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Inspection on 13/11/06 for Sable Cottage Nursing Home

Also see our care home review for Sable Cottage Nursing Home for more information

This inspection was carried out on 13th November 2006.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents are all assessed prior to admission to ascertain their needs and wishes and these are incorporated into a detailed plan of care. Residents are treated with respect and the home promotes equality by treating people as individuals and ensuring their diverse needs are met. Residents health care needs are addressed and the medication arrangements ensure that all residents receive their prescribed medications at the appropriate times. Care is delivered by a team of well trained staff, who take care to preserve residents` privacy and dignity. Residents are able to maintain autonomy and exercise personal choice in all aspects of their daily lives. The home employs an activities coordinator and all staff are involved in providing opportunities for residents to participate in activities both inside and outside the home. Meals are well balanced and varied with plenty of choice. Complaints are handled appropriately and systems are in place to minimise any risk of harm to residents. Residents are regularly consulted about their care and what they think of the home.

What has improved since the last inspection?

Rainbow Unit is now clean and well maintained, providing a better environment for residents.

What the care home could do better:

The service user guide must contain details of the fees, and the contract must include a breakdown of the fees payable and by whom, to ensure that prospective residents have all the information they need before making a choice whether the home is right for them. All care plans should be kept up to date and intake charts should be completed in sufficient detail to ensure that staff have all the information they need to provide appropriate care for the residents.Residents who require assistance at mealtimes should not be given their meal until a member of staff is available to assist, so the meal doesn`t go cold. Clinical waste should be stored in a locked area to prevent any tampering with potentially hazardous material.

CARE HOMES FOR OLDER PEOPLE Sable Cottage Nursing Home Chester Road Kelsall Cheshire CW6 ORZ Lead Inspector A Gillian Matthewson Unannounced Inspection 13th November 2006 09:30 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 Sable Cottage Nursing Home DS0000018816.V314756.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. Sable Cottage Nursing Home DS0000018816.V314756.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sable Cottage Nursing Home Address Chester Road Kelsall Cheshire CW6 ORZ 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) 01829 752080 01829 752098 Mrs Celia Ann Minshaw Mrs Julie Cummings Care Home 38 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (15), Learning disability (1), Old age, not falling of places within any other category (23) Sable Cottage Nursing Home DS0000018816.V314756.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 38 service users to include:* Up to 23 service users in the category of OP (Old age, not falling within any other category) * Within the 23 OP beds, 1 agreed service user in the category of LD (Learning disability) may be accommodated * Up to 15 service users in the category of DE(E) (Dementia aged over 65 years) * Within the 15 DE(E) beds, 2 service users in the category of DE (Dementia) 20th December 2005 Date of last inspection Brief Description of the Service: Sable Cottage is a care home providing both nursing care for 23 older people and personal care for 15 people with dementia (Rainbow Unit), two of whom may be under 65 years of age. The home is located in a quiet residential area in the village of Kelsall, which is eight miles from Chester. Local amenities such as shops, churches, pubs and restaurants can be found within a short distance of the care home. It is served by local transport. The care home has a pleasant and well laid out garden to the side of the building, which is accessible from the dining room. There is car parking to the rear of the care home. The premises are purpose built and comprise three floors. Nursing care is provided on the two lower floors and a separate unit on the top floor is provided for people with dementia. The care home provides a number of communal living areas. Sable Cottage nursing care unit provides 19 single en suite rooms, plus one double with adjoining bathroom and two double rooms with en suite. The Rainbow Unit provides 15 rooms, all having en suite facilities. A passenger lift and staircases provide access to all levels. Sable Cottage Nursing Home DS0000018816.V314756.