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Inspection on 06/06/06 for Oaklands Nursing Home - KWD

Also see our care home review for Oaklands Nursing Home - KWD for more information

This inspection was carried out on 6th June 2006.

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.

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 have a comprehensive assessment of their needs before coming to the home. Detailed care plans are developed from the assessment of needs which are regularly reviewed. Service users say that staff are caring and committed to their care. The home has a good commitment to staff training and have over the expected ratio of NVQ 2 (or above) trained care staff.

What has improved since the last inspection?

Terms and conditions of residency at the home have been updated but still require further development to meet the requirements of the regulations. Staff ensure whenever possible either the service user or their representative are involved in the planning and review of their care, and ensure that service users all have access to an Optician and Dentist. Medication policies have been updated following requirements made at previous inspections. Recruitment and selection procedures have improved and are robust safeguarding service users from people who are unsuitable to work with vulnerable people. Staff supervision has also now commenced.

CARE HOMES FOR OLDER PEOPLE Oaklands Nursing Home - KWD 82 Wartell Bank Kingswinford Dudley West Midlands DY6 7QJ Lead Inspector Mrs Amanda Hennessy Key Unannounced Inspection 6th June 2006 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Oaklands Nursing Home - KWD DS0000004881.V297812.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. Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oaklands Nursing Home - KWD Address 82 Wartell Bank Kingswinford Dudley West Midlands DY6 7QJ 01384 291070 01384 291070 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. Richard Perkins Mr. Charles Fraser Macnamara Mrs. Beverley Jane Freeman Care Home 62 Category(ies) of Old age, not falling within any other category registration, with number (62), Physical disability (13), Physical disability of places over 65 years of age (3), Terminally ill over 65 years of age (12) Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 13 PD, 3 PD(E), 12 TI(E) and up to 62 OP One service user identified in the variation report dated 23 June may be accommodated at the home in the category of MD (E). This will remain until such time that the current service users placement is terminated. 29th December 2005 Date of last inspection Brief Description of the Service: Oaklands is a care home that can provide both nursing and personal care to older people on one site. The building is normally divided up into two distinct sections, The Lodge and the Manor, although the former is divided off at present pending building works. The home also offers accommodation to service users with a physical disablement and terminal illness. The staff group work under the supervision of one manager and consists of a number of nurses, care staff and some ancillary staff. Accommodation consists of 38 single and 8 double rooms, this subject to some change pending completion of an extension to the Lodge which means the home is only able to offer a proportion of its beds for accommodation at this time. There is one large communal space between the Manor and the Lodge. The home has a range of facilities and aids necessary for care of older people this including adapted bathing facilities, shaft lift, hoists, grab rails and similar. The home is sited close to the centre of Kingswinford and its facilities, but is positioned in the centre of a residential area. There is access to bus routes following a short walk. As mentioned, there are plans to extend the home on the Lodge side so as to enable the home to offer sufficient beds so as to fulfil its registered number. The CSCI have not been given any firm dates for the commencement of this work, although the Lodge side of the home is now sealed off with exploratory works underway. Fees vary between £345 and £445 and are dependant on the needs of the service user and the type of room that will be occupied. Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken by one inspector. The inspection was carried out between 09.00 and 17.15.The inspection included a tour of the Manor side of the building (the Lodge being totally closed and locked), talking to service users, staff and visitors and a review of records. Five service users completed questionnaires that asked their views on the home, which positively identified their life at the home. A review of information supplied by the Manager (pre inspection questionnaire) was also undertaken and expanded upon during the visit. Care records were reviewed as part of the “case tracking” of three service users. The manager is Mrs Beverley Freeman. The registered proprietors are Mr. Richard Perkins and Mr. Charles Fraser Macnamara. Ten of the previous sixteen requirements from the previous inspection were met. Nine new requirements were made as a result of this inspection. What the service does well: What has improved since the last inspection? What they could do better: Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 Page 6 The main areas of improvement centre around a need to refurbish the home and ensure that it is safe and comfortable place for service users to live. Medication procedures are generally acceptable but as medicines are not stored within the required and safe temperatures the safety and effectiveness of medicine is compromised. Staff need to ensure that all concerns are passed to the Manager to ensure that the concerns are appropriately and effectively investigated and acted upon. Social care plans need to be developed so that all service users have social opportunities regardless of their dependency. 