Inspection on 09/10/08 for St Georges Nursing Home

This inspection was carried out on 9th October 2008.

CSCI found this care home to be providing an Excellent service.

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

St Georges Nursing Home 26/10/06

St Georges Nursing Home 22/11/05

St Georges Nursing Home 05/07/05

St Georges Nursing Home 03/02/05

St Georges Nursing Home 04/06/04

St Georges Nursing Home 15/03/04

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Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

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Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: St Georges Nursing Home 13 Vigo Lane Harraton Washington Tyne & Wear NE38 9AH     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Andrea Goodall     Date: 0 9 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: St Georges Nursing Home 13 Vigo Lane Harraton Washington Tyne & Wear NE38 9AH 01914191878 01914157037 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Hazel Khan Type of registration: Number of places registered: Wellburn Care Homes Limited care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 38 The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 38 Dementia - Code DE, maximum number of places: 4 Date of last inspection Brief description of the care home This home has two stories and was purpose built. It provides both personal care, and nursing, for up to 38 elderly persons, all within single rooms. There is a passenger lift to give access to the first floor. The home has recently undergone internal alteration to improve the layout. Although the grounds are not extensive they are adjacent to the Care Homes for Older People Page 4 of 28 Over 65 0 38 4 0 Brief description of the care home local church, this and the absence of a boundary fence, gives them a spacious feel. A sheltered patio area is located at the rear of the home. The home is in a quiet residential area of Washington, close to the main North / South highway (A182). There are some local shops and facilities within walking distance, and a large retail development (The Galleries) is only a few minutes away by motor transport. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Before the visit we looked at information we have received since the last visit on 26th October 2006. We looked at how the service dealt with any complaints & concerns since the last visit. We looked at any changes to how the home is run. We asked the Provider for their view of how well they care for people in their annual quality assurance assessment (called an AQAA). We made an unannounced visit on 7th October 2008. During the visit we talked with people who use the service, relatives, staff, the manager & visitors. We joined residents for a meal and looked at how staff support the people who live here. We looked at information about the people who use the service & Care Homes for Older People Page 6 of 28 how well their needs are met. We looked at other records which must be kept. We checked that staff had the knowledge, skills & training to meet the needs of the people they care for. We looked around parts of the building to make sure it was clean, safe & comfortable. We checked what improvements had been made since the last visit. We told the manager what we found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations – but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get Care Homes for Older People Page 8 of 28 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents are fully assessed before they make a decison about moving here so they can be assured that the home can meet their needs. Evidence: At the time of this inspection there were 36 people living at St Georges and two more people were to move here in the near future. In this way the home is typically full and there is currently a waiting list. Before people come to live here their needs are asssessed by health and social care professionals to see what sort of care they need. There was good evidence in recent residents assessment records to show that this home carries out comprehensive assessments of all prospective residents to ensure that the home can provide the right care that they need. The manager was able to describe occasions where people had not been admitted to the home because the assessment showed they needed a different type of care. Care Homes for Older People Page 11 of 28 Evidence: It is good practice that the assessment forms include details of peoples spiritual and cultural needs. The home also uses detailed social care assessments to get information from each person about their individual preferences, hobbies, and interests so that staff can look at how they like to spend their day and at social events that they may enjoy. It was clear that prospective residents and their relatives are encouraged to come to visit the home before they make a decision about moving here. Many relatives commented that they had been very pleased to be advised by the home to visit at anytime when they looking for a place for the resident. One relative said, I looked at many other homes before choosing this one. When I rang here they told me to just pop-in anytime, which I did - and it had such a good atmosphere. Some residents have moved here from other homes and were able to make very favourable comparisons about this home. One visitor said, I chose to move my mum from another home to here and Ive made the right choice. Another relative said, Mum had stayed here for a couple of weeks break a while ago and she loved it. So when she needed nursing care I wouldnt have brought her anywhere else. