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Inspection on 04/06/07 for Sutton Valence Nursing & Care Centre

Also see our care home review for Sutton Valence Nursing & Care Centre for more information

This inspection was carried out on 4th June 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.

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 service continues to benefit from a committed staff team, who provide good standards of hands on care. Residents continue to enjoy the structured activity programme, which provides for a variety of interests. The majority of residents enjoy the quality of food and varied menu. Residents felt that the manager and staff would listen to any complaint they had and would act on their concerns. The recruitment policy and procedures are robust and protect residents from abuse, as far as possible. The home already many elements of a quality assurance system in place.

What has improved since the last inspection?

Alterations in the homes documentation make finding the relevant paperwork easier, for staff. Improvements made in the risk assessments better protect residents, as they are now more comprehensive.

What the care home could do better:

Updating care plans to encompass the changes made in the evaluation record will offer better clarity and will offer better records of care and specific support or improvement for individuals. The medication fridge must be kept locked and all prescribed medicines must be kept in their original packaging which contains the prescription, name of the resident etc. Whilst the majority of residents were happy with the meals some said they did not like the gravy which accompanies many of the meals. The refurbishment to the home which did not take place in November 2006 is now desperately overdue with the communal areas looking very shabby, and presenting serious risks to residents safety in some areas. An immediate requirement notice to address the issues of trip hazards, poor security and risk of falling trees in the car park was left. Water damaged ceilings and walls were seen and stained carpets in the communal areas. Some infection control issues were identified presenting further risks to residents well being, with net underwear being shared, and not for individual named residents, damaged bath surfaces which may not be cleaned adequately, and dirty equipment being stored in sluices. The noise of slamming doors where door closure devices are no longer working properly is upsetting some of the residents. The training updates for some staff is long overdue, and there are no night staff with first aid training. Few staff have attained NVQs.

CARE HOMES FOR OLDER PEOPLE Sutton Valence Nursing & Care Centre North Street Sutton Valence Maidstone Kent ME17 3LW Lead Inspector Justine Williams Key Unannounced Inspection 4th June 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 Sutton Valence Nursing & Care Centre DS0000026208.V340016.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. Sutton Valence Nursing & Care Centre DS0000026208.V340016.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sutton Valence Nursing & Care Centre Address North Street Sutton Valence Maidstone Kent ME17 3LW 01622 843999 01622 844364 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) Tamhealth Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Mrs Carla Jayne Wilson Care Home 73 Category(ies) of Old age, not falling within any other category registration, with number (73) of places Sutton Valence Nursing & Care Centre DS0000026208.V340016.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home can provide care for up to 8 persons with a physical disability 40 years and over. The home can care for up to 8 persons who are terminally ill. Of the 8 persons with a physical disability, one person under 40 whose date of birth is 28.07.1972. 26th June 2006 Date of last inspection Brief Description of the Service: Sutton Valence Nursing and Care centre provides nursing care and accommodation for seventy-three older people, including eight places for people who are physically disabled. Sutton Valence Nursing and Care centre is owned by Tamhealth Ltd, a wholly owned subsidiary of Four Seasons Health Care. The home is located close to the outskirts of Sutton Valence village and local public transport is available nearby. The home is purpose built, set in its own grounds and provides car parking to the front of the main building. Accommodation is over two-storeys, with access to the first floor via two shaft lifts. Some of the rooms on the first floor have balconies that overlook the garden and car park areas and some of the ground floor rooms look onto an inner landscaped courtyard. Sutton Valence has sixty-one single rooms, eleven of which have en-suite facilities and six double rooms, two of which have ensuite facilities. All the residents’ rooms are equipped with a nurse call system, television and telephone points. The home’s staffing team is comprised of the manager; one clinical specialist, one deputy manager; staff nurses and carers who work a roster to give 24hour cover. The home also employs other staff for administration, maintenance, catering, housekeeping and laundry duties. The current fees range from £437.02 to £770.00 per week. Chiropody, hairdressing and other sundries are not included. This information was given at the site visit. Sutton Valence Nursing & Care Centre DS0000026208.V340016.