Inspection on 15/05/06 for Silverdale Nursing Home

This inspection was carried out on 15th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Silverdale Nursing Home 20/05/08

Silverdale Nursing Home 29/05/07

Silverdale Nursing Home 15/12/06

Silverdale Nursing Home 25/01/06

Silverdale Nursing Home 09/05/05

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

CARE HOMES FOR OLDER PEOPLE Silverdale Nursing Home Newcastle Street Silverdale Newcastle Staffordshire ST5 6PQ Lead Inspector Mrs Yvonne Allen Unannounced Inspection 15 May 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 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. Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Silverdale Nursing Home Address Newcastle Street Silverdale Newcastle Staffordshire ST5 6PQ 01782 717204 F/P 01782 717204 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) Silverdale Care Homes Ltd Care Home 27 Category(ies) of Dementia - over 65 years of age (27), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (27) Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. That Mr Pynadath completes the RMA course. That Mr Pynadath completes the Dementia Awareness Training Course. 25th January 2006 Date of last inspection Brief Description of the Service: Silverdale Mental Nursing Home provides nursing care for up to twenty-seven older people, both male and female, requiring long stay, short stay and respite care with severe mental health or dementia care needs. The home is situated in the residential area of Silverdale and is approximately two miles from Newcastle town centre. The home provides single storey accommodation and comprises of single and shared rooms. The majority of rooms are single rooms and some of them have en-suite facilities. Bedrooms can be personalised by the individual service user. The home has assisted bathing and toilet facilities, two communal rooms, a dining room and a quiet area. There are catering and laundry facilities on site. There are small car parking areas to the front and rear of the home. The grounds are not extensive and are easily accessible to the residents. There is a small patio area to the rear of the home equipped with garden furniture for residents to use during the summer months. Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection was carried out over four hours and was undertaken by two inspectors. The inspection was planned and several methods were used to gather evidence during the visit. These were as follows – Direct observation. Examination of records. Discussions with staff members, residents and a visiting relative. Tour of the premises. A Pre-Inspection Questionnaire had not been completed by the provider. The CSCI had not received any comment cards from residents, relatives, placement officers or GPs. The provider stated that he had not received these prior to the inspection. The provider was not present during this inspection. The nurses in charge at the time explained that they were overseeing the management of the home, as the Registered Manager was no longer employed there. One of these nurses was acting as manager in his absence and the other was the Deputy Manager. Both nurses were Registered Mental Nurses with experience of nursing home management. Since the last inspection the home has received two additional visits. One on 15th March 2006 and the other on 3 April 2006. Serious concerns were found during the first visit in relation to residents’ welfare. Urgent requirements were left and a letter of serious concerns sent to the provider. An action plan was received within the week from the provider outlining his actions and requirements were addressed. On the second visit made to the home inspectors were satisfied that urgent requirements had been addressed, although further requirements were made as a result of this visit. The key standards were assessed at this visit. Some urgent requirements were left at the time of the visit and other requirements have been generated as a result of this report. Verbal and written feedback was left with the acting manager at the end of the inspection and timescales were agreed. Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 Page 6 It was concerning to note that there were eight requirements left on previous visits which have not been attended to. If these requirements are not completed by the next visit the Commission may be mindful to take legal action against the provider. The 17 other requirements should also be completed within the given timescale. What the service does well: What has improved since the last inspection? What they could do better: This care home must improve in many areas and across many of the standards in order to fully meet the needs of the residents accommodated at the home. This must start with the initial assessment of individual needs, which needs to be thorough and comprehensive and needs to take into account the social history, interests and therapeutic needs of the individual. Care plans must be consistent with records completed and regular reviews should include the contribution by the resident’s representative. Individual wishes in respect of spiritual and religious needs must be sought and promoted with Church services held on a regular basis, and some residents may wish to attend Church or have visits from the Clergy. Resident’s views and wishes must be sought from relatives and/or friends or advocates in respect of the routines of daily life in the home. This must include Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 Page 7 evidence that individual residents are able to make choices and that these choices are being upheld by the staff in the home. The Home was weak in promoting diversity and autonomy. Residents are cared for as a group and not as individuals with differing needs. A more holistic approach to care needs to be adopted by the home. The care staff team, as a whole, did not possess the required skills and expertise to meet the residents’ collective or individual needs. Some of the residents had challenging and specific