Inspection on 01/11/05 for Oak Tree Court

This inspection was carried out on 1st November 2005.

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

Oak Tree Court 10/02/10

Oak Tree Court 24/07/09

Oak Tree Court 05/07/07

Oak Tree Court 29/06/06

Oak Tree Court 17/06/05

Oak Tree Court 16/12/04

Oak Tree Court 22/06/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Robins Close Nursing Home Middle Green Road Wellington Somerset TA21 9NS Lead Inspector Barbara Ludlow Announced Inspection 1st November 2005 09:40 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 Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Robins Close Nursing Home Address Middle Green Road Wellington Somerset TA21 9NS 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) 01823 662032 01823 665010 Majestic Number One Limited Care Home 61 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability over 65 years of age (0) of places Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Up to 35 places for elderly persons of either sex, not less than 60 years, who require general nursing care Up to four persons of either sex, between the age range of 50-59 years, who require general nursing care To include up to 31 beds for personal care Registered for a total of 61 places in Categories PD(E) and OP The manager must commence Registered Managers training within 6 months and achieve a relevant Manager`s qualification by 2005. 17th June 2005 Date of last inspection Brief Description of the Service: Robins Close has been part of Majestic Number One since September 2001. The home offers nursing and residential care. The Deputy has been promoted to the post of Manager, the application for CSCI registration has not yet been completed. The Home is situated in the countryside on the outskirts of Wellington, surrounded by lawn and gardens, which now includes a new level access sensory garden. The home is well presented and has ample parking. The home accommodates up to 61 service users in total. Thirty nursing places are provided. Where nursing is provided the corridors are spacious and wheelchair users can be accommodated. There is a large passenger lift between floors. The facilities for functions and some activities are in the older part of the house previously known as the residential unit. The home has been suitably adapted to provide general nursing care and personal care for an elderly client group. The home is adequately equipped and adjustable beds are provided in the nursing wing. There is a registered nurse on duty at all times. The communal areas had been refurbished and a new kitchen had been installed, at this inspection the ongoing refurbishment programme included new carpets having been fitted to some rooms and redecoration of the dining room. Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over one day by two inspectors for CSCI. The inspection was supported by the homes appointed Manager and Company Director Mrs SA Freestone. The inspectors had an opportunity to discuss the completed pre inspection questionnaire with the Manager before commencing a tour of the premises. The tour included all communal accommodation and a large number of service users individual rooms. The inspectors met and spoke with service users and staff throughout the day in both communal rooms and in private in their bedrooms. Very positive comments about the care, the staff and the food were heard at this inspection. Mealtimes, both lunch and tea were observed in the dining rooms. Service user, Visitors, G.P and District Nurse feedback forms were sent out and 8 visitors/carers, 7 service user and 3 visiting professional written responses were returned. The analysis of the findings is included in the text of this report. The visit concluded at 1830 hours. This was a positive inspection. What the service does well: What has improved since the last inspection? Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 6 The company has now appointed the deputy to the post of Manager. Staff commented that this was working well and service users asked knew who the Manager was and confirmed they would be able to speak to her and one commented that she is ‘very good’. The home was well presented; all bedrooms and communal areas had been cleaned to a good standard. Service users commented on the ‘good job’ done by the cleaners. The redecoration and refurbishment programme continues and the home is maintained to a good standard. Case tracking demonstrated that care plans reflected the care being given. Service users seen at earlier inspections were noted to have benefited from care input, health and social gain was evident. Service users commented that the catering had improved over recent months and positive comments were made by all those asked, ‘foods good’ and ‘foods excellent’. What they could do better: Service users asked were unsure what to expect from the lunchtime menu, it is recommended that table menu cards would be helpful. The management agreed and have already plans to introduce a menu card. One fire door leading to a staircase did not close fully nor easily from the corridor, it is required that this is repaired. Prompt attention to remedy this was agreed with the management at the inspection. Written feedback from three out of seven relatives indicated that they were unsure of the complaints procedure. It was confirmed that the service user guide contained the latest complaints procedure and the inspectors noted that the complaints procedure was displayed at the home. However the complaints procedure on display was not the latest version. It was agreed that this should be updated. Five of the seven relatives responding in writing to CSCI felt that there were not always enough staff on duty. The worked weekend duty rotas examined after the inspection indicated that there were only two carers on duty during the afternoon on the residential wing. A review of this minimum staffing level is recommended. Liquid soap dispensers were found to be empty in a three areas where staff may need to wash their hands, this must be rectified. Medications management was examined; a requirement is made with regard to the fridge temperature. A recommendation about skin creams which should be Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 7 monitored by having an opened on / discard by date recorded. The treatment room was quite poorly lit and this could be improved. Fluid intake must be more carefully monitored for those service users who are in bed and require staff assistance or supervision with eating and drinking. 