Inspection on 05/09/07 for Sloane House Nursing Home

This inspection was carried out on 5th September 2007.

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

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

Other inspections for this house

Sloane House Nursing Home 05/09/06

Sloane House Nursing Home 09/01/06

Sloane House Nursing Home 17/06/05

Sloane House Nursing Home 31/01/05

Sloane House Nursing Home 28/10/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Sloane House Nursing Home Sloane House Nursing Home 28 Southend Road Beckenham Kent BR3 5AA Lead Inspector David Lacey Unannounced Inspection 5th September 2007 09:45 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 Sloane House Nursing Home DS0000010141.V343516.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. Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sloane House Nursing Home Address Sloane House Nursing Home 28 Southend Road Beckenham Kent BR3 5AA 020 8650 3410 020 8650 5009 managersloane@dsl.pipex.co.uk 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) The Mills Family Limited Ms Traute K M Gladstone Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Staffing Notice issued 28 September 1998 Date of last inspection 5th September 2006 Brief Description of the Service: Sloane House is a large, detached building in a residential area of Beckenham. It has been converted for use as a care home providing nursing care for older people. The home has a team of qualified nurses, supported by care and ancillary staff. There are single and shared bedrooms, most of which have ensuite facilities. Accommodation for residents is on different floors, with access by passenger lift. The home has some off-street parking at the front and a back garden with patio. There are bus and rail services nearby, with links to the public tram service. The fees for this home range from £750 to £850 each week (this information given to the CSCI in September 2007). Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection included an unannounced visit to Sloane House, carried out by an inspector who was accompanied by one of the commission’s ‘Experts by Experience’. During the visit, we observed some care practices and spoke with residents, visitors, staff members and the persons in charge of the home. The home’s manager was away on leave. The inspector also toured the premises and sampled documentation such as care plans, staff recruitment files and medication charts. Residents and relatives were surveyed to gain their views about the home and its service provision, and their responses have been incorporated into this report. The commission carried out a random inspection in December 2006, which followed up the home’s progress in meeting requirements and recommendations from the last key inspection. What the service does well: What has improved since the last inspection? Some former shared bedrooms have been refurbished, to become single rooms with en-suite facilities. There is a new summerhouse for residents to use in the warmer weather. Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 6 There is more evidence of residents’ and/or relatives’ involvement in care planning and review. What they could do better: 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. Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 7 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 Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 8 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, 2, 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with enough information about the home to decide if they wish to move in. Residents are assessed before being offered a place in the home, and have contracts with terms and conditions. EVIDENCE: Two residents stated they had received enough information about the home before moving in so they could decide if it was the right place for them. One said insufficient information had been received, and one was not sure. Relatives/friends who returned survey questionnaires to the commission stated that their relative either always or usually gets enough information about the home to help them make decisions. Service user guides, including a copy of the last inspection report, were seen in residents’ bedrooms. The home’s statement of purpose was kept in the manager’s office, and was available to residents or their representatives on request. Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 9 Of the residents who returned survey questionnaires to the commission, one stated s/he had received a contract, two that they had not, and one resident was not sure whether s/he had received one. Three residents’ files were sampled and each contained contracts/statements of terms and conditions. Residents’ needs are assessed before they move in to ensure the home is suitable. Pre-assessment information was seen on a sample of residents’ files, and a resident explained how staff had asked her and her family about her needs to make sure the home could meet them. Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ care plans are based on assessment of their needs, and provide guidance to staff. Residents have good access to local health care services. The administration of medicines is generally satisfactory, with a few aspects needing attention. EVIDENCE: Of the residents who returned completed questionnaires to the commission, two stated they always or usually receive the care and support they need. One resident stated s/he sometimes receives this. One did not respond to this question. Two residents stated they either always or usually receive the medical support they needed. One stated s/he sometimes received this, and one commented, “I don’t think I need any”. Care plans I sampled had been drawn from assessment of the resident and offered staff guidance to ensure all aspects of the residents’ needs are met. Documentation seen showed that specific needs, such as continence and nutrition, had been assessed and were being kept under review. There was