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit took place on 13th November 2006 and took eight and a half hours. It was carried out by an inspector of the Commission and Mr. Alf Clemo, an ‘expert by experience’. CSCI are trying to improve the way we engage with people who use services so we gain a real understanding of their views and experiences of social care services. We are currently testing a method of working where ‘experts by experience’ are an important part of the inspection team and help inspectors get a picture of what it is like to live in or use a social care service. The term ‘experts by experience’ used in this report describes people who have been appointed by Help the Aged, under the direction of the Commission for Social Care Inspection, to take part in the inspection of services for older people. The visit was just one part of the inspection. The home was not informed of the date the visit was to take place, but a few weeks prior to the visit the manager was asked to complete a questionnaire to provide the inspector with some information about the service. The manager was also asked to distribute questionnaires to residents, relatives and health and social care professionals to help the inspector find out what they think of the home. Responses were received from four residents, eleven relatives, two health professionals and two general practitioners. All were positive about the standard of care in the home. “ Excellent, caring staff.” “ I am very pleased with the home and the staff are always very pleasant.” “ I am very happy with the care for my father.” During the visit the inspector and ‘expert by experience’ spoke with the manager, staff, residents and visitors. They looked around the premises and the inspector looked at various records held by the home. Most residents expressed pleasure in the home. One said “ I’m very satisfied. The staff are very helpful and the food is lovely. When I was in hospital I couldn’t wait to get home to Sable Cottage.” The resident’s daughter said “It’s a very good home.” Feedback was given to the management team immediately following the inspection. What the service does well: Sable Cottage Nursing Home DS0000018816.V314756.R01.S.doc Version 5.2 Page 6 Residents are all assessed prior to admission to ascertain their needs and wishes and these are incorporated into a detailed plan of care. Residents are treated with respect and the home promotes equality by treating people as individuals and ensuring their diverse needs are met. Residents health care needs are addressed and the medication arrangements ensure that all residents receive their prescribed medications at the appropriate times. Care is delivered by a team of well trained staff, who take care to preserve residents’ privacy and dignity. Residents are able to maintain autonomy and exercise personal choice in all aspects of their daily lives. The home employs an activities coordinator and all staff are involved in providing opportunities for residents to participate in activities both inside and outside the home. Meals are well balanced and varied with plenty of choice. Complaints are handled appropriately and systems are in place to minimise any risk of harm to residents. Residents are regularly consulted about their care and what they think of the home. What has improved since the last inspection? What they could do better: The service user guide must contain details of the fees, and the contract must include a breakdown of the fees payable and by whom, to ensure that prospective residents have all the information they need before making a choice whether the home is right for them. All care plans should be kept up to date and intake charts should be completed in sufficient detail to ensure that staff have all the information they need to provide appropriate care for the residents. Sable Cottage Nursing Home DS0000018816.V314756.R01.S.doc Version 5.2 Page 7 Residents who require assistance at mealtimes should not be given their meal until a member of staff is available to assist, so the meal doesn’t go cold. Clinical waste should be stored in a locked area to prevent any tampering with potentially hazardous material. 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. Sable Cottage Nursing Home DS0000018816.V314756.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 Sable Cottage Nursing Home DS0000018816.V314756.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 & 3. Standard 6 does not apply because the home does not provide intermediate care. Quality in this area is adequate. This judgment is made based on the evidence available at the time of the inspection. Prospective residents have their needs assessed and are given all the information they need to help them decide whether the home can meet their needs, but are not given sufficient information about the fees. EVIDENCE: Upon making an enquiry, prospective residents or their relatives are provided with an information pack that contains the service user guide, the complaints procedure, details of the falls prevention programme, the care plan policy, risk assessment policy and information on bed rails. It also contains details of an advocacy scheme, information about the regulation of care homes and how to obtain an inspection report, and a copy of the latest home newsletter and a blank contract. Sable Cottage Nursing Home DS0000018816.V314756.R01.S.doc Version 5.2 Page 10 Upon making a decision to take up residence, residents are asked to sign a contract that sets out the services to be provided for the fee and the rights and obligations of the resident and the provider. The service user guide does not contain details of the fees the home charges and the contract does not make it clear whether any part of the fees are to be paid by a third party such as social services or the NHS. All prospective residents are assessed by a manager prior to admission to determine whether the home can meet their needs. Sable Cottage Nursing Home DS0000018816.V314756.