Inspection on 02/10/07 for Prospect House Care Home

This inspection was carried out on 2nd October 2007.

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

The inspector 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

Prospect House Care Home 11/02/09

Prospect House Care Home 16/04/08

Prospect House Care Home 18/04/07

Prospect House Care Home 08/01/07

Prospect House Care Home 25/05/06

Prospect House Care Home 20/12/05

Prospect House Care Home 01/09/05

Prospect House Care Home 18/10/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Prospect House Nursing Home Blundells Lane Rainhill Merseyside L35 6NB Lead Inspector Mr Mike Perry Unannounced Inspection 2nd October 2007 10:00 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 Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Prospect House Nursing Home Address Blundells Lane Rainhill Merseyside L35 6NB 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) 0151 4931370 Ms Maureen Bromley Mr Neil Malkhandi Ms Maureen Bromley Care Home 24 Category(ies) of Dementia - over 65 years of age (24) registration, with number of places Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The Service should, at all times, employ a suitably qualified and experienced Manager who is registered with the CSCI. The service is registered to provide personal care to 24 older people with Dementia Date of last inspection Brief Description of the Service: Prospect House is a care home for 24 older people with dementia, and the registered manager is Mrs. Maureen Bromley. The home is a large converted dwelling house, which has been extended. Prospect House is set in its own grounds a short car journey from local amenities and bus routes. The home provides single accommodation and is staffed throughout the day and night. All residents are registered with a local G.P. and the service includes personal care, home cooked meals and a laundry service. The grounds include a car park, paved areas and extensive gardens with views of the countryside. The fees in the home are £399 per week. Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a period of 9 hours over 2 days. The inspector met with the majority of residents and spoke with visitors including a social care professional, who were visiting at the time. The inspector also spoke with members of care and ancillary staff on a one to one basis and the registered manager [also the Registered provider]. A pre inspection questionnaire and self-assessment [AQAA] aimed at eliciting information before the site visit was completed and returned by the management. Survey forms aimed at getting the views of relatives were sent out and two of these were returned and comments have been used in the report. A tour of the premises was carried out and this covered all areas of the home including the resident’s rooms [most rooms were seen but not all]. Records were examined and these included three of the resident’s care plans, staff files, and staff training records and health and safety records. As part of the inspection a short [2 hour] observational tool [SOFI] which looks at the interaction of the care environment and staff with respect to dementia care was used and some outcomes from this helped frame the inspection report and provided further evidence of the care standards in the home. What the service does well: The health care of residents is met with consistency in terms of appropriate referral to health care professionals. A social worker spoken with said that the home had been proactive in reporting changes in the behaviour of one resident and a referral to a psychiatrist had been made. The personal care carried out by staff was observed and residents were treated with patience and respect. The meal time period for example evidenced some residents requiring sustained assistance by staff with feeding and this was carried out with much patience and preserved the dignity of the residents concerned. Residents were observed to be appropriately dressed and the standard of personal hygiene was maintained well. Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 6 One relative comment summed up the positive feedback from relatives: ‘even though my auntie passed away recently I feel it necessary to write to you. My aunt was always shown great care, love and respect and I have no complaints at all’. The home has a relaxed atmosphere and staff are friendly and welcoming. Social interaction was observed and the general interactions of staff were very positive. Staff were supportive to residents and there was a relaxed pace to the care with staff acknowledging residents feelings. Residents were observed to be displaying a high level of wellbeing and involvment in terms of reacting to events around them. Information from relatives is that the home has an open policy of visiting and that staff are always welcoming. The home have a complaints procedure and this is in the information guides available in the home. Staff interviewed were aware of the complaints procedure and relatives feel that the managers were appoachable and any issues would be addressed. What has improved since the last inspection? The service has improved in quiet a few ways since the last inspection. There is now more evidence in the care plans to suggest that relatives are consulted and are able to inform the drawing up of the care plans. This means that the relatives are more involved with the care. The requirements listed on the last inspection around the safe administration of medicines have been actioned and the medications are therefore administered safely and with reference to good practice. Most notably the environment of the home has been improved so that on this inspection there was evidence of continued maintenance and ongoing decoration. Flooring in many areas has been replaced and the unpleasant odour evident on the previous visits has been eradicated. The home was clean and generally well presented so that residents are able to live in more pleasant and homely environment [although the need for further developments in line with good care for people with dementia remain]. Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 7 The training records for staff were available evidencing that training is ongoing so that staff can be prepared for the care work required. The management have started to look at ways of accessing residents and relative’s views of the service so that improvements can continue to be made. There has been a recent survey of relative’s views and these can be used to inform future plans. The management of health and safety issues in the home has improved with better records being maintained and more checks on the environment made. Although this can still be improved further [see below]. Staffing generally has improved. There were adequate staff on duty including ancillary staff cover. The recruitment records showed that staff are not employed without the appropriate checks being made to ensure that they are fit to work with vulnerable people such as criminal records checks and written references. What they could do better: Some care needs require more detail to the care plan. For example one care plan, under ‘maintaining a safe environment’, simply read ‘promote’. There was no detail as to the nature of the care need. The staff said that this resident was at risk of bumping into furniture but this was not recorded. Similarly staff reported that another resident needed some prompting around personal care but this was not detailed in the care plan. Care is evaluated regularly through the daily records and the monthly evaluations. Again these could be in more depth. For example one daily entry read ‘had a lovely afternoon no problems’. The monthly evaluations are recorded as ‘no change – continue care’. There was some discussion as to the need to make written observations with reference to the care plan and for the monthly evaluation to be a record of the progress the resident has made against the aims and objectives of the care plan. One resident spoken to wanted a newspaper – ‘ if I had a paper I would know what day it is’. There is a lack of orientation aids available. There have been signs made to identify bedrooms and toilets but there should be much more in Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 8 terms of providing cues and prompts so that residents who are disorientated can be enabled to both find their way around and to be more aware of their surroundings. Access to the garden still has not been addressed and this was again discussed in terms of quality of provision in the home and improving the quality of life for residents. Although improved it was still difficult for the manager to evidence some of the ‘statutory’ training such as fire safety and manual handling that all staff should receive and records should be easily accessible and continually updated to monitor this. NVQ training is offered to staff but presently there are only three of the care staff [out of 11] that have at least at level 2 in this qualification. This should be developed further over the next 6 – 12 months so that a higher percentage of the staff are trained to care for the people in the home. Fire records still need to be tightened up with respect to regular recorded checks on a monthly basis for fire extinguishers and the recording of fire safety training [last recorded entry over a year ago]. It is still required that a regular [monthly?] environmental risk assessment be recorded so that any environmental risks can be picked up and appropriate action taken. 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. Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 9 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 Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Appropriate assessments are carried out by the home, which include social service and / or health assessments so that the home is better able to ensure care needs will be met but this also needs to include residents admitted for respite or on an emergency basis. EVIDENCE: The policy of the home is for all residents to receive a preadmission assessment prior to entering the home so that their care needs can be assessed. Two care files were inspected. The admission assessments were present for one resident and covers mental state assessments as well as personal care needs. There were also referring assessments from social workers. Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 11 The other care file was for a resident who has been admitted for two periods of respite care. There were no assessments, either preadmission or in-house assessments, present. The manager explained that this resident had been admitted in an emergency by the social worker [this confirmed by the social worker] and therefore assessments had been impossible to carry out preadmission. The resident had been known to the service for 3 months however and some in-house assessments should be present. This is to establish the care needs and draw up a care plan. Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 12 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): Key standards Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home manages the health and personal care needs of residents satisfactorily so that care needs are respected and met safely. EVIDENCE: The plan of care for two residents were seen on the inspection. These varied in the amount of detail recorded as necessary to carry out the care. One contained very good detail around the personal care of the resident and was easy to follow. It also contained appropriate reference to wound care and interventions around dementia care needs. This care plan was signed by the relative indicating that it had been shared with the family and that their input had been requested. Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 13 Some care needs needed more detail however. For example under ‘maintaining a safe environment’ it simply read ‘promote’. There was no detail as to the nature of the care need. The staff said that this resident was at risk of bumping into furniture but this was not recorded. Similarly staff reported that another resident needed some prompting around personal care but this was not detailed in the care plan. Care is evaluated regularly through the daily records and the monthly evaluations. Again these could be in more depth. For example one daily entry read ‘had a lovely afternoon no problems’. The monthly evaluations are recorded as ‘no change – continue care’. There was some discussion as to the need to make written observations with reference to the care plan and for the monthly evaluation to be a record of the progress the resident has made against the aims and objectives of the care plan. It was not clear on some of the records which staff was responsible as signatures were not clear. The health care of residents is met with consistency in terms of appropriate referral to health care professionals. The district nurse team are regular visitors and input is recorded in care files. A social worker spoken with said that the home had been proactive in reporting changes in the behaviour of one resident and a referral to a psychiatrist had been made. Residents reviewed were receiving their medications safely. The requirements made during the previous inspection have been addressed. For example the temperatures of the drugs fridge are now recorded accurately and the PRN [give when required] medication for one resident is now referred to in the care plan. The manager has started a cycle of 4 weekly auditing of medicines in order to maintain satisfactory standards. The personal care carried out by staff was observed and residents were treated with patience and respect. The meal time period for example evidenced some residents requiring sustained assistance by staff with feeding and this was carried out with much patience and preserved the dignity of the residents concerned. Residents were seen being assisted to the toilet and those staff interviewed were aware of the need to maintain privacy. Residents were observed to be appropriately dressed and the standard of personal hygiene was maintained well. One relative comment summed up the positive feedback from relatives: ‘even though my auntie passed away recently I feel it necessary to write to you. My aunt was always shown great care, love and respect and I have no complaints at all’. Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 14 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): Key standards Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are supported to be involved in activities and the daily social life is relaxed but there needs to be further development with reference to good practice in dementia care and the removing of barriers so that residents make use of the facilities in the home. EVIDENCE: The home has a relaxed atmosphere and staff are friendly and welcoming. The social life of the home is organised around the dining room with none of the other two day areas being in much use. Social interaction was observed in this area over a continuous period [2 hours] and the general interactions of staff were very positive. Staff were supportive to residents and there was a relaxed pace to the care with staff acknowledging residents feelings. Residents were observed to be displaying a high level of wellbeing and engagement/ involvement in terms of reacting to events around them. This was particularly so over the dinner time period. There was a good staff presence and residents were offered plenty of support so that those residents who had difficulty were Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 15 enabled to take their diet. There was some good social interaction. The meal was well presented and a choice was offered. Staff offered residents some activities including a card game as well as one to one interaction through discussion. One resident spoken to wanted a newspaper – ‘ if I had a paper I would know what day it is’. There is a lack of orientation aids available. There have been signs made to identify bedrooms and toilets but there should be much more in terms of brightening up the environment and providing visual [and auditory – radio for example] cues and prompts so that residents who are disorientated can be enabled to both find their way around and to be more aware of their surroundings. The day of the inspection was marked by good weather and some residents commented on this. Despite good staffing levels at the time there was no attempt by staff to get any of the residents out doors and in the garden. One resident commented that to go out ‘you have to have a staff member with you’. Access to the garden still has not been addressed and this was again discussed in terms of quality of provision in the home and improving the quality of life for residents. Information from relatives is that the home has an open policy of visiting and that staff are always welcoming. Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 16 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): Key standards Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a complaints procedure including action for more serious allegations so that residents rights are upheld and people feel that concerns are addressed. EVIDENCE: The home have a complaints procedure and this is in the information guides available in the home. Staff interviewed were aware of the complaints procedure and relatives feel that the managers were appoachable and any issues would be addressed. There is a complaints file and this was seen. There have been no complaints since the last inspection. Complaints prior to this have been noted to be investigated by the manager and reported appropriately. There has been some training around awarness of abuse and poor practice and how this relates to local policy in reporting abuse. Staff spoken to were able to understand the process of reporting abuse or mistreatment. Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key standards Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements have been made to the environment of the home and the management/provider are continuing the process of upgrading so that residents live in comfortable surroundings. EVIDENCE: The pre inspection information listed all of the improvements that have been made to the environment of the home following requirements made on previous inspections. These include the upgrading of flooring in much of the home including some of the bedrooms. There has been some décor completed. There are now sufficient cleaning staffs employed so that the home is now maintained in a clean state. All bathrooms and toilets seen were now functional and maintained for residents use. Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 18 The maintenance person now has a maintenance book so that staff can enter jobs and a record can be maintained of completion. There are some areas still needing attention [such as the carpet in the dining room which is worn and retains an unpleasant odour] but following discussion it is clear that the provider / manager intend to carry on the work. The external gardens have not received any development and are still inaccessible for residents without staff escort. During the inspection at least one resident expressed a wish to go outside but this was not facilitated. The requirements to develop safe access to the garden remain. In terms of quality there is still a need to develop orientation aids and this has been discussed earlier under ‘daily life and social activities’. Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The recruitment and the number of staff in the home has improved so that basic care needs can be met but there needs to be ongoing developments in training so that more staff have skills to develop care standards further. EVIDENCE: The two issues that were listed as requirements on the previous inspection have both been addressed. These were around staff numbers and the recruitment checks needed to ensure staff are fit to work with vulnerable people. On this inspection it was clear that the manager has recruited more care and ancillary staff so that the home was appropriately staffed. For 20 residents there were 5 – 6 care staff on duty [including the manager] on both days of the inspection visit. Some of these staff were very new and were being supervised on ‘trial’ days while the necessary checks were being carried out. There has been a realisation by the manager that to recruit staff more locally is important in terms of reflecting the cultural identity of the resident group. Ancillary staff cover has also improved. There were two domestic staff on duty at the time of the inspection. The improved staffing levels have had a positive effect on the care so that at meal times, for example [see previous comments] there was sufficient staff on Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 20 hand to ensure a positive experience for residents. The home is also maintained in a clean state. The manager was