Inspection on 26/11/07 for The Firs Nursing Home

This inspection was carried out on 26th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Firs Nursing Home 04/12/08

The Firs Nursing Home 19/04/07

The Firs Nursing Home 11/01/07

The Firs Nursing Home 23/05/06

The Firs Nursing Home 15/02/06

The Firs Nursing Home 23/06/05

The Firs Nursing Home 27/01/05

The Firs Nursing Home 01/09/04

The Firs Nursing Home 22/03/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 The Firs Nursing Home Kings Hill Great Cornard Sudbury Suffolk CO10 0EH Lead Inspector Tina Burns Unannounced Inspection 26th November 2007 09:45 The Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 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 Firs Nursing Home DS0000031547.V355534.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 Adults 18-65. 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 Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Firs Nursing Home Address Kings Hill Great Cornard Sudbury Suffolk CO10 0EH 01787 371301 01787 880603 the.firs@craegmoor.co.uk www.craegmoor.co.uk Speciality Care (REIT Homes) Ltd 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) Post Vacant Care Home 21 Category(ies) of Learning disability (21), Learning disability over registration, with number 65 years of age (6) of places The Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home may care for 21 adults, under the age of 65, of either sex, who require care by reasons of learning disability. The home may care for 6 named service users over the age of 65 years, under the category of Learning Disability as named in the letter to the Commission dated 10th November 2006. 19th April 2007 Date of last inspection Brief Description of the Service: The Firs is a care home with nursing for adults with a learning disability run by the large organisation Craegmoor Healthcare. It is located in Gt Cornard close to the town centre of Sudbury. The home is on two floors with a shaft lift connecting the two. It has two interconnecting lounges and a separate dining room and a mixture of single and double bedrooms. The premises are set on a compact site that allows for parking of several cars to the front. There is a small garden area to the entrance of the home and an enclosed garden at the rear. Daytime activities tend to be provided by and based at the home. The current base line accommodation fees are £953.08 per week but are variable according to service users needs. The Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection, which focused on the core standards relating to care homes for young adults. It was undertaken by two inspector’s, on a weekday over approximately six hours. The report has been written using accumulated evidence gathered prior to and during the inspection. The inspection process included examination of a range of documents including staff records, service user’s files, financial records, a number of policies and procedures, and health and safety records. One inspector also carried out a tour of the premises, spoke with several service users and staff, and observed some of the daily routines. Further information provided to the Commission has included the homes Annual Quality Assurance Assessment (AQQA) and a return of two staff surveys, four service user’s surveys and eight relative’s surveys. The manager was present through out the day and fully contributed to the inspection process. What the service does well: What has improved since the last inspection? Three requirements relating to long standing issues about the management of service users financial accounts had been met. The home was working within the framework of Craegmoor healthcare’s new and updated procedures for handling service users monies, appropriate action had been taken with regard to deceased residents estates and interest owed to resident’s accounts had been paid. Care plans examined were more person centred and meaningful and reflected service users wishes and preferences. The manager had developed a shortterm maintenance plan and begun to tackle issues about the suitability of the premises and facilities. Just over fifty percent of staff had achieved or were undertaking NVQ qualifications. The Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 6 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 Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 3. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective service users can expect to have their individual needs assessed but they cannot be sure that they will receive information about the home in a format that is suitable to their needs. EVIDENCE: The homes Statement of Purpose had been amended since the last inspection to reflect the fact that there had been further changes regarding the management of the home. Discussion with the manager indicated that they were clear that the document needed to be regularly reviewed and maintained up to date and accurate. The manager advised that although the home had made no further progress regarding the development of the service users guide, a corporate document in a more suitable style and format for the service user group was being developed. Service users records examined included local authority assessments of need and assessments undertaken by the home prior to admission. The homes assessments covered areas such as maintaining a safe environment, communication, breathing, eating and drinking, elimination, personal hygiene and dressing, controlling body temperature, mobilising, social care/family The Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 9 involvement, sleeping and pain. Further assessments included nutritional assessments, moving and handling assessments and waterlow pressure sore assessments. Feedback from surveys, training records examined and observations made during the inspection indicated that overall the home had the capacity to meet service users primary needs. Records seen and discussion with the manager about two residents with additional mental health needs confirmed that under the Commissions current guidance the home was not functioning outside of its category of registration. The Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect to have a needs led person centred care plan. Further more they can expect to become increasingly involved in decisions about the home and their every day lives. EVIDENCE: At the last inspection a new corporate care plan format had been devised with the intention of promoting service user