Inspection on 10/05/05 for Wayside Nursing Home

This inspection was carried out on 10th May 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Wayside Nursing Home 15/11/07

Wayside Nursing Home 03/05/07

Wayside Nursing Home 06/02/07

Wayside Nursing Home 20/10/05

Wayside Nursing Home 14/01/05

Wayside Nursing Home 22/07/04

Wayside Nursing Home 23/02/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Wayside Nursing Home 25 New Road Bromsgrove Worcestershire B60 2JQ Lead Inspector Mandy Burton Draft Unannounced 10 May 2005 07:45 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 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. Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Wayside Nursing Home Address 25 New Road Bromsgrove Worcestershire B60 2JQ 01527 837774 01527 872631 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Alpha Health Care Limited Pamela Ann Andrews Care Home with Nursing 30 Category(ies) of DE(E) Dementia (over 65) - 3 registration, with number OP Old Age - 30 of places PD(E) Physical Disabilities (over 65) - 30 Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 14 January 2005 Brief Description of the Service: Wayside Nursing home provides care and accomodation for up to 30 older people. Its registration allows the home to offer all 30 placements for older people with physical disabilities and includes up to 3 placements for people who are over 65 of age and have dementia. The home is a large detached period property which includes a pleasant and mature enclosed garden and limited car parking. Residents accommodation is on three floors (ground, first and second floors) which can be accessed by a central passenger lift. A stair lift also acesses a limited number of rooms on the first floor. There are a range of single, double and en-suite bedrooms. The home has several lounges, a dining room , a conservatory and a hairdressing room. Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 07.45am. The main focus of this inspection was to review requirements from the previous inspection. It took place over an eight hour period. A partial tour of the home took place and a selection of care records were examined. During the course of the inspection nine residents, eight members of staff and two visitors were spoken to. What the service does well: What has improved since the last inspection? What they could do better: Staffing levels must be improved in order to ensure residents safety, continuity of care and provide residents with the ability to exercise choice and control over their lives. Comments made by residents included: “Home is in a bad state due to the lack of staff”. “There is not enough staff, but those here are lovely” “If I became very ill, there is no one about”. Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 Page 6 Further opportunities for obtaining feedback from residents, staff and relatives should be developed, which enables them to influence service delivery. Systems for recording training need to be improved in order to ensure all staff are appropriately trained for the duties they are to perform. All care staff should be supported by regular supervision sessions. Increasing staff’s awareness of the policies and procedures in relation to health and safety practices. Outstanding maintenance issues should be addressed in order to provide a safe and comfortable environment for residents and equipment provided to ensure individuals’ needs can be met. 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. Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 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 standard(s) 3 and 4 Basic pre admission assessments are completed for each resident. The lack of specific detail of individual care needs and preferences provides no assurance that care needs of residents have been identified and can be met by the home. EVIDENCE: All residents are assessed by a registered nurse prior to their admission to the home. A pre admission assessment was seen of a resident recently admitted to the home. The assessment contained basic information about the resident but failed to fully identify how their health care needs were to be met and any individual preferences they may have. A resident highlighted concerns that prior to their admission they had been reassured that as part of their care their mobility would be encouraged and staff would be on hand to facilitate this. They expressed disappointment that their needs had not been met. They said that staff did not have the time available to them to assist them. No changes had been made to the assessment documentation as recommended at the previous inspection in order to accommodate more detailed information. Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 Page 9 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 standard(s) 7, 8, 9 and 10 Care planning systems in this home are weak and fail to ensure that the health care needs of all residents are identified and appropriate care provided. The home has made some limited progress to improve arrangements for administration of medication, but the poor standards of recording continues to place residents at risk. The shortage of staff to provide personal support can potentially compromise residents’ dignity and independence. EVIDENCE: The care plans for three residents were examined. Basic care plans had been written which did not provide sufficient information about the individual needs of residents and the care to be given to meet any needs identified. • One resident was diabetic, their plan made no reference to the current treatment for the diabetes and the need for, or frequency of monitoring of their blood sugar levels • One resident had a visual impairment and required regular eye care throughout the day. No care plan was in place to identify this need and to direct the care to be provided. Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 Page 10 • • One resident had difficulties communicating at times. There was no supporting care plan in place to identify these difficulties and to ensure consistency of care. One resident had a care plan in relation to weight gain. The plan had not been reviewed since august 2004, and it contained no reference to the required frequency of weight recording. Since the last inspection care plans had been documented for some residents in respect of their social and emotional needs as per previous inspection. This should now be extended to ensure assessments are completed for each resident and plans documented whenever necessary. Since the last visit to the home a system has been introduced for internally auditing care plans. Resident and relatives spoken to said that had not seen or been involved in the care planning process. Daily progress records were inconsistent. One resident was being nursed in bed. No current recording system was in place to monitor fluid intake, oral care and pressure relief. High dependency records were seen for April 2005 but no further documentation had been maintained. Moving and handling assessments had been completed for each resident. Assessments for two residents had not been reviewed and updated once a month as required at the previous inspection. Information contained in their assessments did not accurately reflect their current mobility and moving and handling needs. All residents are registered with a local doctor. One resident had requested a visit for their doctor and staff had arranged this. A relative was able to confirm that staff are responsive to any changes in the condition of their mother and that doctors visits are arranged when any need arises. They raised some concerns about the fact that they were not always told promptly of any impending health care appointments or any visits that had taken place. Medication records were examined. Although there was some noted improvement in the quality of recordkeeping since the last inspection, there was still a significant number of omissions with no reason noted for this. An Immediate Requirement was issued in relation to this Not all written additions or amendments to medication administration records had been signed and countersigned. The home has a drug fridge for the cold storage of any medication/treatments. Daily monitoring of the fridge temperature had not been maintained as required at previous inspections on 22nd July 2004 and 14th January 2005. Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 Page 11 A clinical equipment cupboard was seen which contained a selection of equipment including suction machines, and catheters. Some of the stock stored had exceeded its use by date. Three residents spoken to referred to waiting long periods for assistance to the toilet on a regular basis due to insufficient numbers of staff available to assist them. One resident spoken to had asked for urgent assistance to the toilet (as a result of medication taken for fluid retention) but had been told by staff that they would have to wait as they attending to another resident. The resident said that this situation occurred on a regular basis and caused them much upset and anxiety. There was no privacy lock to one bathroom (bathroom 3). It was reported by the trained nurse that no residents had pressure sores or wounds that required ongoing treatment. It was not therefore possible to review requirements issued at the last inspection in relation to this. Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 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 standard(s) 13, 14 and 15 Inadequate staffing levels and an inflexible routine fails to ensure residents maintain independence and can make decisions and choices about how they wish to spend their time, and what they would like to eat. EVIDENCE: Residents spoken to were unable to confirm that they were able to make choices in relation to day-to-day living. The main reason given for this was the lack of staff in the home available to provide support and assistance to them. Residents spoke about several incidents, which included: • One resident being taken to the toilet and when they called for help they were told staff were busy with another resident but would return. They said that staff forgot to return until some time later. • One resident highlighted the absence of staff in communal areas, which is more noticeable in the evening. They spoke about several occasions when they have wanted to go to bed but have been unable to call staff for help so have to wait until staff come into the lounge which may be some time later. • Several residents spoke about delays in the morning. They said they have to fit in with the staff’s routine, as “they are all so busy”. • The daily notes for one resident noted that the resident concerned ‘complained’ of being last to bed when told by staff that they could not take them to bed as they wished, as there was three more residents to attend to before them. Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 Page 13 Staff spoken to supported the need for residents to make choices and to take control of their lives but said that this was not always possible with the numbers of staff on duty. Staff also said that any time to sit and chat with residents or their families was limited. Two visitors to the home were able to confirm that they were welcomed there at any time. A written record was kept of any visitors. The breakfast routine was observed and a number of residents were spoken to. By 9.35am 18 of the 30 residents had had their breakfast. Breakfasts were served in the dining room or in residents’ bedrooms. • • Residents were not able to confirm that they were made aware of the menu for the day or that they were provided with a choice at mealtimes. One resident said that they did not know what the meal was going to be until it was served, and then they ate what they could as they did not wish to cause extra work for staff to provide an alternative as they were so busy. One resident said that they were hoping to have an egg for their breakfast. Staff did not consult with the resident about their breakfast choice and served them porridge, as was the normal routine. Staff said that they have a good understanding of the individual likes and dislikes of residents which enables the to know what each resident will eat. Residents’ spoke about the lack of variety for the evening meal. Sandwiches were served most days with no options available except for those residents on soft diets. Staff said that the reason that hot meals were not made available was due to lack of catering staff. A kitchen assistant is on duty every evening solely to serve meals and wash up. The menu book was seen, which showed the main meal of the day. There was no record of alternatives being served each day. One resident described meals as “terrible, and night time is the same”. • • • • • The activities coordinator was not on duty at the time of this visit and requirements from the previous inspection could not be assessed during this visit. Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed. EVIDENCE: Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25 and 26. Although there has been some limited improvement to the standard of the environment, current conditions and the need for significant maintenance and refurbishment does not provide a safe and comfortable environment for residents to live in. The lack of suitable equipment to meet the individual needs of residents potentially places residents and staff at significant risk. EVIDENCE: Since the last inspection in response to requirements issued, some maintenance work has take place, which has included: • New fencing erected at the bottom of the garden. • A sluice machine replaced. • Thermostatic controls have been fitted to hot water outlets. • Window frames in the lounge had received a light coat of paint. • A shower room on the first floor has been refurbished and a bathroom on the ground floor has been changed to a shower room. The ground floor facilities were not being used, as there was ongoing problem with fluctuating water temperatures, which was thought to be Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 Page 16 due to problem in the home with water pressure. Because of the risk involved staff were not using the shower. The handyperson was asked to disable the shower until the situation was resolved. Further action is required to fit grab rails in the shower room and to make sure that the temperature ranges of each shower setting is displayed, to ensure residents can be showered at safe water temperatures. Maintenance staff are on site 2 days pre week to delay with any day to day work and to do weekly/monthly health and safety checks. During this inspection a partial tour of the home took place during which a number of areas for action were identified which included: • Not all rooms have lockable storage for residents to securely store personal items. • The toilet in bathroom4 was out of order. (An Immediate Requirement Notice was issued in relation to this.) • Carpets in F7, F14, S7 and ensuite, WC3 and WC4 were in a poor condition and in need of replacement. • Carpet on main staircase and in hallways continues to be a problem. It is very worn and requires replacing. • Grab rails required in WC5. • The conservatory carpet had a