Inspection on 18/07/06 for Southerndown Nursing Home

This inspection was carried out on 18th July 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.

Other inspections for this house

Southerndown Nursing Home 18/03/08

Southerndown Nursing Home 02/03/06

Southerndown Nursing Home 27/07/05

Southerndown Nursing Home 03/01/05

Southerndown Nursing Home 22/07/04

Southerndown Nursing Home 02/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Southerndown Nursing Home Worcester Road Chipping Norton Oxfordshire OX7 5YF Lead Inspector Annette Miller Unannounced Inspection 18th July 2006 2.00 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 Southerndown Nursing Home DS0000027169.V304882.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. Southerndown Nursing Home DS0000027169.V304882.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Southerndown Nursing Home Address Worcester Road Chipping Norton Oxfordshire OX7 5YF 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) 01608 644129 01608 641737 southerndown@barchester.com www.barchester.com Barchester Healthcare Plc vacant Care Home 87 Category(ies) of Dementia - over 65 years of age (42), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (42), Old age, not falling within any other category (45), Physical disability (3) Southerndown Nursing Home DS0000027169.V304882.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. On admission persons should be aged 60 years and over. The total number of persons that may be accommodated at any one time must not exceed 87 of which 42 may be in either the DE(E) or MD(E) category. Admittance of two named residents under the age of 60 in the PD category Admission of one under age resident for respite care from 23 to 30 May 2006 2nd March 2006 Date of last inspection Brief Description of the Service: Southerndown Nursing Home consists of two units providing a total of 87 beds for residents aged 60 and over. There are 45 beds in the original house for people who are physically frail. An extension (Memory Lane) was completed in 2002 to provide a further 42 beds for residents with mental health needs, generally dementia. The two units are linked by a covered walkway. Registered nurses are on duty 24 hours a day and are assisted by a team of carers and ancillary staff. Spacious lounges and dining rooms are provided on both units and there are extensive grounds surrounding the home. There is a secure area of garden at the back of the main house with fencing and a locked gate, and a secure courtyard garden on Memory Lane. The main house has a mix of single and double rooms, with Memory Lane having only single bedrooms. En-suite facilities are provided in some bedrooms in the main house and in all bedrooms on Memory Lane. Recreational activities are provided on both units and the home has transport that can be used for outings. The fees for this service range from £750 to £1000 per week. Southerndown Nursing Home DS0000027169.V304882.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Since the 1st April 2006 the Commission has developed the way it undertakes its inspection of care services. This inspection of the home was an unannounced ‘Key Inspection’. The inspection took 14 hours over two days and was a thorough look at how well the service is doing. It took into account detailed information provided by the manager and any information the Commisson had received about the home since the last inspection. The inspector asked the views of the people who use the service and other people seen during the inspection, or who responded to questionnaires that the Commission had sent out. 14 residents and 17 relatives returned comment cards directly to the Commission and the majority of comments received were positive. The inspector looked at how well the service was meeting the standards set by the government and has,in this report,made judgements about the standard of the service. What the service does well: What has improved since the last inspection? The company has good monitoring and auditing procedures in place and any areas of weakness are quickly identified, leading to improvements being made in a timely way. For example, extra medication training was arranged recently to deal with some specific medication issues that were identified during the company’s regular unannounced inspections of the home. Southerndown Nursing Home DS0000027169.V304882.R01.S.doc Version 5.2 Page 6 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. Southerndown Nursing Home DS0000027169.V304882.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 Southerndown Nursing Home DS0000027169.V304882.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Prospective residents have the information they need to make an informed choice about admission to the home. Pre-admission assessments are carried out so that the home, the prospective resident and their family are clear that the person’s care needs can be met. Intermediate care is not provided. EVIDENCE: A recently admitted resident confirmed that she had received a good range of information about the home, including the Statement of Purpose and Service User Guide. All residents receive a copy of the home’s terms and conditions and these are well presented and clearly state what residents can expect. Information is included about the registered nurse care contribution paid to residents who have been assessed as needing nursing care and are self-funding. Southerndown Nursing Home DS0000027169.V304882.R01.S.doc Version 5.2 Page 9 Four pre-admission assessments were looked at and each one showed that assessment was thorough in all areas of potential care need. The manager welcomes visits by prospective residents and relatives before any decision is made about moving into the home. A resident confirmed this, saying she found her visit very helpful and reassuring. Southerndown Nursing Home DS0000027169.V304882.