Care Home: Foresters Nursing Home

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What the care home does well The home continues to offer a high standard of care to elderly residents, with both physical and mental frailty, which is focussed on individual need. The home has a committed staff group who well understand the needs of residents. The registered manager spends time with the residents and ensures staff are aware of the needs of residents through documentation such as risk assessments and care plans. What has improved since the last inspection? What the care home could do better: CARE HOMES FOR OLDER PEOPLE Foresters Nursing Home Foresters Walton Pool Lane Clent Nr Stourbridge Worcestershire DY9 9RP Lead Inspector Keith Salmon Unannounced Inspection 4th February 2008 09:45 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 Foresters Nursing Home DS0000064130.V352570.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. Foresters Nursing Home DS0000064130.V352570.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Foresters Nursing Home Address Foresters Walton Pool Lane Clent Nr Stourbridge Worcestershire DY9 9RP 01562 883068 01562 887474 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) Redwood Care Homes Ltd Mrs Carol Palmer Care Home 30 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (30), of places Physical disability over 65 years of age (30) Foresters Nursing Home DS0000064130.V352570.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd July 2007 Brief Description of the Service: Foresters Nursing Home is registered to provide nursing care and accommodation for a maximum of 30 residents over the age of 65 years, 6 of whom may have dementia related illness. Situated in a quiet, rural location the home provides accommodation on three floors, accessed via a passenger lift, or main staircase. There are a total of 24 single rooms and 3 shared rooms (double) with en-suite facilities provided in most of the rooms. The home benefits from generous, well-tended gardens and enjoys panoramic views of the Malvern Hills and Welsh Hills. Fees are not stated in the Service User Guide or brochure, but confirmed directly to individuals who are private residents, or otherwise charged at local authority rate. Foresters Nursing Home DS0000064130.V352570.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This Unannounced ‘Key’ Inspection commenced at 9.45am, concluded at 3.30pm, and was conducted by Mr Keith Salmon. Present on behalf of the Home was the Manager, Mrs. Carol Palmer. In addition to the inspection of ‘Key’ Standards, this Inspection also sought to review progress in meeting ‘Requirements’ arising from the most recent Unannounced ‘Key’ Inspection, held in February 2007, and a ‘Random’ Inspection undertaken in July 2007. This Report is based on observations made during a tour of the home, a review of care related documentation, staff duty rotas and staff files, plus a range of other documents/records reflecting the general operation of the Home. We were also able to verify information contained in the home’s Annual Quality Assurance (AQQA) document submitted to the Commission in November 2007. The Inspector also held individual discussions with 6 Residents, 3 Visitors, the Manager, and several other members of staff. What the service does well: What has improved since the last inspection? From seven Requirements cited at the previous inspection six have been met. In doing this the home has successfully addressed issues relating to: • • Information for residents/prospective residents and relatives through review and revision of the Service User Guide. Retention of copies of contracts/terms and conditions within the home. Foresters Nursing Home DS0000064130.V352570.R01.S.doc Version 5.2 Page 6 • • • Improvements to the design and maintenance of care planning documentation. Aspects of the management of medicines. Provision of locks to bedroom doors (for resident’s use) and the fitting of safety chains to windows where necessary. What they could do better: In general, the home achieves good quality performance in the provision of care. However, there are two specific areas identified for improvement: • There remains the need for the home to address the one outstanding requirement, i.e. the installation of an appropriate sluice machine on the ground floor. Whilst the home provides an activities/social leisure programme there is scope for development in this important aspect of care provision. • 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. Foresters Nursing Home DS0000064130.V352570.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 Foresters Nursing Home DS0000064130.V352570.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): 1, 2, & 3 (6 - not applicable). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People wishing to move into the home are provided with information to assist them in making an informed decision, and their needs assessed to ensure the home can successfully meet these needs. Processes to ensure appropriate and thorough care needs assessment, prior to admission, are effectively applied, and subsequent findings are utilised to ensure appropriate placement and care provision. EVIDENCE: Two requirements were cited at the previous ‘Key’ inspection (held in February 2007) with regard to the ‘Choice of Home’ outcome group. The first of these was: • “The registered person shall amend the service user guide to provide the detail required by the amendment Regulations 2006.” Foresters Nursing Home DS0000064130.V352570.R01.S.doc Version 5.2 Page 9 At this inspection a review of relevant documentation evidenced the Service User Guide has been revised in accordance with the Standard, and copies are readily available to interested parties. The Home also issues a ‘welcome’ letter to all new residents. This requirement is met. The second requirement relates to the provision of a written contract/ statement of terms and conditions to each resident, and comprised three elements, which stated: • • “The home must retain a copy of individual contracts.” “The registered person shall maintain a record of the care home’s charges to service users, including any extra amounts payable for additional services not covered by those