Inspection on 25/09/07 for The Grange Nursing And Residential Home

This inspection was carried out on 25th September 2007.

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

The inspector 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 Grange Nursing And... 01/08/06

The Grange Nursing And... 11/01/06

The Grange Nursing And... 02/09/05

The Grange Nursing And... 27/09/04

The Grange Nursing And... 26/02/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Grange, The Nursing And Residential Home Field Drive Shirebrook Nottinghamshire NG20 8RL Lead Inspector Rose Veale Key Unannounced Inspection 25th September 2007 09:45 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 Grange, The Nursing And Residential Home DS0000002082.V345522.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. Grange, The Nursing And Residential Home DS0000002082.V345522.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grange, The Nursing And Residential Home Address Field Drive Shirebrook Nottinghamshire NG20 8RL 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) 01623 747070 01623 746513 www.schealthcare.co.uk Southern Cross Care Management Limited Angela Susan Flavell Care Home 50 Category(ies) of Dementia (16), Old age, not falling within any registration, with number other category (50) of places Grange, The Nursing And Residential Home DS0000002082.V345522.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 place for (YA) for named person, (identified in the proposal notice), for as long as they are accommodated at the home. Date of last inspection 1st August 2006 Brief Description of the Service: The Grange Care Centre is situated in village of Shirebrook, near to local shops, pubs and public transport. The home provides personal and nursing care and accommodation for up to 49 older people, including 16 people with dementia, plus 1 place for a named person under the age of 65. All residents are accommodated in single rooms with en-suite toilets. The home has lounge and dining areas suitable for use by small or larger groups of residents. There is a large garden area with patios accessible to residents and a car park to the front of the home. Information about the home, including CSCI inspection reports, is available from the home. Fees at the home range from £290 to £472.50 per week. This information was provided by the home’s manager on 26/09/2007. Grange, The Nursing And Residential Home DS0000002082.V345522.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and took place over 2 days, (11 hours in total). The inspection visit focused on assessing compliance to requirements made at the previous inspection and on assessing all the key standards. There were 48 residents accommodated in the home on the day of the inspection visit, including 11 residents assessed as needing nursing care and 15 residents assessed as needing dementia care. Residents, visitors and staff were spoken with during the visit. The manager was available and helpful throughout the inspection visit. Some residents were unable to contribute directly to the inspection process because of communication difficulties, but they were observed during the visit to see how well their needs were met by staff. Records were examined, including care records, staff records, maintenance, and health and safety records. Some areas of the home were seen, including most of the communal areas and some of the bedrooms. The Annual Quality Assurance Assessment, (AQAA), had been completed and returned prior to the inspection and information from this has been included in the body of this report. The Short Observational Framework for Inspection, (SOFI), was used during this inspection to collect information about the experience of residents with dementia. SOFI was designed for inspectors to record their observations during the inspections of care homes where people have dementia or severe learning disabilities. It organises the observation by giving clues about what to look for and a format for recording observation. SOFI provides a snap-shot observation, usually of around two hours, conducted as part of a key inspection. SOFI is designed to provide first hand experience of sitting alongside people for a couple of hours in a communal space within the care home; to give insight into the general well being of people living in the home and into the staff interaction during this time. What the service does well: Residents at The Grange commented that “they treat me very well”, “they’re very good to me”, and that staff were “very good”, “kind and patient”. One resident commented that they were “well looked after” during a recent illness. The Grange provided a clean, fresh, pleasant and comfortable home for residents. Grange, The Nursing And Residential Home DS0000002082.V345522.R01.S.doc Version 5.2 Page 6 There was a good staff training programme in place with most of the staff up to date with required training. Staff said the training provided was of good quality and useful. What has improved since the last inspection? 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. Grange, The Nursing And Residential Home DS0000002082.V345522.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 Grange, The Nursing And Residential Home DS0000002082.V345522.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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was a comprehensive needs assessment process so that residents were assured that the home could meet their needs. EVIDENCE: The care records of 6 residents were seen, including residents assessed as needing nursing care, and residents with dementia. There was a range of assessment information in each of the records, including information from social services and/or hospital staff. The Annual Quality Assurance Assessment, (AQAA), completed by the home’s manager said that an improved Grange, The Nursing And Residential Home DS0000002082.V345522.R01.S.doc Version 5.2 Page 9 pre-admission assessment document had been implemented. This was seen in the records of residents recently admitted to the home. Residents and visitors spoken with confirmed that an assessment of their needs had taken place before admission to the home. Some residents had been able to visit the home prior to admission, or had spent a period of respite care at the home before deciding to live there permanently. Standard 6 did not apply to this service. Grange, The Nursing And Residential Home DS0000002082.V345522.