Inspection on 30/11/06 for The Village Nursing Home

This inspection was carried out on 30th November 2006.

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

The inspector 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 Village Nursing Home 04/01/10

The Village Nursing Home 04/08/09

The Village Nursing Home 21/05/09

The Village Nursing Home 09/10/08

The Village Nursing Home 05/10/07

The Village Nursing Home 12/01/06

The Village Nursing Home 14/06/05

The Village Nursing Home 06/01/05

The Village Nursing Home 22/06/04

The Village Nursing Home 23/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Village Nursing Home Church Road Banks Southport Lancashire PR9 8ET Lead Inspector Mrs Janet Proctor Unannounced Inspection 30th November 2006 09:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Village Nursing Home DS0000025583.V320903.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 Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Village Nursing Home Address Church Road Banks Southport Lancashire PR9 8ET 01704 220061 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) www.craegmoor.co.uk Parkcare Homes Limited Mrs Doreen Whitlow Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (39), Physical disability (3) of places The Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Up to 39 service users in the category OP (Old Age) who need nursing care. Up to 20 service users in the category OP (Old Age) who need personal care only. Up to 2 service users in the category of PD (Physical Disability). 1 named service user in the category of PD (physical disability) Date of last inspection Brief Description of the Service: The Village is a forty-bedded care home with nursing set in its own wellmaintained grounds. It is located in the village of Banks and there are sufficient amenities of shops, a Church and public house nearby. Transport to nearby towns of Southport and Liverpool can be accessed. Four beds are available for service users with a physical disability and there is a trained nurse on duty at all times. The home is purpose built, with all accommodation at ground floor level. There is easy access for wheelchair users and the less mobile. All rooms have an en-suite facility and there are two shared rooms. Communal space for service users comprises a lounge, dining area and two small seating areas along the corridors. The home has a patio area to the front and garden with greenhouse and patio to the rear. Residents receive information about the home in the form of the Statement of Purpose and the Service User’s Guide. A small brochure is also given out to anyone making enquiries. In early December 2006 the fees charged were from £315-00 per week to £500-00 per week, depending on the level of care needed. The Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted at The Village Nursing Home on the 30th November and 1st December 2006. The previous inspection was done on the 12th January 2006 and information on the findings of this can be obtained from the home or from www. CSCI.org.uk . No additional visits have been made since the previous inspection. Prior to the inspection information had been submitted by the Manager in a pre-inspection questionnaire. On the day of the inspection there were 37 residents at the home, 23 of who were receiving nursing care and 14 receiving personal care only. Information was obtained from staff records, care records, and policies and procedures. Information was also got from talking to residents, the Manager, staff members and visitors. A tour of the building took place. Wherever possible the views of residents were obtained about their life at the home. Due to memory and communication difficulties, some of the residents were unable to engage in conversation or make comment about their experience of living in the home. What the service does well: The service provided all residents with a contract stating what their terms and conditions of residency were. This meant that they knew what they were to be provided with and reduced the potential for misunderstandings. There were good relationships between staff and residents and relatives. This meant that residents felt comfortable with the people who cared for them. Residents said, “They’re all nice”, “They’re very good with me” and “They look after you well”. Residents were able to make choices about what they did so that they had some control over their lifestyle. Residents said, “You can get up when you want, there’s no rules about that” and “I get up when I’m ready and can go to bed when I like.” Apart from one person the residents were happy with the food served at the home. They had a choice of food at each meal and could request alternatives to this. They said, “The food’s good” and “The food’s good and you get a choice”. Residents and visitors were happy and had no complaints. They indicated that they felt confident that any concerns would be sorted out as they said, “If I The Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 6 wasn’t happy I’d go to the manager I’m sure she’d sort it out” and “I don’t know how to make a complaint, I’ve no idea at all. But I don’t have any complaints” A visitor spoken said, “I’m not aware of how to make a complaint. I would speak to the manager she’s very approachable. I’ve never had to do it”. Another said there’s” no complaints – I would go to the manager if I had”. Residents were safeguarded by the fact that all staff received training in what to do if they witnessed or suspected something was not right. They were supported in this by the policies and procedures. Residents were also safeguarded by the recruitment systems at the home. These were thorough and ensured that staff were fully vetted for their suitability to work with vulnerable adults. All staff received training at the start of employment and had regular updates following this. This meant that they were given