Inspection on 27/04/06 for The Crown Nursing Home

This inspection was carried out on 27th April 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 Crown Nursing Home 03/02/09

The Crown Nursing Home 21/05/08

The Crown Nursing Home 26/11/07

The Crown Nursing Home 29/06/07

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The Crown Nursing Home High Street Harwell Didcot Oxfordshire OX11 0EX Lead Inspector Philippa MacMahon Unannounced Inspection 27th April 2006 10:30 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.V291417.R01.S.doc Version 5.1 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.V291417.R01.S.doc Version 5.1 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 Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16), Terminally ill (3) of places The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The total number of persons that may be accommodated at any one time must not exceed 16. On admission persons should be aged 60 years and over. Date of last inspection 8th December 2005 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, but only three have a bath. 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. The range of fees at this home is £518 to £807.15p per week. The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’ carried out by two inspectors. The inspectors arrived at the service at 10.30am and were in the service for five hours. The inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has, in this report, made judgements about the standard of the service. The inspectors examined a sample of the care plans and then followed this through by meeting with the residents to ascertain if they were a reflection of the persons care needs and if those needs were being met. A tour of the building was made, and discussions with the manager, staff, a relative and residents were undertaken to gain a wider view of what it is like for the residents living in the home. Records required by regulation, and staff files, were examined and the food was sampled whilst observing staff/resident communication. . What the service does well: The manager is an excellent communicator and a relative spoken to said, “We chose this home due to the Marion’s management style, she’s been great”. The manager said that one of the things they do well is to have fun and laughter. The residents are well cared for and very appreciative of the care provided by all the staff. One resident spoken to said, “The staff look after us very well and are kind. It is like a big family really”. The home offers a homely, intimate and comfortable place to live. The cooks provide good, wholesome home cooked meals that are much appreciated. The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 Page 6 All visitors to the home are made to feel very welcome. What has improved since the last inspection? What they could do better: Pre-admission assessments of care need to show a clear picture of the person’s primary reason for requiring care in a care home, and that this fits the categories of care for which the home is registered. The care planning documentation needs to be rationalised to ensure that only relevant information is included in the care record. The care planning process needs to be reviewed by all the staff who input information into it so that they all are more confident in its value and use, rather than relying on the manager to write them up. Every resident requires an assessment of their nutritional status, and ongoing monitoring of this. A plan of activities needs to be developed further to ensure that all of the residents lifestyles and interests are addressed. The induction training for new staff should be implemented so that all staff receive training within six weeks of commencing duties. A training and development plan needs to be drawn up to include all staff. The manager should have a personal development plan and support to achieve this from her manager. The manager would like to have a computer available in the home so that she can write letters and other documents in a timely way, and have access to the Internet for smarter communication with other external organisations. The manager would like to see the home redecorated to provide a brighter, lighter environment for the residents. The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 Page 7 The manager acknowledges that all the relevant service and contact documentation in relation to the home needs to be put together in one file for ease of access when required. 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 Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 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 Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. At the present time the information given to prospective residents is of the home under the previous ownership and is therefore poor, as it does not reflect the present situation. Every resident has a pre-admission assessment carried out by the manager that is good, but requires further development. The home does not provide intermediate care. EVIDENCE: The manager told the inspector that the statement of purpose, service users’ guide and Southern Cross policies and procedure documents are in the process of being delivered to the home by the operations manager. The Crown Home’s documents are all that are in place at the present time. The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 Page 10 The inspector examined a sample of care plans to look specifically at the pre-admission assessments. Those examined showed that the home was able to meet the needs of the person, and that they fitted into the category of care that the home is registered for. The inspector also had the opportunity to examine the pre-admission assessment of a prospective resident who is due to be admitted to the home shortly. The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care planning system has improved and is adequate to meet the residents’ needs, but requires further development by all the nurses using the system. The medication administration system is adequate but requires further clarification and communication between the pharmacist, GP and the home. Overall, the staff have a good understanding of issues around maintaining residents’ privacy and dignity, and the manager is aware of a member of staff who is needing further training in this area. EVIDENCE: The care plans are written on new Southern Cross corporate documentation. They are much clearer to read and give a good picture of the individual resident’s care needs and how these will be met. There is still evidence of a lot of information being placed in the daily record rather than being written in the care plan and, in the inspector’s view, this could lead to changes in the care provision being missed. The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 Page 12 Two of the care plans were in relation to wound care and it was noted that there was no measurement of the wounds in order to see if there was any improvement. There was a photograph of a wound, but this was not followed up to show any progress in healing or deterioration. It is a recommendation that some form of systematic measurement of any wound to show healing or deterioration should be included in the care plans. The tissue viability specialist nurse had visited one of the residents and had recommended changes to the type of dressings being used. One of the residents spoken to said that she had a painful foot and that the nurses were looking after it very well and that she thought it was improving. She did say that she has a special mattress on her bed, a cushion in her chair and a special boot for her bad leg that helped to make her comfortable. A nutritional assessment tool is in place but has not been