Inspection on 19/12/07 for St Oswalds Nursing & Residential Home

This inspection was carried out on 19th December 2007.

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 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 Oswalds Nursing & Residential... 23/04/09

St Oswalds Nursing & Residential... 18/08/08

St Oswalds Nursing & Residential... 17/07/07

St Oswalds Nursing & Residential... 29/06/06

St Oswalds Nursing & Residential... 02/02/06

St Oswalds Nursing & Residential... 02/09/05

St Oswalds Nursing & Residential... 04/01/05

St Oswalds Nursing & Residential... 27/05/04

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

CARE HOMES FOR OLDER PEOPLE St Oswalds Nursing & Residential Home 2 Crowhall Lane Felling Gateshead Tyne & Wear NE10 9PX Lead Inspector Mr Tom Moody Unannounced Inspection 19th December 2007 09:30 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 Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Oswalds Nursing & Residential Home Address 2 Crowhall Lane Felling Gateshead Tyne & Wear NE10 9PX 0191 495 0585 0191 438 1722 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) None Four Seasons Healthcare (England) Limited (Wholly owned subsidiary of Four Seasons Health Care Ltd) Ms Valerie Kelly Care Home 70 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (64), of places Physical disability over 65 years of age (52), Sensory Impairment over 65 years of age (9) St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One person under the age of 65 who also has a physical disability. The Manager will be supernumerary to the staffing complement Date of last inspection 17th July 2007 Brief Description of the Service: The home is in an urban setting close to local facilities. The home extends to four stories. It is contains 70 registered beds. The charges range from £370 to £456. Social care is provided on the ground floor and social care for service users with dementia is provided on the top floor. The middle two floors provide nursing care for older persons. The home is of traditional appearance with a tiled roof. It has one passenger lift and because it is built on rising ground there is access to the outside from the two lower floors. For the same reason views from some of the lower floor windows are restricted. There is a lounge and dining room on each floor with additional lounge space close to the first floor entrance. The home has a patio area and a large car park. The grounds are landscaped. St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day in December. Two inspectors were present during the site visit. Although the last inspection showed that the homes standards were improving, concerns expressed by the Local Authority contracting department suggested a deterioration in standards. In light of this this another inspection was carried out. Three service users on the nursing floors of this home had the documents relating to their care examined and they and their relatives were asked about their care experience. The focus on the top floor was specifically on two service users but a different technique involving observation was used to judge their care. One inspector carried out an observation specifically to assess the quality of life for service users on the top floor of the home and whose mental health problems make it difficult for them to communicate. The acting manager and staff were spoken to, as well as other service users and relatives. Other documentation were examined and a tour of the premises took place. Verbal feedback was given to the manager on the main findings of the site visit. The home is reasonably well equipped with appropriate aids and adaptations in bathrooms and toilets. However, the standard of maintenance has fallen and there were defects in a number of areas. The decor is being gradually improved in a style that is suited to the client group’s age and lifestyle preferences although this has not progressed as rapidly as it might have. The home has plenty of space in all areas. It is popular with service users and their families. What the service does well: The morale in the staff in the home remains good, in spite of the change in management. Staff said that the Manager is approachable and they have confidence in her abilities. St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 6 The kitchen staff are well motivated and provide a flexible service tailored to service user’s needs. People in the home enjoy their meals. The ground floor of the home has a very homely feel and service users show a sense of ownership. Staff on the top floor have had training in dementia care and these ideas are being put into practice with good effect. What has improved since the last inspection? What they could do better: The home has a long standing problem with the hot water supply to some baths, showers and basins. In spite of numerous attempts to remedy this the situation the problem has not been solved. The home had suffered a failure in the heating system on the day before the site visit. Temporary heating had been provided using portable heaters that did not have low surface temperature. The existing heating system must be reliable and any supplementary heat sources must be low surface temperature to avoid the danger of burns to service users. Several extract fans were not operating and some areas of the home smelled unpleasant. Regular maintenance must take place to ensure adequate ventilation is provided in all areas. A bath thermometer was in use but it was broken. Staff had no way of ensuring bath water was at a safe temperature