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Inspection on 01/05/07 for Willows Nursing Home, Blacon

Also see our care home review for Willows Nursing Home, Blacon for more information

This inspection was carried out on 1st May 2007.

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.

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

What the care home does well

Willows Nursing Home provides a safe and well-maintained environment for residents. There has been continuous improvement of the environment over recent years and a programme of further refurbishment is in place. The home is a single storey building and is well equipped to meet the needs of service users. There is a good choice of lounges for the residents of the dementia care unit, and there are safe open spaces both inside and outdoors for residents who like to walk around. Residents` health needs are met to a good standard, and they are supported to maintain high standards of personal appearance and hygiene. Visitors are made welcome and a visitors` room is available where relatives may stay overnight. A good variety of food is provided, including cooked breakfast at weekends. There is a stable staff group who have a positive attitude towards the residents and training is provided for staff. The home has the Investors in People award. The home is well managed by a competent and experienced manager. Regular health and safety checks are carried out and recorded by the manager. There is a good standard of record keeping.

What has improved since the last inspection?

The recording of medicines and auditing of medicine administration had improved to identify and address any shortfalls. The conservatories on the elderly frail and dementia care units had been refurbished and a suspended ceiling added to provide a choice of comfortable sitting areas for residents. NVQ level two qualifications had improved and exceeded the Department of Health target for 50% of care staff to have a qualification in care.

What the care home could do better:

The recruitment of staff needs to improve so residents are protected from harm. The duties and deployment of care staff should be reviewed so that staff are involved in social and recreational activities and have the time to do so and residents are provided with recreational choice and support. The quality assurance system should be reviewed regarding the audits of medicines, care plans and staff recruitment to identify what actions will be taken and by whom when errors are found during the checks made on these procedures so residents health and welfare is protected.