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. Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 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 Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 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): 2,3 The overall outcome for this group of standards is judged to be adequate. Service users have an assessment of their needs giving assurance that the home will be able to meet their needs. Terms and conditions of residency are available but do not give all required information about the home. EVIDENCE: Service users are admitted following an assessment of their needs undertaken by either the Manager or a senior nurse. The care assessment is also supplemented in most cases by a care management assessment and a range of individual risk assessments. Whenever possible prospective service users or their representatives are involved in the assessment of their needs. The Manager writes to the prospective service user confirming that following the assessment of their needs their needs can be met by the home. Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 Page 9 The home have recently updated their contracts giving terms and conditions of residency at the home. Contracts do not include the fees payable as required and need to ensure that the trial period is extended as required by legislation for property disregard. Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 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 The overall outcome for this group of standards is judged to be adequate. The home meets service users healthcare and personal care needs but medicines are not stored safely. EVIDENCE: Service users have a plan of care that comprehensively identifies all their needs. Care plans are developed and regularly reviewed with the involvement of the service user. Service users have required risk assessments for the risk of pressure sores, moving and handling, nutrition and falls which are reviewed monthly as required. Service users are weighed monthly and when service users weight is a cause for concern appropriate action is undertaken. Care records and service users identified that they are appropriately referred to and have visits from Health Professionals such as GPs, specialist nurses, dentists, opticians and chiropodists. Visitors spoken to said that they felt that they were informed of any changes in their relative’s health. Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 Page 11 The administration, safe keeping and storage of medicines is undertaken by nursing staff. There is a record of all medicines service users have received, although staff do not sign to confirm the administration of creams and lotions as required. The treatment room was warmer than required for the safe storage of medicines. The window was open to ventilate the treatment room but this compromised security of the treatment room. All medicine policies have been updated as required following previous inspections. Over the period of the inspection staff were observed to interact with residents in a kindly way with respect and thoughtfulness that is sensitive to protecting service users dignity. Service users spoken to said that the staff were very good, kind and treated them with respect. Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 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 The overall outcome for this group of standards is judged to be adequate. The daily life and social activities of the home meet service users needs, capabilities and preferences. EVIDENCE: Activities in the home are mainly organised by the care staff. Staff try to ascertain service users life history with the help of the service user or their family. A record of life history is an excellent way to try and ensure that activities and daily life within the home meets service users choices, needs and capabilities. Information gained from the life history however needs to be transferred into a social plan of care. Activities are mainly watching television, bingo, games, sing-along sessions and trips out with family members, there is also a fortnightly music to music sessions which the residents thoroughly enjoy. Residents spoken to during the inspection said that: “I like to watch the television” and “I also really enjoy the movement to music”. Another service user said: “ I think there could be more activities”. Visitors are welcome at any time and all met said that they always felt welcome at the home. Care plans identify residents individual likes and dislikes and choices about their individual routines, these are carried out flexibly to provide for choice of the moment. Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 Page 13 The four-week menu provides a balanced and nutritious diet. The menu identifies one choice of meal although staff said that an alternative choice is always available. Visitors can also have a meal when the visit with service users and visitors that the food is very tasty. Service users comments about the food included: “ The meals are `always very good and are varied”. Staff give residents discreet assistance to feed themselves whenever it is required. Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 Page 14 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 The overall outcome for this group of standards is judged to be poor. The home has appropriate policies to highlight concerns and complaints but staff do not always action the required procedures. The adult protection policy needs slight amendment to ensure that it fully safeguards service users. EVIDENCE: The complaints procedure is on display on the notice board and is in the terms and conditions of residency. Discussions with residents and comment cards received before the inspection said if they had any concerns they would not hesitate to speak to staff. Care records of two service users identified that relatives had highlighted concerns but these concerned had not been passed to the Home Manager to enable appropriate action to be undertaken. Staff must ensure that the Home Manager. No complaints have been received in recent times. The home has appropriate policies for staff to highlight concerns whilst feeling safe to do so. There is a need to update the Homes Adult Protection policy to meet the “No Secrets Legislation” referring any allegations of abuse to all required agencies. The home has appropriate policies to ensure that staff who are not suitable to work with vulnerable people do not do so by robust recruitment and selection procedures. Staff spoken to had appropriate knowledge of what is abuse and what actions they must take if any allegation of abuse is made to them. Staff receive in-house training in adult protection procedures. Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 Page 15 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): 19,26 The overall outcome for this group of standards is judged to be poor. Residents are living in an environment that is poorly maintained with frayed and worn carpets a risk to service users, staff and visitors. EVIDENCE: The premises are poor and are in urgent need of improvement and which detracts from all the positive attributes of the home. Whilst the grounds are tidy and safe the internal premises are in urgent need of redecoration as wallpaper is marked and ripped throughout the home. Wheelchairs have damaged doorframes; carpets are frayed and are a risk to service users and staff. Bath and shower rooms are stark, not homely and in need of refurbishment. A number of previous requirements relating to the improvement of the premises have not been met. The planned building works also due to commence imminently for some time has still not commenced. There is a plan to fit new carpets in the lounge/dining room shortly. There remains a need for a written plan with timescales for the refurbishment of the home. Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 Page 16 The laundry is well equipped with industrial capacity washing machines and tumble driers that meet the requirements for sluicing and disinfection of linen. A sluice disinfector is provided for cleansing of toileting items such as bedpans and urinals. Staff are currently not disposing of clinical waste appropriately, which was highlighted to the Manager during the inspection. Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 Page 17 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 The overall outcome for this group of standards is judged to be good. The home has sufficient staff to meet all service users needs. Recruitment and selection procedures are robust and safeguard the service users. Staff training opportunities are good with a good proportion of qualified care staff enhancing the care that service users receive. EVIDENCE: Staffing levels are for 28 residents are: 7.30 am-2.30 pm 1 Trained Nurse and 5 Care Staff 2.30 pm-9.30 pm 1 Trained Nurse and 4 Care staff 9.30 pm-7.30 am 1 Trained Nurse and 2 Care Staff. Additional kitchen, laundry and domestic staff are also available seven days a week. Service users spoken to and comment cards returned said that; “ the staff are very good, always ready to help with any problem”. The home currently has 9 of its 15 care staff (60 ) with a minimum of National Vocational level 2 qualification (NVQ) or equivalent. This exceeds the requirement of at least 50 of care staff with NVQ 2. Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 Page 18 When new staff are employed recruitment and selection procedures are robust to protect the service users. The home has induction training for all new staff that meets National Training Organisation standards. Staff are supported to undertake further training. Recent training has included fire safety, moving and handling, food hygiene, health and safety, infection control, nutrition in the elderly, tissue viability, managing challenging behaviour, leadership and management and dementia care. Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 Page 19 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): 31,33,35,38 The overall outcome for this group of standards is judged to be adequate. The home’s manager is developing and strengthening management arrangements which will increasingly give assurance of the development of the home and the protection of service users. EVIDENCE: The home has an experienced manager who is also a registered nurse. Staff, visitors and service users all spoke highly of the manager and find her very approachable. The Manager has demonstrated that she is an effective leader with staff aware of their roles and responsibilities. Staff supervision has commenced since the previous inspection, although new staff had not received supervision (although some had been in post for three months). Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 Page 20 The home does not have a formally recognised quality assurance tool, although a quality plan for the home is being developed. Quality audits are undertaken monthly by the home manager with corrective actions identified and implemented. A service user survey was undertaken in January 2006. The findings of the survey was fed back to service users during a subsequent service user meeting. The manager must ensure that findings of the survey are available to share with stakeholders and all interested parties. Documented visits by an identified Responsible Person within the organisation are undertaken regularly. The majority of services users have their finances managed by their families or by the Court of Protection. The home’s staff do not manage the finances but small amounts of service users money can be kept for safe keeping if requested. Records of money held show that there are appropriate procedures in place for the safe handling and storage of this money. The current poor standard of the decoration, furnishings and furniture of the home do compromise service users, staff, and visitors safety. The worn and threadbare carpet and the lack of appropriate adjustable beds for people who require care whilst in bed are of particular concern and need to be urgently addressed. The home has appropriate and regular checks of the fire alarm, emergency lighting and fire extinguishers to protect service users. Hot water temperature are checked and recorded monthly but records identified that sometimes the hot water can be outside safe temperature (see requirements section). All staff receive regular mandatory training in fire safety, moving and handling, food hygiene, first aid, infection control and health and safety. Maintenance records (with the exception of the hot water temperature records) and contracts were reviewed and were found to be complete and up to date. Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 2 1 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 2 Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 Page 22 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 OP2 Regulation 5(1) b Requirement The registered provider must revise the contract/statement of terms and conditions so as to include: Fees payable and by whom (for example the service user, representative, social services or health authority). A clear statement as to the rights and obligations of the service user and who is liable if there is a breach of the contract by the registered provider/service user. A clear statement for those service users that receive free nursing care as to how this impacts on the fees charged and what proportion of the service is free, dependent on the level of financial assistance. This is a repeated requirement That was to have been met by the 31/12/05 and was found to be partially met- Contracts have been updated but needs to include the fees payable and change the trial period from four weeks in line with the legislation Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 Page 23 Timescale for action 31/07/06 for property disregard. 2 OP9 13(2) Medicines must be stored safely: The treatment room temperature must be maintained below 25oC. The treatment room temperature must be recorded. The treatment room must be secure and there is additional security to the treatment room window. There must be no gaps on the treatment sheet. The administration of creams and lotions must be recorded. A date of opening must be recorded for short life items. The registered provider must make suitable arrangements to allow residents to engage in activities, as is their choice. This is a repeated requirement That has been partly met. Work to fully met this requirement must be continued. 6 7 8 OP12 OP15 OP16 15 16(2)(i) 22(3) All service users must have a social plan of care. A additional meal choice must be identified on the menu. Staff must be made aware of a need for the Home Manager to be made aware of all concerns to ensure that these concerns are recorded and appropriately investigated. There must be a planned programme for the routine maintenance and renewal of the fabric and decoration of the premises, this reviewed at least every 12 months. To submit an action plan with timescales for redecoration, renewal of damaged doorframes, carpeting, refurbishment of shower and bathrooms, kitchen equipment DS0000004881.V297812.R01.S.doc 07/06/06 3 OP9 13(2) 07/06/06 4 5 OP9 OP12 13(2) 16(2) m 07/06/06 31/07/06 30/09/06 31/07/07 30/06/07 9 OP19 23 31/07/06 Oaklands Nursing Home - KWD Version 5.2 Page 24 cleaning schedule and any other matters detailed in the body of this report. This is a repeated requirement that was to have been met by the 30/11/05 10 OP24 16 To provide the following in service users’ bedrooms where not already present and in accordance with any risk assessment and service user choice: -Bedside lighting which when combined with overhead lighting provides 150 lux (an assessment of the lux should be undertaken) - Adjustable beds for any service user receiving nursing care (assessed as needing such a bed). This is a repeated requirement and was partially met- there remain insufficient adjustable beds. 11 OP26 13(3) An additional sluice must be fitted in the Manor side of the home to prevent having to carry full commode pots between floors. Not assessed as Manor is not occupied by service users at the present time. This is a repeated requirement The home must dispose of clinical waste appropriately and within the required clinical waste bags. To commence formal supervision system, ensuring care staff receives a documented DS0000004881.V297812.R01.S.doc 31/07/06 30/09/06 12 OP26 13(3) 07/06/06 13 OP36 18 30/06/06 Oaklands Nursing Home - KWD Version 5.2 Page 25 supervision session at least six times every year. This is a repeated requirement and was found to be partially met. Supervision has commenced but new staff had not received supervision. 14 15 OP38 OP38 13(4) 13(4) A record must be made of the “flow and return” hot water temperatures. Hot water must be maintained within safe guidelines. 30/06/06 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Oaklands Nursing Home - KWD DS0000004881.V297812.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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 Oaklands Nursing Home - KWD DS0000004881.V297812.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. 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