involvement and the home had begun the process of completing them with service users and/or their representatives where possible. At this inspection discussions with the manager and staff and records seen confirmed that all care plans had been re formatted into the new person-centred style. Entries in the care plan were written in the first person, as if they had been written by the service user, and although it was recognised that not all residents could achieve this level of understanding the topics listed were important and meaningful. Sections included; Dates that are important to me, What I do now and what I’d like to do, Social interaction, Health and The Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 11 keeping safe, Finances, Personal Care, Mental health/behaviour, Communication, Independence and When I become sick or might die. Due to the complexity of needs most of the service users resident at the home require assistance to make decisions about their every day lives. The manager advised that approximately eighty percent of service users had relatives, friends and visitors that they worked in partnership with to assist residents in this area. Surveys received from relatives confirmed that overall the home consulted them fully about their relative’s care and any decisions that needed to be made. Comments included; “I am generally asked for my opinion on aspects of my relatives care & needs” and “…appears to be giving a good standard of care to my relative & I therefore must assume they must also be acting on advice & information available from all sources”. Discussion with the manager and records seen also confirmed that the home works closely with local authority care managers and has links with independent advocacy services that they can make referrals to on an as needed basis. Three service users were also supported by the home to attend ‘residents forums’, a group advocacy initiative set up by Craegmoor Healthcare. There was also good evidence that the manager had begun to look at ways of increasing the opportunities for service users to be involved in decisions about the home, for example the health and safety committee now included a service user representative and key policies and procedures were being developed in formats more suitable to the service users needs. The Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users can expect to enjoy a healthy diet. They can also expect to maintain relationships with their friends and families. However, they cannot be certain that they will have the opportunity to routinely participate in activities of their choice. EVIDENCE: The home employed two part time activities co-ordinators and on the day of inspection one was providing one to one support to one resident and the other accompanied two service users to the cinema. Throughout the morning, most of the other service users were seated in one of the two adjoining lounges. The televisions in these rooms were on at the time but no one appeared to be watching them and although there was some engagement with staff service users were mostly unoccupied. The Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 13 Care plans examined gave some information about the activities and interests of service users but daily records did not consistently list what people had taken part in each day. Feedback from service users and relatives indicated that some people were happy with the support provided in this area and others did not feel that it was adequate for service users whose needs were more complex. One service user spoken with said that they regularly went to a resource centre during the day and also gave examples of places that they visited with staff, another confirmed that the home enables them to go to church and celebrates birthdays and other special occasions with them. This was reflected in photographs displayed around the home. The manager also advised that several of the service users continued to participate in pottery and art activities and they planned to sell some of the products at a Christmas sale. Records seen and feedback received indicated that relatives and visitors were always welcome and service users were supported to maintain relationships and friendships. Comments included; “…it always feels very warm & the staff are always very welcoming…”. Following concerns raised at the previous two inspections about evening routines it was positive to find that care plans included service users individual preferences about going to bed and getting up times. These varied from person to person. The manager reported that day and night staff were working more positively together so that people were not expected to get ready for bed at unreasonably early times. The manager confirmed that due to lack of space in the dining room they continued to provide the main midday meal in two sittings and eight service users were observed having their lunch in the dining room. Six of the eight service users required staff assistance to eat their food but there was sufficient staff to support them and the meal seemed relaxed and unhurried. Observations made and discussion with the kitchen staff confirmed that they continued to cater for service users special dietary needs and were aware of their likes and dislikes. The Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 & 21. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect to receive appropriate personal and health care support. EVIDENCE: Records seen and staff and service users spoken with confirmed that service users continued to receive consistent support from designated ‘key workers’. Service users spoken with indicated that they were happy with the support they received. Observations were that service users seemed physically well cared for. Comments received from service users and their relatives included “They always look after me very well”, “Nursing care is very good”, “Good care is given…the staff are very familiar with their needs and preferences”. Feedback received, records examined and information provided in the homes AQQA confirmed that the home works closely with relevant health professionals to meet service users physical and emotional health needs. This was also confirmed by case tracking three residents with different health care needs. Records included appropriate assessments such as nutrition, pressure The Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 15 care and manual handling and these were regularly evaluated and updated. Daily