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Inspection on 01/05/07 for Winton Nursing Home

Also see our care home review for Winton Nursing Home 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 Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

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

What the care home does well

The home has a warm and welcoming atmosphere. The residents looked comfortable and those that spoke to the inspector said that they felt they were well looked after. Relatives said they felt comfortable visiting and were confident they could be involved in supporting their relative. They said communication was excellent and they were kept fully informed of their relative`s well being. Residents and relatives said the food provided was of a high standard, with plenty of fresh meat, fish and vegetables as well as fruit, homemade cakes and puddings.

What has improved since the last inspection?

The home has updated the staff training records and further training has been planned by the training co-ordinator. The records were available for inspection. One of the part -time nurses has recently taken on the role of activities coordinator , and is making plans to ensure that appropriate and relevant activities are available for the residents in both parts of the home.

What the care home could do better:

The residents have individual care files, which still do not actually form a plan of care. The assessments have been completed and are updated, but the care needed by each resident is not always apparent. New `quick reference care guides` are now available in each residents bedroom and contain one or twoword sentences regarding care needs, but without the necessary `how` or `why` information, and do not indicate the more complex needs of some of the people who live in the home, which may result in some care needs not being met appropriately. The home`s policies and procedures have still not been reviewed and updated, they were last reviewed in 2003 and do not reflect changes in legislation or current good practice. The provider, or their representative, needs to ensure that monthly visits are made to the home. A report on the conduct of the home should then be written based on talks to the residents and staff about the standard of care provided in the home and inspection of the premises and its record of events and complaints. Copies of these reports must be kept in the home and made available for the manager and for inspection

