Inspection on 12/11/08 for Village Nursing Home

This inspection was carried out on 12th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Village Nursing Home 14/11/07

Village Nursing Home 27/11/06

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

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Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Village Nursing Home Wellfield Road Murton Seaham Co Durham SR7 9HN     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sam Doku     Date: 1 4 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Village Nursing Home Wellfield Road Murton Seaham Co Durham SR7 9HN 01915171020 P/F NOE-MAIL Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Jigsaw Care Ltd care home 41 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Village Nursing Home provides nursing and residential care services (41 beds) for people in the following categories: Old age, not falling within any other category (41) and Physical disability (14). Jigsaw care Limited is the registered provider of the service. Mr P S Kohli is the responsible individual for the company and Mrs Sharon Simpson is the registered manager responsible for the day-to-day conduct of the home. It is located in a housing estate close to the centre of town and has good links with the local community. It is a single storey building with an enclosed courtyard/garden area, plus car parking space to the side. There are 37 single bedrooms, including a small proportion with en suite facilities, plus 2 double bedrooms. These are all fairly spacious rooms. The fees vary between 390 Pounds and 440 Pounds per week. The fee covers all accommodation, meals and personal care (plus nursing care for those residents in receipt of continuous nursing care at the home). Hairdressing, toiletries, newspapers, plus services from private opticians, dentists and Care Homes for Older People Page 4 of 28 Over 65 41 0 0 14 Brief description of the care home chiropodists are not included in the fee. The actual amount people pay will depend upon their individual circumstances. Up to 3 day-care places are available each day for non-residents. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating of this service is 1 Star. This means the people who use the service experience adequate quality outcomes.The inspection was unannounced and commenced on 12 November 2008 and completed on the 14 November 2008. Before the visit the inspector looked at: Information we have received since the last inspection visit on 14 November 2007. How the service dealt with any complaints and concerns since the last inspection. Any changes to how the home is run. The providers view of how well they care for people, as highlighted in the details provided in the Annual Quality Assurance Assessment (AQAA). During the visit the inspector did the following: Talked to the people who use the Care Homes for Older People Page 6 of 28 service, the manager and the care staff. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff have the knowledge, skills and training to meet the needs of the people they care for. Looked around the home to make sure it is safe and secure. Checked what improvements have been made since the last inspection. The inspector told the manager what he found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations- but only when it is considered that people who use the services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: Bedroom doors were wedged opened with all kinds of devices. These include large stones, iron-cast door stoppers, chairs, cushions, slippers and tables. These poor practices were commented on in the fire risk assessment report commissioned by the home, but no action was taken by the proprietor to address them. On entry to the home at 06:20 it was noticed that the lounge was being hoovered by a domestic staff member. The noise was such that it was likely to wake people up at that time of the morning. The nurse in charge at the time seemed powerless to stop the staff member from hoovering at that time of the morning. The nurse in charge stated that this is a regular occurance and that she had on previous ocassions tried to stop this practice without success. Some of the breakfast bowls were badly chipped around the the edges and could potentially injure someone. In one case the inspector had to intervene and he asked a staff member to replace the bowl as he considered it unsafe, and also compromised the dignity of the gentleman in question. The inspector noticed at 07:20 in the morning that the treatmenet room door had been Care Homes for Older People Page 8 of 28 left open and there were no staff around to supervise the place. The room, which contained medicines, oxygen cylinder and other medical materials was accessible to anyone, including residents, some of whom may be confused. It was noticed during the inspection period that when serving meals for the residents, the staff wore plastic gloves. Staff also wore plastic gloves when assisting residents with their meals. This pratice compromised the dignity of the residents and therefore should be reviewed. The pratice is not in line with the homes own written policy on assisting residents with meals. The carpets in some parts of the home, particularly along the corridors, were old, worn and dirty and need to be replaced. The carpet in the staff room was badly stained and dirty. The complaints procedure should be amended to provide the correct contact details of the Commission for Social Care Inspections. Staff supervision is currently not taking place and the manager needs to put systems in place to allow this to happen. The staff job application form should be amended to make sure that it makes provision for the details of person who is providing the reference. