Inspection on 18/10/05 for Temple Ewell Nursing Home

This inspection was carried out on 18th October 2005.

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

Temple Ewell Nursing Home 11/07/06

Temple Ewell Nursing Home 28/06/05

Temple Ewell Nursing Home 28/09/04

Temple Ewell Nursing Home 01/06/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

Insight - Eastchurch

Southfields

Magenta

Seabourne House

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

CARE HOMES FOR OLDER PEOPLE Temple Ewell Nursing Home Wellington Road Temple Ewell Dover Kent CT16 3DB Lead Inspector Chris Randall Unannounced Inspection 09:15 18 October 2005 th 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 Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 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. Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Temple Ewell Nursing Home Address Wellington Road Temple Ewell Dover Kent CT16 3DB 01304 822206 01304 822208 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) Charing Cross Investments Limited Ms Christina Osborn Care Home 44 Category(ies) of Learning disability (10), Old age, not falling registration, with number within any other category (44), Terminally ill (5) of places Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. LD service users age 45 and over up to a maximum of 10. TI service users age 45 and over up to a maximum of 5 Date of last inspection 28th June 2005 Brief Description of the Service: Temple Ewell Nursing Home is a purpose built, detached building, set into a hillside, which overlooks the village of Temple Ewell. The providers are Charing Cross Investments Ltd., who have a number of care homes in the region, and are experienced providers for the care of older people. Service user accommodation is provided on the upper 2 floors with laundry and staff facilities on the lower floor. The home has a very large passenger lift giving access to all service user and communal areas. The corridors and door widths are suitable for the use of wheelchairs. The majority of the bedrooms are single, some with en-suite toilet facilities. There are 3 double rooms available for people who wish to share. The home has a variety of outside sitting areas, walkways, and a sensory garden, enabling service users to sit in sun or shade and with other people or in solitude. The registration of the home is for a total of 44 service users who need nursing care, and has conditions allowing up to 10 service users with learning disabilities and up to 5 terminally ill service users to be accommodated within the 44 maximum limit. Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection held over one day and took 12 hours (7.5 in the home plus preparation time). The previous announced inspection had covered the majority of standards and this inspection looked at the outstanding standard regarding service users finances, and then mainly concentrated on chatting to and gaining the views of service users, visitors and staff. The inspection comprised of a the tour of the building and grounds; meeting service users and speaking more fully to 21 of them, talking to 10 visitors, 8 staff, the hairdresser and a therapist; observing preparation and serving of lunch; examining some records; and discussion with the manager about the home in general and about some concerns raised by a neighbour which were proved to be unfounded. A variety of responses, both positive and negative, were gained from talking to service users, visitors and staff and varied from “it’s a truly wonderful place”, “I like it here”, “I love my job”, and “I cannot praise the home enough” to “the cleanliness is disgusting” “I don’t like it”, and “I hate it here”, the positive comments, particularly from service users and visitors, outweighed the negative. Staff morale appeared low and the majority of staff expressed the opinion that staffing levels needed increasing. The home was generally clean although there were some areas that needed attention. The majority of the home was odour free but there is one area where there is a very stale, almost rancid odour. The food served was nutritious, balanced, nicely presented, and hot, although it was served more than 30 minutes late because the care staff were under pressure during the morning. What the service does well: The outside areas of the home are well arranged with several sitting areas, a sensory garden, a water feature, and a pleasant walkway. Terminally ill service users are well cared for, clean, comfortable, and as pain free as possible. Staff ensure that all service users dignity is maintained, they look clean, tidy and well turned out in clean, pressed, and colour coordinated clothing. Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 Page 6 The home has a snoezelum or sensory area, which is well used and very relaxing, this area is also used for other activities. There is a variety of activities provided for those who wish to take part, including a therapist who visits the home 3 or 4 afternoons a week to do reflexology, counselling and who also brings a registered pat-a-dog to visit. Food served at the home is balanced, nutritious and nicely presented and there is a choice at each meal. A visitor commented, “they are very caring, the food is lovely, I can’t fault it here”. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 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 Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: This section was not addressed at this inspection. Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 10 Service users privacy and dignity are upheld and they are treated with respect. EVIDENCE: Care plans were looked at in some depth on the announced inspection and have therefore not been looked at during this inspection. Although medication was not inspected at this time the manager was able to demonstrate that a new pharmacy fridge had been purchased following the recommendation on the last inspection report regarding fridge temperatures. Currently both fridges are in use and the temperature recording was witnessed and within the approved guidelines. A discussion was held on the recent changes regarding disposal of drugs. The new regulations mean that unused drugs are no longer returned to the pharmacy but are collected by a specialist firm for disposal. The home are disposing of controlled drugs appropriately by first denaturing them. The new system, although complying with legislation, is less than ideal and it is suggested that monthly collection, is arranged to minimise any possibility of abuse of the system. Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 Page 11 Service users privacy and dignity are respected. Personal care is given in service users own bedrooms, or in the homes bathrooms. Staff knock on doors before entering and other people are deterred from entering whilst personal care is being given. Service users commented, “its very good, we are well looked after”, “if there is anything you want you just ask”, “I never realised how helpful people could be”, and “I’m being looked after, they are very good”. Visitors commented, “she is always clean and comfortable, they even wash her hair and keep it nice”, “they do a good job, and they give her mouth care”, and “the care is very good”. Maintenance of social contacts with relatives and friends is encouraged. The home has a mobile pay phone, and a cordless telephone that can be used for service users to take incoming calls. Service users wear their own clothes at all times. The home employs a laundry assistant who sews nametags into clothes and also makes repairs as needed. One visitor commented, “xxx always looks nice, and the staff ensure that her clothes are colour coordinated”. Service users are called by their preferred or chosen name. Where shared rooms are used there is screening provided to ensure that personal tasks can be carried out in privacy. General comments from service users included, “they look after me fine”, “people are so caring”, and “the cleaner posts my letters for me”. Visitors commented”, “if you want to talk about anything they are always there”, “the care is good, they work hard”, and “they look after her well”, and staff members said “we don’t always have enough staff on duty to give the care we would like to but we give the best care we can” and “we give good care”. Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, & 15 Service users have choices in all aspects of daily living, their recreational needs are catered for, visitors are made welcome, and they receive a wholesome appealing and balanced diet. EVIDENCE: The routines of daily living are flexible but with so many of the service users having high levels of dependency and a good proportion needing hoisting to move this flexibility is limited by the number of staff available at any one time. Service users are able to have a say in when they get up or go to bed, where and what they want to eat, what they wish to wear, and who they wish to see. Service users choose whether or not they wish to participate in the activities that are on offer and service users commented, “they do activities every afternoon”, and “I prefer to stay in my room”. A therapist visits 3 or 4 afternoons a week, she mainly does reflexology and counselling with the service users and also brings in a registered ‘pat a dog’ which was sitting on a service users lap on the afternoon of the inspection and both were enjoying the attention of the other. The therapist had previously been employed as a staff nurse at the home and understands the needs of the service users; she said that she loves her job. On the morning of the inspection the hairdresser was Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 Page 13 in attendance and said that she normally does about 8 service users hair a week. On the day of the inspection this included 2 service users who were having perms. Other activities that take place include an art class and the activities organiser who arranges this class writes a very detailed diary of service users participation and reactions. Samples of the artwork, including mobiles, are displayed in one of the dining rooms. Friday afternoons there is a bingo session and one visitor explained that he and his wife had been encouraged to help and he was now the regular bingo caller, he said that it was always a good afternoon and the service users enjoyed it. Staff comments included “the activities are appropriate but the majority opt not to do them”, and “we don’t have enough time to give 1:1 attention and sit and talk to residents in their rooms”. The home has the facility of a ‘snoezelum’ or sensory room that contains various pieces of equipment such as a bubble lamp, projectors, optic light strands and different types of floor beanbags. There are various slides to use in the projectors that give different effects within the room. Service users from all categories of the homes registration enjoy the benefits of this room In the better weather the grounds of