Care Home: North Hill House

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What the care home does well The home is homely, comfortable and clean and hygienic. The staff are friendly and work together to deliver care to the people living in the home. The recent refurbishments and redecoration means that people have a wellmaintained and up to date environment in which to live. Staffing levels are designed to meet people`s needs throughout the day and night. Recent changes in shift patterns means that there is a sufficient number of staff on duty at peak times. The care plans are up to date and have a lot of relevant information about people`s assessed needs meaning the care is based on individual need. What has improved since the last inspection? The Statement of Purpose /Service Users Guide has been updated. This is available in the front entrance and a copy is also kept in each room. The recent refurbishments and redecoration of the home mean that the requirements made following the last inspection around health and safety have been met.There is level access around the front garden and the paved area at the back of the home. The areas have been landscaped and seating is provided for people to use. An improved training package is now in place. Some changes to the shifts have ensured that there are sufficient staff on duty at peak times of activity within the home. What the care home could do better: The manager should ensure that all charts included in the care plan are completed. This means that if there is a query about the level of care somebody has received, the completed charts will show what has taken place. The provider was reminded to ensure that any free- standing radiators in use have been risk assessed and that all window restrictors are in working order. CARE HOMES FOR OLDER PEOPLE North Hill House North Hill Park St Austell Cornwall PL25 4BJ Lead Inspector Mandy Norton & Megan Walker Key Unannounced Inspection 10:30 20 May & 10th June 2008 th 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 North Hill House DS0000070881.V364070.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. North Hill House DS0000070881.V364070.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service North Hill House Address North Hill Park St Austell Cornwall PL25 4BJ 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) 01726 72647 01726 69509 northillhouse@hotmail.com Mr David Leslie Smith Mrs Mandy Elizabeth Trask Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24), Physical disability (6) of places North Hill House DS0000070881.V364070.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with Nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) - maximum 24 places Physical disability (Code PD) - maximum 6 places The maximum number of service users who can be accommodated is 24. N/A – New Service 2. Date of last inspection Brief Description of the Service: North Hill House is a care home with nursing registered to provide care and accommodation for up to twenty-four (24) people of either gender who have care needs within the categories of Old Age, not falling within any other category (24), and up to six people who may have a physical disability. There is a trained nurse on duty 24 hours a day. North Hill House does not have the specialist categories to provide care for people with significant dementia or mental frailty needs. It is not registered to provide intermediate care. North Hill House is an old house converted in the past to be used as a care home. It has recently undergone extensive refurbishment and redecoration to bring it up to modern day standards. The accommodation is provided on 2 floors and a shaft lift provides level access throughout the home. The communal areas, comprising of 3 lounges and a dining room are all on the ground floor. The grounds have been landscaped providing seating areas and pathways allowing level access for people with mobility problems. Parking is available. North Hill House is on the outskirts of St Austell near to local facilities and on a bus route. The fees charged range from £466.74 to £572.52 (correct as of May 2008). Each person is issued with a contract once a settling in period has been achieved. A copy of the last inspection report is displayed in the front entrance. North Hill House DS0000070881.V364070.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This unannounced inspection took place from 10.55 am until 4 pm on the 20th May (1 inspector) and from 11.10 am until 5.20 pm on the 10th June (2 inspectors) 2008. It was conducted with the provider and the nurse in charge on the first day and the manager and nurse in charge on the second day. A tour of the home was carried out and some of the people living in the home were spoken to and observed during the visit. This report also contains information taken from discussion with staff on duty on the days of the inspection. There were 24 people living in the home at the time of the inspection. What the service does well: What has improved since the last inspection? The Statement of Purpose /Service Users Guide has been updated. This is available in the front entrance and a copy is also kept in each room. The recent refurbishments and redecoration of the home mean that the requirements made following the last inspection around health and safety have been met. North Hill House DS0000070881.V364070.R01.S.doc Version 5.2 Page 6 There is level access around the front garden and the paved area at the back of the home. The areas have been landscaped and seating is provided for people to use. An improved training package is now in place. Some changes to the shifts have ensured that there are sufficient staff on duty at peak times of activity within the home. 