Inspection on 27/06/07 for The Adelaide Nursing Home

This inspection was carried out on 27th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Adelaide Nursing Home 24/10/06

The Adelaide Nursing Home 31/05/06

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE The Adelaide Nursing Home 203 - 205 New Church Road Hove East Sussex BN3 4ED Lead Inspector Elizabeth Dudley Unannounced Inspection 10.00a 27th June 2007 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 The Adelaide Nursing Home DS0000065729.V339190.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. The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Adelaide Nursing Home Address 203 - 205 New Church Road Hove East Sussex BN3 4ED 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) 01273-410530 01273 423413 Seaway Nursing Home Limited Mrs Kusumawattee Heard Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That service users should be aged sixty-five (65) years or over on admission The maximum number of service users to be accommodated is thirtyfive (35) Only older people requiring nursing are admitted to the home. Date of last inspection 24th October 2006 Brief Description of the Service: Adelaide Nursing Home is a care home providing care for up to thirty-five (35) residents over the age of sixty-five (65) and requiring nursing care. Rooms are located over two floors and are accessible by stairs. A passenger shaft lift is available for those residents unable to independently mobilise. Communal areas consist of a lounge/dining area and access to garden. Assisted bathing facilities are in place. It is located in a quiet residential area of Hove. Local amenities and the seafront are within walking distance of the home. There is nearby access to public bus routes and rail links to Brighton. The home provides parking for approximately four cars and further car parking is available in adjacent roads, which is unrestricted. Weekly fees range between £500 and £650. There are additional charges for hairdressing, Chiropody, newspapers/magazines, and personal toiletries. This is based on information given by the provider on 27.June 2007. The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on the 27th June 2007 over a period of six hours and was facilitated by the manager Mrs K Heard and the provider Dr R Sumorreah. Prior to the inspection the CSCI sent ten questionnaires to residents, ten to relatives or visitors and two questionnaires to health care professionals. Four of the visitor’s questionnaires, three resident questionnaires and both professional questionnaires were returned. The comments made on the questionnaires were varied and included the following: “ The staff treat residents and visitors extremely courteously and friendly and I have nothing but praise for the care that they give’. “ They look after residents exceedingly well”. “ Good standard of care observed”. “ I think more training for staff in the basic skills of care would help to ensure that every attention be given to the various and differing needs of the resident, I feel that some staff do not fully understand the residents condition.” “ Some staff are very good”. During the inspection a tour of the home was undertaken, documentation which included care plans, medication records, health and safety, training and personnel files were examined, and two visitors, seven members of staff and nine residents spoken with. Six residents had their care examined in depth to ensure that the assessed needs of the residents were being documented in the care plans and that the care that was being given met with the expectations of them or their representatives. What the service does well: The service provides nursing care for older people within a homely environment. Residents and visitors to the home described the standard of catering as: ‘Very good with plenty of vegetables’.“ The cook does a good job”. Residents said that they had choices at mealtimes and that a cooked breakfast was available. The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 Page 6 The ethos in the home is good, and the residents said that staff were friendly and looked after them well. What has improved since the last inspection? What they could do better: Staff need to be employed in sufficient numbers to meet the psychological, health and social needs of the residents. New staff should receive health and safety training which includes moving and handling training at the commencement of their employment in the home to ensure that both staff and residents’ safety is maintained. Ongoing training for all staff must continue, with efforts made to ensure that the Registered Nurses have the opportunity to attend training in end of life The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 Page 7 care and clinical practice in aspects of nursing care as discussed with the manager. Risk assessments are required throughout the home to minimise any potential risk to the resident, and this must include those residents who wish to have their door remain open but are not protected by a self closure on the door. Ongoing improvement to the environment is in place, but in some areas the standard of cleanliness and odour control is poor. It would be good practice for residents to be moved out of the lounge chairs and be able to sit at the table for mealtimes. The manager should ensure the provision of activities and one to one social contact for residents and this must be considered a priority. 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. The Adelaide Nursing Home DS0000065729.V339190.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 The Adelaide Nursing Home DS0000065729.V339190.