Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: The Laurels Nursing Home Francis Way Hetton Le Hole Houghton Le Spring Tyne & Wear DH5 9EQ The quality rating for this care home is:
one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sam Doku
Date: 2 5 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home
Name of care home: Address: The Laurels Nursing Home Francis Way Hetton Le Hole Houghton Le Spring Tyne & Wear DH5 9EQ 01915173763 01915260837 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Tamaris Healthcare (England) Ltd Type of registration: Number of places registered: care home 55 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 55 The registered person may provide the following categories of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 55 Dementia - Code DE, maximum number of places : 3 Date of last inspection Brief description of the care home The Laurels is a privately owned care home, which is located in the village of Hettonle-Hole. It is within walking distance of a range of local facilities including shops, public houses, a health centre, library and a Church, and is also near to a bus stop. The home may provide permanent accommodation with personal care support and nursing for up Care Homes for Older People
Page 4 of 31 Over 65 0 55 3 0 Brief description of the care home to fifty-five older people, some of whom may have a physical disability or sensory impairment. A limited number of physically disabled adults under the age of sixty-five may also be accommodated within this total number. The home?s entrance is level, and a shaft lift provides access between floors. Accommodation is laid out over both the ground and first floors. Each has self-contained lounges, dining areas and adequately equipped bathrooms. All bedrooms have en-suite toilet facilities. The building shares it grounds with another care home owned by the same company. The grounds are well kept, there are accessible paved areas for residents and car parking is available. The weekly fee for this home 381 Pounds. The nursing care element is 101 pounds extra and is set nationally. People who are paying for their own care are charged 420 pounds per week. There are extra charges for hairdressing, toiletries, newspapers and chiropody services. Care Homes for Older People Page 5 of 31 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The inspection was unannounced and started on 24.09.08 and completed on 25.09.08. The first visit was unannounced but the second day visit was known to the staff. Before the visit the inspector looked at Information we have received since the last key inspection visit on 8 August 2006, How the home dealt with any complaints and concerns since the last visit; Any changes Care Homes for Older People
Page 6 of 31 to how the agency is run, The providers view of how well they care for people, as highlighted in the details provided in the Annual Quality Assurance Assessment (AQUAA), The views of the people who use the service. During the visits the inspector: talked to the people who use the service, the manager and care staff; looked at information about the people who use the service and how well their needs are met, looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for, looked around the home to make sure it was safe & secure; checked what improvements had been made since the last visit; the inspector told the manager what he found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: The quality and quantity of the food provided by the home has been commented on by a number of residents and relatives. Residents and relatives complained about the poor quality of meals whereby most of the vegetables provided are processed frozen vegetables. They also said that often the food gets cold by the time they get their meals. Staff should review the practice surrounding the serving of meals. It was noticed that small plates were being used to serve lunch and some residents, in trying to manage their food in such small service area had their foods dropping onto the dining table. The planned menu did not reflect what was being provided. Furthermore, the displayed menus could hardly be read by residents as the writing was small for anyone with failing eyesight to read. Care Homes for Older People Page 8 of 31 Residents care plans should be reviewed to ensure that it provides sufficient information to guide staff in providing care for the individuals. A number of the care plans were vague and did not provide sufficient details. A number of fluid and diet intake charts were not properly completed and gives the impression that those residents concerned are not receiving adequate fluid or diet. In serving meals and providing support for residents who require assistance with eating, the staff wore plastic gloves and wore plastic aprons. This presented as institutional and compromised the dignity of the residents. During the administration of medication to residents, one residents medication was not properly supervised. The tablet was left on her dining table and there was no arrangements to make sure she took her medication. Later on the staff wheeled her away when she had finished her meal and the tablet was left on the table, which she was sharing with others. The observational charts for people who are wholly dependent on staff for all aspects of their care show that they are either not receiving adequate diet and fluid intake, or these are being given but not being recorded as required. Discussion with staff show that these residents often end up being the last group of residents to be attended to when it comes to meal times. Observation on the day of inspection confirmed this when at 10:10 in the morning some of the dependant residents had not received their breakfast yet. Some of the practices in the home compromised the residents dignity. These include the content of some of the notices in peoples rooms, and also