Inspection on 02/10/08 for The Orchard Nursing Home

This inspection was carried out on 2nd October 2008.

CSCI found this care home to be providing an Poor service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Orchard Nursing Home 31/03/09

The Orchard Nursing Home 27/11/08

The Orchard Nursing Home 18/04/08

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Orchard Nursing Home 189 Fairlee Road Newport Isle of Wight PO30 2EP     The quality rating for this care home is:   zero star poor 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: Anita Tengnah     Date: 0 2 1 0 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 30 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 30 Information about the care home Name of care home: Address: The Orchard Nursing Home 189 Fairlee Road Newport Isle of Wight PO30 2EP 01983520022 01983528788 sue.burton@barchester.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Barchester Healthcare Homes Ltd Type of registration: Number of places registered: care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 40. The registered person may provide the following category/ies of service only: Care home only (PC) 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 (OP) Date of last inspection Brief description of the care home The Orchard Nursing Home is a care home registered with the Commission for Social Care Inspection (CSCI) to provide nursing and personal care for 40 service users in the older person category. The home is situated in a residential area within easy access to local facilities. Accommodation is provided over two floors with a shaft lift that allows access to all parts of the building. All the bedrooms are single and have en suite facilities. There is a well -maintained garden to the side of the home and ample parking at the front of the building. Barchester Healthcare owns the service. There is Care Homes for Older People Page 4 of 30 Over 65 40 0 Brief description of the care home no registered manager for the service at the time of this visit. The current fee charged is £608-£850 Care Homes for Older People Page 5 of 30 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: zero star poor 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: We undertook an unannounced visit to the service on the 2nd October 2008 as part of our process of monitoring the service. The inspection was completed over one day and a senior representative from the company assisted the inspector during the visit. We sent out the Annual Quality Assurance Assessment (AQAA) to the service which is one of the means of collecting data about the service. We spoke to six of the service users, staff and other health care professionals as part of this visit. We also sampled care plans care and staff records as part of the visit and observed practices. Care Homes for Older People Page 6 of 30 What the care home does well: What has improved since the last inspection? What they could do better: 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 7 of 30 Care Homes for Older People Page 8 of 30 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 9 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a range of information including a pre admission assessment to assist prospective service users in making an informed choice about the suitability of the service. Evidence: We looked at the pre admission assessment process. The home has in place documentation and this included a revised pre admission record and other information such as a statement of purpose and the sevice users guide. The person in charge reported that these are available to all prospective service users. The process would involve a full assessment of needs prior to people being offered care to ensure that the service can meet their assessed needs. This was not available at the last key inspection and improvement has been made. Care Homes for Older People Page 10 of 30 Evidence: We were not able to assess the pre admission process, as the person in charge confirmed that that there has been no new admission to the service since the last key visit. Hence the quality rating remains adequate as we have been unable to test this section at this visit. The registered person has voluntarily agreed with the commission not to admit any new service users while the safeguarding investigation is in process. The service does not provide intermediate care. Care Homes for Older People Page 11 of 30 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care plans and risk assessments have been put in place, however further development would ensure that all the information and records of care and fluids given are maintained accurately to inform practice. The medication management remains poor and does not protect people using the sevice. The privacy and dignity of the service users are promoted when receiving personal care. Evidence: We looked at the care records and assessments for three service users as part of this visit. We noted that care plans had been developed and there was some improvements in the way that care planning was completed. During a random visit in June 08 we found that a nutritional assessment had been Care Homes for Older People Page 12 of 30 Evidence: completed for one resident requiring Percutaneaous Endoscopic Gastrostomy (PEG) feed and swallowing assessment was available. Care plan for people requiring thickening agent did not contain adequate information to inform practice and needed to be developed. We noted that records of food/ fluid balance remain poor, as these were not recorded as required. Staff spoken with were unsure regarding the fluid balance recording for two of the residents who were on fluid/ food charts. Another staff said that she thought that only the output was being recorded for one of them. Record showed that some staff had recorded some fluid intakes on the chart, however the charts were incomplete. The care plans must contain clear guidance regarding the care including nutritional needs of people to inform practice and ensuring that care needs are consistently met. This must include food/ fluid records as required following assessments. Risk assessments for falls and moving and handling assessments had been developed and were available in the three records that we looked at. The falls assessments were completed and these included bed rails assessments and checks to ensure that they minimise the risks to people using these. We found that the service has put in place evidence of consultation regarding bed rails such as consents were gained from the service users or their relatives. During this visit we found that the moving and handling assessments were more detailed and dietary needs assessments contained good details of the assessed needs and actions needed by staff in order to meet those needs. This was in particular for the care of a service user receiving PEG feeds. Care plans included personal care, dietary needs, likes and dislikes and continence management. Although there was some evidence