Inspection on 16/01/06 for Ticehurst Nursing Home

This inspection was carried out on 16th January 2006.

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

Ticehurst Nursing Home 17/10/07

Ticehurst Nursing Home 29/01/07

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Ticehurst Nursing Home Whitchurch Close Aldershot Hampshire GU11 3RX Lead Inspector Mr Rodney Martin Unannounced Inspection 16th January 2006 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 Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 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. Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ticehurst Nursing Home Address Whitchurch Close Aldershot Hampshire GU11 3RX 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) 01252 311832 Hampshire County Council Marion-Hazell Mears-Owen Care Home 48 Category(ies) of Dementia - over 65 years of age (48), Old age, registration, with number not falling within any other category (48) of places Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13 June 2006 Brief Description of the Service: Ticehurst Nursing Home is a newly built forty-eight bedded care home for residents with nursing needs, and is an initiative between Hampshire County Council, Hart Primary Care Trust and Blackwater Valley. The home is in Whitchurch Close, Aldershot; a mile from local shops. The home was registered on 1 March 2005, with Hampshire County Council as the registered person and Maizie Mears-Owen, as the nurse registered manager. Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. There were no requirements made following the inspection on 13 June 2005. There has been no involvement with the home, apart from the Commission receiving notification of death, illness and other events [Regulation 37 notification] and a telephone call, in August 2005, from a service user’s daughter, regarding the lack of meaningful activities in the home. This was discussed with the manager and action put in place to arrange an individual activities care plan for the resident. There have been no written complaints, recorded in the home. There have been verbal complaints about food, which has been taken up with the caterers, by the manager. The unannounced inspection took place between 10.30am and 12noon on 16 January, with the inspector returning the following day from 9.35am to 2.30pm. In line with CSCI policy all the key standards need to be inspected at least once over the two inspections. Following the inspection on 13 June 2006, ten key standards were outstanding, including the key standards in the management of the home section. It is confirmed that all the key standards have been inspected during this inspection year. As the manager was not available on 16 January 2006 a second day was necessary. Ticehurst was accommodating eighteen residents, with nursing needs, which included one service user on a short respite stay. Over the two days of inspection, three visitors were interviewed and one resident, at length, in the privacy of their room. The visitors were very happy with the care given and had no complaints. The resident was very satisfied with the accommodation. They commented that their only complaint was with the temperature of the meal, as they like food, hot. This is recorded in their care plan, although staff need to be reminded of this, from time to time. The ground floor of the building was not occupied, on the day of the visits. A problem had occurred with the under floor heating and so the carpets had been removed. Although the contractors had given a completion date of 14 January the work was not finished. It was reported that the office and the rest of the ground floor needs to be done, following the completion of the ground floor resident accommodation area. Care, medication, fire and financial records were inspected. These were relevant and up to date. Although Ticehurst Nursing Home and Ticehurst are two separately registered homes, with two registered managers, there is a sense where both homes want to present a more integrated approach, with residents with nursing needs making use of the facilities in Ticehurst, joint staff training sessions and joint assessments by both managers. Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 Page 6 What the service does well: What has improved since the last inspection? 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. Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 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 Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Prospective service users have their needs assessed, prior to admission and are only admitted if the home can meet them. EVIDENCE: Prospective service users need to have a diagnosis of dementia, for admission to Ticehurst Nursing Home. The home requires written confirmation from their medical practitioner of the diagnosis. Care managers are told that, for short stay clients, they must also have GP support, before making a referral, in case there is a change in the resident’s condition during their stay in the home. The nurse manager assesses all prospective service users with dementia, requiring nursing, in their home or in hospital. The senior nurse is currently able to assess prospective service users, if they have a physical need. The manager has done joint assessments with the senior nurse. If there is a query over whether the prospective service user requires nursing or residential care, the nurse manager will go out with the unit manager of the residential unit. The majority of assessments take place in the local units in hospital, in Cedar Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 Page 9 House, Ridgewood Centre Frimley, Frimley Park hospital, Farnham Road hospital and Hale ward at Farnham hospital. Ticehurst has a very comprehensive assessment form that covers all aspects of the service users’ abilities and capabilities. Service users are only admitted after an initial assessment by a care manager, from Adult Services. Following the home’s assessment, the manager liaises with the care manager, the hospital and the gatekeeper of beds at Aldershot Adult Services [previously known as Social Services] to arrange an admission date. The home prefers not to have a resident admitted on a Friday or weekend and also an afternoon