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): 1,2,3,4,5,6. People who use the service experience adequate quality outcomes in this area’ This judgement has been made using available evidence including a visit to this service. The home produces documentation to enable the prospective resident to make an informed choice about the home, but this is not given to the resident at their assessment. Preadmission assessments are not sufficiently detailed to allow the admitting staff commence the care plan on the resident. The combined knowledge and skills of the staff at the home are sufficient to enable resident’s needs to be met. EVIDENCE: The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 Page 10 The statement of purpose has been updated to reflect most of the current practice in the home and comply with the regulations, however amendments are required to show that due to the current staffing status, activities are not provided in the home at this time. All residents have a copy of the Service user guide, which is produced in a format suitable for residents to use. The terms and conditions of residence comply with the regulations and a copy of this is given to residents at the point of their admission into the home. The manager or a registered nurse visit and assess each prospective resident to ensure that the home can meet his or her needs. No information about the home is currently taken by the assessing member of staff to give to the prospective resident, and this was discussed with the manager. The information about the resident gained at the preadmission assessment is used to form the basis of the care plan. This assessment requires to be more in depth and to address the psychological and social needs of the resident and to be more detailed regarding current needs. The present assessment does not give enough guidance or information to staff that will be admitting the resident and forming the initial care plan. All residents or their representatives are encouraged to visit the home before admission, but three residents spoken with said that they had received little or no information about the home prior to coming to live there. At present residents or their representatives do not receive written confirmation confirm that they will be admitted to the home. The training plans show that Staff receive training relevant to the health and personal care needs of the residents and two members of staff (12 ) of care staff currently hold the National Vocational Qualification level 2 in care. There are eight registered nurses who supervise the shifts over the twenty-four hour period. The home admits residents for respite care but not for intermediate care. The Adelaide Nursing Home DS0000065729.V339190.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. People who use the service experience adequate quality outcomes in this area. The standard of care planning does not fully reflect the current and ongoing care needs of the residents or the actions to be taken to meet these needs. The standard of medication administration safeguards the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans are in the process of being reformatted to make them easier to access and read. The standard of care planning was variable, issues around the care planning had been the subject of recommendations by social services but this had not been adhered to. The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 Page 12 There was insufficient information or guidance on the current state of treatment given to some residents. There was little care planning around mental health or social issues. Information regarding the involvement of other health care professionals including the Wound Care Specialist Nurse and Speech and Language Therapist was in the care plans. There was evidence that some residents or their representatives had been involved in the compilation of the care plan, and although there was information to indicate that reviews of care plans had taken place, the current care needs had not always been reviewed. Staff have received recent support in the care of the residents and ongoing training from the Care Home Support Team. The Care Home Support Team provides physiotherapy, and the home also employs their own physiotherapist who assesses all new residents and provides physiotherapy to existing residents on a monthly basis. Most residents spoken with were satisfied with the care they received and said that they were treated in a dignified manner and that their privacy was respected. Information was received prior to the inspection stating that at times staff show a lack of courtesy to the residents when giving care, by speaking amongst themselves rather than to the resident, and that staff do not always knock the residents door prior to entering the room. The administration, storage and receipt and disposal of medication were satisfactory, although some handwritten prescription orders had only one signature and it would have been good practice to have this signed by two registered nurses. The clinic room was clean but medicine cupboards were in need of repair or replacement. Records showed that equipment was checked on a regular basis. The home admits residents for continuing care, but staff have not received any specialist training in the care of these residents or end of life care. Positive comments from families of residents who had received end of life care in the home were seen, but the standard of end of life care given could not be assessed or tested at this inspection. The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 