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Care plans provide a good source of information about residents’ individual care needs, as well as detailing the action that needs to be taken by care staff. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Residents spoken with were generally very happy with their care. One said, “I’m very impressed with the home’. Her visitor said she was made welcome whenever she visited and was offered refreshments to have with her friend, which she appreciated. Another resident and her visitor commented that everything was “very good”. The majority of residents who returned comments cards said that they received the care and support they needed. The inspector observed carers to act kindly to residents on Memory Lane, but residents were unable to confirm if their care was good. Southerndown Nursing Home DS0000027169.V304882.R01.S.doc Version 5.2 Page 11 One resident on Southerndown raised some concerns and it was established these were being dealt with. A small number of concerns were raised by relatives in comment cards about the standard of personal care, such as: “Sometimes Mum isn’t dressed well”, “In general the care provided is of a high standard, but at times it can be a bit sloppy”, “I needed to ask them to wash Mum properly”. These comments were brought to the attention of the manager to monitor. The names of the people making these comments were not divulged. Four care plans were looked at and residents’ care needs and also the action to be taken by care staff were clearly stated. Daily records of the care provided are kept. The home has a range of pressure relieving mattress and cushions, which are used when risk assessments indicate that there is a potential risk of a resident developing a pressure sore. A resident said she needed a specialist bed and that it was obtained before she moved in. Falls risk assessments are not routinely completed and these should be started, particularly when a resident has a history of falls. One of the plans looked at included information about a resident’s history of falls before admission. This should have resulted in the home undertaking a falls assessment shortly after the resident was admitted, but this had not been done. This was discussed with the manager during the inspection so that an assessment could be arranged. The inspector looked at medication storage facilities on the ground floor in Memory Lane and found everything to be satisfactory. The company had identified some issues regarding the administration of medication during a routine monthly unannounced inspection and extra medication training had been arranged to ensure procedures improved. A resident confirmed that staff knocked on her bedroom door before entering, and that her personal care was given in private. Doctors regularly visit the home to monitor residents’ healthcare and residents are seen in the privacy of their rooms. Two GPs returned comment cards to CSCI and both were satisfied with the overall care provided, but had concerns about the communication skills of some overseas staff and thought that they did not have a good understanding of the UK healthcare system. These matters were brought to the attention of the manager to monitor. Southerndown Nursing Home DS0000027169.V304882.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are helped and encouraged to make choices and to maintain independence for as long as possible. There are good opportunities for residents to take part in stimulating and motivating activities. Menu choices are available at all mealtimes. EVIDENCE: There is a good choice of activities arranged by two full-time activity organisers, one on each unit. A week’s activity programme is displayed on each unit, as well as a separate list showing musical events and outings planned monthly. The activity organisers have each developed systems for recording the activities undertaken each day. One-to-one and small groups feature prominently on both units. The majority of residents returning comment cards to CSCI said activities suited their needs. A resident confirmed that she could make choices about a variety of matters and was very pleased with this aspect of life in the home. She said she liked to go to bed late and this had never been a problem for the night staff. Southerndown Nursing Home DS0000027169.V304882.R01.S.doc Version 5.2 Page 13 Visitors to the home during the inspection confirmed that they could visit whenever they wished. Menus are varied and provide a nutritionally balanced diet, with good use of seasonal foods. Cold drinks are served at mealtimes, as well as throughout the day. Two mealtimes were observed, lunch on Southerdown and supper on Memory Lane. Carers assisted residents in a kindly and attentive way, providing one-to-one assistance when needed. A resident on Memory Lane displayed signs of agitation at the start of supper and a carer handled the situation particularly well, showing the resident kindness and patience. Snacks are served between meals to suit individual needs, such as sandwiches and a hot drink given to a resident an hour after supper had finished. The inspection took place during a period of very hot weather and residents were given frequent cold drinks, as well as ice cream. The environment was kept as cool as possible by using fans and portable air conditioning units. Residents are consulted about meals and the catering staff are eager to provide