Inspection on 02/11/06 for The Chestnuts

This inspection was carried out on 2nd November 2006.

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

The Chestnuts 26/04/07

The Chestnuts 24/02/06

The Chestnuts 22/09/05

The Chestnuts 02/03/05

The Chestnuts 25/08/04

The Chestnuts 04/03/04

The Chestnuts 13/08/03

Similar services:

Trevayler Residential Care Home

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

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

CARE HOMES FOR OLDER PEOPLE The Chestnuts 29 Station Road Ruskington Lincs NG34 9DR Lead Inspector Moya Dennis Key Unannounced Inspection 2nd November 2006 10:00 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 The Chestnuts DS0000002439.V318323.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 Chestnuts DS0000002439.V318323.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Chestnuts Address 29 Station Road Ruskington Lincs NG34 9DR 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) 01526 832174 Mr George Eric Stafford Mr Graham David Stafford Mr George Eric Stafford Mr Graham David Stafford Care Home 14 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (1), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (1), Old age, not falling within any other category (12) The Chestnuts DS0000002439.V318323.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th July 2006 Brief Description of the Service: The Chestnuts Care Home is family owned and has been adapted and extended from a former family home. The home is in the village of Ruskington, which contains a range of facilities such as shops, Post Office, public houses, a library and churches. There are also rail and bus links to local towns and cities. The home provides personal care for up to 14 people over the age of 65. The home had one vacancy on the day of inspection. Bedrooms are on two floors. Access to first floor rooms is by a stair lift. All the rooms are single but none of them have en-suite facilities. There is a small car parking area to the front of the home and more car parking spaces in the road outside. There is a garden area at the back. The home advertises in the monthly Ruskington parish magazine. The Chestnuts is well known in the area and enquiries are often generated by personal recommendations. Fees are £335 per week. Toiletries, hairdressing, chiropody, newspapers and external activities are not included in the fees. The Chestnuts DS0000002439.V318323.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 in November 2006. The inspection was carried out by two inspectors, one of who was pharmacist inspector, and took place over 6 ¾ hours. All key standards were inspected. Additional standards were inspected to check issues raised at previous inspections. Pre inspection information from the provider was not available. The inspection method used was to case track the care received by a sample of residents by looking at their records and discussing their experiences of care with them and with their relatives. General care practices were observed throughout the visit. Residents’ survey replies were not available before inspection. The inspectors spoke to six residents, three care workers, one senior carer, the acting deputy manager, three relatives, a Community Nurse and a visiting GP. All comments from visitors were positive about the home and the standard of care. One resident showed an inspector their room; other areas of the home were also seen. The acting manager was present throughout and assisted the inspectors. She was given general feedback about the outcomes of the inspection at the end of the visit. What the service does well: What has improved since the last inspection? Two new care workers had been recruited, following thorough recruitment, selection and induction processes. The home was fully staffed and workers said that morale within the home was high. “Everybody pulls together”. Staff sleep-in arrangements were being reviewed. This would provide a quiet room for residents and space to receive visitors in private. The dining room had new furniture and floor covering. The Chestnuts DS0000002439.V318323.R01.S.doc Version 5.2 Page 6 The handyman employed by the home had redecorated the hallways and toilets, painted the outside of the home and replaced a large bay window. Work on residents’ bedrooms was about to begin. The proprietors had engaged a professional consultant to develop good working policies and procedures. Progress had been made to improve recruitment policies, management structure, staffing levels and medication training. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Chestnuts DS0000002439.V318323.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Chestnuts DS0000002439.V318323.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People had access to sufficient information to decide if the home could meet their needs. Every prospective resident’s needs were assessed and they had opportunities to visit the home before moving there. EVIDENCE: No residents had moved to the home since the last inspection. Prospective residents would be given a brochure of the home on initial enquiry. After consultation with them, relatives and any other professionals involved, the acting manager would visit to assess their needs. However, assessments contained basic information only, with little or no social history, no diagnosis and no supporting information from social workers, hospitals or GPs. The majority of residents were self-funded and had not received care management assessments. The Chestnuts DS0000002439.V318323.R01.S.doc Version 5.2 Page 9 If the home could meet the assessed needs, prospective residents and/or their relatives would be invited to visit and look round. A visiting relative confirmed that they had done so and had been shown the available room. The acting manager would write to confirm that the home was able to meet the assessed need. All stays were on a trial basis. All residents, or their relatives, had received a service user guide, statement of purpose, a contract and terms and conditions, as confirmed by a relative. Training programmes evidenced that staff had skills and experience to meet assessed needs. The home did not provide Intermediate Care. The Chestnuts DS0000002439.V318323.