the skills and knowledge to do their work in a competent and safe manner. What has improved since the last inspection? What they could do better: Residents must receive written confirmation that their assessed needs can be met by the home so that they can be confident that they will be looked after. All of the needs of the residents must be documented in the plan of care. This is so that staff know the correct actions they need to take to care for the residents. There should be an indication of progress made when the plan of care is reviewed so that it is evident that the care directions are being effective. Wound assessments should be completed when the dressing is done so that there is a record of the progress of the wound. Risk assessments The Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 7 should show what factors have been looked at, why this is a risk and what degree of risk it is. Residents must only self-medicate after they have been assessed as being competent to do this. This reduces the risk of the medication being taken incorrectly and protects their health. If a resident self-medicates they must store their medications safely and securely so that other residents cannot access these. Any cultural food preferences must be identified and provided so that all residents are provided with a diet that is to their liking. When food is liquidised this should not be all done together so that the meal looks appetising and appealing. The access to fire doors must be kept clear at all times so that there are no obstructions if the home should need to be evacuated. Liquid paper should not be used on records as it cannot be ascertained when changes have been made to the document. The results of any resident and relative surveys should be available to the staff at the home. This is because they need to know what areas they are performing well in and which need to be improved. 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 Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 8 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 Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 9 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): 1, 2 , 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were supplied with information about the home and terms and conditions of residency. This reduced the potential for misunderstandings about what would be provided. Assessment procedures were more thorough but residents could not be confident that their needs could be met, as they did not receive confirmation about this. EVIDENCE: There was a Service User’s Guide and a Statement of Purpose on display in the reception hall. The manager said that these were not given as a routine to people who came to look around. Instead a brochure sheet was available that gave information on the features and facilities of The Village. This had pictures of the home on it. Residents spoken to could not remember getting any written information on the home. One said that he hadn’t needed any as he “was taken with the home The Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 10 and wanted to come here”. A visitor spoken to said that they’d, “Visited the home at first and were given a brochure sheet”. The manager said that every room should have a folder with the Service User’s Guide and Statement of Purpose, a copy of contract, and the complaints procedure. Residents were sometimes reluctant to keep these in their room and handed them back to staff. One resident spoken to remembered being given a contract and signing this. A visitor spoken to said that she’d been given information about the fees before her relative was admitted and she thought she’d been given a contract. Both of these had only been in the home a short time and there had not been any fee changes in that time. Therefore, they unaware of what the system of informing them about this was. The manager said that a contract was given to all residents. Copies of these were seen in the files of those residents who were case tracked. The manager said that Head Office send out letters in approximately January to let residents and relatives know about the fee increase to occur in the April. The files for three residents were examined. Two of these showed that a suitable pre-admission assessment had been done. There was no letter on file confirming that the home could meet their assessed needs. One resident who was case tracked had been resident for many years. Therefore, the preadmission procedures had been different at that time. On the day on inspection a family came unexpectedly to look round the home and were seen to be given a brochure sheet. Arrangements were made for a pre-admission assessment to be done on their relative. Intermediate care is not provided at The Village Nursing Home. The Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 11 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. Although the individuals’ physical needs were clearly documented not all of the residents’ social care needs were included in the care plans, which may result in them not being met. Medication practices safeguarded residents’ health and welfare. Residents were treated with respect and their privacy and dignity protected. EVIDENCE: The care plans for three residents were examined. The plans contained good details about physical health needs and gave good directions to staff on how to meet these. Social and mental health needs were not covered in as much detail. In particular, one resident who had an active social life did not have any mention of social needs at all in his plan of care. Also a recent bereavement had not been identified as a need. This meant that staff would be unaware of the correct actions they needed to take to support the resident through this. Discussion took place on how a more ‘person centred’ approach to care The Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 