Inspection on 12/07/07 for Nutley Lodge

This inspection was carried out on 12th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Nutley Lodge 10/10/06

Nutley Lodge 21/12/05

Nutley Lodge 24/05/05

Nutley Lodge 08/03/05

Nutley Lodge 18/05/04

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 Nutley Lodge 43 Sherford Road Elburton Plymouth Devon PL9 8DA Lead Inspector Anita Sutcliffe Unannounced Inspection 12th July 2007 09:50 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 Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Nutley Lodge Address 43 Sherford Road Elburton Plymouth Devon PL9 8DA 01752 402024 01752 408059 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) Mr Jeremy Woodcock Mrs Lynwen Miles Woodcock Mrs Allison Thompson Care Home 25 Category(ies) of Dementia - over 65 years of age (25), Old age, registration, with number not falling within any other category (25), of places Physical disability over 65 years of age (25) Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age range 55yrs Date of last inspection 10th October 2006 Brief Description of the Service: Nutley Lodge is a detached, extended property, situated in the village of Elburton. It is set in its own grounds with easy access for service users. The Home is registered to provide accommodation and personal care for up to 25 service users over the age of 55 for reason of old age, physical disability and dementia. The home is registered for the categories OP (Older Person), PDE (Physical Disability Elderly) and DEE (Dementia Elderly).The home is owned Mr Jeremy and Mrs Lynwen Woodcock and the registered manager is Mrs Allison Thompson. The home has 23 single bedrooms and 1 double bedroom, 14 of the single bedrooms and the double bedroom have en-suite toilet facilities. On the ground floor there are two lounge rooms and a large dining room with a further seating area in the entrance lobby. A shaft lift and a stair lift provide access to the first floor. There is a call bell system throughout the home. Service users are enabled to access any health or social care services they require and various social activities are arranged by the home. The garden is attractive, spacious and has physical disability access. Current fees are: £350 - £400 Additional costs are made for hairdressing and chiropody. The most recent report is made available on request at the home. Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Collection of information toward this key inspection started in November 2006 and the home has provided the Commission with current information about the service. Opinion was sought from service users (residents), their family and staff through anonymous survey. The home received one unannounced visit. The care of two residents, one newly admitted, was examined in detail. This involved meeting them, visiting their room, reading records associated with their care, and discussion with staff; most residents were met. Staff were observed in the course of their work. Most of the home was visited. Records of care, staff recruitment and training, money kept on behalf of residents, and medication, were examined. The manager was available and helpful throughout. What the service does well: What has improved since the last inspection? Risk at the home is now better managed. Chemicals and hot water pipes are no longer a hazard to the safety of confused residents. The home’s complaints procedure now contains the contact details for the Commission and makes it clear that we can be contacted at any stage of a complaint. Staff are receiving training in how to protect vulnerable adults from abuse. There is now less likelihood of confused residents being able to access medicines since the Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 Page 6 purchase of a lockable medicines trolley and medicines fridge. The specialist fridge also keeps medicines at the correct temperature. The importance of dedicated management time has been accepted and a new post of deputy manager introduced. The deputy is sharing administrative duties and it is evident that the standards of administration and management have been improved through the new arrangements. The manager Mrs. Thompson is now able to fulfil her responsibilities fully and she says she also has time for more staff training. Record keeping is now up to date, quality assurance improved, staff supervision more regular. Staff comments about the home were almost entirely positive. Now both the manager and deputy visit and assess a potential resident’s needs. This reduces the likelihood of a placement breaking down and the hurt and disruption this might lead to. A non-touch system is now in use to reduce the risk of cross infection when moving soiled laundry. This should also remove the necessity for hand sluicing. What they could do better: For a second time recruitment practice does not meet the national minimum standard. There has been some improvement but the list of persons unsuitable to work with vulnerable adults is still not being checked before staff start working at the home. Recruitment must be robust. Lack of knowledge is not an acceptable reason for putting residents at risk. The use of hand gel for staff hand cleansing has been introduced and no poor practice was observed. However, staff are still unable to wash their hands adequately immediately before and after providing personal care. The home’s owners also need to take expert advice on the suitability of their domestic washing machines to handle to laundry requirements at the home. Unless evidence confirms that the machines are able to clean soiled laundry adequately an alternative laundry method must be found. A home, which provides care for older people with dementia and physical disability, must ensure that the environment is reasonably adapted to meet their needs and promote their continuing independence. Currently there is no adaptation for people with dementia to help them find their way around the building and no wheelchair access to the garden without staff assistance. The home must also consider how it will comply with the Disability Discrimination Act 2005 in this respect. It must be clear to staff in what circumstance an ‘as required’ medicine may be administered to a resident. It must be part of their individual plan of care. This will lesson the possibility of inconsistency. There should be a system for routinely checking staff competence of handling medicines. Induction training should include an understanding of the condition of dementia. Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 Page 7 The programme of activities should be regularly reviewed to ensure that they are flexible and varied to suit all residents’ expectations, preferences and capacities. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4 & 5 (Standard 6 does not apply to Nutley Lodge). Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Potential residents receive help and information from which they can decide if the home is suitable for them. The specialist needs of some residents, and the promotion of independence, are restricted by the current environment. EVIDENCE: The manager said that written information about the home is being updated so that it is current and will better inform potential residents about the home. Nine of the ten residents surveyed said they had received enough information about the home prior to admission. One added: “Everyone is friendly and it is very comfortable”. The admission of a recently admitted resident was examined. The manager, Allison Thompson, and her deputy undertook the assessment and decided if the home could meet the person’s needs. A trial visit was also arranged. Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 Page 10 The assessment records contained information in some detail about the person’s needs, preferences, history and hazards to their health and welfare. Assessment information from relevant health care professionals was also available and family provided ongoing information and were involved in decisions on the resident’s behalf. Assessment records were clear and provided the basis from which care and support could be planned. Staff understood the needs of the new resident. They were observed putting her at ease and chatting about music, a particular interest. The home is able to provide a piano and there are sufficient staff to enable the resident to have the walks she enjoys. The resident was observed smiling and engaged in conversation with others. However, independence is restricted by the current environment/decor. Although fully mobile, and in many ways able to be independent, finding her bedroom, or the lavatory, is difficult when all doors look the same and signage is poor. With dementia, and therefore reduced memory and reasoning skills, décor can help or hinder independence. It was previously recommended that the environment be improved so that all residents, especially those with dementia, can lead as independent a life as possible. This has not been met. The home is also registered to provide care for people with a physical disability. This might include the use of a wheelchair. One resident surveyed said: “I am unable to get into the garden with my wheelchair as there is no ramp to the garden”. Currently access to the garden is via a ramp with a small step and corners to negotiate. This would make independent access to the garden very difficult. Plans are already being considered which would increase the space available within the home. The environment must be suitable to meet the needs, and promote the independence, of all residents it admits. Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care resident’s receive is based on their individual needs and dignity and respect are promoted. EVIDENCE: Six residents surveyed said they always received the care and medical support they needed and three said they usually do. Five family surveyed said they believed their relative always received the support and care they expected and three said they usually do. One commented: “I can entrust my mother to their care. The staff are patient and caring. Many of the staff have worked there for more than 10 years. The younger staff show care and compassion”. The care of two residents was examined in detail. Both appeared happy at the home and one spoke very favourably about the staff and service at Nutley Lodge. Plans of their care contained important detail and were informative. They had been regularly reviewed so the information within them was up to date ensuring that staff were aware of how the person’s needs should be met. Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 Page 12 The manager was observed liaising with a district nurse and was clearly fully up to date on resident’s health care needs. A district nurse, asked her opinion of the care delivered at Nutley Lodge, had said about the home: “We have a very good professional working relationship, and I can honestly say it is a pleasure to visit this home”. Medication at the home is now kept safely as a lockable medicines trolley and a medicines refrigerator have now been purchased. Nine staff have completed ‘safe handling of medication’ training and the home maintains good records about medicines brought into the home, administered and disposed of. This protects both residents and staff alike. Where a resident is prescribed medicine to be taken ‘when required’ no information was written in the plan of care to allow staff to determine under what circumstances it could be administered. Without this it may be given inappropriately; too often or too infrequently. The manager should also have a system for checking staff competence of handling medicines. Residents said how much they liked the staff and interactions between staff and residents were polite and respectful. Privacy and dignity is promoted through the ethos of the home. Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are supported to make choices and have fulfilled lives within a limited framework for them to do so. EVIDENCE: Asked if there are activities arranged by the home that they can take part in two residents surveyed said there always are, four said there usually are and two said there sometimes are. Residents with dementia may have been less able to contribute to surveys. The two comments received from residents are: “There are not so many activities as there used to be. Too busy with residents who are needing more care” and “I am sometimes able to join in activities”. We sat in the lounge during the morning observing what happened there. There was quiet music in the background, which was repeated over and over. Residents sat around the edge of the room. This limited whom they could engage with. When staff organised dominoes it was, of necessity, only with two at one time. Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 Page 14 Residents have their interests and hobbies recorded so that staff know things of interest and importance to them and preferred routines, such as waking and sleeping times. One resident, who becomes agitated when confined to the home, goes for walks with staff. There are regular visits from local clergy, musical preferences are known and organised activities include quizzes, board games, visits from the Donkey Sanctuary, musical events and a once or twice yearly clothes show. Reminiscence discussions, provided by Plymouth Museum, are now available once or twice a year. One resident was observed reading. Some were only taking an interest in their surrounding when staff were available to engage closely with them. One survey response said: “As many of the other people seem to spend a lot of the day sleeping my friend feels that she has nothing to do but sit and watch them”. Some family surveyed said they visit the home regularly. There was no praise received for the level of activities. Comments from family include: “Just a little more stimulation needed” and “More occupational activity needed”. The provider and manager say that entertainments are more structured and steps have been taken to vary and balance the entertainments provided. We feel this needs to be explored further. Two residents surveyed said they always like the meals, six said they usually do and one said sometimes they do. Two residents family commented on the good food, whilst another said it “could be improved a bit”. The provider reports that meetings between residents, their family and the home have led to additional menu options. The menu remains quite traditional. There are set meals but residents confirmed that an alternative was available if wanted. . Fresh fruit and vegetables are used, there is home baking and food is cooked well. We feel that menu options should be explored further. . Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their family can be assured that complaints would be properly responded to and residents are protected from abuse. EVIDENCE: Each of the nine residents who returned surveys said they knew how to make a complaint. Five resident’s family knew how to make a complaint but three said they did not know. On said: “I have no doubts about making a complaint. The matron is accepting of criticism, and wants to know if I am unhappy about any aspect of my mother’s care”. The home’s complaints procedure now contains the contact details for the Commission and the registered manager, or her deputy make themselves available to speak with residents and visitors. There is an open culture at the home. Quality monitoring, which includes comment cards for visitors, also provides a method for giving negative feedback, should it be wished. The home has received no formal complaints since 2006 and the Commission has received no complaints about the home. They said that minor complaints or grumbles are recorded in the individual daily record of care provided. Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 Page 16 All staff returning surveys said they are aware of adult protection procedures. There have been no allegations of abuse at the home. The registered manager is aware of how to respond to any allegations or concerns raised. The whistle blowing policy, which would inform staff what do should they have a concern which they do not wish to take to the manager, contained the Commission’s address and the contact details for the Local Authority Adult Protection team. Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, pleasant and homely environment, which they enjoy, and meets most needs, but they could be further protected from the risk of cross infection. EVIDENCE: In many ways the home lends itself well to the provision of care for service users with dementia and physical disability; for example, its size and layout. However, some important improvements would improve this. (See Standard 4). All communal rooms and bedrooms were pleasantly decorated. A resident said he was very happy with his room and each of those visited was clearly individual to the resident and well furnished. Surveys included comments such Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 Page 18 as: “It is very comfortable here.” and “Comfortable, warm and generally clean accommodation”. Radiators were guarded to prevent contact burns, first floor windows have protectors to prevent falls and residents are protected from very hot water. Cupboards containing very hot pipes have now been locked and made safe. The standard of maintenance is good. Records show that the maintenance of the building is regularly checked and monitored. Any problems are dealt with promptly. There are plans to upgrade the building through the extension of two bathrooms. This will provide better access and space for improved equipment for assisted bathing. Additional handrails have been provided in response to resident request. Seven residents surveyed said the home is always fresh and clean and two said it usually is. We found the home was clean. However, improved measures to prevent cross infection are still recommended. Whilst staff are provided with hand gel they remain unable to properly wash their hands in residents bedrooms where personal care is provided. Staff should be able to wash and dry their hands before leaving the room. To this end liquid soap and disposable hand towels are necessary. Domestic washing machines are used for soiled laundry rather than those with the ability to disinfect or designed to handle soiled linen. The provider says that it is not possible, due to the age of the building and its electrical supply, to use commercial machines. The home is now using a non-touch system for the handling of soiled linen. This reduces the possibility of cross infection. However, the home must confirm that the washing machines in use are able to destroy pathogens, which might transmit infection from one resident to another if not dealt with properly. Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The numbers, knowledge and skill mix of staff are appropriate to meet the needs of current residents, but poor recruitment practice continues to put residents at risk. EVIDENCE: There were many comments about the friendliness and helpfulness of staff. One resident said: “No complaints. Staff very friendly and helpful”. A resident’s family said: “Very good and picking up and dealing with medical matters. 90 of staff are wonderful and the other 10 OK. There is a feeling of genuine caring for the individuals as well as practical aspects of the job”. Four of the residents surveyed said staff were available when needed and five said they usually were. Each of the six staff surveyed said they had enough time to carry out their duties as required in resident’s plans of care. Resident’s families felt that most staff were sufficiently skilled and five of the six staff surveyed said they were not asked to care for people outside their area of expertise. The sixth said she felt more confident since training was provided on how to care for residents with dementia. Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 Page 20 Most of the staff have been with the home for several years and residents benefit from their experience and the continuity at the home. It is the home’s policy that all care staff undertake the National Vocational Qualification (NVQ) Level 2 in care, which is an indicator of their competence. To date 63 of care staff have achieved this. Newly recruited staff receive induction training and are given time to understand individual residents before working unsupervised. However, the current induction programme does not include any reference to the specific needs of residents for which the home is registered, dementia and physical disability. Staff receive ongoing training. This has recently included moving and handling, dementia care, (staff said the content was good), fire safety and first aid. The home works closely with health care professionals taking advice and instruction. Staff surveyed had no negative comments about the training provided and the manager said she now has more time available for it. The recruitment records of three recently recruited staff were examined. Each contained two references including that of last employer. The standard of references accepted at the home has improved. The level of employment history provided was acceptable, but a little weak. Each potential employee is checked for criminal convictions, but the information was not in place prior to employment starting. Where the need for staff to start is urgent the POVA List (which lists people deemed unsafe to work with vulnerable adults) may be checked quickly, but the home had made no attempt to do this. Nor was there sufficiently close supervision arranged until it was confirmed that the new employee was safe. Although improvements to recruitment practice are evident the home still falls short of robust, safe recruitment. Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect, and has effective quality assurance systems developed by a qualified, competent manager. EVIDENCE: A resident said: “It’s a very well run home and everyone is helpful and friendly”. A resident’s family member said: “The care home and management have done that could be expected of them in responding to my mother’s needs over the last 12 months”. A member of staff said: “Nothing could be improved. This is a friendly home that always puts the needs of residents first”. Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 Page 22 Staff said they feel supported. Previous staff dissatisfaction has been addressed and staff are now receiving regular formal supervision. There have been many improvements since the previous inspection. A new post, deputy manager, has provided for better allocation of management time. This has led to improved management of care and training. The registered manager, Mrs. Allison Thompson, is now able to work to her full potential and discharge her management responsibilities fully. She receives support on a daily basis from the home owners/providers. The home keeps money on behalf of residents who are unable to handle their own safely. There are clear records kept and those checked were correct. All money is kept securely. Mrs. Thompson maintains standards at the home through checking and monitoring the standards of maintenance, care records and medication, money kept for residents, accidents and falls. Residents and their family are encouraged to complete surveys and make their wishes known. There is an ‘open door’ policy and keenness to improve. Meetings have led to a review of menu options and additional handrails in the home. There have been surveys of professional opinion on the home. Previously identified risks to residents have been properly dealt with. We discussed legislation that will impact on the care of residents. Included are the Disability Discrimination Act 2005, Mental Capacity Act 2005 and Equality Act (Sexual Orientation) Regulations 2007. The provider should ensure that the home understands and makes provision for meeting this legislation through its Statement of Purpose, policies, procedures and training programme. Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP4 Regulation 23(1)(a) Requirement The premises must be suitably adapted to meet the needs, and promote the independence, of residents with dementia and physical disability. To this end there must be usable wheelchair access to the garden and décor or signage, which help confused residents find their way around the home. There must be arrangements for clear directions to be available to indicate how and when any medicines prescribed to be administered “when required” are to be used and also for these decisions to be recorded. This ensures residents receive the medication as intended and in their best interest. The home must confirm, through the environmental health authority, that the washing machines in use are able to destroy pathogens, which might transmit infection if not dealt with properly. Persons must not be employed to work at the home until all DS0000003484.V341026.R01.S.doc Timescale for action 01/02/08 2. OP9 13(2) 31/07/07 3. OP26 16(2)(j) 28/09/07 4. OP29 19 Schedule 31/07/07 Nutley Lodge Version 5.2 Page 25 2 required and relevant checks have been completed including the protection of vulnerable adults list. If this list is checked but the full Criminal Record Bureau (CRB) not returned the person must not be employed unless they have a dedicated, named, supervisor with them at all times. This protects vulnerable residents from staff unsafe to work with them. This amended requirement was not met on 19th October 2006 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. 3. 4. Refer to Standard OP9 OP12 OP25 OP30 Good Practice Recommendations There should be a system for formally checking staff competence when handling medicines. The home should explore ways in which all residents preferences and recreational needs can be met more frequently. Staff should be able to wash their hands using liquid soap and disposable hand towels wherever personal care is delivered, including bedrooms. Induction of staff should include information about meeting the needs of residents with dementia, physical disability and the protection of vulnerable adults from abuse. Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Nutley Lodge DS0000003484.V341026.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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