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. North Hill House DS0000070881.V364070.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 North Hill House DS0000070881.V364070.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information about the home must be up to date in order that people may make an informed decision about whether the service is right for them. The personalised needs assessment means that people’s diverse needs are identified and planned for before they move to the home. The home is not registered to provide intermediate care. EVIDENCE: The copy of the Statement of Purpose that we looked at on our first visit was out of date. The provider agreed that it needed to be updated to reflect the refurbishments that have been done. It also needs to include information about North Hill House DS0000070881.V364070.R01.S.doc Version 5.2 Page 9 the change of ownership and registration as well as describing what the new service can offer. On the second visit we looked at a number of these documents that are kept in each bedroom. Those we looked at had up to date information in them. The provider explained that the manager or one of the senior nurses visits people to assess their needs prior to them moving into the home. The information gathered is then used to form the basis of the care plan. The previous CSCI inspection report is displayed at the front entrance along with other useful information about local events and community services. North Hill House DS0000070881.V364070.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 & 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The practice regarding the planning and delivery of care means that people can be sure that their health and personal care needs will be met. EVIDENCE: Care plans examined had information about the individual and their health and personal care needs including moving and handling, tissue viability, continence and nutritional risk assessments. Bedrail risk assessments were in place. The manager was advised that more information about the reasons for them being used should be included in the assessment document. The plans were up to date and had been regularly reviewed. Some charts are kept in individual rooms to be completed on an ongoing basis. These included fluid balance & turning charts. The charts for personal hygiene North Hill House DS0000070881.V364070.R01.S.doc Version 5.2 Page 11 had not been completed consistently making it look like people had not had attention to their needs for several days in some cases. It was identified during discussion that these omissions are likely to be when agency staff have been working in the home and may not know about the charts. The manager was reminded that these should always be completed so an audit trail of what care a person has on a day-to-day basis is maintained. During a tour of the premises a call bell was found to be out of order. Although this had been logged and was awaiting repair, no alternative temporary provision had been made. The occupant of the room was distressed because there was no means to summon a member of staff. The manager was prompted to look for an alternative method of calling for assistance until the bell was repaired. She was also advised to have a contingency plan in place should this happen again. The medicines are dispensed to the home in blister packs. These are kept in the drugs trolley along with ‘as required’ medicines and bottles of liquids. The medicines are dispensed as required by the trained nurse on duty. The temperature of the drugs fridge is taken and recorded daily. The procedures for ordering, receipt, recording, storage and disposal of medication are clear and in accordance with laid down legislation. The creams and lotions seen in individual rooms nearly all had prescription labels on them. The nurse in charge said that each person has a new pot/tube ordered monthly and they are always kept in people’s rooms for individual use only. No people were able to self medicate at the time of the inspection. Staff were heard interacting with people living in the home appropriately and providing support and help in a discreet manner. Doors were closed when personal care was in progress. During a tour of the home a tour of the home it was noted that some people have their own telephone (which they/ or their representatives are responsible for paying for) and post is given to people to open themselves or with help if required. Screening was seen for use in the 2 double rooms. The trained nurse said that the end of life care plan known as the Liverpool Care Pathway is in use in the home. This is designed to ensure all staff and health care professionals that have an input into a persons care at the end of their life are using the same document and are aware of peoples ongoing wishes and needs. North Hill House DS0000070881.V364070.R01.S.doc Version 5.2 Page 12 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. The people using this service have the opportunity to participate in a range of activities within the home and community. Meals and mealtimes are not rushed making them an enjoyable, social occasion for a number of people. EVIDENCE: The provider said that entertainments and activities have been a priority since the refurbishments have been completed. Weekly activities are displayed on the notice