12 planning would further improve the plans as this would make them precise about the diverse needs of each resident. There was evidence that the resident or the relative had been consulted. The care plans were reviewed each month. The review did not always give an indication of the progress that was being made to meet the needs. There were assessments for health. These included: moving and handling; nutrition; and risk of developing pressure sores. If the resident was identified as being ‘at risk’ then this was included in the care plan. A full risk assessment for the use of bedside rails was now being used. This gave a clear indication whether the bedside rails were in the best interests of the resident or not. Other risk assessments used were more of a statement than an assessment and did not clearly show why the issue mentioned was a risk or what degree of risk it was. Continence needs were identified in the plan of care and stated what aid was to be used. One resident had a wound. There was a plan of care for this and a dressing plan. This had not been completed since 11th November 2006 so there was no objective description of how the wound was progressing. There was good evidence that other health professionals were consulted when needed. These included: chiropodist; optician; dietician; GP; and Practice Nurses. Residents spoken to all said that they were well looked after. Visitors spoken to said that they were kept informed of their relative’s condition. There were some good practices in respect of the control of medications. These included appropriate storage and records of medicines ordered, received, administered and disposed of. Prescriptions were seen before the medicines were dispensed. A criteria sheet was used for ‘as required’ medications. This meant that all staff would be giving them in a consistent manner. Controlled Drugs were correctly stored and recorded. The balance of drugs kept was checked and agreed with the records. The administration of creams was not being signed for. Lactulose was being given from one bottle to all residents due to lack of storage space in the trolley. A handwritten entry on the Medication Administration Recording chart had not been signed or witnessed. This meant that there was the potential for error if the original instructions had been written incorrectly. There was no record of dressings dispensed and administered for a resident. One resident was self-administering medications. There was a disclaimer stating that he was taking responsibility for this, but no assessment to show that he was competent and capable to do this. Some of this resident’s tablets were seen in a dosette box out on a bedside table in full view of anyone in the room. The door to the room was unlocked and standing open. Eye drops had not been dated. This is recommended to help ensure they are not used for extended periods. The Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 13 Residents were seen to be treated with dignity and respect. Their privacy was respected by staff knocking on doors before entering their rooms. The subjects of privacy and dignity were covered in the Induction training given to staff. Screens were available in the two double rooms to respect privacy when care needs were being attended to. A variety of unnamed toiletries were seen in bathrooms giving the impression that these were used communally. The Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 14 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 good. This judgement has been made using available evidence including a visit to this service. Residents’ social and recreational needs were met by activities being available and contact with visitors. The daily routines for residents matched their preferences and choices. Residents received a balanced diet. EVIDENCE: Activities were done each weekday and there was a designated person to do this. Records were kept of the activities done. Residents spoken to said that they enjoyed the activities on offer and had a choice about whether they joined in or not. A mini-bus had recently been purchased by the home and trips out had been arranged. There were entertainers each month. An Xmas programme was in the process of being arranged. On the day of inspection an Aromatherapist was in the home doing hand massages. Residents were also seen to join in a game of Bingo. There was a visiting policy in the Service User’s Guide. This confirmed that residents could see them in private if they wished. Visitors spoken to said that they were made to feel welcome. The Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 15 Residents spoken to said they could get up and go to bed when they wished. They said they could use their rooms as and when they wished. They could have meals in their rooms if they wished to. Residents spoken to said that they enjoyed the food. One resident’s specific cultural needs were not being addressed through his diet. He said, “I eat it, but it’s not to my taste”. There was a four-week rota of menus. There was a choice at each meal and alternatives could also be had. The day’s menu was displayed in the dining room so everyone was aware of what was on offer. Staff were seen to go round and ask residents what they wanted for their teas and for lunch the next day. Special diets could also be catered for. Liquidised diets were served as all one item, not as separate components. This reduced the attractiveness of the meal. Night staff had access to foodstuffs so that they could make snacks if anyone was hungry. There was a sufficient stock of food on the premises, including fresh fruit and vegetables. Records were kept of fridge, freezer, trolley and cooked temperatures. The Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents and visitors were confident that any concerns or complaints would be listened to and acted upon. Appropriate training and policies and