staff assisting people with their meals and drinks while wearing plastic gloves. Staff confirmed that the routines in the home did not allow them to spend quality time with residents either talking to them or engaging them in social or recreational activities. Staff said that they don’t have time to sit and talk to the residents as they would have wished. Residents complained that there is nothing to do in the home and that they just sit all day without any activities. The practice of encouraging some residents to remain in their wheelchairs all through the day should be reviewed, unless this is part of their assessment and a professional decision is made about people being safe and comfortable to remain in their wheelchairs for long periods of time. Staff supervisions is not happening at the rate that is recommended to promote their development and wellbeing. The manager should review the domestic arrangements in the home. The current arrangement is that after 14:30 there is no domestic and laundry cover till the following morning at 08:00. After 14:30 the care staff have to take responsibility for laundry and domestic activities. Also the domestic staff talked about lack of sufficient equipment to enable them to work on both floor of the home at the same time. Care Homes for Older People Page 9 of 31 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 10 of 31 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 31 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service user guide provides good information about the service provided in the home, which enable people to make decisions about the service. All the residents have contracts between the company and the individual, providing them with the opportunity to have in writing their obligations under the terms and conditions of residence and also that of the company. The needs of all service users are assessed by the social worker or the nurse assessor and also by the home before they move into the home. These processes ensure that the care needs of the individual can be met by the home. Evidence: There is a service user guide, which provides good information about the home and the services offered. This is readily available in the home and is made available to the
Care Homes for Older People Page 12 of 31 Evidence: residents and the general public. The guide is in two part, a first part which provide information about the company as a national organisation and then a second part which gives information specifically about The Laurels. All the residents are provided with contracts with the company and also a copy of the local council’s service agreement is kept on individual files. The home would insist on full assessments from a social worker or the nurse assessor before admissions are arranged. The home also carries out their own assessment of the individual in their own setting to make sure that they can meet the prospective resident’s needs. Copies of such assessments were available on individual files. The inspector discussed with some of the residents and relatives about the arrangements before admissions were arranged. A number of residents who recently relocated from another home described the arrangements made by the staff to come and see The Laurels before they moved in. Relatives confirmed that they had the opportunity to visit the home when they considered looking for a care home for their loved ones. One service user described the visits she made to the home in the company of her daughter, which she said was very helpful. The manager and staff stated that it is the policy of the home to ask prospective service users and their relatives to visit the home and assess the place for themselves before making up their minds. Care Homes for Older People Page 13 of 31 Health and personal care
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are generally good care plans in place but some aspect of the plans do not contained detailed instructions to staff on how some specific care needs are to be met which could potentially compromise some aspect of the residents welfare. The home has good procedures in place for the safe administration of medicines. However, a piece of practice observed on the day showed that the correct procedures are not always followed, which seriously compromise the health and welfare of the service users. Although in general, the service users are treated with respect and dignity, some practices that were observed undermined this. Evidence: Residents files contain details of residents contacts with healthcare professionals, including GPs, psychiatrist, chiropody service, dentist, optician and other healthcare services. Risk assessments are carried out for the service users if the staff feel there is
Care Homes for Older People Page 14 of 31 Evidence: the need for it. These include pressure areas care, falls risk assessment and aspects of mental health needs. The risk assessments are followed by risk management plans to ensure that all staff are aware of how best to manage a specific risk. The nurses are responsible for the administration of medicines and have had safe handling of medication training. The home has proper arrangements for the storage and administration of medicines in the home. The drugs administration system was examined and there were no discrepancies. However, the practice observed in one case seriously undermines the otherwise good drugs administration system. One resident was given her medication in the dining room but staff did not supervise her to make sure that she had taken her tablet. The tablet remained on the dining table that she shared with two others. She was later taken away in a wheelchair by staff, leaving her medication lying on the table, which could have been taken by anyone who is confused. Staff expressed concerns about the care received by the residents who are totally dependent on staff for all their care