CARE HOMES FOR OLDER PEOPLE Winton Nursing Home Wallop House Nether Wallop Nr Salisbury Hampshire SO20 8HE Lead Inspector Pat Griffiths Key Unannounced Inspection 1st May 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Winton Nursing Home DS0000012032.V336202.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. Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Winton Nursing Home Address Wallop House Nether Wallop Nr Salisbury Hampshire SO20 8HE 01264 781366 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) Mrs Evelyn Mary Cornelius-Reid Mrs Elaine Phelps Care Home 45 Category(ies) of Dementia - over 65 years of age (45), Old age, registration, with number not falling within any other category (45) of places Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st November 2006 Brief Description of the Service: Winton Nursing Home is one of three owned by Mrs Cornelius-Reid, two are in Hampshire and the other in Wiltshire. It is set in the village of Nether Wallop, a rural area, within easy reach of local amenities at Stockbridge and Andover. The home is registered as a care home providing nursing care and may accommodate up to forty-five service users who are older persons, or older persons with dementia. Accommodation is provided in two areas of the home, both on two floors with lift access to the first floor. The main house accommodates those who require assistance with personal and nursing care, whilst the annex accommodates those who have dementia and require assistance with personal and nursing care. There are thirty-five single and five double bedrooms and all have en-suite facilities. There is extensive communal space with several lounges, a garden room and dining room. There is a large landscaped garden, which is accessible to the residents. The current weekly fees are £525 - £850 per week, depending on assessed care needs and type of accommodation. Extra services such as hairdressing and chiropody are usually billed monthly. Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This fieldwork visit was unannounced and took place on the 1st May 2007. All key standards were examined and the visit included looking at areas of the home such as bedrooms, communal and shared areas and the home’s kitchen and laundry as well as the garden. Documents and records were examined and staff working practices were observed where this was possible without being intrusive. People who use this service, visitors and staff were spoken to in order to obtain their views of the service that the home provides. Visitors that spoke to the inspector were very positive about the care their relatives received. The home’s manager was present throughout the day and was available to provide assistance and information when required. Other information included in this report is obtained from sources such as information that the commission has received since the last visit made to the home in November 2006, and notices received about incidents that have occurred in the home. The preinspection questionnaire and service user surveys had not been returned to the commission before this report was written. What the service does well: What has improved since the last inspection? The home has updated the staff training records and further training has been planned by the training co-ordinator. The records were available for inspection. Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 6 One of the part -time nurses has recently taken on the role of activities coordinator , and is making plans to ensure that appropriate and relevant activities are available for the residents in both parts of the home. 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. Winton Nursing Home DS0000012032.V336202.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 Winton Nursing Home DS0000012032.V336202.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. A comprehensive pre-admission assessment is completed before a placement is offered, to ensure that all needs can be met. Standard 6 does not apply to this service EVIDENCE: The files for three recently admitted residents were examined. Each contained a comprehensive assessment, which had been completed prior to admission. Prospective residents are invited to visit the home, but when this is not possible, assessments are completed by the manager in the resident’s current care home, as well as getting information from their care managers, GP and relatives. The pre admission assessments identified personal and social needs as well as health and nursing care needs. Areas that had been assessed included Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 9 personal care, social, religious and cultural needs, nutrition, dietary likes and dislikes, mobility, sight and hearing. Potential residents with dementia have additional assessments completed and information is sought from any attending healthcare professionals, such as the psycho-geriatrician Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans do not always provide sufficient information to ensure that the people in the home, especially those with complex health care issues, have all their needs met. EVIDENCE: The inspector looked at three care plans and found that thorough assessments had been completed, such as manual handling, nutrition and skincare and risk assessments. They had identified areas of physical risk, such as falls, with guidance for staff to follow to minimise the risk. There was evidence that the assessments were being reviewed regularly, with staff signatures. These assessments gave staff guidance on each person’s abilities and needs but did not actually form a plan of care Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 11 New ‘quick reference care guides’ are now available in each residents bedroom and contain one or two-word sentences regarding care needs, but without the necessary ‘how’ or ‘why’ information, and do not indicate the more complex needs of some of the people who live in the home, which may result in some care needs not being met appropriately when the residents is unable to indicate their needs. Staff do not have explicit information available to refer to when caring for the people who live in either part of the home, as it is necessary to read all of the different assessments, such as mobility, skin care and bathing to see what is needed for the care of the residents and if any changes or amendments had been made. It was not clear that the individual likes and dislike of the residents had been identified, such as what time they liked to get up or go to bed or how often they would like a bath or at what time of the day they would like a bath. The staff that spoke to the inspector said that they knew the residents very well as they had been there a long time and any changes were always mentioned during report at shift handover. The manager said that the ‘quick reference care statements’ had been developed and implemented for each resident. They were kept discretely in the residents’ bedrooms, where care is usually provided, and gave an up to date point of reference for the staff providing care. The manager said that it also enables residents, or their nominated representatives, to check on the outline of the care being provided. The actual care plans, on which the quick reference statements are based, have not been written. The manager, her deputy and the inspector discussed the need for up to date care plans that are regularly reviewed and will support the ‘quick reference care statements’ that are in place. Following a change in staff on ‘the wing’ the use of the ‘person centred planning’ approach for the care plans for the residents with complex care needs has not been developed but the provision of care is good as staff say they know the needs of the people who live in the wing. Staff on the wing say that they are too busy caring for the residents to have time to plan, write or review the care plans. The residents sit in the communal areas for most of the day, either sitting, watching television or wandering around and the staff spend time with some of them or watch to ensure there are no falls or accidents. Some of the people from the wing are able to join in with activities in the main part of the home, but there are not many suitable or specific activities available in the wing for them. The need for management or administration time for the senior staff on the unit was discussed and the manager said that time would be allotted for the senior staff to leave the unit and develop and update their care plans for the residents with complex care needs. Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 12 The manager said that the residents are registered with a local doctors surgery and they hold weekly clinics in the home as well as providing emergency visits when required. Residents confirmed that they were able to see their doctor when they wished. Other visiting healthcare professionals include the local dentist, optician, physiotherapist and the chiropodist. The home has medication policies and procedures in place, but they are written for a hospital ward. An action point was made at the last visit for the medication polices and procedures to be reviewed and updated. They have been dated and signed, but they have not been reviewed, amended or updated to reflect changes in legislation and current good practice, so do not provide a suitable reference source for the nursing staff. Nursing staff that spoke with the inspector indicated a knowledge and awareness of the correct and safe procedures for the ordering, storage and administration of medication. The manager said there was an arrangement with the local surgery for the disposal of unused drugs, and a written record was kept. No information was available regarding the use of ‘homely remedies’, which is a list of medications that can be administered to residents, which have not been prescribed by the doctor, such as paracetamol or cough linctus. The manager said that staff receive training regarding the privacy and dignity of the residents and how to treat them with respect. The staff were observed throughout the inspection knocking on doors and waiting for permission to enter. All bedroom doors have locks fitted, so residents can have privacy if they want it. Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have good quality food and their diverse needs are generally well supported. EVIDENCE: The manager said that a variety of entertainment was provided in the home, such as music and movement sessions, old time music and short plays, which is arranged by the administrator. On the first Sunday of each month the local church choir attend the home and there is hymn singing for those who wish to join in. There are also extra activities arranged for the Christmas period, such as carol singing with the church the school choirs and a visiting pantomime show. Staff said that they are aware of the likes and dislike of the residents, but there is little documentation actually recording the residents likes and dislikes and what activities they are interested in. A recommendation was made at the last visit regarding the need for an activities co-ordinator, and one of the part-time nurses in the home has decided to take on this role. She has been asking the residents what they would like to do and is planning activities Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 14 that that will suit their likes and dislikes, such as flower arranging for some of the ladies. A fete is also being arranged for the summer to raise funds for ‘Naomi House and for the ‘Inca Trail’ for breast cancer research. The manager, inspector and new activities co-ordinator discussed the need for more appropriate activities for the residents in the wing who are more mentally frail and have complex needs. The co-ordinator said that they do attend some of the activities in the main part of the home and also have some activities in the ‘wing’, but this does not address the particular needs of all residents. The availability of specialist training courses for activities coordinators was also discussed. Newspapers are delivered daily to the home for those who wish to read them and the library visits monthly. The manager said that the home has an open visiting policy and visitors are always made welcome and may stay for meals if they book in advance. Several residents told the inspector that they do get out and about when their relatives take them out. Comments from relatives indicated that they felt included by staff in the care of the resident. They also felt that staff communicated well and kept them informed of anything affecting the wellbeing of the resident. Residents said they felt that they were able to make choices, such as what to wear each day or how to spend their time, and that staff helped with these choices. Staff also said that they thought that an important part of their role was to ensure that residents were supported to maintain their independence for as long as possible. The home has a new system for recording meals, which indicates a planned approach to meal provision. The manager said that there is a menu in place, which is changed regularly and choices are available at each mealtime. Residents are asked daily about their menu choices and are advised of the choices available. The food such as meat, fish and vegetables is ordered from local suppliers and delivered several times a week. The residents are able to take their meals in their own rooms or in the dining room. There is a waitress service in the dining room, where the main meal is served on the plate to the residents and then waitresses serve dishes of vegetables, so everyone has as much or as little as they wish. Residents have commented ‘the choices in the menu are really good’ ‘we eat too much of the same thing’ ‘if I don’t like what is on the menu they replace it with something I do like’ ‘I enjoy all the food I get’ ‘they bring me just what I am able to eat, even though I am difficult’ Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff training in adult protection, and the knowledge that all complaints are dealt with appropriately usually safeguard the people who use this service. EVIDENCE: The manager said that home has a system for recording complaints but none had been received since the last inspection. The commission had not received any complaints in respect of the home. Residents that spoke with the inspector said that they knew they could complain if they needed to and knew who to go to, but the need had not arisen. The complaints procedure is currently being reviewed to include relevant timescales and to indicate who deals with complaints within the home and details of relevant external agencies, such as social services. The home has a copy of the local authority adult protection policy, and the manager has started to incorporate the information into the home’s policies and procedures. The current policy did not reflect good practice, such as initially contacting adult social service for advice should abuse be suspected. The home is one of a group of three and now has a group-training manager who is arranging further training for all staff in the homes. Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 16 The manager said that staff have had some adult protection training as part of their induction training and that it is also been one of the sections of the carers [NVQ] National Vocational Qualification training. Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 17 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 good. This judgement has been made using available evidence including a visit to this service. People who use this service live in a safe, well maintained, clean, and hygienic home. EVIDENCE: The inspector was able to tour the home and see the communal areas, kitchen, laundry, and some of the bedrooms. The home has a reception area in the large hallway, which is staffed by the homes administrator. There are several sitting areas around the home, as well as a large lounge, dining room and conservatory on the ground floor. On the day of the visit the home was seen to be clean and tidy, with no unpleasant odours. The care staff in the home are supported by cleaners, laundry and kitchen staff. Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 18 Kitchen staff showed the inspector round the kitchen explaining that they were using the new ‘Safer Food, Better Business’ documentation for recording the fridge, freezer, and cooked food temperatures as well the kitchen cleaning routines. Following a visit from an environmental health officer the kitchen storage area needs to have new tiles fitted. The laundry is run by the laundress, who ensures that all laundry is done during the day and none is done overnight. The laundry room is accessible from the corridor, so dirty laundry is not taken through the kitchen or food preparation areas. The bedrooms seen by the inspector looked homely and had been personalised by the residents and their families, with their own furniture, pictures and ornaments. The manager said that residents are encouraged to bring personal items with them and as some of the bedrooms are quite large so bigger items of furniture, such as desks and wardrobes, can be accommodated. Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 19 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 good. This judgement has been made using available evidence including a visit to this service. Robust recruitment practices and staff training protect people who use this service. EVIDENCE: The home employs thirteen registered nurses and thirty-eight carers as well as ancillary staff such as cooks, cleaners and laundry staff. There are also maintenance and decorating staff and a team of gardeners. The administrator said that twelve staff have National Vocational Qualifications in care at level 2 or above and five were doing the course. The home currently employs thirty-eight care staff so the requirement of 50 of staff with NVQ 2 or above is nearly met. Staff are encouraged to obtain this qualification by being supported to study and being given more responsibility and pay for achieving it. The recruitment procedure has improved, references are obtained and all staff have satisfactory Criminal Records Bureau disclosures. The inspector looked at the files of three new members of staff and found that all the relevant checks Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 20 had been completed, such as obtaining references and Criminal Records Bureau [CRB] disclosures. Other staff files were checked and found to contain the correct information and there was evidence that the nurses have had Nurses and Midwives Council checks on their professional qualifications before starting work in the home. The home continues to have a large handwritten staff roster, which looks complicated but the staff find easy to use. The administrative staff continue to keep a separate record of who has actually worked which shift in the home. The group of homes now has a training manager who will co-ordinate training in all of the homes. Supervision sessions have started and are being used to identify training needs for the staff. The manager said that training completed so far this year has included moving and handling, fire safety, food hygiene, dementia awareness, promoting continence and dysphagia awareness. Staff said they had to complete an induction course before being able to work unsupervised in the home. A member of the care staff who has achieved an NVQ 3 is appointed as their mentor during induction. A copy of the new induction training booklet was seen, which care staff should complete over a three-month period. Staff training records were available on the day of the visit and the inspector was able to see what is planned for the rest of the year. Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 21 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 adequate. This judgement has been made using available evidence including a visit to this service. People using the service are not always safeguarded by good management , but their privacy, independence and dignity is promoted. EVIDENCE: The manager was on duty on the day of the visit, and has recently completing her registered managers’ award. She is supported in her role by a deputy manager and a management team who are responsible for the day-to-day administration of the home, as well as the nursing, care and ancillary staff. Residents and relatives felt the home was well run and that the needs of residents were considered when decisions about the day to day running of the Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 22 home were made. The manager said that a quality assurance survey had been sent out and was able to show the inspector the results, which covered nursing care, cleanliness, laundry and kitchen. The majority of people who responded gave scores that were good or excellent, a few gave poor. The comments made included: ‘I am extremely pleased with the quality of care my father receives. The family feel welcome every time we visit’ ‘they are usually around when you need them’ ‘there is not enough staff, they always have too much to do’ ‘ ‘the cleaners are good, the place is always clean’ ‘they could do with more staff’ the home is clean, but the wheelchairs could do with a good scrub’ ‘they wash my clothes very well’ ‘my relative is sometimes in someone else’s clothes, but she always looks tidy and hair is always smart’ ‘nothing gets done’ ‘they always return my clothes in one piece’ ‘care is good, communication is poor, the foreign staff can be difficult to understand’ ‘I think the food is outstanding’ ‘I enjoy it a lot, it is always varied’ ‘they go out of their way to fulfil my awkward diet’ The home does not have regular residents or relatives meetings as the manager or the provider are usually available for discussions. The manager said it was the policy of the home not to hold money on behalf of residents and that those who could not manage their own finances had to arrange for someone to do it for them. The home pays for any bills incurred by residents and then invoices the family for payment on a monthly basis. This includes sundries such as hairdressing and chiropody. The monthly visits required by Regulation 26 had not been carried out, the manager said the providers son visited the home at least weekly, but no Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 23 reports of these visits had been given to the manager. An action point was made previously, which has not been met, that these monthly visits must be made and written reports and feedback kept in the home so that the registered manager is aware of the comments and requirements made by the provider. The home has a set of policies and procedures in place but they are dated 2003 and they have not been updated to reflect changes in legislation or current good practice, some were inappropriate for a care home. An action point was raised at the last visit and the policy front sheets have been signed and dated, but the contents have not been reviewed and updated. The manager and inspector discussed the need for accurate information to be available for staff, to inform their practice and be used as a reference tool. The manager was away during the last visit and said she now felt better informed following the discussions and was able to address the issues raised during this visit The new pre-inspection questionnaire had not been completed before the visit took place, but information from the visit in November 2006 indicated that the service contracts for services such as the boilers, the fire safety equipment and the lift, were are all up-to-date. The weekly fire alarm tests was also examined and found to be up-to-date. A fire risk assessment for the home has been completed but following changes in October 2006 to the fire safety legislation in care homes it may need to be reviewed. Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X N/A X X 2 Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement All people using the service must have an up to date, detailed, care plan. This will ensure that they receive the person centred support that meets their needs. The previous timescale of 27/02/07 was not met Monthly visits by the provider or their representatives must be made to the home and the reports of these visits must be kept in the home and made available for the manager and for inspection The previous timescale of 27/02/07 was not met The manager must ensure that all of the homes policies and procedures are reviewed and updated to reflect any changes in legislation or current good practice. The previous timescale of 27/02/07 was not met Timescale for action 01/07/07 2. OP33 26 01/07/07 3. OP38 12 01/07/07 Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Winton Nursing Home DS0000012032.V336202.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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