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Inspection on 06/03/07 for The Winsor Nursing Home

Also see our care home review for The Winsor Nursing Home for more information

This inspection was carried out on 6th March 2007.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service users appeared clean and well cared for. Many service users were not able to express an opinion. Those who could said that staff were kind to them and that there was enough food. There has been considerable investment in the home by Sanctuary Care including refurbishment and equipment. Visitors are welcomed into the home.

What has improved since the last inspection?

The recording of care provided to frail service users has improved since the last inspection. It was possible to see that regular drinks had been offered and there were records of diet taken. Action taken to prevent pressure damage was recorded more regularly. The home environment has been disrupted whilst substantial internal and external renovations have taken place. This work is now complete and at this inspection the home appeared clean and well maintained. The area around the home was free of scaffolding and efforts have been made to restore the area to order. Service users now have full use of all communal areas and most rooms were attractive and comfortable. The kitchen has been refurbished promptly and a new experienced chef manager has been appointed. Overall the management of the home is improving. Staff rotas have been reorganised to support the needs of service users and whenever possible to provide a balanced skill mix and enable choices of male and female carers. The current manager has been in post since January and has held team meetings and begun to address concerns within the home. For example the home received a concern about an aspect of care. The manager had produced an action plan that was followed up by the inspector during the inspection. All actions had been taken and appropriate training had been promptly arranged.

What the care home could do better:

There are aspects of the service that need improvement. The personal care delivered to service users is organised in a "task based" manner. Service users were seen during the inspection with half their morning care completed waiting for a second carer to give assistance. A service user was observed to have gone back to sleep whilst waiting for the carers to return. Carers spoken with were not happy with the organisation of care and spoke of time wasted and the disruption to service users. The morning hot drinks round did not occur until 11:45 am and was undertaken by the Registered Nurse. This is too late and an inappropriate use of a skilled nurse. The inspectors observed several instances of poor infection control practice. Carers were observed moving from room to room and floor to floor wearing the same gloves and aprons. The provision of activities in the home appeared poor. On the first day of inspection an entertainer had been expected. This was cancelled at short notice. No alternative activity was evident. The communal rooms are used by a very small number of people. The appraisal and supervision system in the home has been under development for some time. There is still little evidence that there is a robust system of staff performance review and guidance. An improvement in practice in this area is fundamental to the improvement of services to residents. There should be a formal agenda for all supervisions that addresses individually the issues of concern in the home.