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was carried out on 4th June 2007 between 09.30 am and 3.30pm by regulatory inspector Justine Williams. During that time residents, staff and the Registered manager agreed to speak with the inspector both in public and privately. This report contains assessments made from observations, conversations and records, case tracking and a tour of the premises. Feedback was given during and at the end of the inspection. As part of the inspection process surveys were sent to service users, GP’s, health care professionals, care managers and relatives of residents. The surveys received indicate general satisfaction with the service. Some specific comments made included“very friendly willing staff” “staff are professional and courteous” “More activities are needed to improve the service” “seems understaffed at times” “the staff are very efficient and caring but do appear to be working to the limit, particularly at weekends when shortages seem noticeable” What the service does well: What has improved since the last inspection? Alterations in the homes documentation make finding the relevant paperwork easier, for staff. Sutton Valence Nursing & Care Centre DS0000026208.V340016.R01.S.doc Version 5.2 Page 6 Improvements made in the risk assessments better protect residents, as they are now more comprehensive. 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. The summary of this inspection report can be made available in other formats on request. Sutton Valence Nursing & Care Centre DS0000026208.V340016.R01.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 Sutton Valence Nursing & Care Centre DS0000026208.V340016.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. Residents have their needs fully assessed prior to moving to the home. EVIDENCE: A senior trained Nurse assesses prospective residents prior to their moving in, and residents said this gave them an opportunity to find out more information about the home, as most had not visited the home prior to moving in. Trial visits are offered and arranged on behalf of new residents but often residents are too unwell to visit, and the home welcomes the family to visit on their behalf. Intermediate care is not offered at Sutton Valence. Sutton Valence Nursing & Care Centre DS0000026208.V340016.R01.S.doc Version 5.2 Page 9 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. Ensuring care plans are up to date and contain details of residents preferred times for getting up, washing etc will benefit residents. Adhering to the homes medication policy will better protect residents. Residents health needs are generally well managed. EVIDENCE: Every resident has a plan of care drawn up from the assessment, residents were aware of their care plans and had signed them when they were first drawn up. The care plans contained a good level of detail to enable staff to carry out the care residents required. At the last inspection it was identified that updates to the care plan were not being recorded in the care plan but written in the review, this means staff would have to read all of the reviews to find out what care they should be giving. Unfortunately this was found in some of the care plans. The home has changed some of the documentation and layout of the residents care files, and they are now clearer. All the care plans Sutton Valence Nursing & Care Centre DS0000026208.V340016.R01.S.doc Version 5.2 Page 10 are reviewed regularly. The care plans do not detail the time residents like to get up, wash, go to bed or their preferences for how often they bathe or shower. Whilst social needs and preferences are assessed separately, residents do not have care plans on social needs stored with the main care plan, these are kept with the record of activities participated in by the activities coordinator. This would suggest that when the activity coordinator is not on duty the residents have no social activity, or at least no record of social activity. Risk assessments were seen in respect of falls, but must also be carried out for other specific activities, including keeping alcohol in residents rooms. Residents said they could access their GP at any time, and they are able to choose their GP from the 3 local practices. All residents have access to dentists, opticians and other community services. Residents requiring wound care may be referred to the Tissue Viability Nurse, depending on the complexity of need. All residents had been risk assessed using appropriate and recognised tools including Waterlow for pressure area risk, MUST for nutrition, as well as continence, moving and handling etc. The resident’s health is monitored and appropriate action taken. The home seeks professional advice on health care issues, acts upon it and generally is able to provide the aids and equipment recommended. The home has a medication policy the staff work to and residents may self medicate if they wish to and subject to risk assessment. All residents have lockable storage space for medicines, some prescribed creams and lotions were seen in a