board in the entrance foyer. A garden club has recently started. The recent refurbishment included building raised flowerbeds so people living at the home can be actively involved in tending and maintaining some of the garden. Recently a small number of people living at the home helped put together the hanging baskets on display around the outside of the home. An activities co-ordinator has recently been employed to work at the home part time. He is assessing the needs of the people living at the home to ensure North Hill House DS0000070881.V364070.R01.S.doc Version 5.2 Page 13 activities offered are suitable. He had brought the registered providers dog into the home to visit a number of people who are fond of it on the first day of the inspection. Two people were in one lounge with no stimulation, apart from when they were being offered a drink or being fed at the mealtime. Other people were in their rooms or in the other lounge watching TV, listening to the radio or reading newspapers/ or magazines. People were not directly asked about the activities programme during this visit. One person said she likes interacting with the staff and looks forward to being taken out by her family member. The gardens have been landscaped and allow for level access all around the outside of the house, and seating areas are provided for people to use. On the second day of this inspection visit the hairdresser was at the home. She comes in on Tuesday mornings and Thursday mornings. We were told that one of the double bedrooms is used or occasionally another large single bedroom. This means that the occupants of these rooms have to go elsewhere whilst the hairdresser is working. We looked at the care plan of one of these people. It stated that she liked to have her hair done early in the day. There was nothing on the care plan showing that there was any sort of formal agreement with the occupants of these bedrooms. The Registered Manager told us that there was nowhere else in the home suitable to use. There are links with the local community including the church and local amateur dramatics groups. The provider has sent a letter to the clients, their relatives and staff to explain about the changes that have taken place and the improvements that have been made. An open day was planned (a flyer for this was seen displayed in the home) for people from the local community to come and see the re- launched home. The meals are prepared in the kitchen and taken into the main home in a heated trolley. People can then be served the amount of food they like. Some people were eating in the dining room and some people preferred to stay in their rooms for their meals. A small number of people were in one of the lounges where staff were available to help them eat their meal. The home uses fresh local produce and has homemade cakes regularly. Some people require special diets. The dietician and Speech and Language team assess a number of people on a regular basis. The manager said the staff follows instructions given by this team. The staff also monitor peoples’ progress by weighing them regularly, providing mouth and teeth care, and getting to know what flavours/ foods people like and don’t like. During a tour of the premises on the second day staff were observed assisting some people to eat their lunch. The assistance was being given in such a way that the dignity and respect of the person was maintained. It was also noted that the lunchtime meal was not rushed and people were able to eat at their own pace. North Hill House DS0000070881.V364070.R01.S.doc Version 5.2 Page 14 North Hill House DS0000070881.V364070.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. Formal complaints and reporting of abuse policies and procedures are in place. They are available to all staff at all times. People’s concerns are listened to and the relevant authorities contacted when necessary meaning that people are protected from abuse. EVIDENCE: The complaints procedure is in the Service Users Guide/Statement of Purpose and is displayed within the home. Following the first visit, the manager received a letter of concerns about poor care practice alleged to be happening at the care home. The manager alerted the local authority safeguarding team and an investigation was started. On the second visit, the issues raised in the letter were discussed with the manager and the nurse in charge. The concerns raised were difficult to substantiate at that time because the complainant did not provide dates and names. The investigation is ongoing. North Hill House DS0000070881.V364070.R01.S.doc Version 5.2 Page 16 Staff files examined showed that a number of staff have attended adult protection (safeguarding) training. The provider and nurse in charge showed the inspector the training package (paper based) they have in place bought from an outside provider. The package includes safeguarding training. A matrix has been devised that ensures staff all undertake statutory training as required; safeguarding is included in this. North Hill House DS0000070881.V364070.