completed for all residents. One resident has a problem with eating and was described in the daily record as having lost weight but no weight had been recorded. This resident also has pressure wounds. A further resident was assessed as having diabetes and to be obese. The diabetes is controlled by diet and oral medication, and there was no weight measurement recorded in the care record. It is a requirement that a record of a nutritional assessment, including the recorded weight, must be kept for all residents. Observation of the staff interacting with the residents showed some lack of understanding of how to deal with people who have dementia and, on one occasion, a conversation was overheard that was inappropriate and demeaning. The inspector discussed this with the manager who will deal with the issues. The medication system was examined and, overall, was in good order. The home has recently changed to a medication dosage system (MDS) supplied by a corporate pharmacist. The pharmacy is a long distance from the home and if interim medication is required between the monthly ordering, this is obtained from the local pharmacist, as it is impracticable to send a member of staff a long distance to collect it. The repeat prescriptions from the GP surgery this month did not reach the pharmacist in time to meet the deadline for making up the MDS packs. The medication was delivered to the home in ordinary packages and bottles. This makes it very difficult for the staff to manage. It is recommended that the manager should contact the supplying pharmacist and arrange to meet to discuss how best to manage the MDS system. The medication fridge was found to contain other items than medication, including the sheets of paper recording the daily fridge temperatures that were also incomplete. It is a good practice recommendation that only medication requiring to be kept in a fridge should be stored inside the fridge, and that the checking of the daily temperatures should be monitored regularly. The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 Page 13 The inspectors observed the staff interacting with the residents, both in carrying out care and assisting with mealtimes, and this was carried out in a kindly, respectful manner. Before entering a resident’s room the staff always knocked on the door, and addressed the residents by their preferred term of address. One of the residents spoken to said, “The staff look after us very well and are so kind”. The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 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 at least once during a 12 month period. 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. The opportunities for taking part in social activities are adequate but are being developed by the manager. Communication with the local community is very good and, from the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. Meals and mealtimes are very good and enjoyed by the residents. EVIDENCE: Discussion with the manager about this area of care took place and she is very committed to improving this aspect of care. Negotiation with her manager has led to her having a budget for activities, and a past member of staff is interested to assist for a few hours a week in giving 1:1 time, and escorting residents on outings. The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 Page 15 One of the residents spoken to said that she loved to talk to people and this was her main interest, and that being in the home meant that she had ready access to meeting all sorts of people, even though she can’t get out and about. The home is very much part of the village life and residents take part in local events, helped by members of staff in their own time. Residents spoken to feel that they are a part of the local community and many have lived in the village before coming to The Crown. Family and friends are treated as “one of the family” and are always popping in. The local church provides communion in the home on a regular basis and residents wishing to attend church are able to do so. One relative spoken to said that it would be good if there were more activities available for the residents. It was also mentioned that sometimes it was thought to be difficult for the residents to understand some of the staff whose first language is not English. The inspectors joined the residents for lunch, and a lovely “home cooked” meal was enjoyed by all! The residents said that both cooks were very good and they had lovely meals, and that they had a choice of food on the menus. Those residents requiring assistance with eating were treated in a kindly and appropriate manner by the staff, and the meal presented looked appealing. The inspector met with the cook on duty who has worked at The Crown for many years and clearly is very much part of the family, and knows each of the residents and what their likes and dislikes are. Discussion about the change in ownership revealed a real frustration with having to take on administration tasks that were previously carried out at head office, as well as cooking the meals. The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The complaints system in place is adequate and accessible to residents, relatives, visitors and staff. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. The staff have an adequate awareness of issues of protection of vulnerable adults and the manager makes every endeavour to ensure that the residents are protected from abuse. A recent untoward incident has been thoroughly investigated by a director of the company and appropriate actions taken. EVIDENCE: The complaints procedure is posted in the entrance hall and can be seen by any visitors to the home. It is also included in the service users’ guide for each prospective service user. The manager had one complaint on file that had been dealt with appropriately that concerned a member of staff and communication with other members of staff. A very serious incident had occurred recently and is being investigated by the company and the Health and Safety Executive. The management of the investigation and outcome is being monitored by the Commission for Social Care Inspection and the Oxfordshire Multi-Agency Team for the Protection of Vulnerable Adults. The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 Page 17 Staff spoken to are aware of issues around the protection of vulnerable adults and receive instruction as part of the induction process. Some have had further training on this subject. Residents spoken to said that they felt safe and protected living at The Crown. The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and offers a good comfortable home for the residents. Following the investigation into the untoward incident that occurred earlier in the year, all necessary changes have been made to ensure the residents’ safety. EVIDENCE: The inspector toured the home and found that, overal,l all areas were clean, tidy and maintained to a good standard. The residents’ rooms were found to be homely and very individual, with personal possessions in place. The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 Page 19 The manager told the inspector that they are proposing to create hanging baskets to be placed outside each room so that the residents will be able to see them from their beds. The residents will be able to choose which flowers they would like. New radiator covers have been fitted, window restrictors have been replaced and the boxing in of exposed hot water pipes is in progress. These are in response to an improvement notice being issued by the Health and Safety Executive following an investigation into an untoward incident that occurred in the home earlier in the year. The inspector noted that keypad locks have been fitted to