Inspection on 09/05/06 for St Oswalds House Nursing Home

This inspection was carried out on 9th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

St Oswalds House Nursing Home 14/08/07

St Oswalds House Nursing Home 30/01/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE St Oswald`s House Nursing Home 12 Golborne Road Winwick Warrington Cheshire WA2 8SZ Lead Inspector A Gillian Matthewson Key Unannounced Inspection 09:30 9th & 16th May 2006 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 St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 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. St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Oswald`s House Nursing Home Address 12 Golborne Road Winwick Warrington Cheshire WA2 8SZ 01925 656337 01925 573113 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) Southern Cross Healthcare (Cheshire) Limited Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42) of places St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 42 service users in the category of OP (Old age, not falling within any other category) The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance which may be issued through the Commission for Social Care Inspection 30th January 2006 3. Date of last inspection Brief Description of the Service: St Oswald’s House is a care home providing personal and nursing care and accommodation for 42 older people. The home was first registered in 1987 and consists of a two-storey building and a single storey extension. A passenger lift provides access to the first floor. There are 42 single rooms. Twenty of the rooms have en-suite facilities. In addition to these there are 4 bathrooms with toilets and 5 separate toilets. The home has a large reception room and two lounges and a dining room downstairs and a lounge/dining room upstairs. It is set in its own gardens in the village of Winwick. The location has easy access to the main Manchester and Liverpool motorway network and is on bus routes from Warrington. A registered general nurse (RGN) is on duty at all times to meet the needs of those residents requiring nursing care. The fees range from £273 to £650 per week. St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a day and a half and was carried out by 2 regulatory inspectors. Prior to the inspection they had reviewed previous inspection reports and the service history over the previous twelve months. At the inspection a tour of the premises was carried out and records were examined. Building work was continuing to improve the facilities within the home and a further inspection will be carried out when the work is complete. Inspectors consulted with six residents and one relative. They also spent time in conversation with the manager and six other members of staff. Overall, there had been many improvements since the last inspection, which is reflected in the reduced number of requirements. There are no outstanding requirements. Residents’ and relative comments were generally much more positive about the home. What the service does well: Residents are assessed prior to admission to ensure that the home has the resources to meet their needs. Care plans are detailed, giving staff clear instructions on the actions they need to take to meet the residents’ needs. Residents are able to access health care services as required. Residents expressed their satisfaction that the home provides an activity programme to fulfil their social and recreational needs. Residents’ wishes and feelings are taken account of in relation to activities of daily living and access for visitors.The food provided for residents is of a good standard. Residents and visitors have access to a clear complaints procedure. Staffing levels are sufficient to meet residents’ needs and a comprehensive staff training programme is in place. The home is clean and equipment is well maintained. St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Staff must appreciate the need to ensure that the medicine records are clear, complete and are made immediately following administration so that not too much reliance is made on memory. A clear record of medicines received, given or refused and medicines destroyed shows that residents have had their medicines correctly. Staff should be reminded to offer choices for both courses to all residents at mealtimes. Staff recruitment practices could be further improved by obtaining a reference from the last employer prior to employment. This would further enhance the protection of residents. Further work is needed to improve the facilities in the home. St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 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. St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 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 the following standard(s): 1&3 The quality in this outcome area is good. Prospective residents and their representatives have the information needed to choose a home that will meet their needs. EVIDENCE: The home provides a statement of purpose that clearly sets out the objectives and philosophy of the home and a resident guide that summarises the statement of purpose and provides clear information about the home. The guide explains what residents can expect and gives a detailed account of the accommodation, qualifications and experience of staff, how to make a complaint, recent CSCI inspection findings and contains comments from residents and relatives. The guide is available in reception and on the residents’ notice board. A relative confirmed that she had been given a copy of the guide and the home has a policy that all new residents are given a copy. Case tracking confirmed that admissions are not made to the home until a full needs assessment has been undertaken. The assessments are carried out by a senior member of staff, who reviews the care management assessment, meets with the prospective resident and their representative, if possible and carries St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 Page 10 out a full needs assessment. The admission procedure is set out in the resident guide and residents confirmed that pre-admission assessments had taken place. The home does not provide intermediate care. St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 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 the following standard(s): 7, 8, 9 & 10. The quality in this outcome area is adequate. The health and personal care that a resident receives is based on their individual