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Inspection on 28/09/05 for The Old Lodge Nursing Home

Also see our care home review for The Old Lodge Nursing Home for more information

This inspection was carried out on 28th September 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.

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

The issues mentioned in this section of the report were the items inspected on this visit to the Home. The Registered Provider had provided a satisfactory statement of purpose and Residents Guide to the Home. The Acting Manager undertook assessments of need of all new Residents moving to the Home. Residents` health needs were well met by the Home. Two Residents were interviewed during the inspection, and they were able to say that care was provided at a good standard. Their relatives and friends could visit at any time and could always been seen in private. It was also said that terminal care were well addressed by the Home. The Home provided a choice at all mealtimes provided throughout the day. A satisfactory complaints procedure was examined, which showed that both verbal and written complaints were recorded by the Home. The Home also had satisfactory protection policies and procedures to safeguard Residents from abuse. The Home was well maintained throughout, although as will be seen, some attention was needed. Staffing was provided to a very good standard. Staff also received induction and foundation training.

What has improved since the last inspection?

The Registered Provider has ensured that Residents needs are reviewed a 6 monthly intervals. The name of the admitting Care Manager is now included in all Residents files

What the care home could do better:

The Residents Guide needs to be extended to include Residents views of life in the Home. The Residents Care Plan was found to be well completed although a number of elements were not included. The Acting Manager needed to ensure that in future all staff employed at the Home could competently communicate with all Residents. Medication was also well administered, but the administration of medical creams to Residents skin was not being recorded accurately. The `signature record`, made by staff, of the distribution of medication was also found to have been poorly maintained. The Acting Manager needed to ensure that staff knocked and waited to be invited into bedrooms by the more able Residents staying in the Home. Although the Home was well maintained there were a number of issues the Registered Provider and Acting Manager needed to address to keep the Home at a high standard. The Registered Provider and Acting Manager should review the length of the normal working week to prevent care staff working excessive lengths of time. The Registered Provider needed to begin `inspecting` the Home on an unannounced basis to ensure that high standards were maintained. The Acting Manager needed to begin to address the quality assurance issues needed in the Home. The Acting Manager also needed to begin her planned supervision of all care staff, and to ensure that all night staff attended Fire Training at least twice a year.