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements had been made to the care plans and there was sufficient information in the care records to ensure that residents’ personal and health care needs were met. EVIDENCE: The care plans seen were well organised and covered all the assessed needs of residents. Improvements had been made to the care plans for all residents, and particularly for those residents with dementia. Some of the care plans seen did not include enough detail of residents’ personal preferences. The care plans seen had all been reviewed regularly and updated when necessary. There was some evidence that residents or their representatives were involved Grange, The Nursing And Residential Home DS0000002082.V345522.R01.S.doc Version 5.2 Page 11 in care planning and review. The AQAA states that this is an area the home could improve on. Most assessments seen had been reviewed and updated monthly, such as assessments of the resident’s nutritional needs. There were risk assessments in place, such as the risk of developing pressure sores, and the risk of falls. Some risk assessments had been signed by the resident or their representative, as well as by staff. Some had not been signed at all. Risk assessments had all been reviewed monthly. Records were seen of the input of other professionals, such as GP, District Nurse, optician, dentist, chiropodist, and care manager. There was evidence that residents’ healthcare needs were identified and followed up appropriately. For example, staff noticed a resident had a lump on their leg and asked the GP to visit; a resident was referred to the speech and language therapist because of difficulties with swallowing. Residents and visitors spoken with confirmed that residents saw their GP when needed. One resident commented that they were “well looked after” during a recent illness. Improvements had been made since the last inspection to medication systems and storage. The Medication Administration Records, (MARs), were checked daily by 2 staff to ensure they had been correctly completed. The ground floor medication room was now used to store all medication and air conditioning had been installed to ensure the temperature was correct. The MARs seen were all correctly completed. There was a photograph of each resident with the MAR to ensure correct identification. Although the administration of medication observed during the inspection was mostly good, there were some poor practices seen. This was discussed with the manager during the inspection visit. Residents and visitors spoken with said that staff treated residents with respect. Residents said, “they treat me very well”, and “they’re very good to me”. There was one comment that staff at night were sometimes noisy – letting doors bang and talking in corridors outside residents’ rooms. Residents said that staff ensured their privacy and dignity. The SOFI used to observe the care for residents with dementia showed that there were some good interactions where staff demonstrated warmth, affection and respect for residents. There were a few examples of poor interactions, such as staff speaking to residents in a patronising way, and not waiting for a response to a question asked of a resident. Grange, The Nursing And Residential Home DS0000002082.V345522.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 adequate. This judgement has been made using available evidence including a visit to this service. Although there was a good range of activities offered, this did not meet the needs of all residents. There were poor food hygiene practices that put residents at risk. EVIDENCE: There was an activities coordinator at the home and a range of activities was offered to residents. There were photographs displayed of recent activities and events, such as trips out, and a summer fair held at the home, and examples of residents’ art work. Residents spoken with said they enjoyed playing bingo and making cards. A local vicar was visiting the home on the first day of the inspection visit. Grange, The Nursing And Residential Home DS0000002082.V345522.R01.S.doc Version 5.2 Page 13 It was commented that the range of activities did not cater for the needs and preferences of all residents, particularly those with dementia or who were less physically able or less able to communicate. During the observation of residents with dementia, residents were involved in activities by staff. The activities were listening to music, craft work, and chatting with staff. Residents showed positive responses to the choice of music and clearly enjoyed talking with staff. The craft work was not well organised so that residents soon lost interest. One resident was encouraged to use a duster they had picked up, and staff said that some residents helped to make their own beds. Otherwise, there appeared to be little attempt to involve residents in everyday tasks. There were times when the staff talked to each other across the lounge about work issues. It was commented that activities were not always offered to residents with dementia and that there was usually a lack of stimulation for them. Residents spoken with confirmed that they were able to get up and go to bed when they chose. The care plans seen included residents’ preferences about bedtimes and getting up. Some residents said they were able to follow a daily routine they preferred. For example, one resident said they preferred to spend most of the time in their room, but liked to use the dining room for meals. Residents and visitors spoken with said that visitors were made welcome at the home. One visitor was pleased that staff greeted them by name and always offered a hot drink when they visited. The care records seen included details of relatives and of any communication with family and friends. There were mixed comments about meals at the home. Some residents were satisfied with the choices available and the quality of the food. One resident was pleased that pasta dishes were included on the menu. There were comments from residents