some evidence of residents’ and/or relatives’ involvement in care planning and Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 11 review. The standard of care documentation is monitored by the manager and through the monthly provider visits. The relatives or friends who returned survey questionnaires to the commission stated they felt the home always or usually meets the needs of their relative. One commented, “My relative has many and various needs which are met daily. The care plan is available for discussion”. Three stated the home always gives the support or care that they expected or agreed. One preferred to just offer a comment, “I have seen and signed the care package they have set up”. A relative said she had no complaints about the care, “as far as I can see, everyone is kept clean and well fed, and the staff are friendly and treat the residents with compassion”. A person whose relative had recently been admitted to the home commented, “We are very satisfied with her care so far”. During our visit, we saw and heard about good standards of care being given to residents. We also saw some inappropriate practice in moving and handling residents, which is discussed below under the Management and Administration standards. Health care services are made available to residents as they need, including a visiting GP. Discussions and scrutiny of documentation showed that the home maintains good liaison with local health and social care services. The home has two part-time physiotherapists, which is a service much appreciated by some residents. Medicines were seen being administered at midday by one of the qualified nurses. Administration was being carried out safely, in line with the home’s procedures. There were no residents who were managing their medication. Medicines are stored in several places within the home. The storage on the middle floor, next to bedroom 8, has no natural or artificial ventilation. The temperature was 24 degrees C when I inspected but was said to get hotter when the weather is warmer. The large cupboard opposite the visitors’ toilet is also used for drug storage. Its thermometer was showing 28 degrees C at the time of inspection (requirement 1). Controlled drugs (CD) are stored in a room next to bedroom 10. The CD records and stock that I checked with the nurse in charge were satisfactory. However, a bottle of temazepam elixir with a manufacturer recommended discard date of three months from opening did not have the date of opening recorded (requirement 2). The Nomad Duo Disposable system for night medication had labels inside the dossette, which were difficult to read to determine what the tablets were (recommendation 1). The medicine charts I sampled showed no unexplained gaps in administration records. The homely remedies protocol had been signed by the home’ visiting GP in April 2007. Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 12 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 good. This judgement has been made using available evidence including a visit to this service. Residents have opportunities to take part in various activities, though would benefit from further development of the activities programme. The home needs to ensure all its residents are supported to make choices. A nutritious, balanced diet is provided and residents generally like the food served. EVIDENCE: We heard mixed comments about the provision of activities that indicated residents might benefit from more variety in the activities and outings offered as well as more frequency. One resident said she was very happy with the home, as there are plenty of things to do and that she enjoyed being there. A visit by musicians had been very successful and she believed more were planned. Another resident commented that the activities coordinator came to play games with the residents once a week, but it would be better if she did this more frequently. Other residents said that if they were aware of any trips out, they usually went on them and said they had been to a local park recently and some gardens. Some residents seemed not to be aware of trips out. One said she would enjoy a trip to the theatre if it were arranged. Another resident said that she used to enjoy dancing but there was no opportunity to dance here. Of the residents who returned completed questionnaires to the Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 13 commission, one stated the home usually arranged activities that s/he could take part in, and three stated this was sometimes the case. Three relatives commented positively about entertainments provided, mentioning the visiting musicians and a recent dog show. We saw little evidence of any activities being offered throughout the day of our visit. A residents’ newsletter was pinned to a notice board in the reception area informing residents of future activities, such as visiting musicians and entertainers. Residents said they had enjoyed the recent garden fete and there were photos of this event on the notice board. The newsletter was also available in residents’ rooms. One resident was unaware of any forthcoming activities. This might be because the newsletter was printed in a font that would be difficult to read for people with some visual impairment. The notice in the reception was pinned quite high up and might have been hard to read by anyone of average height or with a stooped posture, or visual impairment. The newsletter in bedrooms was in the same format (recommendation 2). I spoke with a pastoral assistant from a local church, accompanying the vicar in a visit to the home to conduct a communion service. She told me they visit the home to conduct a service twice each month, and will visit at other times on request. She said she had been visiting the home for the past seven years and has always been made welcome. Of the relatives who returned survey questionnaires to the commission, three stated the home always helps their relative to keep in touch with them. Two did not answer this