in this bathroom. Some kitchen equipment, such as jugs, were badly stained and cracked. Worn or damaged equipment should be reported and replaced to ensure service users safety and comfort. Care plans contained some inaccuracies and they did not always agree with some of the care that was given to people in the home. Plans must be consistent; they must reflect the needs of service users, and the care given to them. St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 7 Refurbishment must be completed in all areas of the home to ensure there is the minimum disruption to service users lives. All of the patio areas should be kept clean and tidy and their appearance could be improved by better container planting. Although many areas of the home were clean some were found to be dusty or dirty. Some surfaces in the kitchenettes had food remains or stains on them that could have been easily have been wiped away when they occurred. After the loss of the registered manager, management arrangements must be reviewed to ensure greater stability and continuity of management. Although the senior management of the company have resisted this suggestion in the past, the company should seriously consider altering the management arrangements, and possibly the layout of this home, to ensure stable management and the well being of service users. 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. The summary of this inspection report can be made available in other formats on request. St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 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 Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All service users entering the home have their needs accurately assessed by social care and health service staff. The home makes it’s own assessment in addition to this and, although there are some weaknesses, this does include a “Life History”. This should ensure service users needs are met. Most service users and their family have the opportunity to visit the home before they come to stay, unless there are exceptional circumstances. This allows them to make an informed choice about staying in the home. EVIDENCE: The provider’s self-assessment indicates they provide a satisfactory Service Users Guide which includes terms and conditions and statements of purpose. They also state that the latest CSCI report is available and that service users can make visits and have trial periods before deciding to come into the home. Past inspections and service users comments have confirmed this. St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 10 The manager confirmed that service users and visitors are able to visit the home. There are new assessment forms in place that are comprehensive, but quite lengthy. Most examples had been filled in quite well but one service user’s records had little information on her life history. Some parts of this assessment were contradictory. St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users health care needs are largely met. They have access to all healthcare services that they need but inconsistencies in the care plan and some care practices may leave some service users at risk. Appropriate policies and procedures ensure that service users receive their medication in a safe way. EVIDENCE: The provider’s self-assessment indicates that they provide good documentation and individualised holistic care practice. It also states service user and relatives participate in meetings and that care plans are audited. Recent information from local authority contractors indicate concerns about inadequate nutrition and unexplained weight loss in service users as well as poor care planning. St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 12 When documents were checked during the site visit there were some inaccuracies in the care plan assessments on the middle floors which could be due to the documents being new and relatively complex. Health professionals visit the home, including doctors, dentist, podiatrists, dieticians and psychiatrist. Risk assessments are carried out and the home has obtained new equipment such as profiling beds. The home now has a working set of scales and service users weights are recorded. At the time of the site visit the home was suffering from an outbreak on diahorrea which was of viral origin. The relevant health protection agencies had been informed and the home were taking suitable measures to prevent further spread. The service users on the top floor experience a reasonably good quality of life. For example one resident spent much of the time singing along to the Christmas tunes playing in the background. Another resident had his glasses and a photograph of himself and his wife, who is also in the home, by his side on a table and staff spent time discussing this with him. However, the care plans on the top floor were also inconsistent and the care that was given did not always match the planned care. Staff knocked at service users doors but the style of locks in usee do not ensure privacy for service users. Medication is stored safely. A monitored dosage system is in use and recording is good. Adminstration was observed and was satisfactory, although the timing coincided with lunch. This could be reviewed as it tended to detract from the dining experience and devided staff’s attention at a busy time of day. St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home provides a lifestyle that matches service users needs and preferences. Furthermore meals are of good quality and the timing and choice can be varied to