Page 13 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. People who use the service experience adequate quality outcomes in this area. Failure to provide activities or a social and leisure programme results in lack of stimulation for residents. Residents’ choices in activities of daily living are restricted in some areas. The standard of catering meets the needs of the residents and provides and nutritious and varied diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are no activities provided at present, the home does not have an activities coordinator and staff have little time to engage with residents in these. Three residents spoken with said that staff come in and talk to them when they have time, but staff said that generally they were not able to spend more than a few minutes on this. Social care plans did not reflect the leisure interests or social needs of the residents. The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 Page 14 Residents appeared to be dependent on television or relatives visiting for social interaction. Some residents said that their choice of times of rising and retiring were overridden by staff need to get the work done, but others not so dependent on staff said that they could make their own choice. One resident who prefers to get up very early said that this was her choice and staff ensure this takes place. Visitors are welcome at any time, and two visitors spoken with said that the home informs them of any concerns about the residents. The menu is varied and provides a nutritious and balanced diet, the majority of the cakes and puddings, and all main meals, are homemade Fresh fruit and vegetables are included in the menu and the chef is able to provide for medical and ethnic diets. The kitchen is clean and catering staff have the food hygiene course. Residents said that the food was ‘good’ with choices being available at lunchtime and suppertime. Staff inform the residents of the choice of meals available on the following day and the cook sees all new residents. Residents have a choice of breakfasts and can have a cooked breakfast if required although few have asked for this. Mealtimes were seen to be unhurried with staff attending to residents in a dignified and leisurely manner, using the opportunity to sit and talk to residents whilst assisting them with their meals. The home has the clean food award and all records as required by the EHA are in place and up to date. The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 People who use the service experience adequate quality outcomes in this area. Lack of available records does not support the home’s handling of complaints. Not all staff have received training in safeguarding the people in their care, which could put residents at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints policy is displayed in the entrance to the home and included in the service user guide; details of the CSCI need amending to reflect the current changes of address. The provider stated that 5 complaints have been received in the last twelve months of which two of these were safeguarding complaints. The documentation relating to these are not kept in a secure confidential file but in with the care plans making it difficult to access these within the timeframes allocated at the inspection and also this has implications for maintaining resident and staff confidentiality. The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 Page 16 The CSCI is aware of three complaints over the last 12 months relating to the concerns over the care of a specific resident, these were prior to the last inspection and one safeguarding allegation since the last inspection which is relating to care of a resident, only one of the three issues in this complaint was substantiated. The home must keep documentation about complaints in a secure and confidential manner, which identifies the actions taken and is available to be examined at the inspection. Residents and relatives were aware of how to make a complaint and were confident that their complaint would be dealt with in a satisfactory and nonjudgemental manner. Previous complaints that have resulted in the CSCI receiving details of actions taken from the provider have shown that these have been addressed in a thorough and fair manner. New staff have not yet received training in safeguarding adults, and some staff have not yet received updating on this training. Planning for both initial and updating training is included in the training programmes. The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26. People who use the service experience adequate quality outcomes in this area. Gradual refurbishment of the home is taking place and cleanliness and odour control within the home shows some improvement, but the home still requires further improvement to become a pleasant environment for residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has been under new ownership for fourteen months and during this time the provider has replaced some beds, put new flooring in the entrance hall and replaced the lounge windows. Some new equipment has been purchased for the home and rooms redecorated as they become empty. The provider agrees that there is still maintenance, décor and refurbishment to be The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 Page 18 attended to, and is planning to enlarge the lounge, replace the front door to the building and to replace one of the baths with an assisted shower. Residents would benefit if the enlargement of the lounge permitted sufficient space for residents to be able