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. Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 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 Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 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 the following standard(s): 1,2,3,4,5. NMS 6 does not apply. The home has information available for service users to make an informed choice. Service users are assessed prior to admission to ensure that care needs can be met and a trial period is offered. Visits to view the home can be made. EVIDENCE: The home has a Statement of Purpose and is currently updating the Service User Guide. The Service User Guide is given to all service users and copies were seen in bedrooms during the tour of the premises. One new service user was asked if they had received sufficient information. Information had been given to the family who had also made a visit to view the home. It was evident that pressure from the placement authority and on the place available had affected the process for the service user. Care plans seen evidenced the pre admission assessment process by the homes Manager. Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 10 Contractual arrangements for a sample of service users were seen. The social service contracts and third party contributions were documented. The Registered Nurse Care Contribution was seen on the computer record for one service user, this showed the contribution included as part of the costing and was clear. The current fees for residential are: £500.00 to £550.00 per week and the nursing fees are £600.00 to £650.00 per week. The home has been adapted for purpose to meet general nursing and residential service user care needs; it has pressure relieving equipment, hoists and assisted bathing facilities. The home does offer respite care; one service user was receiving this service. Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Care plans evidenced relevant information and demonstrated care assessment. Care being given was in line with the care planned to meet the service users needs. Service users confirmed and were observed to be treated well by staff. Medication was generally well managed, although a requirement is made. EVIDENCE: Care plans were used to case track the care and attention given to four service users, seven care plans were reviewed in total. Care plans were found to be detailed, and had been updated and reviewed. Where manual handling or pressure relieving equipment had been indicated, it was found to be in use. Families had been involved in the care planning process. Relative’s written feedback to CSCI indicated that relatives felt that they are kept informed about important matters affecting their relative. Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 12 All 5 service user feedback forms indicated that the service users like living at the home and feel well cared for and that their privacy is respected. Feedback from visiting professionals indicated good relationships with the local health care services. Professional visitors feedback indicated that communication between the nurses and the GP’s was not always clear. The District Nurses had been assisting the home with the management of a syringe driver. This equipment had been loaned by the district nurses and the homes nurses were not skilled in the administration of medication by this method. The home has arranged training at the Somerset Hospice for staff in early December to rectify this. The homes management is also considering purchasing a syringe driver for the homes use. No service users were reported to have pressure sores. Service users on the residential wing receive input for surgical and chronic wound dressings from the district nurses. Medication management was examined. The treatment room has signage to indicate that oxygen is stored there. The cylinders were all secured. The medications fridge temperature is monitored daily as a high/low reading. It was noted that the temperature had dipped below 0 degrees Celsius to minus 5 degrees Celsius on 21.10.05 which may have affected stock items, the deputy manager was alerted to this at the time of the inspection. The MAR charts are well kept and all medications are logged in and signed for, a second signature is required on the nursing MAR charts. A small number of gaps were seen where signatures had been omitted. This was discussed and the deputy manager agreed to address this with the staff concerned. The stock levels were satisfactory. The deputy Manager was planning to meet with the surgery to discuss prescribing practice to reduce waste where possible. The home has arranged a pharmaceutical waste removal contract. Service user / staff interactions were appropriate and kindly. Service users were very complimentary about staff and the kindness shown by them to service users. One dependent service user did either not have an accurate fluid intake chart or had not been offered fluids at a care intervention. Staff must be vigilant when delivering care to nursing clients who are resident on the nursing wing to ensure that drinks are offered and intake is recorded. Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 The home offers a range of activities arranged by a dedicated activities organiser. Service users can choose whether or not to join in. The menu served looked appetising and was served in comfortable dining rooms or the service users own room. EVIDENCE: The home has an experienced and enthusiastic activities organiser. Service users all commented positively about the activities offered in the written feedback to CSCI and at the inspection. One service user was celebrating a birthday and there was a tea party with a home made birthday cake, was held during the afternoon. The home had held a firework display and had a special tea at the weekend, which service users said they had enjoyed. Visitors are welcomed, confirming this at the inspection and in writing on the feedback forms to CSCI. Service users also felt that their visitors are made welcome at the home and are offered refreshments. Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 14 Social care is included in the care planning. It was observed that one to one input could be more focussed for the less able who remain in their bedrooms. Communal rooms have been refurbished to make them more appealing, with fireplaces and electric coal effect heaters. Bedrooms can be personalised and made homely. The home takes a daily paper. The dining rooms are well decorated and the tables are attractively laid for meal times with linen tablecloths. Meals were served from hot trolleys and were attractively presented. Staff assisted service users requiring help, discreetly. Service users praised the quality of the food. Fresh fruit is offered and some service users were seen having this as an alternative dessert at lunchtime. The kitchen was seen and records were sampled, there were up to date temperature records for hot food checks and for the fridges and freezers routine checks that were all satisfactory. Dietary requirements are recorded the home was catering for special diets that included diabetic, vegetarian and soft diets. The cook stated that cakes are baked most days. Birthday cakes are made and three birthdays were being celebrated that week. The cook and assistant cook confirmed that they had food hygiene certificates. The kitchen was clean and deep cleaning of the cooker was seen to be in progress early afternoon. Lunch was seen the main course: Leek, ham and cheese pie with roast and mashed potatoes, green beans and mashed swede. A vegetarian bake was available and salads were served. Dessert was: treacle sponge and custard, yogurt and fresh fruit. Drinks were served during the day. Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 The home issues the complaints policy in the Service User Guide. The policy that is displayed at the home needs updating. Service users are protected from abuse by the homes policies and current recruitment practice. EVIDENCE: Each service user has a Service User Guide in their room. This contains the complaints policy and information for those wishing to make a complaint. Feedback was obtained from relatives, 3 of the 5 said they were not aware of the complaints policy. The inspectors checked and found the complaints policy on display at the home. The version displayed was not as up to date as it should be and updating is recommended at this inspection. The home has a whistle blowing policy to protect staff to enable staff to raise concerns about practice without fear of losing their position. The homes recruitment practice was satisfactory and included CRB, POVA First checks on all employees. The home reported having received seven complaints during the past 12 months. All had been responded to within 28 days and the Manager reported that none of the open complaints were of a serious nature. CSCI has not received any complaints for investigation within the past twelve months. Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 16 One service user asked about voting confirmed that they had been offered postal votes at the last election. All service users responding to the CSCI questionnaire responded to say that they felt safe at the home. Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The home is clean, tidy and well maintained and appropriately adapted. There is level access around the home and level access around the grounds and garden. Communal and individual accommodation is comfortable and can be personalised. EVIDENCE: The home sits in large grounds and there is a new sensory garden with level access. A tour of the premises was made and the home was found to be clean and tidy. One service user commented that their room was kept very clean and praised the efforts of the domestic staff. Communal rooms are comfortably furnished and arranged to feel homely, fireplaces with coal effect heaters enhance this effect. There are large screen televisions to make viewing easier. Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 18 Individual accommodation can be personalised and many service users have their own items of furniture, pictures, photographs and other personal items. Two bedrooms that previously had hard vinyl floor coverings now have carpets and look much better. There are 35 bedrooms with en suite facilities. Of the 26 residential bedrooms and 2 are below 10sq.m in size. The bedrooms on the residential wing are smaller than the nursing bedrooms. Care must be taken if service users needs increase to ensure that their care needs can be met in these rooms. Commodes are available for the bedrooms (if required) where there is no en suite provision. The home has separate sluice facilities for hygiene purposes. There is staff hand washing facilities although in a number of areas there was no liquid soap available for staff to use from the dispensers or in the service user bathrooms. Aids and adaptations are sufficient to meet the general personal and nursing care needs of the service users at Robins Close. There is a nurse call system throughout the home that is serviced. There are assisted baths. Hot water bath temperature checks are made and the bath water outlet tested at this inspection was within the safe range at 41 degrees Celsius. Pressure relieving and manual handling equipment identified in care plans was seen in use. The home has a fire alarm and detection and fire fighting equipment. The fire risk assessment has been completed. One fire door was identified for attention, the director confirmed this door would be adjusted within 24 hours, this must be confirmed with the inspection response. Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 There was sufficient staff on duty at this inspection. It is recommended that the number of afternoon staff on duty in the residential wing be reviewed. Staff are being actively recruited to vacancies. The recruitment practice was of a good standard. EVIDENCE: The occupancy level at the home was 58 in total with 30 residents being nursing clients and 28 residents requiring personal care only. There was sufficient staff in number for each department at this inspection. The home has been recruiting to its vacancies in all departments, leaving only a small number of vacant hours to recruit into. It was evidenced that the perception of visitors and service users responding to the CSCI questionnaire was that there are too few staff on duty at times. The homes Manager has alerted CSCI by Regulation 37 notification when the staffing number has fallen below the recognised minimum level. Duty rotas were requested by CSCI when this happened for monitoring purposes. Worked rotas were forwarded for checking after this inspection for the dates 22/10/05 and 23/10/05.These rotas demonstrated that the minimum staffing number was provided on these dates for the nursing unit however the provision on the residential unit is less than the anticipated minimum levels for example only Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 20 two carers were on duty for the residential wing between 2pm and 8 pm on both the 22/10/05 and 23/10/05, a review is recommended. The inspectors were informed that staff have worked extra shifts to help out at times of shortage. Staff asked also said they have been very busy at times but are hoping the recruitment will improve the situation. Staff recruitment files were sampled and four were examined in detail. All had been completed in line with NMS 19 schedule two and included CRB checks and were satisfactory. Staff reported that Robins Close is ‘a very friendly’ place to work. Staff were praised by service users, comment included, staff are ‘very good’, ‘kind’, ‘pleasant and very good’. The perception was that staff are ‘very busy’. Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33.35.27.38 The Manager vacancy has been filled and the CSCI Fit person process will begin on the receipt of the application form. The home is well maintained records are stored safely. All financial accounts checked were satisfactory. EVIDENCE: NMS 31 and 32 cannot be assessed at this inspection. The application form for the appointed Manager has not yet been received for processing by CSCI. Staff and service users spoke highly of the new Managers leadership. The home is running well and there is a senior person for the residential wing and a newly appointed Deputy Manager who is based mainly on the Nursing Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 22 wing. These supportive roles were noted to have a positive impact on the quality of the care delivered at Robins Close. A company quality appraisal document is beginning a trial at the home, it is too early to begin to determine the influence of this service appraisal as a quality control and improvement measure, and however this should assist the continued development of the home. Residents meetings are held and it was seen in the questionnaire responses to CSCI that 2 of the 5 service users responding may wish to become more involved in decision making at the home. Service user files were examined and their contractual arrangements were examined. These appeared to be clear and the fees are clearly broken down. Small amounts of personal money can be held for safe keeping, the records of this money were examined and two signatures were seen for all transactions. Receipts are kept for expenditure, the balances are stored safely and access is restricted. Maintenance records were sampled. Fire safety records demonstrated servicing of the fire alarm, emergency lighting and fire extinguishers. Fire doors and exits are checked regularly. One fire door was identified for attention, the director confirmed this door would be adjusted within 24 hours, this must be confirmed with the inspection response see NMS 19. Forty-two staff had received fire training in September and fire drills had been carried out in August, September and October. Hoists had been serviced in October 2005. The chair scales had been calibrated in February 2005. The lifts had been serviced in July 2005. The gas safety certificate was valid until 15/4/05. The nurse call system was checked in October 2005. Other equipment monitoring seen was satisfactory. The home has arranged an appropriate waste collection contract that includes the movement of pharmaceutical waste. The company updates policies and procedures centrally; a number of policies had been updated in September 2005. Accident records were discussed, there had been no accidents reported under RIDDOR since the last inspection. Employers Liability Insurance was displayed but had expired; the latest certificate was copied by fax to CSCI after the inspection. Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 23 All records were stored securely and appropriately. Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X 3 3 Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 25 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 2 3 Standard OP19 OP26 OP9 Regulation 23(4)(b) (c) 13(3) 13(2) Requirement The identified fire door must be repaired to ensure that it closes fully. Liquid soap must be available for staff hand washing. The fridge temperature must be maintained between 2 and 8 degrees Celsius. Skin creams must be monitored for opened on and discard by dates. Gaps must not be left on MAR charts; either the drug administration or reason for nonadministration must be recorded. Timescale for action 14/12/05 14/12/05 14/12/05 Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 26 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 OP15 Good Practice Recommendations Menu cards on the dining tables would be helpful to service users. Service users requiring assistance with there fluid and food intake should monitored closely and accurate records made at each care intervention. The complaints procedure on display should be updated. Care staffing should be reviewed for the afternoons on the residential wing. 2 3 OP16 OP27 Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Robins Close Nursing Home DS0000003284.V254127.R01.S.doc Version 5.0 Page 28 - 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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