CARE HOMES FOR OLDER PEOPLE The Winsor Nursing Home 54 The Avenue Minehead Somerset TA24 5AW Lead Inspector Shelagh Laver Unannounced Inspection 6th March 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Winsor Nursing Home DS0000061582.V327499.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 Winsor Nursing Home DS0000061582.V327499.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Winsor Nursing Home Address 54 The Avenue Minehead Somerset TA24 5AW 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) 01643 707870 Sanctuary Care Limited Post Vacant Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43) of places The Winsor Nursing Home DS0000061582.V327499.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One named person aged 45 - 64 years for General Nursing Care Three places for Respite Care for people aged 45 - 64 years, for a period of up to 28 days 12/12/06 Date of last inspection Brief Description of the Service: The Winsor Nursing Home provides nursing care for 43 persons over the age of 60 years. The home is situated in Minehead, a short walk from the seafront. The accommodation is arranged over three floors serviced by a passenger lift. The accommodation is provided in 38 bedrooms that include 33 single en-suite rooms. The home is well adapted for the service user group. There are assisted bathrooms and disabled toilet facilities. There is a spacious communal dining room and three lounge areas. A Registered General Nurse is on duty at all times and links are made with a network of health services to meet service users’ needs. The home has been owned by Sanctuary Care Ltd. since 27th July 2004. The Winsor Nursing Home DS0000061582.V327499.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In the past year the home has undergone a period of disruption and change that has impacted on the care provided. This has been reflected in the Key Inspection on 02/08/06 and the Random Inspection on 12/12/06. A Pre-Inspection Questionnaire was completed prior to this Key inspection. The inspection took place over two days. On the 7th March 2007 two inspectors visited the home speaking to service users and observing care. Some records were examined. On 8th March 2007 one inspector returned to the the home to meet with the manager and to review outstanding records. On 9th March there was an opportunity to meet with the Acting Regional Manager Annette Denson and Mr Klingenberg to discuss the recovery plan for the home. There were 26 service users in the home during the inspection. Of these 23 required two people to assist them with their care. One service user said “I am fine here ..it suits me..” Another said staff were “kind but busy.” What the service does well: What has improved since the last inspection? The recording of care provided to frail service users has improved since the last inspection. It was possible to see that regular drinks had been offered and there were records of diet taken. Action taken to prevent pressure damage was recorded more regularly. The home environment has been disrupted whilst substantial internal and external renovations have taken place. This work is now complete and at this inspection the home appeared clean and well maintained. The area around the home was free of scaffolding and efforts have been made to restore the area to order. Service users now have full use of all communal areas and most rooms were attractive and comfortable. The Winsor Nursing Home DS0000061582.V327499.R01.S.doc Version 5.2 Page 6 The kitchen has been refurbished promptly and a new experienced chef manager has been appointed. Overall the management of the home is improving. Staff rotas have been reorganised to support the needs of service users and whenever possible to provide a balanced skill mix and enable choices of male and female carers. The current manager has been in post since January and has held team meetings and begun to address concerns within the home. For example the home received a concern about an aspect of care. The manager had produced an action plan that was followed up by the inspector during the inspection. All actions had been taken and appropriate training had been promptly arranged. What they could do better: There are aspects of the service that need improvement. The personal care delivered to service users is organised in a “task based” manner. Service users were seen during the inspection with half their morning care completed waiting for a second carer to give assistance. A service user was observed to have gone back to sleep whilst waiting for the carers to return. Carers spoken with were not happy with the organisation of care and spoke of time wasted and the disruption to service users. The morning hot drinks round did not occur until 11:45 am and was undertaken by the Registered Nurse. This is too late and an inappropriate use of a skilled nurse. The inspectors observed several instances of poor infection control practice. Carers were observed moving from room to room and floor to floor wearing the same gloves and aprons. The provision of activities in the home appeared poor. On the first day of inspection an entertainer had been expected. This was cancelled at short notice. No alternative activity was evident. The communal rooms are used by a very small number of people. The appraisal and supervision system in the home has been under development for some time. There is still little evidence that there is a robust system of staff performance review and guidance. An improvement in practice in this area is fundamental to the improvement of services to residents. There should be a formal agenda for all supervisions that addresses individually the issues of concern in the home. The Winsor Nursing Home DS0000061582.V327499.R01.S.doc Version 5.2 Page 7 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 Winsor Nursing Home DS0000061582.V327499.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 Winsor Nursing Home DS0000061582.V327499.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): 3 5 Quality in this outcome area is adequate. There is a range of information available for service users and their representatives. Assessment documentation is available and there is a procedure in place. For at least one service user the evidence of pre-admission assessment was missing. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the Key Inspection on 02/08/06 service users contracts were assessed. The last admission was on 19/05/06. The home has a pre-admission assessment system and the documentation was seen. However one service user case tracked did not have a completed pre-admission document and their needs were not clearly identified. The Winsor Nursing Home DS0000061582.V327499.R01.S.doc Version 5.2 Page 10 There is a range of information available to prospective service users. Visits are welcomed from prospective service users or their representatives. The Winsor Nursing Home DS0000061582.V327499.