Key inspection report CARE HOMES FOR OLDER PEOPLE
Stephenson Court Nursing Home Station Road Forest Hall Newcastle Upon Tyne NE12 9BQ Lead Inspector
Janet Thompson Key Unannounced Inspection 29th July 2009 09:30
DS0000069661.V376897.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Stephenson Court Nursing Home DS0000069661.V376897.R01.S.doc Version 5.2 Page 2 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Stephenson Court Nursing Home DS0000069661.V376897.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Stephenson Court Nursing Home Address Station Road Forest Hall Newcastle Upon Tyne NE12 9BQ 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) 0191 2702000 0191 2150040 stephensoncourt@schealthcare.co.uk Southern Cross Healthcare (Focus) Limited Vacant Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (45), Physical disability over 65 years of age (2) of places Stephenson Court Nursing Home DS0000069661.V376897.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Should any of the residents in the PD category leave the home, the Commission for Social Care Inspection must be notified immediately. The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places 45. Physical disability, over 65 years of age - Code PD(E), maximum number of places 1. The maximum number of service users who may accommodated is 46. 3. Date of last inspection 4th February 2009 Brief Description of the Service: The premises are purpose built and are located within a residential area of Forest Hall. The home is close to shops and local facilities including the Metro station. The home can accommodate 46 frail elderly residents who require nursing care. Short stay respite care is also offered when rooms are available. All accommodation is within single rooms with en-suite facilities. There are two dining rooms in the home and three lounges. A passenger lift is available to the first floor. Car parking is situated to the front of the building and there are gardens at the back. The weekly fees for the home vary. Information is available on request from the home. Further information about the home can be found in the service user guide, which is located in the main entrance. Stephenson Court Nursing Home DS0000069661.V376897.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations. This will only happen when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Before the visit: We looked at: • Information we have received since the last visit to the home. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service. These are usually given to us in the form of questionnaires. At the time of writing this report we received six completed questionnaires from staff and residents or their relatives. The Visit: An unannounced visit was made on 29th July 2009. The inspection was carried out by two inspectors and took a total of nine hours. A pharmacy inspector is visiting the home at a later date to carry out an inspection of all medication practice and procedures. During the visit we: • Talked with people who use the service, staff, the acting manager & visitors. • Looked at information about the people who use the service & how well their needs are met, • Looked at other records which must be kept, • Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, • Looked around the building to make sure it was clean, safe & comfortable. Following this inspection feedback was given verbally to the acting manager for the home and two representatives of the Provider. Stephenson Court Nursing Home DS0000069661.V376897.R01.S.doc Version 5.2 Page 6 The last Key Inspection of this home was in February 2009. A lot of concerns were raised at that inspection and two further unannounced random inspections were carried out in April and June 2009. What the service does well:
Throughout the series of inspections that have been carried out in 2009 residents have always told us that staff are polite and kind to them. The staff in the home have been open and co-operative throughout the inspections. The staff appear to welcome guidance and constructive criticism and have responded well to the changes in the last six months. What has improved since the last inspection?
The nurses working on both floors demonstrated an ability to organise the care team and showed good leadership. The care staff were able to tell the inspectors about the needs of the people in their care and were seen to be filling in care records correctly. We noticed that trays of fresh juice and water were provided throughout the day. We also observed staff helping people to drink regularly and assisting people to eat. Residents looked clean and well cared for. Residents were dressed in appropriate clothing which was clean. Staff were seen to regularly attend to resident’s needs and there was a good level of staff presence in the communal areas. A relative told us that the home had improved. She said the home smelled fresher, there were more staff available and that they were very pleasant. A resident told us that she thought staff showed more interest in what she wanted to do instead of what they wanted her to do. We checked the pressure relieving equipment people were using and found that it was correctly set and matched the documented assessments. Care plans were up to date, clear and easy to follow. They contained good personalised information about resident’s likes and dislikes, needs and abilities. The building was generally clean and tidy.
