Inspection on 21/05/08 for The Crown Nursing Home

This inspection was carried out on 21st May 2008.

CSCI found this care home to be providing an Good service.

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 Crown Nursing Home 03/02/09

The Crown Nursing Home 26/11/07

The Crown Nursing Home 29/06/07

The Crown Nursing Home 27/04/06

The Crown Nursing Home 08/12/05

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE The Crown Nursing Home High Street Harwell Didcot Oxfordshire OX11 0EX Lead Inspector Ruth Lough Unannounced Inspection 21st May 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Crown Nursing Home DS0000065924.V363330.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 Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Crown Nursing Home Address High Street Harwell Didcot Oxfordshire OX11 0EX 01235 820010 01235 834050 thecrown@schealthcare.co.uk 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) Trinity Care (Crown) Limited Mrs May Sancio Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (0) of places The Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing only - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 16. Date of last inspection 26th November 2007 Brief Description of the Service: The Crown Nursing Home is a purpose built home located in the village of Harwell, Oxfordshire, close to local shops and amenities. The home is part of the Southern Cross group of homes. The Crown is home to 16 older people who require nursing care. The accommodation is on two floors and all the rooms have en-suite facilities. There is a lift to provide access to the first floor. Twelve of the rooms overlook the garden and some have a small balcony. The garden, which is largely paved, was designed to be easily accessible for wheelchair users. People living at the home pay extra for hairdressing, podiatry, newspapers, toiletries and taxi fares. The Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means that people who use the service experience good, quality outcomes. This was an unannounced inspection process generated from concerns raised during a Key Inspection visit to the service in November 2007. This inspection process included reviewing documentation relevant to care planning and the administration of the home and an assessment of the environment. The inspector took the opportunity to speak to service users, a relative, and some of the staff during the one-day visit to the service. Key areas that were looked at were the staff’s practices for moving and handling as this was a major deficit at the last inspection. Additionally there were concerns previously about the standard of cleanliness and the control of infection in some parts of the home. Both these concerns had been rectified before this inspection visit took place. What the service does well: What has improved since the last inspection? What they could do better: The registered nurses must ensure that the written information about the treatments and medical support they provide is recorded in better detail to ensure continuity of care. The Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 Page 6 They could improve how they seek and record the personal wishes of the people living in the home with particular reference to the support they may need should their health deteriorate and at the end of their lives. They are strongly advised to review the bathroom and shared bedroom facilities to ensure that the home can provide the best it can offer for privacy and comfort for people living there. The manager and responsible individual could look to improve the infection control processes by installing appropriate sterilising equipment for the bed and commode pans. Greater care should be taken in the storage of equipment to ensure that fire exits are fully accessible at all times and that control of infection is not compromised. 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 Crown Nursing Home DS0000065924.V363330.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 Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use the service are provided with the necessary information and have their needs assessed before they decide to move into the home. EVIDENCE: The care records for three people currently living in the home were reviewed to see what processes are in place to assess their nursing and care needs before a decision is made to live in the home. At least two of the service users had been admitted to the home within the last five months and the other had been living in the home for a number of years. All three records showed that information is taken from any referral process from other health practitioners, and consultation with the service users, and their families. The manager also carries out an independent assessment to identify the health and wellbeing needs of the individual. They use a detailed The Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 Page 9 document tool to record the outcomes of this assessment that includes looking at the person’s mobility, skin integrity, nutritional and mental wellbeing. They do note some of the individual’s choices of how they wish to live and where able they request the service user to acknowledge their consent to the process, although this is difficult at times and dependant on their health. They could improve and develop how they obtain greater knowledge about the personality, life history, and social interests during this initial assessment process as to aid building a holistic picture of the person they are going to support. The inspector met two of the service users whose care records were reviewed and they both stated that they had previous knowledge of the home as they had lived in the local vicinity prior to moving there. Both said that they had been made to feel welcomed when they arrived in the home. Service users are provided with copies of the Statement of Purpose and Service User Guide within their rooms. The Crown Nursing Home DS0000065924.V363330.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 and 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users health and personal care needs are met and safe moving and handling practices are now carried out. EVIDENCE: The service users who spoke to the inspector thought that they were being cared for well and that they were supported with their healthcare needs. The care planning records that were seen were in the majority, detailed documents that provide information for staff about the health and personal care needs of the individual. Each care plan has key topics such as personal care, nutrition, mobility, and continence. Risk assessments are also put in place for pressure sore/ tissue damage, nursing or care dependency, and any moving and handling support required. The use of body maps within the assessment process is carried thorough into the care planning should a concern arise. The Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 Page 11 During the last inspection process it was observed that staff were not using appropriate methods of moving and handling some of the service users, putting them, and themselves, at risk from injury. This has now been rectified as staff