individual requests whenever possible. Menus were an agenda item at the last residents’ meeting, when agreement was reached about having menus on dining room tables. A question on the residents’ comment cards asked: “Do you like the meals at the home?” One respondent said ‘always’, six said ‘usually’ and seven said ‘sometimes’. From the evidence seen by the inspector and comments received, the inspector considers that this home would be able to provide a service to meet the needs of individuals of various religious, racial or cultural backgrounds. Southerndown Nursing Home DS0000027169.V304882.R01.S.doc Version 5.2 Page 14 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 good. This judgement has been made using available evidence including a visit to the service. The home has a satisfactory complaints policy and complaints are taken seriously. There are procedures in place to protect residents from abuse. EVIDENCE: Information about the complaints procedure is given to residents before admission and a copy is also displayed prominently in reception. A complaints log is kept and was provided for inspection. Eight concerns had been dealt with since the last inspection and a record of each concern, the action taken and outcome was shown. The CSCI has not received any formal complaints since the last inspection. A file containing the company policy on the protection of vulnerable adults, a copy of ‘No Secrets’ and the local guidance for dealing with allegations of abuse is kept in reception. Training on the protection of vulnerable adults features as mandatory training within the home’s training programme. The home’s training officer attended a half-day training course on adult protection in March 2005 and the certificate of attendance was seen. Southerndown Nursing Home DS0000027169.V304882.R01.S.doc Version 5.2 Page 15 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The overall quality of the furnishings and fittings is good, creating a comfortable and safe environment for residents. Cleanliness is good throughout, although there is a smell of urine in some areas on Memory Lane that is unpleasant for residents and visitors. The company was in the process of dealing with this at the time of inspection. EVIDENCE: There are plans to update the communal areas on Southerndown, although final decisions have not yet been made. Memory Lane is a purpose-built unit completed in 2002 that provides spacious accommodation over two floors. There is an ongoing programme of routine maintenance keeping the home in good order. Southerndown Nursing Home DS0000027169.V304882.R01.S.doc Version 5.2 Page 16 There are extensive grounds surrounding the home. The internal courtyard on Memory Lane provides an extremely pleasant secure area of garden that is used regularly by residents. The garden behind Southerndown has a plentiful supply of shrubs and plants, some in raised beds, and a good range of garden furniture. The gardens are easily accessible from both units and are kept tidy and well maintained. The Fire Service and Environmental Health Department carry out regular inspections to check that safety in these specific areas are satisfactory. Cleanliness throughout this large home is good and the domestic team clearly work hard to achieve this. A resident on Southerndown commented on the home’s cleanliness and the lack of unpleasant smells. A question on the comment cards sent to residents aske,: “Is the home fresh and clean?”. Twelve said ‘always’ and two said ‘usually’. There was, however, a smell of urine on Memory Lane, which has been raised as an issue at the last two inspections. The manager outlined the measures taken, but as odour continues to be a problem the company has decided to replace sections of carpet and to purchase two new commercial carpet cleaners. These measures need to be treated as a priority, to ensure the environment on Memory Lane is pleasant for those living there and visiting. The on-site laundry provides a good standard of service ensuring residents’ clothing is returned promptly. Staff confirmed that there was always a plentiful supply of table and bed linen. Southerndown Nursing Home DS0000027169.V304882.R01.S.doc Version 5.2 Page 17 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 good. This judgement has been made using available evidence including a visit to the service. Overall, staffing levels are good but planning rotas need to be carefully monitored to ensure that periods of staff absence are adequately covered. The home has not yet reached the 50 level of care staff with a national vocational qualification in care, but the company is committed to supporting staff through this training. Staff induction is thorough and comprehensive. EVIDENCE: The staffing levels during the period of inspection appeared adequate for the needs of residents, taking into account the fact that the home was not full. The total number of residents cared for was 79 – two residents were in hospital and there were six vacancies, although some of these were in the double rooms on Southerndown that were being used as single rooms. The only period when staffing seemed low was from 6.00–7.30pm on the 18th July when a member of staff went off duty at her normal time of 6.00pm, leaving one registered nurse and two carers to care for 19 residents. The inspector observed that some residents needed more individual help than was available. This situation was not helped by the fact that the evening hostess was on holiday, which meant staff had to serve suppers and clear away. Duty rotas need to be carefully monitored to ensure that periods of staff absence are adequately covered. Southerndown Nursing