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DS0000069661.V376897.R01.S.doc Version 5.2 Page 7 Staff spoken to were most positive about the changes that have occurred in the home. They said the home had improved 200 . Staff said they enjoyed coming to work and felt supported by each other. In questionnaires staff told us that the acting manager has made a good impact on the home. Staff said they were now clear of the standards expected and thought the acting manager showed good leadership. Staff said “the start of my work here was not good but that has now been dealt with” and “I look forward to the future”. Recruitment of staff has been ongoing. Whilst not all posts have been filled there are now fewer vacancies for carers and none for nurses. Staff training is ongoing. The staff files have now been organised so that a true picture of staff training needs is available. Although more training is needed than first thought, the acting manager has taken steps to address this. A high number of staff have attended training in the last month. Two new carers were on duty, they told us that they had been trained in moving and handling, food hygiene and fire safety before they entered the home. They had also received instruction within the home about the location of fire exits and equipment. We checked the recruitment files for people recently employed. Good recruitment procedures were followed. The home now has a permanent manager. She is referred to as ‘acting’ because she is not yet registered with CQC. This should give the stability and continuity needed in the home. We ate the food at the home which was hot, well presented and tasty. Residents told us the food was good. A relative said: “if anything there is too much food offered”. The Cook on duty had a list of special diets needed, she had home baked some scones and the kitchen was clean and tidy. T What they could do better:
Although recording of care needs has improved there appears to be a duplication of information across various documents. This has led to some information not being in the individual’s record. For example, mouth care and nail care was not recorded regularly on the personal hygiene sheet for some
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DS0000069661.V376897.R01.S.doc Version 5.2 Page 8 people. Some of the weekly reports had not been completed on a weekly basis. The recording of wound care was generally good but became muddled when multiple wounds were documented over a long period of time. In one case there was confusion regarding advice from a tissue viability nurse resulting in her prescription not being followed. Fresh fruit was available on the breakfast, coffee and tea trolleys. Some residents did have this but we thought more residents would take fruit if it was already sliced and offered on a plate. Some refurbishment of the building has taken place with good results. There is still more to be done. Residents and staff told us in questionnaires that bedroom furniture needs to be replaced. The acting manager has already started to purchase some of this. A plan needs to be in place for continual replacement of furniture, redecoration and carpet replacement until all rooms are completed. Although some residents were enjoying a music session, and staff are providing some activities, there was not enough. Social care plans were lacking in some resident’s files and records of activities were not detailed enough. In questionnaires residents asked for more activities, outings and events. In questionnaires staff and residents commented that the continuity of staff was lacking and that there were too many new or unknown faces. A lot of agency staff have been used whilst recruiting new staff. This has been unavoidable in the short term. The situation should improve now that new staff are in place. The managers of the home have focussed on improving the basic standards of care and providing staff with basic elements of training and supervision. Training relating to quality elements have therefore not been a priority and should now be addressed. Staff need to be trained in conditions relating to the care of older people, person centred care, capacity and consent. The permanent Cook for the home has not been available and there are some continued problems about continuity of the provision of a Cook and standards of hygiene in the kitchen. Stephenson Court Nursing Home DS0000069661.V376897.R01.S.doc Version 5.2 Page 9 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Stephenson Court Nursing Home DS0000069661.V376897.R01.S.doc Version 5.2 Page 10 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 Stephenson Court Nursing Home DS0000069661.V376897.R01.S.doc Version 5.2 Page 11 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents’ needs are fully assessed before they enter the home. EVIDENCE: There have not been any admissions to the home since the last inspection. There are policies and procedures in place to assess new residents and provide them with information before admission. Stephenson Court Nursing Home DS0000069661.V376897.R01.S.doc Version 5.2 Page 12 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, and 10. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive personal care that is well planned but not fully and consistently recorded. EVIDENCE: Five care plans were examined and two were case tracked. This means that we spoke to the individual residents or observed their care then matched our observations to what was written in the care plan. Both case tracked care plans reflected the actual needs of the residents. All assessments were up to date. Care plans were in place for each area of need identified in those assessments. Residents’ food and fluid needs were documented and a record kept of people’s weights and nutritional state. The weight of all five residents had remained stable over the past three months. Where residents were at risk of pressure sores this was clearly documented. Pressure relieving equipment
