Care Home: Heathfield House Nursing Home

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What the care home does well The home is well managed by a strong management team. The home provides a comfortable, homely, environment set in attractive grounds and gardens. Furniture and fittings are of a good quality and the refurbishment programme is ongoing. The residents are treated with dignity and respect and a relative spoken with said complimented the staff on their kindness and attentiveness. Every effort is made to ascertain the residents` wishes in all respects. Good training opportunities are provided. The communication between the GP`s and the nursing staff is excellent. The nursing staff have ready access to specialist nurses and other health care professionals. Meals and mealtimes are much appreciated by the residents. The activities programme is well planned to provide for the residents` collective and individual interest. What has improved since the last inspection? The requirement and recommendations of the previous inspection have been acted upon. A new manager and strengthened management structure ensure that the home is well managed. The Equality and Diversity policy is being implemented. Robust training packages have been introduced. A safe disposal system for no longer needed medication has been introduced. Residents` records in respect of risk assessments have improved. A policy for the administration of vaccines has been devised. Fabric tablecloths and napkins have been provided in the dining rooms. Exposed pipes have been covered and unpainted areas painted to maintain a hygienic environment. The home is being further extended thus providing additional day space. Additional equipment has been provided including "profile" beds. No information of a sensitive nature was seen on display. What the care home could do better: The home must ensure that the category of registration is correct and is reflected in its Statement of Purpose. Whilst the format of care plans has much improved and a range of risk assessments used, these need to be further enhanced. Activities need to be more focussed on the needs of people with dementia care needs.The care and nursing staff urgently need dementia care training. The manager is aware and this is addressed. A training matrix for specialist training is being devised. This would include staff awareness of the Mental Capacity Act. Formal Regulation 26 visits must be carried out and recorded. In respect of infection control an audit should be carried out to ensure that all clinical waste bins are of the foot-operated type. CARE HOMES FOR OLDER PEOPLE Heathfield House Nursing Home Bicester Road Bletchingdon Oxfordshire OX5 3DX Lead Inspector Lisbeth Scoones Unannounced Inspection 12/13th December 2007 12:30 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 Heathfield House Nursing Home DS0000027155.V342647.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. Heathfield House Nursing Home DS0000027155.V342647.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heathfield House Nursing Home Address Bicester Road Bletchingdon Oxfordshire OX5 3DX 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) 01869 350940 01869 350251 info@heathfield-house.co.uk Heathfield House Nursing Homes Limited vacant Care Home 48 Category(ies) of Dementia (20), Old age, not falling within any registration, with number other category (40) of places Heathfield House Nursing Home DS0000027155.V342647.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd January 2007 Brief Description of the Service: Heathfield House is a privately owned, recently extended care home for older people registered to provide nursing care for up to 48 people, including up to 20 with dementia. The home originally was a Georgian Manor House and has been established since 1986. It is situated north east of Oxford City, surrounded by open countryside with landscaped gardens. Accommodation is provided in mainly single en-suite rooms and currently there are 5 shared rooms over two floors. There is a sitting room, dining room and conservatory, with a patio area, secure area and grounds with seating and a walkway. There are 2 communal bathrooms. The home’s proprietor also works as the administrator in the home. An extension to provide a dining room and additional day space is near completion. Weekly fees range from £650 to £800. Heathfield House Nursing Home DS0000027155.V342647.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over two days and comprised discussions with the manager, deputy home manager, deputy nurse manager, the proprietor, many other staff and a visiting relative. Residents were spoken with and a tour of the premises was made. A lunch time session was observed. Records pertaining to care planning and risk assessments, staff training, staff files, complaints, medication adminstration and residents’ finances were examined. The inspection was further informed by an AQAA (annual quality and audit) completed by the manager. Many residents, relatives and staff completed a comment card expressing their views. The great majority of these were positive. Information thus received is incorporated in the report. Since the previous inspection the CSCI has been made aware of one complaint which was investigated by the home. It was satisfactorily concluded. The inspector was afforded a warm welcome by the staff and all cooperation was given thoughout the inspection. What the service does well: The home is well managed by a strong management team. The home provides a comfortable, homely, environment set in attractive grounds and gardens. Furniture and fittings are of a good quality and the refurbishment programme is ongoing. The residents are treated with dignity and respect and a relative spoken with said complimented the staff on their kindness and attentiveness. Every effort is made to ascertain the residents’ wishes in all respects. Good training opportunities are provided. The communication between the GP’s and the nursing staff is excellent. The nursing staff have ready access to specialist nurses and other health care professionals. Meals and mealtimes are much appreciated by the residents. Heathfield House Nursing Home DS0000027155.V342647.R01.S.doc Version 5.2 Page 6 The activities programme is well planned