Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 29/06/06 for St Oswalds Nursing & Residential Home

Also see our care home review for St Oswalds Nursing & Residential Home for more information

This inspection was carried out on 29th June 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

What the care home does well

The kitchen staff are well motivated and provide a flexible service tailored to service user`s needs. The ground floor of the home has a very homely feel and service users show a sense of ownership. The home has a wide ranging social programme and good contacts with the surrounding community. Staff on the top floor have attended a course in dementia care and these ideas are being put into practice with good effect. The manager ensures that regular staff meetings are being held. There is a good relationship between service user`s relatives and many of the staff.

What has improved since the last inspection?

There has been some improvement in decoration. There has been some improvement in cleanliness and odour control. Care staff morale has improved and staff on the top floor are volunteering ideas to improve the quality of service user`s lives. The quality of care plans has shown further improvement, in most of the examples seen. Some decoration has been carried out to improve the appearance of the home.

What the care home could do better:

Decoration still needs further improvement. Stained and marked carpets must be replaced. Equipment and fittings must be suitable and be maintained in a safe condition. All assessments must be completed accurately when service users are admitted to the home, including pressure damage risk. There is scope for further improvement in the cleanliness of some areas of the home. Staff must adhere to company`s medication policy and professional guidelines to ensure service users receive their medication safely. The management of the home must ensure they eliminate bad care practice such as, swearing, "rough handling" and "noisy behaviour" cited by some service users. The management of the home must eliminate the flouting of company`s smoking policy by some of their staff. The management of the home must eliminate the petty vandalism that some staff members are indulging in.

