Inspection on 25/06/07 for The Northwood Nursing Home

This inspection was carried out on 25th June 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Northwood Nursing Home 26/02/07

The Northwood Nursing Home 18/01/06

The Northwood Nursing Home 22/06/05

The Northwood Nursing Home 21/10/04

The Northwood Nursing Home 17/06/04

The Northwood Nursing Home 24/12/03

Similar services:

Claremont House

Chesham House

Oak Ridge

Argyll House

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

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

CARE HOMES FOR OLDER PEOPLE The Northwood Nursing Home 24 Eastbury Avenue Northwood Middlesex HA6 3LN Lead Inspector Claire Farrier Unannounced Inspection 25th June 2007 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Northwood Nursing Home Address 24 Eastbury Avenue Northwood Middlesex HA6 3LN 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) 01923 826807 01923 841624 M D Homes Care Home 35 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (19), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (19), Old age, not falling within any other category (35), Physical disability (35), Terminally ill (1) The Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. This home may accommodate 35 older people who require respite nursing care. Within the overall capacity this home may accommodate a total of 19 people aged 40 years and over with a Mental Disorder, excluding Learning Disability or Dementia. The manager must complete the Registered Managers Award assessment by 30th April 2006 3rd May 2007 Date of last inspection Brief Description of the Service: The Northwood Nursing Home is owned and operated by MD Homes, which is a private organisation, and is registered to provide personal care and accommodation for 35 older people. 19 beds are registered for adults aged 40 years and over with a physical disability who may also have mental health problems. The Northwood Nursing Home is a detached three storey Victorian house situated in a residential area of Northwood. Service users rooms vary in size and some have en-suite facilities. Six bedrooms are currently registered as double rooms. The floors are linked by two passenger lifts and the home is accessible for wheelchair use. There is a well kept garden with a large patio area that is accessible for people in wheelchairs. The Statement of Purpose and Service Users Guide provide information about the home for referring social workers and prospective clients. The most recent CSCI inspection report is available on request. The current charges are from £735 to £1020 per week. The Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over one day. The focus of the inspection was to assess all the key standards. Some additional standards were also assessed. We talked to as many of the people who live in the home as we were able to. We spoke to several people who were visiting the home, including relatives of the people there. We also talked to some of the staff. When we were in the home we looked at the home’s records, care plans and staff files, and we made a tour of the premises. We talked to the home’s manager and the company’s operations manager about what we had seen during the day. The provider has addressed the immediate requirement that was made at the time of the inspection. What the service does well: What has improved since the last inspection? A new manager has been appointed since the last inspection, and she has made several changes in the procedures and the provision of care. A new care plan has been devised and implemented since the last inspection. All the care plans that we saw were up to date and easy to follow. One person said that she was involved in writing her care plan, and she agrees with what it said about the help and support that she needs. The manager has changed some of the procedures, and in particular for supporting people who wish to smoke. The people who live in the home feel that they are treated with respect, and they are able to make decisions and choices about their daily lives. The chairs in the lounge and conservatory have been arranged in small groups. There is a sociable atmosphere in both rooms, and several people said that they like the new arrangement because they can talk to each other more easily. The Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 6 The CSCI pharmacist inspector visited the home following the last inspection, and made requirements about procedures and storage of medication. On this occasion we found that all medication is recorded and stored properly, and the nursing staff demonstrate good practice in this area that protects the people in the home from any avoidable risks. 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 Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Northwood Nursing Home DS0000019581.V346304.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 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who are considering moving into the home have sufficient information, and a detailed assessment, to be confident that their needs will be met. EVIDENCE: One person has been admitted to the home since the last inspection. Their file included a detailed assessment that was carried out before they came to the home, and a full assessment and history from the mental health trust that referred them. The care plan was written from the information in the assessments and the assessment and care plan provide appropriate information so that the staff can meet the person’s needs. We spoke to the resident, who said that they are happy here. All the staff are very nice, and they understand the person’s needs and concerns better than the staff at their previous placement. The Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 9 Following the last inspection it was reported that the assessments of every resident in the home had been audited, and the only person with a primary diagnosis of dementia was the one noted during that inspection. This person has now been assessed by two other homes, but remains at The Northwood Nursing Home. The home has applied to CSCI to include dementia care in the categories for which it is registered, and if this is agreed this person will be able to remain there. At the time of writing this report, the application was still under consideration. The home is registered to provided care for people with mental health needs, and sufficient evidence was seen during the last inspection to show that the staff can meet those needs. There is no RMN (a nurse with a mental health qualification) employed in the home, but MD Homes employs a RMN who visits the home every week. The Northwood Nursing Home DS0000019581.V346304.