Care Home: Lower Farm Nursing Home

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What the care home does well The home works hard to maintain a high standard of cleanliness throughout that is carried out by a well-managed group of domestic staff. The home has an established team of staff who have been working at the home for a number of years who are qualified and have up to date knowledge and understanding of the developing needs of the residents. The whole environment is light, bright and well decorated with a well-kept garden for people to sit in and enjoy. The comments received from both residents and relatives are very positive. What has improved since the last inspection? The home has worked hard to find ways of checking the quality of the service by regular questionnaires and listening and acting on comments. The home now encourages all professionals who visit the home to write the record of their findings in the residents care plan to assist staff in the care of each individual.The home has purchased more electronic beds and pressure relieving mattresses after a quality check on the type of equipment now required to ensure the best pressure relief is offered. What the care home could do better: The development of care plans and daily records would be further improved if social needs were included and have as much importance as the health and personal care needs. Some of the meal choices could be clearer to ensure that the choices are not similar. CARE HOMES FOR OLDER PEOPLE Lower Farm Nursing Home Grimston Road South Wootton Kings Lynn Norfolk PE30 3PB Lead Inspector Ruth Hannent Unannounced Inspection 10th October 2007 10:00 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 Lower Farm Nursing Home DS0000053263.V352831.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. Lower Farm Nursing Home DS0000053263.V352831.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lower Farm Nursing Home Address Grimston Road South Wootton Kings Lynn Norfolk PE30 3PB 01553 671027 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) Imalgo Limited Mrs Jane Lewis Care Home 45 Category(ies) of Learning disability over 65 years of age (1), Old registration, with number age, not falling within any other category (44) of places Lower Farm Nursing Home DS0000053263.V352831.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st November 2006 Brief Description of the Service: Lower Farm is a 45 bedded nursing home providing care for elderly people. The home, originally a farm, has been developed and enhanced over the years. There is good access to all parts of the home. The home is on the ground and first floor and there are two lifts in the home. The home is decorated and furnished to a high standard. There is a car park at the front of the home. The home is situated on Grimston Road, in the suburbs of Kings Lynn, and is adjacent to local shops and facilities. Email lower.farm@eidosnet.co.uk Fees range from £460 - £700. Lower Farm Nursing Home DS0000053263.V352831.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report has been completed following an unannounced inspection at this home that took place over a period of four and a half hours. The Inspector was assisted throughout the day by the Management team. Staff, residents and relatives were spoken to, records were seen and a tour of the building took place. The Manager had completed, comprehensively, the Annual Quality Assurance Assessment and sent it to the Commission in plenty of time for the in-depth information written to be used as part of this inspection report. Seven comment cards from residents had also been received at the Commission with many positive comment included in the content written. The quality of this service is of a high standard that has been sustained over the last twelve months, since the last inspection that is commendable. What the service does well: What has improved since the last inspection? The home has worked hard to find ways of checking the quality of the service by regular questionnaires and listening and acting on comments. The home now encourages all professionals who visit the home to write the record of their findings in the residents care plan to assist staff in the care of each individual. Lower Farm Nursing Home DS0000053263.V352831.R01.S.doc Version 5.2 Page 6 The home has purchased more electronic beds and pressure relieving mattresses after a quality check on the type of equipment now required to ensure the best pressure relief is offered. 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. Lower Farm Nursing Home DS0000053263.V352831.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 Lower Farm Nursing Home DS0000053263.V352831.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): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home does assess potential residents to ensure suitability for the service offered by the home. Intermediate care is offered and carried out appropriately to ensure a person is rehabilitated and helped to return to their own home. EVIDENCE: The home has a good assessment process that uses all relevant information that is forwarded to the home from professionals who are involved with the potential resident. The Manager or Deputy will visit the person when possible to assess fully the needs required. A recent admission from another country meant the home had to rely on information sent by others. With comprehensive details sent from the Social Worker, Nurses involved and the family, the home was able to accommodate the person successfully. Lower Farm Nursing Home DS0000053263.V352831.R01.S.doc Version 5.2 Page 9 Each resident is given all the relevant information about the home and the terms and condition with a list of fees of what is covered and what is not. Lower Farm does, on occasions, offers intermediate care to aim to prevent a hospital admission. This can be over a period of 2 to 6 weeks. The multi professional team such as Physiotherapists and Occupational Therapists work with the home to rehabilitate the person to assist them to return to their own home. At present there is no one using this service but records show that some intermediate stays have been successful and people have returned home. Lower Farm Nursing Home DS0000053263.V352831.