have all undergone retraining, the risk assessments have been updated, and further equipment has been obtained to ensure that safe practices are carried out. Staff were observed during this inspection visit to be using hoists correctly and transferring service users safely. Through discussion with the manager and a review of the care planning it was identified that some of the nursing tasks and treatments that are carried out should be recorded with greater detail. This is in particular reference to catheter care for one service user and the care and use of a body brace that is part of another service users medical treatment. The manager did assure the inspector that staff had been physically instructed of how to provide support or treatment but the information had not been recorded sufficiently in the individuals care records. Any medication prescribed is recorded on admission and changes are noted in the care planning. The records for administration for medications were reviewed to assess if the process is managed well and if controlled drugs are kept securely. The home uses a MDS (monitored dose system) for the majority of the medications they administer that is provided by a recognised pharmacy company who also supports staff with training and periodical audits. Controlled drugs are kept in accordance with regulations and staff are recording appropriately in a register the movement and dispensing of any medications. Staff are provided with photographs of the individual with brief information about any allergies they may have as to assist them to administer to the correct person and to ensure that they have a good awareness of any risks to the persons health. Service user and their families choices of their care after their death is noted in the assessment and care planning records, if the information has been available. Little is recorded about their choices about support as their health deteriorates. The manager provided information that this was an area of improvement that they had already identified they wanted to develop and that advice was being sought of how to consult with service users, record and review the information held and the use of recognised care planning processes such as the Liverpool Care Pathway. The Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14, and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff have made some improvements in developing a greater variety of activities to enhance the lifestyle of the people who live in the home. EVIDENCE: The manager provided information that the recommendations made during the last inspection process about providing a greater variety of social activities has been acted upon. They have started to develop the activities they bring into the home and have been looking at how they can improve what they can provide to meet individuals personal preferences. There is a regular programme of visiting activities that include exercise to music, Pat-a-dog, and weekly visits from the local church. During the day of this visit the weekly exercise to music class was taking place. The inspector observed that residents, staff, and visitors appeared to be enjoying the activity together. Some information is noted in the care plan records about personal choice and interests, although these could be enhanced with the information they obtain The Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 Page 13 from developing their knowledge about an individual in the initial assessment of need process. One resident who spoke to the inspector during the day expressed a wish to go out to do something outside the home but felt it would be too difficult because of mobility and transport problems. This had already been identified by the manager and organisation as one of the improvements that should be in place and that they are in the process of securing the use of a shared minibus with the other homes in the local area that are owned by the same company. The service users who spoke to the inspector said that the meals provided were enjoyable and were good-sized portions. The cook provided information about the meal planning and the variety of meals on offer. Usually there is a choice of either a hot or cold fare for the midday or evening meal and if required, alternatives to the planned meal can be had. Knowledge about special diets and personal choices are provided by the nursing and care staff to the cook who records the relevant information in the kitchen. The menu is generally of traditional English fare that suits the particular needs of the current group of people living in the home. Relatives and friends are often invited to take part in mealtimes as some have wives or partners who now live on their own in the local community. A recent visit by environmental health verified that they have safe systems and practices for food hygiene in the kitchen. Also a recent addition to the home of a computer has enabled staff to access dietary information to use for planning meals and special diets should it be required. The Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 Page 14 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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users concerns are listened to and acted upon and the home has strategies in place to ensure that they are safeguarded from possible harm. EVIDENCE: Residents and their families are provided with information of how to make a complaint in the Statement of Purpose and Service User Guide. A copy of the complaints process is on display in the entrance hall and available to take away from the home should it be required. The complaints information includes contact numbers of the home, responsible organisation, local social services, and the commission. A comment book and cards have been left in the entrance area along with information about the home and the planned activities programme for visitors and residents to read, should they want to. The manager confirmed that they had not received any complaints or concerns since the last inspection in November 2007. They have received a compliment from a relative of elderly person from the village to whom they provided shelter for when they got lost. The home has procedures in place for the safeguarding adults from possible abuse or harm including a ‘whistle-blowing’ policy for staff to report concerns. The Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 Page 15 Training about abuse and safeguarding adults is provided on an annual basis to staff, and is incorporated in the induction process. The Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 Page 16 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, 22, 23, 24, and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally maintained well and suitable to meet the needs of the current residents. The processes and practices for the control of infection could compromise the well being of the people living there. EVIDENCE: The home is a converted public house that is situated in the centre of the village of Harwell. The front of the home still retains some of the features associated with its original role in the community when it was built in 1815. Many changes have been made