able to show some evidence from staff files of the ongoing training in the home. A training schedule has been drawn up for various external and internal training over the next few months. Staff spoken to had already undertaken some of this training. There was also evidence that staff are given appropriate supervision so that they can be supported in the work that they do. It was difficult for the manager to evidence some of the ‘statutory’ training such as fire safety and manual handling that all staff should receive and the compilation of a training matrix, which can be continulllay, updated was discussed and is recommended for monitoring purposes. NVQ training is offered to staff but presently there are only three of the care staff [out of 11] that have at least at level 2 in this qualification. This should be developed further over the next 6 – 12 months so that a higher percentage of the staff are trained to care for the people in the home. The staff files evidenced appropriate recruitment checks had been made prior to employing staff in the home. Staff files were complete in the detail required and this is an improvement on the previous inspection. The feedback from relatives [survey forms] was positive and staff are seen as caring and interested in their work. Observed care [see previous comments] was also positive. Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The management team are developing processes so the views of residents and their supporters can influence the running of the home so that further improvements to the service can be made. EVIDENCE: The homes proprieter, Mrs Maureen Bromley, is the registered manager. She has many years experience in the home and also has a general nursing qualification [RN]. The deputy manager also plays an important role in the running of the home. Mr Malkandi, also provider, assists in an administration role. Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 22 Staff interiewed felt supported by the manager and felt that they could approach her and the deputy for help and assistance. The management team have tackled the key areas listed as requirements on the last inspection report. The recruitment and provision of staff has improved and the internal environment of the home is now satisfactory. Both of these areas need further development and the manager was able to discuss this and provide the inspector with plans for further commitments. There appears to be a realisation that consistency in terms of management processes is important in the longer term if the service is to progress. A further improvement plan will be drawn up and submitted to the Commission. The manager as able to discuss and evidence some initiatives in terms of quality assurance processes which have hitherto been missing. For example there has been a relative survey carried out with a good return ratio so that the people who use the service are now represented and can have some formal input into the running of the home. The feedback from this was generally very positive and the manager had picked up some ideas for development such as the provision of reading material for one resident. The development of further quality assurance processes and internal auditing can serve to both monitor and provide feedback for further improvements. The manager has started to audit medication and care planning for example. The management of resident’s monies was discussed. The home includes smaller items such as toiletries and small outings in the fees of the home. More substantial purchases such as clothing is billed to families through the homes finance officer. Staff do not handle residents money and the practice is for relatives to manage all monies. The health and safety records were seen and the requirements from previous inspections have generally been met although the fire records still need to be tightened up with respect to regular recorded checks on a monthly basis for fire extinguishers and the recording of fire safety training [last recorded entry over a year ago]. It is still required that a regular [monthly?] environmental risk assessment be recorded so that any environmental risks can be picked up and appropriate action taken. This will compliment the newly commenced maintenance book. Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 24 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 OP19 Regulation 23 Requirement The internal environment of the home must continue to be developed as planned with timescales for completion of the work made explicit. This will further enhance the quality of life for the homes residents. The Registered Person shall ensure that all parts of the home to which service users have access to are practicably free from hazards to their safety; therefore the health and safety risk assessments carried out monthly must continue to be documented. A general risk assessment of all areas must be conducted to identify hazards and risks to residents and appropriate action recorded. External grounds which are suitable for, and safe for use by service users are provided and appropriately maintained; therefore the garden area must be made accessible and safe for residents. Timescale for action 30/12/07 2 OP38 13 30/12/07 3 OP19 23134 01/03/08 Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP3 OP7 OP7 OP12 OP14 Good Practice Recommendations The assessments carried out for residents should be extended to those admitted for respite or for emergency purposes. The care plan is evaluated but the recording of these should be in more detail and should be a record of progress made against the objectives of the care plan. The staff making the record should sign all care notes clearly [signature rather than abbreviations]. The quality of provision in terms of daily activity can be improved by gearing the environment towards enabling residents with dementia to become more autonomous by the introduction of orientation aids and the opening up of external garden areas so that there is more choice. Activities should continue to be developed with reference to good practice in dementia care. The internal environment t of the home should be developed in line with recommendations made in standards 12 and 14. The home should have 50 care staff trained to NVQ level to meet this standard. There needs to be easily accessible monitoring of care staff training and a training matrix is recommended so that up-to-date information on all statutory training is available. The quality assurance initiatives already commenced should continue to be further developed. Monthly checks on fire extinguishers [see schedules] should be recorded. Fire safety training needs to recorded. 5 6 7 8 OP12 OP19 OP28 OP30 9 10 OP33 OP38 Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Merseyside Area Office 2nd Floor South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Prospect House Nursing Home DS0000005467.V346912.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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