Inspection on 31/08/07 for The Tiled House and Cottage Annexe

This inspection was carried out on 31st August 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

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Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOMES FOR OLDER PEOPLE The Tiled House Nursing Home And Cottage Annexe Southdown Road Shawford Winchester Hampshire SO21 2BY Lead Inspector Pat Griffiths Unannounced Inspection 23rd August 2007 10:00 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 Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.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 Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Tiled House Nursing Home And Cottage Annexe Southdown Road Shawford Winchester Hampshire SO21 2BY 01962 713152 01962 713152 tiledhouse@saffronland.co.uk Address 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) Saffronland Homes Faith Munyoro Care Home 29 Category(ies) of Dementia (24), Dementia - over 65 years of age registration, with number (24), Learning disability (5) of places The Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. LD service users under 65 years to be only in The Cottage Only those service users identified to the Commission on the date of 28 February 2005 under the MD category to be accommodated. 19th July 2006 Date of last inspection Brief Description of the Service: The Tiled House, which is one of a group of homes owned by Saffronland Homes, is a large manor house on the outskirts of Winchester. The home is set in its own grounds with several separate and secure garden areas. There is a large parking area at the front of the home. The Tiled House is registered to provide both personal and nursing care for up to twenty-four older persons with dementia and up to five younger adults with learning disabilities in the Cottage Annexe. The home provides single and shared accommodation, some with en-suites; the Cottage Annexe provides single accommodation. On the day of the inspection the fees at the home ranged from £529 to £680 per week in the main house and from £2,183 to £3,187 in the Cottage Annexe. The residents pay for other services such as hairdressing and chiropody and items of a personal or luxury nature separately. The Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection visit was unannounced and took place on 23rd August 2007. The manager was away on the day of the visit but the general manager and the quality assurance manager and the nurse on duty were able to support the inspector during the course of the day, providing information about the home and access to a variety of documentation. All key standards were examined, policies and procedures, documents, staff and residents’ files and other records were examined. Other information included in this report is obtained from sources such as the Annual Quality Assurance Assessment [AQAA] which was completed by the manager, completed survey forms and information that the commission has received such as notices about incidents or accidents that have occurred in the home. Staff working practices were also observed where possible, without being intrusive. During the course of the day the inspector looked at different areas of the home, such as bedrooms, communal and shared areas and the home’s kitchen and laundry as well as the garden. Residents, visitors and staff were spoken to in order to obtain their views of the service that the home provides. Visitors that spoke to the inspector were very positive about the care their friends or relatives received. What the service does well: What has improved since the last inspection? The Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.R01.S.doc Version 5.2 Page 6 The care plans have been developed in the cottage annex and enable staff to provide a consistent level of care. Am education manager has been employed and staff training needs are being addressed. A policy is now available for the administration of ‘when required’ medication, which protects the people living in the home. There is now a dedicated staff team working in the Cottage Annexe. 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 Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.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 Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.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): Standard 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. People wishing to use this service benefit from a comprehensive pre-admission assessment of their needs before moving into the home. The home does not provide intermediate care. EVIDENCE: All potential residents are provided with information about the home, which is very clear about the type of care provided. The care plans and pre-admission assessments for three new residents were seen, which confirmed that potential residents are usually assessed by the manager prior to a place in the home being offered. If people are moving from a distant hospital or care home the assessments are usually completed by care managers or hospital staff and the information faxed to the home. The general manager said that further The Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.R01.S.doc Version 5.2 Page 9 information would also be discussed over the telephone, to ensure that the home could meet their needs. The inspector looked at three care files and all had completed needs assessments completed prior to admission to the home. It was not possible to speak some service users to confirm this due to their dementia, however other residents spoken to confirmed that the home had carried out assessments when someone came to see them. The assessments were detailed and there was evidence that potential residents and their relatives are encouraged to be involved in the assessment process to ensure that all information is gained. Care management assessments are also sought and both of these pre-admission assessments form part of the care planning for each resident. The general manager said that few potential residents are able to visit the home before admission, but usually a friend or relative will visit on their behalf. The Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.