Care Home: Garston Manor Nursing Home

What the care home does well Garston Manor provides comprehensive information for people may need a place in the home. People are properly assessed before they move in so that the home knows it can meet their needs. Relatives feel confident in the standard of care provided by the staff People are treated with respect and their dignity is preserved. Information about people`s interests is gathered so that the home can try to involve them in activities. Most people feel confident that their concerns are taken seriously and acted upon. Staff know what to do if they suspect that someone is being abused. Garston Manor is a clean, comfortable and safe place to live. Staffing is well organised so that people get the attention they need. Staff are well trained and have a caring attitude. Standards of record keeping in the home are generally very high. What has improved since the last inspection? New behaviour management forms have been introduced The flooring in the main lounge has been replaced to reduce the potential risk of infection Shortfalls in staff training in areas such as moving and handling have been addressed. What the care home could do better: Forms about administering crushed tablets need to be completed fully When people leave the home, a record should be kept of all the possessions leaving with them. CARE HOMES FOR OLDER PEOPLE Garston Manor Nursing Home 10 Knowles Hill Road Newton Abbot Devon TQ12 2PW Lead Inspector Graham Thomas Unannounced Inspection 14th November 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 Garston Manor Nursing Home DS0000028671.V349431.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. Garston Manor Nursing Home DS0000028671.V349431.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Garston Manor Nursing Home Address 10 Knowles Hill Road Newton Abbot Devon TQ12 2PW 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) 01626 367654 01626 367662 garstonmanor@googlemail.com Mr Robert Malcolm Parkhouse Mrs Edith Magaly Parkhouse Mrs Edith Magaly Parkhouse Care Home 24 Category(ies) of Dementia (24), Mental disorder, excluding registration, with number learning disability or dementia (24), Old age, of places not falling within any other category (24), Physical disability (24) Garston Manor Nursing Home DS0000028671.V349431.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service Users over the age of 60 years may be admitted to the home One Service User (named elsewhere) who is under the age of 60 may reside at the home. 26th October 2006 Date of last inspection Brief Description of the Service: Garston Manor is a large Victorian house set in a third of an acre of landscaped garden, overlooking the market town of Newton Abbot. It aims to meet the needs of elderly mentally ill people who may also have a physical disability. There are 18 single and 3 double rooms with wash hand basins and nurse call alarms. In addition there is a large lounge and two separate dining rooms. The home has a registered nurses on duty at all times who are trained to assess the nursing and social care needs of each resident. Care staff support the trained nurses in providing the care for the residents. There is a large, level garden that provides a secure outdoor area for the use of people living at the home. There is also a small sheltered area with seating. Comments are invited from residents and visitors through an anonymous satisfaction questionnaire that is available in the main reception area of the home. Weekly fees at the time of this inspection ranged between £300 and £545 with continuing care by negotiation according to individual need. Extra costs include toiletries, hairdressing and chiropody. Garston Manor Nursing Home DS0000028671.V349431.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Before the inspection visit, an Annual Quality Assurance Assessment (AQAA) self assessment form was completed and returned by Mrs Parkhouse. Eight questionnaires were sent to relatives of which four were returned. Further written feedback from a relative was seen during the inspection. Seven questionnaires were sent to care managers and two were returned. None of the five questionnaires sent to General Practitioners was returned. A visit to the home took place over one and a half days. During the visit we (the Commission) toured all parts of the premises and observed staff at work. We spoke with five visiting relatives and friends and interviewed three staff. Three care plans were examined in detail and others were partially examined. A sample of three staff files was examined as well as other records relating to the running of the home. We also spent time in discussion with Mr and Mrs Parkhouse. What the service does well: What has improved since the last inspection? New behaviour management forms have been introduced The flooring in the main lounge has been replaced to reduce the potential risk of infection Shortfalls in staff training in areas such as moving and handling have been addressed. Garston Manor Nursing Home DS0000028671.V349431.R01.S.doc Version 5.2 Page 6 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. Garston Manor Nursing Home DS0000028671.V349431.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 Garston Manor Nursing Home DS0000028671.V349431.