Care Home: Horton Cross Nursing Home

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What the care home does well People using the service were complimentary about the kindness and support provided by the staff.Pre admission assessments to the home are detailed and provide staff at the home with a clear indication of care needs for prospective people using the service. Staff training encompasses all the mandatory training requirements and some staff have undertaken further training. Staff training needs are identified through supervision and appraisal. The recording and overview of staff training is comprehensive and ensures that staff training is up to date. The records of staff training are very well managed. People using the service spoken with all confirmed that the quality, quantity and variety of food is always good, there was evidence that individual preferences are catered for. Accident audits were very well undertaken with clear identification of incidences and trends and included an action plan to address any findings. The environment of the home continues to have an ongoing maintenance plan and the upper floor has been redecorated and re-carpeted and appears bright and clean. What has improved since the last inspection? It was observed that there was evidence of a substantial financial commitment to provide equipment and facilities to improve care for people using the service. Controlled medication is now stored in the correct area of the cupboard The manager has implemented systems to ensure that that all creams used are signed for at the appropriate time prescribed and a record maintained by the home. The boiler system within the home is now working to a satisfactory standard. What the care home could do better: The registered manager is recommended to ensure that the application forms used have a section to request a full employment history to ensure that people using the service are not placed at risk. The home must ensure that hot water outlets do not exceed 43 degrees. Any rooms which have ongoing maintenance of hot water systems must not beaccessible to people using the service to ensure that they are not at risk of burns and scalds. The registered manager is recommended to review the locks available on each persons room to ensure that they are easily operated by people using the service and accessible in an emergency by staff. The registered manager is required to review the exposed pipe work in the ground floor bathroom to ensure that people using the service are not at risk of injury. CARE HOMES FOR OLDER PEOPLE Horton Cross Nursing Home Horton Cross Ilminster Somerset TA19 9PT Lead Inspector Gail Richardson Unannounced Inspection 13th 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 Horton Cross Nursing Home DS0000057288.V353307.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. Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Horton Cross Nursing Home Address Horton Cross Ilminster Somerset TA19 9PT 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) 01460 52144 01460 55471 Sentimental Care Ltd Mrs Jacqueline Anne Gingell Care Home 47 Category(ies) of Old age, not falling within any other category registration, with number (47) of places Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Where rooms are shared, they are occupied by service users who have made a positive choice to share with each other. One named service user, requiring nursing care, may be admitted in the age range 55 - 65 years. 25/01/07 Date of last inspection Brief Description of the Service: Horton Cross is a home providing general nursing care for older people. The home is a former motel on the edge of the small village of Horton, 2 miles from Ilminster. Accommodation is on two floors accessible by a passenger lift. Most of the rooms are for single occupancy although a small number of shared rooms are available. Downstairs there is a large lounge/diner with adjoining dining room/lounge area, overlooking the garden and patio area with seating. There is also a quieter lounge available and a seating area in the reception hall. Access to local services would require transport but are within a short distance of the home. The current fee scale is £518.00 to £731.00. Extra charges are made for hairdressing, newspapers and magazines and private chiropody. Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over 1 day (13 hours) on the 13th November 2007 by inspector Gail Richardson and inspector Kathy McCluskey. A tour of the home took place and a selection of bedrooms and all communal areas were seen. There were 40 people using the service currently residing at the home. The inspectors spoke to 8 people using the service and 7 members of staff, the Registered Manager was available throughout the inspection. The inspectors spent time talking to people using the service, visitors and staff and observed that on the day of inspection, people appeared comfortable in all areas of the home and the atmosphere was calm. Records relating to care including 4 care plans, staff files, finances and health and safety records were examined. As part of this inspection the inspectors surveyed the opinions of a random selection of residents and their representatives, GP’s, District Nurses and Care Workers, a moderate response was received and their comments will be included in this report. The focus of this inspection visit was to inspect relevant key standards under the CSCI ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are; - excellent, good, adequate and poor. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. What the service does well: People using the service were complimentary about the kindness and support provided by the staff. Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 6 Pre admission assessments to the home are detailed and provide staff at the home with a clear indication of care needs for prospective people using the service. Staff training encompasses all the mandatory training requirements and some staff have undertaken further training. Staff training needs are identified through supervision and appraisal. The recording and overview of staff training is comprehensive and ensures that staff training is up to date. The records of staff training are very well managed. People using the service spoken with all confirmed that the quality, quantity and variety of food is always good, there was evidence that individual preferences are catered for. Accident audits were very well undertaken with clear identification of incidences and trends and included an action plan to address any findings. The environment of the home continues to have an ongoing maintenance plan and the upper floor has been redecorated and re-carpeted and appears bright and clean. What has improved since the last inspection? What they could do better: The registered manager is recommended to ensure that the application forms used have a section to request a full employment history to ensure that people using the service are not placed at risk. The home must ensure that hot water outlets do not exceed 43 degrees. Any rooms which have ongoing maintenance of hot water systems must not be Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 7 accessible to people using the service to ensure that they are not at risk of burns and scalds. The registered manager is recommended to review the locks available on each persons room to ensure that they are easily operated by people using the service and accessible in an emergency by staff. The registered manager is required to review the exposed pipe work in the ground floor bathroom to ensure that people using the service are not at risk of injury. 