Inspection on 22/01/08 for Swiss Cottage Nursing Home

This inspection was carried out on 22nd January 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Swiss Cottage Nursing Home 22/04/09

Swiss Cottage Nursing Home 08/10/08

Swiss Cottage Nursing Home 19/09/07

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Swiss Cottage Nursing Home Plantation Road Leighton Buzzard Bedfordshire LU7 3HU Lead Inspector Mrs Sally Snelson Unannounced Inspection 22nd January 2008 07:00 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 Swiss Cottage Nursing Home DS0000069674.V358438.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. Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Swiss Cottage Nursing Home Address Plantation Road Leighton Buzzard Bedfordshire LU7 3HU 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) 01525 377922 01525 373791 swisscottage@schealthcare.co.uk Southern Cross Healthcare (Focus) Limited Vacant post Care Home 85 Category(ies) of Dementia (85), Old age, not falling within any registration, with number other category (85), Physical disability (10) of places Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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: 85 Dementia - Code DE, maximum number of places: 85 2. Physical Disability - Code PD, maximum number of places: 10 The maximum number of service users who can be accommodated is: 85 19th September 2007 Date of last inspection Brief Description of the Service: Swiss Cottage Care Home with Nursing is situated in a pleasant suburb of Leighton Buzzard within easy reach of the town centre amenities by car or public transport. Extensive gardens and woodlands surround the home. The accommodation is divided into two main areas with separate dementia care areas on the first floor, and a nursing unit on the ground floor. The home provides single accommodation for up to 83 people. In addition, there is a double room within the dementia care unit. Access to the first floor is via a shaft lift or stairs. Various communal areas are located throughout the home. Copies of the homes statement of purpose and service user guide are available in the reception area. A copy of the most recent inspection report is displayed in the entrance of the home and is available to prospective people who may wish to move into the home. The manager of the home provided the following in April 2007. The fees for this home vary from £443.75 per week, to £669.50 plus per week, depending on the funding source and assessed need of the person. Additional charges are made for hairdressing, newspapers, toiletries and chiropody. Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out in accordance with the Commission for Social Care Inspection’s (CSCI) policy and methodologies, which require review of the key standards for the provision of a care home for older people that takes account of service users’ views and information received about the service since the last inspection. This inspection of Swiss Cottage was the second key inspection, was unannounced and took place from 07.00hrs on 22nd January 2008. Sally Snelson and Louise Trainor undertook the inspection and as it was the second key inspection we did not request a second Annual Quality Assurance Assessment (AQAA), but continued to use the information from the one provided prior to the last inspection in September 2007. The manager Mr Lazarus Staziyo was present for most of the inspection. The operational manager Jennie Acre also met with us for a time. Feedback was given to the manager throughout the inspection and at the end. During the inspection the care of four people who used the service was case tracked. Case tracking involved reading residents records and comparing what was documented to what was provided. Two of the people were accommodated on the ground floor and two on the first floor. In addition to sampling files, people who lived at the home, staff and visitors were spoken to and their opinions sought. Any comments received from staff or service users about their views of the home plus all the information gathered on the day was used to form a judgement about the service. The inspector would like to thank all those involved in the inspection for their input and support. What the service does well: One resident when talking about the staff said, “they are all so caring, they take me out for walks to see the garden, did you know there is a wishing well?” Another said, “It is quite nice here, there are worst places than this.” Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 6 The home is situated in pleasant secluded grounds, which the residents have access to. The decor throughout the home is comfortable and staff appear to be happy working at Swiss Cottage. All of the documentation in the home was presented very neatly and staff were able to find it easily. The dementia unit was being run in a way that indicated knowledge of best practice in caring for people with dementia. What has improved since the last inspection? What they could do better: Care must be taken that staff update care plans as a resident’s care needs alter. Where observations, taken as part of routine risk assessments, indicate a change in condition, staff must recognise this and consider altering care practices. Medication, that belongs to a resident, but is destroyed by the home because it is not needed, must be documented. Staff must ensure that resident’s dignity is not compromised in any way. Activities within the dementia care unit should be developed around individuals known social histories, and promote meaningful opportunities for service user participation, based on principles of ordinary living. Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 7 All areas must be free of offensive odours to provide a pleasant environment for the people living there. The manager must develop effective ways to check the quality of the home. 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. Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information gained about a prospective resident, prior to them being offered a place at Swiss cottage, was sufficient to ensure that an informed decision could be made that the home could meet their needs. EVIDENCE: The Statement of Purpose and the Service Users Guide were on display to the public in the entrance hall of the home. The documents had all the required information and were available in audio form if needed. However care needed to be taken to keep them under review when information altered. For example, they had not been changed to reflect the resignation of the Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 10 registered manager or that our address and telephone number changed as a result of a move from Bedford to Cambridge. At the last inspection it was noted that those people who were self-funding did not have signed terms and conditions. This had been rectified and all residents were now aware of what to expect from Swiss cottage. Contracts provided resident and their families with detailed information about how the charges were broken down. All of the pre-admission assessments completed since the last inspection were of a high quality. The information gained was found to be accurate and used to inform the care plans, and even before admission potential risks were recorded. In addition, each section of the pre-admission assessment was scored and signed and a summary written by the person undertaking the assessment. The amount of training undertaken by staff at the home, and the changes to the environment, showed that all concerned were more aware of the needs of the residents. The manager was working closely with staff to make the necessary changes, and to ensure that the home had the capacity to meet the needs of the resident’s. Swiss cottage did not provide intermediate care. Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents had care plans for all their care needs. More detail in the care plans would ensure that all staff would be aware of the way care should be provided and ensure consistency. EVIDENCE: Each of the files sampled had care plans for each of the resident’s needs. The care plans had been reviewed and altered monthly, but had not always been altered as care needs changed between review dates. To ensure that all the staff provided an adequate standard of care, the plans needed to be written in more detail. For example rather than saying a catheter needed to be changed, the date of the next change should be highlighted and the type and size of the catheter needed recorded. It would also be beneficial to provide more Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 12 information about how personal care should be delivered, i.e. can the person shave himself or apply the shaving cream when it is written ‘needs some help with personal care’. Care plans were organised well and neatly presented making it easy for the reader to find information. It was apparent in some cases that families had been involved in providing information to support care plans and had agreed their content. There was a definite improvement in the standard of documentation since the last inspection. All of the residents had been registered with a GP and the home reported having good relationships with the local surgeries. GP’s, chiropodists, dentists, opticians and other health professionals visited residents as and when necessary. The home also used visiting professionals for advice and for training. All but one of the residents whose care was tracked had been weighed monthly and their weight used to inform the assessment of the risk of a pressure sore developing. Unfortunately the resident who had not been weighed had lost weight when weighed in October 2007. The manager was made aware of this shortfall. There was evidence that any pressure sores were being dressed, viewed and assessed regularly, and where necessary photographic evidence taken. Specialist advice and support was also sought as necessary. Staff had healed the pressure sore of a resident who had been admitted with a broken area, it was also noted that her dependency level had decreased since admission, suggesting that staff supported residents to maintain their independence wherever possible. The medication records of the people whose care was tracked were looked at, and the medications procedures on the first floor were looked at in detail. On the whole mediations records were well kept and accurate, however it was noted that any unused medication, that needed to be retuned to the pharmacy, was placed in a disposal bin, but it was not documented anywhere that the medication had been destroyed. We were also concerned that the bin was not sealed and could be opened by anyone. It was however stored in a locked area. The manager agreed to address this concern immediately and ensure that the procedure was part of the medication policy. Throughout the inspection we witnessed staff knocking on doors before entering bedrooms and speaking to resident’s in an appropriate way. We were however concerned that people’s dignity was compromised by having staff enter their bedroom and comment on them, and their care needs, as part of the handover process. Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 13 On one of the units there were two night duty male staff working together. They reported that none of the female residents minded having their personnel care provided by male staff. However, there was no documentation to support this and it is extremely unlikely that, if given the choice, this would be the view of all female resident’s. All of the files sampled had some details about the person’s wishes at the time of sudden illness or death, including who should be contacted at this time and during what hours contact should be made. Swiss Cottage Nursing Home DS0000069674.V358438.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There were a variety of activities organised within the home and staff asked residents and relatives for information about residents previous interests. However more work was needed to ensure that the activities provided were what residents wanted. EVIDENCE: At the start of the inspection very few of the resident on the ground floor had chosen to get up. As expected, more were up and about in the dementia units. Night staff gave those residents that were awake the option to get up, if not they waited until breakfast time. The social interests of residents were recorded in their care plans, but there was little to suggest that this information was used to plan an activity programme. Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 15 Group activities were planned and these included playing bingo, listening to music and being entertained by a visiting organist. The manager was encouraging care staff to also instigate some of the activities, so that activities could be available at all times. We observed a member of staff encouraging residents to do gentle exercises, but throughout the visit we noted missed opportunities for socialising and encouraging stimulation, such as during coffee time or when preparing the tables for mealtimes. The dining rooms were attractive. Dining tables were laid with flowers and there was appropriate background music playing throughout the mealtime. One visitor, who came each day at lunchtime, commented that the food always smelt and looked very good. We observed a staff member working on the first floor, offering a resident choices when supporting him at breakfast time and ensuring that the food she was feeding him was not too hot. We also noted that at lunchtime residents were shown two plates of food and asked to make a choice. Picture menus were not in use. The daily menu was not displayed on either floor. A rolling menu was available, but this required the reader to not only know the day of the week but also know within which of the four week rolling programme the home was operating. Where support was being provided to residents who needed help with feeding this was done in an appropriate unhurried way. A variety of different crockery was used to suit the needs of the individual. Swiss Cottage Nursing Home DS0000069674.V358438.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. 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. A robust complaints procedure, and staff knowledge about safeguarding adults from all forms of abuse, ensured that residents were kept safe and provided with adequate care and support at all times. EVIDENCE: At the last inspection it was reported that, ‘The complaints procedure gave simple guidance in how people could raise a concern. Feedback from people living at the home indicated that they would feel confident in raising a concern or complaint and to whom they could complain to. Clear timescales had been included in the procedure so complainants would know when the manager of the home would respond to them. Complaints investigated since the last inspection had been responded to within timescales. Evidence of investigation and responses to the complainants were also seen, as was evidence of action taken as a result of the investigations. One complaint was in the process of being responded to at the time of the inspection.’ As there had been no further complaints, the complaint that was under investigation was reviewed and it was apparent that this had been dealt with correctly also. Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 17 The manager was aware of the local policy for the safeguarding of adults (SOVA) and had appropriately referred any incidents that could be considered possible abuse. This included medication errors and unexplained injuries and bruising. The manager had ensured that all staff had been trained to understand the various forms of abuse and how they could recognise these and respond. If necessary, staff were taken through the correct disciplinary processes by the management. Monies held on behalf of residents by the home were checked and found to be correct. Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 18 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 adequate. This judgement has been made using available evidence including a visit to this service. A number of changes had been made to the environment that made it a more homely and appropriate place for resident’s to live. EVIDENCE: At the start of the inspection the inspectors could not gain access to the home, despite ringing the doorbell on several occasions. When access was eventually gained, following a telephone call to the home, the nurse in charge reported that the doorbell did not sound throughout the home. Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 19 At the last inspection it was reported that the first floor of the home had an offensive odour, as a result carpets had been replaced and there was an ongoing programme of redecoration. However this had not completely resolved the situation. The cleaner believed that it maybe because some of the comfortable chairs in the lounge areas did not have protective covers and the foam may have absorbed the odour. The manager and the operational manager reported that it was planned that these chairs would be replaced as part of regular refurbishment programme, and in fact some had already been replaced. A lot of work had been done on the first floor to ensure that the environment was suitable for people with a diagnosis of dementia. For example themed areas, such as a red telephone box had been developed and bedroom doors had been painted different colours. Several tactile boards had been put up. The manager stated that he was planning to have a sensory unit installed on the ground floor, which would be accessible to all of the residents. Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager was committed to providing the staff with a training programme that equipped them with the essential knowledge to meet the needs of the residents. EVIDENCE: The manager reported that there were sufficient staff to cover the required shifts in the home and that there was only occasional need to use agency staff. For operational purposes the home was divided into two units with its own allocated staff. There was always a nurse on duty on each floor. The off-duty suggested that some staff were offering to work a number of additional shifts. For example over the course of 2 weeks, one nurse on night duty was rostered to work ten night shifts and had also volunteered to cover an early and late duty shift. We reminded the manager of the need to ensure that staff did not offer to work too many additional shifts so that the standard of care they provided could be compromised. Staff confirmed that, although staffing levels were set, extra staff were provided if it was necessary for a resident to have additional one to one support. Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 21 The manager told us that he was committed to encouraging and supporting staff to attend training. He had devised a matrix to easily identify staff training needs and was confident that all staff would complete mandatory training by the end of January. From there on mandatory training would be block booked for the rest of the year and new staff fitted in to the next available session. This would ensure that there was a continual programme of training. There were posters in staff areas advertising fire awareness training for 23.1.08 and 24.1.08 and Yesterday Today and Tomorrow, (dementia awareness training) training for 25th of the month. There had been a dramatic increase in the amount of staff who had, or were in the process of undertaking, NVQ training. Since the last inspection the number had raised from 20 to 78 . To ensure compliance with recruitment we sampled staff files, looking particularly at staff recruited by the new manager. As with other documentation these files were well presented. The files included all the required documentation and checks, and confirmed that the manager was recruiting and starting new staff in accordance with regulation. The manager had concentrated on ensuring that mandatory training was in place but was also sourcing specialist training. It was reassuring to be told that ancillary staff were being offered training that included dementia awareness. All new staff completed an induction programme, which the manager believed should take staff about three months to complete. Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,37,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager had a clear vision for Swiss Cottage, which ensured that residents and staff were safe and lived in a happy environment where their views were considered. EVIDENCE: At the last inspection the manager was in an acting position, covering the registered managers sick leave. The majority of the staff spoke highly of the support that they received from the new manager and described him as Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 23 approachable and helpful. Independently a commissioning officer and a reviewing officer from the Local Authority spoke of the confidence they had in Mr Staziyo as a manager. He had previously worked as a deputy manager and was both a general nurse and a mental health nurse. He confirmed that he had started processes with CSCI, to be considered for the position of registered manager. The manager was working on the ways in which the quality of the care provided could be assured. To date, staff and resident surveys had been sent out, but there was nothing detailed about the way the information received had been used to inform practice. Staff meetings had been held and the manager was aware of the need to organise a relatives meeting soon. Night staff commented that it was not always possible to attend staff meetings as they were held during the day, but it was hoped that the night staff would also have their own meetings at times. As already stated, monies held on behalf of residents were checked and found to be correct. The administrative officer was responsible for resident’s money and had processes to ensure money could be accepted and was available in her absence. A supervision programme had been operational since October 2007 and indicated that all of the staff had had a least one supervision, and many two, in that period of time. A senior domestic confirmed that she was supervising some of the ancillary staff. The manager should ensure that all the staff that were supervisors, had had the necessary training and were providing supervision in a consistent way. Documentation throughout the home was presented in neat way. Fire safety checks and water temperature checks were all up to date and recorded neatly by the maintenance person who was responsible for the checks and ensuring the safety and efficiency of the equipment. Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 4 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 2 3 3 Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP7 OP8 Regulation 15(2) 12(1) 13(1) Requirement Care must be taken that staff update care plans as a resident’s care needs alter. Where observations, taken as part of routine risk assessments, indicate a change in condition staff must recognise this and consider altering care practices. Medication, that belongs to a resident, but is destroyed by the home because it is not needed, must be documented. Staff must ensure that resident’s dignity is not compromised in any way. Activities within the dementia care unit should be developed around individuals known social histories, and promote meaningful opportunities for service user participation, based on principles of ordinary living. This had improved greatly but there was still a need for more stimulation to be available throughout the day 6. OP26 16(2)(k) All areas must be free of DS0000069674.V358438.R01.S.doc Timescale for action 31/03/08 31/03/08 3 OP9 17(1)(a) 01/03/08 4 5. OP10 OP12 12(4)(a) 12,13,18 31/03/08 31/03/08 01/04/08 Version 5.2 Page 26 Swiss Cottage Nursing Home offensive odours to provide a pleasant environment for the people living there. Previous timescale of 30/06/07 and 31/08/07 30/11/07 not met. This standard had improved somewhat but more investigation into the cause needs to take place. The manager must develop effective ways to check the quality of the home. 7 OP33 24 01/04/08 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 OP1 Good Practice Recommendations The manager should ensure that the Statement of Purpose and the Service User Guide are kept under review so that they accurately reflect the current position of the home. Staff should consider photographing meals and using these to offer the residents choices at mealtimes. Daily menus should be displayed so that residents know what to expect at mealtimes. The manager should ensure that an application is completed for him to become the registered manager of the home. The advertised programme of supervision should be adhered to. 2 OP15 3 4 OP31 OP36 Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Inspection Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Swiss Cottage Nursing Home DS0000069674.V358438.R01.S.doc Version 5.2 Page 28 - 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. 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