residents room, which should be locked away. The home has a medication room with hand-washing facilities, and storage for medicines and drug trolleys. The medication fridge was not locked and 3 unlabelled nova pens were stored in the fridge. Medicines are stored in line with good practice guidelines. Residents said they are treated with respect for their privacy by the staff when being helped with personal care, and being helped with mobilising etc. Some residents have a private telephone line in their rooms, for those who do not there is a payphone available. Sutton Valence Nursing & Care Centre DS0000026208.V340016.R01.S.doc Version 5.2 Page 11 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 judgement has been made using available evidence including a visit to this service. Residents find the lifestyle at the home matches their expectations and wishes. EVIDENCE: The home employs an activity coordinator who arranges the activity programme and runs many of the activities as well as organising external entertainers. Regular residents’ meetings continue to provide a forum for residents to influence and feedback how the home is run, daily routines, events etc. Residents enjoy the activities arranged and felt the frequency of events and activities fitted in with their expectations. Family and friends feel welcome and know they can visit the home at any time. Staff try to make time to talk to visitors and share information with the agreement of the resident. The design of the home provides seating areas within the communal areas of the home where residents can entertain their visitors, in addition to the privacy of their own room. Residents said they enjoy the food, and that the quality of meals continues to improve. Unfortunately many could not remember what was on the menu that Sutton Valence Nursing & Care Centre DS0000026208.V340016.R01.S.doc Version 5.2 Page 12 day for lunch, but the manager is looking into advertising the meals better, presently the menu is displayed it the lobby, the manager plans to put menus on each dining table. Care staff are sensitive to the needs of those service users who find it difficult to eat and give assistance with feeding. The dining room is in need of refurbishment, and some residents said they prefer not to eat there as it is not a very pleasant area in which to enjoy their meals. The home has employed a “beverage manager” her duties are to help with feeding residents at breakfast and lunch and to provide residents with drinks, residents s may chose from tea, coffee, lemonade, orange juice, or squash. Residents do not have access to fresh fruit unless it is on the menu and part of pudding choices. Sutton Valence Nursing & Care Centre DS0000026208.V340016.R01.S.doc Version 5.2 Page 13 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 good. This judgement has been made using available evidence including a visit to this service. Residents were confident that any complaint they had would be listened to. The home has strategies in place to protect vulnerable adults. EVIDENCE: The manager has received 4 complaints since the last inspection, the details of the actions taken and any investigation was documented. One of the complainants has referred their complaint to the Commission, the issues raised are being looked into as part of the inspection. The actions taken to address complaints made must be clearly documented once completed not just at the investigation stage. The home has a complaints policy on display on a notice board, given the infirmity of many of the residents, they may not be able to access the policy. Residents said they would feel comfortable approaching the manager with any concern. The home does not record minor complaints or dissatisfaction centrally, these are dealt with informally and may be recorded in the daily events in the care plan, recording them centrally would enable the manager to discover any trends, and could feed in to the quality assurance process. The home has an adult protection policy. Staff receive an introduction to adult protection issues at induction and training thereafter. The manager is aware of her responsibilities regarding adult protection allegations and investigations. Sutton Valence Nursing & Care Centre DS0000026208.V340016.R01.S.doc Version 5.2 Page 14 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): 19,26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The residents are at risk due to the poor state of the environment presenting health and safety hazards, and infection control hazards. EVIDENCE: Sutton Valence was due a major refurbishment in November 2006, unfortunately this did not take place and as a result, several health and safety issues were identified, some requiring immediate attention. The home has 3 lounges, a conservatory and dining room. The “pink” lounge had a stained loose carpet, presenting a trip hazard. The conservatory has damaged flooring presenting a trip hazard and a member of staff has already fallen over, as well as a stained and tired looking carpet. The “yellow” lounge is very sparsely furnished and is not very homely, there is water damage and staining from a leak in the ceiling and the doors to the garden are warped and cannot be Sutton Valence Nursing & Care Centre DS0000026208.V340016.R01.S.doc Version 5.2 Page 15 locked properly. The dining area is poorly lit, with a stained carpet, which is sticky underfoot, and the wall paper is peeling off the walls. Some areas of the corridor carpets on the ground floor are badly frayed and worn, and there is a hole in the carpet near the laundry. Several areas of the walls are damaged in the corridors. Several of the doors bang shut as the door closure devices are not working, residents said the home had become very tatty and some were bothered by the noise of slamming doors. Some of the corridors are poorly lit which could present a risk of falls, and particularly for those who are sight impaired. 