admission. The prospective service user is likely then to have had lunch and it was reported that more staff would be available to help the resident settle in. A relevant terms and conditions of residency, signed and dated was seen on a service user’s file. Residents are assessed as low, medium or high banding for funding purposes. However, each resident is individually means tested and pays according to the financial assessment. Various residents’ files were seen. A comprehensive pre-admission assessment had been carried out along with other assessments since admission, including a manual handling assessment, a pressure sore risk assessment and nutrition assessment. The file was modular and indexed in ten sections that were easy to read. All the residents have been moved upstairs, as there are problems with the under floor heating. The section of the home with residents’ bedrooms is currently cordon off, as the carpet has been removed. Ticehurst Nursing Home has one respite and one permanent bed available. Staffing is now at a level where more residents could be admitted but the building works are restricting this. Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9 The arrangements for planning are good, ensuring residents’ physical and emotional health needs are met with evidence of good multidisciplinary working. EVIDENCE: The care plans are comprehensive and easy to read, highlighting where there were problems or needs, which in turn detailed the aim of care and the method needed to carry it out. The care plan detailed the individual’s abilities regarding activities of daily living, communication, eating, recreation and their fire awareness/abilities. A well-being profile designed by the Bradford Dementia Group had been completed. The daily notes [contact sheet] extensively completed and were up to date. There was also a turning chart, fluid chart and an observation log, which were also up to date with relevant comments recorded. The home has also changed the care plans over to a new set of care plans from Hampshire County Council. The new care plan [seventeen pages] comprehensively details activities of daily living, with a section on ‘memory’ and ‘communication’. The home already had comprehensive care plans for those with dementia. Where information from Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 Page 11 the previous plans did not equate with the new care plan format the need to have additional headings was discussed. Three visitors were interviewed along with a resident, in some depth. They were all very happy about the care given. Service users are registered with seven GP practices in the Aldershot and Farnham area. The manager reported that the Alexandra surgery has redefined its boundaries and so although they will keep on existing patients, they will not take any new referrals from Ticehurst Nursing Home. The manager reported that the home has a good relationship with the various GP’s. The home is about to run a pilot scheme, with one surgery, which if successful could be tried with the other surgeries. Referrals for a psychogeriatrician assessment, currently, have to go through the resident’s GP. This can take up to a month before the psychogeriatrician receives the referral. As the nurse manager is an RMN [registered mental nurse] she is meeting with the local consultant psychogeriatrician to discuss referrals going straight to them, rather than through the GP. The service users’ psychological health is constantly monitored and the home is aware if there are physical changes, whether this is due to a deterioration in the resident’s physical health or mental health. One resident has regular community psychiatric nurse [CPN] support and the home is requesting support, from a CPN, for another resident. Service users have access to all other health professionals on an as needs basis. An individual record is kept of all health professional visits. The home has a large medical room. Ticehurst operates a monitored dosage system [MDS] from a local pharmacist, with individual blister packs for each prescribed medication. The blister packs, liquid and topical medication is kept secure in two drugs’ trolleys. The medicine administration sheets were satisfactorily maintained, with no omissions. None of the residents are selfmedicating. After a six-week initial period, following admission, the manager requests a medication review with the GP, especially if they are on a large cocktail of psychotropic medication. The home does not currently have any residents on controlled drugs. The manager reported that GP’s are very supportive with palliative care, especially including giving support to relatives. Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 15 Social activities are arranged on an individual basis to reflect the needs and interests of service users. Although there has been some variation in the quality and quantity of meals, since November 2005, residents are offered three full meals a day, which are nutritious, well balanced and given in an unhurried way. EVIDENCE: Activities are on an individual basis as the majority of residents are frail, ill or bed bound. Five staff members have been on a Vitalize course [for gentle exercises, music and movement et cetera]. Staff spend time with individual residents reading newspapers, helping with artwork and using reminiscence material. The communal lounges have large print books, games, bingo material, skittles available, as well having a large screen television with Freeview and a DVD/VCR player. For some of the more able residents, arrangements have been made to have joint ventures with the residential unit. Although there are communal lounges and quiet areas within the home, Ticehurst Nursing Home does not have a large communal area sufficient to take all the residents, when full [48]. One resident, spoken to, enjoys outdoor activities such as, fishing, walking and photography. The home has tried to obtain volunteers and has also been in touch with the resident’s care manager to see explore the use of volunteers. There has been some success in taking Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 Page 13 them out, although it is not always possible to arrange an ad hoc trip at short notice, if the person is not available to take the