needs and the principles of respect, dignity and privacy are, in the main, put into practice. Current practice in the administration of medication could put residents at risk. EVIDENCE: The home has a belief that it is essential to involve residents in the planning of care. Each resident has a plan that has been agreed with them or their representative. The plans that were examined included signatures of the residents’ representatives to demonstrate that they had been consulted and agreed with the plan of care. Plans also contained evidence of reviews of care with the resident, their representative, key worker and social worker. The home has a policy that reviews are carried out after six weeks and six monthly thereafter. Plans also included risk assessments and details of aids and equipment needed. Two of the care plans examined indicated that the residents were at risk of pressure sores and pressure relieving mattresses were in place, but they were not specific about the type of mattress. See Recommendation 1. St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 Page 12 Residents have right of access to health services. This is stated in the resident guide and case tracking demonstrated that this was the case. The care records of those residents who were case tracked showed that referrals had been made to various health care professionals as necessary, for example GP, district nurse, podiatrist. The statement of purpose states that residents are entitled to access to NHS services and that the home will make arrangements for transport to attend appointments. Staff training records demonstrated that care staff are trained to meet residents health care needs. The manager is a registered nurse and the home also provides a registered nurse on duty twenty four hours a day. The home has company policies and procedures for medicines management. Some residents’ medicine records were completed to a good standard but others were not so good. Sixty-seven unexplained gaps were found in the records of giving medicines. Four service users had not been recorded as having any of their medicines that morning. The tablets were not in the pack. It was not clear whether medicines not packed in the blister had been given. The nurse on duty said that she had given the medicines. The dose of medicines prescribed as a variable dose was not recorded in four service users’ records. One resident was prescribed a medicine to control the heartbeat. It is usual for nurses to take the pulse before giving it to be sure that the heart is not being slowed too much. This was not always done. One resident was prescribed a food supplement twice daily that on one day was recorded as given three times. Another resident was prescribed a pain killing gel three times a day and on one day it was recorded as given four times. Neither of these errors would be likely to cause harm but it does show that staff need to take more care when reading medicine directions. Two residents’ medicines were recorded as out of stock for four days. One resident was prescribed a laxative and one a pain killing liquid with no specific directions of how much to give. The painkiller was recorded as given every day but not how much was given. There was no evidence that medical advice had been requested. One resident’s dose of a heart drug had been recorded as given for the following day. One resident’s record had been amended with liquid paper. There were two omitted records of receipt of medicines into the home. The nurse looking after the personal care residents put medicines from a resident’s blister pack into a specimen jar. She said that they were for the resident to take during the afternoon at the dialysis unit. The Medicines Act 1968 states how medicines are to be labelled so that if lost or used in an overdose they can be identified. The transfer to the specimen pot loses the important label information. The residents’ medicines had been recently moved to a room that was being refurbished for the purpose. It had plenty of space for staff to work in and had both a hand washing basin and a washing up sink. The medicines belonging to the residents receiving nursing care were segregated from those having personal care only in cupboards and trolleys. The cupboards had hasps for St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 Page 13 padlocks but these had not yet been fitted. The trolleys were very crowded and it needed quite a bit of force to squeeze the blister packs in. There was a lockable refrigerator for medicines. Its temperature probe showed room temperature as the inside and the refrigerator temperature as the outside temperature. The temperatures were recorded on most days. The room temperature was as high as 31.2 degrees. It was agreed that the radiator would be turned off. The refrigerator minimum temperature was –8.4 degrees. There was no evidence that staff had identified this as a problem. There was a container of reagent sticks for urine that date expired last November and one of blood testing sticks that had date expired the previous April. If used these may give misleading results. Controlled drugs are stored in a secure metal cupboard that was accepted as a controlled drug cupboard on registration. It does not completely comply with the Safe Storage Regulations of the Misuse of Drugs Act 1973. There is a controlled drug record book and staff make the legally required extra records satisfactorily. The quantities held are checked and recorded at each shift change. Training manuals and records of competence assessment in handling medicines were available. An immediate requirement was served at the time of the inspection. See also Requirement 1. The aims and objectives of the home reinforce the importance of treating residents with respect and dignity. This is emphasised in relation to the delivery of personal care. The home’s induction training includes maintaining residents’ privacy and dignity. All bedrooms have a sign saying ‘please knock’ on the door. Residents spoken with confirmed that staff treated them well and staff were seen treating them in a respectful manner. One resident who required assistance with feeding had dribbled some food down their top at lunch time. The resident, who would have been unable to change their own top, was still wearing the stained top later in the afternoon. See Recommendation 2. St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 Page 14 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 & 15. The quality in this outcome area