and visitors that the menu lacked variety, particularly at teatime. One resident said that they did not like either of the choices offered at lunchtime on the first day of the inspection visit. The resident was not aware that they could ask for something different. The manager said that comments and complaints about the menus had been listened to and a new menu was about to be put in place. The dining rooms were bright and pleasant with tables laid with cloths. There were no menus displayed in any of the dining rooms. The lunchtime meal was observed in the first floor dining room. There was a good atmosphere with some residents chatting to each other. A resident who needed help with eating was assisted in an unobtrusive way by a care assistant. The meals served appeared appetising and most residents appeared to enjoy them. The teatime meal was observed on the Hamilton Suite, where the residents with dementia lived. Residents could choose from soup, sandwiches or Grange, The Nursing And Residential Home DS0000002082.V345522.R01.S.doc Version 5.2 Page 14 omelettes, with cakes to follow. Some residents were seated at the tables in wheelchairs, rather than being assisted to transfer to dining chairs, so they were not near enough to the table. One resident spilt their soup because they were too far from the table and also because they were given a large spoon to use. The resident had not been given a napkin, or other way of protecting their clothes and was upset that they had spilt the soup on their clothes and the tablecloth. Although this resident was then helped sympathetically by a care assistant, the situation could have been avoided by some thoughtful planning. It was commented that residents in the Hamilton Suite were sometimes handed sandwiches when seated in the lounge, without any plates and from staff not wearing disposable gloves or using tongs to handle the sandwiches. It was observed that there were 2 plated meals left over from lunchtime. 1 of the meals was left uncovered in the dining room all afternoon and was disposed of at teatime. The other was reheated in the microwave for a resident. The meal was not checked with a probe to ensure that it had been properly reheated. Grange, The Nursing And Residential Home DS0000002082.V345522.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were robust policies in place and good staff awareness so that residents were protected and their complaints were listened to and acted upon. EVIDENCE: There was a complaints procedure in place. Not all residents spoken with were aware of this, though all said they felt able to raise any concerns with staff. Visitors spoken with were aware of the complaints procedure. Records were kept of complaints made and the action taken. Residents and visitors were generally confident that complaints would be effectively dealt with. However, it was commented that sometimes issues raised were addressed but then reoccurred. One complaint had been received by CSCI since the last inspection. The complaint was referred to the provider to investigate and a satisfactory response was received. Grange, The Nursing And Residential Home DS0000002082.V345522.R01.S.doc Version 5.2 Page 16 There were policies and procedures in place for safeguarding vulnerable adults. The policy had been reviewed since the last inspection. Most of the staff had attended training in the safeguarding of vulnerable adults. Staff spoken with were aware of the correct procedures to follow if abuse was suspected. Grange, The Nursing And Residential Home DS0000002082.V345522.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was clean and generally well maintained so that residents lived in a pleasant and comfortable environment appropriate to their needs. There were some lapses in keeping confidential information securely that could put residents at risk. EVIDENCE: Since the last inspection the storage cupboards in the first floor office had been repaired and air conditioning had been installed in the ground floor medication Grange, The Nursing And Residential Home DS0000002082.V345522.R01.S.doc Version 5.2 Page 18 room. The majority of staff had attended training in the control of infection, as required at the last inspection. The communal areas of the home were bright, pleasant, warm and comfortably furnished. The bedrooms seen were cheerful and personalised with residents’ own furniture and possessions. The home was clean and free from offensive odours. As noted at the last inspection, the Hamilton Suite for people with dementia had appropriate décor and signs. It was observed that the outside sitting area for the Hamilton Suite was used as a smoking area by visitors. There was an ashtray on the table in this area that was overflowing with cigarette ends and packets, suggesting that this area was commonly used for smoking. There was also a small bag of rubbish discarded in this area. It was seen that the small sitting area at one end of the corridor on the first floor was cluttered with a television and a mattress overlay. On the first day of the inspection visit, the office in the Hamilton Suite had the door propped open and confidential records left on the desk. It was observed that residents went into this office when staff were not present. On the second day of the inspection visit, the door was closed and only accessible using a code lock. The door to the office on the first floor was observed to be routinely wedged open and, again, confidential records left out. The door to the nurses office on the first floor was not locked and records were kept in a cupboard that was not lockable. The manager said that a code lock was to be fitted to the door to the nurses office. Grange, The Nursing And Residential Home DS0000002082.V345522.