of reviews, these did not always included evidence that the service users/ relatives were taking part in the reviews of the plans of care. The care plans as discussed contained information in different places and some was not available such as the swallowing assessment by an external healthcare professional. There is a risk of this information being lost to those providing care. We noted that one of the service users care plan showed they were on a pureed diet following the last speech therapist assessment last year. We found that they had been provided with a soft diet and had food like doughnuts in their room. Care record showed that this person had choked on their meal recently and had been referred for Care Homes for Older People Page 13 of 30 Evidence: further swallowing assessment and must be observed at meal times. Staff reported that this person was able to manage soft diet, however this was not reflected in their assessment and care plan. Following the choking incident further reviews of this persons dietary needs had not been developed and action plan put in place in order to inform practice and safeguard them. We found that the records of food and fluids did not accurately reflect what was being administered. This was in particular in relation to the service user having a mixture of diets orally and via a Percutaneous Endocopic Gatrostomy (PEG) feed. Other fluids and food records did not record the volume of fluid taken. We looked at the medication management that the home undertook on behalf of the service users. The home maintained a record of medication administered on the Medication Administration Record (MAR ) sheets. The nurse in charge reported that the home was using the monitored dosage system that ran on a twenty eight days cycle. There was a procedure that had been recently developed regarding crushed medication that were administered via the PEG feeds. This was done in consultation with the GP and is good practice to ensure that these are provided in liquid form as required. The nurse in charge stated that all excess medication held as stock has now been discarded as required. A random visit was undertaken on 26th June 08 where we looked at the Medication Administration Record (MAR) sheets as maintained at the service. Staff had maintained records of medication administered to the residents. There have been improvements in the recording of medication and the MAR sheets seen had been reviewed following the last visit. Staff reported that all excess medication had been returned. The home still has a number of dressing as old stock that had not been prescribed for the service users. The acting manager stated that wound dressing would be reviewed to ensure that they relate to the prescription and the named residents as required. The management of prescribed creams/ ointments must be looked into to ensure that they are accurate records on the residents MAR sheets as required. We found an ointment had been allocated to a service user. The nurse in charge stated that this was one they had at the home, however we found that this ointment had expired and had to be discarded. During this visit the excess stock medication has been addressed, however the dressing stock remains outstanding and action is needed. The home was monitoring the drug fridge temperature, however a record of the Care Homes for Older People Page 14 of 30 Evidence: minimum and maximum temperature was not recorded. The nurse in charge confirmed that this will be addressed. The controlled medication was maintained safely and the registered nurses were responsible for all medication management at the service. We have recently received two reports of drug errors, one of these related to a missed controlled medication and the other to a medication that was administered twice within an hour. An action plan was being developed in the way that variable time/ dosages are recorded on the MAR sheets. The stated that an investigation would be carried out for the other medication error, which remained outstanding at the time of the visit. Partial compliance has been achieved. However it is not currently fully implemented and sustained in practice. Prior to this visit we had information that at a recent review by external agencies that highlighted that not all medication given were accurately recorded on the MAR sheets. From the records that we looked at, this showed that the staff were maintaining records of all medicines administered to the service users. The home has put in place a system whereby the staff are checking the MAR sheets at end of each shift to ensure that any medicine missed/ not signed for is addressed promptly. We have received serious concerns regarding medication management that has been referred as safeguarding relating to one of the service users. This has highlighted some problems about the way that medication is ordered and administered that put the service users at risk of harm. We noted that there was still incidence where medication was recorded more that once on MAR sheets. The nurse in charge was aware of this and action is required to address this. The outcome of the safeguarding investigation relating to the recent medication concern has not as yet been determined. Although partial compliance has been achieved and this is not currently fully implemented and sustained in practice including the other concerns regarding medication management at the service.. The service users we spoke to said that the staff treated them with respect and that they were well cared for. Comments included that the staff were very nice and helpful. We observed that staff attended to people in a courteous way and on two occasions we noted that staff knocked prior to entering the service users bedrooms. All the bedrooms are of single occupancy and call bells were available and accessible to the sevice users in their bedrooms. It was evident from the interaction observed that the Care Homes for Older People Page 15 of 30 Evidence: staff had developed good relationships with the service users. Care Homes for Older People Page 16 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The activity programme at the home has been developed and was satisfactory. The service users are supported to maintain links with their friends and family. The meal at the home was managed to the satisfaction of the service users Evidence: The home has recently recruited an activity coordinator who has been employed on a full time basis and will be available on weekdays. An activity programme was being developed, some of the activities are already in place. We noted the service users were involved in growing some tomatoes plants. Other recent events/ activities included a Victorian cream tea party. There is also a mobile visiting library where the service users are supported to choose books and DVDs of their choice. Forthcoming events planned for November 08 included a Halloween party, a pink ladies day and shoe box appeal. The home has a monthly newsletter where this information