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Inspection on 10/08/05 for Prestwood (Main House) Nursing Home

Also see our care home review for Prestwood (Main House) Nursing Home for more information

This inspection was carried out on 10th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

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 standard of care provided within the home from both trained nurses and care staff was very good. A large number of questionnaires were sent directly to the Commission from service users and relatives which were generally very complimentary about the staff and the service provided in the home. One service user stated `It is a very nice and caring home`, and another wrote `Amanda is doing so well as manager, always cheery and cheerful`. Service users also confirmed that they were treated politely and respectfully at all times. Health care needs were met and service users had access to a range of health professionals who, when spoken to, confirmed that they were satisfied with the care provided to the service users. A visiting general practitioner told the inspector that she felt the home had good communication internally and liaised well with the surgery. Comments in a questionnaire from another general practitioner stated `Extremely well run and caring home`. No incidents of neglect or abuse of any kind had been reported. Documentation evidenced that service users were protected from all forms of abuse.

What has improved since the last inspection?

The Statement of Purpose had been updated to reflect the changes in staff. Attempts to improve the recruitment and selection procedures within the home had already commenced at the time of the inspection and staff were to be credited for their proactive approach to rectifying the problem before it was raised by the inspector.

What the care home could do better:

A number of requirements were raised as a result of this inspection. These included: written confirmation to service users that their needs could be met, signed agreement from service users or their representatives in the use of bed rails, improved access to other health care professionals, repair to bath seat, more robust procedures for the recruitment and selection of staff and updates required to fire risk assessment and fire drill attendance. Recommendations raised were: to streamline the care plans to provide current, pertinent information to enable staff to meet the needs of the service users at all times, and to record and provide opportunities for stimulation and recreational activities which suit the needs, preferences and capacities of the service users.