1 of the bedrooms has water damage and staining to the ceiling following a leak from the balcony room above, the resident still occupies this room. Some bedrooms have curtains hanging off. There is broken furniture in corridors and hoists and other items being stored in poorly lit corridors. Many of the toilets and bathrooms are shabby, and poorly lit. Residents said they liked their own bedrooms, but were disappointed that the home has been allowed to get in such as state. The grounds are attractively kept with exception of the rear car park which had lots of broken furniture being stored there. There are also several trees leaning with their roots exposed, presenting a hazard, one has already fallen. At the last inspection 3 bathrooms were out of order, one has been refurbished and made into a wet room, the other 2 are still out of order. Most of the baths have damage to their surfaces presenting an infection control risk. One of the sluice rooms was very cluttered with old stained and dirty raised toilet seats being stored there. The sinks and sluices have been cleaned of lime scale since the last inspection. The laundry was extremely hot, despite it not being a particularly hot day, the staff confirmed that the room is frequently uncomfortably hot to work in. The home do not label residents own net underwear, and it is shared among the residents, in order to protect residents health and dignity, residents must have their own items of clothing labelled and for their use only this includes net underwear. Sutton Valence Nursing & Care Centre DS0000026208.V340016.R01.S.doc Version 5.2 Page 16 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 judgement has been made using available evidence including a visit to this service. The numbers of staff are barely adequate for the current residents needs. Residents are cared for and supported by properly recruited and trained staff. EVIDENCE: Residents said they frequently have to wait excessive periods of time for help when they ring for assistance, waiting for up to 10 minutes for help was common and some said if they needed the help of 2 members of staff, they often waited even longer. The manager looked into to wait times as part of a complaint investigation and found on occasion residents waiting for 9 minutes to have their call bell answered. Staff said they are always helping residents get up and wash until around 11.45am, and said they struggled to answer call bells particularly in the mornings and at meal times. Residents preferred times for getting up and washing etc are not recorded and as such it could not be evidenced that any residents prefer to wash at 11.30, or late morning. The staff said staffing numbers have been reduced despite the dependency of residents going up. The manager agreed to look into conducting a dependency and staffing numbers study. The staffing rota should include the manager and all staff, indicating the capacity in which they are employed. Sutton Valence Nursing & Care Centre DS0000026208.V340016.R01.S.doc Version 5.2 Page 17 The home still has not achieved 50 of staff having achieved NVQ, although some staff are studying at present. The home operates a robust and thorough recruitment procedure, with all staff providing 2 written references and having POVA checks and CRB checks. Staff training is ongoing and the manager using a matrix to track training due for each staff member. The moving and handling trainer has left and a staff member has just completed the course, 14 staffs moving and handling training has lapsed, with some having been lapsed for a considerable time. The manager said there is not a trained first aider on night duty, though registered Nurses are on duty. Despite the core training needing to be addressed, staff have received training such as wound care, palliative care, leadership, and care planning. Sutton Valence Nursing & Care Centre DS0000026208.V340016.R01.S.doc Version 5.2 Page 18 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): 31,33,35,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The health and safety of residents is not fully promoted and protected. EVIDENCE: The manager has run the home for the last 2 ½ years and prior to this managed another home for 3 years. The manager has the Registered Managers Award, and attends periodic training to update her skills. The home already has a comprehensive quality assurance system in place, and regular audits are carried out on documentation, medication etc, as well as regular surveys being conducted and residents meetings, staff meetings etc. A