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Inspection on 11/07/05 for Woodlands Nursing Home

Also see our care home review for Woodlands Nursing Home for more information

This inspection was carried out on 11th July 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.

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 one positive aspect of this visit was that the service users themselves commented that they were satisfied with the service being provided. The only relative present during the inspection was also happy, albeit they stated that there had been some problems with the quality of the service initially. It is, of course, of paramount importance that the service users feel happy with their home, and it could be said that all else is secondary to this. To a great extent this is true, however if the manager and the proprietors took the steps needed to meet the requirements, then the service could be so much better, thus improving the quality of life for the residents.

What has improved since the last inspection?

Disappointingly, little has improved since the last inspection. A large number of requirements still remain unmet from earlier visits.

What the care home could do better:

The proprietors must ensure that the Registered Manager is enabled to carry out the tasks involved in the day-to-day running of the home. At present the majority of decisions regarding the home are made without her involvement,which has resulted not only in requirements remaining unmet, but also a slow deterioration in the quality of the service being provided. Of particular concern was the ongoing failure to ensure that staff recruitment was of a satisfactory standard; that previously agreed minimum staffing levels were always maintained, and that requirements regarding fire safety had been ignored. An Immediate Requirement Notice was left with the manager with regard to these particular three issues.

CARE HOMES FOR OLDER PEOPLE Woodlands Nursing Home 38 Smitham Bottom Lane Purley Surrey CR8 3DA Lead Inspector Margaret Lynes Unannounced 11 July 2005 09:30 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. Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Woodlands Nursing Home Address 38 Smitham Bottom Lane, Purley, Surrey, CR8 3DA 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) 020 8645 9339 020 8668 9371 Guidebefore Limited Ms Mona Hooprajie Seegobin Care Home 18 Category(ies) of Old age (18) registration, with number of places Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4/1/05 Brief Description of the Service: Woodlands is a home registered for up to eighteen service users who, because of their age and general infirmity, require nursing care. Its relatively small size lends itself to the creation of a homely atmosphere not always seen in larger establishments. The home is situated in the pleasant suburb of Purley, within reasonably easy reach of the centre of Croydon and well placed for access to road and rail links. Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced, and was conducted over the course of a day. During that time a number of records were examined, a brief walk was made around the premises, and time was spent talking with service users, relatives and staff. Due to ongoing concerns regarding the number of unmet requirements, this home received an additional inspection last year. At that visit it was noted that there were still fifteen outstanding requirements, while a further 3 new requirements were made. This visit showed that, disappointingly, the majority of those requirements still remain unmet. This inspection has resulted in a further eight requirements being made. The majority of these requirements should not be difficult to meet, and in meeting them the home will improve the overall quality of the service being provided, and improve the well-being of the service users. What the service does well: What has improved since the last inspection? What they could do better: The proprietors must ensure that the Registered Manager is enabled to carry out the tasks involved in the day-to-day running of the home. At present the majority of decisions regarding the home are made without her involvement, Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 Page 6 which has resulted not only in requirements remaining unmet, but also a slow deterioration in the quality of the service being provided. Of particular concern was the ongoing failure to ensure that staff recruitment was of a satisfactory standard; that previously agreed minimum staffing levels were always maintained, and that requirements regarding fire safety had been ignored. An Immediate Requirement Notice was left with the manager with regard to these particular three issues. 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. Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 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 Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 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 (6 is N/A) Pre-admission assessments had been carried out by the home for four of the five service users whose files were examined. Most of these were extremely brief. One resident had not been assessed by the home prior to admission – the home had relied on information being provided by the placing authority. Unfortunately this information was very poor. The Inspector could not be satisfied, therefore, that the needs of potential service users were being identified. This means that service users cannot be reassured that the home has taken into account their individual needs, and will be able to meet them; while the staff in the home cannot be as familiar as they might be with new service users, or have an understanding of what specific service they will need to provide. EVIDENCE: While it would be acceptable for the home not to carry out a pre-admission assessment if this assessment was provided by another source, such as the placing authority, the manager does need to ensure that the information supplied is as comprehensive as possible. In the case of the service user mentioned above, the information provided was minimal, and could not have given the staff a picture of the incoming client’s needs. Where the home had Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 Page 9 carried out its own assessment, the information recorded by staff was similarly brief. It is beholden on the home to ensure that they have as full a picture as possible of potential service users, so as to be able to match the service provided to the service required. Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 The service user plans seen adequately covered the health and personal needs of the service users, but did not include reference to their social care needs. This means that the staff team are not aware of the differing needs of their residents, and cannot fully know what specific care should be given. Staff ensure that each resident is able to access community based health facilities as and when required. Staff were not, however, fully completing wound care documentation. This means that it is feasible that not all staff will be aware of the specific treatment to be given, which in turns can have a detrimental effect on the service user. The medication administration records were examined. Two errors were noted. Although a small number, any mistakes made in giving out medication can have serious consequences for the service users. From observation the Inspector was not satisfied that service users right to privacy was always upheld. Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 Page 11 EVIDENCE: Each of the files inspected contained a service user plan and these were supplemented by a variety of other assessments. They did not, however, contain any reference to social care needs. Not all plans were being reviewed monthly, as recommended in the Standards. The manager explained that this was because she had been on leave. It was suggested that she delegate this task (or at least some of it) to some of her senior staff, so that it would both free up some time for her and also enable the staff to develop their skills. It would also be beneficial for the service users. Comment has been made in previous inspection reports regarding crossreferencing the needs identified in the service user plan to the daily notes. This is still not being done, so it is not always easy to identify what specific action staff have taken to meet individual service user’s needs. A number of service users suffer from pressure sores however the treatment records were not, in all cases, being kept up to date. It was difficult to determine, therefore, if the intended treatment routine was being adhered to. The previously made requirement re the need to ensure that records of GP visits were adequately maintained has been met. Two errors were noted on the medication administration records. One related to staff signing to say medication had been given but then apparently crossing this through (so it was not possible to determine if the medication had actually been given), while the other concerned staff not giving an explanation as to why medication had not been given. It is disappointing that a requirement has yet again to be made with regard to the medication administration sheets. It was disappointing to note that staff did not always knock on a resident’s door before entering their bedroom. It is a simple matter to do so, and would ensure that a basic right to privacy is being upheld. Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 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) 12, 13, 14 and 15 The home employs two part time activities co-ordinators. Between them they provide an adequate amount of social stimulation and activities for service users to enjoy. The service users spoken with said that they were satisfied and had no issues to raise. The only relative spoken with echoed these sentiments. No CSCI questionnaires were returned prior to this inspection. Visitors are encouraged to call. The lunchtime meal was observed and was evidently enjoyed by service users. EVIDENCE: One of the co-ordinators keeps a log of the activities provided and which service users participated. The manager persists in trying to ensure that the other co-ordinator commences similar records. While activities are not provided on a daily basis, there are a number provided during the course of each week, and service users commented that these were adequate in number. It was pleasing to see staff assist two service users into the garden so that they could benefit from the good weather in very pleasant surroundings. It was noted, however, that one of these service users, who met with the Inspector before going into the garden, commented that they hoped their Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 Page 13 garden visit would take place, as staff had said they would take them out on previous occasions recently, but had failed to do so. On this occasion, at least, the visit to the garden did take place. Although not sampled on this occasion, the lunchtime meal was well presented, hot, and in plentiful supply. Residents clearly enjoyed it. Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 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) 16 and 18 The home has a satisfactory complaints procedure in place, which is accessible to service users, however some relatives indicated to the Commission that they did not think that their concerns were listened to or acted upon. There was also a procedure re adult protection but in light of a recent incident at the home, and the slow reaction of the staff, the Inspector was not satisfied that service users were adequately protected from abuse. EVIDENCE: Two complaints had been made to the home since the last inspection visit. These were dealt with by the manager. Additionally one complaint was made directly to the Commission. This resulted in an additional visit being made to the home to investigate the issues raised. Two elements of the complaint (all of which related to poor care practice and poor staff attitude) were upheld, the remainder were unresolved. While there is an Adult Protection procedure in place, as mentioned above, staff were slow to respond to an issue of potential abuse which arose recently. The Commission had to request action, and it is for this reason that the Inspector was not satisfied that the service users were being adequately protected. A requirement will be made re the need for all staff to receive training in adult protection. Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 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, 22, 24, 25 and 26 A brief tour was made of the premises, largely to determine if previously made requirements had been met. They had, and in general the premises were found to be reasonably well maintained and provided comfortable surroundings for the service users. Following on from a visit by an occupational therapist, the need for additional grab rails around the home was identified, and a requirement to fit them was included in the last report. Disappointingly, there still remain a number of areas where the rails have not been fitted. This means that the premises are not as well adapted for the service users as they could be. This in turn means that they may not be able to move around the home as independently as they otherwise might be able to. The Inspector was again disappointed to find that in spite of previous requirements, those residents who would wish it could still not lock their own bedroom doors or store precious items in a lockable area in their room. This means that their privacy and independence is compromised. It was not felt that service user safety in the home had been of a high enough priority, as the relatively new electric hot water heater still did not have a Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 Page 16 thermostatic control. This means that service users (and indeed staff) are at risk from scalding because of the high temperature of the hot water. All of the areas of the home that were inspected were clean and hygienic. This of course means that the home environment is pleasant to live in. EVIDENCE: It was previously required that staff ensure that the interior of the microwave oven be regularly cleaned. This has been done however on this visit it was clear that the oven needed to be replaced. In general, the home was being maintained to a satisfactory level however there is a need for a rolling maintenance programme so that all areas of the home are periodically refreshed/refurbished. The previous inspection report contained a requirement with regard to the need to fit additional grab rails around the home. These have still not been fitted, and there seems to be no reason for this lengthy delay. It was evident that an additional (transporter type) hoist is needed, to aid staff in the safe and comfortable movement of service users. In spite of previous requirements, bedroom doors had still not been fitted with suitable locks, and not every room contained a lockable piece of furniture. It was also required that new carpets be fitted in three of the bedrooms. While two of the carpets have been successfully deep cleaned, and for the near future remain acceptable, one new carpet is still needed. It was of considerable concern to find that no action had been taken regarding the temperature of the hot water produced by the recently installed electric hot water heater. At the time of the last inspection the temperature exceeded the scale on the thermometer and the manager was required to ensure a thermostatic valve was fitted. The safety of the service users is being unnecessarily compromised by the ongoing failure to ensure that the hot water does not reach excessively high temperatures. There were no concerns regarding cleanliness in the areas of the home visited. Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 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 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, 29 and 30 The Inspector was not satisfied that the needs of the service users were always being met as the minimum staffing levels previously agreed were not always being adhered to. Due to ongoing poor recruitment practice, the Inspector was not satisfied that service users were adequately protected. Progress had been made with regard to staff training, with six of the care staff team having achieved an NVQ award. This means that the staff team have received adequate training, which should allow them to do their jobs competently. EVIDENCE: The rotas provided showed that on occasion there were insufficient numbers of qualified staff on duty during the day. The Inspector was concerned at the manager’s apparent acceptance of this situation. Minimum staffing levels have previously been agreed with the home and the manager must take all possible steps to ensure that these levels are maintained. In spite of previous requirements regarding the recruitment procedures in the home, new staff have still been recruited without undergoing a CRB/POVA check. This is unacceptable and an Immediate Requirement notice was left regarding both this issue and staffing levels. Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 Page 18 As mentioned above six of the care staff team are to be congratulated for having obtained NVQ level II and/or III awards. Additionally, staff have been able to attend training in areas such as palliative care; medication, infection control and wound care. Given this, it is a little surprising that the documentation in the home with regard to some of these areas is substandard. This is an issue for the manager to follow up, as closer monitoring and supervision is needed. Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 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 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 and 38 Within this home there continues to be a blurring of roles, which is neither helpful nor conducive to good team relationships. It is the Registered Manager who has responsibility for the day-to-day running of the home, and all other staff should report to, and take their lead from, her. The present situation, where, for example, the manager does not have free access to staff records, is becoming divisive and causing widespread resentment, which will ultimately have a bearing on the quality of care being provided. A small number of residents have their finances (pocket money) looked after by the home. The records of these transactions were satisfactory albeit a recommendation will be made with regard to the payment of interest. The Inspector was not satisfied that the home was being run in the best interests of the service users as there were still no systems in place to determine the quality of the service being provided. Staff were still not being supervised to the level recommended in the Standards, albeit some improvement had been made. This means that there is Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 Page 20 more possibility that the quality of care being provided is not always as it should be. Failure to take action regarding previously made requirements about fire safety and the need for radiator covers indicated that the home was not being maintained to an appropriate level of safety, thus putting service users at risk. EVIDENCE: Comments were made in the last inspection report regarding the necessity of the proprietors allowing the registered manager to run the home on a day-today basis, without unnecessary interference. Unfortunately, this has not occurred, and in many cases the manager is expected to defer to the home’s