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. The care plans provide clear information on the residents’ care needs, which enable the staff to provide a good quality of care. The home has good procedures for administering and recording medication safely. EVIDENCE: We looked in detail at the files of five people who live in the home. The files provide generally satisfactory information on each person’s needs and the measures needed to meet them. A new care plan has been devised and implemented since the last inspection. All the care plans that we saw were up to date and easy to follow. There are good risk assessments that ensure that people can live safely in the home. The care plans for people who need nursing care have good procedures and recording of pressure sores, catheter care and PEG feeds. The care plans are reviewed every month, and they have been signed by the person or by their relative. One person said that she was The Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 11 involved in writing her care plan, and she agrees with what it says about the help and support that she needs. During the last inspection a visiting psychiatrist said that Northwood provides good care for people with a mental illness, and evidence was seen of appropriate referrals to mental health services and the speech and language therapy service. One person with mental health needs who spoke to us during this visit said that the staff understand their needs very well and support them as they wish. Everyone that we spoke to said that the staff treat them well, and two visiting relatives said that they are very happy with the care that the staff provide. We observed a good relationship between the staff and the people who live in the home. The new manager has changed some of the procedures, and in particular for supporting people who wish to smoke. The people who live in the home feel that they are treated with respect, and they are able to make decisions and choices about their daily lives. The CSCI pharmacist visited the home following the last inspection. He found that the registered provider had given staff clear and detailed procedures for the safe and appropriate handling of medication. However stock control systems must be put in place so that medicines are stored in appropriate environmental conditions as stated by the manufacturer so that service users receive medicines of usable quality. There must be protocols in place for the use of medicines on a discretionary basis so that service users are not put at risk of inappropriate use of medicines. • There was no record of some medicines having been given to the service users when they were due, as the entries on the charts had been left blank. This means that it is not possible to tell whether service users got their medicines on these occasions • If medicines were not given to service users the reason why was not being clearly recorded. • A few service users have medication given to them mixed with food and drink. There is a good procedure in place to ensure that all relevant parties consent to this and that the medication can be given in this way. However, such documentation was not completed in full for all relevant service users. • The temperature of the area where medication is stored was above the recommended maximum of 25C. There is no regular monitoring of the temperature. Medicines stored outside the manufacturer’s recommended maximum will deteriorate and put service users at risk of receiving substandard medicines. Daily refrigerator temperature records were kept but no action had been taken when the readings were outside of the required range of 2 to 8 C, despite a requirement to report this being part of the home’s own procedures. One product which needs to be stored in a fridge was kept in the medicines trolley. The failure to store medicines at the proper temperature could result in service users receiving a treatment that is ineffective. The Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 12 On this occasion we found that all medication is recorded and stored properly, and temperatures of the medication room and the fridge are monitored effectively. It was reported that all the nurses have had further training in the procedures for administering medication, and the result is that they demonstrate good practice in this area that protects the people in the home from any avoidable risks. The pharmacist has been unable to give clear information on whether specific medicines should be given covertly, mixed with food or drink. It was reported that he is seeking advice on the home’s behalf from the manufacturer about whether the prescribed medicines can be crushed safely. The Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 13 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. The quality of life is limited for the people who live in the home due to the shortage of time spent on providing each person’s choice of activities. EVIDENCE: The activities co-ordinator has been away from work for two weeks, and there is no formal programme for activities. It was reported that the care staff carry out activities with the people in the home. On the day of the inspection a ball game took place in the afternoon. The atmosphere of the home has improved. The new manager has rearranged the chairs in the lounge and conservatory so that they are in small groups. There was a sociable atmosphere in both rooms during the day, and several people said that they like the new arrangement because they can talk to each other more easily. A second activities