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10. Quality in this area is good. This judgment is based on the evidence available at the time of the inspection. The health and personal care a resident receives is based on their individual needs and the principles of respect, privacy and dignity are put into practice. EVIDENCE: Case tracking was carried out for three residents. This involved talking with the residents and their relatives, the staff that cared for them and reviewing all documentation relating to them. Plans of care had been devised for most of their identified needs, which set out in detail the action needed to be taken by staff to ensure that all aspects of the health, personal and social care needs of the residents were met. The majority of plans were reviewed monthly and updated as required. However, two residents were identified as having behavioural problems, but there were no care plans in place to instruct staff on how to manage aggressive outbursts. The manager was advised to obtain advice from the mental health team. Also, one resident had a care plan in place for a chest infection, which had not been reviewed for three weeks. Another resident had recently been in hospital and some areas of the care plan had not been updated following discharge. Sable Cottage Nursing Home DS0000018816.V314756.R01.S.doc Version 5.2 Page 12 There was evidence of involvement of residents and their relatives in care planning. Care plans demonstrated that residents’ personal and oral hygiene were maintained. All residents were assessed as to their risk of pressure sores using the Braden risk assessment tool and appropriate equipment was identified and provided. Residents were assessed in relation to their nutritional needs. One resident had a care plan in place relating to nutrition because of weight loss. Although the appropriate diet and supplements were being provided, these were not identified in the care plan and dietary and fluid intake charts were not in sufficient detail to be able to evaluate whether the resident was taking enough. There was a satisfactory policy in place for receipt, recording, storage, handling, administration and disposal of medicines. Arrangements for storage, administration and disposal of medication were satisfactory. Some staff were not using the correct codes for recording when a resident had refused medication or was asleep. Residents confirmed that their privacy and dignity were respected at all times. Customer care was taught as part of the induction training programme. Nursing and personal care were administered in the privacy of the resident’s own room or in the bathroom and all examinations were conducted in private. Residents could have a telephone in their room if they wished. Privacy screens were provided in double rooms. Sable Cottage Nursing Home DS0000018816.V314756.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this area is good. This judgment is based on evidence available at the time of the inspection. Residents are able to choose their lifestyle and social activity and keep in contact with family and friends. They receive a healthy, varied diet according to their needs and choice. EVIDENCE: Sable Cottage Nursing Home DS0000018816.V314756.R01.S.doc Version 5.2 Page 14 Residents could choose when to rise and retire, and were assisted by care staff to wash or bathe and dress in the morning. Visitors confirmed the only restrictions on visiting were those imposed by residents themselves. Visitors were encouraged to become involved in social activities. The registered person employed an activities coordinator and there was an activities plan posted on the notice board, however this plan could change in accordance with the wishes of the residents. There was an individual social activities record and plan in each resident’s file. The activities coordinator organised entertainers, outings and events, which had recently included a day out in Llandudno and an autumn fayre. Two trips out had been arranged for November. Residents had been involved in flower arranging a few days before the inspection and their work was displayed around the home. All special occasions were celebrated in the home and there was a newsletter compiled by the activities coordinator. The local mobile library visited the home every month and Holy Communion was also provided monthly by the local clergy for those who could not get out to church. The home had a pet cat, a parrot and three rabbits. The registered provider also brought in her dog to visit residents. Breakfast was served between 8am and 11am, lunch was at 12.30pm, the evening meal at 5pm and supper at 8.30pm. Menus rotated on a four weekly as well as seasonal basis and there was always a second choice on the menu. Residents confirmed this when in discussion with the inspector. The main meal was served at lunchtime, with a lighter meal in the evening. There were policies on nutrition in the home. Residents’ likes, dislikes and special diets were recorded and the chefs were aware of those who required a special diet. Food for special occasions such as birthdays and anniversaries was provided. Residents could choose to eat in their rooms or in the dining room. They could also eat on the patio in fine weather. Lunch on the day of inspection was steak pie or gammon and egg with chips. Residents had been asked to choose from the menu the day before, but staff and residents confirmed that they could ask for other alternatives if they wished. Staff were observed serving food and providing discreet assistance as required. The expert by experience had lunch with the residents and found the meal to be well cooked and tasty. He noted that the meals were served by two housekeepers. When all the meals had been served they returned to some residents to help them cut their food up. It would have been better to cut up the food as soon as it was placed in front of the resident so they could eat it while it was still hot. One resident who required feeding had to wait several minutes for a member of care staff to come and assist. Residents spoken with said the food was very good Sable Cottage Nursing Home DS0000018816.V314756.