charges, and the amounts paid by or in respect of each service user.” “The registered person shall ensure that the records referred to 17(2), (a) are kept up to date; and (b) are at all times available for inspection in the care home by any person authorised by the Commission to enter and inspect the care home.” • ‘Case Tracking’ involving the review of 4 Residents’ Care Plans/Files, i.e. those relating to the two most recently admitted Residents, plus 2 selected at random, demonstrated that copies of the written contract are now retained at the home. In addition, evidence was observed which confirmed information is provided to residents relating to any extra amounts payable for additional services not covered by the basic fee, and records are retained of the amounts paid by, or in respect of, each service user. Therefore, with all three components having been addressed this requirement has been met. If they wish all prospective service users are welcome to spend time at the home and to partake in a meal with residents. The guide describes what a prospective resident may expect and gives a good detailed account of the quality of the accommodation, qualifications and experience of staff, and how to make a complaint. Admissions are not made to the home until a full needs assessment has been undertaken by the Registered Manager, with involvement of the resident and/or relatives where possible. The home is then in a position to confirm they can meet the needs of the individual through the service they deliver as detailed in the service user guide. Foresters Nursing Home DS0000064130.V352570.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, & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s assessed care needs are set out in a written care plan which helps ensure provision appropriate and effective care. Storage, reception, disposal, and record keeping, relating to medicines’ administration are all in accordance with accepted ‘good practice.’ The care provided is delivered considerately and effectively with Residents’ privacy and dignity being respected. EVIDENCE: At the previous ‘Key’ inspection, held in February 2007,a requirement was issued in respect of resident’s care plans, i.e. • “Unless it is impracticable to carry out such consultation, the registered person shall, after consultation with the service user, or a representative of his, prepare a written plan.” DS0000064130.V352570.R01.S.doc Version 5.2 Page 11 Foresters Nursing Home Further to this, at the ‘Random’ inspection, held in July 2007, it was noted care plans were of a design based mainly on ‘tick boxes’ and, as such, the Inspector found them difficult to follow. Specific comments made included: “The font on the care plans is small and crowded making them difficult to read and to draw out the relevant information.” “The care plans seen lacked detail as to how care is to be delivered and were primarily objectives and aims rather than strategies to guide staff as to how to meet individual care needs.” “Care plans are not person focused or individual. The daily routine form was blank.” As a result of these findings a further requirement was issued, i.e. • “Care plans must be sufficiently detailed and cover all identified care needs. Care plans must be up to date and reviewed on at least a monthly basis or when significant changes occur or become apparent.” At this inspection the Manager informed us care plans have been revised with the above comments in mind. A sampling of eight care plans (the three most recent admissions plus five selected at random) demonstrated the following improvements: o Care plans are more evidently person focussed. o Information and instructions relating to care provision appears to be more detailed than previously. o Staff interviewed considered the care plans were now more helpful in enabling them to provide appropriate care. However, some members of staff told us they would prefer a model with fewer tick boxes. From our own observation, and from comments by staff, the model remains predominantly one of ‘tick’ boxes, with many of the items offered for completion being redundant when applied to many of the residents and, to an outside assessor, remains very difficult to follow. Although, on balance, it is considered the requirement is met, it is recommended that a further revision of the care plan be undertaken, involving direct input from those staff responsible for making care needs assessment and daily entries, with the aim of making care plans more ‘user friendly’. Notwithstanding the above comments, discussions with Residents and relatives, were very positive including such comments as “my (relative) is very Foresters Nursing Home DS0000064130.V352570.R01.S.doc Version 5.2 Page 12 well looked after here and we are very pleased we chose this home…” … “The girls look after us as one of there own – it is like a family.” The final requirement in this section (comprising two elements) was for the home to ensure: • “…that medication records and other documents are up to date, accurate and that items are administered in line with the instructions of the prescribing person.” “… sufficient supplies of all items prescribed must be available therefore ensuring the health safety and welfare of people using the service.” • Inspection of medicine storage provision, and administration records, demonstrated the matters addressed in the above requirement have been satisfactorily addressed, and the home’s practices relating to medicines now meet the guidelines of the Royal Pharmaceutical Society. The requirement is considered met. Foresters Nursing Home DS0000064130.V352570.