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. Horton Cross Nursing Home DS0000057288.V353307.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 Horton Cross Nursing Home DS0000057288.V353307.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 4 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home continues to be able to provide prospective residents and relatives with sufficient information in the format of brochures, the Service User Guide and Statement of Purpose for them to make an informed decision about the home. All prospective residents receive a pre admission assessment by the registered manager to ensure the home can meet the assessed needs identified. EVIDENCE: 4 Residents surveys received stated that all 4 had received a contract and all felt they had received enough information prior to admission, about the home to make an informed decision. Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 10 Each resident receives a pre admission assessment to ensure that the home can meet all assessed needs. 3 care plans confirmed that this had taken place and was detailed enough to ensure that staff were aware of the needs of the person when admitted. A sample contract was examined and contained all relevant information. Horton Cross Nursing Home DS0000057288.V353307.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person using the service has a care plan, the assessed areas of need were reflected in this plan of care and the detail recorded ensures that staff can provide a good standard of care. The management of medications systems has improved and now meets the required standard. Staff were observed to treat service users with dignity and respect at all times and residents confirmed that they felt well cared for. EVIDENCE: The inspectors case tracked 4 service users from pre-admission to care planning . Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 12 The care plans seen were of a good standard and provided staff with the details of identified risks and made a plan of care to meet these risks. These plans were written in a clear and concise manner, which was supported by an underpinning knowledge of resident’s choices and needs. The registered manager is recommended to include the input of people using the service and their relatives/representatives in the gathering of information and review of the care plan process. Inspectors observed at timed intervals throughout the day, one person being nursed in bed.This person received regular care and all nursing input was documented. When asked do you receive the care and support you need, 1 survey said always and 3 said usually, all 4 responded that staff listen and act on what the residents say and 3 felt they received the medical support they needed and 1 said usually. On the day of inspection, people using the service who were able, confirmed that the staff were kind and supportive. 2 people using the service raised a concern with the inspectors about staffing which the registered manager is currently addressing. Comments received included “the staff are kind and answer my buzzers” and “on the whole they are wonderful”. 8 staff surveys received, confirmed that 7 staff were involved in care planning for residents. Evidence of the input of visiting health professions was seen within the care plan. 7 surveys were received and 6 confirmed that they satisfied with the overall care provided to service users within the home and 1 said no. Comments included, “Communication is dependant upon which member of staff is involved, basic observation results are frequently omitted, BP pulse and temp” and “Overall care and presentation has improved” Medication systems were examined and found to be of a good standard with evidence of ongoing audits and clear systems of organisation. Previous requirements regarding the recording of creams had been met and all creams administered are now recorded within the care plans. 2 medications which are hand transcribed were noted not to be named and dated and this was feedback to the manager at inspection. Horton Cross Nursing Home DS0000057288.V353307.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 adequate. This judgement has been made using available evidence including a visit to this service. There are opportunities for social stimulation and people are supported to join in with organised activities or pursue their own interests. Further development is needed to ensure that activities are specific to peoples choices and preferences and that they are recorded regularly. The meals in the home are of a good quality and a range of choice is available. EVIDENCE: Resident’s surveys asked are there activities arranged by the home that you can take part in, 1 usually, 2 -sometimes, 2-blank. The inspectors spent time talking with people using the service and observed people reading newspapers and watching TV. The planned activities are advertised on a board in the hallway including entertainers, Church Services and social events. In the lounge there was a TV, radio, books, magazines and Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 14 newspapers. On the day of inspection drawing and chat took place in the lounge. The registered manager confirmed that since the last Random inspection there has been a vacancy for the role as activity co-ordinator and until that the role was filled, care staff were adding this role to their other duties. The social care records within the care plans were not all up to date and require further review. The home is required to maintain a record of all activities undertaken to include one to one sessions for those people who choose to remain in their rooms. One comment received was “I feel the residents could be stimulated and encouraged more if staff weren’t under so much pressure and there were better OT support”. Everyone who expressed an opinion stated that they have choice about all aspects of their care and are comfortable to request any particular preferences. Many people appeared to spend the day in their room and had the opportunity to do so. People explained that delays in getting up sometimes happened as