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this area is good. This judgment is based on the evidence available at the time of the inspection. Complaints are handled appropriately and residents have confidence that their concerns will be taken seriously. Satisfactory systems are in place to minimise the risk of harm to residents. EVIDENCE: There was a satisfactory complaints policy and procedure on display and a complaints leaflet was made available to residents and their relatives. The complaints procedure was also printed in the Statement of Purpose. Residents said they would inform the registered manager or deputy manager if they wished to raise any concerns or complaints and felt confident they would be listened to. All concerns and complaints were recorded, together with details of the investigation and action taken. The home had received two complaints this year, one of which was resolved and the other was still under investigation. There were satisfactory policies and procedures on adult protection and whistle blowing. Staff received training on abuse awareness during induction and all staff had received further training in May and June. During a recent incident the manager and staff had followed the correct procedures. Sable Cottage Nursing Home DS0000018816.V314756.R01.S.doc Version 5.2 Page 16 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): 19, 22 & 26. The quality in this area is good. This judgment is based on the evidence available at the time of the inspection. The standard of the environment within the home is good, providing residents with an attractive and homely place to live. EVIDENCE: The home was nicely decorated, furnished to a good standard and well maintained. There was an ongoing programme of maintenance, redecoration and refurbishment. Bedrooms were redecorated for each new resident. The garden and patio area were kept tidy, safe and attractive. There was a range of equipment and adaptations in the home, including grab rails along corridors, specialist beds, pressure relieving mattresses, raised toilet seats, wheelchairs and hoists (bath and freestanding). The care home had a passenger lift and a call system in all bedrooms. Residents had their own possessions in their bedrooms, which made for a comfortable and homely environment. Sable Cottage Nursing Home DS0000018816.V314756.R01.S.doc Version 5.2 Page 17 The home was clean and tidy and staff were trained in the prevention of cross infection. There were adequate laundry and hand washing facilities. There were adequate facilities for the disposal of clinical waste, but the area at the back of the home that contained the sluicing facilities and clinical waste bins was not locked. Sable Cottage Nursing Home DS0000018816.V314756.R01.S.doc Version 5.2 Page 18 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 & 30. Quality in this area is excellent. This judgment is based on evidence available at the time of the inspection. Staffing levels, recruitment procedures and staff training ensure that residents are protected and well cared for. EVIDENCE: The home was providing accommodation for 15 people in Rainbow Unit and 21 people in the nursing unit. The home had a full complement of permanent staff and was not using any agency staff. There were three staff working in Rainbow unit from 8am to 10pm. In the nursing unit there were four staff from 8am to 4pm and three staff from 4pm to 10pm, with an additional member of staff to help with the evening meal. From 10pm to 8am there were four staff throughout the home. There was always a first level registered general nurse on duty. In addition, the home employed a full time administrator, a handyman three days a week, a chef, a cleaner on each floor and a kitchen assistant and laundry assistant from 8am to 4pm. Three staff files were reviewed. All the required information and documentation, including references and Criminal Records Bureau checks had been obtained before offering employment. The home had high standards in relation staff training. All staff underwent an induction process linked to Skills for Care standards. The home actively Sable Cottage Nursing Home DS0000018816.V314756.R01.S.doc Version 5.2 Page 19 encouraged ongoing personal development for all staff and had an excellent training programme. Staff who attended external training were expected to disseminate the information to other staff. Training attended since the last inspection had included moving and handling, fire safety, nutrition, oral hygiene, continence awareness, tissue viability, customer awareness, bereavement, management