question. One person said the home is good at maintaining relationships with its visitors, “I am always made very welcome and offered refreshments”. Four relatives stated the home either always or usually supports people to live the life they choose. Another commented that residents “would rather be at home but support here is good”. There were minutes of a residents’ meeting held in April 2007, attended by sixteen residents and two visitors, when topics discussed had included food, activities, newsletter, care and cleanliness. Some choices had not been met (requirement 3). For example, one resident said she had always been on the ‘second sitting’ at lunchtime and she would like to have the opportunity to swap sittings sometimes. Because the dining room is too small for the number of residents accommodated, there are two sittings. It was understood from staff on duty that residents are allocated to a particular sitting rather than choosing one, and there is no opportunity to change. Any new residents are allocated to the same sitting as the previous occupant of their room. Another example we saw was when a resident expressed a strong aversion to being hoisted and told the carers she did not want them to move her. She was being taken into lunch and the carers proceeded without taking her wishes into account. They did explain the need for her to go and eat but she continued to protest. Staff handled this resident Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 14 reasonably gently and spoke to her gently but it was not clear why it was necessary to compel her to attend a meal if she did not wish to go, and why she was not offered the opportunity to have her meal in the lounge instead. Other residents appeared to be supported to exercise such choice, for example, one said she had had breakfast in her room that morning, which she enjoyed. She was pleased to have the option of eating in her room if she wanted to and praised the relaxed atmosphere in the home. A further example of where preferences could be supported came from a resident who had an adjustable height bed. She said she wished the carers would always remember to return the bed to its normal height, as she had a struggle to use the foot pedal herself. Such adjustable beds are provided throughout the home and staff should ensure that whenever possible they leave an adjustable bed at a height preferred by the resident. The dining room was clean and attractive. As noted above, because it is too small for the number of residents, lunch is held in two sittings. Tables were set with condiments, napkins and tablecloths, fresh flowers and cutlery, and some residents were enjoying a sherry with their lunch. The choice of food was good, and it looked appetising and well balanced. Carers offered sensitive assistance to people who needed help with feeding, and were patient and attentive. There was no mention on the menu of the availability of drinks and there were no water jugs or juices actually on the tables or at the side of the room. A resident said these were usually available on the side. It may have been the case that they had been removed by the time of the second course of the second sitting. A carer began to offer teas at the end of the meal, which was welcomed by residents. There were cold drinks dispensers in the living room. We did not see any bowls of fresh fruit available in the living areas or dining room. Of the residents who returned completed questionnaires to the commission, three stated they usually liked the meals at the home, and one stated s/he sometimes liked the meals. Several residents said the meals are good. One said, “The food is nice, it’s plain food but that’s what I want at my age, I don’t want spicy stuff”. She said she gets offered a choice of meal. Another resident said the food was “edible, but not much more”. She would have preferred more variety with vegetables, and said her relative often supplements her meals with food from home. Sloane House Nursing Home DS0000010141.V343516.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected from abuse and any concerns or complaints they raise will be listened to and acted upon. EVIDENCE: Of the residents who returned completed questionnaires to the commission, three stated they either always or usually knew who to speak to if they were not happy. One commented, “I don’t know who to speak to – I would find out who is in charge”. Two stated they knew how to make a complaint and one that s/he did not know how to do this. One resident preferred to offer a comment, “I would find someone to complain to”. All of the relatives/friends who returned completed questionnaires to the commission stated they knew how to make a complaint about the care provided by the home if they needed to do so. Four said the home had always responded appropriately if they or the person using the service has raised concerns about their care. One did not answer this question, commenting that they had not needed to raise any concerns. The commission has not received any complaints or allegations about this home since the last inspection. The home’s complaints book showed eleven complaints received over the past year, including five from the same source. These had been recorded in a format that outlined the complaint and the actions taken. Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 16 Staff members spoken with were aware of their responsibilities with regard to safeguarding the residents in their care. The home had an abuse policy on file, which takes account of the local (Bromley) safeguarding guidance and which gave the contact number for the Bromley adult protection manager. The review date for this policy was stated as March 2006 but it was not evident this had been carried out at that time and some details about the CSCI needed updating. The home’s whistle-blowing policy, which refers to relevant legislation, dates from July 2000. There was no evidence the policy had been reviewed since that date (recommendation 3). Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, comfortable and well-maintained environment. EVIDENCE: The home has a pleasant, homely reception area where fresh flowers gave a good impression as well as a welcoming scent. The home looked clean and attractive with a pleasing conservatory adjacent to the living area. The lounge was reasonably homely and decorated attractively. Furnishings looked in reasonable repair, although one chair seemed to lack a seating cushion. Of the residents who returned completed questionnaires to the commission, three stated the home was always or usually fresh and clean. One stated this was sometimes the case. A visitor stated the home is “always attractive with flowers and pictures”. A resident told me she enjoys being in the home’s garden when the weather is nice and pointed out the new summerhouse for Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 18 residents to use. Several residents commented on how nice it was to look out over the garden and watch bird life. The bedroom of a resident who was sharing with another resident was clean, light and well furnished, and had a pleasant aspect. The resident I spoke with found the sharing arrangement was acceptable and worked satisfactorily. The room had an en-suite toilet and washbasin. A resident said that when the hairdresser visited, she washed her hair for her in the resident’s washbasin and she would bend forward over the basin. She commented “Some of the ladies say that it makes them go dizzy bending over the basin, but I am quite a tough person, me. I’m alright!” The home should consult residents about whether access to adjustable hairdresser’s basins might be preferable (recommendation 4). There were no unpleasant odours anywhere that we visited, which included bathrooms, toilets and residents’ rooms. Infection control procedures were in place and staff showed good understanding of basic infection control principles. The laundry was well organised, with all machines in good working order, and the assistant was able to describe how she deals with soiled laundry. A contract for the disposal of the home’s clinical waste was in place. Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Suitably qualified and competent staff are employed to meet residents’ needs. They must be deployed so that residents are supervised and receive prompt attention when needed. The home’s recruitment procedures are robust and offer protection for residents. EVIDENCE: On the day of our visit, the staffing level and skill mix were sufficient to meet the needs of the residents in the home. There were two qualified nurses on duty, supported by six carers. Ancillary staff on duty included two cleaners, a cook and a kitchen assistant, and one staff member working in the laundry. All of the residents who returned completed questionnaires to the commission stated that staff listened and acted on what they [the residents] said. Two residents stated staff were either always or usually available when they needed them, and two stated this was sometimes the case. There were several occasions during our visit when we observed a lack of supervision of residents, and residents having to wait to receive attention. For example, one of us sat in the conservatory during the morning and became aware of requests from residents for help. One request was for a cushion to be repositioned, another was for a glass of water. Another resident was asking for assistance to go to the toilet. A resident said that she needed her pad changed. Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 20 There was no-one present in the conservatory supervising care so the observer went to ask staff for assistance. Help was sorted out immediately for the first three residents but the resident whose pad needed changing was not attended to and when seen half an hour later appeared to be in considerable discomfort. A further request for help had to be made on behalf of this resident. A resident in a wheelchair in the living room also seemed to be in discomfort and two other residents said that they thought he needed assistance. When spoken to, he indicated that he was in discomfort. Again, there was no supervision in the living room at that time. Residents need prompt attention with personal care needs and staff need to be in close attendance (requirement 4). Of the relatives who returned completed questionnaires to the commission, three stated that staff always have the right skills and experience to look after people properly, and two that this was usually the case. One relative said, “The staff have the right skills. They have helped my relative quickly when he required help for bathroom or feeding”. Another commented, “People have different needs and the staff can be seen looking after people appropriately and in a caring way”. The staff recruitment files sampled were satisfactory with the necessary information being included. Staff undertake induction training before they work on their own with residents. Residents praised the staff on several occasions as “excellent” or “very good”. Staff were seen carrying out various duties, and they were kind, gentle, patient and good humoured with the residents. One resident said all the day staff were excellent but some of the night staff were “too serious” and were not particularly friendly, “they never laugh or smile”. Several residents said they would find it helpful if all staff wore name badges, as only some do at present. The home may wish to ensure if staff members are to wear name badges, that all staff do so. Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is fit to run the home. Nurses are supported to undertake management training. Reports of monthly provider visits are supplied to the commission. Although the home aims to promote the health and safety of its residents, staff and visitors, risk assessments must always be followed when assisting residents to mobilise. EVIDENCE: The registered manager was away on leave and thus not present during this inspection visit. She is an experienced manager whose fitness to be the manager of the Sloane has been determined by the commission following a process of assessment. We heard positive comments about the manager. For example, a resident’s regular visitor stated, “the manager is easily accessible, her office is near the main door and she has a welcoming smile”. Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 22 When we arrived in the home for the inspection visit, it was not clear who was in charge as we were initially told the two nurses on duty were sharing this function. When questioned, the nurses agreed the one who had been employed longest was in charge. Both nurses were on the rota with neither having been given supernumerary time to devote to management duties. I later raised this with the company’s nursing director who confirmed this was the provider’s usual arrangement to cover a manager’s leave, and also said she was giving additional management support to the Sloane during this period. It is positively noted from information supplied by the manager that four of the home’s qualified nurses have completed the Level 4 NVQ (Registered Manager, Adult). The conversion of some shared bedrooms to single rooms has reduced the number of residents that the home can accommodate. The new maximum number is twenty-nine and it was evident this is now being advertised as such by the provider. This should be formalised through a variation to the home’s registration. We have advised about this previously and I discussed the matter again with the nursing director. Of the relatives or friends who returned questionnaires to the commission, four stated they were always kept up to date with important issues affecting their relative. One did not answer this question. One commented, “I am telephoned with any important issues and as I am living very close I can call in immediately”, and another stated the home rang her up when her relative had a fall. The commission has been supplied with monthly reports of the provider’s visits to the home, in compliance with regulation 26. The company’s nursing director has carried out these visits. It is evident from the reports that important aspects of service provision are kept under review and improvements are recommended as the need is identified. The views of residents and staff are taken into account. The home aims to promote the health and safety of its residents, staff and visitors. However, on several occasions while we were in the home, residents were lifted from their chairs and into wheelchairs by holding the resident under their armpits. This was despite the fact that handling belts were available and that other transfers were being carried out with appropriate equipment such as standing hoists and sling hoists. For one resident being case-tracked, it was evident that her transfer was not being carried out in line with mobility care plan, which stated all transfers should be carried out by two carers using a hoist. This was raised with the nurse in charge for attention, as the home must ensure that moving and handling risk assessments are followed at all times (requirement 5). This was a matter that was raised at the last key inspection and addressed by the home at that time, so it was disappointing to see that standards in this respect had slipped again. Staff members whose training records were seen had undertaken moving and handling training. The home had three documents on file - Moving and Handling Policy, Moving and Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 23 Handling Techniques, Moving and Handling (Blue Slings) – that were all dated July 2000 and did not have evidence of review since that date (recommendation 5). I inspected a sample of documentation relating to health and safety, and found checks were up to date and within the appropriate timeframes. A food hygiene inspection by Bromley environmental health service in June 2007 required repairs to areas of the kitchen’s flooring and to cracks in its ceiling. The home had been asked to forward copies of the staff’s food hygiene training certificates. The environmental health officer is to carry out a ‘Safer Food Better Business’ training session at a later date. At the time of our inspection, the home had not yet had renewal of its Clean Food Award. Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 Requirement The registered person must ensure medicines are never stored at more than 25 degrees centigrade. The registered person must ensure the date of opening a medicine is always recorded where the manufacturer recommends a discard date. The registered person must ensure that each resident is supported to exercise choice whenever this is possible. The registered person must ensure staff are deployed so that residents are supervised and receive prompt attention for their personal care needs. The registered person must ensure that moving and handling risk assessments are followed at all times when staff are assisting residents to mobilise. Timescale for action 30/09/07 2 OP9 13 31/10/07 3 OP14 12 30/09/07 4 OP27 18 30/09/07 5 OP38 13 30/09/07 Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard OP9 OP12 OP18 OP19 OP38 Good Practice Recommendations The registered person should ensure the dossette system for night medication has labels that are easy for staff to read. The registered person should consider making the newsletter font/format suited to residents’ capacities. The registered person should ensure the home’s abuse and whistle blowing policies dated July 2000 are reviewed. The registered person should consider providing residents with access to adjustable hairdresser’s basins for hair washing. The registered person should ensure the home’s manual handling policy and accompanying documentation dated July 2000 are reviewed. Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Sloane House Nursing Home DS0000010141.V343516.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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