meet service users needs. EVIDENCE: The Providers self-assessment indicates that relatives and service users have regular meetings. Also there are plans for a sensory room and there is a minibus available for outings. Recent information from local authority contractors indicate the level of service provision may not meet the assessed needs of all individuals. Some have been isolated on floors that were being refurbished with few service users and staff around them at times. At the time of the site visit, all service users in the nursing part of the home were on the one floor, that remains open whilst the other is refurbished. St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 14 Staff dealt appropriately and politely with visitors to the home. Staff addressed service users appropriately. Visiting is unrestricted and visitors were seen coming and going throughout the day although there were relatively few at the time of this site visit. The chef makes regular contact with service users to monitor satisfaction with the meals. Menus are satisfactory. The meal seen by the inspector was of good quality and service users were able to make a choice. Service users were supported by staff if they needed assistance with their meal. Service users said that they enjoyed their food and one relative said ,”They get good food.” Photographs were displayed of recent social events and staff confirmed his had been a recent birthday party for one service user. Another service user spoke warmly of having enjoyed a “sing-song” the day before. Service users were watching T.V. and appropriate music was playing. Unfortunately bedroom door locks are not appropriate and at least one bathroom door did not lock properly. This would not provide either privacy or dignity to anyone attempting to use the toilet. On the top floor there was a lot of activity. Some service users were asked by staff if they would like their hair styled and on their return were complimented on their appearance. One person was supported by staff to take part in baking activity in the dining room. Staff had taken time to ensure that personal objects were to hand, such as a comb and glasses, which resident’s actively used. There was a large faced clock in the lounge which resident’s also actively used. Resident’s were offered tea and biscuits by staff. Staff interactions were good. For example, they got down to the resident’s level when talking with them. They spoke to one resident about their photograph, complimented people about their appearance and gave people choices, for example one resident was asked if they wanted to help to make a Christmas log or have their hair styled. Staff also handed out Christmas cards to individuals. The lunchtime was quiet and relaxed on this floor. Menus on the tables would be beneficial, to help service users remember what is for lunch, and guide staff who were not sure what was for lunch on the day of the site visit. St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. The homes policy on adult protection reflects the multi-agency approach to adult protection, the local procedures and staff know how to use it. This helps ensure the protection of service users. Recruitment and selection procedures have not been robust and lapses in obtaining CRB checks for staff potentially puts service users at risk from unsuitable carers. Service users and relatives are confident that the complaints process, and the staff, will act in the service user’s best interests. EVIDENCE: The provider’s self-assesment indicates the home has appropriate policies and procedures, including whistle blowing, and they make the statutary notices required under the regulations. The regulators experience has shown this to be largely accurate. Service users confirmed that they would be happy to raise issues and problems with the staff. All of the relatives that were spoken to confirmed that they found the staff helpful and felt that the Manager was approachable. St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 16 Complaints are recorded appropriately and staff training includes adult protection issues. Staff who were spoken to said that they had training in adult protection issues. However staff files confirmed that not all staff had current CRB checks and this could put service users at risk. Although this had been brought to the regulatory authorities notice by the current Area Manager this situation had persisted for some time. The new manager and Area Manager both said that checks had been sent off when this discrepancy was discovered but not all of them had been returned. St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26. Quality in this outcome area is adequate. This judgment has been made using available evidence including visits to this service. The environment is generally safe, comfortable and furnished to service users tastes, but a number of health and safety weaknesses exist that may pose hazards to service users and others in the home. EVIDENCE: It was disappointing to find the second floor of the home still being refurbished. Other works have been carried out on the occupied floors but this part of the home has been out of use for some months now. Although much work has been done, it is not yet completed. It would have minimised disturbance in the home if priority was given to completing the work on the unoccupied floor. St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 18 In spite of the expenditure of a considerable sum of money on the second floor, service users are not able to benefit from this refurbishment and