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DS0000069661.V376897.R01.S.doc Version 5.2 Page 13 was identified, there were records of how this equipment was to be used and this did match our observations of the equipment in these residents’ bedrooms. Care plans were personal to the individual, for example, one care plan contained details of medication compliance strategies for the resident who had difficulties in this area. One of the residents was assessed as high risk of tissue damage due to skin frailty. This resident had multiple superficial wounds, marks or grazes over a long period of time. The records for these were becoming confusing. Body maps had been drawn and labelled as A or B but a few months later another had been labelled as A. There was also evidence of some confusion regarding advice from the tissue viability nurse, although instructions had been recorded they had not been fully carried out. Good records were in place to show residents’ food and fluid intake and we noted that residents had access to fresh fluids throughout the day. Records relating to personal care and washing were duplicated in individual’s files and work books. In some cases records of mouth and nail care were recorded in the work book but not in the individual’s file. Residents did look well cared for. Their personal preferences relating to baths or showers were recorded. A resident said “now they are interested in what I want to do, not what they want me to do”. A resident sitting by an open window told us she wanted to be there and said that staff had put her warmer clothes on to enable her to sit near the fresh air. A visitor said the home had improved and now her relative was sitting in an armchair rather than being left in her wheelchair every day. Medication will be inspected at a later date by the pharmacy inspector. Stephenson Court Nursing Home DS0000069661.V376897.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 12, 14 and 15. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are not fully supported to lead a healthy and fulfilling personal lifestyle that takes account of their wishes and diverse abilities. EVIDENCE: An activities coordinator is usually employed at the home, however, she has been absent for a long period of time. The staff at the home do make an effort to provide activities such as music, karaoke, crafts and quizzes but this is not the same as having a planned programme and dedicated personnel to carry it out. Due to the small number of residents staff have more time to spend with individuals, which is good, and residents told us they like this. In questionnaires staff and residents asked for more outings, events and entertainment. Records relating to social care were inadequate. There was not enough information in social care plans. Activities were recorded using a code system
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DS0000069661.V376897.R01.S.doc Version 5.2 Page 15 which did not give any indication as to the extent of involvement of the resident or whether they had enjoyed or refused a particular activity. Residents told us that they could have visitors at any reasonable time. We noticed visitors in the home coming and going freely. A visitor told us that she has noticed a change in the atmosphere in the home and that it is a more pleasant place to visit. There continues to be problems in retaining a suitable Cook for the home. The catering audits show that standards in the kitchen are variable. On the day of inspection the assistant cook was acting as Cook. The kitchen was clean and tidy. The menu was being followed. The dining rooms were attractively set and residents were helped to eat if they needed it. The Cook was aware of the special diets needed by residents and any allergies related to food. We tasted one of the lunch options of braised steak, cabbage, peas and potatoes. The food was hot enough and very tasty. The meat was tender enough to be eaten easily. There was fresh fruit available on the breakfast and drinks trolleys and some of this was eaten by residents. We noted that the fruit was presented whole which could be off putting to some residents. Fortified milk drinks were also served mid morning. Stephenson Court Nursing Home DS0000069661.V376897.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are protected from harm through good protection procedures. EVIDENCE: At the previous inspection some complaints were not recorded. There is now a new complaints record in place. The latest complaint, which was received shortly following the last inspection, has been recorded. This has now been investigated and CQC are satisfied with the results of that investigation. Staff have recently received training in adult protection and more is planned. As a result of rigorous local authority reviews each resident has had the opportunity to raise concerns and have their views documented. This has resulted in some changes to the care, management and practice in the home. The new procedures and training in place now need to be tested through time. This will be reassessed as more residents enter the home. Stephenson Court Nursing Home DS0000069661.V376897.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a comfortable home that is generally pleasant but not well maintained. EVIDENCE: The home has been thoroughly cleaned since the last inspection. Some infection control audits have been carried out, the results of which showed an improvement over the last six months. There are now cleaning schedules in place which have been adhered to. Staff told us that they now had enough equipment to carry out their duties and keep the home hygienic. Stephenson Court Nursing Home DS0000069661.V376897.R01.S.doc Version 5.2 Page 18 There were no offensive odours in the home. A visitor said the home was now a much more pleasant place to visit as it no longer smelled. She confirmed that lately the home always smelled fresh and clean. Bathrooms were clean and tidy and some maintenance work has been carried out in these areas. Although residents bedrooms are well personalised and looked comfortable, some of the furniture and carpets are old, worn and chipped. There has not been maintenance in some bedrooms for a number of years. The acting manager has started to purchase new bedroom furniture and the provider confirmed that this will be continued on a rolling programme. Stephenson Court Nursing Home DS0000069661.V376897.R01.