CARE HOMES FOR OLDER PEOPLE Prestwood (Main House) Nursing Home Main House Prestwood Stourbridge West Midlands DY7 5AL Lead Inspector Gammon Lynne Announced 10 August 2005 9:30 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 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. Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Prestwood (Main House) Nursing Home Address Main House Prestwood Stourbridge West Midlands DY7 5AL 01384 877440 01384 877900 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Completelink Limited Mrs Jayne Elizabeth Tatler CRH 59 Category(ies) of DE(E) 2 registration, with number OP 59 of places Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 OP Minimum age 60 years 2 2 beds for persons with a minimum age of 55 Date of last inspection 9 February 2005 Brief Description of the Service: Prestwood House provides full nursing care, given by fully trained care staff and registered nurses. The service is for older people requiring nursing and residential care; there are also 2 beds available for elderly dementia care. There are 59 beds available organised on three floors, occupying a delightful rural position on the 48-acre Prestwood Estate. The home is situated off the main A449 close to the village of Kinver with good road connections. Service users enjoy the well-tended gardens and views of the extensive countryside. The Prestwood site accommodates both the Main House and the Coach House annex, sharing utility resources, and a level of joint managerial control, at times of emergency staff coverage is available. The principle aim of the Home is ‘to add life to years not years to life’. Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced visit was made on the 10th August 2005 at 9.45 a.m. The inspection was carried out by two inspectors who used the National Minimum Standards for Older People as the basis for the inspection. The total time spent for the inspection, including pre and fieldwork, amounted to 11hrs. The registered care manager, Director of Nursing, Jayne Tatler and the Home Manager, Amanda Randall were present throughout the inspection. Also on duty that day were 2 trained nurses, 10 care assistants and a range of support service staff including administrative staff, a personnel development manager, an activities co-ordinator, contracted domestic staff, catering, laundry and maintenance staff. There were 47 service users living in the home and it was agreed that the numbers, skills and experience of staff on duty that day were adequate to meet the needs of those service users. The inspection included a tour of the building, inspection of records, observation, and discussions with service users and staff, and also with visiting health professionals. Since the last inspection on 9th February 2005, one complaint had been received by the Commission and had been investigated in accordance with the complaints procedure. The complaint was not substantiated. No any incidents or reports of abuse of any kind had been received. No requirements against the regulations and the minimum standards were outstanding from the last inspection report but one recommendation from the previous report has been raised again at this inspection. All aspects of care had been addressed well and service users were able to make a decision about the home following an assessment and invitation to visit the home. However, written confirmation that their needs could be met was not provided. Care plans were generally well written but needed to be streamlined to provide current pertinent information for the care required to enable staff to meet the needs of the service users at all times. Health care needs were being met, however, access to advice and treatment from other health care professionals needed to be quicker in some cases and it was felt that the above streamlining would facilitate this. Also, completed risk assessments should include the signed agreement of the service user or nominated relative. All aspects of service user privacy, dignity and choice were recorded and supported by staff. Service users spoke highly of the quality of care provided by the staff and said that they were treated respectfully and politely. Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 Page 6 The home was generally bright, comfortable and clean. It provided a safe and secure environment for the service users and staff, but some areas of the home required attention in terms of decorating and some furniture needed to be replaced. The bedrooms were individually personalised and very clean. Menus were balanced and nutritious, with choices available to meet a range of needs. The recruitment and selection procedures within the home were generally satisfactory and references and CRB clearances had been obtained. Photographs and proofs of identity for all staff should also be obtained to maintain the ongoing protection of the service users. Staff meetings and supervision took place and service users confirmed that they were able to make their own choices and decisions about the day-to-day activities within the home. Regular weekly fire tests took place but fire risk assessments and fire drill attendance records needed to be updated. What the service does well: What has improved since the last inspection? The Statement of Purpose had been updated to reflect the changes in staff. Attempts to improve the recruitment and selection procedures within the home had already commenced at the time of the inspection and staff were to be credited for their proactive approach to rectifying the problem before it was raised by the inspector. Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 Page 7 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. Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 5 Initial assessments were carried out for all prospective service users but written confirmation that their needs could be met was not provided. Service users were invited to visit the home prior to moving in to enable them to make an informed choice about the home. EVIDENCE: Records showed that pre-admission assessments were carried out by the Director of Nursing or the Care Manager for all prospective service users prior to admission. These were seen to be comprehensive and informative, however service users did not receive written confirmation that their needs could be met and it is a requirement of this report that this takes place for each new service user. Trial visits were available to all potential service users and some service users who were spoken to confirmed that they had been able to visit the home before choosing to stay. Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9 and 10 A more formal streamlined care plan would provide immediate relevant care details and ensure the needs of service users were being met at all times. There needs to be refresher awareness training on the safe administration, recording and handling of medicines for the protection of service users. Service users were cared for by committed staff; training ensured that they were competent in their role. EVIDENCE: A sample of the care plans was seen, and while the majority of the information was relevant to the individual, the care manager should consider streamlining the plans to provide current pertinent information for the care required to enable staff to meet the needs of the service users at all times. Care plans were reviewed monthly. Daily reports were completed and health care records such as waterlow risk assessments, weight records, pressure sore treatments etc, were generally well documented. Records showed that service users had received access to relevant health care professionals but some delays were noted for example, in making referrals for nutritional assessments. It is a requirement of this report that access to other health professionals is undertaken without delay to ensure treatment is provided as soon as needs are identified. Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 Page 11 Risk assessments were carried out and reviewed monthly. However, it is important that guidelines are followed before fitting any bed rails, and the result of the risk assessment and agreement of the people involved in the use of bed rails should be recorded. It was noted that this had not taken place for one of the service users tracked. It is a requirement of this report that where it has been assessed that bed rails are required to ensure the continued safety of the service user, that completed risk assessments include the signed agreement of the service user or nominated relative. Pre-admission assessment documentation was seen to include social care needs, but these should be reviewed and addressed on an ongoing basis. The inspector had some concerns when inspecting medication and while touring the environment. Prescribed creams were seen to have the name of a person erased and the name of another person added. This is not acceptable. Prescribed medication should not be transferred to another service user. The manager was required to continue with the provision of photographs on the MAR sheets. A number of gaps were identified on the MAR sheets. The trained nurses at the home were responsible for the administration of medicines; this practice should be monitored. Medication with a short shelf life should be dated when opened; staff had failed to date one container of eye medication. Residents and visitor spoken with confirmed that they were well cared for and treated with respect and dignity. Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 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 standard(s) 12, 13 and 15. The home had a planned activity programme on display within the home. Open visiting enabled service users to maintain contact with families/friends. Service users were provided with choice to their daily menus and food was well balanced and presented in an attractive manner. EVIDENCE: The inspector observed an activity for the service users taking place in the lower lounge. Not all service users chose to be part of the exercise session, some of them continued to sleep. The activities co-ordinator told the inspector that she held one to one sessions with those service users who had a mental frailty, however, the inspector did not see any evidence of this during the inspection. Displayed on the wall near to the kitchen and on the weekly event programme were various activities and records of these activities were maintained. The recent Summer Fair had raised money for the Residents Fund. One relative commented in a questionnaire to the Commission that ‘the recreational activities do not always reflect the culture of the residents but I am sympathetic to the difficulties’. The inspectors would like to see evidence of more individual activity based on individual’s hobbies and interests and it is recommended that this takes place to suit the needs, preferences and capacities of the service users. Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 Page 13 The visiting times for families were at any time to suit them. During the inspection the inspectors were aware that a number of visitors came to the home and were welcomed in a friendly and open manner. Food was prepared from a central kitchen, distributed to lounges in heated trolleys. The kitchen was well maintained; the recent Environmental Health inspection had highlighted two minor defects, which will be addressed. The menus provided a varied balanced diet for the service users. The catering staff were made aware of the dietary needs of a new service user, two days in advance. Records for this were maintained. One service user confirmed that the cook was aware that she preferred sandwiches and liked salad cream, both of which had been provided for her. The inspector was concerned about the length of time that potatoes were held in still water. There is a tendency for toxins to build up and for the potatoes to lose their starch content. The chef told the inspector that the home had not experienced any problems with this system. Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 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 standard(s) 16 and 18. The home operated a robust complaints procedure, which was displayed for easy access. Staff received training to enhance their knowledge and to ensure they were competent in their duty of care. EVIDENCE: Records evidenced that internal complaints were addressed within the required time scales. The Commission had been made aware of a concern and this had been investigated in accordance with the complaints procedure. At the time of the inspection, the Commission did not have any outstanding complaints for Prestwood Main House. The home had a comprehensive complaints process, displayed in documents and in the entrance hall. This document was without the Commission’s telephone number. Service users spoken to stated that they were aware of whom to contact if they had a concern. Staff confirmed that they had received current mandatory training. They were aware of whom to report to if any form of abuse was observed. From the home’s induction programme it was recommended that the programme be extended to highlight POVA and abuse awareness training early in the induction. Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 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 standard(s) 19, 20, 22, 24 and 26. The home provided a safe and comfortable environment. On- going decoration further enhanced the environment. Specialist equipment was available within the home but should be audited to ensure its suitability for use. The home was very clean, warm and tidy. EVIDENCE: Located off the busy A449 in a quiet, rural setting, the home provided sufficient parking space at the front of the home. The home was maintained to a satisfactory standard and service users were provided with a safe comfortable environment. Communal facilities were decorated to a satisfactory standard and contained suitable furnishing for the comfort of the service users. Throughout the home, there were sufficient bathing and toilet facilities, however, the bath seat in bathroom 207 required urgent attention. The seat top coating was fraying leaving the surface rough and hazardous to delicate skins. It is a requirement of this report that this bath seat is replaced or repaired as soon as possible. Assisted bathing facilities were provided to support the less mobile service Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 Page 16 users. Service users spoken with confirmed that they had to rely on the staff to hoist them. They appreciated the assistance given. Bedrooms seen today identified that personalisation had been encouraged to suit individuals, however, some rooms were in need of attention in terms of redecoration and some furniture needed to be replaced. Redecoration had taken place in some areas, and work was in progress to repaint the corridors. The home was very clean, hygienic and free from offensive odours. Laundry facilities were inspected and seen to be well equipped and orderly. Alginate bags were used to contain soiled linen and to reduce the risk of cross infection. Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28 and 29. Staff received the required mandatory training to ensure that they were competent in their roles. Recruitment and selection procedures needed additional information to be robust enough to ensure the continued protection of the service users. EVIDENCE: Records seen at the time of the inspection confirmed that training had been provided for staff. It was noted that fifteen of the staff were involved in a distance learning course for Infection Control Awareness. The recruitment and selection procedures within the home were examined and were generally satisfactory. Three staff files were examined and each contained an application form, interview record, CRB clearances and two references. Qualifications and training undertaken was recorded in a separate file. The staff files did not, however, contain a photograph of the individual staff member or proof of identity as required in Schedule 2 of the Care Home Regulations 2001. However, this had been raised as a requirement at the previous inspection of the Prestwood Coach House on the same site, and the staff within Prestwood Main House had noted this and already begun the process of rectifying this problem at their home at the time of this inspection. Therefore, it will be a requirement of this report to obtain a photograph for all staff members, and for all employees to have copies of proof of their identity held within their individual staff files, but staff should be credited for their proactive approach to addressing these issues before having it raised by the inspector. Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 36 and 38 Satisfactory quality systems were in place which enabled a structured, methodical process for obtaining feedback from both service users and staff. Formal supervision was carried out for staff to provide them with a regular, documented, one to one session with their line manager. There was a requirement to monitor and maintain current tests and record accordingly for the protection of service users. An audit of fire drill attendance was necessary as failure to undertake the appropriate training could leave service users at risk. EVIDENCE: A variety of staff meetings took place including general staff meetings and team leader meetings, which enabled staff to contribute to service delivery, and promoted an open and inclusive atmosphere within the home. One inspector was shown a questionnaire for service users and relatives, which had recently been redesigned and awaiting approval from the Directors of the Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 Page 19 home. The Director of Nursing stated that the approved questionnaire would be used annually and feedback would be used to influence service planning. Residents meetings did not take place at the home but suggestion boxes were in situ and used by service users and relatives. Completed questionnaires were sent directly to the Commission by service users and relatives prior to the inspection. One relative commented ‘I am so pleased with my mother’s progress since moving to Prestwood’, and ‘I do feel that the staff value and respect my mother as a person. There is a humour and lightness which makes Prestwood ‘home’ and the capabilities of the residents are not underestimated’. Staff supervision records were examined and seen to cover all recommended areas. The Director of Nursing confirmed that supervision sessions (which would include an annual appraisal session) would take place for each member of care staff six times per annum. During the inspection, records showed that the last annual fire risk assessment was completed in 2002 and therefore it is a requirement of this report for this to be updated. Weekly fire tests of the system were satisfactory. There was a need to review the records to ensure that each member of the staff team had been part of a fire drill. From the records it was not possible to confirm participation. Other fire system testing was current. Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 4 COMPLAINTS AND PROTECTION 3 3 x 2 x 3 x 4 STAFFING Standard No Score 27 x 28 3 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 4 x 3 x 3 3 x x 3 x 2 Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 Page 21 NO Are there any outstanding requirements from the last inspection? 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 OP 3 Regulation 14 (1) (d) Requirement The registered provider to confirm in writing to the service user that having regard to the assessment the care home is suitable for the purpose of meeting the service users needs in respect of his health and welfare. Where it has been assessed that bed rails are required to ensure the continued safety of the service user, that completed risk assessments include the signed agreement of the service user or nominated relative. To ensure access to other health care professionals is undertaken without delay. Refresher awareness training to take place for trained staff on the safe administration, recording and handling of medicines for the protection of service users. To replace or have repaired the bath seat in bathroom 207 to prevent risk of harm to service users. To obtain a photograph for all staff members, and for all employees to have copies of Timescale for action Immediate 2. OP 7 12 (2) (3) Immediate 3. 4. OP 8 OP 9 13(1)(b) 13 (2) Immediate 31/10/05 5. OP 22 23(2)(c) Immediate 6. OP 29 19(1)(b) (i) Immediate and ongoing Page 22 Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 7. OP 38 23 (4)(a e) proof of their identity held within their individual staff files. To carry out an annual fire risk Immediate assessment and audit attendance at fire drills to ensure each member of the staff team has been part of a fire drill. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP 7 OP 12.3 OP 18 Good Practice Recommendations To consider streamlining the plans to provide current pertinent information for the care required to enable staff to meet the needs of the service users at all times. To record and provide opportunities for stimulation and recreational activities which suit the needs, preferences and capacities of the service users. For POVA and abuse awareness training to be undertaken early in the induction programme for all new staff. Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Prestwood (Main House) Nursing Home E15 -E09 S22361 Prestwood (main house) 100805 V239534 Stage 4.doc Version 1.40 Page 24 - 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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