needs. One such concern is that these residents tend to be attended to last and consequently often have their breakfast quite late. These concern were confirmed on the day of the inspection where the inspector noted that two very dependent residents had not received their break at 10:10 when the inspector visited them in their rooms. The record of diet and fluid intake is poorly maintained and the evidence on some of the sheets indicate that at the residents nutritional needs are not being met. For example, in one case the resident received 150mls of tea at 21:30 and has had nothing to eat or drink at the time the inspector visited her room at 10:10 (the following day). This means the resident has had no drink for over 12 hours. Another resident had 50mls of juice at 06:00 a.m. and at the time of going into her room at 10:15 she had not received any drink or her breakfast. The two hourly turns charts were also not properly maintained. In two cases that were examined, the last time they were turned was 06:00 a.m. and there was no further record of being turned at 10:15 a.m. These instances support the view by some staff that they feel under pressure and that those residents who require more staff attention do not get it as promptly as they should have. Service users confirmed that the staff treat them with respect and promote their right to privacy. Comments from the service users include, the staff are really nice and friendly, the staff treat us with respect here, they are always there when you need them. Visiting relatives also stated that the staff treat them with respect and dignity. It was noticed that when a staff member was going to assist a resident with drink in her room, the carer closed the door to ensure her privacy. The care provided for one resident who was dying was described by a relative as
Care Homes for Older People Page 15 of 31 Evidence: excellent. The relative was pleased with the care and attention the resident received. The family felt well supported by the staff and they showed good level of professionalism by the care and attention they gave the resident and her relatives. Care Homes for Older People Page 16 of 31 Daily life and social activities
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents social and recreational needs are not fully met due to the absence of an activities coordinator. Furthermore, there is lack of time for staff to engage in meaningful activities with the residents. This has led to boredom and apathy amongst some of the residents. Relatives are encouraged to be involved in the care of their love ones, thus promoting their welfare and self esteem. Recent mealtime experiences and arrangements have been less than satisfactory which compromises the health and welfare of the residents. Evidence: The home has been without an activities coordinator in recent months. Residents commented that there is nothing to do and that staff are too busy to do social activities with them. The manager confirmed that an appointment has been made for an activities coordinator and she is waiting for a start date so that the home can begin to provide planned social and recreational activities for the residents. Staff who were interviewed confirmed that they feel under pressure and therefore have little or no
Care Homes for Older People Page 17 of 31 Evidence: time to sit and talk to the residents. Residents confirmed that they receive regular visits from their friends and relatives and this is supported by the details in the visitors sign-in book. Visitors commented that they are always made welcome in the home and staff are always helpful. The mealtime arrangements in the dining room could have been better organised to create a relaxed atmosphere for the residents to enjoy their meals. The dining room was overcrowded and there was very little room for staff and residents to move around freely. One staff member later described the dining room as potential hazard because there is hardly any room to move especially when they are carrying hot pots of tea around to serve the residents. Some residents and relatives complained that the quality of food provided in the home is not as good as they would have expected. People gave examples of food being cold and not enough food on their plates. On the day of the inspection, the inspector noticed that the food served on the plates at lunchtime were of moderate sizes. A number of residents were noticed to have completely emptied their plates but no second helping was offered for those people. The meals were served on small plates and desert dishes. A number of residents found it difficult to manage their food from such small plates without the food falling off their plates. Staff were noticed to be wearing plastic gloves when serving residents and assisting them with their meals. Mid-morning hot drinks were also served with staff wearing plastic gloves. This looked institutional and compromised the dignity of the residents especially those residents who are totally dependent on the staff and require assistance with their meals and drinks. Residents and relatives complained that the kitchen staff do not follow the planned menu and often they don’t know what is for lunch. However, the manager explained that this was due to not having a permanent cook in the home. She indicated that with the appointment of a new cook she hope this situation would be resolved. The new cook who had just taken up her post also indicated that she would be reviewing the menus to make sure that the residents get what is planned for them. Care Homes for Older People Page 18 of 31 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure is clear, uncomplicated and accessible. This gives people the opportunity to use the procedure if they wish. There are good staff recruitment and training procedure, which safeguard the residents form harm. Evidence: The home has a written complaint procedure, which is easy