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live here receive excellent support so that their personal and health care needs are very well met. Evidence: Care plans are records that are used by all care services to show what sort of help each person needs and how staff will provide that care. For example how to help people with their mobility, diet, and emotional well being.The care plans at St Georges provide staff with excellent guidance which show them exactly how to support each person with their individual needs, and show how the resident would like to be supported. The care plans are detailed, easy to follow, and up to date. The plans are written in a respectful and sensitive way that values each persons needs and their abilities to still do some things for themselves. The care records also show that peoples health care needs are assessed and regularly checked. The home has detailed assessment records of peoples mobility, nutrition, Care Homes for Older People Page 13 of 28 Evidence: risk of falling, and risk of skin pressure. These are linked to the persons care plan so that staff know how to support the person with their health care needs. One relative said, Mum used to have lots of falls at another home but she has had very few since moving here. St Georges provides both nursing and personal care so there are qualified nursing staff on duty at all times of the day and night. It was clear from care records that the home also has good contact with district nursing services, GP practices and other health care services. The home would support people to manage their own medication if they chose to and were assessed as capable of doing so.There are lockable drawers in each bedroom for residents to store private possessions, including medication. Some people do manage their own creams and inhalers. In all other cases the nurses and senior care staff take responsibility for managing medication. Medication is stored securely and safely, and records of the administration of medication were up to date. Some people have pain relief medication that is prescribed by their doctor. Sometimes the staff are only signing for this when the resident requests or requires this. However in some cases this medication was not prescribed by the doctor as as and when required. In this way the records are not being completed in the right way as there are lots of gaps where codes have not been used to show why these painkilling medications have not been given. Some prescribed creams are also not being signed as administered because they are kept in individual residents bedrooms. All the residents who took part in discussions during this visit said that they feel very well cared for by friendly, helpful staff. The home arranges regular hairdressing, manicure and pamper sessions. During this vist many residents enjoyed having their hair done by the visiting hairdresser. Residents and relatives commented that people living here are very well supported with their personal appearance, and in this way their dignity is upheld. Discussions with several staff, including housekeeping staff, showed that staff respect and value the individuality of each resident. Staff were sensitive and courteous whilst supporting the residents. One resident said, Theyre all lovely to me. I feel very well cared for here. They do anything for me that I need. Another resident said, They look after me and make sure Im alright. Residents can use their own bedrooms for privacy whenever they want. People are offered a key to their room on admission, though few people take these. There are also easy to use bedroom locks on the inside of bedroom doors if people do not wish to Care Homes for Older People Page 14 of 28 Evidence: be disturbed. In this way their privacy is respected. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have excellent support with social interests and can make choices about their own daily routines so that they lead a lifestyle that matches their individual preferences. Evidence: The home provides activities and social events on a daily basis. A list of the activities for each month is placed in every bedroom so residents can see whats coming up. Recent activities have included trips to the winter gardens, along the coast, and shopping. The home has a large, open plan lounge on the ground floor that has been extended and this is the ideal place to hold larger social events and entertainment. It was clear that residents on the first floor nursing unit are supported to come down to the larger lounge at anytime to socialise. People are supported and encouraged to choose their own daily routines and to spend their time how and where they wish.Some people like to spend time in their bedrooms at their own choice and this is respected. One resident said, I stay in my room all the time because I want to. They invite me to join in the activities but I prefer to stay in here, and thats ok. Care Homes for Older People Page 16 of 28 Evidence: The home has good links with the local community. Residents are invited to the church (which is next to the home) for coffee mornings, to a local community centre for special events, and to the local operatic society productions. There are also occasional trips to local pubs. There were several relatives and visitors at the home on this day. Relatives had many positive comments to make about the sociable atmosphere in the home and there is clearly a good relationship between staff and visitors. One relative said, All the staff are friendly and Hazel (the manager) is very helpful with anything you ask. All the residents and their visitors were very complimentary about the excellent quality of meals. Residents are offered choices of two main dishes (and other alternatives) for their main meals. It is very good practice that residents are asked at the table what they would like so that they can make an informed choice, and can see what is on offer. At the time of this lunchtime meal a visiting relative was invited to join the residents for the three course lunch. The meal was very good quality. Residents said, There are always lovely meals here, and were always well fed. There are pleasant dining areas on both floor, but people can dine wherever they