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): Standards 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service and their relatives can feel confident that a thorough assessment will be made to ensure the person’s needs can be met by the home. EVIDENCE: Mr and Mrs Parkhouse have developed a web site, which enables those who are interested to look at the home’s facilities and services on line prior to visiting the home. This includes a description of the of the home’s environment with photographs and a floor plan. Details of the objectives of the home and how care is planned are also described. One visiting relative confirmed that he had used this facility. Others confirmed that the home had supplied sufficient information for them to consider a placement in the home. Garston Manor Nursing Home DS0000028671.V349431.R01.S.doc Version 5.2 Page 9 The home’s statement of purpose and service users’ guide are regularly updated and revised copies sent to the Commission. These were readily available in the home for residents and others to see on request. Examination of individual care plan files showed that a thorough and comprehensive assessment process was in place. This encompassed health, personal and social care needs. The home’s own assessments were supplemented by information gathered from referring authorities. One care manager commented that “I have never known this home to take a client without a face to face assessment” A continuous risk assessment process ensures that the residents’ care needs are monitored and changes in their care needs reflected in their plans of care. For example, at the time of this inspection a new system had been introduced to monitor weight loss and diet. Garston Manor does not provide a service for those who require intermediate care only. Garston Manor Nursing Home DS0000028671.V349431.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): Standards 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s individual needs are clearly set out in well detailed care plans. People living at Garston Manor and their relatives can feel confident in a good standard of care provided by the home. EVIDENCE: During our inspection visit we examined three care plans in detail and parts of others. The plans were well organised, clearly set out and included separate details for day and night care. The plans had been reviewed regularly and amended, if necessary, as the person’s needs had changed. Signatures of relatives had been obtained where involvement in the plans was possible. Each plan contained details of the person’s needs and guidance as to how these should be met by staff. Risk assessments were contained in the files concerning, for instance, fluid intake and risks posed by the individual’s immediate environment. Behaviour management plans had been produced where the person’s behaviour was likely to cause a risk to themselves or Garston Manor Nursing Home DS0000028671.V349431.R01.S.doc Version 5.2 Page 11 others. The behaviour management plan of one person who had recently moved to the home was awaiting completion at the time of the visit. Visitors with whom we spoke during the inspection visit expressed their confidence in the care provided at Garston Manor. In particular they all mentioned that their relatives were always clean and well presented. An email from one relative seen during the inspection stated “….Mum’s hair was done….and she had earrings on and a necklace…..it absolutely delighted Dad. ..We appreciate the wonderful loving care Mum is getting from you all and.. that gives Dad peace of mind enough to take a holiday” Individual files showed evidence of consultation with healthcare professionals such as GPs and District Nurses as well as mental health specialists. Both care managers who returned questionnaires stated that individual health care needs were “usually” monitored and attended to. Results of the home’s own quality assurance questionnaires indicated that 7 out of 8 people responding felt that there was good access to healthcare professionals. Staff confirmed the evidence seen in care plans that regular monitoring of weight and fluids was undertaken. Following a recent analysis of the weight changes of people living at the home, the Registered Providers had consulted with the local GP and were looking at ways to modify individual diets to reduce the risk of significant weight loss. Inspection of staff files showed that they had received training in moving and handling and pressure area care. Staff were seen using hoists during the visit. During the process the staff member offered reassurance to the person being hoisted and described what was about to happen at each stage. Pressure relieving mattresses and cushions were seen in individual rooms in accordance with needs identified in individual plans. The home’s system for administering medicines was examined. None of the residents at Garston Manor has been assessed as able to self medicate. Medicines were found to be securely stored. Additional security and an appropriate recording system were in place for controlled drugs though none was in use at the time of our visit. There was a separate, secure refrigerator for medicines requiring cool storage. A “monitored dosage system” was in use. This means that most tablets are provided by the pharmacy in pre-packed cartridges divided into individual doses. The medicines