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): 19,20,21, 22, 23,24,25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has just undergone extensive refurbishment and redecoration meaning that people have more homely, comfortable and safe environment in which to live. EVIDENCE: The home presents as welcoming and homely. It has recently undergone extensive refurbishments both indoors and outdoors. The provider was able to provide completion certificates for the building work and the fire safety from the local building control services dated 2nd May 2008. The provision of wheelchair storage and discreet storage of hoists means that the environment does not look clinical. North Hill House DS0000070881.V364070.R01.S.doc Version 5.2 Page 18 The communal space consists of 3 lounges and a dining room. There is variety of seating and each room is decorated in a domestic style. One person spoken to enjoys the views from the window and can see everybody that comes and goes from the home. Another person spoken to prefers to stay in her room as she has everything to hand, but frequently sees staff who pass the time of day with her and she has visitors regularly. People’s rooms seen were personalised with furniture, pictures and photographs and were homely even when they had clinical equipment in them. Doors are lockable and lockable space is provided, although the provider says most people use the safe within the home for storage of valuables. There are toilets and bathrooms throughout the home, with adaptations to meet the needs of the people currently living at North Hill House. A number of rooms have en-suite facilities. The newly landscaped gardens are accessible to people and seating is provided. The home was clean and tidy with no offensive odours. The housekeeper and domestic staff were seen to be going about their duties throughout the inspection. North Hill House DS0000070881.V364070.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The provider and manager show a responsible attitude and continue to implement changes and improvements in order to keep improving quality and outcomes for people living in the home. Staffing must ensure people’s needs are being met at all times. EVIDENCE: The first day of the inspection was conducted with the nurse in charge and provider with input from the administrator, the second day was conducted with the manager and the nurse in charge on that day. A duty rota for the week of the inspection was provided which showed that for 24 people there is a trained nurse and 4.5 carers until 11.30 am and 4 carers until 2.30 pm, a trained nurse and 3 carers from 2.15 pm to 5 .30 pm and a trained nurse and 3.5 carers until 8.15 pm. Overnight there is one trained nurse and two carers. The provider and the manager said that shift times have been altered and a split shift introduced so that more staff are available at peak times. Catering staff do the mid morning drinks round and the care staff do the mid afternoon round. Care staff were seen helping people with their drinks and meals. Two care staff spoken to in the afternoon said that they had enough time to do their work and didn’t feel they had to rush people. The nurses and care staff North Hill House DS0000070881.V364070.R01.S.doc Version 5.2 Page 20 are supported to provide care to people by a part time activity co-ordinator, a designated laundry person, a catering team, a housekeeping team, and an administrator. During a tour of the home on both visits, the home seemed well organised and calm. Information forwarded to the CSCI following the first inspection visit alleged that some peoples’ care needs were not being met and care staff were cutting corners due to poor training, and a lack of staff. It also alleged that some staff were working a lot of overtime to cover the staff shortages. This is the subject of an ongoing investigation. The provider said that they do have a problem with some care staff starting work but quickly realising it is not suitable for them despite a short induction period. This means there are regularly some vacancies to fill. The administrator was interviewing people for care staff roles during the first visit and decided two were suitable to take on. On the second visit the manager told us that in recent months there has been a number of difficulties with staffing levels and that staff morale had been low. In her opinion this was now improving as there had been a big recruitment drive and new staff had been appointed or were due to start work in the very near future. She explained that there had been a recent period when the staff skill mix had been poor however this was due to impromptu changes to the rota. Four staff files were examined and contained all the information required including 2 written references (one file had informal references, the manager has asked the staff member for names of referees who can give more relevant information about them) and a clear CRB check. Some of the files also included evidence of appraisals and supervision. All files contained contracts of employment (the provider said that new ones had just been issued to staff following advise from a company they use that advise the provider on employment law matters) and training certificates for numerous courses and study days attended. The provider and nurse in charge said that the induction process in place was now ongoing. There was some evidence in one staff file examined to support this. A 2-day induction takes place where people can get a feel of whether the job is going to be suitable for them. If this is successful then they work on the floor with an experienced member of staff and complete a 12-week induction that uses ‘Skills for Care’ induction standards. The manager said that this is sometimes completed before the 12 weeks but often they are not completed in the 12 weeks meaning she has to remind them to complete it and then it is kept on their staff file. The provider and nurse in charge explained that they now use an outside company to provide