CARE HOMES FOR OLDER PEOPLE Old Lodge, The Nursing Home Sandypits Lane Etwall Derby Derbyshire DE65 6JA Lead Inspector Steve Smith Unannounced Inspection 28th September 2005 09:30 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 Old Lodge, The Nursing Home DS0000002135.V250954.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. Old Lodge, The Nursing Home DS0000002135.V250954.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Old Lodge, The Nursing Home Address Sandypits Lane Etwall Derby Derbyshire DE65 6JA 01283 734612 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) Folcarn Limited Mrs Karen Gillian Bardoe Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (5) of places Old Lodge, The Nursing Home DS0000002135.V250954.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 40 Places for OP 5 Places for younger PD aged 50 years and over included in the total above 15 December 2004 Date of last inspection Brief Description of the Service: The Old Lodge is a detached house, which has been adapted and extended to provide nursing care for up to 40 people, aged 65 years and over. However, up to 5 of the bedrooms can accommodate disabled people, aged 50 years and over. The Home is situated in a rural position, approximately a mile from Etwall village centre. The village has several local shops and is on a bus route for Derby. The Old Lodge has 32 single and four double bedrooms across two floors. 10 of the bedrooms have ensuite facilities. Access to the first floor is by stairs or by a passenger lift. The Home has 2 lounges, a conservatory and dining room. The Home also has a well laid out garden. Old Lodge, The Nursing Home DS0000002135.V250954.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place in just over 7 hours. Discussion was held with the Home’s Acting Manager and Deputy Manager. Some of the Home’s records were examined, some of the bedrooms were seen, and the public areas of the Home were looked at. What the service does well: What has improved since the last inspection? The Registered Provider has ensured that Residents needs are reviewed a 6 monthly intervals. The name of the admitting Care Manager is now included in all Residents files Old Lodge, The Nursing Home DS0000002135.V250954.R01.S.doc Version 5.0 Page 6 What they could do better: 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. Old Lodge, The Nursing Home DS0000002135.V250954.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Old Lodge, The Nursing Home DS0000002135.V250954.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 & 3. New Service Users moving to the Home were always provided with an assessment of need completed by either a Care Manager or the Acting Manager to ensure all needs of Service Users could be met by the Home. EVIDENCE: During this inspection the statement of purpose was not examined. Good documentation was provided, however, while reviewing the Recommendations made following the inspection of December 2004, the Acting Manager said that she had not extended the Residents Guide to include Residents view of life in the Home. When new Residents were admitted to the Home, the Acting Manager was provided with a summary of needs of each person, completed by the Care Manager supporting each Service User. She also visited those potential Residents and undertook her own assessment of need before agreeing to their admission to the Home. If the Resident was self-funding, and therefore not Old Lodge, The Nursing Home DS0000002135.V250954.R01.S.doc Version 5.0 Page 9 supported by Care Managers, the Acting Manager completed her own summary of need. Standard 6 does not apply to this Home. Old Lodge, The Nursing Home DS0000002135.V250954.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): Standards 7, 8, 9,10 & 11. The care provided to Residents appeared to be good, however, Residents’ health and personal care needs were not being fully met, as care plans were found to be often badly out of date. EVIDENCE: To help assess Standard 7, the Resident’s Plan, the records of four Residents were examined, for the purpose of case tracking. Almost all of the basic information concerning each Resident was found to be in the files examined. However, all of the files lacked details of the keyworker allocated to each Resident. All but one of the files contained the initial assessment completed by the Care Manager placing each Resident at the Home. The Acting Manager had also completed her own initial assessment of needs for the four Residents. There were also copies of the ongoing care plan and risk assessment available in each file examined. However, neither of these documents, in any of the files, was kept up to date. For example, in one of the files the last care plan entry Old Lodge, The Nursing Home DS0000002135.V250954.R01.S.doc Version 5.0 Page 11 was February 2005 and no risk assessment had been completed in another Resident’s file. The Acting Manager had not provided details of each Residents limitations of choice, freedom and decision making ability. The Acting Manager carried out 6 monthly reviews of care on each Resident, although neither the Residents nor the Representative relative/person had signed the reviews. The Residents Guide had been made available to all Residents. The files showed that recording of events affecting each Resident were not kept up to date. Only one file had entries in that had been made in September 2005. One file had not had entries made in it since June 2004. All of the files examined were found to be well organised. However, the files did not show that the Acting Manager had read each file at regular intervals, although all files contained a confidential section. Lastly, all of the files contained a copy of a letter given to the Resident, before admission, to say that the Home was suitable to meet the Resident’s needs in respect of their health and welfare. In a number of places in the recording of daily events in one of the files looked at, staff had written ‘please observe’ or something similar. However, staff had not consistently responded to this in the notes they chose to record. The member of staff who requested the ‘observation’ did not