to follow. Summary of the complaint procedure is included in the Service User Guide and is also displayed in the home for visitors and relatives to see. Some of the service users and relatives indicated that they are aware of the procedure and would know how to complain if they had a need to do so. Staff have had training in safeguarding adults. Discussions with staff indicate that they are aware of the need to protect the residents from harm. The home takes all complaints seriously and the records in the home support this. One relative said that any concerns she had were immediately dealt with and that every concern was taken seriously and acted upon. Care Homes for Older People Page 19 of 31 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers an accommodation and an environment that is generally clean, safe and well-maintained. This promotes the general welfare, dignity and comfort for the service users. Evidence: The home provides good standard of accommodation, which meets the needs of the residents. The residents are encouraged to furnish their rooms with personal items, making it pleasant and familiar environment for them. The bedrooms are large and spacious and allow residents to accommodate their personal belongings. Access into and within the home is good and meets the needs of those residents who have mobility difficulties or have use of walking aids such zimmer frames or wheelchairs. However, the dining room on the ground floor is not large enough to allow free and unrestricted movement by staff and residents during meal times. There is specialist bathing facilities to promote independent use by those who are capable of doing so. All the bedrooms and toilets have suitable lock on the doors to ensure privacy for them. This provides the opportunity for residents to remain independent and to enjoy good levels of privacy. Care Homes for Older People Page 20 of 31 Evidence: There are sufficient numbers of communal areas for service users to choose from. These include a range of lounges and communal spaces that service users can use. Window restrictors have been fixed to all windows and all radiators have suitable coverings, which ensure security and safety for the residents. Checks of hot water at randomly selected bathrooms confirmed that hot water did not exceed 43°c. A record of regular water temperature checks by the handyman is kept. The home has written policies and procedures relating to safe handling of hazardous materials for staff to follow. The manager indicated that staff have had training in health and safety, infection control and food hygiene. The home was noted to be clean and free from offensive odour. The laundry machines have facilities for sluicing and washing foul linen at very high temperature to avoid the spread of infection. Care Homes for Older People Page 21 of 31 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing levels, although seem adequate on paper, this seem inadequate to meet the needs of the residents, which could adversely affect the welfare of the residents. The home adheres to the companys recruitment policies, which are designed to safeguard the residents from bad practices and abuse from people who would otherwise be deemed as unsuitable to work with vulnerable people. Evidence: Examination of past rotas show that the home provides sufficient numbers of staff but this does not seem sufficient enough to meet the needs of the residents, especially those residents who rely on care and nursing staff for all of their needs. Staff expressed concern about feeling under pressure. Staff said they are so busy they hardly have time to sit and talk to the residents. Staff said that sometimes they are not able to see to the residents promptly enough as they would have liked to. This particularly relates to the residents who are totally depend on them for all their care needs. Sometimes dependent residents are late in getting their breakfast as compared with the more able residents. Staff said how promptly they see to the dependent residents depend on which nurse is in charge. The company has provided good training for the staff and records show that refresher
Care Homes for Older People Page 22 of 31 Evidence: training continue to be provided where necessary. Examination of staff records show that all staff have received enhanced CRB and proper recruitment procedures have been followed by the manager. Nurses have had their PIN numbers checked against the Nursing and Midwifery Council (NMC) register to make sure they remain registered with the NMC. The company is also providing good training for care staff on NVQ Level II or above. Of the 17 permanent care staff, 8 have NVQ level II of above and there are plans to extend the training to all care staff. Other training that has been planned for staff include Moving and Handling, Communication Skills, Care Planning, Safeguarding, Infection control, Customer service, safety awareness. Care Homes for Older People Page 23 of 31 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are generally good arrangements in the general management of the home and also on health and safety issues, which safeguard the health, safety and welfare of the service users. There are good arrangements for handling the finances of the service users, thus protecting the service users from being financially disadvantaged. The provision of regular supervision would enhance the professional and personal development of the staff for the benefit of the service users. Evidence: The registered manager has a long experience of working and a care home. She is well experienced and competent to run the home to met its stated purpose, aims and objectives. However, comments from staff would indicate that the registered manager needs to be aware of the concerns of some of the staff and to make suitable