CARE HOMES FOR OLDER PEOPLE St Oswalds Nursing & Residential Home 2 Crowhall Lane Felling Gateshead Tyne & Wear NE10 9PX Lead Inspector Mr Tom Moody Key Unannounced Inspection 29th June 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Oswalds Nursing & Residential Home DS0000018178.V299145.R02.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.V299145.R02.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) 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.V299145.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One person under the age of 65 who also has a physical disability. Date of last inspection 2nd February 2006 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. 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. 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.V299145.R02.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 June commencing at 10am. One inspector was present throughout the day. The manager and staff were spoken to as well as service users and relatives. Care plans and other documentation were examined and a tour of the premises took place. Verbal feedback was given to the manager, on the day, on the main findings of the inspection. The home is reasonably well equipped with appropriate aids and adaptations in bathrooms and toilets. The decor is looking rather worn but the style is suited to the client group’s age and lifestyle preferences. The home has plenty of space in all areas. It is popular with service users and their families. What the service does well: What has improved since the last inspection? There has been some improvement in decoration. There has been some improvement in cleanliness and odour control. St Oswalds Nursing & Residential Home DS0000018178.V299145.R02.S.doc Version 5.2 Page 6 Care staff morale has improved and staff on the top floor are volunteering ideas to improve the quality of service user’s lives. The quality of care plans has shown further improvement, in most of the examples seen. Some decoration has been carried out to improve the appearance of the home. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Oswalds Nursing & Residential Home DS0000018178.V299145.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Oswalds Nursing & Residential Home DS0000018178.V299145.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3, 5. Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. Although most service users have a comprehensive assessment of need this is not so in all cases Some of the information provided to service users, in the service users guide, is out of date and innaccurate. EVIDENCE: A number of relatives of service users chose this home because of personal recommendation by a third party. Service user and relative comment card indicates they are satisfied with the information they receive. There is a service users guide available and an example of this was seen. It is not up to date and the information about how to identify staff uniforms and the identity of the manager is very out of date. Some comments may indicate service users needs are not being fully met. Providers self assessments indicate service users have contracts. The manager and administrator confirmed that service users have contracts. St Oswalds Nursing & Residential Home DS0000018178.V299145.R02.S.doc Version 5.2 Page 9 Examination of care plans revealed that most service users have an assessment carried out by the referring agencies as well as senior staff at the home. There has been a further improvement in care planning and most examples seen were comprehensive. One example of a care plan was seen where the assesment of some aspects of care needs was not comprehensive. Staff are aware of service user’s needs when they are asked about this, however this needs to be formalised into a written care plan. Staff on the floor caring for service users with mental health problems have responded well to training in this field. They have a carried out a number of initiatives and have constructive ideas to improve the environment. This initiative is to be applauded and deserves the support of the company. This home does not provide intermediate care and standard 6 is not applicable. St Oswalds Nursing & Residential Home DS0000018178.V299145.R02.S.doc Version 5.2 Page 10 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. Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. Although one care plan indicated that needs are not assessed in every case the majority of needs were accurately assessed and this would contribute to health care needs being met. Medication policies are robust, and in most cases, the home is operating these to ensure service users receive appropriate medication. There are some areas of significant weakness that could pose a hazard to some service users. The care practice that was observed would promote service users privacy and afford them respect but some service users and staff comments indicate this may not always be the case. EVIDENCE: A number of complaints in recent months have highlighted deficiencies in care plannning, recording and in areas such as mangement of continence and cleanliness of clothing reflect on Service users dignity. Remarks in service users survey about staff being noisey and thoughtless tend to reinforce some of these concerns. St Oswalds Nursing & Residential Home DS0000018178.V299145.R02.S.doc Version 5.2 Page 11 During the inspection visit staff were observed to knock at doors before entering. Service users were addressed respectfully using appropriate terms of address. A minority of service users spoke of staff using bad language, and of rough handling. One service user was unwilling to raise this because they were worried about repercussions. Some of these aspects of carers behaviour were confirmed by other staff members. This behaviour would not promote the respect for, or enhance the dignity of, service users and this information was fed back to the home manager on the day of the inspection. On the day of the inspection visit, the service users who were case tracked had a comprehensive care plan that addresses all aspects of their care, including healthcare. There has been a further improvement in