eventually say when the ‘observation’ was to end. During the inspection of the Home two staff were observed to assist a disabled Resident into her chair. The staff were observed to carry out an inappropriate lift of the Resident, which was discussed with the Acting Manager. The Acting Manger agreed to follow this issue up with all care staff. Staff of the Home were appropriately maintaining the records of Residents health needs, which included a record of meals provided for Residents. All medication and the method of distributing it to Residents were examined, and a good record was found. However, a large number of signature gaps were found on the Medication Administration Record (MAR) sheets, and a number of Residents required creams to be applied by staff but the record of this was not maintained on the MAR sheets. Two Resident were spoken to about life in the Home. They said that staff were very good at listening to their views on how their wished to be cared for and staff would carry out their wishes. They said that care needs were always met with dignity and respect. As a result, they said they felt very safe in the Home, and appeared to have a strong sense and appearance of well being. Both Residents were concerned to some degree about the poor English spoken by some staff. It was their opinion that not all staff understood what was said Old Lodge, The Nursing Home DS0000002135.V250954.R01.S.doc Version 5.0 Page 12 to them, and they often found it difficult to understand the replies made by the staff. One Resident said that terminal care needs were discussed on admission to the Home. This ensured that, when necessary, the correct funeral directors were called and that the Home knew each Resident’s choice of whether a burial or cremation service was required. Old Lodge, The Nursing Home DS0000002135.V250954.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): Standards 12, 13, 14 and 15. Residents preferred lifestyles were respected by the Home. They were able to receive visitors and to exercise choice and control over their lives. Residents were given a wholesome and appealing diet in pleasant surroundings EVIDENCE: The Residents spoken to during the inspection said that they felt very safe in the Home. Staff respected their confidences and all their needs were met with dignity, respect and choice. The Residents said that they could go to bed and get up at times of their own choosing. They could also choose or change their bath times. They said that staff did not attempt to influence them on how they spent their money, as family or supports provided this. Residents said that they could go shopping in the local town, but their health currently prevented this. They explained that at times of local or general elections the management team provided a postal vote for them. They also said that entertainers visited the Home at least monthly. Old Lodge, The Nursing Home DS0000002135.V250954.R01.S.doc Version 5.0 Page 14 Relatives and friends of the Residents were able to visit at any time, and could always be seen in private. Both Residents said that staff always knocked, paused and entered their bedroom, rather than waiting to be invited in. They said that their mail was always delivered unopened, and were able to describe the system in place should they wish to smoke. Both Residents said that there was always a choices provided at meal times. Old Lodge, The Nursing Home DS0000002135.V250954.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): Standards 16 & 18. Complaints made to the Registered Providers were appropriately addressed to meet Residents needs. The protection policies and procedures provided by the Home meant that Residents were well protected. EVIDENCE: The Residents spoken to said that if they had any issues of complaint they would take them to the Acting Manager, as they had considerable confidence in her. The complaints procedure provided for Residents was seen and found to provide details on how to refer a complaint to the Commission, if the Resident, or their relatives, wished to do so. It stated that all complaints would be addressed within 28 days. However, the Acting Manager could not find the record of complaints received by the Home before she began working there. One complaint was seen and this had been appropriately addressed by the new Acting Manager. The Registered Provider had a good policy to protect Residents from abuse and the Acting Manager was aware of the Derbyshire Adult Protection Procedures sponsored by the Local Authority. The Acting Manager agreed that she would refer unsuitable staff to the Protection of Vulnerable Adults register, now that it was operational. Old Lodge, The Nursing Home DS0000002135.V250954.R01.S.doc Version 5.0 Page 16 The Home had polices and procedures for handling Residents money, which included a section preventing staff from benefiting from or assisting in the making of Residents wills. Old Lodge, The Nursing Home DS0000002135.V250954.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): Standards 19, 20, 21, 22, 23, 24, 25 & 26. The Home was well maintained throughout, providing all Residents with a safe, comfortable environment in which to live. However, attention was needed in a number of areas. EVIDENCE: A tour of the public areas of the Home was made. The Home was found to be maintained to a good standard, and was well decorated throughout. The dining room, lounges, conservatory and public areas of the Home were inspected. The following areas needed attention within the Home: In toilet 13 the air extractor was broken and so was in need of repair. Staff call points in toilets were reported, in the inspection report of November 2003, to have the call for assistance button situated right next to the cancel Old Lodge, The Nursing Home DS0000002135.V250954.R01.S.doc Version 5.0 Page 18 button, thus allowing Residents to inadvertently cancel their call for assistance if that assistance was slow in arriving. However, the Registered Provider had still not addressed this. In bathroom 11 and 12 the staff call points were situated to far from the baths to allow a Resident to operate them, if left to spend time in the bath alone. The call points therefore needed to be moved closer to the bath or a longer call line provided. Many bedrooms were provided with only one chair. A number of bedrooms were found to not be providing lighting of 150 lux (approx 100 watts). Residents’ bedrooms were again found to not be fitted with door locks that could be operated, by the Resident, from both inside and outside of the bedroom. This had been outstanding since November 2003. The Home had still not been provided with a sluicing disinfector. This issue was also outstanding from November 2003. Residents’ bedrooms were not, in all cases, provided with two double electric sockets, overhead and bedside lighting, a table to sit at and a bedside table. Not all bedrooms were provided with a lockable space for Residents to store valuable items in. Old Lodge, The Nursing Home DS0000002135.V250954.