Inspection on 02/06/08 for Oxford House Nursing Home

This inspection was carried out on 2nd June 2008.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Oxford House Nursing Home 21/05/09

Oxford House Nursing Home 30/10/08

Oxford House Nursing Home 21/02/07

Oxford House Nursing Home 01/02/06

Oxford House Nursing Home 31/08/05

Oxford House Nursing Home 24/01/05

Oxford House Nursing Home 04/05/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Oxford House Nursing Home 204 Stoke Road Slough Berkshire SL2 5AY Lead Inspector Julie Willis Unannounced Inspection 2nd June 2008 11:00 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 Oxford House Nursing Home DS0000011008.V365665.R02.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. Oxford House Nursing Home DS0000011008.V365665.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oxford House Nursing Home Address 204 Stoke Road Slough Berkshire SL2 5AY 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) 01753 536842 01753 539262 info@oxfordhousenursinghome.co.uk Mr Edward Millar Johnston Mrs Abina Teresa Johnston Angela Cole Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Oxford House Nursing Home DS0000011008.V365665.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st February 2007 Brief Description of the Service: Oxford House Nursing Home was opened in 1980 and is owned by independent proprietors Mr and Mrs Johnston. It has the facilities for 34 service users (OP) who require Nursing and Care needs and is situated in a quiet residential close on the northern outskirts of Slough. The home offers views over adjoining school playing fields and residential properties. The establishment was originally an Edwardian family home and has many original features and décor. The fees for this service range from £513 to £618.63 per week. Oxford House Nursing Home DS0000011008.V365665.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 star. This means that people who use this service experience poor quality outcomes. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’ and was undertaken by two inspectors Julie Willis & Tim Inkson - Regulation Manager. The inspectors arrived at the service at 11:00 am and were in the service for five and a half hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s manager, and any information that CSCI has received about the service since the last inspection. Prior to the visit a questionnaire was sent to the Manager along with survey and comment cards for residents and visiting professionals such as doctors and nurses. Any replies were used to help form judgements about the service. Consideration has also been given to other information that has been provided to the Commission since the last inspection. The inspectors toured the building, examined records and met most of the residents and two relatives that were visiting at the time of the inspection. The inspectors also spent time talking informally to staff and observing how care was being delivered to the residents. From the evidence seen by the inspectors and comments received, the inspectors consider that this service would be able to provide a service to meet the needs of individuals with various religious, racial or cultural needs. The inspectors gave feedback about their findings to the homes Proprietor, Manager and Consultant at the end of inspection. There were a number of legal requirements made as a result of this inspection and one good practice recommendation. The Commission has received no information concerning complaints from members of the public since the last inspection however; the home is subject to ‘Safeguarding Adults’ investigations at present and is being monitored regularly by the Local Authority. Oxford House Nursing Home DS0000011008.V365665.R02.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Care plans must be kept up-to-date to ensure that they accurately reflect the needs of people using the service. Residents pressure areas must be monitored regularly and if necessary specialist support and advice sought when needed to ensure that the correct treatment is provided. The Providers must carry out regular quality assurance monitoring which must include audits of information systems concerned with the health & welfare of residents e.g. care plans. Records should be kept of each visit. This is to ensure that the home is managed in the best interests of people living in the home. The Manager must notify the Commission of any incidents or events that adversely affect the well-being of residents. All medication should be administered as prescribed by the doctor and recorded appropriately to ensure that it is managed safely and properly on behalf of the people for whom it is intended. Oxford House Nursing Home DS0000011008.V365665.R02.S.doc Version 5.2 Page 7 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. Oxford House Nursing Home DS0000011008.V365665.R02.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 Oxford House Nursing Home DS0000011008.V365665.R02.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): Standard 3 People who use the service experience adequate quality outcomes in this area. Although all prospective residents are fully assessed prior to their admission it is not clear how the information gathered is used in practice. Care plans developed following admission have not been routinely followed by the staff and this has compromised the health & welfare of people living in the home. (see standard 7) This judgement has been made using available evidence including a visit to this service. EVIDENCE: Examination of pre-admission documentation of four residents indicated that management of the home endeavour to gather as much information about the needs of the individual as possible prior to admission. The assessment takes place at home or in hospital and is carried out by the homes Registered Manager along with another senior member of staff. Oxford House Nursing Home DS0000011008.V365665.R02.S.doc Version 5.2 Page 10 The records examined provided information about the resident’s health and personal care needs. A brief medical history was gathered along with the prospective residents medication and healthcare regime. Clinical tools were used to assess the resident’s level of mobility, risk of developing pressure damage, risk of falls and nutritional needs. Manual handling risk assessments and ‘safe systems of work’ had been devised to reduce the likelihood of injury to residents and to staff. The information gathered pre-admission had been used to develop