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 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Leisure opportunities provided are consistent with residents’ capabilities though could be developed and expanded. The home facilitates achievement of desired lifestyle through Residents conducting the pattern of their day, where possible, as they wish, including contact with family and friends. There is a daily choice of attractive and nutritious meals. EVIDENCE: A flexible approach is adopted to resident’s preferences as to how they wish to spend their time/undertake activities – stated by the Manager and confirmed by residents and relatives. Residents are consulted (both directly and through the use of questionnaires) on how the home can work to provide them with a flexible lifestyle. In addition, the home offers regular meetings for service users/families/supporters to provide a forum where they can air their views and make suggestions for improvement. However, the Manager told us most contact is day to day, as and when relatives visit the home, as they take Foresters Nursing Home DS0000064130.V352570.R01.S.doc Version 5.2 Page 14 advantage of the Manager’s ‘open-door’ availability. Visitors who spoke with us confirmed this. Each resident’s documentation incorporates a life history record, which provides the basis for a ‘social care plan’, aimed at ensuring each resident achieves a lifestyle, which reflects his or her social/leisure activities. To achieve this the home operates a structured activities programme, which includes an organ recital every 2 weeks, exercise sessions (also held fortnightly), poetry readings, jigsaws, celebration of seasonal events and celebration of resident’s birthdays. Residents also receive regular visits from the Timeless Partnership Group who carry out ‘one to one’ activities such as hand massage. Whilst the current level, and range, of activities provides a good basis the Manager agrees there is the need for further development. To enable this we were informed of plans to possibly formalise lead responsibility for the activities programme by specifying the activity as part of the job responsibility of one of the care staff who has shown an interest and ability in leading such a development. It is recommended that steps be taken to formalise such an arrangement. The home has open visiting arrangements and service users spoken with told us they could entertain their family and friends in their own room, or, if they prefer they can use communal areas of the home to talk to visitors – the quiet first floor lounge being a favourite in this respect. The cook has received basic food hygiene training, consults with service users and tries to meet the preferences and suggested dishes when preparing the menu. The menu on the day of the inspection was displayed on a wipe board within the lounge. Service users may choose to eat in their own room if they wish and drinks and snacks are available throughout the day. Foresters Nursing Home DS0000064130.V352570.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 &18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The interests of Residents are protected through ready access to information relating to advocacy services and the home’s Complaints Procedure. Staff are aware of their role in protecting Residents from abuse and of taking appropriate action should it be necessary. EVIDENCE: The home’s Complaints Procedure is displayed within the entrance to the Home and up-to-date information advising on how to proceed in making a complaint is found in the Service Users’ Guide. At the previous Random Inspection (held in July 2007) it was strongly recommended that a review of the current training in relation to safeguarding adults be undertaken. Discussions with the Manager and staff, plus a review of staff training records, ‘Adult Protection’ documentation and guidelines, evidenced the home has responded positively, and effectively, in addressing this issue through the establishment of more relevant and robust policies and procedures, which are in accordance with current local authority ‘adult protection’ practices. In addition, revised training is now in place to ensure staff are aware of their responsibilities in respect of the prevention of adult abuse, ‘whistle-blowing’ and action they should take should they see, or be concerned that such abuse may be taking place. Foresters Nursing Home DS0000064130.V352570.R01.S.doc Version 5.2 Page 16 A review of the complaints log demonstrated there had been no complaints registered since the previous Inspection and the Commission, during this period, has received no complaints. Residents and Visitors, consulted during the inspection, stated they would raise any matters of concern with the Manager, and were confident issues raised would be dealt with properly. Foresters Nursing Home DS0000064130.V352570.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): 19,24 & 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides a generally safe, well-maintained environment with communal rooms and bedrooms, which are satisfactorily decorated with furnishings being in good order and presenting a ‘domestic’ ambience. Some previously noted areas of concern have been addressed, making Foresters a safer and more comfortable environment. Specialist equipment, consistent with meeting the assessed care needs of service users and the demands of tasks carried out by care staff, and is appropriately serviced and maintained. Whilst the home is clean, and there are satisfactory standards of hygiene, one aspect of infection control (sluicing arrangements) could be improved. Foresters Nursing Home DS0000064130.V352570.R01.S.doc Version 5.2 Page 18 EVIDENCE: The tour of the home demonstrated it offers well-furnished, homely and comfortable accommodation. Bedrooms visited (i.e. ten), and selected at random, showed them to be warm, comfortable and with evidence of residents bringing their own personal possessions into the home. Communal areas include a lounge on each of the two floors with a separate ground floor dining room. Improvements to the internal décor include redecoration of the upper corridor and several bedrooms, replacement of the carpet by the dining room and safety glass has been fitted to the patio window. The gardens are generous in size and well tended. Recently, trees located around the westerly boundary of the garden, which obstructed panoramic views towards the Malverns, and the Welsh hills, have been lopped so as to make those views accessible once more. At the previous ‘Key’ inspection two requirements relating to ‘Environment’ were issued, as follows: • “Locks must be available for all of the bedrooms.” The tour of the home showed that suitable locks have now been fitted and lockable furniture provided in each bedroom. The requirement is met. The second