administrator. This is not satisfactory, particularly in instances where clinical judgement and expertise is required. The lack of a consistent management approach is now starting to have an impact on the quality of service being provided. The last inspection report also contained a requirement re the need for a quality assurance system to be implemented in the home. A start has been made on this, with some questionnaires being sent out to service users and relatives however a more comprehensive system still needs to be developed. The home’s administrator keeps a computerised record re some of the service users finances. One bank account is kept into which all service users’ monies is paid. The record was satisfactory however the Inspector did query what happened to the money gathered as interest, as this should be returned (proportionally) to the service users. The manager has made inroads into staff supervision, and while it still falls short of the frequency recommended in the Standards, some improvement was noted. Three requirements were made at the last inspection with regard to health and safety. Two related to fire safety – the need to consult with the Fire Authority regarding a fire exit through a bedroom, and the need to ensure that bedroom doors were not wedged open. No action has been taken, indeed when one resident asked could his door be propped open, the manager placed a chair in the doorway. This was done only minutes after a conversation between Inspector and manager regarding fire safety. The third health and safety requirement related to the need to ensure that radiators were fitted with covers. This work has still not been completed. Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 Page 21 Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 Page 22 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 x 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 x x 2 x 2 1 3 STAFFING Standard No Score 27 1 28 x 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 x 1 1 x 3 2 x 1 Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 Page 23 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 3 Regulation 14 Requirement The manager must ensure that thorough pre-admission assessments are carried out prior to any new service users being admitted. Service user plans must include reference to social needs; they should be cross-referenced to the daily notes and reviewed on a monthly basis. The manager must ensure that wound care documentation is up to date and that treatment is consistent. The manager must ensure that medication administration records are accurately maintained. The previously set timescale for this requirement has not been met. The manager must ensure that the privacy of service users is maintained as much as possible. This includes knocking on their bedroom doors before entering. The manager must ensure that the complaints procedure is accessible and that service users and their families are confident that any complaints made will be appropriately dealt with. G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Timescale for action 11/7/05 2. 7 15 11/7/05 3. 8 12 11/7/05 4. 9 13 11/7/05 5. 10 12 11/7/05 6. 16 22 11/7/05 Woodlands Nursing Home Version 1.40 Page 24 7. 18 13 8. 9. 19 19 16 16 10. 11. 12. 22 22 24 23 23 23 13. 25 13, 23 14. 15. 27 29 18 19 16. 32 8 17. 33 24 The manager must ensure that all staff have received training in the protection of vulnerable adults, and that refresher training is also available. A new microwave is required for the kitchen. A new carpet is still required in one of the bedrooms. The previously set timescale for this requirement has not been met. Grab rails must be fitted as recommended by the occupational therapist. An additional hoist is required for the safe moving of service users. Bedroom doors must be fitted with suitable locks and each room provided with a lockable item of furniture. The previously set timescale for this requirement has not been met. An appropriate thermostatic valve must be fitted to the electric hot water heater. The previously set timescale for this requirement has not been met. The manager must ensure that the minimum staffing levels are adhered to at all times. The manager must ensure that all staff provided the documentation listed in the Regulations before commencing work. The previously set timescale for this requirement has not been met. The proprietors must ensure that the role of the Registered Manager is clearly defined and made known to all staff. The previously set timescale for this requirement has not been met. Appropriate quality assurance systems must be implemented. The previously set timescale for this requirement has not been met. 31/8/05 31/8/05 31/8/05 31/8/095 30/9/05 31/8/05 30/7/05 11/7/05 11/7/05 30/7/05 31/8/05 Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 Page 25 18. 38 13, 23 19. 38 13, 23 20. 38 13 The manager must ensure that bedroom doors are not wedged open. Appropriate devices must be fitted where service users wish their doors to remain open. The previously set timescale for this requirement has not been met. The manager must seek advice from the Fire Authority regarding one emergency exit through a bedroom. The previously set timescale for this requirement has not been met. Safety covers must be fitted to all bedroom radiators. In the interim period before covers are fitted, staff must carry out risk assessments and take any necessary measures to ensure the safety of service users. The previously set timescale for this requirement has not been met. 31/7/05 31/7/05 31/7/05 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 19 30 35 36 Good Practice Recommendations It would be good practice to commence a rolling maintenance programme so that all areas of the home are periodically refurbished. The manager should make efforts to ensure each member of staff has an individual training profile, and staff are provided with foundation training. The homes admistrator should make enquires re the interest gained on the joint service users bank account and ensure that it is paid to the service users. The manager should continue with her efforts to increase the frequency of staff supervision. Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection 8th Floor, Grosvenor House 125 High Street Croydon CR0 9XP 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 Woodlands Nursing Home G53 G53 S19048 woodlandsNH V198520 110705 stage 4.doc Version 1.40 Page 27 - 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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