of three people were inspected. All records relating to these medicines were found to be up to date and in good order. Some people required tablets to be crushed so that they could take them. Consent forms were contained in individual files to be signed by a relative and GP. One form inspected had not been signed. Garston Manor Nursing Home DS0000028671.V349431.R01.S.doc Version 5.2 Page 12 During our visit we noted that staff treated people with kindness, courtesy and respect. Visiting relatives with whom we spoke confirmed that this matched their own observations. In a questionnaire one care manager commented: “Very difficult client group to care for. Residents generally need close supervision due to disrobing and disinhibition. Staff appear to act quickly and often can predict when this is going to happen” Garston Manor Nursing Home DS0000028671.V349431.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): Standards 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. The staff team at Garston Manor continue to endeavour to provide meaningful activities, which promote dignity for the residents in their care. EVIDENCE: A recent summary of completed questionnaires received by the home indicated that, of eight people responding, five felt that there was good involvement in social activities. One person was “neutral”, one felt that the involvement was poor and one felt that it was not relevant. A care manager commented “I understand they try and encourage residents to participate in things they’ve enjoyed in the past. When people are admitted they try to get a full history” Staff and visitors stated that attempts were made to engage individuals in activities and that resources such as skittles and board games were available for this. One visitor commented that “a lot of effort” was made by staff to help people celebrate special occasions such as Christmas. During the inspection visit we observed staff providing a high degree of individual attention to people and engaging them in conversation, sharing jokes and discussing matters of immediate interest. Mr and Mrs Parkhouse stated that entertainments such as Garston Manor Nursing Home DS0000028671.V349431.R01.S.doc Version 5.2 Page 14 music had been brought into the home though these had not always been well received by all the people living there. Photographs seen during the inspection confirmed that people had enjoyed trips in small groups to various local venues. All the relatives with whom we spoke during the inspection visit stated that they always received a warm welcome to the home and were usually offered refreshments. Based on their experience of the home, each was confident that they would be informed of significant events concerning their relative. One person felt that they could be better informed about the need for replacement clothing and toiletries. A complaint was received before our visit to the home in which the complainant felt that the home had not kept her fully informed about her relative’s changing needs. A re-assessment of the person’s needs was carried out by two visiting professionals. As a result, the person was subsequently moved to a residential setting. Our enquiries concerning this complaint led to the conclusion that a significant difference of view about the person’s needs had resulted in a breakdown of effective communication. However, this was seen to be an individual instance and, on the basis of other evidence gathered, not generally representative of the experience of other relatives. Examination of menus showed that a varied and nutritious diet was provided in the home which included the use of fresh ingredients. Where people required specialised diets such as pureed or sugar free food, these needs were being catered for. Individual files showed that diet and weight were being routinely monitored. Recent findings concerning weight loss had prompted Mr and Mrs Parkhouse to consult with a medical practitioner. Though no obvious cause was apparent, some modifications to the diet provided had been considered. The home has two dining rooms. We observed part of a meal time which was unrushed and convivial. We later sat with a person who was being assisted to eat by a staff member. This person ate their meal with obvious relish and made many positive comments about it. Garston Manor Nursing Home DS0000028671.V349431.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): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Garston Manor and their relatives can feel confident that their concerns will generally be listened to and acted upon. There are sufficiently robust systems in place to respond to suspicion of abuse. EVIDENCE: Garston Manor has a clear complaints procedure which is usually on display in the home’s foyer. All the relatives and care managers who returned questionnaires, stated that the home “always” responded appropriately to concerns. All the relatives who returned questionnaires knew how to make a complaint. Those with whom we spoke during the visit felt confident that there concerns would be listened to and acted upon. Since the key last inspection, the Commission has received one complaint about the home. This was referred to Mr and Mrs Parkhouse to investigate. The complainant was not satisfied with the response and asked us to review the matter. We concluded that there