to the building to bring it to its current facilities including extensions to the rear of the property. Thirteen bedrooms are provided over the ground and first floors, three of the rooms are for shared occupancy. Two of these rooms are being used as shared accommodation, and one has a single occupant. The Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 Page 17 All three rooms have an en suite bathroom or toilet. Of the two, shared bedrooms upstairs, both en suites are poorly laid out. One has a bath that is not in use and the position of the toilet is very close to the wall making the space small and difficult for staff to access should the a service user require the assistance of two staff. There is a rail to the other side of the toilet for service users to use to aid mobility and offer safety whilst the toilet is in use. However, this was loosely fixed to the floor and could not be raised to enable access for a wheel chair user or staff to assist the individual. The toilet is positioned opposite the low window to the front of the property and could put privacy at risk should the curtains not be closed. Access for wheelchairs, hoists, and walking frames to this bathroom is difficult as the door opening is restricted by the recently fitted radiator covers put in place to protect service users from possibly burning themselves against a hot surface. The current occupants of this room are assisted with hoists for transferring and do not personally use the bathroom. A similar situation is in place for the other shared room upstairs. However, the en suite is very small and impractical for frail individuals and not used by the current residents of this room. Neither of these rooms have enough space for the furniture and fittings seen as a minimum standard for accommodation. Wardrobe and bedside cabinets had been provided, but there was no space for comfortable seating should a service user wish to remain in their room. The other shared bedroom downstairs provided greater space including and area to sit and had a reasonable sized en suite bathroom that could be accessible to someone with limited mobility. All three had screening between the beds to allow privacy whilst personal care is taking place. There is one large communal sitting and dining room that can provide sufficient space for the sixteen residents when the home is fully occupied. This leads directly to an enclosed patio garden, the only outdoor space for service users to sit in the warmer months, to the side of the property. There are two communal bathrooms incorporating toilets on the ground floor with one close by to the communal sitting room. The shower room is accessible via the entrance hall at the front of the home the other with the assisted bath is accessed off the sitting room. The majority of the residents will have to pass through this area to reach this bathroom. The assisted bath is now repaired as it was previously out of action at the time of the last inspection. Within this bathroom access to the assisted bath is restricted and according to the manager very few of the current residents use this bathroom, as they prefer the walk in shower. The Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 Page 18 The majority of the bedrooms have access to an en suite facility of toilet and small sink. Some have step in baths that have been de-commissioned, as they are ¾ sized and unsafe to be used by people with limited mobility. As previously stated the home was not purpose built and staff struggle at times for storage of the aids and equipment such as hoists, wheel chairs, and weigh scales. Several areas of the corridors and some of the bathrooms are currently used to store these. During the previous inspection process it was highlighted that there were some areas in the home that were not clean and hygienic. This was generally not seen during this visit in the areas that service users use. Several of the carpets in bedrooms had been replaced and bathrooms and en suites were in reasonably good order. The facilities for the laundry and the disposal of contents and cleaning of the commodes were reviewed as part of assessing the overall control of infection processes in place in the home. The laundry area is in the basement of the home and has the necessary washing machine and dryers to comply with the required standards. However, they do need to review how they store clean linen in the communal bathroom on the ground floor as this leaves it open to contamination. The home has two sluice rooms, one on the first floor, and one on the ground floor. Both have large sinks to wash commode pans but do not have the facilities to flush the contents away or to disinfect them. The inspector was informed that the contents of the pans were flushed down the toilets in each bedroom and the pans cleansed with a disinfectant. They were strongly advised to take a review of these practices to ensure that they are compliant to the Department of Health Infection Control Guidance for Care Homes. The ground floor sluice room is not used at present by the nursing and care staff for this purpose. It is currently used as a domestic/ housekeeping facility. A review of this room indicated that insufficient attention has been paid to maintaining good hygiene practices. Furniture and other sundry items have been left in the room making it difficult to keep clean and tidy or the sink accessible for hand washing. The Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29, and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A skilled and experienced staff team meets Service users’ needs. EVIDENCE: The arrangements the home carries out to recruit and employ staff were reviewed. This was to see if there were sufficient numbers on duty at each time of the day and that they had the skills and knowledge to meet the needs of the people living there. A previous inspection process identified that relatives were concerned about the levels of staff on at certain times of the day. The duty rota provided by the manager shows that usually there are three to four members of staff on duty during the day and evening, with two at night. The rota also showed that the home was always staffed by one registered nurse each shift and that there was domestic support during the morning five days a week. The rota gave the times of each shift but did not indicate any specific time for staff to handover important information to the replacing staff at the end or beginning of each change of shift. The manager did provide information that there was a physical handover period with the registered nurses although this The Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 Page 20 was not accounted for in the schedules. They do use a daily diary for the general home to record significant planned activities for individuals. The home employs four registered nurses to cover the nursing needs of the service. If additional staff are required due to sickness and annual leave they are able to utilise staff from other homes belonging to the same provider should the need arise. Although this happens rarely they should ensure that they keep copies of the recruitment and employment records for these