care planning and most examples seen were comprehensive and well laid out. Care plans also contain references to service users being referred to healthcare professionals and clinical specialist as well as recording GP visits. Staff are aware of services such as chiropody, opticians, district nursing and other services offered by primary healthcare teams. There was one exception to this good practice, where pressure damage risk may have been underestimated and prevention measures may have been inadequate. This service user was on of three who are currently being treated for pressure damage. Some recent complaints have been around the correct handling of service users following accidents, prompt recognition of injury and subsequent actions of staff. the home has taken remedial action following these incidents. On the day of the inspection visit there was a reasonably accurate record of falls and some incidents are recorded comprehensively in care plans. Another area of past concern was how the home managed medication and the around covert administration of medication. On the day of the inspection visit medication storage was appropriate and clinical areas were secure and tidy. Recording of medication is carried out thoroughly on most of the floors in the home. On one floor, medication was found to have been dispensed into a pot and was then left for administration later. This medication was already recorded as having been administered. Staff member who was present was unaware of the importance of administering some of this medication at the stated time. Another example was found of sedative medication being given as necessary during the day, when it was specifically prescribed as night sedation. This is unacceptable practice. The home has appropriate policies and procedures for medication but in the examples above the staff were not adhering to them. St Oswalds Nursing & Residential Home DS0000018178.V299145.R02.S.doc Version 5.2 Page 12 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 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Most service users have had accurate assessments of their needs and preferences, including accurate assessment of social care needs. There is a variety of social events organised that includes the opportunity to go into the local community or have contact with family friends and others from outside the home. Service users are offered a varied diet that is wholesome and appealing, however, as noted in the last inspection, the dining environment does not enhance mealtimes and could be improved. EVIDENCE: Providers self assessment, and sample menus, indicates a choice of meals are available, including special dietary requirements. Catering has always been a strength of this home in the past. Service users comments on meals were positive. statements such as The food is lovely, Jim (the cook) does it very well, were typical. A number of visitors spoke of their relatives enjoying their meals. The midday meal was seen and St Oswalds Nursing & Residential Home DS0000018178.V299145.R02.S.doc Version 5.2 Page 13 looked appetising. it was well presented and service users were supported well, by staff, during their meal. The dining room space and adjacent kitchinnettes are cleaner than during the last visit but they are still in need of decoration and refurbishment. The provider’s self-assessment indicates hair dressing, magazines and papers are available to service users. there is a monthly programme of events that includes organised activities and one to one interventions. This programme also records trips out in minibus and gardening sessions. During the day of the inspection visit the social programme was posted on the notice board. Service users have copies. there are photographs of past events on display. Some service users spoke of a forthcoming trip to lourdes, organised by a local church group, and of a planned get together to view Englands next World Cup match. Staff also spoke of this and were aware of service users birthdays that were to be celebrated. Service users also spoke of enjoying bingo sessions and celebrations organised within the home. Service users were seen enjoying different areas of the home including the patio space outside. Service users rooms contained personal items of furniture or other possessions, including photographs. Visitors were present in the home throughout the time of the inspection and they confirmed they were welcome in the home at all reasonable times of day. Information about advocacy service was displayed on notice boards and service users relatives were invited to be involved in the care planning process. Comments in service users survey confirms this. Relatives meetings were also scheduled to take place on a regular basis and the manager confirmed these take place. St Oswalds Nursing & Residential Home DS0000018178.V299145.R02.S.doc Version 5.2 Page 14 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 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. The majority of service users and relatives told the inspector they would be happy to bring problems to the attention of staff or the manager. This view is not held by all service users and not all of them feel secure. The staff feel more supported in raising issues of practice with the new manager but some skepticism exists, within the staff group, that this will change the behaviour of underperforming staff members. EVIDENCE: Comments from service user survey indicate they would approach the manager if they had problems. Relatives confirmed that they would be happy to raise issues with the manager of the home. The majority of service users who were spoken to, said that they were happy to raise issues with the manager or the staff in the home. One service user spoke of making a recent complaints about swearing and smoking on duty One service user indicated they were unwilling to raise issues because they were worried about repecussions. the same service user expressed disatisfaction about several aspect of care including rough handling. Other things that have been raised were unauthorised smoking by staff and use of bad language. Some of these aspects of behaviour have been