an initial care plan for the individual. However, it is not clear how the information sought before a person moved into the home was transferred into practice, because there was evidence that residents admitted with healthy skin had developed pressure sores in the months following their admission. A number of recently admitted residents had also lost significant amounts of weight. This indicated that the home is not effectively following the care plans that were formulated. The home is currently employing a Consultant who is working to improve the care plans used at the home. The home has adopted the Berkshire Care Associations pre-admission documentation, which is comprehensive and holistic. At the time of inspection the home was in the process of changing all of its care planning documentation to that recommended by the BCA. This is an on-going process. The inspectors spoke to residents and to visitors of the home during the course of inspection. They were able to confirm that they had been visited by the management of the home prior to admission and had been provided with sufficient information about the home to enable them to make a decision as to whether to live there or not. They confirmed that they had been offered the opportunity to visit the home informally before they were admitted in order to tour the home and meet staff and other residents. Oxford House Nursing Home DS0000011008.V365665.R02.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): Standards 7, 8, 9, 10 People who use the service experience poor quality outcomes in this area. Inadequate monitoring of residents health & welfare puts them at serious risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From examination of the documentation of four residents it is evident that poor monitoring and record keeping of health and welfare has had a detrimental effect on people living at the home. Examination of care documentation confirmed that in one case a resident had lost 20kgs in weight since admission. Their weight had not been recorded between the 6th November 2007 and 14th May 2008 and there was no explanation on file as to why this was so. Another resident admitted in December 2007 had lost 8.6kgs in 5 months and there was no documentary evidence in their care plan that a referral had been made to other healthcare professionals for their advice and support. It is clear that record keeping at the home has not been consistent. The home confirmed that it doubted the accuracy of the weight records as the staff had recognised that Oxford House Nursing Home DS0000011008.V365665.R02.S.doc Version 5.2 Page 12 the scales had been providing erroneous and inconsistent results. The chair scales had since been recalibrated to ensure that resident’s weights could be monitored more accurately in the future. At the time of inspection, the Manager informed the inspectors that three residents had Grade 4 pressure sores and one resident had a Grade 3 pressure sore. Records referring to treatment and resolution of these wounds were generally poor and inconsistent. There is a need to keep accurate records of treatment provided and when a referral has been made to specialists for advice and support the outcome should be recorded and changes made to the care plan. There is a need to monitor wounds more closely and to evidence resolution using photographs (with residents consent), measuring and body mapping on a routine and regular basis. The medication systems and records of administration were examined during inspection. There were clear records of medicines received into the home, those administered and how unwanted medicines had been disposed of. Information received from the Local Authority indicated a high level of concern about the administration of medicines and repeated evidence of poor and unsafe practices during their visits. For this reason this standard is scored as poor. The CSCI Pharmacy Inspector will be asked to carry out an unannounced inspection of this service before the next Key inspection takes place. Oxford House Nursing Home DS0000011008.V365665.R02.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): Standards 12,13,14,15 People who use the service experience adequate outcomes in this area. The home provides a range of activities designed to meet the needs of residents. Food is tasty and nutritious but is not provided to residents in a comfortable and relaxing manner. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an Activity Organiser five days a week from 9am to 12noon to engage residents in a range of activities. These are carried out on a one-to-one or small group basis. Other activities are provided by external entertainers including musical entertainments and sing-a-longs. The home has regular visits from a PAT (Pets As Therapy) dog, which is particularly enjoyed by the residents. Local churches are frequent visitors and provide Communion. At the time of inspection a group of residents were sitting in the conservatory engaged in knitting and needlework supported by staff. One resident said “we have things in the morning, we have a church service, there is always something to do, we have bingo and that sort of thing” Oxford House Nursing Home DS0000011008.V365665.R02.S.doc Version 5.2 Page 14 Lunch on the day of inspection was lamb or pork chops with mixed vegetables and creamed potatoes followed by jelly & custard. The residents confirmed that it was tasty and well cooked. One resident said “Its very nice, it always is” and another said “they look after me all right”. The majority of the residents ate their meals in the lounge or their bedroom from cantilever tables. Many of the tables were the wrong height or out of reach of the resident. The residents did not have access to condiments or sauces and none were offered by the staff. There was no use of adapted crockery, cutlery or plate-guards although a number of residents would have clearly benefited from their usage. The use of plastic beakers and drinking cups should be reviewed to ensure that only those residents that need them are provided with drinks in this type of container. Observation of practice concluded that residents that required assistance with their meals were being fed by staff that hovered over them ‘shovelling’ food into their mouths in total silence. This practice appeared demeaning and disempowering to the resident. There is a need to review how meals are provided at the home and to promote them as social occasions to be enjoyed. Residents should be encouraged to eat in a dining area in pleasant and relaxed surroundings. Staff were observed to complete food charts inaccurately. One record stated that the resident had eaten all their lunch when in fact their plate was taken away relatively untouched. This type of inaccuracy poses a risk to residents who may already be nutritionally compromised. Oxford House Nursing Home DS0000011008.V365665.R02.