resident out. All residents, apart from one, has family and friends visiting. This resident has the manager, from their previous care home, who still visits. Since the residents from the residential care unit moved back to Ticehurst in November 2005 the catering side of the home, including providing housekeepers, now comes under Hampshire Caterers, known as HC3S. The kitchen is in residential care unit and HC3S also provides meals for both Ticehurst and the nursing home unit. Care staff are no longer involved in food or drink distribution. However, the housekeepers come on duty after a number of the residents are up [some rising from 6am] and the staff in the nursing home unit are providing the breakfast meal. The manager reported that she has a meeting with HC3S the following week to this inspection, when this matter will be raised. Initially there were teething problems with insufficient portions, especially for some of the male residents. Agency staff have also been employed, to cover gaps in the rota, and the quality of food produced has also fluctuated. One resident said that they like their food hot but that this does not always happen, even though it is recorded in their care plan. Staff have been reminded to ensure that the residents has hot milk on the shredded wheat, at breakfast, and that the other meals are hot. Residents, spoken to, confirmed that the meals are now generally good and that they get enough to eat. Ticehurst has a three-week menu and the meals were varied and well balanced. Service users are offered a choice to the main course. Service users can choose from a selection of grapefruit or prunes, porridge, a selection of different cereals, toast and marmalade, for breakfast. There is a choice of main meal at lunchtime and for the teatime meal residents can select from freshly made soup every day, sandwiches, a hot snack meal, such as jacket potato, a choice of various desserts and homemade cake. Lunch is served at 12.30pm and is brought over on heated trolleys. On the 17 January the inspector was able to have lunch with the service users. The meal was plated and service users had cottage pie or chicken Italian, with apple sponge and custard for dessert. The home does not have any service users that prefer a vegetarian meal. Some residents require their meal pureed and help with the meal. These were presented with each portion separately liquidised. Staff were able to do this discretely. Service users can have a choice of hot milky drink or cup-a-soup and a sweet biscuit or cheese and biscuit for supper. Residents have had a nutritional assessment completed. The manager is planning to photograph meals, using a digital camera, to enable residents to make a more informed choice. Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 Page 14 Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The home has a satisfactory complaints procedure, which residents and/or their representative feel able to use and an adult protection procedure to safeguard residents from abuse. EVIDENCE: The home has a written corporate and in-house complaints’ procedure that is also incorporated in the statement of purpose. The home has a complaints log but there have been no written complaints, although the management have received verbal complaints about the food service, since November 2005. The Commission received a complaint in August 2005, from a service user’s daughter, regarding the lack of meaningful activities in the home. This was discussed with the manager and action put in place to arrange an individual activities care plan for the resident. Ticehurst nursing home has the corporate Hampshire County Council and adult protection procedure, which includes a whistle blowing policy. There have been no incidents of abuse recorded in the home. Staff have received adult protection training but it was identified that there was a need to up date the training. Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 20 EVIDENCE: The environment standards were looked at on the previous inspection, especially as Ticehurst Nursing Home is a new build, which was completed in February 2005. As a temporary measure the residents from the residential care unit moved into the first floor in March 2005, whilst Ticehurst was completely refurbished. The residents, with residential care needs, moved back to Ticehurst on 7 November 2005. Residents, with nursing needs were accommodated on the ground floor, until the move in November. However, following a fault in the under floor heating, the carpeting has been taken up and residents, on the ground floor, moved upstairs. The majority of the ground floor is cordon off. The work was due to be completed by 14 January 2006 but at the time of the inspection there was no sign it was nearing completion. It was reported that once the work is finished the office and other areas of the ground floor will need to be done because there is Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 Page 17 bubbling in the concrete in these areas as well. Despite the contractors working in the building and additional problems with toilets blocking, the staff team have worked well together and kept the residents calm throughout this long period. The manager reported that it would be good when all the contractors have left and the all the minor defaults with the building resolved. Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 30 Residents are well supported by an integrated team of nurses and carers, who are well trained and supervised, ensuring that the residents’ physical and mental health needs, as well as their social needs are met. EVIDENCE: On both days of the inspection visit there were two nurses and four care staff on duty. The home is working on the ratio of one nurse to ten residents. All the staff employed are all full-time. Ticehurst Nursing Home currently employs two senior nurses who are both RGN’s [registered general nurse]. One is also an RMN [registered mental nurse] and the other senior nurse is an RMN but is going for adaptation. There are five nurses, working days, and four nurses working nights. Ticehurst Nursing Home has sixteen carers and three domestic staff. Two ‘E’ grade nurses are due to start shortly. The home is to recruit more care staff. Ticehurst Nursing Home does not currently