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Inspection on 15/06/06 for Southwold Nursing Home

Also see our care home review for Southwold Nursing Home for more information

This inspection was carried out on 15th June 2006.

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

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

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

What the care home does well

The home provides good care for residents in good quality, well maintained premises. Residents felt that they were treated as and respected as individuals by staff who knew their needs and were able to meet them. Residents and relatives felt that, as one relative said, "the staff are wonderful" even if as another relative said "appear overworked on occasions". Residents are in control of their day and the home provides as well equipped bedrooms, a number of lounges and dining rooms and an excellent programme of activities during the day. The home also has two well-maintained gardens, one of which is being developed with monies raised by residents. This gives the residents involved something to aim at, control and a sense of pride as the garden develops. This also helps residents feel that Southwold is theirs. The home serves good food, well cooked by catering staff that know the needs, likes and dislikes of residents and ensure that these are met. Meals can be taken by residents were they wish, but the dining rooms provide good surroundings for what are made social events with good interaction between residents and staff. The home takes resident`s and relative`s concerns seriously and ensure that these are dealt with to the satisfaction of the resident or relative. Regular reviews undertaken by the resident`s key worker enable a review of care to take place and any worries to be discussed, recorded if appropriate answered by the home`s manager.

What has improved since the last inspection?

The home has completed redecoration of communal areas of the home which makes the home an attractive place to live in. A new hoist has been obtained which will continue to ensure safe moving and handling practices for residents.

What the care home could do better:

The home must ensure that locks, that staff are able to override, are fitted as planned to bedroom doors to enable residents who can do so to lock the door to maintain privacy, dignity and security. Ensure that all eye drops in use have the date they are opened put on them, as some in use did not, so that they are not used over the 28 days stated by the makers.