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has the needs of each person clearly documented with staff carrying out the duties and reviewing regularly the care provided to ensure the correct care is offered at all times. Lower Farm Nursing Home DS0000053263.V352831.R01.S.doc Version 5.2 Page 11 EVIDENCE: Two care plans were looked at of residents who had been in the home for some time. The information is written in detail and the care is reviewed. There is still some room to develop the forms used within the care plans and record more information on the whole person and not only the care and health needs. It was evident that the social needs of some residents were being met and during conversation with the people who are able to converse it was clear that stimulation and occupation is available, so some thought needs to take place on how to gather social information about the person and staff need to begin to record a more person centred record for each person to show that the whole care approach is being achieved. (Recommendation). On the wall in the office is information on which nurse is responsible for which resident. The team also have support from specialist nurses, dieticians and speech therapists when required. The records of how the support is offered changes daily and a good example of how this worked for one person who was admitted early was written in the Annual Quality Assurance Assessment (AQAA) document sent prior to this inspection. During the visit the GP arrived who has a good rapport with the nursing staff and notes written within the care plans show how often the GPs call at the home. The AQAA does talk of the need for some of the GPs to visit more often and that staff have attended a training course on assertiveness to be able to handle the more difficult situations and ensure the best care for residents takes place. Due to the high level of needs for people who are admitted each person at present is cared for on a special mattress and in specialist bed that was noted on the tour of the building. At present no resident is managing their own medication as they are risk assessed as being too poorly to take their own medication safely and as stated on the AQAA some of the residents are admitted due to poor management of medication when they are at home. The Manager and Deputy spent some time explaining the procedures of medication on the day of this inspection and this was also clear in the comprehensive detail written in the AQAA. All records were current and all stock was either store is a locked cupboard or in the trolley. The records for all medication that is either destroyed or placed in yellow boxes awaiting collection is held in the medication room. The controlled drugs register was seen and had two signatures at all times on administering the medication. Some concerns were shared over the administration and then signing of creams and lotions that are applied at the time of assisting a resident with their care. This may be resolved if a separate chart for recording could be held in the persons own room and staff can initial at the time of application. (Recommendation). Lower Farm Nursing Home DS0000053263.V352831.R01.S.doc Version 5.2 Page 12 Residents who are admitted for intermediate care will have support to manage their medication and the medication is placed in boxes that make it more manageable on their return to their own homes, but the supply is always locked away during their stay. Privacy and dignity is maintained at all times. Noted throughout the day was the calm approach to all residents. The doors were always knocked upon during the day of this visit and each resident is asked on admission how they would like to be addressed by staff, with at present, two residents requesting their title and the rest by their first name. On observing it was clear that residents are offered choice on what they wish to wear. All the clothes were clean and neatly pressed and everyone looked comfortable where they were sitting. Lower Farm Nursing Home DS0000053263.V352831.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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to take part in recreational interests. Anyone can receive visitors as they wish. Meals are enjoyed and ways to improve them are always being looked at. EVIDENCE: The Manager recognises the importance to be able to meet the social and recreational needs of the residents (mentioned in the AQAA) and does ask for information that is shared with the homes Occupational Therapist who tries to assist with these needs as much as possible. On the day of this visit the residents were having an art session. They were enjoying the work they were creating and animated conversations were taking place. The Therapist will also offer one to one sessions with people who prefer to stay in their rooms. Unfortunately this type of stimulation is only offered through the week as there is not a designated staff member at the weekends. The home does have more visitors at the weekends but some people see no one and this could be improved. (Recommendation). Lower Farm Nursing Home DS0000053263.V352831.R01.S.doc Version 5.2 Page 14 The library van visits regularly and outside entertainment is booked on special occasions. People were noted coming and going as they visited their loved one. One relative was spoken to who was full of praise for the home. ‘I am always made very welcome and it is a pleasure to visit. My relative is very happy here and there is no where better’. The visitors book is full of names of people who have visited recently and staff were acknowledging visitors on the day with courtesy and refreshments. Residents are encouraged to manage their own financial affairs. If the person needs help the home will encourage the family to find professional help to assist the person. A good example of how this worked was written in the AQAA. The staff at the home always go from person to person to discus what the choice of meals are for that day. Noted on the morning of the inspection was the two choices plus other alternatives such as an omelette for someone who did not wish for a big dinner. The menu’s do need to be looked at more in depth as some choices are very similar such as stewing steak and steak and kidney pie which was discussed at the last inspection. The Manager is about to have a meeting with the kitchen staff and this will be part of the agenda along with how to keep pureed food tasteful and attractive. A few residents are on peg feeds and some have liquidised meals that are prepared and placed on the plate separately giving people texture and flavours but more variety is always being sought. People can choose where they would like to eat and noted were some people in the dining room and some in their own bedrooms. Those who are able to comments stated ‘Good food, plenty of choice, nice lot of fresh fruit and fresh vegetables, my appetite has improved greatly since moving in.’ Lower Farm Nursing Home DS0000053263.V352831.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home does listen and act upon complaints. Residents are protected from abuse. EVIDENCE: The home has received concerns rather than complaints and ensures that they are dealt with straight. There is a complaints procedure available in the patients guide and on display around the home. The Manager has written in the AQAA that a person logging a complaint will be contacted immediately and the problem discussed. A comment card sent by a son, stated that the concerns shared with the home on the admission of their relative was dealt with appropriately and promptly. ‘I have found that staff have addressed our initial concerns and have been keen to do so.’ The Commission has not received any concerns and all seven comment cards received by the Inspector state they know who to complain to but have not had the need. Lower Farm Nursing Home DS0000053263.V352831.R01.S.doc Version 5.2 Page 16 Staff are all issue with a policy on reporting abuse with a policy also held in the office. They are trained as part of their induction on the subject. Over 50 of the staff are now NVQ qualified and have covered the subject in their training and on talking to one staff member would report any concern on to the Manager. The Manager is aware (mentioned in the AQAA) that some staff may be reluctant to whistle blow and is planning another training session with a recognised trainer to ensure staff understand their duty of care and report on. (Discussed in full). Lower Farm Nursing Home DS0000053263.V352831.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is to be commended on the suitability of the environment and standards of cleanliness. EVIDENCE: This home is to be commended on the standards held throughout on the environment. A tour of the building took place and everywhere was fresh, clean and pleasant to sit in. All rooms are well furnished with plenty of areas to sit and enjoy both inside and out. One gentlemen commented ‘Who could ask for a nicer environment than this’ as he looked out of the conservatory into the neatly kept gardens. Lower Farm Nursing Home DS0000053263.V352831.R01.S.doc Version 5.2 Page 18 Each bedroom is individual and residents do make them personalised. One lady has her own mini fridge, all she requires is ready to hand and the room is inviting and cosy. ‘ I love my room and choose not to join others in the home’ another person who was fairly new to the home stated ‘this was the right move. I have a lovely room with lovely staff who are so friendly. I am now ready to sell my home’. The home has been inspected by the fire department and the Environmental Health Officer with dates available, to show the Inspector. All moving equipment (of which the home has many to meet the different needs of different residents) and includes tracking hoists were all serviced recently with next date due in January 2008 (seen). Again the home must be commended for the cleanliness with schedules in place that ensure the home remains of a high, clean standard. The day of the visit the home had two domestic staff, two laundry staff and a kitchen cleaner. (On this particular day the food serving trolleys were upside down and having the wheels and bases of the equipment thoroughly cleaned). All residents clothing that had been washed was seen hanging in the laundry or placed folded in the individual baskets. The linen trolley that was around the building was piled with perfectly ironed sheets. The two laundry staff talked of nearly every bed in the home now needing daily fresh linen due to the needs of the residents and the two washing machines are on constantly. They both have a sluice cycle and noted was the red soiled linen bags to place items into before they go in the machine. Available throughout the building was protective gloves and aprons. Also noted was the antibacterial hand solution for visitors and staff to use as they pass around the home. On the wall in the cleaners room is clear cleaning schedules from soaking the toilet brushes to a full spring clean. The manager also has further plans to ensure all staff are trained in infection control. It is obvious on the standards held within the home that this subject is given high importance. Lower Farm Nursing Home DS0000053263.V352831.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The number and competency of staff on duty meet the needs of the residents. They are trained and recruited to ensure safe practise is in place that protects the residents. EVIDENCE: On the day of the visit 11 care staff members (including 2 nurses) were on duty to care for 43 residents. The staff work with a nurse in an area of the home to prevent travelling from one end of the home to another when on duty. On talking through the staff employed with the Manager it is clear that quite a number of staff are long-term employees at Lower Farm and have a wide range of knowledge and experience. The Manager holds regular meetings (1 was in place when the inspection began) to ensure staff are up to date and competent in the care needs of the residents. Lower Farm Nursing Home DS0000053263.V352831.R01.S.doc Version 5.2 Page 20 The Home has worked hard to achieve the number of staff who have NVQ 2 or 3 qualification. Due to some staff leaving last year it has needed a number of staff to begin the training this year. The AQAA states 12 have NVQ 2, 6 have NVQ 3 and 6 are aiming for the qualification this