staff were busy. Morning coffee and afternoon tea was served all around the home accompanied by cake/biscuits. Any dietary supplements prescribed are given at this time. The staff are required to audit returns of drinks to ensure that those people receive enough support as required. Breakfast is served to each person’s room each morning, the main meal of the day is at lunchtime and there is a dining room arranged in the conservatory. The tables were nicely laid with a choice of condiments and drinks to have with their meals. Several people using the service chose to eat at small tables in the lounge and were supported to do so. There is a choice of meal at both lunch and teatime , on the day of inspection the lunch menu was a choice of meatloaf, cheese and onion flan or sausages with mashed potato, sauté potato, carrots, cauliflower and gravy. Desert was chocolate and pear upside down pudding. The inspector observed lunch being served both in the dining room and people’s bedrooms and it appeared to be enjoyed by all. Vegetables were served in serving dishes, which allowed people to choose which, and how much they wanted. Puree diet was served separately to enable people to discern different tastes and textures. People using the service who required assistance were helped in a dignified and discreet manner. A member of staff was awarded a grant from the Foundation of Nursing Studies to improve nutrition and the study was commenced on June 2006. The report was very detailed. A questionnaire had been sent to all people using the service and the results were seen and action evident from those results. Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 15 Resident’s surveys asked if residents like the meals at the home, 3-always, 1usually. Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 16 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 17 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff and people using the service are confident that the homes management team would deal with any complaints or concerns. Policies, procedures and training are available to staff to ensure they have the knowledge to prevent service users from the risk of abuse EVIDENCE: 4 people using the service surveys, confirmed that they knew how to make a complaint and surveys confirmed that people knew who to speak to if they were unhappy. The complaints procedure is displaced on the back of the door of each bedroom. CSCI have received 2 concerns which have been investigated by the home and responded to within an appropriate timescale. People using the service told the inspector that they would be comfortable to approach the manager or a member of staff with any worries or concerns. Staff also confirmed that they were happy to approach the management with any concerns and would be confident that they would be dealt with appropriately. The home has policies and procedures in respect of recognising and reporting abuse, making a complaint and whistle blowing and staff training in abuse awareness takes place. Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 17 8 staff surveys confirmed that they were aware of policies about protecting vulnerable adults and how you report any concerns about poor care practice or allegations of abuse. All 8 staff surveys received confirmed that they had received a Criminal Record Bureau Check and examination of recruitment files confirms that these check were undertaken before staff commenced employment. Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 18 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 20 21 22 23 24 25 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is a large building with some parts of the building suffering from wear and tear that would be typical of a building of similar age and usage. An on going maintenance program is in place and improvements to areas of the home are evident. The gardens are attractively laid out and suitable for people using the service use. EVIDENCE: The home is a former motel which has been converted and extended. There is a communal lounge and dining area, these are well furnished and decorated. Reclining and upright chairs have been purchased in good numbers to ensure the comfort of people using the service. Personal accommodation is located on each of the floors of the home and is accessible to people with all levels of mobility. Lift access is available to each floor. Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 19 All bedrooms seen by the inspectors were comfortably furnished and had been personalised to reflect the tastes of the individual person. People are able to bring personal effects and small items of furniture with them when they move to the home, which gives rooms an individual homely feel. Various aids and adaptations have been put in place to assist people to maintain their independence. Specialist pressure relieving cushions and mattresses were seen were there was an assessed need. Profile beds have been purchased and a specialist bed was purchased to support staff and the person using the service. Toilet and bathing facilities are provided in sufficient numbers and were clean and odour free, building work has been undertaken in an upstairs bathroom. It was brought to the mangers attention that the hot water temperature in that bathroom was in excess of 43 degrees. The manager immediately arranged for that room to be inaccessible to people using the service. The manager is further recommended to ensure that any building or maintenance work undertaken is risk assessed and appropriate action taken. It was noted that a radiator in the ground floor bathroom had some exposed pipe-work which may be a potential risk to people using the service. This area is to be addressed by the manager of the home. The home was clean and appeared fairly well maintained. It is evident from observing the home over a period of time and records of purchases made, that considerable financial support has been given to improving the environment and supporting people using the service and staff with new equipment. One maintenance staff was seen working on the day of the inspection and it is clear that the home has an ongoing maintenance programme. Several rooms have been redecorated and appear light and pleasant. The upstairs corridor is now completely refurbished and is a considerable improvement. The lower floor re decoration remains ongoing and the heating system is operational. The garden area is well maintained and a patio is also available for people using the service. 4 people using the service surveys confirmed that the home is always clean and fresh. Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 20 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. Staffing levels at the home are adequate to meet the assessed needs of people using the service and staff training is promoted. The induction process for staff has been developed to meet the Skills for Care, Common Induction Standards. Staff training is comprehensive and well recorded. EVIDENCE: Resident’s surveys asked if staff were available when you need them -4 said usually. People using the service confirmed to inspectors that whilst some delays in answering buzzers take place, the staff do come to their assistance. Examination of the staff rota’s confirm that staffing levels are maintained at a constant level and minimal agency use is required. The qualified staff are an established team. 8 staff returned comment cards to CSCI, all 6 staff confirmed that they felt they had received adequate induction and supervision when they commenced their job. 6 staff confirmed that they were clear of what the service users needs were and all 8 staff were aware of the duties they must not undertake. Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 21 Staff training, including induction is the responsibility of the deputy manager who ensures that all mandatory training is up to date and that addition training to specific areas of development is made available. Training records including a comprehensive overview with supporting certificated evidence were observed to be excellent. These records ensure that staff remain updated to support people using the service. 3 recruitment files of the most recently recruited staff were examined. The recruitment procedures were mostly complete, it was noted that the application form used did not request an employment history. The registered manager confirmed that an alternative application form will be used. The Commission recommends a 10 year employment history to be requested and any gaps explored and documented to ensure people using the service are not put at risk. It is further recommended that the manager dates the references when received to provide a clear audit trail of recruitment processes. Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 22 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 37 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is effectively managed and benefits from the positive and proactive management style of the registered manager. Systems are in place to ensure the health and safety of service users whilst encouraging and promoting independence. EVIDENCE: The registered manager of the home is Jackie Gingell who has managed the home for several years. Discussions with the inspectors confirmed that she has a clear understanding of the needs of the people using the service and strives to develop a team of staff to provide a high standard of care at all times. Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 23 One staff comment received was that “There has been additional support from nursing management to ensure staff can provide a high standard of care”. Another stated “In my opinion there has been many changes over the past couple of years”. The home undertakes regular audits of care by surveying the opinions of the residents and their families This was last done in July 2007. There are established systems in place for dealing with service users finances. The inspector evidenced that each person’s personal monies were stored in individual envelopes with a running total of deposits and withdrawals. All records are stored confidentially in line with the Data Protection Act. All 8 staff surveys received stated that they were provided with protective clothing and necessary equipment to do their work safely and cleaning staff confirmed that they had access to COSHH data sheets and had received training in the safe use of chemicals. On the day of inspection it was observed that one room had an opened cupboard which contained cleaning solutions which are substances hazardous to health. The registered manager dealt with this matter immediately and ensured that the staff member involved was aware of the danger of this practice. 6 staff stated on the comment cards supplied that they were receiving regular supervision 2 stated they were not. The records available supported this, all areas contained within the supervision sessions are recommended within the National Minimum Standards and staff receive supervision 6 times per year. Accident records were viewed and were seen to be reviewed and audited monthly for trends and regular occurrences and action taken to reduce any risks of further accidents taking place. These records were of a very good standard and the practice is to be commended. Maintenance records were well maintained and up to date, these included ; * * * * * * * * * * Fire Extinguishers last tested 11/06/07 Fire alarms are tested weekly 08/11/07 Fire Alarm servicing 07/08/07 Hoist Servicing, Due Nov 2007 Emergency lighting checked monthly PAT Tests 15/04/07 Boiler servicing work is currently ongoing COSHH data sheets are available Hot water temperatures are being monitored Pharmacy inspection last done 02/08/07 DS0000057288.V353307.R01.S.doc Version 5.2 Page 24 Horton Cross Nursing Home * Electrical Hard Wiring 24/01/07 * Nurse call servicing due to be services 19/11/07 * Accident audit is ongoing monthly Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 25 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 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 1 Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP12 Regulation 16(2)(n) Requirement The registered manager is required to ensure that social care is maintained and that records recording this social and recreational activity are maintained for each person using the service. The general manager is required to ensure that any carpets which may present a trip hazard to staff and service users are replaced. Previous timescale 01/04/07. This requirement has not been met. 3. OP38 13(4)(a) The manager is required to ensure that all solutions which are hazardous to health are stored safely at all times. 4. OP38 13(4)(a) The registered manager is required to ensure that exposed pipe work in the downstairs Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 27 Timescale for action 01/01/08 2. OP38 13(4)(a) 01/01/08 01/01/08 01/01/08 bathroom is made safe and is not accessible to people using the service. 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. Refer to Standard OP7 OP29 OP29 Good Practice Recommendations The registered manager is recommended to develop care plans to include the input of people using the service and their relatives/representatives. The registered manager is recommended to ensure that all prospective employees provide a 10 year employment history. The registered ,manager is recommended to date references when they are received to ensure a clear audit trail of recruitment processes. Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Horton Cross Nursing Home DS0000057288.V353307.R01.S.doc Version 5.2 Page 29 - 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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