prefer. One resident said, I like to eat my meals in my room, and they help me to do that. Meals are served to individual request from hot lock trolleys. It is very good practice that the chef is highly involved in making sure that people have enough to eat so that their nutritional needs are met. This was evident from the clear care plans that show how the chef is involved. Residents and relatives commented that if someone does not seem to eat much of their meal the chef goes to them to find out if there is something else they would like. Some people need support to eat their meals. This was carried out in a very sensitive manner by a staff who sat with the person and engaged them in an enjoyable, sociable and fulfilling mealtime experience at the residents own pace. Staff also had many positive comments about the quality of the food as they can purchase the meals at the home and the monies are put into an Activities Fund for the residents. This indicates that the home is run in the best interests of the people who live here. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their representatives have clear information so they would know how to make a complaint. The staff team have had suitable training so they know how to protect residents from abuse. Evidence: People have good information about what to do if they are not happy with the service. There is an information pack in every bedroom that clearly tells people how to make a complaint. Residents and their relatives also have opportunities at the Residents Meetings which are held every couple of months to comment on the service. It was also clear that the manager and staff make themselves available to people to discuss the service. Residents and relatives said that they would feel comfortable about mentioning any concerns, if they had any, and were confident it would be put right. One relative said, I would feel comfortable about talking to the manager about anything. The homes complaints records show that there have been no formal complaints about this service since the last inspection. It is good practice that the home also keeps a record of any informal comments about the service which shows how these have been addressed and resolved. Care Homes for Older People Page 18 of 28 Evidence: The home uses the safeguarding adults arrangements that are promoted by the City of Sunderland. These are robust procedures for dealing with suspected abuse.The manager has had training in the safeguarding adults processes and so she is familiar with her responsibilities in this area. All staff have previously had good training in protection of adults. Arrangements have also been made for all staff to receive updated training in safeguarding adults in the next few months. In this way staff are clear about how to protect the people who live here. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall the home is well maintained and decorated so that people live in good quality accommodation that is safe,warm, and comfortable. Evidence: St Georges is a purpose built care home that has been operating for many years. There is level access into a homely reception area at the front of the home and there is a passenger lift to access the first floor. Overall the home is well maintained and well decorated. The home benefits from the input of maintenance staff who carry out routine checks and repairs. Sitting areas and dining rooms are comfortable, well decorated and furnished. There are plans to provide lowered windows in the first floor lounge room so that people can see outside better, particularly for those people who use a wheelchair. Since the last inspection the ground floor lounge has been extended to create a sun room area next to the patio, which has really opened up this room and provided more seating for residents and their visitors. All the bedrooms are single occupancy and 26 have private en-suite facilities. Bedrooms are well decorated, cosy and comfortable and many rooms on the nursing unit have special (profile) beds. Bedrooms have been highly personalised by the Care Homes for Older People Page 20 of 28 Evidence: people who live here and some residents have brought many personal object and furnishings to make them feel at home. Several people enjoy spending a lot of time in their rooms, and some have have televisions, telephones, and small fridges. There are sufficient bathrooms and communal toilets that are well placed around both floors. However these are beginning to show signs of wear and tear, such as loose tiles, and the decoration is quite dated. Also there are no baths on the first floor nursing unit that are fitted with integral hoists or chair lifts. People currently have to use a portable hoist that is taken into the room. One bathroom is also used as a staff locker room (due to the lack of alternative storage area within the home) and also has some staff notices on the walls. This detracts from the residents accommodation. The manager indicated that one solution would be to split this room into two separate areas. The standard of odour control and cleanliness around the home was very good. It is clear that housekeeping staff work hard to keep this busy home so clean and hygienic. Some light pull cords are becoming grubby, as they are difficult to clean in their current state. The laundry room is well-equipped and there is dedicated laundry staff to manage this task. There are gaps to the floor covering in this room which could compromise infection control. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides suitable, competent, well trained staff to ensure that the people who live here are protected and that their needs are met. Evidence: The staff team consists of the manager, a deputy manager, four qualified nurses, two team leaders, 23 care staff, as well as housekeeping and catering staff. There are also part-time activities and maintenance staff provided once a week. There is a good mix of age and experience amongst the staff team. Some of the staff have worked here for some years and there is clearly a good team spirit and good relationship with residents and visitors. One resident said, All the staff are nice - you can have a good laugh with them. The daytime staffing levels provided at this home are one qualified nurse (who supervises the nursing unit), one team leader (who supervises the residential unit) and five to six care staff. During the night there are one qualified nurse and three care staff. These are satisfactory staffing levels to meet the number and needs of the people who currently live here. Staff responded quickly and sensitively to requests for support, and there was good staff presence around the home. Care Homes for Older People Page 22 of 28 Evidence: However, as reported at the last inspection, the manager is rostered to carry out 15 hours of her time (usually alternate weekends) as the only qualified nurse on duty. This means that she is responsible for all nursing tasks during those hours such as administering medication and carrying out nursing support to residents. In this way she cannot also supervise the staff or carrying out the many managerial, administrative, assessment and review tasks involved in running a care service. Similarly when the deputy manager is on duty through the week to cover the managers days off, she is also the only qualified nurse on duty, so is also responsible for carrying out all nursing tasks and so cannot fully deputise for the many managerial tasks. Wellburn Care Homes Limited is an equal opportunities employer, and has robust recruiment and selection processes to make sure that only suitable staff are employed here. It was clear from personnel records that no staff start work until satisfactory checks, reference and police clearance (called a CRB disclosure) have been received. Discussions with staff and the training records show that staff have very good opportunitities for training. At this time 19 of the 23 care staff have completed a recognised professional qualification, called NVQ level 2 in care, and two more care staff are working towards this award. There are also 9 staff who have completed an advanced stage of the training called NVQ level 3. It is also good practice that the housekeeping staff have also completed NVQ level 2 in support services. Staff training records clearly show that all staff have up to date training in all health and safety matters including First Aid, Food Hygiene, Moving & Assisting, and Fire Safety. About half the staff team have also completed training in dementia care, continence awareness and safe handling of medication. The Provider has a longstanding arrangements with a local training agency and any refresher training is planned and provided to any staff member whenever this is required. In this way the service is clearly committed to the continued professional development of all its staff. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and is run in a way that upholds the best interests of the people who live here. Evidence: The manager is a qualified nurse and has many years experience of managing care services. She has been the registered manager at St Georges for the past 3 years. Visitors and residents had many positive comments to make about her management style and skills, for example she is very caring and the home is very well run. The manager stated that she feels supported by an Operations Director who visits the home on a not less than monthly basis and reports on how the home is running. The home also uses residents comments to assess the quality of the service it provides, for example at the Residents Meetings. The minutes of a recent meeting showed that residents have made individual requests Care Homes for Older People Page 24 of 28 Evidence: for supper time snacks; suggestion for future activities; and arrangements for Christmas shopping trips to the Metro Centre. This shows that the views of residents are listened to and changes made as a result. The home will support people to safely store small amounts of personal monies if they request. Records of this were up to date and in good order. Monies are kept in individual, named wallets and securely stored in a safe. The home keeps numbered receipts of any trandsactions carried out on behalf of a resident, for example for hairdressing. In this way residents monies are safely managed on their behalf. The manager carries out and records weekly health & safety checks such as water temperatures and fire safety checks. All staff have up to date training in all health and safety matters, and they used safe working practices when supporting the people who live here. In-house fire instruction is well documented to show that staff have regular training in this area. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 The codes to denote why a medication has not been given should be used where the medication has not been prescribed as as and when required. Consideration should be given to providing new baths on the first floor with integral lifting equipment that would better meet the needs of the people who live here. Bathrooms would now benefit from refurbishment to bring them up to the same good standard as the rest of the home. To support the control of infection the floor covering to the laundry room should be made good so that there are no gaps or cracks; and light pull cords could be replaced with wipeable cords and be included on the cleaning schedule. Serious consideration should be given to an increase in qualified nursing hours to relieve the manager of shifts spent as the only nurse on duty, so that she can concentrate her time on the management of the service, clinical supervision of nursing staff, and assessment and review of residents. 2 21 3 21 4 26 5 27 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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