both of the internal fire exit doors on the first floor in response to the fire officer’s report as part of the investigation into the untoward incident mentioned earlier. A sample of hot water outlet temperatures was recorded and found to be within the required limits to prevent the residents from scalding. The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is sufficient number and skill mix of staff on duty at all times to meet the needs of the residents. Staff training and development is poor. EVIDENCE: Staff rosters showed that sufficient number and skill mix of staff were on duty at all times. The inspectors also noted that at the time of this inspection there was an appropriate number of staff to meet the needs of the residents. A sample of staff files was examined and showed that appropriate recruitment procedures are carried out. It was noted by the inspector that there was no record of the disclosure number in relation to the criminal records bureau checks. The manager said that, since the company takeover, Southern Cross staff had been unable to find the criminal records bureau records that had been placed in safe keeping and had previously been kept at the head office of Crown Homes. The inspector had previously examined these at Crown Homes’ head office. The Southern Cross operations manager is addressing this issue. The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 Page 21 The inspector found that the training records previously held centrally are waiting to be transferred to the individual staff files. One of the registered nurses has recently taken on responsibility for staff training and will be developing a programme of training and development with the manager. The company is very committed to staff training and provides relevant in-house training, and encourages all nurses to maintain their ongoing clinical update and development. A new member of staff was spoken to about the induction she had received in the two months since she has been employed. She has not worked in the care environment before and, from her description, the introduction process she had received was very scant. She did not have any record or documentation to support learning, although she is supervised at all times. It is a requirement that all new members of staff must receive training appropriate to the work they are to perform. A further staff member spoken to had just undertaken first aid training last week for the first time since being employed. She said that she felt the need for refresher training in all aspects of care. She very much enjoyed working at the home and felt that they had a good staff team who worked well together. The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The management of the home is adequate, considering the inexperience of the manager in managing, and the changes as a result of becoming part of a large corporate organisation. All necessary checks and balances are in place to ensure the health and safety of the residents and staff. EVIDENCE: The manager is relatively new to the role and is a very experienced nurse who has worked at the home for many years prior to taking up this role. The application of the manager for registration with Commission for Social Care Inspection is being held pending further personal development into the role. The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 Page 23 Part of this development is for the manager to commence the NVQ Managers award. The manager said that the new operations Manager, who has been in post for just a few weeks, is supporting her. The operations manager is visiting the home weekly and is in daily contact with the manager at the present time. The manager has not had supervision herself and does not as yet have a personal development plan. The inspector advised the manager to discuss this further with the operations manager. Staff spoken to really enjoy working at The Crown and feel that they work well as a team. They are still apprehensive about the future under new ownership. During visits to the home the operations manager talks to staff and the residents and tours the home. A record of the monitoring visits is sent to the Commission for Social Care Inspection and this includes the views of residents and staff on the service provision. The company recently carried out a relatives’ questionnaire and a good response was received, but the report has not yet been published. It is proposed to follow this up with a residents’ questionnaire. In the interim, residents are encouraged to communicate any concerns or improvements to the manager. The manager is to hold the first relatives’ meeting in a week’s time. Southern Cross requires managers to carry out regular audits of various management systems within the home and these were made available to the inspector at the time of this inspection. These included regular maintenance checks on equipment such as wheelchairs, walking frames and sticks and bedrails. The manager told the inspector that the Southern Cross financial services department deals with the payment of fees and the families or advocates deal with their individual financial affairs. The residents’ personal cash is put into individual containers and kept in the home’s safe. A record of the running balance is kept, and receipts of all transactions made. The Health and Safety Executive carried out an investigation into an untoward incident earlier in the year and an improvement notice was issued that required window restrictors to be replaced, hot water temperatures to be checked regularly and hot water pipes and radiators to be covered. This work is almost completed. The fire officer also attended as part of the investigation and a recommendation was made that both internal fire exit doors should have keypad locks applied. This has been carried out. The inspector examined records required by regulation and found these to be in good order. The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 Page 24 The policies and procedure files are of the previous company, and the manager informed the inspectors that the Southern Cross documentation is being dealt with by the new operations manager and will be in the home in the next few days. The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 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 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X 2 3 STAFFING Standard No Score 27 3 28 2 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 3 3 X X 2 The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 Page 26 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 OP8 Regulation 17(4) Requirement It is a requirement that a record of a nutritional assessment, including the recorded weight, must be kept for all residents. Timescale for action 01/06/06 2 OP30 18(c)(1) It is a requirement that all new members of staff must receive training appropriate to the work they are to perform. 01/06/06 The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 Page 27 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 OP8 Good Practice Recommendations It is a recommendation that some form of systematic measurement of any wound to show healing or deterioration should be included in the care plans. It is recommended that the manager should contact the supplying pharmacist and arrange to meet to discuss how best to manage the MDS system. It is a further good practice recommendation that only medication requiring to be kept in a fridge should be stored inside the medication fridge, and that the checking of the daily temperatures should be monitored regularly. 2 OP9 The Crown Nursing Home DS0000065924.V291417.R01.S.doc Version 5.1 Page 28 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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