is shared with the service users, their friends and families. Care Homes for Older People Page 17 of 30 Evidence: The home has an open visiting policy and evidence from the visitors book indicated that people visited at different times of the day. The service users we spoke with also confirmed that they can receive their visitors at any time that is convenient for them. The home has a planned menu and the service users are supported to choose from the menu. This looked varied and offered them choices. Two of the service users said that they could have something different if they did not like what was on the menu. We observed the lunchtime meal on the day of the visit that looked well presented, appetizing and balanced. The four service users we spoke to all said that the food was very good and plentiful. As discussed with the person in charge the process of how the meals are recorded including fluids must be addressed to ensure that the service users receive adequate amounts of food and fluids and accurate records are maintained. We noted that the staff were available to offer support with meals as needed in a sensitive manner. Hot and cold drinks were available throughout the day. Staff must ensure that when hot drinks are served there are support available to people as required so that they could have these drinks as this was not always the case on the day of the visit. Care Homes for Older People Page 18 of 30 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a satisfactory process in place for raising and investigating any concerns raised at the service. There is an ongoing safeguarding investigation at the home. The management of some medication does not fully protect people at the service. Evidence: We undertook a random visit in June 08 and we found that a complaint log had been developed and a tracking sheet put in place to record all actions taken following receipt of complaints/ concerns as required. An anonymous complaint was recently received and had been referred to social services as safeguarding and had been investigated. During the course of this investigation, concerns were raised that the home needed to address. The home had taken appropriate action and the acting manager reported that they had been involved with social services in the investigation. Both of these investigations are ongoing and the outcome of these investigations had not been determined at the time of this report. The acting manager reported that training in safeguarding has not as yet been completed for all staff. Staff stated that they would be confident to report to the Care Homes for Older People Page 19 of 30 Evidence: management any allegation of abuse. During this visit we noted that there continues to be a satisfactory process in place and records of concerns and complaints are recorded. There have been four concerns raised since the last key inspection and record seen at the service showed that these have been investigated and resolved. We found that the acting manager continues to raise any concerns that need to be reported. There has been one incident of alleged theft that was referred appropriately to the Police as required. The home has an ongoing safeguarding investigation regarding allegation of abuse involving two staff members that has been referred and investigated by a multidisciplinary team including the Police and the outcome of this investigation has not yet been determined. The process of referring staff when appropriate to the Protection Of Vulnerable Adult (POVA) team for consideration of inclusion on the POVA list must be looked into. This would ensure that people who are considered as risk are not able to work with vulnerable people while an investigation has not been completed. This remains outstanding at the time of writing this report. We have also received information where the safety of a service user had been affected through inappropriate medication management of one of their medicine over a number of weeks. This has been referred to Social services as safeguarding and the outcome has not as yet been determined. The person in charge has confirmed that a training programme in safeguarding adults has been put in place and staff have completed this training. There must be a system in place and staff must ensure that they follow the procedures for making referral as safeguarding and not undertake the investigation. The home did not have the updated safeguarding policy and procedure that the person in charge said she would be accessing. Care Homes for Older People Page 20 of 30 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 service users are provided with a homely and well maintained environment that is appropriate to their needs. There is good infection control procedures in place to ensure that the service users are protected. Evidence: Random inspection in June 08 showed that the sharp boxes were maintained safely, the electrical cupboard was locked and access to the sluice area restricted. This was a requirement from the last key inspection that has been fully complied with. We found that the home was clean and maintained to a high standard. Furnishing was of good quality and appropriate to the needs of people using the service. The home was warm and homely and three people we spoke with said that they were very happy with the accommodation and their bedrooms. We noticed that the bedrooms were personalised and one of the service users stated that their daughter had brought in bits and pieces from home and they had everything they needed. Care Homes for Older People Page 21 of 30 Evidence: There were a range of equipment including hoists and assisted baths in place that were appropriate to the service users needs and to support them to maintain their independence. Observation of staff practices on the day of the visit showed that they were aware of infection control procedures and equipment such as gloves and aprons were available. The sluice door had been fitted with a key pad lock that allowed restricted access to an area where some chemicals are kept. The staff discussed that the service had disposable slings in place that are allocated to individual service users as part of infection control and prevention of cross infection. Care Homes for Older People Page 22 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is adequate staff to meet the present needs of people accommodated. The recruitment process is good and all necessary checks are completed prior to employment. The training programme is satisfactory. However the induction programme need further development. Evidence: Random visit in June 08 showed that the registered person has been looking at the staffing at the home and a recruitment process has commenced. There is also a senior nurse who has the clinical lead for the service. The staff spoken with reported that “things were more settled “and the service would benefit from a period of stable staff team as there had been a lot of changes. During this visit the person in charge that they