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Poor recording practices did not reflect the actual care given. Residents’ needs were not clearly recorded in care plans and there was no evidence that they had been involved in reviews. Visiting health professionals confirmed that residents’ health needs were fully met. EVIDENCE: Three care plans were inspected. Information was fragmented and kept in several files. Care plans contained only basic information and did not detail what actions staff should take to meet those needs. The manager and staff were all aware of the needs of each resident but this information had not been recorded. There was no recorded monitoring of weight or pressure sores but the manager and staff confirmed that it happened. The Chestnuts DS0000002439.V318323.R01.S.doc Version 5.2 Page 11 Medication policy. The medication policy was several years old and one of a set of policies that had been purchased and did not accurately describe the procedures in the home. The policy was not being followed for example cupboard keys were not kept securely and were in the cupboard doors or on top of the cupboards. There was no record that staff had read the policy, were trained in its use or that it was reviewed to reflect changes in practice. Residents were at risk or not receiving medication safely and as prescribed. Record keeping. Records for medication were not an accurate record of all medication in the home and all medication taken or used by residents. Medication Administration Records (MAR) were unorganised, did not include allergies or complete details of all medication received and carried forward from the previous month. There were gaps with no codes used for the reason why medication had not been given. There were no photographs of residents to aid identification and handwritten MAR were of a poor standard and did not include full information on how to give the medicines. Information in care plans was very limited for example records kept for diabetic residents and those with pressure sores and weight loss issues did not give information that would inform staff how to manage and monitor such conditions. The poor records meant that residents were at risk of not receiving medication as prescribed and of not having their individual health needs met. Administration. Medication given to one resident in a pot was not observed to have been taken. This practice increases the risk of medication not being taken as prescribed. Homely remedies and medicines that were not prescribed: There was medication in the cupboards that had not been prescribed and had been brought in by relatives. The medication included a medication that is not very often used because of the potential risk of complications. Staff said that the relative had given permission for them to use the medication but there was no risk assessment and they had not spoken to the doctor. Relatives cannot give permission for medication to be given to others and if homely or nonprescribed medications are in use, risk assessments should be carried out and professional guidance sought to ensure there is no risk of the medication interfering with prescribed medication or being a risk health. Secondary dispensing: The cupboards in the dining room contained two monitored dosage boxes with labels saying morning, lunch and teatime. Staff confirmed that they were to dispense medication into when residents went out for trips. This is secondary dispensing and puts residents at risk of not receiving medication as prescribed. The Chestnuts DS0000002439.V318323.R01.S.doc Version 5.2 Page 12 Medication should be in containers that are correctly by the pharmacist or dispensing doctor. Training. A record of training was kept for all staff on the computer and medication training had taken place in August 2006. Practices seen at the home indicated that the training had not met the needs of the staff and that competencies had not been checked adequately. The staff responsible for medication lacked awareness and knowledge of legal requirements and safe practices in relation to medication including the importance of secure storage, expiry dates, storage temperatures and accurate records. Residents were at risk due to poor practice of not receiving medication as prescribed and of not having individual health needs met. Controlled drugs. The storage for controlled drugs was not secure. Keys were not kept securely and the cupboard was not fixed, wooden and used to store items other than controlled drugs. Temazepam being used was not recorded in a register. Therefore, controlled drugs could not be accounted for and there was no appropriate audit trail, which put residents at risk of not receiving medication as prescribed. Storage: Medication was not stored securely and temperatures were not monitored adequately to ensure that storage was within the range specified by the manufacturers. The cupboards and fridge were used to store items other than medication and the keys were available to anyone because they were left in the doors or on top of the cupboard The main medication cupboard was not large enough for the medication in use or of a standard suitable for medication storage. The fridge storage was the food fridge, which was not secure, and a minimum and maximum thermometer was not in use, which meant that staff would be unaware if temperatures had been at unsuitable levels for the medication. Medication for different residents was stored together in ice cream tubs. Medication should be stored separately to reduce the risk of being given to the wrong person. Residents were at risk of not receiving medication as prescribed and of receiving medication that was not suitable because of contamination or decomposition. Expiry Dates: There were unlabelled eye drops in use with no date of opening on. Medication should be labelled so that it can be administered as prescribed and dates of opening should be put on eye drops because there is a risk of infection if they are used for more than 28 days after opening. The Chestnuts DS0000002439.V318323.R01.S.doc Version 5.2 Page 13 Expiry dates for medication were not being checked properly. Two creams were in the fridge which two creams, which were not in use, and one was dispensed in Dec 2004 and went out of date in Sept 2005 Waste: Unused or damaged medication was stored in a box with medication that was in use. This was a potential health risk to residents and staff. All waste medication should be stored and recorded appropriately so that audit trails can be followed. A community nurse called each week and commented that staff were bright, enthusiastic, questioning, well