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. There were robust recruitment practices, a good staff training programme and sufficient staffing levels so that residents were protected and well supported. EVIDENCE: Staff rotas showed that staffing levels throughout the day were 3 care assistants for the residents on the first floor needing personal care, 1 nurse and 2 care assistants for the residents needing nursing care, and 3 care assistants for the residents on the Hamilton Suite. The staffing level for the Hamilton Suite had improved since the last inspection. Residents, visitors and staff spoken with said that staffing levels were usually sufficient to meet residents’ needs. There was one comment that residents were sometimes left too long in the dining room after meals. The records of 2 members of staff were checked and found to contain all the required information. There was evidence of good recruitment practices – such Grange, The Nursing And Residential Home DS0000002082.V345522.R01.S.doc Version 5.2 Page 20 as keeping interview notes, exploring gaps in employment histories, and following up references. There was a staff induction programme in place that met Skills for Care standards. There was a training programme in place that included all the required training – such as fire safety and manual handling – plus other training relevant to the needs of residents – such as dementia awareness and pressure area care. Information supplied in the AQAA indicated that 50 of care assistants had already achieved National Vocational Qualification (NVQ) at Level 2 or above, and that another 6 care assistants were working towards the qualification. Staff spoken with were pleased with the training programme. They said that the training was good quality and was relevant to their work. Residents and visitors spoken with commented that the staff were “very good”, “kind and patient”. Grange, The Nursing And Residential Home DS0000002082.V345522.R01.S.doc Version 5.2 Page 21 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. The home was well managed and there were satisfactory systems in place so that the health, safety and welfare of residents was promoted and protected. EVIDENCE: The manager had been in post for about 2½ years and had completed the Registered Manager’s Award. Residents and staff spoken with said they felt the manager would listen to and act on issues they raised. A deputy manager Grange, The Nursing And Residential Home DS0000002082.V345522.R01.S.doc Version 5.2 Page 22 for the home and a team leader for the Hamilton Suite had recently been appointed. There was a quality assurance system in place at the home. There were regular audits by the home manager and by the operations manager. Surveys were sent out to the relatives of residents, although this had not happened recently. Some completed surveys were seen that were not dated and were said to be ‘old’. There was no annual report of the analysis of quality assurance information and of action taken to address any issues raised. There were meetings held approximately every 6 months for residents and relatives. It was commented that these meetings were useful and that they should be more frequent. The manager had a weekly ‘open door’ session if any residents or relatives wanted to discuss anything with her. There were systems in place to ensure that residents’ money held at the home was securely kept and properly accounted for. The AQAA indicated that the health and safety policy, and most of the other policies / procedures in place, had not been reviewed for over 18 months. Staff training statistics supplied by the home indicated that most staff were up to date with fire safety, manual handling, health and safety, and food hygiene training. The AQAA indicated that the maintenance of equipment in the home was up to date. Grange, The Nursing And Residential Home DS0000002082.V345522.R01.S.doc Version 5.2 Page 23 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 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 2 X 3 X X 3 Grange, The Nursing And Residential Home DS0000002082.V345522.R01.S.doc Version 5.2 Page 24 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 OP9 Regulation 13(2) Requirement When staff are administering medication, it must be removed from the packaging directly into a small pot or spoon to hand to the resident. This will ensure hygienic handling of medication. The medication administration record must be signed immediately after the medicine has been given. This will ensure medication is given as prescribed and is correctly documented. Food must be stored correctly, including left over meals, to ensure hygienic conditions and to reduce the risk of infection. Records relating to residents must be stored securely at the home to ensure the confidentiality of information is maintained. The unnecessary clutter in the first floor corridor sitting area must be removed to ensure a safer and more pleasant environment for residents to use. The quality assurance system must include consultation with residents and / or their DS0000002082.V345522.R01.S.doc Timescale for action 12/10/07 2 OP9 13(2) 12/10/07 3 OP15 13(4) 12/10/07 4 OP19 17(1)(b) 12/10/07 5 OP19 13(4)(a) 12/10/07 6 OP33 24(1)(5) 31/12/07 Grange, The Nursing And Residential Home Version 5.2 Page 25 representatives. 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 3 4 5 Refer to Standard OP7 OP9 OP15 OP19 Good Practice Recommendations The care plans should include more detail of residents strengths, personal preferences, and interests to ensure they are more person centred. There should be a system operating to ensure that the competence of staff to administer medication is checked at least annually. Residents should be provided with napkins, or other means of protecting their clothes at mealtimes to ensure their dignity. The use of the area outside the Hamilton Suite lounge as a smoking area should be reconsidered, in consultation with residents and their representatives. The quality assurance system should include an annual report analysing results of surveys and giving details of action taken to address issues raised. The report should be available to residents / their representatives so they know that the home is run in their best interests. Polices and procedures at the home should be reviewed annually, or sooner if necessary, so that they are in line with current good practice and guidance. OP33 6 OP33 Grange, The Nursing And Residential Home DS0000002082.V345522.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Grange, The Nursing And Residential Home DS0000002082.V345522.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. 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