multitude of stains apparent and requires cleaning or replacement. • Not all radiators are guarded. Some work has taken place since the last inspection, but this needs to be extended to include all radiators as a matter of urgency. • The garden shed was not appropriately secured and contained a multitude of tools and some chemical products. • Remedial paintwork needed to an area in conservatory where a leak had occurred previously. • Wallpaper was peeling from wall in a bedroom (F3), and redecoration is necessary. • One of the tumble driers was out of order and had been for 2 weeks creating additional pressure on staff. (An Immediate Requirement Notice was issued in relation to this.) • A television in one lounge was positioned so low down it made it difficult for residents in some chairs to view it. • Plaster missing off a sluice room wall exposing pipe work, which requires some attention. • Not all areas of the home were clean and many bedrooms were very dusty. The lounge (red) carpet had food debris evident in several areas. • Infection control measures need to be improved. A wash hand basin in the laundry noted to contain laundry items (An Immediate Requirement Notice was issued in relation to this.). Tablets of soap were observed in two communal toilet facilities. Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 Page 17 Residents have access to three lounge areas and a conservatory all of which are very homely in appearance. A pleasant outdoor seating area has been provided for residents to enjoy. Staff and relatives have done much of the work to this area. Fundraising has taken place to purchase garden furniture. One relative said how nice it was to have the outside area but said that their relative was reluctant to sit outside as they had no way to call for help and there was not always staff available to supervise them. Resident’s bedrooms were very personalised and homely in appearance. The home has a passenger lift to all floors and a stair lift from the ground to the first floor. During this inspection staff were observed having to lift a resident who was in a wheelchair down two steps from their first floor room to the passenger lift. They said that had to do this, as the stair lift was not suitable for use. They confirmed they were doing this twice daily for three residents. This practice is unsatisfactory. Staff raised concerns about lifting aids for two residents in the home and the absence of suitable equipment to meet their needs. Records for one of these residents showed that although concerns had also been raised by the doctor in relation to safe moving and handling and the risks to staff no equipment had been provided. Staff and a relative said that a member of staff based at head office had told them that staff would have to fundraise for equipment. One resident said that they had purchased their own reclining armchair for use in the lounge when the one provided by the home was no longer suitable. Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, and 30 Residents in this home are being placed at risk due to insufficient numbers of staff. It is not clear if all staff have received the health and safety training necessary to ensure residents are safe in their care. EVIDENCE: Staffing levels in this home continue to raise concerns as per inspections 14.01.05 and 22.07.04. At the start of this inspection (7.45am) there was one registered nurse and four carers on duty to care for 30 residents. Staff were seated in the office receiving a handover report. The handover was very informative and information was passed on about each resident and any changes, which may have occurred. No one was on the floor supervising/assisting residents during this time as night staff had already left. Two more carers were due on duty by 8.30 am taking the total to six. By 9.35am 18 of the 30 residents had received their breakfast. Rotas seen showed: • Two occasions where there was only five carers on duty on one morning and four on one late shift which is contrary to the previously agreed staffing levels for the home. • One member of staff was noted to have worked over 56 hours in 7 days before having a day off. Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 Page 19 It was reported that agency staff are used occasionally and typically at night. Where possible shifts are covered by the home’s own staff or staff from another Alpha Health Care home. Discussions with residents, staff and visitors and observations made during the inspection show that the numbers of staff on duty at the home are insufficient. As a result of this resident’s needs are not always being met. Comments made include: “Home is in a bad state due to the lack of staff”. “There is not enough staff, but those here are lovely” “If I became very ill, there is no one about”. An Immediate Requirement Notice was issued during the inspection which stated that staffing levels must be increased in order to ensure that the health and welfare needs of the residents are met and that sufficient numbers of staff are available to supervise residents at all times. (Within 