of medicines and dementia care. Copies of training certificates were kept on file. All staff, including domestic staff, had a training and development file. Staff were encouraged to complete a personal journal, reflective diary and a learning log. The management of the care home acknowledged achievement with an in house annual awards ceremony. The home had achieved the Investors in People award with additional accreditation for providing staff with opportunities to maintain a work/life balance. Fifty seven percent of staff had an NVQ Level 2 or equivalent in care. Residents said that staff are skilled and able to meet their needs. Staff were confident and encouraged residents to remain as independent as possible. They appeared happy, hardworking, friendly and responsive to the needs of the residents. Sable Cottage Nursing Home DS0000018816.V314756.R01.S.doc Version 5.2 Page 20 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): 31, 33, 35, 36 & 38. Quality in this area is good. This judgment is based on evidence available at the time of the inspection. The home is well run by a strong management team who provide leadership, guidance and direction to staff to ensure that residents receive consistent, quality care. EVIDENCE: The registered manager is a registered nurse with 20 years post registration experience in caring for older people. She has completed ENB N35 Management in the Private Healthcare Sector and a Business Link Managers course and has managed the home the past ten years. She is supported by a deputy who also has a Diploma in Management and the unit manager of Rainbow unit who has the Registered Managers’ Award and is undertaking a Diploma in Dementia Care. Sable Cottage Nursing Home DS0000018816.V314756.R01.S.doc Version 5.2 Page 21 The home’s training package was externally accredited by Investors in People and had achieved the Profile Standard in August 2003. Customer satisfaction surveys were carried out six monthly and the results were published in the service user guide. These were sent to all key stakeholders. The results of one carried out in October were available and indicated an overall satisfaction with the service. The manager conducted regular audits of falls, accidents and pressure sores. The home was accredited by the Nursing and Midwifery council to provide training for three overseas nurses on supervised practice placements and educational audits were carried out by Manchester Metropolitan University. Policies and procedures were last reviewed in February 2006. The home did not handle residents’ financial affairs. If a resident did not wish to or was unable to handle their own affairs, and there were no family to undertake this task, a solicitor was appointed. The home only retained spending money up to £50 for each resident. Individual records were maintained, which included a running balance. Receipts were given or obtained for all transactions. Three were chosen at random, audited and found to be accurate. Records were also maintained of valuables handed over for safe keeping. Monies and valuables were kept in the safe. Staff were supervised as part of the normal management process on a continuous basis. The registered manager had implemented formal, documented supervision for all care staff working at the home. Supervision records had been devised, which covered all aspects of care practice and the General social Care Council Code of Conduct and Practice. Staff also received an annual appraisal, which covered performance and career development needs. The registered manager carried out risk assessments and ensured that staff received health and safety training. Core training included fire safety, manual handling, infection control, food hygiene and COSHH training. The registered nurse on duty assumed the responsibility for first aid in the home. A fire risk assessment had been carried out. All equipment was tested and maintained at the required intervals, apart from the electrical wiring which should have been tested in September, but this had been arranged for the end of November. Staff were provided with training in safe working practices on a regular basis. Sable Cottage Nursing Home DS0000018816.V314756.R01.S.doc Version 5.2 Page 22 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 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 4 X 3 Sable Cottage Nursing Home DS0000018816.V314756.R01.S.doc Version 5.2 Page 23 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 OP2 Regulation 5 & 5A Requirement The registered person must include details of the fees in the service user guide and a breakdown in the resident’s contract of the fees payable and by whom. Timescale for action 31/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2 3 Refer to Standard OP7 OP15 OP26 Good Practice Recommendations Care plans should be kept up to date and dietary and fluid charts should be in sufficient detail to measure the intake. Food should not be placed in front of residents who require help with eating until staff assistance is available. Clinical waste should be stored outside in a locked area. Sable Cottage Nursing Home DS0000018816.V314756.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Sable Cottage Nursing Home DS0000018816.V314756.R01.S.doc Version 5.2 Page 25 - 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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