development plan has not yet been produced. The home practices around keeping residents monies is unchanged, in that Sutton Valence Nursing & Care Centre DS0000026208.V340016.R01.S.doc Version 5.2 Page 19 the home keeps small amounts of money for the majority of residents, and there is a system in place with clear records of expenditure and money deposited. Receipts are kept for individuals, it is recommended that the money is not pooled, but held separately, and that the bank account be set up so that it is for individuals and that they may receive interest on their money. The health and safety of resident sand staff is not safe guarded, as the moving and handling training for many staff has not been updated for some since 2005. Fire training is up to date with a record of drills and checks, drills are currently conducted every 6 months, the night staff must be included in fire drills, and the evacuation plan must include a contingency for where residents would be looked after if the fire was very serious and they were unable to return to the building. There is not a qualified first aider on every shift at present, as night staff have not received training. The health and safety of residents and staff is not protected due to the trip hazards, identified earlier in the report, as well as the leaning trees in the rear car park, and the security of the premises being compromised due to the warped doors to one of the lounges. The health and safety committee at the home had identified and the manager said she had reported these issues to head office and no action has been taken. Sutton Valence Nursing & Care Centre DS0000026208.V340016.R01.S.doc Version 5.2 Page 20 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 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 3 17 X 18 3 1 X X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 1 Sutton Valence Nursing & Care Centre DS0000026208.V340016.R01.S.doc Version 5.2 Page 21 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 OP7 Regulation 15(1) Timescale for action The registered person shall, after 30/07/07 consultation with the resident or their representative, prepare a written plan as to how their needs in respect of their health and welfare are to be met. In that all care plans must be up to date and comprehensive as required for service users care needs to be met. The registered person shall make 12/06/07 arrangements for the safe handling, safe administration and safe keeping of medication in that, The medication fridge must be kept locked, Medicines must be kept in their original packaging with the prescription. 30/08/07 The registered person shall ensure the home is kept in a good state of repair, internally and externally, and all parts of the home are reasonably decorated, broken door closing devices must be made good as the noise of slamming doors is upsetting some of the residents. DS0000026208.V340016.R01.S.doc Version 5.2 Page 22 Requirement 2 OP9 13 (2) 3 OP19 23 (2)b,d Sutton Valence Nursing & Care Centre 4 OP21 23(2)(c)(j ) The registered person shall having regard to the number an needs of residents ensure that the equipment used by the home is maintained to good working order with sufficient numbers of lavatories, bathrooms and showers fitted with hot and cold running water. In that there remain 2 assisted bathrooms are out of order. Repeated from the last inspection The registered person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home in that Baths with damaged surfaces be made good, raised toilet seats being stored in the sluice be thoroughly cleaned, and net underwear be used for named individuals and not shared. The registered person shall ensure that staff are working at the home are employed in such numbers as are appropriate for the health and welfare of the service users in that The manager conduct a review of the staffing numbers The registered person shall ensure staff receive training appropriate to the work they are to perform, in that staff receive regular training and updates in moving and handling and first aid. The registered person shall ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of service users, in that damaged flooring presenting trip hazards be made DS0000026208.V340016.R01.S.doc 30/08/07 5 OP26 13 (3) 30/07/07 6 OP27 18 (1)(a) 30/07/07 7 OP30 18 (1)(a) 30/07/07 8 OP38 12 (1)(a) 06/06/07 Sutton Valence Nursing & Care Centre Version 5.2 Page 23 safe, the damaged doors which cannot be adequately locked be made good, damaged leaning trees be made safe. 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 OP28 OP33 Good Practice Recommendations It is recommended that care staff be encouraged to undertake NVQ training. It is strongly recommended that the home continue to develop effective quality assurance and monitoring systems using resident’s views and feedback, and to produce an annual development plan. It is strongly recommended that residents’ monies are not pooled either in the homes safe or in a bank account, for ease of auditing and to ensure residents do not miss out on opportunities to earn interest. 3. OP35 Sutton Valence Nursing & Care Centre DS0000026208.V340016.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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