confirmed by staff members. These concerns were relayed to the manager on the day of the inspection visit. St Oswalds Nursing & Residential Home DS0000018178.V299145.R02.S.doc Version 5.2 Page 15 Staff spoke of having been trained in adult protection issues, and the manger confirmed this. The manager spoke of starting regular staff meetings. Staff confirmed these took place regularly but some staff were not convinced that action would be taken when issues were raised. The home has appropriate policies and procedures which include whistleblowing although staffs actions have not always adhered to this policy in the past. The company’s whistle blowing policy encouraged written disclosure by staff and it was felt that this may discourage whistle-blowing by concerned staff. The whistleblowing policy has been revised but, although the manager has stated the policy has changed, a copy has not yet been submitted to CSCI. Providers self assessment shows 8 complaints in the last 12 months 2 of which have been substantiated and 1 partially substantiated. This seems a low level of substantiation given information and action of Local Authority team. During the inspection documentation revealed that complaints are recorded in line with the policy and some incidents were recorded in care plans. St Oswalds Nursing & Residential Home DS0000018178.V299145.R02.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for 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 a visit to this service. The main systems in the home are maintained in a safe condition however fire precautions should be observed to ensure that service users are safeguarded. Service users have access to communal facilities that meet their needs and bathroom and lavatory facilities are sufficient, but light levels must be improved to ensure service user’s safety. Most service users have bedrooms that are furnished to their own taste and meet their needs but the general standard of decoration needs to be improved in many areas of the home. EVIDENCE: Past inspection reports and visits by local authority staff have highlighted weaknesses in the maintenance of the home and the levels of cleanliness. St Oswalds Nursing & Residential Home DS0000018178.V299145.R02.S.doc Version 5.2 Page 17 Some recent visits by the local authority team have indicated an improvement in some areas but some weaknesses remain. On the day of the inspection visit it was found that the paintwork in many areas has been retouched but further refurbishment still needs to be carried out. This is particularly so in relation to impact damage on and around doors. Cleaning has improved in many areas but stained surfaces in kitchens and dining rooms need to be dealt with. It was noted that paintings in corridors have been defaced with graffiti and damaged. The inspector was told that care staff were responsible for this. It was also mentioned that some care staff were responsible for acts of petty vandalism such as pulling pieces of wallpaper off walls. This wilful degradation of the home environment is reprehensible and the manager was advised of this on the day. The past reports suggest the environment is maintained at a level that ensures service user’s safety. Providers self assessment indicate equipment and services are maintained and tested regularly. Room temperatures were satisfactory on the day of the inspection visit but the outside temperature was high and this may not be an accurate indication of an improvement in heating systems. One radiator was found to be loose, in the ground floor lounge, and was propped up on wooden blocks. Staff comments indicated that the supply of hot water to some bathrooms was still not reliable. Some lounges do not have sufficient power sockets. This is leading to Multipoint adaptors being used, with the potential for overloading at single sockets. This is especially so when some appliances include portable heaters. As these appliances are not of low surface-temperature design, they should not be being used in this environment. Staff spoke of unauthorised smoking taking place in none designated areas and some service users also talked of this. Some areas of the grounds, below windows, have accumulated considerable amounts of cigarette ends, packets and other associated litter. This practice is a potential fire hazard as well as creating a litter and health hazard to other occupants of the home. Light levels in some areas of corridors, bathrooms and toilets is far below the required minimum standard. The home does not have a loop indiction system for hearing aid users in all lounges. There is a wide variety of communal space and the patio area at the back of the home has been developed. This area to a useful amenity space and is well used by service users. St Oswalds Nursing & Residential Home DS0000018178.V299145.R02.S.doc Version 5.2 Page 18 Some carpets are still worn and stained. Although some corridor carpet has been replaced this has been done with a uniform black colour that gives a drab and “industrial” effect. It is far from “homely Service user’s bedrooms were well furnished and contained personal items. They reflected the taste of the occupants. It has been noted in earlier reports that the types of locks in use are unsuitable and did not ensure privacy for service users.”