to provide for the residents’ collective and individual interest. What has improved since the last inspection? What they could do better: The home must ensure that the category of registration is correct and is reflected in its Statement of Purpose. Whilst the format of care plans has much improved and a range of risk assessments used, these need to be further enhanced. Activities need to be more focussed on the needs of people with dementia care needs. Heathfield House Nursing Home DS0000027155.V342647.R01.S.doc Version 5.2 Page 7 The care and nursing staff urgently need dementia care training. The manager is aware and this is addressed. A training matrix for specialist training is being devised. This would include staff awareness of the Mental Capacity Act. Formal Regulation 26 visits must be carried out and recorded. In respect of infection control an audit should be carried out to ensure that all clinical waste bins are of the foot-operated type. 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. Heathfield House Nursing Home DS0000027155.V342647.R01.S.doc Version 5.2 Page 8 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 Heathfield House Nursing Home DS0000027155.V342647.R01.S.doc Version 5.2 Page 9 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 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents and their relatives are provided with adequate information about the services offered by the home. However the Statement of Purpose needs revising to reflect the category of registration. Every resident has a contract. Every resident is assessed prior to admission to ensure that their needs can be met. Heathfield House Nursing Home DS0000027155.V342647.R01.S.doc Version 5.2 Page 10 EVIDENCE: A service user guide is available in the entrance hall and a copy given to every resident. Whilst containing much relevant information, the document needs to be updated to reflect the additional bed numbers and clarification on the category of registration. The home is registered to care for 20 people with dementia care needs and for 28 elderly people with nursing needs. It was apparent that the great majority of residents at the home have dementia care needs. The home must address this with the registration team and update its Statement of Purpose accordingly. A sample of contracts was examined and this provides clear information about what is and what is not included in the fee. It is evident that the senior staff undertake pre-admissions assessments to determine whether the home can meet the residents’ needs. Heathfield House Nursing Home DS0000027155.V342647.R01.S.doc Version 5.2 Page 11 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, 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Every resident has a regularly reviewed care plan in which their individual care needs are identified and the action required to meet them. These could be further enhanced. Care plans are informed by a range of risk assessments. The medication system is clear and auditable. Residents are treated with dignity and respect at all times. Every effort is made to ensure that at the time of their death residents wishes are respected. Heathfield House Nursing Home DS0000027155.V342647.R01.S.doc Version 5.2 Page 12 EVIDENCE: A sample of selected care plans was examined and this in general provide staff with the information they need to care for the residents. Pre-admission assessments are used to inform the care plan. It was agreed with the managers that care plans could be further enhanced paying particular attention to the residents’ dementia care needs. Care plans are regularly audited for quality and consistency. It was noted that residents’ next of kin are included in the writing of the care plan. Good wound care documentation was seen. Since the previous inspection a range of risk assessments has been introduced to support the care plan. These include moving and handling, nutrition, prevention of pressure ulcers and falls. The manager reported good cooperative working with GP’s, CPN’s and psychiatrist, dieticians and speech and language therapist, in order to meet the residents’ needs. The nursing staff have ready access to Macmillan nurses, continence and infection control specialist nurses. A conversation was held with the GP who frequently visits the home. He confirmed the good working relationship with the home. He provides some staff training and has recently become involved in assisting the home with devising a resuscitation policy. This is commendable. Medication charts were examined and were found to be in good order. Since the previous inspection an appropriate arrangement has been made for the disposal of no longer needed medication. The clinical room contains nursing equipment and dressings. Staff must ensure that this area is uncluttered to allow for effective cleaning. Staff must ensure that fridge temperature readings are correct and that the ambient room temperature is recorded. The latter also applies to a medication cupboard storing the medication trolley. This area is very small and has no worktop. Discussions ensued of finding a more suitable and larger area. Since the previous inspection a policy for the administration of flu vaccines has been devised and staff have had the appropriate training. Residents are treated with dignity and respect by the staff. Residents are called by their preferred name and staff always knock on the bedroom doors before entering. A good example of respecting dignity is the home’s intention that residents have their own named towels. Information about the residents’ wishes about arrangements at the time of their death is recorded in the care plans. The manager confirmed that the home has become involved in the NHS End of Life Care project implemented in Oxfordshire. See also standard 30 in respect of staff training. Heathfield House Nursing Home DS0000027155.V342647.