24 hours) Residents and two relatives spoken to were highly complimentary about staff, their caring attitude and their level of commitment to the residents. It was concerning to note that all residents and relatives spoken to expressed serious concerns about staffing levels in the home and the fact that staff were too busy to do anything more than provide basic care. Relationships between staff and residents were good. Morale among staff was noted to be poor. The main reason given for this was lack of staff and a recognised inability to meet the needs and preferences of residents in their care. One resident referred to the fact that staff are never accessible in communal areas and always busy particularly in the evening. Staff were only observed in communal areas when carrying out tasks. Other residents spoke about waiting for long periods (up to twenty minutes) to use the toilet. The majority of residents in the home require the assistance of two staff when mobilising. Requirements from the previous inspection in relation to staff recruitment could not be assessed as it was reported that no staff had been employed since the last inspection. Training records were examined. It was not possible from records seen to determine if all staff had received up to date training in moving and handling, fire safety and infection control. Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 35,36,37 and 38. Shortfalls in health and safety practices in this home are placing residents at risk. The systems for resident and staff consultation are weak with little evidence that their views are acted upon. EVIDENCE: The Home Manager was not on duty on the day of this inspection. Morale among staff employed in the home was low. Staff commented that they felt unsupported form Alpha Health Care and that inadequate staffing levels were compromising the care being given to residents. Staff said that there was no point in raising concerns to management as they were ware of the situation and were unable to do anything to improve the situation. Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 Page 21 Relatives spoken to also commented that they had raised concerns to Alpha Health Care in the past, which changed things for a short period and then things returned to the way they were. A satisfaction survey had recently been undertaken and findings had not been collated. Any other opportunities for staff, residents and relatives to provide feedback are limited. As result of inspection findings and the need to ensure feedback is not only obtained from staff on duty at the time of this inspection, the Commission for Social Care Inspection advised the Area Manager from Alpha Health Care that it will be surveying all staff in the near future. Health and safety records relating to kitchen fridge, freezer and food probing temperatures were incomplete. (An Immediate Requirement Notice was issued in relation to this.) This presents risks to residents in respect of food safety. Not all catering staff had received up to date food hygiene training. (An Immediate Requirement Notice was issued in relation to this.) Ten fire doors were observed to be wedged open (An Immediate Requirement Notice was issued in relation to this.). This presents a fire safety hazard. Concerns were raised regarding the safe moving and handling of 4 residents. 3 residents were being lifted up and down 2 steps twice daily in wheelchairs, and no suitable equipment had been accessed for another resident, which was putting both the resident and staff at risk. (An immediate Requirement Notice was issued in relation to this matter). The garden shed was not appropriately secured and contained a multitude of tools and some chemical products. Chemical cleaning products were observed in two communal toilet facilities. Multi socket electrical extension leads were in use in some bedrooms. This is not safe practice and additional sockets should be fitted whenever possible. Hot water temperatures were tested in Bathroom 4, the initial reading was 46.4 degrees Celsius, it then dropped within safe ranges. The wash hand basin’s initial reading was 48.3 degrees Celsius, which then again dropped to safe ranges. A shower room on the first floor has been refurbished and a bathroom on the ground floor has been changed to a shower room. The ground floor facilities were not being used, as there was ongoing problem with fluctuating water temperatures, which was thought to be due to problem in the home with water pressure. Because of the risk involved staff were not using the shower. The handyperson was asked to disable the shower until the situation was resolved. Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 Page 22 Further action is required to make sure that the temperature range of each shower setting is displayed, to ensure residents can be showered at safe water temperatures. Not all radiators have been appropriately guarded. Some work has taken place since the last inspection, but this needs to be extended to include all radiators as a matter of urgency. Records were seen of regular fire safety checks which had been undertaken by maintenance staff and temperatures of bath water temperatures recorded by care staff. No information was displayed in the home or on the staffing rota to identify the trained first aider each day. Individual records were kept in relation to each resident. not on file of all residents. Photographs were Monies held for safekeeping were audited. No discrepancies were evident, but it was noted that a receipt was not in place to support money spent on behalf of one resident. Although documentation has been in place for some time, the home has yet to implement a staff supervision programme. Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 1 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 1 15 2 COMPLAINTS AND PROTECTION 2 2 1 2 3 2 2 2 STAFFING Standard No Score 27 1 28 x 29 x 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x 1 2 x 2 1 2 1 Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 Page 24 YES Are there any outstanding requirements from the last inspection? 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 4 27 15 14 Regulation 18 Requirement At all times suitably qualified , competent and experienced perosn are working at the care homes in such numbers as are apprapraite for the helath and welfare of residents.(previous immediate requirement 22.07.04 and 14.01.05 not met) Residents care plans must accurately reflect the individual needs of the resident and the care to be provided by staff to meet those needs. Care plans must take into consideration how the emotional, spiritual and social needs of each resident are to be met by the home.(Previous immediate requirement 14.01.05 not yet met in full) Old/out of date stock to be removed from first floor clinincal cupboard. Moving and handling asessments must be reviewed and updated at least once a month and also when significant changes ocurr. (Previous immediate requirement 14.01.05 not met) Assessments for pressure sore risks must be reviewed and Timescale for action Immediate 2. 7 15 Immediate and ongoing Immediate and ongoing. 3. 7 12(1) 15(1) 4. 5. 89 8 12(1) 12(1) 13(5) 1st July 2005 . Immediate and ongoing 6. 8 12(1) 13(4) Immediate and Page 25 Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 7. 87 12(1) 15 8. 9 13(2) 9. 9 13(2) 10. 9 37 13(2) 11. 9 37 13(2) 12. 13. 10 12 12 (4) 16(2)(m) updated at least once a month and also when any significant changes occur.(Previous immediate requirement 14.01.05 not met). A written programme of wound care management must be developed which ensures that current treatment is documented. Document the dimensions of wounds to assist with the evaluation of treatment being given.(This requirement from 22.07.04 and 14.01.05 could not be assesssed on this occasion.) The temperature of the medicine refrigerator must be monitored and recorded daily.Levels must be maintained between 2 and 8 degrees Celsius.(Previous requirement 22.07.04 and 14.01.05 not met) All trained staff must follow the homes policies and procedures for the safe administration and storage of medication at all times.(Previous immediate requirement 14.01.05 not met). Any written additions or amendments to the drug adminstration records must be checked, dated and countersigned by two staff.(Previous immediate requirement 14.01.05 not met) Registered nurses must sign for all medicines administered and document a code for any omissions.(Previous immediate requirement 14.01.05 not met) Privacy lock to be fitted to Bathroom 3. Consult with residents to establish their expectations, preferences and capabilities to engaghe in activities/day trips outside of the home.Action ongoing 1st August 2005 Immediate and ongoing. Immedoate and ongoing Immediate and ongoing Immediate and ongoing. 1st August 2005. 1st August 2005 Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 Page 26 14. 15 12 15. 15 16(i) 16. 15 17(2) Schedule 4 12(1) 18(1) 17. 15 27 18. 19. 20. 21. 22. 23. 19 19 26 19 26 19 19 19 38 23 23 23 23 23 13(4) 24. 19 38 13 should be taken wherever reasonably possible/practicable to faciliatate opportunities identified.(This standard was not inspected.) Sytems should be put in place to ensure all residents are made aware of food available to them at mealtimes and are of consulted about their choice of meal . The evening menu must be reviewed to ensure it contains a sufficient variety of hot and cold meals which meets the need of the residents Written records must be kept in the home of all meals served to residents. (Previous requirement 14.01.05 not met) Sufficient numbers of catering stafff must be employed throughtout the day/evening in order to ensure the nutritional needs of the residnets can be met.(Previous requirement 14.01.05 not met) Plasterwork to be replaced to wall in first floor sluice room. All tumble driers to be fully operational. The conservatory carpet must be cleaned or replaced as appropriate Remedial paintwork should be undertaken to the conservatory were a leak occurred previously. Bedroom F3 must be redecorated. Electrical extension leads must not be used. Additional sockets must be provided by a suitably qualified electrician where needs are identified. Ensure residents accessing the garden area are appropriately supervised and have the facilities 1st July 2005 1st August 2005. Immediate and ongoing. Immediate and ongoing. 