the home are used to enable service users to either sit out or to wander or be pushed in wheelchairs up the pathway to the upper terrace. There are several areas where service users can sit with others or in more solitude and there is also a sensory garden that is very good for the service users with limited sight. The sun lounge, which has access to one of the patio areas and the walkway, gives a pleasant area to sit on cooler days. One service user commented, “the sun lounge is nice and we can go outside”. Visitors are able to visit at any time and can see the service users in their own rooms, in one of the lounges or dining rooms, or weather permitting in the garden. Visitors comments included, “I am made very welcome”, “one of the family visits every day”, and “I visit nearly every day”. The kitchen in the home is clean and well organised. Daily temperatures are taken of all fridges and freezers and food is properly covered and dated before storing in the refrigerators. The meal served on the day of the inspection gave a choice between a home cooked chicken pie or a freshly prepared curry, fresh vegetables were served and the meal was balanced, nutritious, and healthy. The food was attractively presented, and was hot when served to the service users. Unfortunately the care staff were under some pressure during the morning and service users were beginning to get agitated when their lunch was over half an hour late being served to them. Those meals that are served pureed are attractively presented in separate portions of meat, potato and vegetable in the same manner as a ‘normal’ meal. There is a choice of food for each meal and the service users choice is checked during the afternoon for the next day. Staff assist the service users who need their help with feeding before serving the rest of the service users. There is a dining room in each of Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 Page 14 the wings in the home and some service users choose to eat in their own bedrooms. Service users commented, “its good food and we have a choice”, “I enjoy my dinner”, “the food is lovely, they have a good cook” and “the food is good”. Visitors commented, “I have some meals here, it is good”, “the cook makes a lovely quiche”, “the food is top notch, mother eats everything”, “the food is good, xxxx has a liquidised diet but it is nicely presented”, and “I must say the food is excellent, good helpings, and well presented”. Staff comments varied from “the meal was lovely”, to “its awful”. Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, & 18 Service users can be confident that their complaints will be listened to and acted upon. Some recruitment procedures leave the service users at risk of abuse. EVIDENCE: The home has its own complaints policy and a copy is prominently displayed in the entrance hall and includes details of how to complain to CSCI if appropriate action is not taken by the home. A written record is kept of all formal complaints. There had been one complaint since the last inspection, this had been investigated and the complainant was satisfied with the outcome. One visitor commented, “I have no complaints”. The home has an abuse policy and a whistle blowing policy. All staff have received some training in adult protection, some have received basic training on induction and others have attended specific adult protection training. A member of staff confirmed, “I would know what to do if I had any concerns about abuse, I would report it straight away to the manager”. The manager was reminded about ensuring that POVA checks are received before new staff commence employment in the home and that they should not even start under supervision. Some of the nursing staff who were employed before CRB checks came into place have not yet had enhanced disclosures as the manager has been waiting for CRB to inform her that these now have to be undertaken. These nurses have had their nursing registration checked. A requirement has been added that all staff should have enhanced disclosures and that no Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 Page 16 member of staff should be employed until a satisfactory POVA check has been received. Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25, & 26 Service users live in rooms that suit their needs within a safe and wellmaintained environment. Some improvements need to be made to ensure the home is kept clean, pleasant and hygienic. EVIDENCE: The home is purpose built and suitable for its stated purpose. It is divided into 4 areas, 2 on each of the upper floors and each of these areas has its own bathrooms, toilets and communal rooms. The lower floor is used for the laundry, handyman’s room, manager’s office, and staff room. The home employs its own handyman who ensures that all routine maintenance is kept up to date. On the day of the inspection there was scaffolding in place for some repair work that had almost been completed. As the home is set into the hillside there are garden areas on all levels. All areas are accessible by wheelchairs. The gardens are nicely laid out, tidy and include a sensory garden, a water feature, patio areas, and a walkway with attractive planting and a small sitting area along the way. Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 Page 18 The sitting and dining areas are light and airy; there is a conservatory area, and a ‘snoezelum’. One of the dining areas is decorated with artwork from the art class. The home has its own hairdressing salon and this is well used on a Tuesday morning. Lighting and furnishings in the communal areas are domestic in character and suitable to meet the needs of the service users. A staff member commented, “The place is lovely”. There are sufficient toilet and bathing facilities and baths are fitted with hoists. Some of the rooms are fitted with en-suite toilet and washing facilities. Toilets are available in close proximity to the communal areas. Most of the service users bedrooms are single rooms, with 3 double rooms available for those who wish to share. Screens are provided in double rooms to aid privacy. Bedroom furnishings, fittings and lighting is appropriate to the needs of the service users. Most of the service users bring in some of their own possessions to personalise their rooms, some bring small pieces of furniture and others just pictures and knick-knack’s. Service users commented, “I’ve got a lovely room”, and “I’ve got a nice room”. All service users rooms are naturally ventilated. Central heating is appropriate. All taps have pre-set valves to prevent risks from scalding and water storage in the roof is in tanks that are covered, and the handyman checks and records the temperature regularly to avoid the risk of legionella. Generally the home was fairly clean, however there is one area where there is a rancid smell and a recommendation has been made that this is addressed. Some visitors also mentioned that the cleaning was not up to standard, that the bedroom of the service user they were visiting was not clean, and that the chair in which she was sitting was dirty and had been for some time. General cleaning has been added to the recommendation above. Visitors comments varied from “They keep the rooms clean”, “Generally speaking it does not smell”, to “the cleanliness is disgusting, we have complained before, it improves for a while then slips back again”, and “xxx chair is very dirty – that’s not just a couple of days mess”. The laundry facilities are sited on the ground floor. The laundry is suitably equipped and is kept clean and tidy. Red alginate sacks are available for soiled linen although it was mentioned that all staff do not always use these. The manager is addressing this issue and it will be revisited on the next inspection. Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, & 30 Recruitment and staffing levels do not fully protect the service users, however the staff employed are trained and competent to do their jobs. EVIDENCE: Staffing levels for the home are assessed according to the Residential Forum guidelines. The manager has increased levels during the past few months and is currently assessing how the guidelines work in practice and is considering whether she needs to further increase staffing hours. Current staffing during the day consists of a trained nurse for each bay with 2 carers on each bay and 3 on bay 2. Overnight there are 2 trained nurses and 2 care staff. The home are reminded that the Residential Forum guidelines are only guidelines for minimum levels and that staffing should be at a suitable level to fully meet the assessed needs of the service users. Many of the service users at the home are highly dependent in various ways, and many need two staff to hoist them for all movements. On the day of the inspection the staff seemed to be particularly stretched. It is appreciated that an unannounced inspection always affects a home and that there were also service user reviews taking place during the morning that took nurses off the floor, however the majority of staff also expressed the opinion that staffing levels were insufficient. A recommendation has therefore been added that staffing levels are kept under review to not only meet the residential forum guidelines but to ensure that there are sufficient staff on duty to meet the needs of the service users. Staff comments included “the learning disability area needs more staff”, “there are Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 Page 20 not enough staff”, and “the majority of us feel we are short staffed”, a visitor also commented that “sometimes there are not enough staff”. 5 members of the care staff have recently finished their NVQ2, and these, together with staff who have previously completed this training and foreign nurses who are working as carers, the home has now reached the 50 of care staff trained to NVQ level 2 or equivalent as required under the National Minimum Standards. It is encouraging to note that another 2 staff are due to commence NVQ shortly and the home should continue to encourage all care staff to undertake this training. One of the cooks indicated that she is intending to do NVQ level 3 in cooking and this is also commended. A staff member commented, “I have just finished my NVQ 2”. Three recruitment files were witnessed during the inspection. Some of the references, particularly for the foreign nurses, were addressed to ‘to whom it may concern’ and a recommendation has been added that in future such references should not be accepted. The manager confirmed that new staff have been employed in the home under supervision prior to a satisfactory POVA check being received. There are also some of the longer standing members of the nursing staff who have not yet been checked for an enhanced disclosure by the Criminal Records Bureau and a requirement has been made under this standard and under standard 18 that no new member of staff should be employed in the home until an Enhanced Disclosure has been submitted and a satisfactory