are housed in an area that is suffering declining standards of accommodation in many respects. There has been some redecoration on the first floor and the dining room had been redecorated. Some work has been carried out in the kitchenettes but stained and cracked jugs are still in use. Surfaces in these areas were not always kept clean and food debris and stains were left for some time on surfaces. Such elementary hygiene precautions should be observed at all times but even more importantly when there is an outbreak of enteric infection, as was the case the time of this site visit. One service user spoke of their room being “flooded” following an accident involving water pipes during the refurbishment on the floor above. This room is without many of it’s ceiling tiles, exposing pipes and other services. Door locks on service users bedrooms do not have a master key system and can be locked, and opened, from outside only by using a “slot-turn” system. This is unsuitable and unusable by most service users. This system can be used by staff and others and takes control away from service users. The top floor is well decorated and carpeted in most areas. Unfortunately, unguarded, free-standing heaters were in use in the lounge, following a partial failure of the main heating system the previous day. This is not the first time the home has had such a problem and a similar failure occurred last year. The heaters were removed immediately on the manager’s instructions. The home was at a pleasant temperature at the time of the site visit but visitors were aware that the heating had been off the previous day and remarked on previous failures. Several areas on this floor were gloomy and had low light levels. This was because staff had turned lights off. Good light levels are important for the well being of these service user. The top-floor shower room had an unpleasant smell. The shower was ineffective and hot water could not be obtained from it. This may pose a hazard from Legionellae bacteria. Hot water was also not available in some bathrooms. This is another long-standing fault that the home has not solved. Several toilets and the sluice room had ineffective air extract systems. This was causing odour problems in these areas. A number of bathrooms and toilets were poorly maintained and not all clean on various floors. In one bathroom the enamel in the bath is worn on the base. The bath thermometer in one bathroom was broken so staff could not be checking water temperatures before immersing service users. St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 19 There was no liquid soap or grab rails in some toilets. The ceiling in some of these areas is grubby and lampshades very dusty. The wallpaper in bathrooms is inappropriate for people with dementia. In the dining room tables were nicely presented with condiments so people could help themselves. Some of the chairs in the lounge and the carpet in the corridors are stained in places. There are no cues, such as images of toilets, to help people with dementia find their way around. The type of photographs placed on bedroom doors may not be appropriate for some people. St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. The manager ensures that the home operates safely, in terms of sufficient numbers of staff, who are appropriately trained, however staff need to be deployed so that they are available to meet service users needs. The lack of current CRB checks for some staff may put service users at risk from potentially unsuitable carers. EVIDENCE: At the time of the site visit there were sufficient staff on duty on the middle floors. The call system was answered promptly and service users were supported. Some relative spoke of there being few carers at the weekend. The manager acknowledged there was some absence at short notice due to the enteric infection. It was also thought that the layout of the building may lead to the perception that staff are not available when they are occupied in other areas. On the top floor it was noted that one service user became unsettled as other residents start going to bed. Staffing levels need to be reviewed at this time and a behaviour management plan developed for B. Also the senior carer has St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 21 to go downstairs for ½ an hour to administer medication leaving only 1 member of staff on duty on the top floor at this time. A sample of staff records were checked and this revealed that, induction training and supervision takes place, and that most pre-employment checks are carried out. Staff said that good level of induction take place and they feel supported. However, as noted in an earlier section, staff files confirmed that not all staff had current CRB checks and this could put service users at risk. Some staff expressed a keen interest in starting their NVQ training and the home has ensured a high number of staff receive this training. St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36, 37, 38. Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. Due to the lack of a permanent manager there are some areas of management weakness which undermine meeting service users’ needs and potentially put them at risk. EVIDENCE: The home has lost the permanent manager and a peripatetic manager is in charge. Recent information from local authority contractors and providers themselves, indicate that the management performance of the previous manager had deteriorated and service users had been potentially placed at risk St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 23 by the lack of effective management. External management oversight did not appear to detect this. Although the current acting manager is experienced she has only had a number of weeks to come to terms with managing this home. The departure of the Registered Manager (and Area Manager) is a repeat of an all too familiar pattern in this home. This home has a long history of improving it’s performance only for this to be followed by a decline in standards. In several earlier inspection reports it was noted that the design and size of this home makes it difficult for anyone to manage effectively. Previous Registered Manager have said this is the case. The relatively short periods that all previous managers have stayed in the home is another indication of this. The home is currently suffering from a lapse in many environmental standards and some of these issues effect the health and safety of the home’s occupants. Some of these issues, such as the lack of reliable hot water and heating failures, are familiar to relatives and the regulatory authority but the present manager was unaware of this history. These issues range back years, rather than months or weeks, and the company should have solved such problems long ago. Although many aspects of record keeping are satisfactory, the failure to previously send off CRB checks is another risk factor for service users related to inconsistent management. St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 2 3 2 2 3 2 2 2 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 2 x x 3 2 2 St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 25 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 OP3 OP7 Regulation 14(1) Requirement The needs of service users must be accurately assessed to ensure they receive appropriate care The service user’s care plans must accurately reflect their healthcare needs and must be reviewed and kept up to date. The lack of key-operated locks on bedrooms and unusable locks on bathrooms or toilets does not allow service users proper privacy and dignity when using these areas. Adequate checks on persons employed in the home must be carried out to ensure service users are kept safe. The home must be properly maintained to ensure service users safety and well being. Working bathing and showering facilities must be available to service users, with an adequate supply of hot water, to ensure their hygiene needs can be met safely. Timescale for action 28/02/08 2 OP8 15(1) (2)(b) 12 (4) (a) 28/02/08 3 OP10 OP14 28/03/08 4 OP18 19(1) (4) 28/02/08 5 6 OP19 23(2)(a) 23(2)(j) 28/02/08 28/02/08 OP21 St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 26 7 OP22 23(2)(c) 13(4)(a) (c) 8 OP24 16(2)(c) 12(4)(a) 23(2)(d) 9 OP25 23(2)(b) 16(2)(k) 23(2)(p) 13(4)(a) (c) 23(2)(p) 13(4)(a) (c) 23(2)(k) 13(3) 16(2)(g) 16(2)(j) 16(2)(k) 10 OP25 11 OP25 12 OP26 13 OP27 18(1)(a) All toilet and bathing facilities must have suitably positioned handrails and mobility aids to assist service user. Working bath thermometers should be available in all rooms. To ensure service user’s well being their rooms must be fitted with suitable locks that they can use. All bedrooms must be adequately decorated and maintained including appropriate ceiling surfaces. Extract fans in bathrooms, toilets and sluice areas should work properly to ensure adequate ventilation in the home. Reliable heating in the home must be provided, and be of a design that has low surface temperatures, to ensure service users comfort and safety. Lighting in all areas of the home used by service users should be maintained at a reasonable level (150 Lux) to ensure service users comfort and safety. To minimise the risk of infection appropriate sluicing and disposal facilities should be provided on all floors. Water should circulate at appropriate temperatures and unused outlets should be flushed through regularly (at least weekly). Equipment, utensils and surfaces should be kept in good repair, or replaced when worn, to ensure they can be adequately cleaned. All areas of the home should be kept clean. Duty rotas and deployment of staff must be reviewed to ensure staff levels and skill mix match the needs of service users. 28/02/08 28/02/08 28/02/08 28/02/08 28/02/08 28/02/08 28/02/08 St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 27 14 OP29 OP37 19(1)(a) (b) 13(6) 8(1)(a) 15 OP31 OP32 OP33 16 OP38 13 (3) 13(4) (a) (b) (c) Recruitment practice must be 28/02/08 carried out in accordance with statutory guidance, and the homes own policies, to ensure the safety of service users. The home must appoint and 28/02/08 have registered a permanent manager as soon as possible and review the overall management and organisation of the home. They must ensure proper, and stable, management of the home and provide a solution to many of the long standing problems in this home. The management of the home 28/02/08 must ensure safe working practices are carried out. This must include infection control, hygiene, Legionella risk, hot water and surface temperature risk, as well as general maintenance of the environment. St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 28 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP19 Good Practice Recommendations Patio areas should be kept free of leaves and moss to ensure unimpeded access St Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 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 © 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 Oswalds Nursing & Residential Home DS0000018178.V357208.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!