CARE HOMES FOR OLDER PEOPLE Southwold Nursing Home Southmoor Road Wythenshawe Manchester M23 9NR Lead Inspector Leslie Hardy Key Unannounced Inspection 15th June 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 Southwold Nursing Home DS0000021658.V299168.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. Southwold Nursing Home DS0000021658.V299168.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Southwold Nursing Home Address Southmoor Road Wythenshawe Manchester M23 9NR 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) 0161 945 6367 0161 945 9002 sharon.blackwell@anchor.org Anchor Trust Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (37), Physical disability (3) of places Southwold Nursing Home DS0000021658.V299168.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users aged over the age of 60 requiring nursing care shall be 37. 3 named service users are currently accommodated who are below 60 years of age and require general nursing care. 25th February 2006 Date of last inspection Brief Description of the Service: Southwold is a home with 40 beds providing personal care with nursing. The Home was purpose built for the specific resident group in the early 1990’s, initially to provide a better care setting for people on long stay wards within the NHS. It is built on two floors and has a passenger lift. The home is totally wheelchair accessible. The home is divided into 4 care areas which each have 8 single and one double room, all of which are en suite. Each care area has it own lounge, there is also a central lounge and dining room on the ground floor and a smaller dining room on the first floor. There are two gardens. The home is on the edge of the Wythenshawe Hospital site. The home has its own car park at the front of the building. It is close to a major motorway network and public transport provides very frequent services to Manchester, Stockport and Altrincham. These services are situated very close to the entrance to the home. Fees are currently if funded from Social services from £388(shared room) to £404 (single room) plus a £60 “top up fee” paid by the resident or relatives. Residents who self fund are charged £612. Hairdressing and private chiropody are extra. Southwold Nursing Home DS0000021658.V299168.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The report brings together information on the home gathered since the last inspection in February 2006, including returns from the home regarding reportable incidents, and a pre inspection questionnaire, which was used to inform an unannounced inspection that took place at the home on Thursday 15 June 2006. This inspection started at 1. 30 pm and lasted for 7 hours. During the inspection, 15 residents, 6 visitors, 11 staff were spoken with. A tour of the building was also carried out. A number of questionnaires together with reply paid envelopes for return directly to the inspector were given to residents and six of these were returned. The home has undertaken one of the requirements in the last inspection report, and has budgeted to undertaken the other requirement in the current financial year. What the service does well: The home provides good care for residents in good quality, well maintained premises. Residents felt that they were treated as and respected as individuals by staff who knew their needs and were able to meet them. Residents and relatives felt that, as one relative said, “the staff are wonderful” even if as another relative said “appear overworked on occasions”. Residents are in control of their day and the home provides as well equipped bedrooms, a number of lounges and dining rooms and an excellent programme of activities during the day. The home also has two well-maintained gardens, one of which is being developed with monies raised by residents. This gives the residents involved something to aim at, control and a sense of pride as the garden develops. This also helps residents feel that Southwold is theirs. The home serves good food, well cooked by catering staff that know the needs, likes and dislikes of residents and ensure that these are met. Meals can be taken by residents were they wish, but the dining rooms provide good surroundings for what are made social events with good interaction between residents and staff. The home takes resident’s and relative’s concerns seriously and ensure that these are dealt with to the satisfaction of the resident or relative. Regular reviews undertaken by the resident’s key worker enable a review of care to take place and any worries to be discussed, recorded if appropriate answered by the home’s manager. Southwold Nursing Home DS0000021658.V299168.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Southwold Nursing Home DS0000021658.V299168.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 Southwold Nursing Home DS0000021658.V299168.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): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Full assessments prior to admission mean that residents can be assured that the home understands and feels able to met their needs prior to admission EVIDENCE: Residents were only admitted to the home following full assessments. These were not only by the referrer but also a full assessment undertaken by a senior nurse from the home. This ensured that residents were only admitted if the home was able to give care the resident needed. The high level of need in some of the assessments showed that the home was receiving residents with complex needs and was able to give the required care. The home does not have intermediate care beds Southwold Nursing Home DS0000021658.V299168.R01.S.doc Version 5.2 Page 9 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. Good risk assessment and care planning, together with good knowledge of the residents and their identified needs ensured a good standard of care with residents needs being met. Lack of continued attention to the management of medication practice needs addressing to ensure continual safe practice and that residents are not put at risk. EVIDENCE: All residents had care plans which had initially been written using the information from the pre admission assessments and also from risk assessments undertaken by the home following admission. These care plans and risk assessments were reviewed regularly by the residents key worker who also wrote a comment on why the plan or risk was either still appropriate or why it needed changing. Some of the plans were four or five years old, but discussion with staff and discussion with, and observation of resident’s, showed that the plans were not only still relevant, but comments on reviews, both the home’s and those for funded nursing care, demonstrated that they were. Also Southwold Nursing Home DS0000021658.V299168.R01.S.doc Version 5.2 Page 10 as new needs arose during the residents stay new care plans were written to reflect these. This meant that residents were receiving care that meet their needs and in talking to residents and staff it was clear that staff knew what these needs. Staff at the home involved specialist nurses from the local NHS Primary Care Trust (PCT) to give advice as required. Also a Consultant in elderly medicine employed by the PCT carried out regular reviews of residents at this home. This meant that in terms of specialist care residents were receiving a high input and standard of care. Residents were complementary about the care they received with residents commenting that,” the