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): Standard 16 & 18 People using the service experience adequate quality outcomes in this area. Residents feel that their views are listened too and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents and one relative said that that they felt confident that any concerns or complaints would be taken seriously by the home and efforts would be made to remedy any problems in a timely fashion. The majority of residents confirmed that they had never had to make a complaint because they felt that management were approachable and operated an ‘open door’ policy. The complaint policy in the home meets the requirement of Standard and Regulation. Residents and relatives are provided with information on how to make a complaint to the home and the formal stages in procedures. Examination of the complaint records indicated that there have been 2 complaints made to the home since 1st January 2008. The details of the complaints were well documented and indicated that an investigation had taken place and an outcome had been provided to the complainant. There has been no information about complaints provided to the CSCI about the home since the last inspection. However, the home is currently subject to Oxford House Nursing Home DS0000011008.V365665.R02.S.doc Version 5.2 Page 16 ‘Safeguarding Adult’ procedures as a result of poor quality care practice. (See standard 7) There was evidence in staff files and from discussion with staff, that they receive training in ‘Safeguarding Adults’ as part of their formal induction to the home which is later consolidated when undertaking NVQ training in which it forms a core module. However, it is not clear how their learning is translated in to practice as poor quality care has gone unnoticed and as result residents health and welfare have been put at risk. (See standard 7) There is a need for management to inform the Commission (under Regulation 37) of any incident that may adversely affect the welfare of residents. This includes when the Local Authority is undertaking ‘Safeguarding Adult’ investigations. Oxford House Nursing Home DS0000011008.V365665.R02.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): Standards 19 & 26 People who use the service experience good quality outcomes in this area. The standards of décor and furnishings in this home offer residents a comfortable and homely place to live. Standards of hygiene are good throughout. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From a tour of the building it is clear that the home is well maintained for the benefit of residents. All communal areas were clean, airy and well lit and were decorated and furnished to a comfortable standard. The home employs a fulltime maintenance man to ensure that the environment is safe and risk-free. He routinely undertakes a range of health & safety checks that are required as good practice or by legislation. Oxford House Nursing Home DS0000011008.V365665.R02.S.doc Version 5.2 Page 18 The home has a rolling programme of routine maintenance and renewal and a budget is available that reflects this. In the past year the communal areas, hall front stairs and landing have been re-carpeted along with five ground floor bedrooms. New flooring has been laid in the bathrooms. A new call bell system has been installed throughout the home and new lockable cupboards have been provided in bedrooms. The bedrooms were all highly personalised and were warm spacious and comfortable. The home has a range of aids and equipment available to maintain residents independence and to promote safe care. Profiling beds are available for residents that need them and three pressure-relieving mattresses have been purchased to promote tissue viability. There is a choice of bathing and showering facilities both assisted and unassisted and there are sufficient toilets placed strategically around the home to meet the needs of residents. All bathrooms, toilets and sluices have a supply of liquid soap and hand towels to maintain satisfactory infection control standards. The home was clean and hygienic throughout there were no residual odours noted. Residents confirmed that the home is always clean and well maintained and staff work hard to provide a pleasant environment for the residents. There is a need to consider providing a designated space as a dining area to improve the mealtime experience for residents. Discussion with staff and examination of the staff training records evidenced that all staff have received training in infection control and health & safety. Oxford House Nursing Home DS0000011008.V365665.R02.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): Standards 27, 28, 29, 30 People who use the service experience adequate quality outcomes in this area. There were sufficient numbers of staff on duty at the time of inspection to meet the needs of residents effectively. The skill mix of the staff team was appropriate for the size, layout and purpose of the home. Recruitment policies and procedures should be followed robustly to ensure the safety of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Examination of staff records for the four most recently employed staff indicated that the majority of necessary checks are undertaken to ensure the safety and protection of residents. The staff records were well kept and contained copies of induction training, job descriptions, application forms, two written references, training certificates and proof of identity. In the case of nurses a copy of their ‘Pin number’ and ‘Statement of Entry on the Register’ were included. There is a need to ensure that all staff are provided with formal supervision at least six times a year as records indicated some slippage in the frequency between sessions. Oxford House Nursing Home DS0000011008.V365665.R02.S.doc Version 5.2 Page 20 Examination of the staff files, training records and discussion with staff members evidenced that most of the current staff have either gained or are in the process of attaining NVQ qualifications at levels II & III. The Registered Manager provides the necessary support and guidance to candidates undertaking these external qualifications. The Homes