Inspection on 17/07/07 for Royston Nursing Home

This inspection was carried out on 17th July 2007.

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

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

Other inspections for this house

Royston Nursing Home 10/02/10

Royston Nursing Home 11/12/09

Royston Nursing Home 10/08/09

Royston Nursing Home 11/08/08

Royston Nursing Home 07/02/07

Royston Nursing Home 24/05/06

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Royston Nursing Home Brighton Road Clayton Hassocks West Sussex BN6 9NH Lead Inspector Mrs A Peace Unannounced Inspection 10:00 17th July 2007 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 Royston Nursing Home DS0000065926.V341321.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. Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Royston Nursing Home Address Brighton Road Clayton Hassocks West Sussex BN6 9NH 01273 845603 01273 842018 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) Care Reminiscence Limited Vacant post Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A Maximum of 17 service users may be accommodated. Date of last inspection 7th February 2007 Brief Description of the Service: Royston is a care home, which is registered to accommodate up to seventeen residents in the category (OP) old age, not falling within any other category. It provides personal and nursing care. Royston is a detached three-storey property, which provides accommodation in single, and double bedrooms located on the ground, first and second floors. There are also two lounges, which are located on the ground floor. A vertical passenger lift provides access to all floors. The property is located in the village of Hassocks. The registered provider of this service is Care Reminiscence Ltd, who has appointed Mr Ramprakash Beeharry as the responsible individual to supervise the management of the care home. The home has appointed a manager who is responsible for the dayto -day running of the home but he has yet to register with the Commission of Social Care Inspection (CSCI) to become the registered manager. Current fees are from £587.00 to £625.00 per week. Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Mrs Ann Peace carried out this unannounced key inspection on the 17th July 2007. This inspection is the first inspection in 2006-2007. It is called a key inspection and will determine the frequency of inspections hereafter. Prior to the visit to the home the inspector reviewed the last inspection report and information gathered about the home. The Annual Quality Assurance Assessment was returned to The Commission for Social Care Inspection (CSCI) unfortunately this had not been fully or accurately completed so could not inform the inspection. We met residents in the communal areas and in their bedrooms, some areas of the home are looking neglected and some decoration and cleaning up is required. A case tracking exercise for four residents living at the home was undertaken to look at how the assessed needs of this group of residents were being met, in the majority of cases these were in good order and staff are meeting resident’s needs. Residents living at the home, staff working at the home and a visitor to the home were spoken with to gain their views of the service, comments were positive and all residents spoken to said they like living at the home. One resident said, “she could not be looked after any better and that staff are kind”. Another resident said “she is happy with her care and everyone is kind”. A letter was shown to us from a satisfied relative, who said, “the staff were supportive and caring and supportive to the family”. One visitor whose father was very ill said the staff were superb. Two CSCI satisfaction surveys were returned to the Commission and were in the main positive about the home and the staff. Recruitment records, training and induction records and records relating to the health and safety of residents and staff were seen. The majority of these are satisfactorily maintained. Requirements from the previous inspection have been met, however new requirements have been made. Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The manager must apply to be registered with CSCI and in future the AQAA should be completed fully and accurately. Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 7 The statement of purpose does not provide prospective residents with information about the room sizes and communal space available to residents with regard to the home not having a separate dining area. Staff should sign when they have received training and induction records must be available in the home for inspection. Staff should research how to minimise the use of aperients and laxatives to the benefit and well being of residents. Not all areas of the home are clean and hygienic to minimise the risk of spread of infection and equipment must be available to safeguard staff. The garden should be cleared of rubbish to make the environment pleasant for residents. All residents who have been admitted for and paying for nursing care should have an adjustable nursing bed. The registered provider should visit each room and all areas in the home and carry out an audit to plan a cleaning, clearing, refurbishment and redecoration plan with an acceptable time scale, this should then be submitted to CSCI for monitoring. Some new equipment and minor repairs are needed in the kitchen. Since the inspection both the manager and Mr Beeharry have contacted us to say some of the areas of concern identified at the inspection have been addressed. 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. Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,5,6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose and Service User Guide does not provide prospective residents with information about room sizes and the communal space available to residents. All residents in the home have a needs assessment. Risk assessments give evidence that the personal safety of residents and the environmental risks have been considered. The home does not provide intermediate care. EVIDENCE: Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 10 The Statement of Purpose and Service User Guide does not inform prospective residents with detailed information about the accommodation with regard to the size of some of the bedrooms and the lack of a separate dining area in the home. No new residents have been admitted to the home since the last inspection but all those presently accommodated have needs assessments. Risk assessments have been carried out that give evidence that the personal safety of residents and the environmental risks have been considered. The Annual Quality Assurance Assessment (AQAA) returned to CSCI said that the home caters for each and every need of service users and their evidence was a constant review. We could see that the assessments have been reviewed. Copies of the resident’s care management summary from Social Services are obtained and taken into account when planning care. A copy of the social worker’s reviews were available. From the case tracking exercise of the care records of four residents the assessment records showed that residents have up to date assessments, risk assessments and care plans formed from the assessments. There are 9 residents accommodated at present so all residents are in a room on their own and staff are able to use the equipment necessary. However due to some of the room dimensions being small they would not be suitable for residents requiring the use of special equipment and, access to the bathroom using equipment would be difficult, this must be taken onto account when new residents are admitted. Also there is a lack of suitable nursing beds. The home does not provide intermediate care. Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. In the majority of cases the health and personal care that residents receive is based on their individual needs and the principles of respect, dignity and privacy are put into practice. EVIDENCE: The care plans seen are reviewed monthly, daily records are maintained to monitor any changes to the health and welfare of residents. Staff have handovers between each shift to ensure all staff are made aware of the ongoing condition of residents and any changes. One resident’s records were contradictory to the daily report, this was discussed with the manager who said due to language difficulties what had been written was not what was meant. Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 12 In another there was an inappropriate entry the manager was reminded of the importance of accurate records and advised to address this during training and supervision sessions. Care plans are signed by residents or their relatives to say they agree with the care planned. Individual risk assessments are in place, for example: risk of falls and pressure area damage. Records showed that residents have access to other health professionals as required. The home is registered for nursing care, however there are only five beds suitable for residents who require nursing. One resident whose health has deteriorated quite quickly is being nursed in an unsuitable divan bed which could pose a health and safety risk for the resident and the staff. Pressure relieving equipment is available, however the manager was reminded that the airflow mattresses must be inflated to the correct pressure for the resident’s weight otherwise residents could be at risk from pressure area damage. Residents spoken to were very complimentary about the home and the way the staff care for them. On the day of the visit one resident was very poorly and being nursed in bed, a relative told us that they had been kept well informed about their fathers condition and that the care staff give to him is superb. They said they were well supported by the staff and always offered refreshments. This indicated that when people are dying staff do know how to care for them and support relatives. One resident said, “she could not be looked after any better and that staff are kind”. Another resident said “she is happy with her care and everyone is kind”. A letter was shown to us from a pleased relative who said, “the staff were supportive and caring and supportive to the family”. Two satisfaction surveys were returned to the Commission and both said that the staff meet the needs of the residents and respect residents. Staff were observed to speak to and care for residents with respect. The AQAA sent in by the home stated that the home monitors its care practices with an ongoing survey but there was no evidence that a system to monitor quality is in place. Mr Beeharry does visit the home to monitor it on a monthly basis as required but alone this does not constitute a quality assurance system. The medication administration procedures were discussed and policies and procedures are in place to ensure safe medication administration. Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 13 A random selection of medication was checked and found to be in order. Medication administration charts (MAR) are completed as they should, which indicated that residents are receiving their medication as prescribed. Photographs of residents are with their MAR charts It was noted that eight out of the nine residents had been prescribed aperients/laxatives; The manager told us that this was just used as required and not on a regular basis. However medication administration records showed that six residents were having this once or twice a day continually. The manager was advised to refresh himself on the guidelines for overuse of laxatives and try to address this problem through the residents diet. Royston Nursing Home DS0000065926.V341321.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): 12,13,14,15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Activities are arranged on a regular basis However these activities are general and not person centred related to their previous interests. Arrangements are in place to ensure residents maintain contact with family and friends. Residents have their legal rights protected. Residents are offered a well-balanced and varied diet and menus are developed taking into account resident’s likes and dislikes in food. EVIDENCE: The activities programme displayed indicates that activities provided include chair exercises, films, manicures, dominoes, short walks and visiting musical entertainment occasionally. However these activities are general and not person centred related to their previous interests. Care staff provide and arrange activities and on the day of the visit was lady was pleased because she had been given a manicure. While there are only 9 residents in the home staff are able to manage the limited activities offered however if more Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 15 residents are admitted, hours for activities must be in excess of staff care hours. Activities are recorded in an activity book, when they take place and the residents that participate. On speaking with some of the residents about activities, some were happy with what was on offer; others did not choose to participate. Residents are able to bring personal possessions into the home and they or their representatives look after their financial affairs. Menus offer residents a varied well-balanced diet. The cook also works as a senior carer and knows the residents well. She tells them on a daily basis what is on the menu and asks what they would like. Comments from residents were all complimentary about the food served. A record is maintained of resident’s daily food intake and special diets