to eat their meals at dining tables, rather than from the lounge chairs with over chair tables. The cupboards in the clinic room are in urgent need of repair to ensure that the storage of medicines remains viable. The garden is well maintained and accessible to residents from the lounge area. Residents’ rooms have lockable doors and residents are given the opportunity to have keys to their rooms, and all have a lockable drawer or cupboard in their rooms. Many of the rooms have hospital bedside lockers and hospital type variable height beds have been purchased to replace older beds in the home, and residents would benefit for future furniture to be of a domestic rather than an institutional design. The temperature of the hot water provided for residents is monitored regularly and the provider produced records of this. Window restrictors are in place. Previous concerns raised by staff about the fitness for use of the bathrooms have been addressed and staff confirmed that they are now able to use all the bathrooms for residents. One of the ensuite bathrooms has a door, which leads out into the corridor, the residents’ privacy must be maintained and some means to prevent this being used as an entrance in to the corridor should be put in place. The home has been assessed by an Occupational Therapist who has made recommendations to improve access, equipment and other facilities for residents and this is being gradually put in place. There are hoists and other aids for residents, but there is not sufficient storage in the home for the hoists wheelchairs and other equipment which entails them being left in the corridor. Comments about the cleanliness of the home were received from visitors to the home: - “ Variable standard of cleanliness”. “ The standard of cleanliness has improved but could be much better”. The tour of the home undertaken at the inspection showed that cleanliness has improved, especially in bathrooms, but is still in need of further improvement to bring it up to a standard to meet the expectations of those living in the home. Although individual rooms are clean, corridors and communal areas require attention. The need for refurbishment in all areas of the home does not facilitate the domestic staff in cleaning. The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 Page 19 Records of the providers monitoring visits, which have been sent to the CSCI, have identified that the décor in the home ‘appears tired’ whilst also identifying maintenance and refurbishment matters that require attention. The home has recently employed a person for laundry duties and improvement was seen both in the quality of laundering and in the cleanliness of the laundry. Some rooms were malodorous and this should be controlled. The Adelaide Nursing Home DS0000065729.V339190.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. People who use the service experience poor quality outcomes in this area. The number of staff employed over a twenty-four hour period is not always sufficient to meet the assessed needs of the residents. All staff receive suitable training in order to give the relevant to the needs of the people in the home, but the safety of residents and staff is put at risk by new members of staff not receiving mandatory training on their commencing work at the home. Recruitment practices safeguard the residents in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The duty roster shows that there are two registered nurses in the morning supported by four or five care staff, one registered nurse in the afternoon supported by three care staff and 1 registered nurse and two care staff at night. The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 Page 21 Staff stated that they have to work short of staff at times, and agency staff cannot always be obtained. All grades of staff stated that the amount of staff on duty was insufficient to meet the current residents’ needs. Recent reviews of residents in the home by social and health care professionals have identified that there are not sufficient staff on duty to meet the needs of the residents in the home and a reappraisal of staffing levels was a requirement at the last CSCI inspection. This was discussed with the provider who agreed that at times the amount of staff on duty was not sufficient, and that he and the manager would look at the staffing levels relating to the needs of future admissions and also residents currently in the home. The manager must ensure that the number of staff on duty is determined by the needs and dependency of the residents in the home. Staff stated that some residents could not be washed and dressed until 11am stating ‘ We don’t have the time to do it until then’. During the inspection it was noted that staff were very busy and appeared rushed in their work. Residents and visitors also stated “Staff are always so busy”. “ Staff are too busy to talk to us” There is a training programme in place, which shows that all staff have undertaken mandatory training apart from some new staff. The manager and provider intend to commence the ‘ Core skills for care induction training’ which leads onto the National Vocational Qualification level 2 in care. Two members of staff (12.5 ) have the National Vocational Qualification level 2 in care and two members of staff are undertaking the social care course. Registered nurses undertake training as identified by their professional requirements and there is ongoing training supplied by the Care Homes Support Team. All catering staff have the food hygiene course and other mandatory training including moving and handling. Six personnel files were examined and these contained all documentation as required by the regulations. These included new staff members and existing staff. The Adelaide Nursing Home DS0000065729.V339190.