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): Standards 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. Care planning ensures residents have all their needs met. Medication administration practices protect the residents EVIDENCE: As part of the inspection process the care plans of three residents were looked at to assess the information provided about how the staff planned to meet the individual needs of the people living there. An action point was made at the last inspection, which required an improvement in record keeping in the care plans, this has been met. Everyone living in the home had care plans in place, which were seen to contain information about personal hygiene, mobility, nutrition, continence, mental health and well being, equipment needed, communication, risk of falls and moving and handling assessments, ensuring a more person-centred care plan. A separate page was used by the visiting GP to record any observations or changes in treatment. There is also a clear record of any hospital outpatient appointments, so that they do not get The Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.R01.S.doc Version 5.2 Page 11 forgotten. Daily records are written by the care staff and the nurses, activities are recorded separately. A ‘care statement’ is kept at the front of each file as a handy reference or quick guide on the care needs of each resident and copies were also seen stuck on the wall in each bedroom. This was discussed with the general manager and the quality assurance manager and it was decided that these notes would be kept inside each persons wardrobe to preserve the privacy and dignity of the residents and ensure that the information was still available for staff. Information in the AQAA indicates that the staff are encouraging more families to be involved with care planning for their relatives. The files of the people living in the cottage are similar to those living in the main house but also contain daily activity plans and records, such as painting, going for a walk, cooking and shopping. ‘Body charts’ are also kept, which keep a record of any cuts or bruises. All files were seen to be up to date, with regular reviews being completed and amendments made as necessary. The home has medication policies and procedures in place for the receipt, storage, return and administration of medication, which are followed by the staff. The medication in the home is ordered by the manager every month and delivered to the home by the pharmacy. The home has stopped used prepacked monitored dose system boxes for medication administration as they found that too many errors were being made when they were dispensed at the pharmacy. All medication now comes to the home in the original boxes or packets with the resident’s details and dosage labels attached. The home has homely medicines guidelines signed by the GP, which allows staff to give certain over the counter medications that have not been prescribed, such as paracetamol for a headache. At the last visit some discrepancies in the recording of ‘when required’ medication were noted, this has been addressed, a new policy is in place and the medication administration record sheets [MAR sheets] are now used correctly. People living in the home and their visitors said that they were happy with the care provided at the home and that the staff were very helpful and friendly. They felt they were always treated with dignity and respect and their right to privacy is upheld. Observations made during the day by the inspector confirmed that the residents and staff have developed good relationships together and staff were seen to treat the residents with dignity and respect, speaking to them quietly and knocking on doors and waiting for a response before entering. The Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have good quality food and their diverse needs are generally well supported. EVIDENCE: The home has a register of activities in the home, which includes bus trips, family days, a summer fête, ball games, board games, music and visiting entertainers. Photographs were seen on the main notice board of different activities, which were being enjoyed by some of the residents. The staff are aware that the residents attention or interest spans are often quite short, so they try to react spontaneously with games or activities to maintain their interest. Some of the residents spoke to the inspector, saying that they were happy living in the home, the staff were nice and they were well looked after. The people who live in the home are encouraged to maintain contact with their friends and families and care plans emphasised the need for staff to support residents in this. Residents living in the cottage annexe also go home for visits. The visitors’ policy was clear about the rights of residents to receive The Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.R01.S.doc Version 5.2 Page 13 visitors and to meet with them in private. Visitors that spoke to the inspector said that they were always made welcome by the staff and felt able to visit at any time. Visitors were seen coming and going throughout the day, and a couple who were visiting a friend on the day of the visit commented ‘The staff are kindly and seem to really care’ ‘when our friend was ill the staff were really concerned too, it seemed to matter to them – it was a really pleasant surprise to find they cared as much as they did about him’ The home operates a four- week rolling menu, which is written by the senior chef and is based on the likes and dislikes of the residents. Lunch on the day of the visit was meatballs, potatoes and vegetables which smelled appetizing, was attractively presented and the residents said it was enjoyable to eat. Residents are helped to make meals choices by being shown meals on plates, they are usually able to indicate when they want something different and the alternative choices include baked potatoes, salads, sandwiches and omelettes. Staff support was available throughout the mealtime for people who needed it and this support was provided in a discreet, respectful and sensitive manner. Residents who needed softer food were provided with a pureed lunch, which had been attractively presented as the meat and the