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. Residents are provided with varied and suitable activities to meet their needs. These could be further enhanced. Residents are given the opportunity to make choices and take control over their lives. Residents are provided with a choice of wholesome and nutritious meals. EVIDENCE: The home is committed to Equality and Diversity. An activities organiser provides a range of varied activities. NVQ training is to be provided and the activities further reviewed and evaluated. A programme of activities was seen on display and in residents’ bedrooms. The programme includes beauty therapy such as hair dressing, aromatherapy, manicures, musical entertainment, exercise, cookery, and church services. It is the manager’s Heathfield House Nursing Home DS0000027155.V342647.R01.S.doc Version 5.2 Page 14 intention to introduce multi denominational services and the possibility of supplying a customised area for worship within the home is being explored. In response to a recent satisfaction survey, as part of the new development, a café is to be created. Such a facility would allow residents and visitors additional private space in an informal environment. Monthly reminiscence therapy sessions have recently been introduced. Residents chosen lifestyle is respected and the programme tailored to try to meet these. It is the manager’s intention to develop more interactive activities. An individual record is kept for each resident describing how they respond to the activities provided. The manager said that all staff are encouraged to contribute to these records. Residents’ relatives are encouraged to complete an “About Me” booklet providing staff with information of residents’ previous interests and family background. These booklets are contained within the care plans but not all of these had been completed. As part of the building programme, a quiet room is being created which, in future may be used for snoezelen (sensory) therapy, a library and hobby room. Further plans were discussed in respect of the creation of a sensory garden with herbs and lavender. A music therapist entertained the residents on the day of the inspection. Other musical entertainment is provided. A number of relatives were visiting the home at the time of the inspection and in each case were made very welcome by the staff. Relatives are offered beverages, and are able to join in at mealtimes given prior warning to the cook. A lunchtime session was observed. Since the previous inspection, tablecloths, flowers and napkins are provided. Staff assisted the residents in a kind, unhurried and appropriate manner. The chef serves a choice of individually plated meals from a heated trolley. Residents enjoyed the meals. The menus have just been altered to include more fresh vegetables and fresh fruit as a result of a survey carried out recently. Residents may have a cooked breakfast every day. Cakes and pastries are baked daily and mince pies were provided on the day of the inspection. Residents will soon be able to use the new dining room. Heathfield House Nursing Home DS0000027155.V342647.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 home’s complaints procedure is accessible to the residents, relatives, and visitors. Residents are protected from abuse. EVIDENCE: It is evident that residents and relatives are encouraged to bring any issue of concern to the attention of the staff. The complaint procedure is included in the service user guide and seen on display. One complaint has been received since the previous inspection. Documentation relating to the outcome of the investigation was seen. All staff receive training in safeguarding adults and staff spoken with had a clear understanding of the issues around all forms of abuse. Heathfield House Nursing Home DS0000027155.V342647.R01.S.doc Version 5.2 Page 16 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, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable, safe, homely and clean environment. EVIDENCE: A tour of the building was made and all areas visited including the new development. A new wing has recently been added. The grounds and gardens are kept in good order and are accessible to the residents. The rear garden area has been secured and an enclosed patio area provided. The reconfiguring of the new entrance provides an attractive feature. Wheel chair access has been improved. The majority of the residents are provided with high quality specialist beds designed for the provision of nursing care, but are domestic in appearance. In Heathfield House Nursing Home DS0000027155.V342647.R01.S.doc Version 5.2 Page 17 some bedrooms however, “pull out” beds were noted. The potential risks of injury to residents was discussed and it was agreed that the use of these be risk assessed. In due course these beds will be replaced. The décor and furnishings are of a high standard. The completion of the new dining and quiet room is awaited. Plans to reduce the number of shared rooms and provide more single accommodation continue. All bedrooms have en-suite facilities; the recently upgraded rooms have a wet room and wide doorways installed. Some of the rooms on the ground floor of the new wing have a gate fitted to the doorways. This is at the residents’ request because they do not want people wandering into their private rooms but they also do not wish to have the door closed. Evidence was provided that the use of such gates is risk assessed and reviewed. There is a choice of sitting rooms for residents to enjoy and these offer lovely views of the surrounding gardens and countryside. Residents spoken with said that it was very pleasant and homely to sit in the sitting room. It is evident that the maintenance programme of refurbishment and renewal is ongoing. The home employs a maintenance person and his duties include the checking and recording of hot water outlets temperatures on a regular basis. The laundry and sluices were found to be clean and tidy. The standard of hygiene within the home is good. It is recommended that an audit be carried out to ensure that all clinical waste bins are of the foot operated type. Heathfield House Nursing Home DS0000027155.V342647.R01.S.doc Version 5.2 Page 18 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 adequate. This judgement has been made using available evidence including a visit to this service. The home is adequately staffed in respect of numbers and skill mix to meet residents’ needs. Good recruitment procedures ensure that residents are protected. The manager is committed to the training and development of all staff. However, dementia training, though now planned and booked, is overdue. EVIDENCE: During the morning of the