Care Homes for Older People Page 24 of 31 Evidence: arrangements to address these. Some staff felt that when they try to raise concerns they are asked to put their concerns in writing, which they feel is not helpful. Staff said they feel they are not being listened to. Others felt the manager is too busy to listen to them and they can not get hold of her when they want to. All staff have received statutory training in health and safety matters, including Fire Safety, Infection Control and First Aid. Staff supervision is taking place but this is not taking place at the required rate in order to meet the national standards. The company Health and Safety policies remain in place. These cover policy areas such as fire prevention and Care of Substances Hazardous to Health (COSHH). Servicing records confirm that all portable appliances have been tested. A record is maintained of regular water temperature tests in the home. Regular servicing of fire equipment, gas and electrical appliances have been carried out by the contracted companies. All the servicing records that were examined were up to date. These included servicing of hoists, fire safety servicing records, electrical installation and gas servicing. Up to date servicing and maintenance of these services and equipments ensure a safe environment for the service users and the staff who work there. The home is clean and tidy and suitable cleaning procedures are in place to ensure that the home remains free from odour. The home is kept generally clear of hazards to the health and safety of service users, visitors and staff. The home keeps service users personal allowances in a locked safe. Records of all transactions are kept along with receipts. Care Homes for Older People Page 25 of 31 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards
No. Standard Regulation Requirement Timescale for action 1 7 15 The registered manager 11/07/2008 must ensure that resident care plans are specific to the needs of individuals, and be regularly updated to reflect changing needs. Outstanding 20/03/06. Timescale 01/09/06 and 01/04/07 not met. 2 8 12,13,17 The registered person must 11/07/2008 ensure that risk assessments and pressure sore care treatment and outcomes are recorded in individual care plans and kept up to date on a continual basis. 3 12 14,16 The registered persons must 11/07/2008 ensure that resident? interests and life styles are assessed and care plans formulated. Timescale of 01/04/07 not met. 4 19 13(4) The manager must ensure 11/08/2008 that bedroom doors are not wedged open with anything other than an approved door guard. Care Homes for Older People Page 26 of 31 5 19 13,23 The registered persons must 11/07/2008 ensure that the programme of ongoing redecoration and refurbishment continues. Timescale of 01/07/07 not met. 6 21 23 The registered persons must 11/07/2008 ensure that the damage to the walls, floors and tiling in bathrooms and shower rooms is repaired and replaced. Timescale of 01/09/07 not met. 7 26 23 The registered persons must 11/07/2008 ensure that the sluiced is kept clean, tidy, free from odours and make sure hand towels are available at all times. 8 31 9 The manager must progress with the application to become registered with CSCI. 11/07/2008 9 32 10,24 The registered persons must 11/07/2008 continue to ensure that there is a clear sense of direction and leadership, which staff understand and are able to relate to the aims and purpose of the home. 10 38 13,23 The registered persons must 11/07/2008 ensure that all staff receives up to date moving and assisting training with records kept. Care Homes for Older People Page 27 of 31 11 38 13,23 The registered persons must 11/07/2008 ensure that doors are not kept open by artificial means. Care Homes for Older People Page 28 of 31 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 8 15 Service User Plan The care records for residents who rely on staff for all their care needs must state clearly what their needs are, including fluid and diet intake. Staff must record these details to show how the residents needs are being met. 28/11/2008 2 15 16 Facilities and services The registered manager must ensure that the residents receive nutritious and balanced diet, and in sufficient quantities to promote their nutritional health. 28/11/2008 Recommendations
These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 The care plans should be reviewed to provide detailed instructions to staff on how specific care needs are to be
Page 29 of 31 Care Homes for Older People provided. 2 12 The home should identify residents recreational and social needs and make suitable arrangements to meet these needs. Staff should be proactive in assisting the residents who are not able to express wishes, including expressing their views about the service. The registered manager should review the menus to ensure that the residents receive adequate and nutritious diet. The provider should review the staff numbers in the light of the high number of dependent residents. Where possible the provider should limit the number of bank staff being used in the home to ensure that the residents receive a consistent service. All should receive up to date training, including safehandling of medication by the nurses. The manager should ensure that the views and concerns of the staff are listened to addressed. The manager should take appropriate steps to ensure that the views and concerns of the residents are listened to and addressed. The manager should ensure that decisions about the care and the service are done in the best interest of the residents. Residents concerns about the quality of the food and lack of activities should be acted on in a timely manner. Care staff should receive regular supervsion in line with the national minimum requirement. 3 14 4 5 15 27 6 7 8 30 31 32 9 33 10 36 Care Homes for Older People Page 30 of 31 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 31 of 31 - 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!
