangements have improved since the last inspection. What has improved since the last inspection? Thirteen requirements were made as a result of the last inspection, of these three have been repeated as they were not assessed during this visit, three are repeated as they have not been fully met and seven had been addressed and improvements noted in the following areas: • • • • • • • assessment of resident’s needs prior to them moving to Newtown House resident consultation systems regarding their care needs. wound care recognition of resident’s capacity to make decisions for themselves. assessment of risks of accidental scalding posed by unguarded radiators general record keeping continence care management. Three recommendations were made at the last inspection and action has been taken to ensure that two of these have been attended to; these related to • • considering individual preferences with regard to social care arrangements providing radiator guards to prevent accidental scalding The third recommendation was not assessed and therefore is repeated to ensure it remains in focus for the next inspection. What they could do better: Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 Page 7 Three requirements from the last inspection have not been addressed; the registered persons are advised to address these as a matter of urgency to ensure that Newtown House is not in breach of the regulations. Requirements repeated concern the following: • Care planning – all residents must have an individual plan of care based on thorough assessment of need, all care plans must be implemented and reviewed and care delivery must be consistent, in accordance with written instruction agreed by the resident at the consultation stage. Records relating to medication held in the home and managed on behalf of residents must be robust and in accordance with legislative requirements. Staffing levels must be provided at the level determined by the former Dorset Health Authority unless agreement can be made between the home and the Primary Care Trust responsible for funding free nursing care that ratios can be different. • • Two requirements from the last inspection were not assessed during this visit and are repeated here to ensure they remain in focus for the next inspection, these concerned: • • management and recording of resident’s finances. Information for residents in the Statement of Purpose and Service User Guide. A recommendation from the last inspection is repeated concerning availability of lockable storage space for residents as this was not assessed during this visit. It has also been recommended following this visit that, in accordance with good practice, the controlled drugs registered is properly indexed and that resident’s daily care records are stored more securely. 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. Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 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 Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 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): 3 & 4. Standard 6 is not applicable The admissions process is such that it ensures resident’s needs are assessed prior to admission and that residents are assured these needs can be met by the home prior to moving in. EVIDENCE: Care files examined for three recently admitted residents evidenced that assessment information is obtained in order that the home can assure them it is a suitable place for their needs to be met. An initial, basic assessment of personal and physical care needs is carried out by either the manger or deputy following which a decision is made as to whether Newtown house is a suitable place for the residents needs to be met. Assessments seen indicated that the resident or their representative had been included in the assessment process and informed in writing of the outcome. Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 Page 10 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 In the main, care plans provide sufficient detail for staff to be aware of resident’s health and welfare needs and how to meet them; care needs are reviewed appropriately. Procedures for managing medication do not meet the guidance of the Royal Pharmaceutical Society. Systems are in place for resident consultation and participation in the assessment and care planning process and their right to privacy is supported. Residents confirmed that they felt respected although some care practices were not in accordance with identified need and therefore demonstrated a lack of respect for resident’s wishes. EVIDENCE: Four care files were examined; following a basic pre-admission assessment, residents are assessed more fully on admission to ensure all information is available in order that staff can plan care around assessed needs. Assessment information has greatly improved since the last inspection and it was evident that residents are assessed with regard to their mobility, continence needs, skin integrity and nutrition and personal care needs. Additionally, the assessments identify personal preferences such as the time the resident wakes in the mornings, the preferred number of pillows required in their bed, likes Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 Page 11 and dislikes regarding food, preferred radio or television channels, social interests and relationships. Risk assessments are also undertaken to identify if any risks will be presented to the resident in their daily routines in the home such as risks of falling, scalding from hot water, risks of pressure ulcers and risks associated with use of bed rails and moving and handling. One resident did not have any care plans although assessments had been carried out; this person had been resident for 11 days at the time of inspection. Assessments generally provide sufficient detail from which to formulate a plan of care although three issues were noted and