requirement in this area had two components, i.e. • “The registered person, having regard to the number and needs of the service users shall ensure that any necessary sluicing facilities are provided.” “A sluicing disinfector must be available on the ground floor.” • There is evidence the home is aware of their responsibilities in respect of the prevention and management of cross infection, e.g. the availability of antibacterial alcohol hand washing gel located around the home for staff and others to freely use. Therefore, it is surprising no progress has been made in respect of this requirement. In the current climate of increased risk to residents from infection from organisms such as Clostridium difficile (Cl. diff.) it is strongly recommended, as a matter of some importance, that, in the short term, the home carry out a written risk assessment of the possible effect of this shortfall in respect of the Regulations. Beyond that arrangements should be made to install appropriate sluicing arrangements for the ground floor as soon as possible. Foresters Nursing Home DS0000064130.V352570.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 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff numbers on duty, and skill-mix, were sufficient to meet the assessed care needs of current Residents. Recruitment and employment practices are consistent with the safeguarding of Residents. The commitment of the Home in providing training for Care Staff is satisfactory, and in accordance with individual Staff Member’s learning needs. EVIDENCE: A review of recent duty rosters, and staff numbers/deployment at the time of the Inspection, suggested staff cover should now be sufficient to meet Residents’ assessed care needs. The Manager is usually supernumerary. Staff employment files relating to the three most recently employed staff were reviewed and demonstrated recruitment practices at the home to be satisfactory, with all elements required by Care Homes’ Regulations being completed, and evidence retained on file. Foresters Nursing Home DS0000064130.V352570.R01.S.doc Version 5.2 Page 20 Staff training files evidenced the proportion of care staff, who hold National Vocational Qualification Level 2, or higher, comfortably exceeds the minimum 50 required by the Standard, with 70 having attained NVQ Level 2. Files further evidenced that staff have undertaken appropriate induction training, plus mandatory training, including - moving and handling, medication administration, dementia awareness (including management of challenging behaviour), adult protection, care planning, risk assessment, infection control, and fire awareness. Foresters Nursing Home DS0000064130.V352570.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, 36, and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A suitably qualified and experienced person manages the home. Transactions involving expenditure of Resident’s personal monies are safeguarded by the financial procedures operated within the Home. The systems for consultation with Residents have improved, with evidence suggesting their views are acted upon. Health, safety, and welfare of service users, and staff, are promoted fully by safe working systems being in place. Foresters Nursing Home DS0000064130.V352570.R01.S.doc Version 5.2 Page 22 EVIDENCE: The Registered Manager, Mrs Carol Palmer, is experienced and well qualified, having completed the Registered Managers’ Award. Observation by the Inspector, and comments from residents, staff and visitors, suggest the home is currently being well managed and is based on openness and respect. The home has effective quality assurance systems developed, and supported, from Redwood Head Office by the Company’s Quality Manager, who also undertakes and reports on Regulation 26 unannounced inspection visits. Service users can continue managing their own financial affairs if they wish to do so. When there is the occasional need for the home to hold personal monies in safekeeping there are excellent records maintained of all transactions. The inspector concluded that accounting practices (including audit) were appropriate, thorough, and in accordance with the Standard. Staff records demonstrated that formal staff supervision is now conducted in accordance with the related Standard in that the Manager holds supervision meetings with individual staff, by way of a rolling programme, ensuring all staff receive formal supervision at least six times per year, plus an annual appraisal. At the immediately previous inspection it was strongly recommended that – • ‘…the chains used to restrict window opening are reassessed to ensure they are sufficiently strong.’ The tour of the Home evidenced all casement windows accessible to residents are now fitted with suitable safety chains. At the time of this inspection no potential hazards were identified and a review of relevant records provided evidence that Health and Safety Policies/ Procedures/Practices are satisfactory, with all COSHH requirements met. Records were observed providing evidence the home has satisfactorily undertaken appropriate maintenance of equipment, including electrical, lifts, and hoists. Foresters Nursing Home DS0000064130.V352570.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 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 3 X 3 3 X 3 Foresters Nursing Home DS0000064130.V352570.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 OP7 OP12 Good Practice Recommendations It is recommended that the care plan be revised further with the aim of making care plans more ‘user friendly’. It is recommended that plans to formally identify a member of staff to take on responsibility for the planning and development activities be brought into effect as soon as possible. It is strongly recommended, the home carries out a written risk assessment of the possible effect of the lack of appropriate sluicing arrangements for the ground floor so as to ensure protection of residents from gastro-intestinal infection. 3. OP26 Foresters Nursing Home DS0000064130.V352570.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Foresters Nursing Home DS0000064130.V352570.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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