have any bank staff, although there have been various requests from outside nurses to work a shift or two in the home. The manager reported that the director of nursing and residential care is taking this matter forward, in an attempt to resolve the contractual arrangements in temporarily employing NHS staff. Ticehurst Nursing Home also has two assistant unit managers, whose responsibility is overseeing the care staff and they will also ‘work on the floor’. The assistant unit managers can cover the management of the home if a senior nurse was not available, however, the ‘E’ grade nurses are capable of running the shift, if a senior nurse was not available. The assistant unit Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 Page 19 managers would be available to cover for the residential care unit, if there was a need. There is a good team spirit in the home and the team has jelled really well together, especially given the problems with the building. The home has regular staff meetings, involving both the nursing and care staff. There is a senior meeting for the whole of Ticehurst, as well as separate meetings for the nurses and another for the carers. Two staff members have commenced NVQ level 2 and it was reported that other carers are considering this as an option. A programme of training is in place. The home has a good nursing induction programme. Nursing staff have attended courses on phlebotomy, male catheterisation and tissue viability. There is an update on manual handling planned. Staff have the opportunity of attending a four-day dementia course as well as a challenging behaviour course. Staff have received adult protection training as part of their basic induction. However, it was identified that this needs updating through the core-training programme. Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37 and 38 The manager provides good leadership, which ensures staff are supported and residents’ health, safety and welfare are promoted and protected through the home’s practices. EVIDENCE: Maize Mears-Owen is the registered nurse manager. Her professional qualifications are as a registered nurse [mental health] and she has a diploma in nursing studies [mental health] and a postgraduate diploma in drama therapy, having worked in a variety of specialist settings. She is currently doing the NVQ level 4 in management course. The manager communicates a clear sense of direction and leadership through staff meetings, staff supervision and education. Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 Page 21 Although Ticehurst Nursing Home and Ticehurst are two separately registered homes, with two registered managers, there is a sense where both homes want to present a more integrated approach, with residents with nursing needs making use of the facilities in Ticehurst, joint staff training sessions and joint assessments by both managers. Meals are now cooked in Ticehurst and brought across to the nursing home unit. The inspector was able to speak to staff members and they confirmed that they felt supported by the management team. The manager is supernumerary to the main duty rota. Due to the frailty and ability of the majority of service users, the home does not have residents’ meetings but prefers to conduct one-to-one interviews. However, there is a lot of feedback from relatives. The home had a Christmas party for the residents, although this was a low-key affair as all the hype around the festive period can adversely affect people with dementia. The home spoke to the relatives and keyworker about a suitable Christmas present. Relatives commented how thoughtful the gift was. The manager wants to involve relatives more and the use of a newsletter was discussed, as she had done this in her previous jobs, which proved very useful for both residents and relatives. The manager has had exploratory talks with the local Alzheimer Society about setting up a carers/relatives’ support group. Carers can also go to the Alzheimer café in Aldershot, which is a drop-in centre, one evening a week. Hampshire County Council policy is that no more than £50, in cash, should be held for any service user. The home is currently holding money for fifteen service users, which is money given to them by relatives. This tends to be for hairdressing, chiropody, newspapers and incidental items. One resident pays for their own hairdresser who comes into the home. Some families hold the resident’ money. The records, receipts and individual residents’ money were viewed and found to be satisfactory. A system of supervision is in place, where the manager supervises the senior nurses, who in turn supervise the nurses. The assistant unit managers supervise the care staff and the manager and manager from Ticehurst supervise the assistant unit managers. Staff have received supervision and there was confirmation of this. Samples of records the home is required to keep were inspected. These were satisfactorily maintained. One of the assistant unit managers is the fire officer for the home. The home has not had a fire drill yet. It was reported that when the fire alarm goes off it also sets the alarms ringing in the residential care unit, so a co-ordinated fire drill is needed. However, it is strongly recommended that a fire drill takes place, sooner rather than later. Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 Page 22 The manager ensures the safe working practices by planning courses on relevant health and safety issues. Risk assessments are in place. There are current contracts on electrical and domestic equipment. COSHH [control of substances hazardous to health] policies and procedures are in place. The home is double glazed throughout and radiators covered. From an investigation of the records and practices observed in Ticehurst Nursing Home during the inspection, the health and safety measures taken in the home meet the standards of the Commission. Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X X X X STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 Page 24 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 Ticehurst Nursing Home DS0000063269.V278185.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 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. 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