vegetables had been pureed separately, not mashed together. Fresh sponge cake was made in the home for afternoon tea, which was sampled by the inspector who agreed with the residents that it was ‘very nice’. The menu is not usually displayed in the home because one of the residents likes to ‘tidy up’ and anything left out disappears. It was discussed that some visitors or relatives might like to know what meals are being served in the home and could also comment on the likes and dislikes of their relative. The managers said that they would try displaying it on one of the windows in the dining room. The food for the residents in the cottage annex is provided from the main house and a record is kept to indicate how much of each meal they eat. Two of the people living in the cottage spoke to the inspector about the meals and one said they were ‘okay’ and that there seemed to be enough, they would ask for more food if they were hungry. The Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.R01.S.doc Version 5.2 Page 14 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): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff training in adult protection, and the knowledge that all complaints are dealt with appropriately safeguard the people who use this service. EVIDENCE: The home has policies and procedures for complaints and they aim to deal with any immediately. The manager said that there had been no complaints since the last inspection. The home’s complaints procedure has been given to the relatives and friends of the people living in the home, and encourages residents or their friends and relatives to raise concerns or make a complaint if they are not happy about the service they have received. The home has adult protection procedures in place, which includes a whistle blowing policy and a copy of the local authority adult protection procedure. Training records demonstrated that all staff received training on adult protection and abuse issues as part of their induction as well as further, ongoing training throughout their employment. The education manager said that training had also been provided on the new mental capacity act. Staff that spoke to the inspector were clear about their role within the procedures and about the nature of abuse and how to recognise it. The Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.R01.S.doc Version 5.2 Page 15 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): Standards 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service live in a safe, well maintained, clean, and hygienic home EVIDENCE: The home has a warm and friendly atmosphere and was seen to be clean and tidy, but grubby and tatty and in need of refurbishment and decoration. The inspector saw different parts of the home, which included the communal areas, the kitchen, the laundry and some of the bedrooms. The bedrooms in the home provide single and shared accommodation, some with en-suite facilities. Bedrooms seen by the inspector had been personalised with pictures and ornaments and the manager said that potential residents are encouraged to bring their treasured possessions with them when they moved in to the home. The accommodation is over two floors and there are two stair lifts and a The Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.R01.S.doc Version 5.2 Page 16 passenger lift to enable staff and residents to move easily between the two floors. There are two lounges and dining areas which are on the ground floor, the larger room opens out on to a patio area of the garden. The cottage annex has one large communal lounge - dining room, which has large windows at the garden end. It was found at the last inspection to be very hot despite a large ceiling fan being in operation. The manager said that there are now two air coolers that are used in the sitting room in the warmer weather. There has been some redecoration in the cottage annexe, as well as new furniture and curtains and television and DVD player. The kitchen was clean and busy at the time of the visit, with an agency cook on duty. She said that she regularly works in the home and knows the likes and dislikes of the residents and the menu is planned accordingly. The home has a very small laundry, which does the laundry for the main house and cottage annex and is equipped with washing machines and tumble driers. There are laundry staff who also iron the residents clothing. The home has various areas of garden around the house and some have been made secure for the people living in the home. The general manager said that the garden was part of the homes refurbishment programme and was going to be improved with decking at the rear to provide a safe level area for residents, a small garden was going to be created between the main house and annexe and the current annexe garden was going to be paved and a water feature installed. The project manager and the general manager were in the home on the day of the visit to arrange the health and safety issues that would arise when the scaffolding was erected on the outside of the home. It was planned that this would start a few days after the inspection and the first part of the refurbishment would include having a new roof fitted, re-tiling to the front, back and sides of the house and replacement windows, guttering and soffit boards. A new porch will be added to the front of the house and the car park will re-surfaced once the building works have been completed in early 2008. Internally the corridors in the house and cottage will be redecorated and new carpets laid. Once the communal areas have been refurbished the bedrooms will be decorated and refurnished. Whilst looking at different parts of the home it was noticed that the floor in one of the bathrooms was in a very poor condition as was the floor in some of the en-suite bathrooms. When this was pointed out to the general manager she immediately arranged for the flooring to be replaced. It was also noted that the alarm on an air mattress was faulty and staff said it had been for some time and the general manager arranged for a replacement mattress to be delivered. The care staff in the home are supported by cleaners, laundry and kitchen staff. The Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.R01.S.doc Version 5.2 Page 17 Protective clothing such as aprons and plastic gloves were available and staff were seen to be using them appropriately. The Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.