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): 31,32,33,34,35,36,37,38 People who use the service experience adequate quality outcomes in this area. Improvements in management systems within the home are benefiting residents and staff. No risk assessment of the environment has taken place therefore residents are not fully safeguarded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 Page 23 The manager Mrs K Heard has been in post for a number of years, although registered by the CSCI she has not yet obtained the Registered Managers Award intends to commence this in the next six months. Conversation with staff and residents, and two visitors questionnaires received identified that they thought the home has improved under the new ownership with staff stating that there is a relaxed atmosphere and that they “were listened to”. Nine out of the ten residents spoken with during the inspection made comments which ranged from ‘ I am very happy here’ to ‘ I like it here’, no resident said that they were unhappy in the home or had any problems with management or staff. Staff appeared to work as a cohesive team and said that ‘ we all pull together and there are good relationships here from the top down’. A quality-monitoring programme is in place with residents surveys sent out annually, although the results of these have been collated, there was no evidence to show that improvements had been made based on the information gained from the residents. The provider intends to repeat this survey. Surveys were also sent out to health care professionals and received back. All results were mainly positive. Regulation 26 visits (provider monitoring) visits have now recommenced following a period when they were not taking place, these are sent to the CSCI and show that the provider is monitoring the services provided by the home identifying need for improvement. The Annual Quality Assessment required by the CSCI was received within the required time, but the information given was not sufficient to allow a detailed assessment of the services provided. This was discussed with the provider. Nine out of the thirteen requirements made at the last inspection have been complied with. Staff have been receiving regular supervision at intervals directed by the National Minimum Standards. The provider has not received fully audited accounts of the last trading year, but states that to the best of his belief these are in order and that the home is financially viable. The provider is appointee for two residents and holds monies for safe keeping for others. All financial records were in order. The home has evidence to show that all utilities and equipment have been regularly serviced and a recent fire risk assessment is in place. The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 Page 24 All residents’ rooms with the exception of one room have automatic door closures for protection in the event of a fire. There is no risk assessment to address this and the resident prefers his door open, therefore the manager must take action to ensure that this resident is protected in the event of a fire. Some risk assessments have been undertaken on the home, but in order to ensure residents safety risk assessments across all areas are required. The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 2 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 2 2 2 3 3 x 2 3 1 STAFFING Standard No Score 27 1 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 x 3 3 2 2 The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 Page 26 Yes 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 OP3 Regulation Reg 14(1)(b) Reg 15(1) Requirement That the service user receives written confirmation that the home is suitable for meeting the assessed service user’s needs. The review of care plans must include current needs, any changes to the clinical treatment of service users and follow the guidelines as identified in the recent review. That service users are provided with suitable and fulfilling activities. (Previous requirement August 2006, October 2006 not met) The home must keep documentation about complaints in a secure and confidential manner, which identifies the actions taken and is available to be examined at the inspection. That all parts of the home are kept clean and reasonably decorated. (Previous requirement August 2006, October 2006 not met) Timescale for action 10/08/07 2 OP7 30/08/07 3 OP12 Reg 16(2)(m & n) 10/08/07 4 OP16 Reg 22 (3)(8) 10/08/07 5 OP26 Reg 23(2)(d) 10/08/07 The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 Page 27 6 OP27 Reg 18(1)(a) Reg 18(c)(i) 7 OP30 The service needs to review staffing levels to ensure that the care needs of the service users are met. Ensure that all staff receive training to the work they are to perform. Previous requirement August 2006October 2006 That risk to service users throughout the home is assessed and actions to minimise this put in place, including measures to protect residents who prefer to keep their doors open. 30/08/07 30/08/07 8 OP38 Reg 13(4) 30/08/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 Page 28 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. Extracts may not be used or reproduced without the express permission of CSCI The Adelaide Nursing Home DS0000065729.V339190.R01.S.doc Version 5.2 Page 29 - 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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