are catered for. On the day of the visit residents were offered chicken pie or sausage casserole with fresh mixed vegetables and mashed potatoes followed by a choice of desserts. The casserole was sampled and was very tasty, residents said they enjoyed their meal and staff were seen to help those who could not manage alone with sensitivity. One satisfaction survey did say that when the usual cook was not on duty the meals could be better; The manager was advised to monitor this and take any action that may be required. The home does not have a separate dining area so residents eat their meals in the lounge areas on small tables or in their bedrooms. Residents told us that visitors are encouraged and are always made very welcome. One visitor told us that they are always made welcome and refreshments offered. The kitchen was clean and tidy and fridge/freezer temperatures and food temperatures are recorded daily. The food chopping boards and trays are very worn and should be renewed to minimise the risk of spread of infection and part of the kitchen unit needs repairing. Royston Nursing Home DS0000065926.V341321.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): 16,18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a clear complaints procedure in place that is available for residents and relatives informing them of the process for making a complaint. Current procedures and practices ensure residents are protected from harm. EVIDENCE: The home has a clear complaints procedure displayed in the front hallway, and The manager said each resident is given a copy on admission to the home. CSCI has received two complaints about the home since the last inspection both of these were referred to the Social services departments and the manager said there were no outstanding complaints at present. Two residents spoken with said they would speak with the manager should they have any worries or concerns, although one satisfaction survey said they had not been given a copy of the complaint procedure and did not know who to complain to. Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 17 Training records of typed lists indicated that staff have undertaken training in the Protection of Vulnerable Adults in 2007. However these records did not evidence that staff on the list had attended training, the manager was advised to ensure staff sign to say they had attended the training. Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 18 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): 19,20,22,24,25,26. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents live in safe environment but regular maintenance is needed to bring the premises up to an acceptable standard. Suitable bathing facilities are available for the residents presently accommodated. The majority of the home is clean but there is a risk of spread of infection from the staff area and dirty equipment. EVIDENCE: The home is located on the main road running through Hassocks. There is a car park to the front of the home and gardens to the rear. Flowering hanging baskets had been hung around the front of the home. Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 19 Resident’s bedrooms had been personalised to make them more homely. At a previous inspection it was noted that when Mr Beeharry applied to be the registered provider it was advised that some of the bedrooms within Royston were too small with regard to the provision of nursing care, to allow for staff and equipment to be used both sides of the bed when required. Also concerns were raised to the suitability of some of the beds when using a hoist. A complaint was recently made about this where a resident had been accommodated in an unsuitable room. The issue of the small rooms was again raised with the manager to ensure that the environment meets the needs of any future residents accommodated in these rooms and that they would b able to have access to bathrooms. Also it is a concern that the home has only five beds that are adjustable height and suitable as nursing beds. At present here are adequate bathing facilities for the residents presently accommodated and we were told that all residents are able to access the bathrooms. The temperature of the water is regularly tested to ensure it is within safe limits. The home has two lounges for residents to use, on the day of the visit six residents were using one lounge and the other was unused. There is no dining room available at the home. We were told that there are plans to build a conservatory at the home but this was not recorded in the AQAA that was sent to CSCI before the visit. The fire service has recently visited the home and has confirmed that the premises are safe and that the earlier required work has been carried out. Records indicated that regular checks are carried out on the fire safety equipment and records were available of other safety checks carried out in the home. Many areas of the home are in need of decoration, some resident’s bedrooms are not up to standard, plastering had been carried out and not painted over and in other resident’s rooms painting had been started but not completed. Some furniture is worn and looked neglected. One radiator cover was very stained and looked dirty and some of the divan beds are in poor repair, stained and ripped. The rear garden is laid with lawn and has garden seating available for residents. However the garden at present does not have a pleasant outlook as there is an old bath, old carpets, tables, commodes, a fish tank, jugs, vases and other rubbish and rubble around the garden. Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 20 One open sluice did not have goggles I do not think there is anything about this in the standards, we should remove which are necessary to protect staff from splashes of bodily fluids and there were no gloves available. The staff toilet and wash area was very dirty, There were tiles off the wall and the wallpaper was hanging off. There were no paper hand towels or alcohol hand gel only a fabric hand towel. If an infection should occur in the home there would be a risk of infection spreading. Many of the commodes were in need of cleaning and the hoists were dirty which is also an infection control risk. Since the inspection the manager and Mr Beeharry have contacted us to say a number of the issues identified have now been addressed. Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 21 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): 27,28,29,30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides adequate staffing levels to ensure resident’s needs are fully met. Residents are protected from harm by the home’s recruitment procedures. In the majority of cases staff are provided with the training necessary to ensure they are competent to do their work and meet the needs of the residents. EVIDENCE: On the day of the visit 9 residents were accommodated at the home. There were two qualified nurses, one carer, a cook and a cleaner on duty in the home. Residents and a visitor spoken with felt the staffing numbers were sufficient to provide for the current needs of residents accommodated. The staff file was examined for the two new members of staff employed since the last inspection. Prior to employment two satisfactory references and a Protection of Vulnerable Adults (POVA) check had been carried out. A Criminal Records Bureau check was also obtained. However the manager did have Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 22 difficulty locating some of the records to prove safety checks had been carried out and is advised to organise them in a better fashion. The manager told us that the new staff had received an induction into the home and did show us an induction policy and an induction-training package, however neither the basic induction records nor the ongoing induction records for the new staff could be found during the visit. The AQAA records that 90 of care staff have achieved National Vocational Qualification level 2 in Care. There were also typed lists of the staff which indicated the different training they have received, however Mr Gunowa was advised to ensure staff sign at the point of training to show they have attended. Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 23 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): 31,33,35,37,38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager for the home is not yet registered with the Commission of Social Care Inspection. In the majority of cases the health and safety and welfare of residents and staff is protected at all times. Residents, relatives and other stakeholder’s views of the home are not obtained and the results of surveys are not published. In the majority of cases staff have training in order to safeguard residents, but there were no induction records for new staff. Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 24 EVIDENCE: Mr Gunowa has been appointed as manager of the home following the resignation of the former manager. Mr Gunowa has still yet to apply to the Commission of Social Care Inspection (CSCI) to become the registered manager. This was outstanding at the previous inspection and is now a requirement. The Annual Quality Assurance Assessment which homes have to complete as part of the inspection process did not contain enough information to inform the inspection visit, there were lots of statements of ongoing auditing but there is no evidence that this is happening. The importance of completing the AQAA fully and accurately was discussed with Mr Gunowa at the conclusion of the inspection. The AQAA states that the residents and relatives have input into the home and that practices are continually audited and improvements made as a result of their input but there was no evidence of how this is achieved. Mr Gunowa was reminded that results from surveys must be available and feedback on surveys published and made available to current residents and relatives. This lack of evidence was also noted at the last inspection when Mr Beeharry told us that surveys for 2007 had been send out to health professionals, residents and relatives. These were again not available in the home. There was evidence that regular regulation 26 visits are carried out by the registered providers to monitor the home on a monthly basis but this does not constitute a quality assurance system. All equipment and systems in the home are maintained and serviced within appropriate timescales. A staff supervision and appraisal system has been commenced, Mr Gunowa was advised to address how and what staff are recording in the care records because in two cases inappropriate comments in care records had been made. Mr Gunowa stated that the home does not look after the finances of any of the residents. The issue of the health and safety and welfare of residents and staff was mentioned earlier in this report with regard to the size of some of the resident’s rooms and the lack of suitable nursing beds. Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 25 There is an issue of staff safety in regards to using hoists with unsuitable beds, and the absence of suitable protected equipment in the sluices. The typed lists of staff names indicated that training in health and safety is provided, as stated previously staff should sign to say when they have received the training. Records to evidence that new staff have been inducted into the home and have had appropriate training were not available. Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 26 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 2 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 3 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 X 18 3 1 2 X 1 x 2 2 1 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 2 X 1 X 3 X 2 2 Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4 (1) (c) Schedule 1 (16) 9 (1) 13(3) Requirement The statement of purpose must state the number and sizes of rooms in the care home. The manager must start the process to become registered with the Commission. The registered person must make arrangements to prevent infection, toxic conditions and spread of infection at the care home. Also provide equipment to safeguard staff from risk of infection. All new staff should receive induction and records must be available in the home. The premises to be kept in a good state of repair externally and internally. A programme of routine maintenance and renewal of fabric and decoration of the premises shall be produced and a copy sent to the Commission by All parts of the home must be clean and reasonably decorated. Timescale for action 31/08/07 2. 3. OP31 OP26 31/08/07 31/08/07 4. 5. OP38 OP19 18(1)(c) i 23(2)9b) 31/08/07 31/08/07 6. OP19 23(2)(d) 31/08/07 Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 28 7 OP19 23(2)(n) 8 OP19 23(2)(o) 9 OP33 24(1)(a) & (b) All residents accommodated and paying for nursing care should have a suitable adjustable nursing bed. The Commission to be informed of action that will be taken by External grounds must be cleared of rubbish so that residents have access to a safe and pleasant garden. A quality assurance system should be in place which is reviewed at regular intervals to improve the quality of care at the home. 31/08/07 31/08/07 31/08/07 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 OP9 Good Practice Recommendations The qualified staff should research and update themselves in the effects and alternatives to the long-term use of aperients and laxatives in care homes. Royston Nursing Home DS0000065926.V341321.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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