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): Standards 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Robust recruitment practices and staff training protect people who use this service. EVIDENCE: On the day of the visit there were 26 people living in the home, five in the cottage annexe and twenty-one in the house. Information in the AQAA indicates that there are nineteen full-time and nine part-time nursing and care staff who are supported by six ancillary staff. The roster was seen which showed that in the main house there is one registered nurse and four care staff on duty each morning, supported by three ancillary staff. In the afternoon and evening there are four care staff and one registered nurse, with three care staff and one registered nurse on duty at night. The cottage annexe has a separate staffing roster, which showed four care staff on the early shift and three on the late shift. The numbers of staff on duty overall appears to be sufficient to meet the needs of the people living in the home, and the cottage annex now has a dedicated team of staff which provides continuity of care. Comments from relatives indicated that the staffing levels in the home were sufficient and they had confidence in the abilities and competence of the staff. The Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.R01.S.doc Version 5.2 Page 19 The home has a robust recruitment policy and all appropriate checks, such as obtaining satisfactory references and Criminal Records Bureau disclosures, are completed before staff start work in the home. The registered nurses also have their qualifications checked with the Nurses and Midwives Council. Four staff files were checked and the appropriate documentation had been completed in all files, which are kept securely in a locked cabinet in the manager’s office. Agency staff are used to fill gaps in the staffing numbers and the manager ensures that the same staff are booked to provided continuity for the residents. The agency staff are also included in the staff training programmes. Five care staff have completed a National Vocational Qualification [NVQ] in care at level 2 and eight are currently on the course, there are also six agency staff that have an NVQ, which indicates that 62 of the care staff have an NVQ, which exceeds the national expectation that 50 of the staff in a care home will have an NVQ. Staff receive regular supervision and training needs are identified through this process. Training records showed that staff are able to access a wide range of training and those staff spoken with said the training was of a good quality. There is a group training manager who arranges training for the staff in all of the homes. Training that has been arranged for staff in the cottage annexe includes challenging behaviour, breakaway training and working within the learning disability community. Staff were seen to interact well with the residents and spent a lot of time talking to them and ensuring they were comfortable and had something to do. The Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.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): Standards 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service are usually safeguarded by good management and their privacy, independence and dignity is promoted. EVIDENCE: The registered manager of the home is very experienced and has the necessary skills and qualifications to manage the home. She is a registered nurse and has obtained her Registered Managers award and has been in post for more than two years. She continues to undertake further training to develop her professional and clinical practice and is able to support and encourage staff to provide very good care. The manager was away on the day of the visit and the nurse on duty and the general manager and the quality The Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.R01.S.doc Version 5.2 Page 21 assurance manager supported the inspector during the visit. They said that the manager had an open door style of management, welcoming comments and suggestions from residents, staff and relatives. The education manager has arranged suitable staff training to ensure that staff can meet the diverse needs of the people living in the home. Care plans are comprehensive for all residents and monthly reviews and daily events are recorded accurately. The educational manager said that it is hoped to computerise all care plans in the next twelve months. The home had a large number of comprehensive policies and procedures, which are available and accessible to the staff. The organisation has developed a comprehensive quality assurance system and sends out questionnaires to relatives, residents and other healthcare professionals. The results of these questionnaires are collated and made available to all interested parties. Friends and relatives, who were visiting the home on the day of the visit, spoke to the inspector and were very positive about the staff and the management of the home, saying ‘it’s a wonderful place, lovely staff’. Records indicated that staff attended regular and compulsory fire and other health and safety training, the home’s fire alarm system was checked regularly and emergency plans were in place. There was a fire risk assessment for the premises and regular risk assessments of the premises were undertaken. There were also in-date certificates for the homes fixed electrical wiring, portable appliance testing and for gas safety. No outstanding health and safety issues were observed during the inspection visit and records showed that all equipment was regularly serviced. The Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.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 CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X x X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Tiled House Nursing Home And Cottage Annexe DS0000069890.V350580.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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