staff really look after me. The home had good procedures in place for the ordering, receipt and storage of medication and the return and destruction of unwanted medicines. The procedure and practice seen for managing medication was generally safe. The home maintained good records of what medication had either been given or the reason why it was omitted. This good practice was let down by two out of three eyes drops in use seen which did not have the date they were opened on them. As eye drops must be used within 28 days of opening this meant that because staff did not know when they were first opened they could be given after the 28 day and put the resident at risk. Staff must be reminded, by the manager, of the requirement by the manufacturers to do this, which will ensure that all medication practices are safe. Residents were treated as individuals by staff that knew their individual needs and likes and dislikes. Residents spoken to said they were treated with respect by staff. Staff were seen taking residents to their rooms to receive personal or intimate care, and bathroom and toilet doors were closed by staff when resident were using them. Staff were engaged in frequent conversations with residents and these were always noted to be friendly but professional. Southwold Nursing Home DS0000021658.V299168.R01.S.doc Version 5.2 Page 11 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 were able to control how and where they spent their day, with a good range of activities available. The food served was of good quality with the chef’s knowledge of residents helping to ensure that appropriate choices were available to meet resident’s dietary needs. EVIDENCE: Residents said that they were able to get up and go to bed when they wanted. One new resident said he wanted and got a lie in, which was detailed in his care plan. A small number of visitors did comment that staff were not always able to deal with residents immediately they requested help to do activities of daily living, including going to bed, and in one case the toilet. Other residents said staff came quickly when they wanted them and it was noted during the inspection that the nurse call, when operated by a resident sounded before it was turned of by staff going to the residents room, for 75 seconds at the longest and frequently less. The home has a number of lounges, one in each of the four residential areas, and one large lounge that merges into the main dining room but is able to be Southwold Nursing Home DS0000021658.V299168.R01.S.doc Version 5.2 Page 12 separated by curtains. There was also a small dining room on the first floor. Residents were able to and were seen to spend periods of the day in different areas and lounges as well as their own bedroom, so they could mix if they wanted, or be as one resident said, be quite and rest on the bed. The home has a full programme of activities during each weekday with a full time co coordinator and volunteer team. Activities range from cooking to singa-longs and weekly Tai Chi for the elderly, which is always well attended and enjoyed by residents. As a student nurse observer said, this enabled them to come out of themselves. Some residents also spend time making very nice special cards, which are sold in aid of their development fund. This is currently being used to fund the development of a second garden, and one resident spoke proudly of what was new since the last inspection. Staff were seen to encourage residents to go to the various activities, and residents spoke of being encouraged to go but knew they had the final choice. Activities outside of the home, such as shopping trips and further a field to tourist spots were occasional organised. The home encourages visiting at any reasonable time and visitors were seen in the home for the duration of the inspection. Residents spoke highly of the food available in the home. The chef said that menus, which rotated on a four weekly cycle, were reviewed about three times a year, special diets, including medical prescribed diets were catered for. The chef was seen talking to and encouraging residents during mealtime, and asking if they wanted something else if the resident did not appear to want the choice they ordered. There was one hot choice available with two types of potatoes, along with a salad and sandwiches as the evening meal served during the inspection. Residents were seen to exercise choice over what they had, and staff encouraged or assisted residents with their meals as needed. A number of residents choose to have their meal in the main dining room were tables were laid with tablecloths, table decorations, condiments and cutlery. Linen napkins were used to prevent spillages of food affecting residents clothing. Other residents choose to eat in the small lounges and others in their bedrooms. Southwold Nursing Home DS0000021658.V299168.R01.S.doc Version 5.2 Page 13 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. Taking informal concerns seriously and dealing with these meant that residents or relatives did not need to formally complain. Residents should be protected from inappropriate staff actions by a good knowledge of and how to report adult abuse by staff. EVIDENCE: The home has a complaints policy, which is in the service user guide and also displayed in the home, together with a poster that advertised the Anchor Homes confident reporting line number that can be used by anybody to raise concerns. In talking to residents and relatives about their knowledge of how to raise concerns this reporting line was mentioned at least twice. Those residents and relatives who had raised concerns informally stated that they were always dealt with to their complete satisfaction, and this perhaps showed why the home complaints register last recorded a complaint being made over a year ago. A number of staff had recently undertaken a course on adult abuse recognition and reporting and staff spoken to were able to give a clear picture of what constituted abuse, how to report it and the urgency of such reporting. Southwold Nursing Home DS0000021658.V299168.R01.S.doc Version 5.2 Page 14 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, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home was well maintained, and free from offensive odours. Residents were enabled to give their bedroom a personal touch, but lack of locks on bedroom doors meant that if they were able to, residents could not maintain their own privacy, dignity and security. Good infection control practices should protect residents from cross infection. EVIDENCE: The home is a well designed building for caring for resident’s needing nursing care, and was found to be well maintained. The home has its own handy person who dealt with day-to-day maintenance matters so that if a resident reported a problem they said these were dealt with quickly. The handyperson was happy that they were given appropriate funds to keep the home in good order. The home’s manager had control of the maintenance budget and Southwold Nursing Home DS0000021658.V299168.R01.S.doc Version 5.2 Page 15 showed the inspector the major work programme for the year. This included the fitting of locks to all bedroom doors so that residents will be able to lock the door if they are in the room to control privacy and dignity and to lock the door when they are out to maintain security. The fitting of these locks has been a requirement in previous reports and this should be undertaken as soon