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 10 Quality in this outcome area is poor. There is evidence that personal care does not fully meet service users needs. Personal care is sometimes delivered in a manner that does not uphold service users dignity. There is evidence that some staff are not aware of the requirements of safe care practice. Medication practice is basically sound with some erratic practice. There is a need to audit records to ensure consistency. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The recording of fluid and nutritional intake and the prevention of pressure damage was much improved at this inspection. It was possible to see that fluids were regularly offered to service users. Comments such as “has eaten all porridge” or “small amount of shepherds pie..” indicated that service users were assisted with meals. The Winsor Nursing Home DS0000061582.V327499.R01.S.doc Version 5.2 Page 12 In many service users rooms were mouth care swabs and a reminder for use. The service users dignity are not up-held by the current practice of care delivery. The personal care delivered to service users is organised in a “task based” manner. Service users were seen during the inspection with half their morning care completed waiting for a second carer to give assistance. A service user was observed to have gone back to sleep whilst waiting for the carers to return. Carers spoken with were not happy with the organisation of care and spoke of time wasted and the disruption to service users. The morning hot drinks round did not occur until 11:45 am and was undertaken by the Registered Nurse. This is too late and an inappropriate use of a skilled nurse. Carers were observed moving from room to room and floor to floor wearing the same pair of disposable gloves and apron. This is a serious infection risk. The inspectors observed several incidents of care being delivered by staff who did not communicate with the service users. Two service users spoken to felt there was not enough staff on duty and that they “had to wait.” Three care plans were seen. There was a care plan for a service user with diabetes. It stated “Maintain acceptable blood sugar level.” This needs to be specific detailing the normal levels for that person and the action to be taken if there is significant variation. There was evidence that care plans are discussed with relatives and service users. Care plans need to reflect the psychological needs of service users. A service user with Alzheimers’ disease detailed behaviour but gave no insight into the care that was required. Daily records focus on “tasks” completed. Medication administration indicated a generally safe system. Registered nurses must all work to the same standards. For example there was an incident when variable doses were not recorded and one where a Mar sheet was not completed. A system of audits of MAR sheets would standardise administration. The Winsor Nursing Home DS0000061582.V327499.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 Quality in this outcome area is poor. There was little evidence at this inspection that service users are able to access appropriate social or recreational stimulation. The routines of the day are dominated by task- based care. There is choice at meal times and service users can eat in a pleasant dining room. Families are welcomed in the home at all times. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The pre-inspection questionnaire states that a program of activities is available. During the inspection there was little evidence of recreational activities for service users. The manager, activities co-ordinator and staff must work together to develop appropriate social opportunities for people according to their needs. All must be aware that they can contribute to the social wellbeing of service users. For example a young kitchen assistant was observed The Winsor Nursing Home DS0000061582.V327499.R01.S.doc Version 5.2 Page 14 talking and laughing with a service user. Simple measures such as considering service users when choosing radio stations can be adopted by all staff. Currently very few service users appear to use the communal areas. The manager is reviewing how service users spend their days balancing choice, dependency and the need for stimulation. A chef-manager has been appointed with appropriate experience and reviewed and up-dated menus were seen. There is a choice of meals at lunch and supper. Vegetarians and special diets are catered for. The chef has had experience of working in hospitals and liasing with dieticians. Soft diets are prepared using the same ingredients as the main meals. In the afternoon of the inspection a member of care staff was observed taking the tea trolley round the building. There was a container of biscuits on the trolley but none were offered to service users. Staff must be aware that the opportunity to access small pleasures such as a slice of cake or a biscuit are important. Visitors were observed in the home and were heard talking to staff about visits out for service users. Some visitors are in the home very regularly and felt welcomed. The Winsor Nursing Home DS0000061582.V327499.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 18 Quality in this outcome area is adequate. There is a complaints policy that is clearly written and is accessible to service users and visitors. Formal complaints are addressed seriously and actions recorded. Managers of the home are aware of the appropriate procedures to be taken to protect service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Twelve complaints had been received at the home in the last twelve months. 4 had been completely substantiated. 6 had been partially substantiated. The home has a clear complaints policy. Support is available to the manager by regional staff in the investigation of complaints. Action required as a result of a complaint referred to CSCI was taken. A recent allegation has been appropriately dealt with in a manner that protects service users. Staff have received training in Protection of Vulnerable Adults. Staff supervision should include the review of POVA and Whistle Blowing procedures with all staff. The Winsor Nursing Home DS0000061582.V327499.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 20 21 24 25 26 This judgement has been made using available evidence including a visit to this service. Quality in this outcome area is adequate. Service users live in a safe and well maintained home. The home is pleasant and clean. (Infection control issues with regard to infection control are detailed under personal care.) EVIDENCE: Following a period of disruption while the windows of the home were replaced the home is now peaceful and well maintained. Communal facilities are fully restored. Bedrooms are comfortable although in some there was a need to pay attention to tidiness and appropriate storage. The Winsor Nursing Home DS0000061582.V327499.R01.S.doc Version 5.2 Page 17 It is hoped in the future to provide the home with access to an outside space. This has been needed for some time as service users have become more dependent. The home appeared clean and well maintained with some bedrooms being comfortable and spacious. The Winsor Nursing Home DS0000061582.V327499.