Inspection on 25/08/05 for Springfields Nursing Home

This inspection was carried out on 25th August 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Springfields Nursing Home 09/05/07

Springfields Nursing Home 20/01/06

Springfields Nursing Home 22/02/05

Springfields Nursing Home 12/01/04

Similar services:

Claremont House

Sun Court Nursing Home

Bramley Avenue (73)

15 Bramble Close

Dolphin Court

Fen Road

Wakes Hall

165 Putnoe Lane

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

CARE HOMES FOR OLDER PEOPLE Springfields Nursing Home Easthorpe Road Copford Green Colchester Essex CO6 1DH Lead Inspector Diana Green Unannounced 25 August 2005 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 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. Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Springfields Nursing Home Address Easthorpe Road Copford Green Colchester Essex CO6 1DH 01206 211065 01206 213238 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Springfields Residential Homes Limited Mrs Samantha Hursey Care Home 37 Category(ies) of Physical disability over 65 years of age (37), registration, with number Terminally ill (4) of places Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 Persons of either sex aged 65 years and over who require nursing care by reason of a physical disability (not to exceed 37 persons) 2 Persons of either sex aged 50 years and over who require general palliative care (not to exceed 4 persons) Date of last inspection 22 February 2005 Brief Description of the Service: Springfields Nursing Home provides nursing and personal care for up to 37 older people and is also registered to care for service users with a terminal illness.The home is owned by a private organisation, named Springfields Residential Homes Limited.Springfields Nursing Home is located in the rural village of Copford that is approximately a mile from Marks Tey and a few miles from Colchester, Essex. The home is single storey purpose built accommodation and shares catering and laundry facilities with the adjoined residential home.There are 37 single bedrooms with en-suite facilities, one large lounge and two dining rooms.The home has surrounding landscaped gardens with extensive views over open countryside. There is a paved garden to the rear and an internal courtyard that are attractive and accessible to wheelchair users. Springfields Nursing Home is accessible by road and rail. The nearest station is in Marks Tey. Parking is available in the large car park located to the front of the property. Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on the 25/08/05, lasting 6 hours. The inspection process included: discussions with the proprietor, senior nurse in charge, five staff, six residents and an occupational therapy assistant; premises observations on a number of residents’ rooms, two bathrooms and communal areas; and inspection of a sample of policies and records (including any records of notifications or complaints sent to the CSCI since the last inspection). Nineteen standards were covered, and nine requirements made including one third repeat requirement and one second repeat recommendation. The registered manager was not present at this inspection. Whist it was evident that Springfield Nursing Home aims to provide and is successful in achieving a high standard of personal and nursing care for residents, one resident with a diagnosis of dementia had recently been admitted for which the home is not registered to provide care. Several other residents displayed symptoms of dementia and a review of their care needs is required. What the service does well: The home provides a welcoming, clean and homely environment and consistently high standards of nursing and personal care. Residents’ health needs are met appropriately and well monitored and prompt referrals are made to GP’s and relevant health professionals where required. The registered manager ensures that care provided including palliative care is research based. Staff are employed in sufficient numbers and are skilled to care for the needs of residents through regular training and supervision by the manager. A stimulating activity programme is provided for which residents are enabled a choice of taking part. The nutritional needs of residents are closely monitored and the standard of food provided is high. The proprietor is frequently in attendance at the home, ensures the premises are well maintained and is well known to residents. Positive feedback was received from an occupational therapist who said that care staff were helpful and always polite. One resident spoke highly of the manager and said they were kept well informed. Another resident said that “staff are polite and respectful, even during the night” and another resident said they could find no fault with the home. Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Assessment of residents prior to admission could be improved to ensure residents are not admitted unless the home is registered to provide their care. This specifically refers to the recent admission of a resident with a dementia. There is a need to ensure existing residents who display symptoms of dementia/challenging behaviour have their needs reviewed to ensure they receive appropriate treatment and are appropriately placed. Assessment and care planning for residents receiving respite care could be improved to ensure their needs are appropriately met. Wound care plans need to be developed for all injuries requiring treatment, no matter how minor and the use of measurements charts is recommended as good practice. Residents who choose to administer their own medication do not always have a risk assessment recorded and be provided with a lockable facility for safe storage of medicines. There have been several admission following falls with fractures sustained and requiring hospital admissions. Follow up care could be improved to include a risk assessment of the hard flooring in some residents’ rooms and evidence that the risk has been minimised. Recruitment procedures need to be more robust to ensure that no staff commence employment without the required checks being undertaken. The home has no mechanical sluice disinfector as recommended for a care home with nursing and guidance from the infection control nurse should be obtained as previously recommended. Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 7 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. Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3 Residents have the information needed to enable them to make a decision before moving into the home. The admission process is not sufficiently robust to ensure the home can appropriately meet prospective residents’ needs. This home does not provide intermediate care EVIDENCE: Springfield Nursing Home has a statement of purpose/service user guide that are provided to residents on admission and a copy was held in all residents’ rooms. Action had not been taken to separate the documents as recommended following the previous inspection. The manager and deputy manager, both registered nurses, undertake assessment of all prospective residents prior to admission, and information on the person’s needs is recorded. New documentation is being introduced that details all care needs. However for those sampled one resident recently admitted for respite had only a brief assessment recorded and this did not include all elements as detailed in the standard. For example the resident had been admitted following treatment for a fracture as the result of a fall, but there was no recorded risk assessment for falls. There was no assessment for foot-care, although it was evident chiropody treatment had been provided. Another resident admitted 3 days previously Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 10 had a written assessment form but no care plans. The resident had a diagnosis of dementia for which the home is not registered to provide care. This is an offence under the Care Standards Act 2000. A number of residents were displaying symptoms of dementia and a review of their care needs is required. Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 & 10 Residents’ health care needs are consistently well met within the home. Attention is required to ensure the safe storage, administration and recording of medicines at all times. Staff treated residents with respect and supported them in maintaining control of their lives where able. EVIDENCE: Four care files were inspected. Three contained care plans that covered the majority of key needs (physical and social), but one had care plans recorded for personal care, communication, mobility and continence only. All four had daily records that were detailed and demonstrated a good knowledge of the residents’ needs. All care plans had been regularly reviewed. Assessments for moving and handling/mobility, pressure areas and continence needs were recorded in three of the files inspected. There was no care plan recorded for a wound that was being treated for one resident. No risk assessment for falls had been undertaken despite two of the residents having had previous falls. One resident had sustained a second fracture following a fall and had been admitted to hospital but there was no risk assessment of the environment recorded on their return to the home. This is of particular concern as the resident’s bedroom had hard flooring. New care plans recently developed by Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 12 the manager did include their preferences as well as care needs and were written in a language that demonstrated the residents’ involvement. There were plans for the new care documentation to be introduced and this should also include residents receiving respite to ensure their needs are fully assessed. The home had a contracted GP who attended weekly and as required. Residents were enabled access to health and social care professionals as appropriate to their needs. A chiropodist was in attendance and the records confirmed treatment was provided regularly and that residents had a choice of chiropodist. The standard of personal and nursing care was observed to be good. The home had appropriate pressure relieving mattresses and cushions provided as required. The records confirmed that residents’ nutritional needs were assessed and monitored and they were weighed on admission and regularly. From discussion with staff and residents there was evidence that staff were polite and respectful and upheld residents dignity when providing personal care. The records confirmed that staff were instructed at induction on how to treat residents with respect and this was also evident from observation of their care practice. The standard for medication was not fully inspected, however several practices were observed that compromised the safety of residents and visitors. Registered nurses administered all medication. The medication trolley was observed unlocked and unsupervised with medicines (liquid) left on the top of the trolley during the medicines round. One resident was self-medicating but had no risk assessment recorded and there was no lockable facility provided to ensure the safe storage of medicines. Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, & 15 The daily routines are flexible and promote residents’ choice and independence to maintain some control over their lives. The home supplied sufficient quantity and quality of food and provided a well balanced diet that met individuals’ needs. EVIDENCE: From discussion with residents and staff there was evidence that they were enabled some flexibility and a choice in their daily routines. Residents spoken with said they were aware of the social activities on offer but sometimes chose not to take part. Activities were displayed for their information and staff also took time to invite residents to various activities. A lively quiz session was observed that residents taking part clearly found mentally and socially stimulating. Several residents were taking part in a communion service that had been arranged and was held monthly. The home had a menu that was displayed for residents’ information and also explained to residents on a daily basis. Residents’ nutritional needs and preferences were recorded on admission and weights recorded and monitored with appropriate action taken to address changes in weight. The lunch comprised savoury chicken or tuna pasta bake with potatoes, or rice, carrots and greens beans followed by a choice of hot or cold desert. The meal looked appetising and liquidised meals were served attractively. One resident spoken with said the food was good and there was plenty of food and drinks provided. Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 14 Another resident said that “everything was very good” and the “food was adequate”. Residents were encouraged to eat in one of the dining rooms of the home and some ate in their own room as was their choice. Care staff were observed to assist with eating where required in a discreet and sensitive manner. Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The home’s complaints procedures provides residents and their relatives with assurance their concerns will be listened to and acted upon. The home’s recruitment practices do not wholly protect residents. EVIDENCE: The home had a complaints procedure that was contained in the statement of purpose/service users guide that detailed the timescales within which complainants can expect a response and advised complainants of their right to refer to the CSCI at any stage. Residents spoken with were aware of the procedure but said they had no cause to complaint. The standard for protection was not fully inspected, however recruitment practices did not always ensure the safety of residents. For instance, one member of staff had been appointed since the last inspection without a CRB disclosure application or POVA first check being made. The proprietor was not able to confirm if all independent practitioners (i.e. chiropodists) had the required checks. Action had been taken to book care staff to attend the Essex Protection of Vulnerable Adults workshops to be held in the near future. Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 24 & 26 Springfield Nursing Home is well maintained and has a homely and comfortable environment but the safety of some residents is potentially compromised by the presence of hard flooring in their rooms. The home was clean and hygienic with generally satisfactory infection control practices evident. EVIDENCE: A partial inspection of the premises was made that included communal areas, two bathrooms, a number of residents’ rooms, storage rooms and the sluice. The home was in a good state of maintenance and decoration. There was a programme of refurbishment in place and several residents’ rooms had been redecorated in the last year. Communal rooms were clean and well decorated and furnished to provide a homely environment for residents. Residents spoken with said they were satisfied with the standard of cleaning. The gardens were well maintained and provided a pleasant outlook with good access for residents. Records provided evidence that the building complied with the requirements of the local fire and environmental health department. There are no CCTV cameras. Residents’ rooms were comfortably furnished with some personalised with their own furniture. Residents’ rooms were either carpeted or Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 17 had hard flooring which poses a health and safety risk for residents who are at risk of falls. Residents’ rooms were not provided with lockable facilities throughout but were normally provided for residents who were self-medicating. The Home was clean and free from offensive odours throughout. Good standards of infection control were generally maintained, however one bin used for the disposal of clinical waste was not foot operated posing a health and safety risk. The laundry facilities were located in the service area and did not intrude on service users. The home had no sluice disinfector as recommended of a care home with nursing and the proprietor could not confirm that guidance had been sought from the Health Protection Agency on the matter as recommended at the previous inspection. Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 The staffing levels (skill mix, number and competence) are appropriate to the needs of current residents. Recruitment practices were not sufficiently robust to always ensure the protection of service users. Springfield Nursing Home staff are skilled and well trained to enable a good standard of care to be provided for residents. EVIDENCE: There were thirty-four residents at the home and one in hospital. Staffing numbers and skill mix met the levels agreed with the CSCI; from inspection of the staff duty rota and discussion with staff and residents, there was evidence that staffing levels were well maintained, and met the needs of residents. The home had good retention of staff with some having been employed for some years, resulting in the provision of good continuity of care for residents. One staff file for a new employee was inspected. Two satisfactory references had been obtained but the required checks had not been obtained (CRB/POVA checks) and there was no copy of birth certificate, passport or photograph held on file. The staff member had received a statement of terms and conditions of employment. The proprietor could not confirm if independent chiropodists had current CRB disclosures. Individual training records and evidence of induction training were not inspected on this occasion. Records summarising training were seen, and showed that most staff were up-to-date with all mandatory training including health and safety, fire safety, basic first aid and moving and handling. Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 19 Individual staff had also received training on abuse, catheter care, recovery after stroke, palliative care and computer skills. Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 37 & 38 The home is well managed and run in the best interest of residents. Records required to protect residents were well maintained, up to date and stored safely. The health, safety and welfare of residents and staff is promoted through the policies and practices of the home but attention is needed to ensure standards are consistently adhered to. EVIDENCE: The registered manager an experienced registered nurse, had more than five years management experience of the home was on leave. From discussion with the proprietor and an inspection of records there was evidence that regular updated training had been undertaken; she had recently completed a City and Guilds Basic Computing course and was planning to undertake a Post-graduate Diploma in Management course in September 2005. The standard for quality assurance was not fully inspected, however monthly reports on the conduct of the care home had not been received by the commission despite a second Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 21 repeat requirements made. A quality assurance service user questionnaire had been distributed to service users and their relatives but the findings had not yet been reported. The manager was actively involved with nurse manager meetings and was the link for care homes on the locality palliative care group. Positive feedback was received from an occupational therapist visiting the home. There were no volunteers employed at the home. Records required by regulation for the protection of service users and for the efficient and effective running of the business were maintained, up to date and accurate. All records were stored securely and used in accordance with the Data Protection Act 1998. The home had a health and safety policy statement and there was evidence of statutory training being provided for all staff as required. The premises were secure and systems were in place for maintenance of a safe environment. However during a tour of the premises, hazardous substances were noted to be stored in an unlocked cupboard and on an unsupervised trolley. Checks to minimise the risks of Legionella and regular servicing of boilers and central heating systems were undertaken and evidenced from the records. Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x 3 x 2 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 x 2 x x x 3 2 Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 23 yes Are there any outstanding requirements from the last inspection? 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 3 Regulation 14(1) Requirement The registered person must ensure that a full assessment of needs in undertaken for all residents that includes footcare and a risk assessment for falls as relevant. The registered person must ensure that no resident is admitted to the home for which the home is not registered The registered person must ensure that all residents have a care plan that is reviewed to reflect changing needs such as wound care. The registered person must ensure that a risk assessment is undertaken of the residents environment following a fall. The registered person must ensure that residents who choose to administer their own medication have a risk assessment undertaken and are provided with lockable facilities. The registered person must ensure that all the required checks including a CRB disclosure/ POVA check are obtained for all staff prior to appointment. All independant Timescale for action Immediate on receipt of report 2. 3 14(1)(d) & 43(1) 15(1) Immediate on receipt of report Immediate, informed at inspection Immediate 3. 7 4. 7 & 38 13(4) 5. 9 13(2) & 13(6) Immediate, informed at inspection 6. 18 & 29 7, 9, 19 Schedule 2 Immediate, informed at inspection Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 24 7. 26 13(3) & 16(2)(j) 26(4) 8. 33 9. 38 13(4) practitioners who have close contact with residents must have CRB disclosures. The registered person must ensure that foot operated bins are provided for disposal of all clinical waste. The registered person must ensure that monthly reports on the conduct of the home are provided to the commission. This is a third repeat requirement The registered person must ensure that hazardous items subject to COSSH assessment are stored securely in locked facilities when not in use. Immediate Immediate Immediate 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. Refer to Standard 1 Good Practice Recommendations The registered person should develop a separate service users guide and statement of purpose Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Springfields Nursing Home I56-I05 S15341 Springfields NH V246711 250805 Stage 4.doc Version 1.40 Page 26 - 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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