records, although sometimes brief, reflected the care required in the care plan and nursing treatment was recorded fully. The home has appropriate medication procedures in place and medication is administered by qualified nurses only. Medication administered during the lunchtime observation was given safely. Medication Administration charts had been appropriately completed, signed and dated. Information provided in the AQQA and care plans examined confirmed that the home had begun to consult service users and/or their representatives about death and dying so that they could be sure that their wishes and preferences would be respected in such circumstances. The Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect to have their complaints and concerns listened to and acted upon. Furthermore, they should find that they are safeguarded by more robust systems for managing and handling their money. EVIDENCE: The home had a complaints procedure in place and on display in the entrance hall. Feedback from service users and relatives indicated that people felt able to complain but issues were generally raised and resolved before reaching the formal complaints process. Records examined evidenced that there had been one complaint made since the last inspection in April 2007, and the manager had handled this appropriately. There have been no complaints or concerns reported to the commission since the last inspection. Discussion with the manager confirmed that the home works within the local authority policy and procedures for safeguarding adults and staff receive adult protection training as part of their induction training. The home has not made any safeguarding adults referrals since the last inspection. Following the last inspection there were three repeat requirements made about financial procedures and residents monies however all three had been met on this occasion. Firstly, the company had produced an up to date policy for the administration of clients accounts and the handling of service users monies, secondly there was good evidence that deceased residents estates had been The Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 17 appropriately dealt with and finally accounts examined confirmed that the outstanding interest owed to service users had been paid into their accounts. Although it was concerning that Craegmoor Healthcare had taken over twelve months to resolve serious concerns about the handling of service users monies it was positive to find that on this occasion the residents accounts examined were clear and thorough and did not raise any concerns. The Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 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. The physical design and layout of the home does not promote choice and independence. EVIDENCE: The Firs is a large property situated on a main road in the village of Great Cornard. It has parking to the front of the building with paved and bedding areas to the entrance of the home and a small but enclosed rear garden. During the inspection a tour of premises was undertaken and the home was found to be warm, safe and clean. Since the last inspection redecoration had occurred in some communal and private areas and the kitchen had been refitted. It was also positive to find that the manager had developed a six-month property maintenance plan and submitted a number of requisitions for additional work to the company. Records seen and discussion with the manager evidenced that following a The Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 19 series of breakdowns there had been significant works carried out to the homes shaft lift. Further more the manager confirmed that the company had agreed to install a stair lift so that an alternative was available to some service users in the event of a ‘break down’ to the main lift. At the time of inspection there were no assisted baths in use, this left only one shower available to most service users, and this was situated on the first floor. Although it was positive to find that the manager had submitted requisitions for two new shower rooms feedback from surveys indicated that the current facilities did not ensure that service users personal care needs were met in a way that respected their wishes and preferences. Service users bedrooms were comfortably furnished and decorated in a style that reflected their personalities and interests. However, overall the space and layout of the home was not ideal for the numbers of service users that it is registered to care for. Although staff had made a good effort to make the environment cheerful, homely and comfortable service users continued to share communal areas that consist of two adjoining lounge areas and an adjacent dining room. Discussion with the manager about the accommodation and facilities demonstrated that they were clear that improvements could be made. They confirmed that they would approach relevant people within the organisation to look at the development of a short and long term plan to improve the accommodation for people living at the home. The home had a fully equipped laundry room and a dedicated laundry assistant. At the time of the visit the laundry room was clean and tidy. Records examined and observations made indicated that appropriate infection control procedures were in place. The Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users can expect staff to be suitably trained and recruited. However, they cannot be certain that staff will receive appropriate supervision that ensures their needs are met. EVIDENCE: Examination of the staff rota and discussion with the manager confirmed that there was a minimum of one qualified nurse on duty every shift in addition to four to five care workers during day time hours and two between the hours of 8.30pm and 7.30am. Surveys returned and observations made during the inspection indicated that the staffing levels were adequate to meet service users personal care needs. Staff files examined were untidy and disorganised but did include application forms, declarations of health, written references, verification of personal identification and Criminal Record Bureau disclosure checks. They did not include photographs but the manager provided these by the end of the day. The Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 21 Further changes to the management of the home had impacted on the frequency of planned 1-1 staff supervisions. However a supervision programme had been developed and all staff had individual