year and are already commencing the training. Two personnel files were seen. Each person is CRB cleared before commencing employment and the POVA list is checked. Each has two references and copies of identification is held, that has been photocopied. The home has a recruitment procedure that is followed. The AQAA gives a good explanation on the recruitment procedures that includes the checks on domestic staff, care staff and nursing staff. The home follows the ‘Skills for Care’ guidance and staff are assisted through the homes induction programme by competent staff in the home. The home runs regular training programmes and staff have copies of the certificates held in their personnel files. The home does not have a training matrix that ensures staff are trained regularly in statutory courses and this is a good system that would be of use to ensure all staff members are up to date with current practise. (Recommendation). Lower Farm Nursing Home DS0000053263.V352831.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is managed by a very competent and capable Manager who runs the service with the best interests of the residents as paramount. She is constantly using systems to measure the quality provided and ensures that the health and safety of residents and staff is promoted and protected. Lower Farm Nursing Home DS0000053263.V352831.R01.S.doc Version 5.2 Page 22 EVIDENCE: The Manager is a very competent and capable person who has achieved the NVQ 4 management award. The documentation required prior to the inspection (AQAA) has been completed very comprehensively and on each standard full details have been written that has assisted the completing of this inspection report. She leads a team of registered nurses who have the skills and qualifications to care for the residents and manage the care staff appropriately. The level of the quality of this service has been maintained and some areas have improved making it an excellent service. The home and the management team are constantly monitoring the quality of the service they provide. A recent questionnaire completed by a health care professional was seen alongside residents and relatives questionnaire. The home take seriously the results and aims to improve the service from the results found. The manager regular consults with the residents and meetings are held to monitor progress and care practise. Managing money as well as addressing improvements has created a challenge for the Management team but ways of resolving have been achieved. (An example is written in the AQAA about the quality of pressure relieving mattresses and the move taken to provide better equipment). On walking the building the pressure mattresses were seen. Residents’ money is held in the safe and two residents money was picked at random and checked. The home now ensures that any money transaction made, on behalf of the resident is accompanied by the signature of the staff member handling the money. Staff who take money on behalf of the resident at the weekend has access to a receipt book and gives the relative a receipt, locks the money in a medical cupboard and passes it to the Manager to place in the safe when next on duty. The AQAA talks of safe working practises that are monitored and staff training that is ongoing in all health and safety areas such as moving and handling, food hygiene, infection control, first aid and fire awareness. The building is secure and all visitors sign in and out as they enter the front door. Many signatures were seen in this book. The home has a good accident recording practise in place which are monitored and if it involved a resident it is also recorded in their care plan for staff to monitor. There are safety notices posted in rooms to make people aware of the action to take if the fire alarm sounds or notices informing people when to use the alcohol gel on their hands when leaving the building (seen). Lower Farm Nursing Home DS0000053263.V352831.R01.S.doc Version 5.2 Page 23 Senior staff have areas of responsibility and discussed with the Manager was the person responsible for the safe moving and handling practise that would be required for each person on admission. The correct equipment is sort and a full assessment is undertaken and staff are shown how to manage the person transfers ensuring safe manual handling is taking place. A recent example of a problem with one resident that placed people at risk was resolved when a ceiling tracking hoist was installed (seen). All care plans contain risk assessments and relevant moving and handling assessments (seen). The home has sent the regulation notification forms through to the Commission on deaths that have occurred and sent relevant incident forms to the Health and Safety Executive office, which need to be sent to the Commission as well. (Recommendation). Lower Farm Nursing Home DS0000053263.V352831.R01.S.doc Version 5.2 Page 24 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 x x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 4 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 4 x x x x 4 x 4 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 4 x 3 x x 3 Lower Farm Nursing Home DS0000053263.V352831.R01.S.doc Version 5.2 Page 25 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 OP7 OP9 Good Practice Recommendations It is good practise to include the social needs alongside the health and care needs in the daily recording for the individual. To aid recording it would be better for separate charts for creams and lotions to be placed in the residents own rooms and recording occurring when the medication is applied. The home should think of ways to ensure the stimulation for residents is the same throughout the seven days and not just Monday to Friday. It is recommended that a training matrix is devised to ensure that all staff attend training and that the review date for that training is recorded. The home should ensure that all incidents as mentioned in Reg 37 is notified to the Commission and not only deaths. 3 4 5 OP12 OP30 OP38 Lower Farm Nursing Home DS0000053263.V352831.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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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