POVA first has been received, and all existing staff should now have an Enhanced Disclosure. A recommendation has also been added that recruitment files should be updated to comply with the revised Schedule 2. All new staff receive induction training and this is designed to meet the Skills for Care guidelines. The home currently has 2 overseas nurses who are undertaking their adaptation and they work as Senior Carers whilst receiving their training. There are also a further 2 overseas nurses not currently on an adaptation programme who are working as carers. Training in Moving and Handling techniques is updated yearly, and staff are also trained in adult protection, fire, and infection control. There is a member of staff trained in first aid on duty at all times. The cooks have undertaken basic food hygiene and are about to start on intermediate food hygiene. A staff nurse commented, “I did my adaptation here”. Comments about staff from service users included “you could not fault the staff”, “the staff are kind”, and “they are so kind”. Visitors commented, “the staff are terrific”, “some of the staff are lovely, other are not”, “the staff are very good”, and “the staff are brilliant”. Staff comments included “I love it we get on so well together”, and “its generally nice but some people cant work as a team” Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 Page 21 Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 35, & 36 A suitable manager manages the home but she needs to encourage a more positive ethos in the home, and ensure that staff receive appropriate supervision. EVIDENCE: The registered manager is a first level nurse and is currently undertaking her NVQ Registered Managers Award, which should be completed by early in 2006. She undertakes regular training updates to ensure that her nursing registration is kept up to date. There are clear lines of accountability both within the home and within the company as a whole. Comments received about the management and leadership ethos of the home were mixed and varied from staff comments of “I get support when I need it”, “we get support from most of the nurses”, to “the manager does not give us support”, and “we should have meetings once a month but have not had one Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 Page 23 for ages”. Service users commented, “there is a happy atmosphere”, and “the manager is friendly when I see her”, and a visitor commented, “The management is superb”. Currently there appears to be an atmosphere within the home and with the managers office being on the lower floor she is probably not as visible as some people would like, particularly when she is dealing with complicated administrative and management tasks. It is suggested that in order to help morale in the home the manager tries to make herself generally more visible around the home. Financial procedures were inspected. The home has one service user for whom the manager holds her savings book. In all other instances the service users themselves, or their families, powers of attorney, or appointees look after their finances. The home does keep some ‘pocket money’ for a few service users and all of the transactions are recorded and receipts kept. Incidentals that are not covered under the service users fees such as chiropody, hairdressing and newspapers are invoiced to families by the company’s head office. Although some evidence was seen of formal supervisions generally this is not being undertaken as often as required and is not being properly documented. A member of staff commented, “I have not had supervision”. A recommendation is added that supervisions are carried out at least 6 times per year. Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 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 1 3 3 3 X 3 3 3 2 STAFFING Standard No Score 27 2 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 X X 3 2 X X Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 Page 25 No 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 OP29OP18 Regulation 19 (4) (I) Requirement No new member of staff should be employed in the home until an Enhanced Disclosure has been submitted and a satisfactory POVA first has been received. All existing staff should now have an Enhanced Disclosure Timescale for action 30/11/05 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 OP26 OP27 Good Practice Recommendations The odour in one area of the home should be investigated and addressed and the cleaning of service users bedrooms should be kept under review Staffing levels should be kept under review to ensure there are sufficient staff on duty at all times not only to comply with the recommendations of the Residential Forum guidance but also to meet the assessed needs of the service users. Recruitment files should be updated to comply with the revised Schedule 2 The home should not accept references that are addressed DS0000026124.V251282.R01.S.doc Version 5.0 Page 26 3 4 OP29 OP29 Temple Ewell Nursing Home 5 OP36 to ‘to whom it may concern’ but should seek to get references addressed to the home in response to a request from them. All care staff, including trained nurses, should receive formal supervision at least 6 times per year. Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Temple Ewell Nursing Home DS0000026124.V251282.R01.S.doc Version 5.0 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. 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. 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