CARE HOMES FOR OLDER PEOPLE Willows Nursing Home, Blacon Treborth Road Blacon Chester Cheshire CH1 5RP Lead Inspector Anthony Cliffe Unannounced Inspection 09:00 1 and 2nd May 2007 st 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 Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Willows Nursing Home, Blacon Address Treborth Road Blacon Chester Cheshire CH1 5RP 01244 374023 01244 379228 manager.willows@m-a.co.uk 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) Mr Mohammed Hussain Mrs Anwar Hussain, Mr Naveed Hussain Mrs Vivienne Haynes Care Home 73 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (50), Old age, not falling within any other of places category (23) Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 73 service users to include: * 50 persons in the DE (E) dementia over 65 years of age, category. * Within the 50, a maximum of 5 persons in the DE, dementia under 65 years of age category. * 23 persons in the OP, older persons, category. Bedroom numbers 8, 27, 64 and 65 only may be used to accommodate two persons 18th October 2005 2. Date of last inspection Brief Description of the Service: Willows Nursing Home is a single storey building situated in the Blacon district of Chester. The home is conveniently situated for local shops and other communal facilities in Blacon, and there is regular public transport into Chester city centre. The home provides nursing care for 23 older people whose needs are due to physical frailty, and fifty people who have dementia. The home is part of a small group of homes owned by the registered providers. The home has 65 single bedrooms, 26 of which have en-suite facilities, and four bedrooms, which may be shared by two people. An extension to the home was completed in 2004. Externally the gardens are landscaped and additional car parking facilities provided. All rooms and areas, including the gardens, are spacious and are accessible to wheelchair users. Fees range from £394 to £600 per week. Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on the 1st and 2nd May 2007 and lasted 16 hours. A Regulatory Inspector carried out the visit. This visit was just one part of the inspection. Other information received was also looked at. Before the visit the home manager was also asked to complete a questionnaire to provide up to date information about services provided. Questionnaires were provided for residents, families, and health and social care professionals to find out their views. During the visit various records and the premises were looked at. A number of residents, a relative, staff and General Practitioner were also spoken with and they gave their views about the service. What the service does well: Willows Nursing Home provides a safe and well-maintained environment for residents. There has been continuous improvement of the environment over recent years and a programme of further refurbishment is in place. The home is a single storey building and is well equipped to meet the needs of service users. There is a good choice of lounges for the residents of the dementia care unit, and there are safe open spaces both inside and outdoors for residents who like to walk around. Residents’ health needs are met to a good standard, and they are supported to maintain high standards of personal appearance and hygiene. Visitors are made welcome and a visitors’ room is available where relatives may stay overnight. A good variety of food is provided, including cooked breakfast at weekends. There is a stable staff group who have a positive attitude towards the residents and training is provided for staff. The home has the Investors in People award. The home is well managed by a competent and experienced manager. Regular health and safety checks are carried out and recorded by the manager. There is a good standard of record keeping. Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 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 Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are assessed prior to moving in so appropriate care can be provided to them. EVIDENCE: Willows care home accommodates people mainly from the Chester and North Wales area and is welcoming to anyone from outside the area or with a disability, different ethnic or cultural needs or sexual orientation. Three files were examined of residents who recently moved into Willows. The manager or deputy managers were responsible for meeting prospective residents to discuss their care prior to moving in. A form was used to gather and record information on prospective residents. This included information on their physical and mental health. Copies of these documents were on residents’ files. Copies of social workers assessments and care plans were on file with information from the NHS hospital the residents were staying at. Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed records of care, liaison with health and social care professionals and good medicine management ensures residents’ health and welfare needs are met. EVIDENCE: The care files of three residents were examined. Each care plan had a pre admission assessment of physical and mental health and an assessment by the social worker or nurse assessor. From looking at care plans, observing staff working practices and talking with residents, staff and a visiting General Practitioner the health needs of residents were met. Care plans were in place that monitored residents’ health. Care plans were in place to monitor eating and drinking, risk of developing pressure ulcers, managing aggressive behaviour, use of bed rails, diabetes and assistance with personal care as some examples. Good practice in routinely monitoring residents physical health were in place and residents’ blood pressure and weight were monitored. A resident who was provided with meals through a tube had started to eat a soft diet following moving into Willows. Where wound management was recorded staff did not use a wound assessment or wound Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 Page 10 management chart nor did they use a risk assessment format for the use of bed rails but recorded the use of these in a care plan. The manager confirmed new documents were to be introduced to record these in more detail. Care plans were generally detailed and recorded where residents were able to assist themselves or needed help. Some care plans when reviewed recorded ‘continue as planned’ and did not record if support and care provided to residents was working. There were good examples of liaising with health care professionals. A resident had been referred to the district nurses when his skin had started to break down, but the registered nurse managing this had not recorded when the skin had started to break down. The manager was able to demonstrate that there were issues regarding the nurse’s competency, which were being managed through clinical supervision and training. The manager clarified a monthly care plan audit would be reintroduced and this would record the actions and timescales for completion when errors where discovered, including disciplinary action when necessary. A visiting General Practitioner said about the care at Willows, “Our practice has a lot of residents here. They make sure their residents get the same level of healthcare as those living in the community. I’m here regularly at least twice a week. Staff call us as necessary. I find all the staff here very knowledgeable and know the residents’ conditions. The staff on the dementia care side advocate on behalf of residents who can’t tell you what’s up with themselves. There is always someone available who knows the residents. There is always staff around and I never see residents left alone, the level of staffing seems good. I see that residents are well cared for and we have a good working relationship”. Medicines management and administration was examined. No errors were noted on medicine administration records. A monitored dosage system was used throughout the care home. The manager explained how medication administration had improved so there were no larger task orientated medicine rounds. This had been achieved through protected mealtimes when medicines were not administered and medicine administration times altered so medicines were given later in the day. The manager had commenced a medicines audit and said this was to be amended to record the actions and timescales for completion when errors where discovered. Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported in making choices about their lifestyle and they have control over their lives but the coordination of activities could improve so residents have regular activities based on their choice and preferences. EVIDENCE: Willows employed an activities organiser for fifteen hours a week covering Monday to Friday mornings. She was not working at the time of the site visit. There was a vacant activities organiser’s post for the afternoons. A programme of activities was in place and information on the activities available was displayed. Staff at times were involved in activities with residents and were seen chatting to residents and staff put music on for them to listen to and have a sing a long. There was information displayed in the dementia care unit in the form of a spring collage. Information as also displayed on the day and time of year, meal choice and the staff on duty. There were no activities left or planned for staff to do in the absence of the activities organiser. The recording of residents’ preferences of recreational and social activities had greatly improved. Willows had introduced a life and social history record to provide information on residents’ life histories. Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 Page 12 Staff were seen putting residents’ laundry away and cleaning up after lunch. Staff interviewed said this took time away from being with residents as one staff member spent an hour putting laundry away. This coincided with staff taking breaks between 11.00am and 2.00pm, which meant a staff member from each area was on a break during these hours. To confirm how this affected residents a new method on gathering the experiences of residents was used. A small group of residents who were identified as no longer being able to use words or communicate their needs were watched for a period of two hours. Information on how they related to one another, staff, pets and their environment were recorded. This included staff interaction and practice. The findings of the observation were that there were positive interactions between residents, residents and staff and social interactions when staff spent time with residents. The residents observed were sleeping for the majority of the two hours. When staff came to offer them drinks or assist them with personal care there was positive and friendly interaction between all the residents who enjoyed chatting with staff and one another. Staff demonstrated dignified approaches to waking residents by gently rubbing their hands and using their names. They asked residents if they wanted a drink or assistance with personal care and if they wished to have their hair done. Willows was involved in the research of ‘Pictures to Share’ a registered charity which developed a set of books around specific themes. The subjects included childhood in pictures and women’s work in pictures and the countryside. The activities organiser showed residents a range of pictures around the themes mentioned and noted their response to them. This was feedback to the research team and the most popular pictures chosen. Copies of the books were available. The dementia care unit has a snoozelun, a room equipped with comfortable furniture and light and sound equipment to be used to help residents calm down or use the light equipment to stimulate residents’ senses. Residents were complimentary about the level of care and support they received. A resident said, “ I’ve been here just over a week it’s not hospital. I worry a lot and want to get better. Since I’ve been here I’ve eaten some food and sat out of bed. I’ve done really well as I didn’t do that in hospital”. A resident said, “I live not far from here, I think this is Blacon. I’m here most days. I like the people, we have a good chat they’re all sociable and we get on well. I’m never bored. People talk to me. I enjoy talking about rock music and Manchester United. I’m really forgetful at times like some of the others who need my help. Those girls over there are staff and they are really helpful. They bring me meals, which are lovely. I like the chicken. I lost some weight but have put it back on. I feel good in myself and enjoy being here”. Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 Page 13 A resident said, “ I moved here a few days ago from another care home to be nearer to family. My daughter visited and said it was lovely. I had to decide and wanted to be near family but wasn’t just going anywhere. My daughter said I would like it so I decided to give it a trial. I wasn’t well at first but feel better now. The other home was nice but this is much nicer and I really like it. The staff are great. The male carer is so nice he helped me settle in and feel welcomed on my first day and showed me where everything was and answered any questions I had. The big bonus is the food, plenty of choice. I had fish in sauce with vegetables and potatoes, followed by sponge and custard. There’s too much for me to eat even though they give me smaller portions at my request. I don’t know many people having just moved in. There are some activities in the morning I can join in if I want to. There is a large dining room and smaller dining rooms where residents could choose to eat. Mealtimes were seen to be a social occasion and residents seen eating and enjoying their meals. Where residents required assistance staff were available to assist them. Meal times are protected so medicines are not administered during these times. The home revised the meal arrangements and menu to include a wider variety of choice. Meals were served directly from the kitchen to residents. The manager had used the CSCI report ‘Highlight of the Day’ in making changes to mealtimes. Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information was available to guide residents and relatives on how to make a complaint and who to make it to. There were procedures and guidance available for staff to ensure that residents are protected from abuse, harm and poor practice. EVIDENCE: There were no recorded complaints received since the last site visit. A relative/ carer survey returned prior to the site visit recorded information of the complaints procedure and said ‘ the first line of approach is to the matron to give her the chance to address the problem if possible. Failing that social services or the CSCI’. Information given by the manager identified that staff have received abuse awareness training and that further training in this was to be provided for staff that had not received it. The manager demonstrated how concerns about medication administration had been addressed following concerns being referred to the local council. The matters were dealt with as Willows cooperated in full with the local council by amending the medicines policy to improve information on how medicines were received. Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents live in a well-maintained, comfortable environment, which promotes their safety. EVIDENCE: A tour of the home showed that the programme of redecoration and refurbishment for the original part of the building was being followed, and that the extension completed in 2004 had been maintained in good order. The manager said that she was going to discuss providing a designated smoking with the owner as this had to be completed by 1st July 2007 to meet changes in the law. There were no existing areas that could be used as a smoking area. Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 Page 16 In the original part of the dementia care unit the carpets had been replaced. New furniture had been purchased for the lounge and dining areas. New commodes had been purchased for bedroom without en-suite facilities. The two small lounges in original part the dementia care unit had been redecorated and new carpets fitted. The conservatory roof in the dementia care unit had been fitted with a suspended ceiling. In the elderly frail area of Willows the corridor carpets had been measured and planned for replacement by July/August 2007. The main lounge had been redecorated, re carpeted and new curtains fitted. The small conservatory had been fitted with a suspended ceiling. A business plan had been drawn up for the dementia care unit to promote better signage on their bedrooms by using memory boxes. Use different colours on bathroom and toilet doors to distinguish them from bedroom doors and aid independence. Outside it was planned to provide a sensory garden and use more visual features so residents could have relaxing garden areas. Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of staff are adequate to meet residents’ needs but staff recruitment needs to improve to ensure that residents are protected. EVIDENCE: The staff rota confirmed sufficient registered nurses and care assistants were employed to meet residents` needs. There was a balance of registered mental and general nurses employed. The manager’s hours were all supernumerary and she is not included on the staff rota. Thirty care staff were employed. Of these twenty-one had an NVQ level 2 qualification. Staff recruitment records for three new staff were examined. Records confirmed that all appropriate documentation was in place including a Criminal Records Bureau Check (CRB) and POVA First check for the staff employed. The dates of commencement of employment for two of the staff were for the date before the POVA First check had been completed. The manager said this was an oversight and had realised the error of judgement. Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 Page 18 Staff rotas contained details on the contracted hours staff was working. Staff files contained details of contracts of the hours they were employed for and training they had completed. A variety of training had been undertaken by staff including, Yesterday, Today, Tomorrow from the Alzheimer’s society, triage and confirmation of death, tissue viability, assessment and care planning, moving and handling and adult protection as some examples. A staff member said of the training provided “I’ve had the ‘Yesterday, Today, Tomorrow’ training. It’s very good as a domestic staff you don’t get as much one to one time with residents but the training has helped me to understand their conditions, their experiences and how to communicate with them better. I was one of the first staff to do the training and found it really useful. It’s helped me to understand what it’s like to be placed in a strange place where you don’t know anybody. That’s confusing enough, bit if you’ve already got a problem with your memory that’s frightening”. Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An experienced manager is employed who ensures training, quality assurance and staff supervision are completed so residents’ quality of life is promoted and they are protected. EVIDENCE: The home has the Investors in People award and an annual training and development plan for all grades of staff is in place. Investors in People had recently been awarded for a further three years. Staff meetings and staff supervision take place on a regular, planned basis. The last staff meetings were held in March 2007 and the minutes of the meeting were made available. Meetings include care staff, heads of departments with departmental representatives, care supervisors and registered nurses. Resident/relative meetings are not held regularly, but can be called as needed. Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 Page 20 A satisfaction survey has not been carried out recently and the manager considered that the last survey did not provide any useful feedback. She had changed the format from gathering information into an annual development plan covering four key areas; staffing, development and wellbeing, Occupancy and income, Accommodation and resources and Quality and systems. This included meeting with the other home managers from care homes operated by the owner. There was a thorough monthly quality assurance monitoring system in place but this could be improved upon to monitor medicine administration, care planning and staff recruitment. A relative/carer comment card recorded ‘ It depends upon getting a balance between personal independence and freedom and their medical needs. As a specialist dementia care centre the Willows has got qualified registered mental nurses, but could do with more staff who on the whole do a very good job’ A comments card received from a health care professional recorded ‘ Does well, cheerful atmosphere, comfort and supportive care’. The home has two part-time administrators. The home didn’t manage residents’ finances except for small amounts of personal spending money. One resident had appointeeship through the local authority. Personal money was requested for these residents as required. Residents’ money was kept in separate envelopes; all transactions were recorded and double signed; receipts for all expenditure made on behalf of residents were kept. The Willows supplied basic toiletries. Information provided by the provider in a pre inspection questionnaire and records held on site were examined. All the required maintenance and health and safety checks of the building and equipment had been completed. Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 Page 21 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 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 Page 22 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. 1 Standard OP29 Regulation 19(1)(a)( b)(c) Requirement The manager must not employ a person to work at the care home unless she has obtained in respect of that person the information and documents specified in paragraphs 1 to 9 of Schedule 2 so that residents are protected from harm. Timescale for action 01/05/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP12 OP33 Good Practice Recommendations The duties and deployment of care staff should be reviewed so that staff are involved in social and recreational activities and have the time to do so. The quality assurance system should be reviewed regarding the audits of medicines, care plans and staff recruitment to identify what actions will be taken and by whom when errors are found during the checks made on these procedures. Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Willows Nursing Home, Blacon DS0000018789.V333508.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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