attuned and quick to ask for advice. “The staff and proprietors have coped magnificently well; I can’t fault them”. A visiting GP said he called each week, usually at meal times. He remarked that the home was always clean, with no offensive odours and residents’ rooms were well kept. He said the home was, “pretty good” and he had no concerns. He was confident that staff followed advice, such as monitoring fluid intake and follow up appointments. No resident chose to self medicate. Care plans recorded the name by which residents preferred to be addressed and all staff were aware of this information. Medical consultations were conducted in residents’ own rooms. Staff said they were instructed during supervision about the importance of treating all residents with respect. Residents said that staff were “very kind” and that they got on well with all of them. Visitors remarked, “They’re brilliant, I can’t fault any of them”. They said that recent staff changes had not affected the quality of care. Staff were seen to interact with all residents in a caring, respectful manner. The Chestnuts DS0000002439.V318323.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 good. This judgement has been made using available evidence including a visit to this service. Residents had access to social activity and were encouraged to maintain family and community links. They enjoyed a well balanced diet that reflected individual preference and specific dietary needs. EVIDENCE: One resident said they enjoyed going out with a volunteer. Visitors said they took people out into the village but the narrow, uneven pavements outside the home were hard to negotiate with a wheelchair. Some residents had little interest in activities or outings and staff spent time with them on a one-to-one basis. A resident said that musical entertainers called twice a week; one was present during the inspection. Residents enjoyed musical bingo, exercise sessions and some had personal hobbies. Residents were able to see visitors in their own rooms if they wished. Changes to staff sleep-in arrangements will provide a ‘quiet lounge’, and more choice The Chestnuts DS0000002439.V318323.R01.S.doc Version 5.2 Page 15 for residents. There was a cordless phone for resident’ use. This was used as a speakerphone when residents took calls in their rooms. Links were maintained with the local community by visits from local schools, clubs for older people, Brownie groups and members of the local church. The home had a tradition of inviting people in at Christmas for sherry and mince pies. Visiting relatives confirmed they had been given information of contact details for other agencies and advocate services. Residents had brought furniture and personal items when they moved to the home. Menus for the day were displayed on a notice board in the dining room. The cook was aware of residents’ preferences and individual dietary needs. Menus were based on residents’ choice and alternatives were always available. Staff confirmed this happened on an individual basis but this was not recorded. Residents said they enjoyed the meals and visitors said, “The food always looks lovely”. The Chestnuts DS0000002439.V318323.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. Residents and visitors were confident that their concerns would be listened to and acted on. Residents were protected from abuse by well-trained staff. EVIDENCE: All visitors said they would feel confident to raise concerns or complaints directly with any member of staff or with the manager. None had had any reason to do so. “I can’t think of anything to improve the care here. I would definitely recommend it to others”. There was no official complaints procedure or records of complaints received. The manager said that if a concern or complaint were raised she would, “just go off and deal with it and put things right”. She agreed to record all future complaints, along with actions taken. She would also redesign the home’s formal complaints procedure to include stages and timescales for the complaints process. Staff files and training schedules evidenced that all staff had received training on adult protection issues and were able to recognise various forms of abuse. All staff were aware of the whistle blowing process and said they would feel confident to raise any concerns with the manager. The home did not have a signing in book to record visitors to the home, or any form of bell to indicate when someone had entered the building. This posed a The Chestnuts DS0000002439.V318323.R01.S.doc Version 5.2 Page 17 risk to residents if visitors were able to enter unchallenged and to visitors in the event of fire. The manager agreed to purchase a visitors book and ensure that it was used. There was no written policy for handling residents’ monies. However, the manager and staff demonstrated that working practices were acceptable. The Chestnuts DS0000002439.V318323.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): 19,21,24,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents lived in a clean, pleasant home that met their needs. Sluicing facilities were not appropriate to maintain acceptable hygiene levels. EVIDENCE: The home employed a handy man and there was a rolling maintenance programme. The home was well maintained and there were no apparent defects. Bathrooms and toilets were clean and well decorated. The home had no sluicing facilities; sluicing was done outside with the aid of a hosepipe. The manager agreed to take advice about this. One resident invited an inspector to see his room. This was warm, clean and homely, with furniture and music equipment brought from his former home. Other bedrooms were seen to be of the same high standard of cleanliness. A The Chestnuts DS0000002439.V318323.R01.S.doc Version 5.2 Page 19 visitor remarked, “The room is always as clean and tidy. I call at different times of the day but it’s always the same”. As noted by the visiting GP, the home was clean and pleasant smelling. Visitors remarked that the laundry service was very good. No one had lost any items or had clothing spoiled. The GP noted that residents were always clean and well groomed. The home had recently installed a new washing machine with programmes to minimise the risk of infection. The Chestnuts DS0000002439.V318323.