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30 Quality in this outcome area is adequate. There are sufficient staff on duty. The staff training and supervision programme must continue to develop to meet NMS. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of inspection there appeared to be sufficient numbers of staff on duty. There were two trained nurses and five carers supported by cleaning and kitchen staff. There has been a renewed iniative to enable staff to gain their National Vocational Qualifications. Five staff are registered and receive two hours of paid study time per week. Currently there 5 staff (21 ) qualified to this level and above. 12 shifts have been covered by agency staff. Some staff training has been completed in the past twelve months. There is an in-house Manual Handling Trainer. The manager is completing a staff training plan for the next twelve months. Staff have received training in Protection from Abuse, Fire Safety and Promoting Dignity. Individual training for registered nurses has included Pressure Relief and Palliative Care. Three staff recruitment files were seen. Practice was generally satisfactory. It is important to see the final outcome of recruitment. One person seemed not The Winsor Nursing Home DS0000061582.V327499.R01.S.doc Version 5.2 Page 19 to be in post but had been offered a job at a later date. Another had been employed as carer but was currently working in the kitchen. Staff had been issued with the Sanctuary induction book but currently there is no clear allocation of mentors to supervise new staff. The Winsor Nursing Home DS0000061582.V327499.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 32 33 35 38 Quality in this outcome area is adequate. There is currently no registered manager. A qualified and experienced manger has been appointed. There are accounting and financial procedures in place to protect service users. Staff are not appropriately supervised. There are policies and procedures in place to protect the service users health and safety. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is currently no registered manager however Ivor Klingenberg has been in the post of manager since 9th January. Several staff meetings have been held and these demonstrate that staff are encouraged to discuss issues in the The Winsor Nursing Home DS0000061582.V327499.R01.S.doc Version 5.2 Page 21 home. Minutes observed indicated that allocation of duties and “work load “ were key concerns. A new maintenance man has been appointed and is receiving training. Sanctuary Care support the home maintenance through audits and visits. The hoists had been serviced and bed rails have been assessed and maintained. Fire records were observed. A full review of maintenance records was made at the Key Inspection in August 2006. The appraisal and supervision system in the home has been under development for some time. There is still little evidence that there is a robust system of staff performance review and guidance. An improvement in practice in this area is fundamental to the improvement of services to residents. There should be a formal agenda for all supervisions that addresses individually the issues of concern in the home. The Winsor Nursing Home DS0000061582.V327499.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 3 2 X X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 1 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 2 X x X 3 3 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 X X 3 The Winsor Nursing Home DS0000061582.V327499.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP12 Regulation 16 Requirement Service users must be must be consulted about social activities. Both group and individual opportunities must be available. A programme of activities must be arranged to include activities in relation to recreation, fitness and training. Training for the activities coordinator must be provided. A new activities co-ordinator is in post. This requirement will be assessed at the next key inspection. A programme of activities had been drawn up. This requirement is brought forward from the last inspection. Previous timescale not met. 2. OP32 24(1) The manager shall establish and maintain a system for reviewing and improving the quality of care provided in the care home, including the quality of nursing. The quality assurance planned for the home in the coming year The Winsor Nursing Home DS0000061582.V327499.R01.S.doc Version 5.2 Page 24 Timescale for action 23/04/07 01/06/07 will be reviewed at the next inspection. This requirement is brought forward from the last inspection. Previous timescale not met. 3. OP36 18(2) The registered person shall ensure that persons’ working at the care home are appropriately supervised on a day to day basis to ensure the standard of personal care provided is satisfactory. This requirement is brought forward from the last inspection. Previous timescale not met. Care plans must reflect the needs of service users and the action to be taken by staff to meet them. They must be sufficiently detailed to enable staff to deliver care. Opportunities are given for appropriate exercise and physical activity. 23/04/07 4. OP7 12(1) 23/04/07 5. OP8 12(1) 23/04/07 6. OP10 12 (1) 12(4) 7. OP8 18(1)a 12 (4)b 8. OP8 13 (3) 13 (4) The arrangements for health and 23/04/07 personal care ensure that the service users privacy and dignity is respected at all times. The organisation and delivery of personal care is reviewed in order to ensure this. The service users psychological 23/06/07 health is monitored regularly and preventative and restorative care is provided. This includes ensuring that all staff providing personal care must be trained and able to support service users with appropriate communication. All staff must provide personal 23/04/07 care in a manner that DS0000061582.V327499.R01.S.doc Version 5.2 Page 25 The Winsor Nursing Home 18(1) 9. OP36 18(2) 10. OP38 23 (4) demonstrates good infection control practice. Training, assessment and supervision must be provided for staff to ensure this happens. A system of formal and informal supervison must be rigorously implemented. There must be an agenda for individual supervisions that addresses concerns in the homes. All fire notices must be adhered to. The equipment stored in the stair well must be moved. 23/04/07 23/03/07 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. Refer to Standard OP20 Good Practice Recommendations The external space at the home should be reviewed in order to provide an area that is accessible and suitable for service users. The Winsor Nursing Home DS0000061582.V327499.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Winsor Nursing Home DS0000061582.V327499.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!