had been a difference of view as to the best interests of the complainant’s relative which had led to a breakdown of trust and confidence. However, based on the evidence reviewed, we concluded that this did not generally reflect the home’s relationship with relatives or adversely Garston Manor Nursing Home DS0000028671.V349431.R01.S.doc Version 5.2 Page 16 affect the care provided. A shortfall concerning the recording of possessions leaving the home was identified as part of this review. Staff records and discussion with staff showed that they had received training in safeguarding vulnerable adults from abuse. In discussion, staff were able to identify appropriate ways in which they might respond to allegations or disclosures. Behaviour management plans have been produced for people whose behaviour may be challenging. This ensures that there are agreed, non-abusive strategies to manage such behaviour. Mr and Mrs Parkhouse stated that they do not generally involve themselves in the finances of individuals who live at the home. These are managed by relatives or other representatives. Some small amounts of patty cash are handled on behalf of people living at the home. The were detailed individual records concerning cash receipts and expenditure. Garston Manor Nursing Home DS0000028671.V349431.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): Standards 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 living at Garston Manor continue to be provided with a well maintained, safe, pleasantly decorated home. EVIDENCE: The ground floor of Garston Manor comprises a reception area, a large lounge and two separate dining rooms. There are also a laundry, kitchen and two bathrooms with assisted baths. Seven bedrooms are located on this floor, two of which are shared. On the first floor there are a further 14 bedrooms, one of which is shared. Two other bathrooms are located on this floor, one of which has a shower facility. There are also a sluice room and further toilet facilities. Outside, the home has ample car parking space and a garden area. There is also a contained outside seating area. Garston Manor Nursing Home DS0000028671.V349431.R01.S.doc Version 5.2 Page 18 On inspection all parts of the home, including individual and communal rooms were found to be clean, fresh and free from obvious hazards. Relatives with whom we spoke during the visit said that this was usually the case. Individual rooms were comfortably furnished and contained personal possessions such as photographs and ornaments. Shared rooms were provided with screening. Rooms were individually equipped with, for example, electrically adjustable beds, pressure relieving mattresses and bed rails with cushions where these were required. Communal areas were comfortably furnished and clean. Flooring in the main lounge had been replaced to reduce the risk of infections. Toilets were conveniently situated near individual rooms these were supplied with paper towels and liquid soap. Bathrooms were supplied with hand sanitizer. Bath thermometers were available to check bath temperatures and risk assessments had been conducted concerning the supply of hot water to wash hand basins. Laundry facilities comprise of a sluicing facilities on the first floor as well as a fully equipped laundry on the ground floor with maceration facilities. The laundry areas were clean and hygienic. Hand washing facilities were present in the laundries including hand sanitising fluid. The kitchen area was clean and well-organised. A prospective new cook was on a trial day during this visit. He commented that this was “one of the cleanest kitchens I’ve seen” The home’s foyer was being refurbished at the time of our visit. There was evidence of other ongoing refurbishment and redecoration such as the replacement of carpets. Labels on electrical appliances showed that they had recently been tested. There were also extremely thorough and well-organised records of maintenance which showed regular maintenance of such items as hoists. Garston Manor Nursing Home DS0000028671.V349431.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): Standards 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. People living at Garston Manor are supported by a safe, competent and well organised staff team. EVIDENCE: A total of 15 full-time and one part-time care and nursing staff provide direct care to people living at Garston Manor. Additional staff provide cleaning, maintenance and kitchen services. At night the home is staffed by a registered nurse and a night carer Positive comments were received from care managers and relatives about the staff and their work. One care manager commented “The Manager and staff of Garston Manor manage people with complex mental health problems in a sensitive and supportive manner. They communicate well with care managers” In conversation, one visitor described staff as “absolutely wonderful…gentle, caring and loving” Our own observation, examination of staffing records and feedback from relatives showed that there are sufficient staff on duty to provide individual attention to people living at the home. In one questionnaire a relative Garston Manor Nursing Home DS0000028671.V349431.R01.S.doc Version 5.2 Page 20 specifically commented that the staff “Pay attention to..