Home DS0000027169.V304882.R01.S.doc Version 5.2 Page 18 The care team is well supported by a large team of ancillary staff. Residents and relatives returning CSCI comment cards were generally satisfied with the level of staffing, except that some concerns were raised regarding staffing levels at weekends. Also, a relative thought that there was not always an even spread of staff. These comments were brought to the attention of the manager to be monitored. The home has not yet reached the 50 level of care staff with NVQ qualifications, although the company shows a commitment to supporting staff through this training. Eleven carers out of a total of 49 have NVQ - nine at Level 2 and two at Level 3. Ten carers are currently on the training. Ten carers are overseas trained nurses regarded by the home as equivalent to NVQ 3, although an NVQ verifier has not confirmed this. Three staff recruitment files were looked at and the information and checks needed had been obtained. A photograph of each staff member must be obtained and this is currently achieved by using a photocopy of the person’s passport photograph. Whilst acknowledging that these were clear on this occasion, this is not always the case and consideration should be given to obtaining a recent photograph that is not a photocopy. There is a thorough and comprehensive induction programme that is based on the nationally approved Skills for Care induction course. Workbooks are issued to new workers to fill in and are signed by a trainer when the level of competency required has been reached. The company provides a good level of training to all grades of staff and training records showed that staff attendance was good. Southerndown Nursing Home DS0000027169.V304882.R01.S.doc Version 5.2 Page 19 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 outcome area is adequate. This judgement has been made using available evidence including a visit to the service. There are systems for consulting with residents, although these could be improved by obtaining formal feedback through, for example, anonymous satisfaction questionnaires to assist in the future development of the quality of the service. Staff do not have formal supervision with a senior member of staff and this means that the manager cannot be assured that staff have the support they need to enable them to give good care to residents. EVIDENCE: The registered manager left the home in April 2006 and the temporary management arrangements have been extremely good. A new manager was appointed in July 2006 and was in the home on induction at the time of inspection. She is a registered nurse and has management experience. The process of registering with the CSCI as the home’s registered manager needs to be completed before Standard 31 can be assessed. Southerndown Nursing Home DS0000027169.V304882.R01.S.doc Version 5.2 Page 20 Feedback from residents is obtained during residents’ meetings arranged by the activities organisers, as well as during day-to-day conversations residents have with the manager. However, formal quality assurance and quality monitoring systems, based on seeking the view of residents, are not currently obtained, for example through anonymous satisfaction questionnaires. This is recommended to assist in the future development of the quality of the service for residents. The company has a policy for looking after residents’ money used for incidental expenses. This money is paid into a pooled bank account separate from the company’s assets. Invoices are sent to residents (or representatives) monthly showing what has been spent. The accounting procedures appeared to be in good order and well managed. The staff spoken to said they had not had formal supervision with senior staff. It is an expectation, and an indicator of good employment practice, for staff to have regular allocated individual time to discuss their work, progress and any training needs with a senior staff member at least six times a year, and for written records to be held by the staff member and their supervisor. The inspector discussed health and safety issues with the maintenance staff and saw records that showed that safety checks were carried out in a timely way. Records also showed that mandatory training, such as fire safety and handling and moving, were provided regularly. Southerndown Nursing Home DS0000027169.V304882.R01.S.doc Version 5.2 Page 21 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 3 2 3 3 3 4 X 5 X 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 ENVIRONMENT Standard No Score 19 3 20 3 21 X 22 X 23 X 24 X 25 X 26 2 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score N/A X 2 X 3 2 X 3 Southerndown Nursing Home DS0000027169.V304882.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations A falls risk assessment should be completed on residents soon after admission and kept under review. (Reference CSCI guidance: Prevention and Management of Falls in Older People) Action is needed to eliminate the smell of urine on Memory Lane. Outstanding from 2nd March 2006. Cover for staff absence should be provided. Staff should provide a recent photograph that is not a photocopy. Residents should be provided with an opportunity to give formal feedback, anonymously if they wish, on the care and services received. Formal supervision for staff comprising dedicated one-to-one time with a senior member of staff should be implemented. 2 3 4 5 6 OP26 OP27 OP29 OP33 OP36 Southerndown Nursing Home DS0000027169.V304882.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 Southerndown Nursing Home DS0000027169.V304882.R01.S.doc Version 5.2 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!