discussed with the trained nurse the deputy manager: • Care plans in relation to the moving and handling needs of the resident referred to staffing procedures rather than the persons individual needs in relation to their moving and mobility requirements. Care instruction for staff stated that all staff must attend training and will only use equipment if they feel confident and will be supervised by a senior member of the team until confident. Staff were not directed to provide care specifically to meet the individual moving and handling requirements of the resident. One nutritional assessment identified a medium level risk of poor nutrition and advises appropriate action including monthly monitoring of the residents weight. This person was not weighed on admission so there was no baseline on which to monitor and review this person’s weight. One care assessment identified that the resident had confirmed that they preferred to have a bath twice per week. The care plan directed staff to provide a bath ‘at least once per week’. A different care assessment identified that the resident was unable to have a bath due to a wound car regime; the care plan however directed staff to ‘offer a daily bath or shower’. • • Overall, care plans provided a good level of detail to direct the caregiver to meet needs in relation to resident’s health, welfare, personal care and social care needs. It is the role of the registered persons however, to ensure care plans are implemented in order that residents receive the level of care that they expect having agreed care outcomes during assessment and care planning process. Those residents spoken with who were able to communicate did confirm that they felt well cared for and that their needs were being met. Care records evidence how physical care needs are met, for those residents requiring wound care, wound assessments are carried out and reviewed and wound management plans are in place. All resident care records examined Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 Page 12 evidence appropriate contact with other health care professionals as required such as GP, optician, chiropodist etc. (See also standard 37) Management of medication in the home still requires attention; a requirement of the last inspection has not been adequately addressed. Examination of stocks, storage and records of medication found some anomalies. A pharmacist to the home dispenses medicines for individual residents in monitored dosage blister packs, bottles or boxes, examination of these alongside records of medication that had been administered to residents, evidenced that some medicines have not been used in accordance with prescribing instruction. Some resident’s records had been signed indicating that the medicine had been given although the medicine remained in the blister pack or box, some records had not been signed on particular days or times and there was no indication whether the medicine had been refused, omitted for a particular reason, given or spoiled. Medication storage is secure and controlled substances are stored in accordance with Royal Pharmaceutical Society guidance. Two items of controlled substances were recorded in the register although not indexed making it difficult to trace the record. Residents spoken with that were able to comment confirmed that a kind and caring staff group treat them respectfully; staff and residents were observed in their interactions to have mutually respectful relationships Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 Page 13 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 The social, cultural, and recreational activities provided by the home or by resident’s families meet the expectations of residents. Systems regarding resident consultation are in place and residents are able to choose how they spend their day with some limitations due to physical frailty and routines in the home such as meal times and personal and nursing care programmes. EVIDENCE: Some residents spoken with confirmed that they felt their was sufficient stimulation in the home, they were able to make choices regarding how they spend their day which involved watching television, reading books, magazines etc and receiving visitors. Some residents, also able to make these decisions confirmed that there was not any real stimulation or activities available although this did not unduly concern them. As part of the assessment process, residents have been consulted with regard to their hobbies and interests and records examined provided evidence of consultation indicating that they have been helped to exercise choice. Residents spoken with confirmed that they are able to make decisions and choices in the home with regard to what time to get up, go to bed and how to spend their day. Daily records examined provided an account of each resident’s personal and nursing care routines in the home although there was limited information regarding any social activity. Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 Page 14 One member of staff spoken with has an interest in social care and activities and has been provided with an additional twelve hours a week to arrange social care programmes for residents in either small groups or individually. This staff member was enthusiastic about the new role and confirmed that she will be undertaking a specialist course in activities coordination in the new year. Assessments identified the involvement of resident’s families in decision making regarding care planning and residents spoken with confirmed that they are able to receive visitors at any time. Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 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): 17 Resident’s rights are protected through a system of consultation about the care they receive although caution is needed to ensure that these rights are properly upheld by methods of consistent care delivery. EVIDENCE: Standards 16 and 18 were not assessed during this inspection; the last inspection reported that both standards were met and that outcomes for residents were supported in the management of both complaints and adult protection issues. Care homes are expected to carry out an audit of the quality of services and care provided (see standard 33) and Newtown House sent a report of their audit carried out in August 2005 to the Commission. Examination of this confirms that the auditor found that ‘70 of residents rate the way the home deals with their complaints as good, 10 felt that the home dealt with their complaints excellently and a further 20 said that they had no reason to complain’. Whilst this is obviously a positive response, it is unclear from the report whether this means that 70 10 of the residents (21 residents) have made a complaint. Records of complaints shall be examined at the next inspection. The new assessment format demonstrates to some extent that resident’s rights are upheld; records identify the person’s representative, their funding arrangements, and their choices regarding care delivery. Residents or their representatives are requested to sign consent forms where it is necessary to act in a way that could be considered an infringement of their liberty such as Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 Page 16 taking photographs for identification purposes or using bed rails which could be considered a form of restraint. Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 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): 20, 21, 23, 24, 25, 26 Newtown House provides a comfortable and safe environment for those living there and visiting. The home is clean, hygienic and comfortable, sufficient space is provided for residents and toilet and bathing facilities are accessible. EVIDENCE: The interior décor of rooms, the hallways and corridors are decorated, furnished and carpeted to a good standard. Residents are able, if they wish, to bring in items of their own furnishings subject to suitability. Room sizes vary at Newtown House; two shared rooms provide above the minimum space requirements specified in the National Minimum Standards, the remainder of single rooms provide between 10.5 and 15 square metres. Spatial requirements for care homes do not apply for homes that were registered prior to the National Minimum Standards, which state that all accommodation must be offered in single rooms at 12 square metres. Although some rooms are below the 12 square metres that is now expected, best use is made of available space for the benefit of residents. Bathrooms, showers and toilets are sited around the home conveniently for residents. Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 Page 18 The temperature, lighting and ventilation in the home were appropriate for the time of year and weather conditions. Radiators and hot pipe work have been guarded since the last inspection to reduce potential risks of accidental scalding. Measurement of water temperatures using the home’s own, uncalibrated thermometer confirmed that water temperatures are regulated to a temperature not exceeding 43°C, the deputy manager confirmed that thermostatic hot water valves have been installed to all baths. Risk assesmsents are also in place for individual residents with regard to bathing and associated risks such as scalding. Risk assessments provide corrective action needed by staff to reduce risk. The last inspection made the recommendation that residents are provided with lockable storage space to secure their belongings and medication, in rooms visited during this visit, it was evident that this has not yet been addressed. The home was clean and there was evidence of appropriate infection control procedures, including satisfactory hand washing facilities for staff. Residents spoken with confirmed that the laundry system works and items of clothing are laundered and returned in good condition. The laundry area was not inspected. Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 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. Standards 28, 29 & 30 were not assessed as records were unavailable. The deployment and number of available staff is considered sufficient by residents although the registered person must ensure the ratio of trained staff to care assistants is sufficient to meet resident’s needs. EVIDENCE: The manager was on leave at the time of this inspection; the nurse in charge did not have access to staff employment, training and supervision records which is acceptable given the confidential and sometimes sensitive nature of information held. The staffing arrangements do not meet the previous regulators total of six staff for each day shift and four staff at night. During the morning shift, there is one trained nurse and five care assistants (6 staff), in the afternoon there is one trained nurse and three care assistants (4 staff) and at night there is one trained nurse and two care assistants (3 staff). A new post has been created since the last inspection for a care assistant to work between the hours of 10.00am and 8.00pm increasing the total numbers of staffing between these hours. Two trained nurses and four care assistants were required by the previous registering authority between the hours of 08.00 and 20.00 and one trained nurse and three carers were required at night. Karen Watts, the manager and also a registered nurse works varied shifts during the week; at least 3 to 4 of which are supernumerary to the care rota and are used for management and administrative tasks. Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 Page 20 Rotas also demonstrated that there is a cook and kitchen assistant working daily and two domestics during each morning. The home’s maintenance man works from 8.00am – 12.00 for five days each week. Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 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): 32 & 37 The management arrangements for the home are evolving and staff and residents feel supported by the prospective registered manager. EVIDENCE: Newtown House has been through a period of instability with no registered manager since December 2004 and one person being appointed to the post and subsequently leaving. The registered providers appointed Karen Watts to manage the home in June 2005 and an application has been submitted to the Commission for her registration, this is still pending. As Ms Watts was on leave at the time of the inspection, some of the management processes could not be inspected. The next inspection will concentrate in part on the home’s quality assurance procedures, the home’s financial and accounting procedures and management of residents finances, staff supervision, record keeping and health and safety procedures. The process of registering with the commission will address Standard 31. Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 Page 22 With regard to standard 32 however, it was possible to assess this using evidence from staff and residents. Residents confirmed that Mrs Watts and the deputy manager were readily available should they need to speak with them, they confirmed also that they felt able to raise any concerns although none had reported anything specifically and they felt that the care and services provided were well organised with easy access to doctors, opticians, etc. Staff spoken with confirmed that communication was good between the manager and themselves through staff meetings and shift hand over meetings; they felt they had sufficient information and resources with which to carry out their roles and that raining opportunities were good. Record keeping practices were improved since the last inspection although one requirement of the last inspection regarding resident’s financial records has been repeated, as this was not assessed during this visit. Other requirements made or repeated from the last visit concerning care planning (regulation 15), medication (regulation 13) and staffing records (regulation 18) also come under the umbrella of regulation 17 as records relating to these areas are listed in schedules 3 and 4 of the Care Homes Regulations 2001. Records examined were held securely except for the care assistant’s record of care provided on a daily basis, which are held in the entrance hallway of the home, this potentially compromises each resident’s confidentiality. Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 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 1 X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 x X 3 3 x 3 1 3 3 STAFFING Standard No Score 27 1 28 X 29 X 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 X X 1 X X X Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 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 OP7 Regulation 15 Requirement Timescale for action 31/12/05 2 OP9 13 3 OP35 17 All service users must have an individual plan of care, based comprehensive assessment process and data collection undertaken by a competent clinician and in partnership with the service user or their representative. Care plans must be implemented and evaluated and clarify all the service users actual and potential needs providing information to clearly direct and inform the caregiver. Previous time-scale 31/07/05 not met. All medicines must be stored and 31/12/05 maintained in accordance with the safe custody of medicines current legislation and guidance (Medicines Act 1968 from Royal Pharmaceutical Society, Misuse of drugs Act 1971,1973,1985). Previous time-scale 31/07/05 not met. The registered persons are 31/12/05 required to ensure that for any service users who request their assistance with management of their funds either directly or through their representative, DS0000060895.V260894.R01.S.doc Version 5.0 Page 25 Newtown House 4 OP27 18 5 OP1 4&5 that robust procedures are in place to ensure that funds are appropriately managed. Where it has been assessed that a resident lacks an understanding of the value of money, amounts given to that resident for specific purposes must be justified in recorded evidence. Repeated from last inspection as not assessed on this occasion. Staffing levels set by the former 31/12/05 Health authority should be adhered to or a clear, robust and written case must be made in order for a lower ratio of qualified nursing staff to health care assistants to be used. Such a case must have been made following discussion and agreement with the Primary Care Trust responsible for funding free nursing care. This requirement is repeated although re-worded from the last inspection. Previous time-scale 31/07/05 not met. Information for prospective 31/12/05 service users must be up to date and be regularly reviewed. The Service User Guide and Statement of Purpose must contain all the information outlined in Schedule 1 of the Care Homes Regulations 2001. Repeated from last inspection as not assessed on this occasion. Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 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 OP24 Good Practice Recommendations Residents must be provided with lockable storage space and locks to their bedroom doors unless the reasons for not doing so are documented in their care assessments and care plans. Repeated from last inspection. It is good practice to ensure that all medicines that are classed as controlled substances should be itemised in the index of the controlled drugs register to ensure the record is easily identifiable. It is recommended that with respect for residents confidentiality, records of daily care are held more securely. 2 OP9 3 OP37 Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Newtown House DS0000060895.V260894.R01.S.doc Version 5.0 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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