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported through adequate staff numbers, skill and ability. EVIDENCE: The home currently only has 24 residents. The staffing on the day of inspection was two nurses and six care assistants accompanied by two extra care assistants who had just commenced employment. There was also a full complement of ancillary staff. At the last inspection we were concerned that staff were given little or no direction by nurses on duty. During this inspection we noted that the nurses showed very good leadership skills. The staff were organised and their work was being supervised adequately. Staff training records are now up to date and the training plan is in place. There are now clear records that show who requires training. A large number of staff have received training in food hygiene, fire safety, adult protection and
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DS0000069661.V376897.R01.S.doc Version 5.2 Page 20 moving and handling in the last month. Two new staff confirmed that they have received moving and handling training, fire safety and food hygiene training before they were employed at the home. Recruitment files were checked for new staff employed by the current acting manager. Good recruitment practice was demonstrated. Files contained evidence of checks on past employment, two references, evidence of identity and a criminal records check. Stephenson Court Nursing Home DS0000069661.V376897.R01.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service are protected through reflective management that takes account of the diverse needs of the service. EVIDENCE: The home does now have a permanent manager. She is not yet registered with CQC. The manager has not been in post long enough to affect all of the changes that are needed but she has made a good start which is appreciated by residents and staff.
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DS0000069661.V376897.R01.S.doc Version 5.2 Page 22 There needs to be a period of consolidation in the home to test the management systems. This also needs to include a period when there are more residents in the building and staff have a realistic workload. The home currently does seem to be run in the best interests of residents. Staff were seen to be making efforts to find out residents preferences. Residents told us that they are given choices. Staff supervisions have started to take place and there is an overall plan for these to continue regularly. This will be reassessed at the next inspection. Residents’ personal monies are held by Southern Cross in electronic accounts with a pooled float of cash. It is therefore not possible for us to audit the money. Southern Cross carry out their own audit on finances. Health and safety checks and tests were up to date. Records showed internal and external checks are regularly carried out. Safety certificates were in place for electrical systems, hoists and the passenger lift. Stephenson Court Nursing Home DS0000069661.V376897.R01.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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 3 X 3 Stephenson Court Nursing Home DS0000069661.V376897.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 OP7 Regulation 15 Requirement All individual care given must be documented in the care plan. Timescale for action 01/10/09 2. 3. OP15 OP26 18 23 Ensure advice obtained from health professionals is fully recorded and carried out. Ensure that permanent dedicated 01/10/09 catering staff are employed. Renew bedroom furniture and 01/12/09 carpets. 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 OP10 Good Practice Recommendations Provide training for staff in person centred care. 2. OP31 Provide a registered manager for the home. Stephenson Court Nursing Home DS0000069661.V376897.R01.S.doc Version 5.2 Page 25 3. OP9 The treatment room door and drug fridge should be locked when not in use. A system should be in place to record all medication into the home and those carried over from the previous month. This helps to confirm that medication is being given as prescribed. Supplies of regular monthly medication should be synchronised so that all the medication a person needs for the month is received at the same time. A new maximum/minimum thermometer should be obtained and used to regularly record the temperature of the treatment room. A fridge should be purchased for the storage of medicines requiring refrigeration on the ground floor. The supplying pharmacy should be requested to produce monthly MAR sheets, which only contain details of currently prescribed medication. Only controlled drugs, including temazepam, should be stored in the controlled drug cupboard. Disposal of controlled drugs should be recorded in the medicines for disposal book as well as being recorded in the controlled drug register. 4. 5. OP7 OP12 When multiple wounds are recorded each should be given an identifying title which is then applied to every document associated with that wound. Increase the activities provided. Ensure residents’ social needs are fully recorded. Stephenson Court Nursing Home DS0000069661.V376897.R01.S.doc Version 5.2 Page 26 Care Quality Commission North East Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk
We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Stephenson Court Nursing Home DS0000069661.V376897.R01.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!