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): Standards 27 & 30. The Registered Provider was found to be providing more than adequate staffing in the Home. EVIDENCE: Staffing provided in the Home was compared with the details provided by the Residential Forum. This showed that during the four weeks following 15 August 2005 the Home was providing between 122 and 139 hours of care a week more than the minimum amount required for 40 Service Users at the High Dependency level. The Acting Manager’s time was not included within this calculation, as recommended by the Residential Forum. However, it was found that at least four care staff each week worked double shifts that amounted to at least 52 hours of work each week. On one occasion one member of care staff worked 65 hours in one week. This does not encourage staff to meet the needs of Residents in a kindly, understanding and patient manner. Staff induction and foundation training was provided for all new staff, although the Acting Manager said that she intended in improve the foundation training provided during the coming year. The Acting Manager also said that all staff were provided with three paid days training a year. All staff also had an individual training and development assessment and profile. Old Lodge, The Nursing Home DS0000002135.V250954.R01.S.doc Version 5.0 Page 20 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): Standards 31, 33, 36 & 38. The Registered Provider had not provided records of his regular inspection of the Home, which would have ensured on going Resident security. The Acting Manager needed to address the Quality Assurance issues to ensure Residents’ care was maintained at a positive standard. EVIDENCE: During the inspection of November 2003 the Registered Provider was required to start ‘inspecting’ the Home in line with Regulation 26. However, although this had probably occurred, no documentation was completed for use by the Manager or the Commission. The Acting Manager was asked what quality assurance measures the Home provided. It transpired that no issues were currently addressed by the Home. One Resident spoken to during the inspection said that on one occasion, some Old Lodge, The Nursing Home DS0000002135.V250954.R01.S.doc Version 5.0 Page 21 considerable time ago, she completed a questionnaire about her stay in the Home. However, this had not been repeated, and she did not know to what use her answers had been put. During the inspection of June 2004 it transpired that care staff were not supervised as laid down within the Regulations and the National Minimum Standards. The Acting Manager said that as yet care staff were still not being supervised as the Regulations required. During the inspection of December 2004 the Manager, at the time, was required to ensure that all night staff attended fire training at least twice a year. However, the Acting Manager was unaware whether night staff had met this requirement. Old Lodge, The Nursing Home DS0000002135.V250954.R01.S.doc Version 5.0 Page 22 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 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 3 3 3 3 2 2 2 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X 2 X X Old Lodge, The Nursing Home DS0000002135.V250954.R01.S.doc Version 5.0 Page 23 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 17 Sch 3 Requirement Each Resident’s file must contain details of the Care Manager who is currently working with each relevant Resident. An up to date care plan, completed by staff at the Home, must be available in each Resident’s file. The Registered Provider must ensure that a Risk Assessment has been carried out on each Resident staying in the Home, and that this is updated at regular intervals. Each file must contain details of the limitations placed on Residents, as agreed by each Resident or their representative, on the Resident’s choice, freedom and decision-making capability. (This issue should have been addressed from the inspection report 8 June 2004) Each Residents plan of care should be seen and signed by the Resident or the Residents Representative. When the Home’s staff use the DS0000002135.V250954.R01.S.doc Timescale for action 23/11/05 2 OP7 14 & 15 23/11/05 3 OP7 13 23/11/05 4 OP7 17, Sch 3 23/11/05 5 6 OP7 OP7 15 12 23/11/05 23/11/05 Page 24 Old Lodge, The Nursing Home Version 5.0 7 OP7 13 8 OP9 13 9 OP9 13 10 OP13 12 11 OP16 22 12 13 OP19 OP19 23 23 Resident’s record to ask other staff to monitor the condition of a Resident, staff must respond to this request when making entries in the record. The staff member who made the request must eventually sign it off when it is no longer needed. The Acting Manager must ensure that staff use appropriate Moving and Handling techneques whenever assisting Residents. The Acting Manager must ensure that when medical creams are applied to Residents skin that this is done at the frequency shown on the Medication Administration Record (MAR) sheet and that a record is maintained on the MAR sheet. When signature gaps are left in the MAR sheets, the Acting Manager must record on the back of the MAR sheet how this issue has been resolved, on each occasion. The Acting Manager must ensure that staff are aware of the need to knock and await a response from the Resident before entering