. The odour problem in the home has largely been dealt with and no unpleasant odour were apparent at the time of the inspection visit St Oswalds Nursing & Residential Home DS0000018178.V299145.R02.S.doc Version 5.2 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 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. There were sufficient care staff on duty to meet the needs of service users. Training takes palace and staff are competent enough to ensure the safety of service users, however some pockets of bad practice seem to persist, and may adversely affect service users. EVIDENCE: Previous inspections indicate: the home has an appropriate number of staff, with the right skills, to meet service users needs. Duty rotas submitted as part of self-assessment indicates a reasonable level of staffing. Service users were adequately supported on the day of the inspection visit and call bells were answered promptly. The recruitment policies and procedures are appropriate and staff records indicate the procedures are adhered to. Self-assessment indicates staff have had in-service training and further training is planned. Records are kept of training and individual development. Some recent complaints indicate staff are not always operating to company and professional guidelines in some areas of practice (such as record keeping and medication). Although most practice seen during the inspection visit was St Oswalds Nursing & Residential Home DS0000018178.V299145.R02.S.doc Version 5.2 Page 20 acceptable or good, some practices confirmed that these areas of weakness persist. A number of staff spoke of having received training in the Protection of Vulnerable Adults (POVA) procedures and prevention of elder abuse. There was some evidence from service users that this had not been incorporated into practice by all care staff, and some service users spoke of practice, such as “noisy behaviour”, using bad language and “rough handling” that could be interpreted as abusive. The manager spoke of some staff that have received training in dementia care and this was evident in staffs good practice on the top floor. St Oswalds Nursing & Residential Home DS0000018178.V299145.R02.S.doc Version 5.2 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): 31, 32, 33, 35, 38 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. The home is managed by an experienced and manager who has a good approach to running the home but she has not yet completed the registration process. The homes philosophy and statement of purpose is appropriate and most staff act in service user’s best interests. Although most aspects of heath and safety are adequate there are some potential hazards, and practices, that could put service users at risk. EVIDENCE: The manager of the home is not yet registered with the regulating authority although she has been a registered manager in other homes. She is an experienced registered nurse. Past inspections reports have expressed doubts St Oswalds Nursing & Residential Home DS0000018178.V299145.R02.S.doc Version 5.2 Page 22 about the ability of any one person managing a home of this size, layout and client group. In response to recent concerns and complaints the manager has indicated she will spend time every week on individual floors to ensure they are properly run. senior staff will have responsibilities for individual floors. The home does have the support of the senior management team. Self assessment indicates there is a quality assurance system in place and that relatives / service user meetings take place on a regular basis. Examples of the quality assurance programme audits of the home were seen. Service user’s personal allowance is kept in a well audited system but in line with the company policy any excess balances are kept in a pooled account. The manager said that she had regular staff meetings and staff confirmed this. Most aspects of health and safety were addressed and most staff had a good awareness of risk. Staff on the top floor of the home had responded well to training initiatives and were enthusiastic about their work. There were some exceptions and some staff members seem to be ignoring policies and procedures and , in some cases, indulging in acts of petty vandalism. This, allied to allegations of, rough handling, swearing, unauthorised smoking on duty suggests that not all staff are amenable to proper management control and direction. Although the manager stated that some of these problems had been dealt with, it is imperative that these behaviours are eliminated to safeguard the well being of service users, and the morale of the majority of well-motivated staff. St Oswalds Nursing & Residential Home DS0000018178.V299145.R02.S.doc Version 5.2 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 2 3 2 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 2 2 3 3 2 3 3 2 2 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 x 3 x x 2 St Oswalds Nursing & Residential Home DS0000018178.V299145.R02.S.doc Version 5.2 Page 24 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 OP8 Regulation 14 Requirement Assessments must be thorough to ensure that all aspects of the service users’ care needs have been identified and care plans formulated to address those needs. Service users medication must be administered safely and in accordance with the homes policy and professional guidelines. All care practice must maintain the dignity and encourage respect for service users. Timescale for action 31/08/06 3. OP9 13(2)(4a) 14/08/06 4. OP10 12(3)(4a) 31/08/06 5. OP19 6 OP21 OP25 7 OP22 13(4c) 16, The home must be maintained in 23 a safe condition, and that all precautions taken to prevent accidents or hazards to occupants. This must include adherence to the homes own policy on smoking. 13(4c) 16, The home must ensure that 23 heating, lighting and the hot water supply is adequate to meet service user’s needs. 23(2n) The home must have suitable aids and adaptations including equipment for those with DS0000018178.V299145.R02.S.doc 14/08/06 31/08/06 31/08/06 St Oswalds Nursing & Residential Home Version 5.2 Page 25 8 OP26 sensory loss. 13, 16, 18 The home must be kept clean and décor must be maintained to ensure pleasant conditions for service users. 19 (1a) 12 (1a) (5b) The management of the home must ensure that carers are trained in adult protection issues and that their conduct is in accordance with this training. 14/08/06 9 OP30 OP36 OP38 31/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP1 OP14 Good Practice Recommendations The homes service user guide should be updated so that the information it contains is accurate. It is recommended that the type of locks be replaced to ensure service users can control entry to their rooms. St Oswalds Nursing & Residential Home DS0000018178.V299145.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT 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 Oswalds Nursing & Residential Home DS0000018178.V299145.R02.S.doc Version 5.2 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. 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!