individuals in the home. The manager provided information that six of the care staff have recently enrolled on an NVQ training programme to develop their skills and knowledge. There was also evidence that staff have been able to access the key health and safety training required for them to carry out their roles. The manager is in the process of completing the necessary training to be able to train staff in these key topics within the home. This will then enable staff to be trained locally and lessen the effect of staff being absent from the home for long periods. They do keep a monitoring process in place to ensure that staff obtain the skills to carry out their roles, however they do not carry out a training needs analysis of each individual member to identify any personal development needs required. Training that has been provided to some of the staff in the last twelve months has also included Dementia Awareness, Customer Care, Care Planning, and nutrition. A concentrated programme of training has been given to all staff for Moving and Handling during the last six months following the concerns that arose during the last inspection visit. The organisation has recently implemented a training manual/ passport for each member of staff to complete and keep for reference throughout their employment in the home to evidence the training they have undertaken. The recruitment and employment records for three staff were reviewed to see if these processes are carried out safely and service users are protected from inappropriate staff providing support. All recruitment processes are carried out within the home by the management team with advice and support available from the registered provider’s central human resources department. All three members of staff had been employed within the last eighteen months, one within the last few weeks. The records for the employment for these three The Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 Page 21 members of staff were organised and ensure that the topics are separated in accordance to data protection guidelines. Application forms, health declarations, and references are required and obtained. Copies of relevant training certificates are taken. Proof of the applicant’s identity and address is also kept and details of the Criminal Records Bureau and Protection of Vulnerable Adults checks are recorded. For one member of staff the references and copies of training certificates were not written in English and had not been translated to ensure that they are relevant to the applicant or to the role they are employed for. There is a structured induction programme and a probationary period, however very little is noted in the individual’s employment records to show that these have been completed. The use of a training needs analysis would aid to evidence what the home has implemented to develop the individual staff member to be able to carry out the role they have been employed for. The Crown Nursing Home DS0000065924.V363330.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 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. That the home is well run and in the best interests of the people living there. EVIDENCE: The manager has returned from an extended period of leave and it was evident that there had been an improvement in the general running and management of the home. The requirements and recommendations from the previous inspection visit had been met, the general standard of cleanliness has improved, and a training and supervision programme of staff has recommenced and been carried out. There are some processes for consulting with service users about the way the home is run which is carried out through the annual surveys, service users meetings, and reviews of care. The last formal process was carried out last The Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 Page 23 year but the results of which were not available during this inspection visit. However, there is a regular newsletter that is provided to service users, relatives and staff that enables any significant information to be passed back. The manager stated that they were continuing to look at ways to improve the communication between service users, staff and relatives through developing what they currently do. Comment cards are left in the main hallway of the home for service users, relatives and visitors to use for this purpose if they so wish. The home has processes in place for safe working practices to protect the health and wellbeing of service users living and the staff working there. There are a comprehensive number of policies and procedures to support this that are provided to staff in the staff handbook/ induction programme and left in the home for staff to read. The records for fire evacuation and an emergency planning were reviewed to sample the quality of the information that is provided to staff. The records for this are placed in the hallway of the home in preparation for such an event and are easily accessible to all staff. The plans are detailed and kept up to date. Emergency procedures are explained, and contact numbers for emergency services and other relevant organisations are noted. During the day visit to the home it was identified that a fire exit to the rear of the ground floor was partially blocked both inside the home by equipment and externally with surplus wheelchairs and staffs’ bicycles. This was pointed out to senior management and was rectified immediately. The Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 2 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 2 X 2 X 2 2 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 3 X 3 X 3 X X 3 The Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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 OP8 Regulation 13 Requirement The registered nurses must ensure that the written information about the treatments and medical support they provide is recorded in better detail to ensure continuity of care. Timescale for action 12/06/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP11 Good Practice Recommendations They could improve how they seek and record the personal wishes of the people living in the home with particular reference to the support they may need should their health deteriorate and at the end of their lives. They are strongly advised to review the bathroom and shared bedroom facilities to ensure that the home can provide the best it can offer for privacy and comfort for people living there. The manager and responsible individual could look to DS0000065924.V363330.R01.S.doc Version 5.2 Page 26 2. OP21 3. OP26 The Crown Nursing Home improve the infection control processes by installing appropriate sterilising equipment for the bed and commode pans. 4. OP26 OP38 Greater care should be taken in the storage of equipment to ensure that fire exits are fully accessible at all times and that control of infection is not compromised. The Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone 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 Crown Nursing Home DS0000065924.V363330.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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