supervisions planned. It was concerning that at the time of inspection nursing staff did not have the opportunity to have clinical supervision as the manager was not a qualified nurse. However, the inspectors were advised that this would be resolved before the end of December 2007. Feedback from staff, discussion with the manager, and records examined confirmed that staff received appropriate induction and foundation training. Records indicated that all staff received core training that included fire safety, manual handling, health and safety, control of substances hazardous to health, food hygiene, first aid, protection of vulnerable adults, infection control, equal opportunities and primary prevention. The manager also confirmed that sixteen out of thirty staff had achieved or were working towards National Vocational Qualifications and further training was planned covering areas such as dementia care, wound care, bowel management and alternative communication. Feedback from service users and relatives indicated that overall staff were competent, well trained and sufficient in numbers to meet service users needs. Comments included “The nursing care at the Firs at present is very good”, “I do not think ‘X’ would get better care in any other home…. the staff are wonderful” and “They always look after me”. The Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40, 41 & 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users cannot be sure that the home will be consistently well managed but overall they can expect their health, safety and welfare to be promoted and protected. EVIDENCE: Since the last inspection in April 2007 the home has experienced another change in manager. This means that the home has had three managers in eighteen months, none of which have been registered. Consequently we were concerned that this would have a negative impact on the running of the home and the progress made by the previous manager. However, it was positive to find that the new manager had a good understanding of the outcome of the homes previous inspections and outstanding requirements had been met. Further more discussion with the manager, feedback received and observations The Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 23 made indicated that the manager was approachable, competent and keen to improve the service for people living at the home. At the time of inspection the Commission had not received a registered managers application but the manager confirmed that it was their intention to proceed with an application. The homes Annual Quality Assurance Assessment confirmed that the manager is currently working towards the Registered Managers Award. The home provides nursing care but the manager does not hold a nursing qualification. The manager advised that they intended to appoint a deputy manager with a nursing qualification by the end of December 2007; in the meantime they were supported by Craegmoor Healthcares clinical governance team. Records examined confirmed that the home had appropriate quality assurance systems in place. These included health and safety audits, food safety audits, medication audits and infection control audits. It was positive to see that the home had an active health and safety committee that included a service user representative. The manager was also considering the suggestion of a relative’s representative. The home had submitted an Annual Quality Assurance Assessment to the Commission as required. Although the document had been completed by a manager new to the home it was reasonably informative and demonstrated that they were able to identify areas for improvement and set meaningful goals. Information included in the AQQA, discussion with the manager and documentation seen during the inspection indicated that the home works within the framework of Craegmoor Healthcares policies and procedures. These included a wide range of health and safety policies covering areas such as fire safety, infection control, food hygiene and control of substances hazardous to health. Staff induction training included health and safety awareness and moving and handling training. Hot water temperatures were tested at two outlets and found to be at safe levels. Records indicated that temperatures were tested randomly on a daily basis and maintained appropriately. However, although staff confirmed that they checked water temperatures before assisting service users with baths and showers the temperatures had not been recorded. The manager agreed to put temperature charts in bath and shower rooms as a matter of urgency to ensure that staff were following procedures to safeguard service users from scalding. Records examined evidenced that overall the home maintained appropriate health and safety records including fire safety records and incident and accident records. Window restrictors were in place on the ground and first floor and there was a security keypad on the front door for security purposes. However, feedback from relatives indicated that there was some concern about security and the layout of the building; the manager agreed that they would raise this as a matter for the health and safety committee. The Firs Nursing Home DS0000031547.V355534.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 Adults 18-65 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 3 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 1 28 2 29 2 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 2 X 3 3 2 3 X The Firs Nursing Home DS0000031547.V355534.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 YA27 Regulation Requirement Timescale for action 01/03/08 2. YA36 12,23(2)(j) There must be sufficient and suitable bath and shower facilities so that service users personal care needs and individual preferences can be met. 18(2) Appropriate supervisory arrangements must be in place for nursing staff. This is to ensure that their practice is up to date and safeguards service users. 01/01/08 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. 2. Refer to Standard YA24 YA37 Good Practice Recommendations The home should have a clear short term and long term building plan to address shortfalls in the accommodation. The registered person should ensure that the appointed manager submits a registered managers application to the commission without delay. The Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Firs Nursing Home DS0000031547.V355534.R01.S.doc Version 5.2 Page 27 - 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!