had employed two nurses and an activity coordinator. The home has a duty roster for the trained nurses and carers and a separate one for the ancillary workers. This meant that nursing and care hours did not get eroded by other duties. Care Homes for Older People Page 23 of 30 Evidence: The staff and the service users that we spoke to all said that there was adequate staff to meet their needs. People said that usually they did not have to wait long when they rang their bells for assistance. Comments from the service users included that the staff were very good and they come when you need them. We looked at a sample of the recently recruited staff record at the service. This indicated that all staff completed an application form and references were sought as part of the recruitment process. Checks such as CRB and POVA first were also completed as part of the recruitment process as required. The home has an ongoing training programme in place and training is shared between the sister home on the island. The training matrix that the home maintained showed that training programme included mandatory moving and handling, safeguarding and fire safety. The person in charge stated that staff have an induction programme in place, however there were no records available to evidence this at the time of the visit. The person in charge was aware that staff must complete an induction to meet the skills for care guidelines within the timescale. Care Homes for Older People Page 24 of 30 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is an interim management arrangement as the service has been without a manager for a long period. The continuing safeguarding concerns reflect the failure to have in place a registered and accountable manager for the service. The health and safety measures regarding for the maintenance and equipment is good. The staff practices in particular to medication and safeguarding do not fully protect the service users . Evidence: The random report following a visit in June 08 indicated that the provider was actively seeking to recruit a manager for the service and this was ongoing at the time of this visit. The provider was aware that the manager, once recruited will be required to register with the commission. There is an interim management structure that included an acting/ general manager who has recently been employed although she reported Care Homes for Older People Page 25 of 30 Evidence: that she does not intend taking the post. There is also a senior nurse who has the clinical lead for the service. We found that the home remains without a manager. The person in charge has kept us informed of all incidents as required. We have received regular Regulations notices of all incidents that have affected the welfare of people using the service. Our concerns remain that there has been no manager employed at the service for the last six months. The clinical lead who had been employed as an interim measure while the provider was recruiting a manager we have been told has now left the service. There is again new staff responsible for the clinical management of the service users care. The concerns regarding the poor management of medication as previously mentioned continue to not protect people using the service. The person in charge confirmed that the home does not manage any of the service users personal allowances. Invoices are raised and these are sent to the service users or their relatives and records of these are maintained. There is an internal audit system in place. A representative from the company undertakes monthly visits of the service and records of these are maintained. The person in charge stated that the company carried out a yearly surveys of the service users and this was planned in the coming months. There are satisfactory systems in place for the regular servicing of equipment including fire and emergency lights, boiler, hoists and the passenger lift. This ensures that the service users are protected. There had been recent concerns regarding security at the service in particular out of hours. This was highlighted by Social Services following report of theft. The service had failed to identify this risk at the time. However the service has since put in place new security system for the main front door. Care Homes for Older People Page 26 of 30 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(2)(b) (c) The registered person must 30/05/2008 ensure that a detailed care plan is in place for each service user to reflect how their care needs will be met. These care plans must be reviewed to ensure that any changes in needs are identified and action put in place to meet them. The registered person must 30/05/2008 ensure that staff follow procedures for the safe handling, safe administration and disposal of medicines received into the care home. Prescribed medication must only be administered to the named person. 2 9 13(2) 3 30 12(!)18(1) (a) (c) The registered person must ensue that all new staff complete an induction programme that meets with Skills for Care guidance and records are maintained. 30/05/2008 4 31 8 (1) (b) The registered person must 30/06/2008 appoint a suitably competent person to manage the service. Care Homes for Older People Page 27 of 30 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 3 14 The registered person must ensure that a pre admission assessment is completed prior to people moving into the sevice to ensure that their needs can be met. So that people can be assured that the home has the appropriate resources in place to meet their identified needs. 30/11/2008 2 7 12 The registered person must ensure that detailed record of food and fluids are maintained for the service users So that you can ensure that their nutritional needs are met. 14/11/2008 3 9 13 The registered person must ensure that arrangements are in place for the safe handling, recording, safe administration and disposal of medicines at the service. 14/11/2008 Care Homes for Older People Page 28 of 30 So that the service users can receive their prescribed medication as prescribed and are not put at risk of harm and abuse. 4 18 13 The registered person must ensure that clear guidance for staff about reporting, recording all allegation of abuse to the appropriate authority. So that you can ensure that staff follow the procedures and people using the sevice are safeguarded from harm. 5 30 18 The registered person must ensure that all newly appointed staff have an induction programme to meet with skills for care guidance So that you can ensure that staff have the skills to deliver care safely. 6 31 8 The registered person must ensure that a manager is recruited for the service So that there is someone who will be accountable and responsible for the day-today management of the service 30/11/2008 15/11/2008 14/11/2008 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 Care Homes for Older People Page 29 of 30 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. 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