is adequate. Social, cultural and recreational activities meet residents’ expectations. In the main, residents receive a healthy, varied diet according to their assessed requirements and choice. EVIDENCE: The home tries to be flexible and attempts to provide a service that is as individual as possible. Residents are consulted about their wishes in relation to the times they like to get up and go to bed, their food preferences, where they would like to take their meals, what papers they like to read and their hobbies and interests. All this information is recorded in the care plan. Staff spoken with were aware of residents’ preferences. One resident said that he likes to get up after his early morning cup of tea but that staff did not always comply with this request. The manager was requested to look into this. Residents are given the opportunity to take part in a variety of activities both within the home and in the community. The home has recently appointed an activity coordinator for 30 hours a week. She has consulted with residents and produced a weekly activity programme and a programme of outings up to November 2006. The activity programme includes exercises, reminiscence, quizzes and bingo. An outing to Southport Botanic Gardens is planned for May. The residents guide indicates that church services are held in the home and St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 Page 15 that arrangements can be made for residents to attend their preferred place of worship if they wish. At the time of the inspection the visiting hairdresser was in the home. A reminiscence session talking about schooldays was held in the afternoon and afterwards two staff took some of the residents for a walk in the grounds. A visitor said that residents have much more opportunity to engage in recreational activities than they used to and care plans contained a record of activities that each individual resident had engaged in. The resident guide states that visiting is possible at most times of the day and that residents can receive visitors in their own room. Visitors were observed in the home throughout the day and one confirmed that visiting was no longer restricted. Residents are able to manage their own money if they wish, although only one resident does. The home has access to an advocacy service called Care Aware. Information on this service is available in the reception area and staff records demonstrated that staff had received training in what the service could offer and when it would be appropriate to refer a resident to the service. Resident’s rooms were well personalised with their own possessions, such as family photographs, pictures, ornaments, soft toys and small items of furniture. The home makes it known that residents have access to their personal records. Residents spoken with were aware of this, but left it up to their family representative to review the records. Lunch, the main meal of the day, was served to residents during the inspection. It consisted of cottage pie or chicken with chips and mixed vegetables. The dessert was ginger sponge and custard or fruit cocktail and ice cream. Food was well presented and looked appetising. Food for those on pureed diets was blended and set out in separate portions on the plate, for example separate portions of meat, potatoes and vegetables rather than all blended together. Sweetener was used in desserts to enable residents with diabetes to partake of most of the desserts on the menu. Residents were asked what they would like for the main course and those residents in the dining room and lounge were offered a choice of dessert. One resident, who was having lunch in her room, was offered ginger sponge and custard for dessert. She declined, but was not offered any alternative, despite the fact she had eaten very little of the main course. This resident was identified as being at risk of weight loss due to a poor appetite. See Recommendation 3. Staff were observed feeding other residents who required assistance. They sat down with the resident they were feeding and fed the resident in an unhurried manner at the resident’s pace. Some residents had lunch in the dining room, some had lunch in the lounge and some in their own room. The home has a limited amount of dining space, but the manager said she has plans to convert the small lounge into an additional dining area. The home had recently consulted with all residents about what they would like to see on the menu and the manager was in the process of revising the menus. St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 Page 16 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 & 18. The quality in this outcome area is good. Residents have access to a robust, effective complaints procedure and are protected from abuse. EVIDENCE: The home has a satisfactory complaints procedure in the resident guide and on the home’s notice boards and residents and relatives are aware of who to address any concerns to. The policy includes the facility for people to also make suggestions for improvement. The home keeps a record of all complaints, details of the investigation and any action taken as a result. The home had received two minor complaints since the last inspection, neither of which related to care. These had been resolved. The home also has satisfactory protection of vulnerable adults procedures and whistle blowing policy. Staff, when questioned, were aware of the policy and procedures and training records demonstrated that all staff had received training in this matter in October and November 2005. St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26. The quality in this outcome area is adequate. The physical design and layout of the home enables residents to live in a safe and well maintained environment, but some further work is needed to ensure residents’ comfort and freedom of choice in relation to where they spend their time. EVIDENCE: The home was clean and tidy on the day of the inspection and the gardens were well maintained. The home is registered for 42 service users but at the time of the inspection one bedroom was being used as a staff room. The manager explained that, as part of the ongoing refurbishment, a new staff room was to be created and the bedroom would be refurbished. She said there were also plans to create a hairdressing salon. Since the last inspection the provider had created two offices in the reception area for the manager and administrator, put in en-suite facilities in two more bedrooms and done some