as possible for the benefit of residents. Bedrooms are well furnished and all contain appropriate furnishings, and residents were encouraged to add their own furniture or touches to the room to express their personality. In one case, one resident who was keen on football had England flags and banners up as the World Cup was taking place at the time of the inspection. The home was clean and free from offensive odours. Appropriate infection control procedures were in place to ensure that residents were protected as far as possible from the risk of cross infection. The home had 2 bedpan disinfection units; one on each floor, and the laundry used appropriate cycles to reduce infection risk. The home’s laundry washed all the homes linen, and residents appeared smart in well-laundered clothes. Southwold Nursing Home DS0000021658.V299168.R01.S.doc Version 5.2 Page 16 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. The numbers of staff on duty in the home meant that normally residents needs were met quickly and appropriately. Residents are protected as far as possible from inappropriate staff being employed by good appointment procedures. EVIDENCE: Staffing levels in the home were found to be at least to the minimum requirements of the staffing notice currently in force and were usually above this. Two relatives did comment on the staffing levels and felt they were low at times, and said that on the odd occasion staff seemed not able to respond quickly to residents needs. Relatives were quick to point out this was not the staff’s fault and felt they were overworked on occasions. All staff had a training programme and this showed that training was clearly a priority in the home with regular attendance at courses expected. On the day of the inspection a moving and handling course was taking place attended by 9 staff. Staff reporting attending courses ranging from Moving and Handling and Fire Safety to Adult Abuse Recognition and Reporting etc.. Staff were able to attend some courses as part of their working week, but were expected to attend others, including most external courses, in their own time for which overtime payment was paid. Staff spoken to were happy with this arrangement. Southwold Nursing Home DS0000021658.V299168.R01.S.doc Version 5.2 Page 17 The home now has just over 50 of its carers with at least National Vocational Qualification in Care Level 2. The home also had an Assistant Practitioner who had undertaken a course that included a foundation degree. Their role was to support the registered nurses and not replace them and she had developed a particular expertise in moving and handling and was leading the course that day. The home also had an induction programme for new staff that meets the national standard, and a new member of staff was currently on this course. This level of qualified nurses and carers means that residents were receiving care from staff trained and up to date in how to care for them. Residents expressed confidence that staff knew how to care for them. The home also provides a training placement for student nurses from Manchester University. This not only gives them an insight into care of older people but also benefits the current residents as the students are encouraged to question care and treatment that could stimulate a beneficial change for the residents. Also future generations of residents could benefit by these students returning as registered nurses in the future. The home operated Anchor recruitment procedures that met a standard centrally laid down and monitored by Anchor. All staff were employed only after completing an application form, with two written references being obtained and Criminal Records Bureau Clearance including Protection of Vulnerable Adults checks being undertaken. This meant that the home took all the required steps to try and ensure they only employed staff that did not pose a danger to residents. Southwold Nursing Home DS0000021658.V299168.R01.S.doc Version 5.2 Page 18 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home was found to be well run with the new manager having a positive effect on the home. Good systems were in place to ensure safe handling of resident’s monies. Regular servicing of equipment and installations should ensure safety of residents. EVIDENCE: The Manager of the home had at the inspection been in post for three months and was undergoing registration with the Commission. Staff and relatives were positive about her and felt that she listened to them and was committed to ensuring good care for residents. As one relative, who had expressed concerns at a previous inspection, said things are now wonderful, the staff and care excellent and my mother is very happy. Southwold Nursing Home DS0000021658.V299168.R01.S.doc Version 5.2 Page 19 The home had new procedures in place for the handling of residents’ monies and these were found both to be good and operated effectively Receipts are kept for all transactions that are also witnessed and signed by two persons. This should ensure good protection for residents’ monies. All residents had regular reviews of their stay in the home with their key worker. These were used to enable care to be reviewed and for the resident and any relative who attended to raise any worries or concerns they had and discuss these with staff. The home used an Anchor tool called SAM to audit how the home was doing and if it met resident’s needs. The manager was open that this had been a lower priority for her initially, but said she had discussed this with her area manager and was commencing work on it shortly. Results would be fed back to residents and visitors at regular open meetings, the next one of which was advertised for a week after the inspection. The home had regular servicing of equipment and fittings undertaken, which kept equipment fit for purpose, and had also recently identified that a hoist should cease to be used before it became dangerous for residents. This ensures the safety of residents, as does regular check of fire equipment and bath temperatures by the handyperson. The home has two designated health and safety officers, who undertake regular up dating training. An Anchor estates person also carries out safety audits to ensure the home is a safe place for those who live, work or visit it. Southwold Nursing Home DS0000021658.V299168.R01.S.doc Version 5.2 Page 20 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 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 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 2 X 3 STAFFING Standard No Score 27 3 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 3 Southwold Nursing Home DS0000021658.V299168.R01.S.doc Version 5.2 Page 21 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 All eye drops must have the date they are first opened recorded on the container label. Locks suited to service users capabilities and accessible to staff in an emergency must be fitted to all bedroom doors. To ensure that residents are able to maintain their own privacy, dignity and security. (previous timescale of 31/03/06 not met). Timescale for action 31/07/06 2. OP24 23 31/10/06 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 Southwold Nursing Home DS0000021658.V299168.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Southwold Nursing Home DS0000021658.V299168.R01.S.doc Version 5.2 Page 23 - 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. 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