bedrooms. The Acting Manager and care team need to decide which Residents this must apply to, given Service Users differing abilities. The Registered Provider and Acting Manager must ensure that all complaints, both written and verbal complaints, are recorded and positively acted upon. The outcome, following the complaint, must also being recorded. The air extractor in toilet 13 must be repaired. The staff call points in the Residents public toilets must be changed to prevent a Resident DS0000002135.V250954.R01.S.doc 23/11/05 23/11/05 23/11/05 23/11/05 23/11/05 30/11/05 23/11/05 Page 25 Old Lodge, The Nursing Home Version 5.0 14 OP19 23 15 OP24 12 16 OP24 16 17 OP24 16 being able to inadvertently cancel their call for assistance. (This issue should have been addressed from the inspection report dated 27 November 2003) The staff call points in bathrooms 11 and 12 must be either moved closer to the baths or be provided with a longer call line that reaches the bath, to allow Residents to summon assistance when left to bath in private. All bedroom doors must be fitted with a lock that can be operated from both the inside and outside of the room by the Resident. Each Resident must be provided with a key to their bedroom. Risk assessments must be carried out and recorded in the Resident’s file when it is considered by the Acting Manager that the Resident is not able to hold the key to their bedroom. (This issue should have been addressed from the inspection report dated 27 November 2003) All bedrooms should be provided with comfortable seating for two people (per Resident). However, this could be discussed with each Resident, or their Representative, and comfortable seating for one person could be provided if they agreed, and if this was recorded within each Resident’s Care Plan. Two double electric sockets should be provided within each bedroom. However, this could be discussed with each Resident, or their Representative, and fewer electric sockets could be provided if they agreed, and if this was recorded within each Resident’s Care Plan. DS0000002135.V250954.R01.S.doc 30/11/05 30/11/05 23/11/05 31/12/05 Old Lodge, The Nursing Home Version 5.0 Page 26 18 OP24 16 19 OP24 16 20 OP24 23 21 OP25 23 22 OP26 13 & 23 23 OP31 26 Overhead and bedside lights must be provided in all Residents bedrooms. However, this could be discussed with each Resident, or their Representative, and less lighting could be provided if they agreed, and if this was recorded within each Resident’s Care Plan. Bedrooms must be provided with a table to sit at and a bedside table. However, this can be discussed with the Resident or their representative as necessary, giving them the choice of being provided with or without tables as appropriate. The results of the discussion must be recorded within each Resident’s care plan. All Residents bedrooms should be provided with a lockable space for items such as medicine, money and valuables. Lighting of 150 lux (100 watts if a downward facing shade is provided) must be provided in every bedroom. However, if the Resident requests a lower powered bulb this must be recorded in their care plan. (This issue should have been addressed from the inspection report dated 15 December 2004) The Home must be provided with at least one sluicing disinfector. (This issue should have been addressed from the inspection report dated 27 November 2003) The Registered Provider must carry out unannounced inspections of the Home at least once a month and complete the required reports listed in Regulation 26. (This issue should have been addressed from the inspection report DS0000002135.V250954.R01.S.doc 31/12/05 31/12/05 31/12/05 23/11/05 23/11/05 23/11/05 Old Lodge, The Nursing Home Version 5.0 Page 27 24 OP33 24 25 OP36 18 26 OP38 23 dated 27 November 2003) The Registered Provider and Acting Manager must address quality assurance issues listed within Standards 33.1 to 33.7. The Acting Manager must provide supervision for all care staff covering all aspects of practice; the philosophy of care in the Home, and the career development needs of care staff. (This issue should have been addressed from the inspection report dated 8 June 2004) The Registered Provider must provide Fire Training at least twice a year for all staff that work throughout the night. (This issue should have been addressed from the inspection report dated 15 December 2004) 31/12/05 23/11/05 23/11/05 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 OP1 Good Practice Recommendations The Registered Provider and Manager should provide Residents views of life in the Home as part of the Residents Guide. (This issue should have been addressed from the inspection report dated 15 December 2004). Each Residents file should contain details of the keyworker who is currently working with each Resident. The Assistant Manager should ensure that recording of events in each file maintained by both nursing and care staff is kept up to date. The Acting Manager should review each Resident’s file on at least a monthly basis. She could indicate that this has been done by signing the record with a red or green pen. DS0000002135.V250954.R01.S.doc Version 5.0 Page 28 1 2 3 4 OP7 OP7 OP7 Old Lodge, The Nursing Home 5 6 7 OP10 OP24 OP27 8 OP36 (This issue should have been addressed from the inspection report dated 8 June 2004) The Acting Manager should satisfy herself that all staff, and future staff, can understand the English spoken by Residents and that in return, Residents can understand staff. All care staff and domestic staff should be provided with master keys to Residents bedrooms. The Acting Manager should review the length of time care staff are allowed to work in the Home, and where possible limit this to no more than 40 hours each week. The Acting Manager should carry out formal supervision with all care staff at least 6 times a year covering the issues listed in Standard 36.3. (This issue should have been addressed from the inspection report dated 8 June 2004) Old Lodge, The Nursing Home DS0000002135.V250954.R01.S.doc Version 5.0 Page 29 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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