co-ordinator has been appointed, and will start work when the main co-ordinator returns to work. The Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 14 Relatives and friends are welcomed into the home when they visit. Two visitors were spoken to during the inspection. They said that they are very happy with everything about the home. They are kept informed about their relative, and consulted about the care provided. Everyone that we spoke to said that they are able to make choices and decisions about their lives in the home, and they are able to take responsibility for their own affairs if they wish to. The new arrangement of furniture in the lounge and conservatory means that people have a choice of where to eat their meals. There are small tables at one end of the lounge and in the conservatory. However most people still have their meals at their chairs in the lounge. It was reported that this is their choice. However it would be preferable to make a separate occasion of meals, and to encourage more people to move to a different environment at meal times. Lunch was a relaxed occasion, and the staff assisted those who needed help sensitively. The meals are served to each person on a tray that is prepared in the kitchen, and the desserts were served at the same time as the main course, which meant that it would be cold when people ate it. Meals are available to meet people’s cultural preferences. The cook prepares curries for one person, which they said are very good. One person buys food for themselves, by choice so that they feel in control of what they are doing. The Northwood Nursing Home DS0000019581.V346304.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 adequate. This judgement has been made using available evidence including a visit to this service. The home has appropriate procedures to make sure that people are protected from abuse, but some staff are not aware of their responsibilities for whistle blowing which may leave people who use the service at risk. EVIDENCE: There is a satisfactory complaints procedure in place. No complaints have been recorded in the home since the last inspection. We saw evidence of complaints in the files of two people. In each one the process of discussing their concerns was recorded on the daily communication sheet. This showed that time was taken to discuss their concerns, and that both people were satisfied with the actions that were taken. Only formal written complaints are recorded as complaints. The people we spoke to said that they know how to make a complaint, and some of them have done so. One person said, “If I have any concerns I will tell the people causing the concern. If not I will let the manager know or I will write to the operations manager.” The home has comprehensive procedures for prevention of abuse, and the new manager is aware of Hertfordshire’s County Council joint agency procedures for reporting and investigating allegations. Training in protection of vulnerable adults is available for all the staff, but some of the staff who were spoken to were not aware of their responsibilities for whistle blowing. The Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21 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 is generally well maintained and provides a safe and comfortable environment for the residents. EVIDENCE: The Northwood Nursing Home is a three storey detached Victorian building, situated in a pleasant residential area of Northwood. There is a well kept garden, and a large patio area outside the conservatory. There is one communal lounge, and a conservatory. The new manager has rearranged the chairs in the lounge and conservatory so that they are in small groups. There was a sociable atmosphere in both rooms during the day, and several people said that they like the new arrangement because they can talk to each other more easily. The Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 17 The building appeared to be clean and well maintained, and appropriate procedures are in place for the control of hygiene. One bathroom had been out of use for over two weeks, which meant that people on the second floor had to go downstairs to the first floor to use the bathroom there. There were two bathrooms and two shower rooms available in the home, but that number is insufficient for 35 people to use. The Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 18 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 adequate. This judgement has been made using available evidence including a visit to this service. Staff numbers in the home are sufficient to ensure that all the residents’ needs are met. However there is a lack of training in essential skills. Good recruitment procedures and staff training make sure that, as far as possible, the residents are supported and protected in the home. EVIDENCE: There is a good level of staffing, with three or four nurses and five or six care assistants during the day, and one nurse and two care assistants at night. The company provides a comprehensive training programme that covers all the statutory training, and the training matrix that was seen showed that most of the staff have attended essential health and safety training and training in prevention of abuse. However several members of staff have not had training in moving and handling, which could put both themselves and the people they assist at risk of injury. Several members of staff said that they have had no training since they started to work in the home. None of the staff have had training in understanding mental health needs. It was reported that a rolling programme will start in July to ensure that all staff complete the mandatory health and safety training, including moving and handling and control of The Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 19 infection. The manager is also organising training on understanding mental health, and she has arranged some talks for the staff on mental health topics. The induction training programme is based on the Skills for Care induction standards. The new manager has experience of assessing and observing people while they complete their