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. Residents were cared for by well-trained, competent staff. Residents were protected by thorough recruitment policies. EVIDENCE: Residents, relatives, visiting GP and community nurse said there always seemed to be enough staff on duty. Staff confirmed that they were able to meet residents’ needs and spend social time with them. Rotas showed adequate cover at all times. The manager agreed that the practice of one of the registered providers taking sleeping shifts at weekends was unsafe and posed a risk to residents. The provider was in poor health and could not be relied on in an emergency. The acting manager and deputy manager agreed that the provider should take no further part in care duties. Recently updated training schedules showed that staff received mandatory training and 11 members of staff had received medication training. 50 of staff had received, or were training for National Vocational Qualification (NVQ) awards. Three staff files were inspected. All contained the information required by Schedule 2 of the Care Homes Regulations. Two members of staff had been recently recruited. Evidence showed that neither had started work before satisfactory Criminal Record Bureau (CRB) checks had been received. The Chestnuts DS0000002439.V318323.R01.S.doc Version 5.2 Page 21 Staff confirmed that they had been given a copy of GCSC code of conduct and practice when they started work. They had shadowed staff for two shifts, being introduced to residents and observing practice. The induction process lasted six weeks, in which staff had to demonstrate their development. The Chestnuts DS0000002439.V318323.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): 31,33,35,37,38. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents were put at risk by poor medication recording. Policies and procedures did not relate to the home and were not reviewed or kept up to date. There were good quality monitoring systems in place to enable residents, relatives and staff to contribute to improvements in the service. Records were not kept of monies deposited by residents. Health and safety policies were in place. EVIDENCE: The Chestnuts DS0000002439.V318323.R01.S.doc Version 5.2 Page 23 The acting manager had been in post for some years but had not yet applied to the commission to be registered. She confirmed that she would apply in the very near future. She had a great deal of experience in delivering care to older people and was knowledgeable about age related issues. Residents, staff, visitors and health care professionals said she was very caring and approachable. However, she agreed that she had neglected policies and procedures and record keeping within the home was unsatisfactory. The proprietors were seeking professional advice to improve in all areas of record keeping, policies and procedures Because of the home’s size, residents and relatives give feedback and suggestions on a daily basis. No residents’ surveys were returned before the inspection took place. There were no policies and procedures relating to the home. The manager had purchased a book of guidelines. She was advised that this was not acceptable and she agreed to develop and implement policies and procedures relating specifically to practice within The Chestnuts. Staff were not aware of what policies and procedures required, “It’s just common sense, I suppose”. No records were kept of money or valuables deposited by residents for safekeeping. The manager agreed that this would be rectified. There were no clear health and safety policies, other than contained in the book of guidelines. Staff said policies were not discussed at supervision and there were no spot checks to check that practices reflected set policies and procedures. The manager was usually in the home and was confident that she would know, “if anything was wrong”. The Chestnuts DS0000002439.V318323.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 ENVIRONMENT CHOICE OF HOME Standard No Score 1 2 3 4 5 6 Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 2 X X 3 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 1 X 1 2 The Chestnuts DS0000002439.V318323.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 Standard OP9 Regulation 13 (2) Requirement The registered person must ensure that all storage is secure and accessible only to authorised care workers, large enough, maintained at the right temperature and provides extra The registered person must ensure that all waste medication is recorded accurately and stored safely and securely. The registered person must ensure that accurate records are kept of all medication received administered and disposed of. The registered person must ensure that there is a medication policy, which reflects the actual practices in the home, and that staff adhere to the The registered person must ensure that the practice of secondary dispensing by staff into monitored dosage systems when residents go on leave stop and alternative arrangements should be made The registered person must ensure that records for administration are made on the DS0000002439.V318323.R01.S.doc Timescale for action 30/12/06 2 OP9 13 (2) 30/12/06 3 OP9 13 (2) 30/01/07 4 OP9 13 (2) 30/12/06 5 OP9 13 (2) 14/12/06 6 OP9 13 (2) 14/12/06 The Chestnuts Version 5.2 Page 26 7 OP9 18 (1) © 8 OP9 13 (2) 9 OP9 13 (2) MAR at the time medication is administered and taken The registered person must ensure that all staff responsible for administering medication have received training and be assessed for competency The registered person must ensure that there are appropriate policies and risk assessments in place for any homely and non prescribed medication that include the process for seeking professional guidance The registered person must ensure that expiry dates are regularly checked and dates of opening put on creams, ointments and eye drops. 28/02/07 30/12/06 14/12/06 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 OP26 Good Practice Recommendations It is recommended that the registered person consult the environmental health authority to ensure sluice facilities at the home are appropriate to maintain satisfactory standards of hygiene. It is strongly recommended in the interest of residents’, staff and visitors’ safety that that the registered person review access arrangements for visitors and introduce a system to record visitors to the home. 2 OP38 The Chestnuts DS0000002439.V318323.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Chestnuts DS0000002439.V318323.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!