procedures for prevention of abuse meant that residents were safeguarded. EVIDENCE: Every resident got a copy of the complaints procedure in the folder in their room. This was also in the Service User’s Guide on display in the reception hall and the procedure was also displayed on the wall near to the office. There was a complaints recording book. No complaints had been received by the home or by the Commission. There were policies and procedures for Safeguarding Adults. There was also a whistle blowing procedure. Training in this was given to staff on an annual basis, the next training being due in December. Staff also received training in challenging behaviour. Staff spoken to were able to say how they would respond in such situations. The Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents lived in a pleasant, safe and clean environment. The temperature of some areas of the home may not be warm enough for frail, elderly people making them uncomfortable. EVIDENCE: The home provided clean, nicely decorated accommodation for residents. There were two shared bedrooms and all bedrooms had an en-suite facility. The manager said that these were redecorated as they came empty. A resident spoken to said, “When I came in they asked me what colour of carpet I wanted and what colour I would like the room decorated. Then they did it for me”. The Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 18 The pipe work in bathrooms had been boxed in. New specialised beds with integral bed-side rails were being purchased. All bedroom doors had locks and keys were issued to residents. The lounge area felt cool, especially for residents who were unable to move around. Both of the doors to the lounge were open and a through draught was being created. A visitor spoken to said that they thought the temperature of the lounge area was “not always comfortable”. The manager said that there were plans to install central heating so that the temperature of the home could be better regulated. The corridors leading to the fire doors all had some sort of furniture in them. Whilst these did not fully block access it had the potential to cause some sort of obstruction if there should have to be an evacuation through the door. Some carpets in the corridor areas were still in need of renewing. There was a separate laundry room that was fully equipped. The washers had a sluice cycle so that fouled linen could be laundered. There were washable floor and walls, making the area easy to clean. There was a sink with hand wash, paper towels and gloves available so that good hygiene could be maintained by the staff in the laundry. The Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs were being met by the number of staff on duty. Recruitment practices were thorough and safeguarded residents. Training was provided for new and existing staff that helped make sure they were competent do their jobs and able to practice safely. EVIDENCE: There was a duty rota with the name and role of the staff member and the hours worked. Liquid paper had been used on the rotas. Due to staff shortages and changes of duty some weeks nearly all of the hours recorded had liquid paper used on them. This is not good practice as the duty rota is considered to be a legal document and it could not be ascertained when the changes had been made. There had been some recent staffing shortages, and Agency staff had been used to fill in. This did not seem to have affected care to residents who said, “I just pull the buzzer and they come”, “They gave me help last night when I had an accident. Two of them put me in the bath” and “They’ve been short staffed lately. It hasn’t hardly affected me but sometimes, only rarely, I’ve had to wait before they can dress me.” The files for two new members of staff were examined. All had completed an application form. There was evidence that references were sent for and POVA The Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 20 First and CRBs obtained. Staff were issued with a contract so they were aware of their terms and conditions of employment. They did not receive a copy of the General Social Care Council’s code of conduct and practice. This is important as it sets the standards expected for social care workers. There were equal opportunities policies and procedures for recruitment. All new staff received training at the start of employment so that they had the knowledge and skills to do their work. An induction pack was given to them and completed over 12 weeks. At the end of this time the manager confirmed whether they were competent to do the tasks. All other staff received regular training updates. Records were kept of the training undertaken. All staff were undertaking equal opportunities training so that they aware of the need to ensure that all residents and other staff were treated in a fair and equitable manner. 13 of the care staff had NVQ 3. Two care staff were currently on the NVQ 2 course. The Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was managed appropriately and in a way that met the best interests of residents. The health, safety and welfare of residents and staff was promoted and protected. All staff did not receive regular supervision which meant that they might have concerns about their work which are not being addressed. EVIDENCE: Records showed that the registered manager is a first level registered nurse who has extensive experience of running and managing a care home for this client group. The registered manager is due to retire in the next year and does not plan to complete a relevant management qualification. This has not The Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 22 affected her ability to manage the home and ensure that it meets its stated purpose, aims and objectives so that residents feel safe and well looked after. There were systems in place to monitor the quality of service and facilities provided. Monthly