inspection, there were 2 trained and 9 care staff on duty. On duty were also the manager, deputy home manager and administrator. The staffing structure, skill mix and duty rota have recently been reviewed. Adequacy of staffing levels was discussed at length. The manager is in the process of devising an effective dependency tool to ascertain correct staffing levels at all times, including the weekend. Some relatives in comment cards and a visiting relative said that there were not always enough staff on duty. Heathfield House Nursing Home DS0000027155.V342647.R01.S.doc Version 5.2 Page 19 The home is a training centre for student nurses and adaptation staff. Oxford Brookes University/John Radcliffe and Buckingham and Chiltern University carry out external audits. A sample of staff files was examined and found to have the necessary documentation in place. Staff training and development were discussed in detail and it is evident that much training has lately been carried out. Due to the absence of a manager some training, including dementia care is overdue. In respect of dementia care training, it is the manager’s intention that by Easter all care staff will have had YTT (yesterday, today and tomorrow) training. She is to undertake a Masters Degree and the deputy home manager a Diploma in Dementia care with Bradford University. See also standards 31 and 33. In due course every member of staff should have their own individual training and development assessment and profile. Such profiles should be linked to staff supervision. The manager demonstrated a keen interest in such development. See also standard 36 in respect of staff supervision. The manager aims for a minimum of 50 NVQ trained staff. Currently 6 staff have an NVQ level 2 qualification and 9 staff are working towards this. The need to ensure that the training matrix include the Mental Capacity Act and Palliative care was discussed. New staff are provided with a Skills For Care compliant induction programme. The manager said that induction programmes are to be customised to be service specific. Heathfield House Nursing Home DS0000027155.V342647.R01.S.doc Version 5.2 Page 20 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, 32, 33, 35, 36, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a home that is well managed. Good quality assurance systems ensure that the home is run in residents’ best interests. Residents’ finances are safeguarded. Staff are well supported and supervised. Residents’ health safety and welfare is promoted and protected. Heathfield House Nursing Home DS0000027155.V342647.R01.S.doc Version 5.2 Page 21 EVIDENCE: A new manager was appointed in March 2007 and the management structure further strengthened by the appointment of a deputy home manager in June 2007. Together with the deputy nurse manager and the proprietor they form a strong team. The roles and responsibilities are clearly defined in respect of clinical supervision, training and mentorship. The home is trying to recruit a RMN or RN with extensive dementia care knowledge. The manager has many years experience of managing care homes. She has a management qualification and is in the process of becoming registered with the CSCI. She operates an open door style of management and has introduced surgeries for residents, relatives and visitors. Many changes and developments have taken place since the last inspection. On comments cards, relatives said that the new manager has made a difference. Staff appreciate her strong leadership skills. Developments to date include good communication with GP’s and other health professionals, care planning, staff supervision, audit and staff training. See also standard 30. Quality assurance systems are in place and include a range of internal audits. Policies and procedures have been reviewed and new ones introduced. Regular staff meetings are held. A recent relatives’ satisfaction survey has been carried out and the responses collated. These are soon to be presented at the reestablished Relatives Forum. A monthly newsletter is being developed. The provider was reminded that it is a requirement that monthly Regulation 26 visits are made and recorded. It is the home’s policy not to get involved with residents’ financial affairs. Families or representatives are encouraged to deal with this aspect of care. Staff training records show recent training such as fire safety, moving and handling, food hygiene and safeguarding adults. Infection control and First Aid training has been booked. From information contained in the AQAA it is ascertained that all safety and maintenance checks and services are carried out at regular intervals. The kitchen was visited. An upgrading programme is planned for 2008, which would provide additional work surfaces and an office. The Environmental Health Officer recently inspected the kitchen. Heathfield House Nursing Home DS0000027155.V342647.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 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 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 x 3 3 x 3 Heathfield House Nursing Home DS0000027155.V342647.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No Heathfield House Nursing Home DS0000027155.V342647.R01.S.doc Version 5.2 Page 24 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 OP1 Regulation 4 (1) (a) (b) (c) Schedule 1 (6) 26 Requirement That the Statement Of Purpose reflects the category of registration That the registered provider carries out monthly visits in accordance with the regulation. Timescale for action 31/01/08 2 OP33 31/01/08 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 5 6 Refer to Standard OP7 OP9 OP12 OP26 OP27 OP30 Good Practice Recommendations That care plans be further enhanced That temperatures of drug fridges and ambient temperatures in clinical rooms be recorded That activities be further developed and facilities introduced to reflect the needs of residents requiring dementia care That all clinical waste bins are foot-operated That the newly developed dependency tool be used to determine appropriate staffing levels at all times That all staff are trained in dementia care Heathfield House Nursing Home DS0000027155.V342647.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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