redecoration in bedrooms and corridors. St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 Page 18 The home has four bathrooms but only three were in use at the time of the inspection. The fourth had no flooring because this had been taken up to carry out some electrical rewiring. Because this bathroom was out of use the upstairs lounge was hardly used because there is no other communal toilet nearby. See Requirement 2. On the day of the inspection some areas were too warm in the afternoon, despite the windows being open. This was a particular problem in the small lounge. The handyman said he could turn the radiator off in that room, but then it would be too cool later on. One of the residents also complained that their room was too hot. The radiators did not have thermostats. See Recommendation 4. St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. The quality in this outcome area is adequate. Staff in the home are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the changing needs of residents. EVIDENCE: At the time of the inspection there were 25 residents requiring nursing care and 14 residents requiring personal care only. Staffing levels consist of 7 staff on duty from 8am to 2pm, 6 staff on duty from 2pm to 8pm, and 4 staff on duty overnight. These numbers include a registered nurse and a senior care assistant and are sufficient to meet residents’ needs. Apart from the registered nurses, 9 of the 20 care staff hold an NVQ Level 2 in Care or equivalent and 3 more are undertaking the training. Four staff files were reviewed. All staff had submitted an application form and their identity and current qualifications had been checked. A Criminal Records Bureau disclosure had been obtained prior to employment but two staff only had one written reference, and three did not have a reference from their last employer. See Recommendation 5. Staff receive induction training that covers all the Skills for Care induction standards. St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 Page 20 Residents and the relative spoken with said that staff were helpful and caring and relations between staff were much improved since the change of ownership of the home. St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality in this outcome area is adequate. The management and administration of the home is based on openness and respect, with effective quality assurance systems in place. EVIDENCE: A new manager was appointed at the end of March. She is a first level registered general nurse with an NVQ Level 5 in Operational Management and is also trained as an NVQ Assessor. She has not yet submitted an application for registration as the manager of this home to the Commission. See Requirement 3. All those spoken with said that the manager is very approachable and that she listens to and values their opinions. St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 Page 22 There are quality assurance systems in place. The home manager carries out regular audits and the scores have been consistently improving since the change in ownership of the home. The operations manager of the company visits at least monthly and submits a report to the Commission. Relative, resident and staff meetings are held regularly to provide information and seek views about the running of the home. Residents have recently been surveyed about their preferred choices for the activity programme and menu. Comment cards are available in reception and the manager said she was planning to carry out a customer satisfaction survey in the near future. The home has a satisfactory system for looking after residents’ personal monies. The administrator maintains all records on a computer system. The records of those residents who were being case tracked were checked and found to be correct. Regular statements are provided. There is also a safe system for storing and recording any valuables handed in for safekeeping. Records demonstrate that staff receive regular supervision. The home has a good system for checking that all equipment is in working order. Records demonstrate that checks are carried out at the required intervals. Staff receive regular training in safe working practices and have had training in fire safety, food hygiene, moving and handling and first aid in the last six months. An inspection of the electrical installation in September indicated that parts of the installation were unsatisfactory. Records show that a great deal of electrical work has been carried out since then and the manager said that a further electrical inspection had been carried out, but on the day of inspection five of the emergency lights weren’t working and the report was not available. See Requirement 4. St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 Page 23 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 4 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 2 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 2 St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? YES 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(2) Requirement Timescale for action 16/05/06 2 OP21 23(2)(j) 3 OP31 9 4 OP38 23(4) The registered person must ensure that staff make records of medicine administration immediately after they have witnessed the resident taking it. (Outstanding from 31/01/06) The registered person must carry 31/07/06 out any work necessary to ensure that the bathroom on the first floor in the old part of the building can be used. The registered person must 30/06/06 ensure that the manager submits an application for registration with the Commission. The registered person must 30/06/06 ensure that all emergency lights are in working order and submit a copy of the electrical installation inspection report to the Commission. St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard OP7 OP10 OP15 OP25 OP29 Good Practice Recommendations Care plans should include the specific details of equipment provided for service users. Residents should be offered a change of clothes after meals if they are stained. All residents should be offered alternatives for both courses at mealtimes. Thermostats should be fitted to all radiators. References obtained for staff prior to employment should include a reference from their previous employer. St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 St Oswald`s House Nursing Home DS0000066209.V289689.R01.S.doc Version 5.1 Page 27 - 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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