induction programme. No new staff have started work at Northwood since the last inspection, so this process has not yet been fully implemented there. All the care staff are encouraged to undertake NVQ qualifications, and there is an expectation that new staff will register for the qualification. The home has robust policies and procedures for recruitment. We looked at two staff files. They both contained all the required information, including good references and a satisfactory CRB (Criminal Record Bureau) disclosure. The Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 20 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, 36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is well managed. The views of the residents and other involved people are actively sought in order to ensure that a good quality of care is provided. EVIDENCE: A new manager has been appointed since the last inspection. She was the manager of another MD Homes home, and she was previously the deputy manager at The Northwood Nursing Home. She is a qualified nurse, and she is currently completing the Registered Managers Award. A number of changes have been implemented since she was appointed, including a new care plan The Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 21 format and changes in the environment. The ethos of the home is more person centred, and people are treated with dignity and respect. The arrangements for management of residents’ money were inspected and appeared to be accurate. Systems for managing the residents’ finances are transparent and backed up with signatures and invoices. Money is stored safely and adequate records are maintained in order to protect service users from financial abuse. The operations manager for MD Homes makes regular monitoring visits to the home. The reports of these visits show that the operations manager talks to the people in the home, and checks some of the records. The company also carries out a regular quarterly audit report of all procedures in the home, and questionnaires are sent to the people in the home and their relatives to ask their views of the services provided by the home. The annual quality assurance report has plans for some improvements to the environment. The staff who were spoken to during the last inspection said that they did not have regular supervision, and one person who had worked in the home for six weeks had had no supervision. The new manager has implemented a system for the RGNs (qualified nurses) to supervise the care staff. The manager supervises the nurses, and she is also addressing the induction competencies for staff who started work recently, and identifying training needs. Due to the short time since this was implemented, evidence was not seen on this occasion of regular supervision for all the staff. The home maintains appropriate records for the health and safety of the residents and staff in the home, and staff follow the home’s policies and procedures. Hot water temperatures are monitored, and the records show that they are maintained at a safe level. However during the inspection the water temperature in one bathroom was tested, and measured 59°C, which is hot enough to cause a risk of scalding. This has not been addressed since the last inspection. An immediate requirement was made, and following the inspection it was reported that the thermostat has been replaced. The Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 22 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 The Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 23 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 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 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 2 3 X 2 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 2 The Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES 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 OP12 Regulation 16(2)(n) Requirement All people who use the service must have a choice of varied and appropriate activities throughout the day that meets their needs and expectations. Previous timescale of 31/07/07 not met. Some improvement was seen, and a new timescale has been set. Measures must be put in place to ensure that meals are served in an appropriate manner, with each course served separately. This will ensure that food is served at the correct temperature, and maintains its flavour and nutrition. All staff in the home must have adequate and appropriate training in the recognition and prevention of abuse, including their responsibilities for whistle blowing to ensure that service users are kept safe. Sufficient numbers of baths and showers must be made available to meet the needs of the residents. Timescale for action 30/09/07 2. OP15 16(2)(i) 31/07/07 3. OP18 13(6) 30/09/07 4. OP21 23(2)(j) 31/07/07 The Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 25 5. OP30 13(5) 6. OP36 18(2) 7. OP38 13(4) All staff must have a certificated 30/09/07 training in moving and handling that includes the use of wheelchairs, hoists and other equipment. This will ensure the safety of the people who live in the home. Timescale of 31/07/07 not yet expired. Some improvement was seen, and a new timescale has been set. The manager must ensure that 30/09/07 all staff have regular one to one supervision, to ensure that they provide a good standard of care for the residents. This applies especially to new workers. Timescale of 31/07/07 not yet expired. Some improvement was seen, and a new timescale has been set. Measures must be put in place to 25/06/07 ensure that water temperatures are measured accurately. The hot water temperatures for all outlets to which residents have access must be regulated to close to 43°C, in order to ensure that residents are not at risk of scalding. An immediate requirement was made at the time of the inspection. The provider reports that this has now been met. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Northwood Nursing Home DS0000019581.V346304.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Northwood Nursing Home DS0000019581.V346304.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!