Registered Manager is a trained trainer in manual handling and regularly provides updates. Records evidenced that staff have received training in core skills such as fire safety, first aid, infection control, safeguarding adults and health & safety. This training forms part of an on-going training programme, which ensures that the staff team receive the appropriate refresher training at regular intervals. All staff have been properly inducted and have completed training to ‘Skills for Care’ specification. The home has an up-to-date training record, which provides the dates of all training that has been undertaken by staff. The Homes Manager undertakes regular audits of the training records and identifies future training needs and requirements linked to fulfilling the business and financial plan for the home. At the time of inspection their appeared to be sufficient care and nursing staff on duty to effectively meet the needs of residents. There were two nurses and five care staff on duty supported by a maintenance man, cleaner/laundry person and a cook. Residents and a relative were highly complimentary about the quality of staff at the home. One resident said, “It is very nice here, the staff are nice, they will do anything you ask them”. Another said, “The staff are polite and sensitive”. Oxford House Nursing Home DS0000011008.V365665.R02.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): Standard 31, 33, 35, 38 People who use the service experience poor quality outcomes in this area. Lack of effective monitoring of their health and welfare has put residents at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A lack of proper and effective management systems at this home has put residents at serious risk. There has been poor and inconsistent monitoring of residents health and welfare since the last inspection that has resulted in the development of serious pressure sores and significant weight loss for a number of residents. Oxford House Nursing Home DS0000011008.V365665.R02.S.doc Version 5.2 Page 22 From examination of the last six months records it is clear that the Proprietors Representative reports (Regulation 26 reports) have failed to identify serious shortfalls in care provision and therefore steps have not been taken to improve the outcome for residents. There is an urgent need for the Proprietors to increase the scope of their quality assurance checks to include the basics of care provided in the home. The Manager of the home has failed to provide the Commission with the necessary Regulation 37 Notifications about issues that directly affect the health and welfare of residents, which is contrary to good practice and in breach of the law. All incidents or events in the home, which adversely affect the well-being or safety of any resident, should be reported immediately to the Commission, as failure to do so constitutes an offence. The staff team have appeared to lack direction and support since the last inspection. Communication systems at the home have been poor, resulting in problems remaining unresolved. Qualified staff have failed to seek professional advice in a timely fashion when residents health has clearly deteriorated. As a result of recent ‘Safeguarding’ interventions a Consultant has been employed by the Proprietors to support and assist the Manager to further develop the management systems in the home. This individual is a highly experienced and competent and it is hoped that the home can improve the quality of care to its residents as a result of their intervention. The Registered Manager should complete their RMA (Registered Managers Award) as soon as possible to enhance their skills and competence. The home does not hold cash accounts for residents. Most have relatives or friends who manage their finances on their behalf. Examination of health & safety records indicated that they were up to date and in good order. Routine servicing and maintenance of equipment is undertaken at appropriate intervals to maintain the home as a safe and risk free environment for residents. Oxford House Nursing Home DS0000011008.V365665.R02.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 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 x 1 x 3 2 x 3 Oxford House Nursing Home DS0000011008.V365665.R02.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 (2) Requirement Timescale for action 02/07/08 2 OP9 13(2) Ensure that all care plans accurately reflect the needs of residents and are kept up-todate • Ensure that all residents are weighed regularly and referred as necessary to other healthcare professionals for their advice and support • Ensure that all residents are nutritionally assessed • Ensure that residents are referred to tissue viability specialists if they develop pressure sores • Use body maps, measuring and photographs (with consent) to record resolution of wounds • Ensure that treatment plans are kept up-to-date Ensure that the record of 02/07/08 administration of medicines is accurately documented to ensure the safety of residents • Ensure medication is signed for and the time of administration • Ensure that there are no DS0000011008.V365665.R02.S.doc Version 5.2 Oxford House Nursing Home Page 25 3 OP38 37 4 OP33 26 5 OP15 12 6 OP36 18(2) unexplained gaps on the MAR charts Ensure that all events or incidents that may adversely affect the welfare and safety of residents is reported to the Commission Ensure that the Proprietors Representative visits are carried out monthly and include all aspects of the day-today running of the home including the health and welfare of residents Ensure that residents are provided with their meals in a relaxing and comfortable manner • Ensure that residents have access to condiments and sauces at each meal time • Ensure that adapted cutlery and crockery are available to residents at each meal time to aid independence Ensure that a programme of supervision is formulated which ensures that staff are formally supervised a minimum of six times a year 02/07/08 02/07/08 02/07/08 02/07/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP19 Good Practice Recommendations Consideration should be given to enhancing the meal time experience for residents by enabling them to eat their meals whilst sitting at dining tables rather than cantilever tables Oxford House Nursing Home DS0000011008.V365665.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Oxford House Nursing Home DS0000011008.V365665.R02.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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