overview audits were done over a wide range of areas. An action plan was implemented if any deficiencies were found. The Area Manager did regular visits and monitored the environment and the records and spoke to staff and residents. Clinical Governance was done by representatives of the Company but there was no report of their findings following a visit. Residents surveys were done on a cycle over six-months. The results of these were submitted direct to the Head Office. No feedback on the results was given to the home. This meant that the manager and staff were not aware of the areas in which residents thought they did things very well or needed to improve. Residents meeting were held about every three months. Staff meetings were held intermittently. The home handled few personal allowances for residents. Satisfactory written and computerised records of any personal allowances received for residents were kept, which showed income expenditure and any remaining balance. Any valuables or money brought in by relatives for residents was stored in a safe that only two members of staff had access to. This meant that residents’ money was appropriately safe guarded. Records were kept of any money handed in for safekeeping and receipts kept for any purchases made on behalf of residents so a clear audit trail of income and expenditure was available if needed. Each member of staff had a supervision book. One of these examined had not been completed since 31/01/06. The manager said that the supervision of the night carers had not been done for quite some time. This meant that staff did not have a formal opportunity to raise any issues or concerns about their work or practice. Regular servicing had taken place in relation to systems and equipment used by the home to make sure they were safe to use. Records viewed and discussion with staff indicated that they had received instruction in relation to safe working practices, such as moving and handling training and first aid training. This meant that they had been provided with the knowledge to make sure they were up to date with current good practice and able to carry out procedures safely. The Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X 3 3 STAFFING Standard No Score 27 2 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 3 The Village Nursing Home DS0000025583.V320903.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 OP3 Regulation 14(1)(d) Requirement Written confirmation that the home can meet the assessed needs must be sent to the resident or their representative before they are admitted so that they can be confident that their needs can be met The plan of care must include all the personal, health and social care needs of the resident so that staff know what to do to meet these needs. Residents must be risk assessed as competent and capable before self-administering medication to ensure that they take their medication as prescribed. Secure and safe storage must be provided and used for the medication so that other residents do not have access to it. Residents must only receive the medications prescribed individually for them and not use other residents’ medications. The temperature of the home must be kept at a satisfactory level so that residents remain DS0000025583.V320903.R01.S.doc Timescale for action 13/12/06 2 OP7 15(1) 31/01/07 3 OP9 13(2) 31/12/06 4 OP9 13(2) 31/12/06 5 OP19 23(2)(p) 31/12/06 The Village Nursing Home Version 5.2 Page 25 6 OP19 23(2)(d) 7 OP19 23(4)(c) (iii) comfortable. Carpets must be replaced if 31/03/07 cleaning fails to remove the deep stains. (Timescale of 31st October 2005 not met) There must be clear access to 31/12/06 the fire doors so that there are adequate arrangements for the safe evacuation of residents should there be a fire. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP7 OP8 OP8 OP9 Good Practice Recommendations The review of the need should give some indication of the progress being made to meet this. Risk assessments should show the evidence to support why the issue is a risk and what degree of risk this is. A wound assessment sheet should be completed at each dressing change or at regular fixed intervals. All creams should be signed for when being applied. This can either be on the Medication Administration Recording chart or on a separate chart in the resident’s room. All staff applying creams should have appropriate training. Prescribed wound dressing should be identified on the Medication Administration recording chart and signed for when administered. Handwritten entries on Medication Administration recording charts should be signed and witnessed. Prescribed medications with a limited shelf life should be dated when opened. Residents should have their own toiletries allocated on an individual basis. Toiletries should not be left in bathrooms as this means they could be used communally. The cultural aspects of diet should be identified and provided for a specific resident. The components of a pureed diet should be served separately in order to make this look more attractive. Liquid paper should not be used on the duty rota. All staff should receive a copy of the General Social care DS0000025583.V320903.R01.S.doc Version 5.2 Page 26 5 OP9 6 7 8 9 10 11 OP9 OP10 OP15 OP15 OP27 OP29 The Village Nursing Home 12 13 14 OP30 OP33 OP36 Council’s code of conduct and practice. NVQ in care should be obtained by 50 of the care staff. The home should receive information on the results of the residents/relatives surveys so that they are aware of what areas they do well and need to improve in. All staff should receive regular supervision. The Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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 Village Nursing Home DS0000025583.V320903.R01.S.doc Version 5.2 Page 28 - 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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