mental health needs, which require an especially skilled staff team. Further staff training, starting with basic skills, needs to be implemented and NVQ training in direct care would be advised for all care staff. The presentation of the environment was very poor in relation to cleanliness, tidiness and décor. Apart from the lounge area, which had improved, the rest of the Home was in urgent need of attention, starting with a thorough clean and sanitation. Presentation of bedrooms was poor. Some of the furniture was worn and broken and in need of replacement. Bedding was showing signs of wear with some sheets and bedcovers in a poor state of repair. There were no duvets and it is recommended that the home now provide these for residents instead of blankets. The provision of ancillary staff was insufficient to meet the needs of the residents in the home and to keep the home running smoothly. More domestic staff, laundry staff and kitchen staff were urgently needed. In respect of the management of the home, the Registered Manager had recently left after only a few weeks in post. The two Registered Mental Nurses were overseeing the overall management of the home. One was acting as manager and the other as deputy manager. Although both nurses had the required skills and experience to run the home, it is now an urgent requirement that there is a permanent manager registered at this home, guaranteeing some stability for the residents and staff. 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. Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 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 Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 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): 3 and 4 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents and their representatives cannot be assured that this home will fully meet their assessed needs. EVIDENCE: A random selection of care plans was examined. Assessments of needs had been carried out prior to admission to the home but some of these assessments were weak and had not taken into account all needs including individual social history. Individual specific needs were not always met as planned and in keeping with the home’s Statement Of Purpose. The evidence gained in order to reach this conclusion is highlighted throughout this report. Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The systems for the delivery of care are weak with the result that not all individual health and personal care needs are being met. EVIDENCE: Case tracking was undertaken in respect of two residents. Examination of their care plans identified that there was no copy of a contract in place for either of the residents. The initial assessment of needs had been weak. One of the care plans had not been reviewed since January 2006. The other one had been regularly reviewed. Daily records were complete. Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 Page 11 There was one safeguarding referral – one of the residents had been referred to a dietician. There was one record of restraint in the form of bedrails, which had been signed by a relative. There were gaps noted in some of the records contained within the care plans. There was no evidence of contribution to the reviews by representatives or advocates. There was no social history on file. Individual wishes at the time of death were not recorded. Spiritual wishes were not recorded. On one of the plans the manual handling risk assessment had not been reviewed since 06 November 2005. Observation charts were examined as part of the case tracking and it was identified that the completion of the fluid intake/output chart was inconsistent with gaps indicating periods of time between the resident being offered any fluids. There was evidence of this resident having been given nutritional supplements twice daily. There had been a risk assessment in relation to tissue viability and the resident was nursed on a pressure-relieving mattress. Through direct observation it was noted that there was evidence of poor personal care. Individual clothing worn by residents was stained. One of the residents, who was being nursed in bed, did not receive a bed bath until midday. Two catheter stands were observed as being dirty and unhygienic. It was noted that one of the beds had been made up that morning using a bedcover, which was stained with faeces. The medication procedure was examined during the inspection visit. The procedure for disposal and removal of medication was queried, as there was no record in place for this. The home had a contract with a waste disposal company for removal of medication three monthly. There was no list in place of authorised staff signatures in relation to the responsibility for administration of medication. Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 Page 12 There were gaps in recording on MAR charts throughout. There was no photograph in place for one of the residents. The two trained nurses in charge explained that they were attempting to review and amend all the systems in the home in relation to the delivery of care. It was identified that some of the staff did not have a very good understanding of individual needs and of the support required to meet these needs. It was directly observed that there was some difficulty with communication between staff and residents where some staff had a limited command of the English language. As a result of some of the issues of concern in relation to personal care, as highlighted above, it was identified that personal support in this home is not offered in such a way as to promote and protect individual privacy, dignity and independence. Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 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 outcome area is poor. This judgement has been made using available evidence including a visit to this service. Although some social activities were taking place these need to be further developed to ensure that individual needs are fully met. There was no evidence of individual choice or diverse needs being upheld at the home. EVIDENCE: There was now a social activity co-ordinator employed at the home who worked 20 hours per week as dedicated activity hours. Unfortunately she had taken her records home and the inspector was unable to examine these. However, these records had been seen on a previous visit to the home. The activity records should be contained within individual care plans so that appropriate individual activities can be organised. Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 Page 14 Discussions with a visiting relative identified that entertainers do visit the home from time to time and she commented that she does see the activity coordinator organising craft sessions sometimes. Inspectors were informed that the hairdresser was no longer visiting the home due to the backwash facility being faulty. The acting manager stated that there were plans in place to develop the quiet room into a hairdressing salon. There were no records of individual residents maintaining their spiritual needs. There were no Church services held in the home and no residents visited any local churches. The provider had previously informed inspectors that none of the residents were interested and that families, when asked, had stated that their relative did not have any interest in religion. There was no evidence available to support this and it is required that the home provide written evidence, signed by representatives of the residents to confirm their wishes in relation to religious/spiritual needs. There was no evidence that the residents were taken on trips out of the home or visited local amenities or places of interest. The inspector met with the cook who was on duty that day. This cook only worked part time and the inspectors were informed that the full time cook had returned back to her native country for an extended holiday. This left short hours in the kitchen and the inspector was informed that the provider covered these hours by working himself but that the home was advertising for more kitchen staff. The inspector asked for evidence that all staff who worked in the kitchen had completed food hygiene training. A list of attendance at a training session held on 15 September 2005 was provided to the inspector after this visit. The menus were examined and these were found to be 4 weekly rotational. There were no documented choices for lunch. The cook told inspectors that she would cook an alternative for those not wanting the main meal. It is required that an alternative is documented on the menus for each meal. The presentation of soft diets had not improved and the inspector discussed this with the cook, explaining that differing foodstuffs must be served as separate portions on a plate so as to help make this appear more appetising for the individual. There was no evidence of residents eating with adapted cutlery and/or crockery, when, for some individuals this would have helped them to eat their meal. Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 Page 15 Inspectors were informed that there had been a nutritional assessment of the menus carried out by a qualified nutritionalist. Inspectors asked for this report but this could not be found at the time. It is required that this be provided and a copy sent to the CSCI. Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Both the acting manager and deputy are familiar with the importance of dealing with complaints and concerns efficiently and of the procedures in relation to the Protection of Vulnerable Adults. EVIDENCE: The CSCI had recently received one complaint directly since the last inspection. The provider had been asked to investigate the complaint issues and provide a detailed report to the CSCI. The acting and deputy managers would now be responsible for dealing with concerns and complaints and they confirmed that they would be logging these and dealing with them according to the home’s policy. The visiting relative stated that she would approach one of these managers should she have any concerns in relation to the care of her relative. Both managers were fully aware of the local procedure in relation to the Protection of Vulnerable Adults. They stated that some staff had received training in this area but that all staff would be receiving this training. Examination of training records identified that some staff had received this training. Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 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): 19,20,21,22,23,24,25,26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Although there was evidence of some improvements, the overall presentation of the environment does not meet with the minimum standards for décor, furnishings and cleanliness. EVIDENCE: Inspectors toured the home visiting all communal areas, kitchen, laundry and most of the bedrooms. The presentation of the environment overall was poor. Most of the bedrooms were in a poor state of hygiene and in need of a thorough clean. There was one example of a contaminated bedcover in room 14 and another in room 8 of traces of faeces on a door and a wall. Sinks and surfaces in bedrooms were unhygienic. Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 Page 18 Some of the bedroom furniture was broken. In room 13 the drawer handle was broken. In room 11 there was a strong mal-odour and a very badly stained carpet. The bath hoist chair located in the bathroom next to room 10 was dirty and unhygienic. There was also an insufficient number of assisted/adapted baths per resident in the home. This had been a previous requirement. In bedroom 3 there were traces of faeces on the chair in the room and the sink was dirty. The carpets in many of the bedrooms were in need of replacement but particularly in bedroom 8 where there had been a leak from the radiator. Carpeting along corridor areas was stained and these were in need of replacement. There was a mal odour along the corridor area by room 13. Some of the bedding was very worn and in need of replacement. It is required that an audit of bedding is undertaken with replacement as needed. The paintwork around the home on doors and woodwork was unfinished. This now needs to be completed. The fire escape door located next to room 18 had a cracked pane of glass. The cracked pane of glass in room 18 had still not been replaced. It was noted that the new windows, which had been installed in many of the bedrooms, opened very wide and could pose a security problem. As all the residents accommodated in this home had some degree of mental health needs, it was identified that individuals could climb out of these windows if they wanted to. Although all the bedrooms were at ground floor level, there was the concern that a resident could escape through one of these windows. Also, there was the issue of security, as someone could easily access the home through one of these open windows. This was discussed with the acting manager at the time and she was asked to conduct risk assessments on all the residents in relation to the above. The provider must also provide evidence of how security will be maintained at the home in respect of the above. Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 Page 19 There were areas where there had been improvements to the environment. Examples of this were the new double glazed windows and French doors and the new lighting/ceiling in the lounge. The provider had obviously invested in quality and had improved the presentation of the environment in this area. Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 Page 20 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 and 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents are protected by the recruitment policy adapted by the home. There is a need for further development of staff training in order to ensure that all staff have the skills to meet the specific needs of the residents. There were insufficient numbers of ancillary staff provided to meet the needs of the residents. EVIDENCE: At the time of the inspection there were 23 residents accommodated in the home. There was an adequate supply of trained and care staff to meet the needs of the residents. On the morning shift from 7am until 2pm there was 1 nurse and 4 care staff on duty. From 2pm until 9pm there was 1 nurse and 3 care staff. Sometimes this can be 4 or 5 staff if adaptation nurses are working. At night, from 9pm until 7am there is 1 nurse working with 2 care staff. Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 Page 21 The acting manager stated that she had just recruited another staff nurse (General Registered Nurse) from the hospital. There was a shortage of ancillary staff hours in relation to kitchen, laundry and domestic and this was reflected in the presentation of the environment. A requirement was made to increase hours in these areas. There were no care staff working toward NVQ qualification in care and this will need to be addressed so as to comply with the minimum standard for staff training. There were 6 nurses from overseas who were undertaking adaptation training at the home through a University. The inspectors examined staff files in respect of the above trainees. These were found to contain the required information and proof of identity. CRB and POVA checks had been carried out as required. The inspector requested to see a copy of the confirmation letter for training from the relevant University and this was duly faxed over to the CSCI following the inspection. Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 Page 22 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, 36 and 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. There is currently no Registered Manager responsible for this home and the previous manager was only registered for a very short time. This inconsistency needs to be addressed in order to bring the home forward in all aspects. EVIDENCE: The inspector was informed that the Manager, who had only recently been registered at the home, was no longer in post. Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 Page 23 Instead, there was an acting manager, who was proposing to apply for registration, and a deputy manager, who was working alongside her. Both ladies were Registered Mental Nurses with past experience of management in nursing homes and both appeared to possess the necessary skills to care for the residents and manage the home, this however will be assessed at the Care Manager interim help prior to approval being given. There was no quality assurance processes in place at the home. The provider will need to undertake a monthly assessment and monitoring of the home as required under the Care Standards Act. A copy of this Regulation 26 report should be sent through to the CSCI local office each month. Other quality auditing will need to take place in order to help improve and maintain standards within the home. Quality assurance surveys must include the views of the residents and/or their representatives. There were no records of formal staff supervision available and the acting manager stated that she would be starting this very shortly. These will need to be available for examination at the next inspection. Training records in relation to mandatory staff training were examined. Staff received updates in moving and handling, fire safety, food safety and other relevant health and safety training. There were gaps noted for night staff in relation to the number of fire drills they had attended. Accidents are recorded and reported accordingly and the CSCI receives notifications of these and other incidents, including deaths of residents. Fire detecting and fire fighting equipment is regularly serviced and records maintained. The home employs the services of a fire safety officer who organises staff training and has conducted a fire risk assessment at the home. The inspector has seen these records on a previous visit. Their was no evidence of COSHH data sheets being available in respect of cleaning products used. This had been a previous requirement. Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 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 x x 3 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 1 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 1 2 2 2 2 2 2 1 STAFFING Standard No Score 27 3 28 1 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 1 1 x x 1 x 3 Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 Page 25 Are there any outstanding requirements from the last inspection? yes 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 OP38 Regulation 23(4)(b)( d) 16(2)(i) 16(2)(g) Requirement All staff must receive at least 2 fire drills per year and these must be recorded PREVIOUS REQUIREMENT Soft diets served must be properly prepared and presented PREVIOUS REQUIREMENT Suitable cutlery must be provided at mealtimes to include adapted cutlery and crockery where needed. PREVIOUS REQUIREMENT COSHH data sheets must be in place together with risk assessments for all COSHH products used and staff must have training in this area PREVIOUS REQUIREMENT Generic risk assessments must be developed in relation to the safety of the building PREVIOUS REQUIREMENT The bath hoist must be thoroughly cleaned and maintained in a hygienic condition to prevent the spread of infection PREVIOUS REQUIREMENT Timescale for action 20/08/06 2 3 OP15 OP15 20/05/06 20/05/06 4 OP38 18(1)(c)(i ) 20/06/06 5 OP38 23(4)(d) 20/08/06 6 OP26 13(3) 20/05/06 Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 Page 26 7 OP21 18(1)(c)(i ) 8 OP33 9 OP3 10 OP7 11 OP8 12 OP9 13 OP30 Sufficient adapted baths must be provided for the number of residents accommodated in the home at a ratio of 1:8. Another two of the baths must be adapted for use. PREVIOUS REQUIREMENT 24(1,2,3) A system for quality assurance must be developed and any surveys must include the views of the residents or their representatives PREVIOUS REQUIREMENT 14(1) All residents moving into the home must undergo a thorough assessment of their needs and this must be documented. 15(2) Individual plans must be complete, consistent and regularly reviewed. These must contain evidence that representatives or advocates are given the opportunity to contribute to the reviews. 12(1) The registered provider must ensure that the home is conducted so as to promote and make proper provision for the health and welfare of individual residents. This was in relation to the completion of care charts. 13(2) The procedure for disposal and removal of medication must be reviewed, made clear and documented. All Mar charts must contain a photograph to identify the individual resident concerned, (with the resident’s consent). 18(1)(a)(c The registered person shall ensure that at all times suitably qualified, competent and experienced persons are working at the care home. This was in respect of some of the staff having poor communication skills and lack of appropriate training. DS0000060541.V294973.R01.S.doc 20/08/06 20/07/06 20/05/06 20/05/06 20/05/06 20/06/06 20/06/06 Silverdale Nursing Home Version 5.1 Page 27 14 OP13 16(3) 15 OP10 12(4)(a) 16 OP14 12(2) 17 OP15 12(1)(a) 18 19 OP15 OP24 16(2)(i) 16(2)(c) 20 OP19 13(4)(a) The registered provider shall ensure that so far as practicable residents have the opportunity to attend religious services of their choice. The registered provider shall make suitable arrangements to ensure that the care home is conducted in a manner, which respects the privacy and dignity of residents. The registered person shall enable residents to make decisions with respect to the care they are to receive and their health and welfare. This is in respect of the promotion of autonomy and choice. The copy of the Nutritional Assessment carried out at the home, which was unavailable for inspection, must be sent through to the CSCI. There must be a documented alternative to the menu available at each mealtime. The registered provider shall provide in rooms occupied by residents, adequate furniture, bedding and other furnishings, including curtains and floor coverings and other equipment needed by the resident. This was in respect of the quality of the bedding and broken furniture in some of the bedrooms. The registered person shall ensure that all parts of the home to which the residents have access are so far as is reasonably practicable free from hazards to their safety: This was in respect of the new bedroom windows having no restrictors in place. 20/06/06 20/06/06 20/06/06 20/06/06 20/06/06 20/06/07 20/06/06 Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 Page 28 21 OP26 16(2)(j) 22 23 OP26 OP36 16(2)(k) 18(2)(a) 23 24 OP31 OP27 8(1)(a) 18(1)(a) 25 OP19 23(2)(b) The registered person shall after consultation with the environmental health authority, make suitable arrangements for maintaining satisfactory standards of hygiene in the care home. This was in respect of the environment and poor standards of hygiene identified at the inspection The registered person shall keep the care home free from offensive odours. The registered person must ensure that persons working at the care home are appropriately supervised. This is in respect of documented formal staff supervision. The registered provider shall appoint an individual to manage the care home. The registered person shall ensure that there are sufficient numbers of ancillary staff working at the home in respect of catering, domestic and laundry staff. The registered person shall ensure that the premises to be used as a care home are of sound construction and kept in good repair externally and internally. This was in respect of the cracked windowpanes and poor paintwork. 20/05/06 20/05/06 20/07/06 20/07/06 20/05/06 20/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 Page 29 1 2 OP28 OP24 NVQ staff training in direct care should be implemented at the home in order to achieve the minimum standard for NVQ training. The provider should consider providing duvets on beds instead of blankets. Silverdale Nursing Home DS0000060541.V294973.R01.S.doc Version 5.1 Page 30 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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