1st August 2005 Immediate. 1st August 2005 . 1st August 2005 1st August 2005 1st August 2005 and ongoing. Immediate and ongoing Page 27 Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 25. 26. 27. 19 26 19 26 19 23 16 23 13(4) 23 28. 29. 19 21 22 38 23(2) 13(5) 30. 22 38 13(5) 31. 32. 22 22 23 23(n) 33. 34. 24 25 38 12(4) 13(4) to summon assistance if necessary Carpet in room F14 to be cleaned or replaced as appropriate. Carpets in WC 3and WC4 must be replaced. The worn carpeting to the main staircase must be replaced.(Previous requirment 14.01.05 not met) Repairs must be undertaken to the toilet in bathroom 4. The moving and handling assessment for one (named)resident must be reviwed and updated and equipment made availabe as necessary as discussed. Risk assessments must be completed in relation to 3 residents on the first floor who need to be transported to the ground floor each day. Action must be taken to reduce ora eliminate any risk identified. Grab rails must be fitted to downstairs shower room. Aids and equipment must be provided to all residents in accordance with individual needs. Lockable storage to be provided in each bedroom. All pipework and radiators in the home must be guarded or have guaranteed low surface temperatures. (Previous requirment 22.07.04 and 14.01.05 not yet met in full) The wash hand basin in the laundry must only be used for hand washing purposes. All areas of the home to be kept clean and tidy . 1st August 2005 1st August 2005. 1st August 2005 Immediate Within 24 hours of the inspection. Within 24 hours of this inspection. 1st August 2005 Immediate and ongoing 1st October 2005 1st August 2005 35. 36. 26 26 16 23 Immediate Immediate and ongoing. Page 28 Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 37. 38. 26 27 16 18 39. 29 37 19 40. 29 37 19 41. 30 18(1) 42. 36 19 43. 37 17(1)(a ) Schedule 3 13(1) Liquid soap to be provided in all communal toilet facilities. Staffing levels must be increased in order to ensure that the helath and welfare needs of residents are met and that sufficient numbers of staff are availabe to supervise residents at all times. Criminal Recod Bureau checks /POVA checks must be undertaken for all new staff prior to the commencement of duties at the home.(This standard was not inspected) Two satisfactory written references must be obtained prior to the commencement of employment of any new staff.(This standard was not inpected) All staff in the home must have received up to date training in:Moving and Handling, Fire Safety and Infection Control. Written records ust be kept of all training undertaken.(Previous requirement 14.01.05 not met) All care staff must receive formal supervision at least 6 times a year.(Previous requirement 14.01.05 not met) A photograph of each resident must be kept in the home. A qualified first aider must be on duty at the home at all times.(Previous requirement 14.01.05 not met) Food probe temperatures must be monitiored and recorded. 1st July 2005 Immediate Immediate and ongoing Immediate and ongoing 1st August 2005 Immediate and ongoing. 1st July2005 and ongoing Immediate 44. 38 45. 46. 47. 38 38 38 30 16 13(3) 16 13(3) 16 18 13(3) Immediate and ongoing The temperature of the fridges Immediate and freezers in the kitchen must and be monitored and recorded daily. ongoing All catering staff must receive up Immediate to date food hygiene Version 1.30 Page 29 Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc 48. 38 13(4) 23(4) 49. 38 13(4) training.(Previous requirement 14.01.05 not met) Fire doors must not be wedged/propped open. Fire doors may only be kept open by a device that has been approved by the relevant inspecting fire authority.(Previous requirement 22.07.04 and 14.01.05 not met) The garden shed must be kept secure at all times. Immediate and ongoing. Immediate and ongoing. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard 3 33 35 38 Good Practice Recommendations The homes assessment from should be revised to ensure that all relevant information relating to a resident can be documented. Systems should be put in place which faciltiate ongoing feedback from residents, relatives/visitors, staff and visiting professionals. Receipts should be kept of any purchases/transactions from residents personal monies. The staffing rota should denote the person responsible for first aid each shift. Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 Page 30 Commission for Social Care Inspection The Coach House John Comyn Drive, Perdiswell Park Worcester WR3 7NW 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. Extracts may not be used or reproduced without the express permission of CSCI Wayside Nursing Home E52 S4150 Wayside Nursing Home V223793 100505.doc Version 1.30 Page 31 - 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. 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