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents have their needs assessed by people who have been trained to do so before they are admitted to the home. This ensures that their have been identified and arrangements can be made to provide the care that the person needs when they are admitted. The home provides information about the service, including the opportunity for prospective residents to visit the home, which enable them to make informed decisions about whether to live there. Evidence: Residents files contain pre-admission assessments which have been carried out by the home and also by the social worker or nurse assessor. The homes policy is to carry out such initial assessments to make sure that they have the necessary skills and facilities to meet the needs of the person. The home also insists on receiving an Care Homes for Older People Page 11 of 28 Evidence: assessment from the social worker or nurse assessor to make sure that both assessments identify the same care needs. These assessments are then used to prepare the initial care plans for the person, so that all staff know what care and support the person needs when they arrive in the home. The inspector specifically spoke to residents about their experience of the preadmissions assessments. They all confirmed that they were visited in their homes or on a hospital ward and asked various questions about their health and the kind of help that they would need. It was only after the visit that they were formally offered a place in the home. Residents and relatives confirmed that the staff supplied them with good information about the home when they were looking for a place. Information about the home is also available in the reception area for residents and visitors to see. Most of the information is relevant and up to date. However, the information about the complaints procedure need to include the current contact details of the Commission for Social Care Inspection. A number of staff were spoken with about the way admissions take place in the home. Staff described the process including the opportunity for prospective residents to come and visit the home and to find out more about the home before making up their minds about coming to live at the Village Nursing Home. Staff gave examples of specific residents who visited and even had lunch with other residents on the day of their first visit to the home. Two relatives also confirmed that they visited the home when they were looking for place for their family member. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal and healthcare needs of the residents are met, and care plans have been put in place to help staff address their needs. However, the correct medication administration procedures are not being followed which could potentially affect the health and wellbeing of the residents. The residents are treated with dignity and their right to privacy is upheld. However, the wearing of plastic disposable gloves when assiting residents with their meals compromises their dignity. Evidence: Residents confirmed that they have access to healthcare facilities including GP support and other healthcare professionals. Residents gave examples of how the nursing staff regularly arrange for their GPs to visit them. The residents files provide details of the healthcare support that each individual resident gets. The care notes show entries of visits to or from healthcare professionals. Care Homes for Older People Page 13 of 28 Evidence: The care plans are well written and provide good information for staff to follow when providing specific care tasks. The care plan provided details of how staff should support the residents and these are regularly reviewed and changes made to them to reflect the current care needs of the individuals. The inspector spoke to staff about care plans and they were aware of how the person should be cared for. Care staff said that they often read the care plans but are also regularly informed by the nursing staff when changes are made to any of the care plans. The home has detailed written policies on the storage and administration of medicines. The manager confirmed that the nursing staff who are responsible for the administration of medicines have received up to date training on safe handling of medicines. A random check of the medicines administration system was undertaken by the inspector. There were no discrepancies noted, and the administration sheets have been signed and dated as required. However, the inspector noticed two small dispensing pots in the treatment room containing tablets with no names to show whom they belong to. Furthermore, the treatment room was left unsupervised whiles it was left wedged-opened for about half an hour. There were also strips of papers with residents names on them, indicating that the night staff dispense all the medicines into the individual pots in the treatment room and then carry them to the residents. The inspector mentioned his concerns to the manager who took immediate action to dispose of all the strips of papers with names on, and then she advised the staff not to engage in such poor practices again. Relatives commented that they feel that the healthcare needs of the residents are met. One relative stated that the staff always inform her when the doctor comes in to see her mother. She feels her mother is well cared for and her health has improved since she was admitted. Another relative specifically asked to speak with the inspector and she expressed her satisfaction with the care that her mother receives at the Village Nursing Home. The interraction between staff and residents was good. Staff showed respect to the residents and this was commented on by a number of residents. Relatives also confirmed that the staff treat people with respect and dignity. The staff were polite, courteous, friendly and professional in the way they related to the residents. There was a lot of exchange of polite and tasteful jokes and banter between staff and residents. This created a happy and friendly atmosphere in the home. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents engage in meaningful and enjoyable social and recreational activities. Furthermore, families and friends are encouraged to contribute to the residents sense of wellbeing by being supported and encouraged to visit regularly. The residents are provided with good variety of wholesome and nutritious meals, which promotes their health and wellbeing. Evidence: The home has an activities coordinator who described the activities that are organised for the residents. They include bingo, card games, sing along, films and outings. The activities coordinator effectively uses the small shop in the dining room to interest the residents in buying small items, including toiletories, sweets, cards, shampoo, biscuits and packets of crisps. One resident commented on the shop and said how much she enjoys visiting the place. The activities coordinator stated that there are residents who are not able to take part in organised activities, and for those people she often spends time on a one-to-one basis with them so that they can also benefit from her activities. There are two dining rooms in the home, one large one and a smaller one. These are Care Homes for Older People Page 15 of 28 Evidence: pleasantly decorated and furnished to a good standard. However, furniture in the small dining room could do with being replaced as they are suffering from wear and tear. The tables were appropriately set and the residents had their meals in a pleasant and comfortable environment. The residents were given plenty of time to enjoy their meal and people who require help from staff with their meals were given that support in ways that generally preserved their dignity. However, the wearing of plastic gloves when serving and assisting residents with meals compromise the dignity of the residents. Residents commented that they like the food and that there is always plenty to eat. They described the food as excellent and they confirmed that they are offered a choice of menus. A number of residents said that they like to spend a lot of their time in their rooms and that they are not made to join in social activities if they did not wish to. Two residents said they enjoy their own company and the staff respect their way of life. Some residents have their own small fridges and coffee or tea making facilities in their rooms. Those residents said that they are able to remain independent and are pleased that they have the opportunity to remain so. Residents confirmed that they get up and go to bed when they want. They also said that provided with cups of tea when when they first get up in the morning. At the time of the inspection visit at 06:20 some residents were up and dresed and were having cups of tea in their rooms. During breakfast some of the residents decided to have their breakfast in their rooms and the staff made the necessary arrangements for them. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and relatives have information about how to make a complaint thus promoting the residents right to express their views about the service. Staff are aware of safeguarding adults procedures and have received suitable training which safeguard the residents from any form of abuse. Furthermore, there are excellent arrangements in place for accounting for the residents personal allowances, minimising the risk of financial abuse. Evidence: The manager confirmed that all staff have had training in safegaurding adults, and she indicated that refresher training is regularly provided. The staff training log shows that staff have had up to date training in safeguarding adults. Staff who were spoken with were familiar with the homes policy on safeguarding vulnerable people and showed good understanding of safeguarding issues. All staff have had enhanced Criminal Records Bureau (CRB) checks, and also checks against the Protection of Vulnerable Adults (POVA) list. The home has a complaints procedure and a copy of this is posted in the reception area for residents and visitors to see. The contact details of the Commission need to be updated to show the details of the local office of the Commission for Social Care Care Homes for Older People Page 17 of 28 Evidence: Inspections. The inspector examined the complaints book and there have been no complaints received since the last inspection. Residents and relatives said that they are aware of the complaints procedure and feel confident about raising any concerns with the manager if they were unhappy about anything. One residents said that she has no concerns about the home and she described how the manager dealt with a concern that she raised with her, and how this was quickly resolved to her satisfaction. Two staff members were also spoken with about the homes complaints procedure. Staff had good knowledge and understanding of the complaints policy and procedure, and knew how to support residents if they wish to make a complaint. They were also confident about reporting any abuse situation in the home if they become aware of it. The home has an excellent system in place for accounting for the residents personal allowance. The monies are securely kept and are regularly audited and signed by two people. Receipts are avaialble for purchases made on the residents behalf. A random check of four accounts showed no discrepancy in the amount of monies held for the individuals. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides secure, clean, warm and a pleasant environment for the residents to live in. However, the disregard for one area of fire safety measures compromise the safety and welfare of the residents. Evidence: The home generally is clean and maintained to a reasonable standard. Indivudual bedrooms were clean, homely, appropriately furnished and maintained to a good standard. People have been encoruaged to bring into the home their personal items such as pictures, photographs and small items of furniture to furnish their rooms with. Some residents have small fridges in their rooms and use them to store their favourate food items. Residents bedrooms look homely and reflect individual tastes and preferences. All radiators have protective coverings and windows have restrictors on to stop intruders and to ensure the safety of the residents. Carpets in some areas along the corridors were worn, dirty and need to be replaced. The communal areas were clean and pleasantly furnished. Visitors to the home commented that the home is always nice and clean although some commented on the dirty state of some of the carpets along the corridors. The carpet in the staff room was dirty and needed cleaning. The kitchen was well ordered and clean, and the staff maintained good hygiene standards. Care Homes for Older People Page 19 of 28 Evidence: The home has a maintenance man and he has a record of all the work that he does in the home to keep it in a good state of repair. There are written policies covering all aspects of the running of the home, including health and safety. These policies include details policies about fire safety precautions in the home. However, staff do not follow these policies and there were poor fire safety standards relating to fire doors. On arrival in the home at 06:20 it was noticed that the front door had been wedged opened with a cushion and this was in place for sometime until the inspector mentioned it to a staff member. It was noticed that almost all the bedroom doors have been wegded-opened with all kind of devices inclduing tables, chairs, heavy stones, cushions, slippers and iron-cast door stoppers. Examination of the local Fire and Rescue service report dated 23.06.06 highlighted this practice and recommended that if the needs of the persons using the building require the fire resistant doors to be held in posision during normal conditions, they should only be held open by magnetic devices. This recommendation appear to have been ignored and staff continued to use stones, slippers and other devices to keep bedroom doors and other fire resistant doors open. Furthermore, the person who undertook the homes fire risk assessment on the 27.07.07 made similar observations about the use of stools, stones, walking frames and other ornaments to keep doors open. The assessor included photographs of these objects in the assessement to emphasise his concerns. The inspector informed the local fire and rescue service of his concerns and they agreed to visit the home and carry out another inspection. The inspector told the manager about the seriousness of continued failure to maintain adequate fire precautions in the home and failure to take action on professional advice on this matter. Before the completion of this report, the inspector received a phone call from the manager to say that the owner of the home had ordered Doorgards and that these would be fitted to all bedroom doors as soon as they are delivered Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing numbers and skills mix are satisfactory and promote the safety and welfare of the residents. The home adheres to good recruitment practices, which safeguards the welfare of the residents. Evidence: The home employs sufficient numbers of staff to meet the needs of the residents. There is a registered nurse on duty at all times including night duties. Staff, residents and relatives were spoken to about the staffing levels in the home. They all said that there is always plenty of staff on duty. One relative said she visits the home regularly and has found that there are always sufficient and competent staff on duty. Staff have received training in different areas including training in dementia awareness, Palliative Care, safe handling of medication and health and safety training. The manager confirmed that the staff have received training in moving and handling, first aid, protection of vulnerable adults, fire safety, food hygiene and health and safety training. The nursing staff continue to receive refresher training to update them on nursing practices. Staff records show the training that they have received. The inspector spoke with the staff about training in general and they were very pleased Care Homes for Older People Page 21 of 28 Evidence: with the training they recieve from the employer. Four staff files were examined to check on the recruitment process by the manager. The files show that the home has been following good recruitment procedures. All the files contain completed job applications, copy of job description, appropriate references, evidence of CRB checks and record of induction and training. Information in the AQAA shows that all the care staff have NVQ Level II or above. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by a qualified and experienced person, and runs the home for the benefit of the residents. The home has suitable arrangements in place to provide supervision for the staff. This promotes the quality of the service that the residents receive. The safety and welfare of residents is protected by the regular servicing of equipments and safety arrangements that are in place. However, the disregard for fire safety procedures seriously compromises the welfare of the residents. Evidence: The registered manager has a long experience of managing a residential care home, and is pupported by a deputy manager who also has good experience of working in various nursing and care home settings. Staff, residents and relatives commented favourably on the managers ability. Staff stated that she is approachable and and Care Homes for Older People Page 23 of 28 Evidence: always availble to advice. Staff said she is supportive of them and also of the residents.The arrangements for formal one-to-one staff supervision is not happening on regular basis. The manager has responsibility for a whole range of administrative tasks including working out staff wages, residents fees, residents personal allowances and other administrative tasks which would normally be undertaken by an administration officer. The companys policies and procedures are up to date and are regularly reviewed and updated as necessary. These cover policy areas such as abuse, whistle blowing, infection control, first aid, food hygiene, fire prevention and Care of Substances Hazardous to Health (COSHH). Staff who were taking part in a moving and handling training in the home at the time of the inspection confirmed the training they have received and said that they are appreciative of the emphaisis on providing them with the appropriate training in order for them to do their jobs safely and effectively. Servicing and maintenance records show that all portable appliances have been tested. A record is maintained of regular water temperature in bedrooms, toilets and bathrooms. Regular servicing of fire equipment, bath lifts, mobile hoists, gas and electrical appliances have been carried out by the contracted companies. All the servicing records that were examined were up to date. The homes fire risk assessment is up to date. Records examined indicate that fire precautions relating to weekly fire alarm testing and record of inspection takes place. There are records in the home indicating fire drills and fire instructions with staff. The manager confirmed that all staff have received up to date fire safety training. However, this is not reflected in practice as shown by the the poor safety measures that the staff engage in. The owner and the registered manager must give due regards to the safety and welfare of the residents by taking steps to put in place the fire safety recommendations made by the local fire and rescue service, and also by the assessor who undertook the homes fire risk assessment. The safety and welfare of the residents in terms medication administration and security of the treatment room is less than satisfactory. The manager must to make sure that staff supervision, including clinical supervision for nurses takes place regularly in order to avoid poor medication practices as highlighted in other sections of this report. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 12 Health and welfare The method of dispensing medicines as practised by the night staff must cease and the proper drugs administration procedures must be followed to safegaurd the health and welfare of the residents. 09/01/2009 2 38 13 Health and Welfare The treatment room must be locked at all times when it is not in use. The practice of leaving the treatment room door wedged open and unsupervisied for long periods of time is unsafe and compromises the safety and welfare of some of the residents. 31/12/2008 3 38 13 Fitness of Premises The owner must take appropriate action to safeguard the safety and welfare of the residentd by 13/02/2009 Care Homes for Older People Page 26 of 28 adhering to all safety measures, thereby eliminating all unnecessary risks to the residents. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 12 The wearing of gloves by staff when serving meals and assisiting residents with their meals should be reviewed as this is considered as an institutional practice and compromises the dignity of the residents. The manager should review the arrangements for hoovering of the communal areas in the early hours of the morning to reduce the inconvenience or disturbance to the residents whose sleep could be disturbed by such early morning activitiy. The complaints procedure should be reviewed to include the current contact details of the commission for Social care Inspections. The carperts in some part of the corridors are worn and dirty and need to be replace. All staff should receive regular supervision, including clinical supervision for the nursing staff. amaged breakfast bowls should be replaces as this has the potential of causing injury to residents. Furthermore, the use of such bowls compromise the dignity of the residents. 2 12 3 16 4 5 6 19 36 38 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. 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