(people)..on a regular basis” Relatives commented that there was always a member of staff to whom they could speak. Our own observations showed that the staff group spent time with people individually and were able to cater for individual needs and the daily routine without undue haste or pressure. A registered nurse is on duty at all times in the home, including Mrs. Parkhouse. A very well organised system was in place to ensure that less experienced staff were always placed on duty with more experienced colleagues. This involved dividing staff into three levels of experience and identifying each staff member’s level of experience on the rota. Staff files and discussion with staff showed that a sound recruitment procedure was in place. This includes a formal application process in which references are followed up. UK Criminal records checks were seen for each recruit, including those from abroad. Checks from foreign workers’ country of origin were also seen which were translated into English. Each staff member had a job description as well as a detailed work schedule according to their role and level of experience. Of the staff providing care, 75 held a National Vocational Qualification at level 2 or above. Evidence of ongoing training was seen in staff files and confirmed in discussion with individual staff members. Staff attend short courses and updates in subjects relevant to the needs of people living in the home. These include, for example, first aid, incontinence care, pressure area care and moving and handling. Shortfalls in training needs identified at the last key inspection had been addressed. Garston Manor Nursing Home DS0000028671.V349431.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): Standards 31, 33, 35, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Garston Manor is a home generally well managed for the benefit of people living there. There is a particularly high standard of record keeping. EVIDENCE: Mr and Mrs Parkhouse both have many years experience of running the home. Both have a RMN qualification and Mrs Parkhouse, who is the Registered Manager, holds the Registered Manager’s Award. Roles and responsibilities of the home’s staff are clearly set out in job descriptions and work schedules. Staff with whom we spoke were clear about the lines of accountability. Garston Manor Nursing Home DS0000028671.V349431.R01.S.doc Version 5.2 Page 22 Regular quality audit assessments have been carried out and supplied to Commission in summary form. It was evident from our examination of the home’s records that a continuous review and updating of the home’s policies and procedures was taking place. An Annual Quality Assurance Assessment sent to the Commission before our visit states that all policies were reviewed in February 2007. Notwithstanding a shortfall identified in records concerning one service user’s possessions, the overall standard of record keeping was found to be very high. The home’s records generally were clear, well structured and accessible. This was the subject of comment by one care manager in a questionnaire who noted that the home “Keeps good records. Care plans up to date.” One example of good the good practice in this are was information for staff about hazardous substances used in the home. A file contained the usual data sheets about these items. In addition, however, photographs of key specific items had been inserted in the file for easy reference. Records concerning health and safety issues were examined. These showed that regular maintenance and equipment checks such as electrical testing and the maintenance of hoists had been carried out. Labels were seen on individual appliances showing that these had been recently tested. Mr and Mrs Parkhouse stated that a fire risk assessment had been carried out and that staff were trained in fire safety. Staff files also showed that staff had received training in other relevant health and safety topics such as food hygiene, moving and handling, first aid and infection control. Staff were seen observing good practice in the control of infection by wearing protective gloves and aprons when carrying out tasks where infection might occur. Measures were also in place such as the provision of hand sanitizer in bathrooms. All the skin creams in the home were labelled clearly with the user’s name to prevent potential cross-contamination. A recent environmental health inspection referred to “excellent standards throughout” Garston Manor Nursing Home DS0000028671.V349431.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 4 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 X 3 4 X 3 Garston Manor Nursing Home DS0000028671.V349431.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 OP9 OP18 Good Practice Recommendations The Registered Person should ensure that forms giving permission for the administration of crushed tablet are signed and dated by the parties identified on the form. A record should be kept of all possessions leaving the home with a person when they move out so that these can be clearly accounted for. Garston Manor Nursing Home DS0000028671.V349431.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Garston Manor Nursing Home DS0000028671.V349431.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. Re-publishing this information is in breach of the terms of use of that website. 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