training (using a paper based system where staff are given information on a subject and then have to complete paperwork that is then send away to the company who assess the level of competency and provide a certificate). There is a matrix displayed in the office that shows who has had statutory training and when it is next due. Fire training is provided by North Hill House DS0000070881.V364070.R01.S.doc Version 5.2 Page 21 an outside company and although some certificates had not arrived following a recent training session the matrix had dates on it that showed when staff had had fire training. The nurse in charge said that all staff have had POVA (adult protection) training using the outside training agencies package. The matrix also indicated that some staff updated their manual handling training in March 2008. North Hill House DS0000070881.V364070.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): 31,33,35, 36 & 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The procedures the provider and manager have in place are designed to meet the needs of the service, and to continually improve the service the home offers to meet the needs of the people that live there. EVIDENCE: The registered manager has worked at the home for ten years and has been the manager for the last three years. She provides the in-house training for lifting and handling (for which she has to attend an annual ‘train the trainer update’). She says she works well with the staff in the home and the provider. Staff files examined showed that she carries out appraisal and supervision North Hill House DS0000070881.V364070.R01.S.doc Version 5.2 Page 23 sessions with staff. A trained staff meeting was held the week before the first inspection visit and a care staff meeting was scheduled for the week after the second visit. Minutes of these meetings are taken and made available to staff who are unable to attend. A quality assurance system is in place and the results of the survey conducted last year are displayed in the entrance foyer for anybody to read. (A copy was sent to the CSCI as required). The administrator explained the procedures in place for managing peoples’ personal allowances. Incoming and outgoing money is documented on a separate balance sheet (one for each person) and a running total is recorded. All receipts are kept as proof of expenditure and the money is counted on a regular basis and two signatures confirm the amount. The money is stored securely in the safe. Records seen were generally up to date and stored in the office either in locked cabinets or on shelving accessible to staff. A number of requirements about health and safety and welfare of people living in the home, made at the last inspection, have now been met. The local authority supplied a completion certificate for the building work and fire safety in May 2008. The provider was reminded to ensure risk assessments are completed for any freestanding radiators that are in use in the home and to ensure all window restrictors are fitted correctly. He explained that he employs a person to do health and safety checks of the home and to update risk assessments as required. A base line check was done in September 2007 and was due to be done again now the building work has been completed. The training matrix examined shows that people undertake statutory training as required. The manager said an outside company is used once a year to provide fire safety training, the rest of the year this is done in-house, she added that she provides in-house lifting and handling training at least once a year. A variety of documents examined confirmed that regular servicing and maintenance of equipment takes place. The provider said that the water temperature is controlled from a central point. A number of taps were turned on during a tour of the home and the water temperature was found to be satisfactory. Accidents are recorded as required and a trained nurse was seen completing a form during the second visit following a fall by someone living in the care home. The manager showed the induction standards in use (taken from Skills for Care Standards as required). These include information about safe working practices. The laundry assistant and the housekeeper were aware of the data North Hill House DS0000070881.V364070.R01.S.doc Version 5.2 Page 24 sheets kept for each chemical substance in use in the house and where to find them. North Hill House DS0000070881.V364070.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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 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 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 North Hill House DS0000070881.V364070.R01.S.doc Version 5.2 Page 26 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 OP8 OP8 Good Practice Recommendations The manager should ensure that charts included in the care plan are completed in order that a clear record is maintained of the care received by a Service User. The manager should ensure that there is written and signed formal consent from anyone whose bedroom is used and/or their representative, for the bedroom to be used by the hairdresser. This should include specific days of the week and times when the occupant would be required to vacate the room for this purpose. The manager should have in place a written plan stating where the hairdresser is allowed to work if the Service User’s room she usually uses is not available to her. The manager should ensure that the numbers and skill mix of staff on duty at all times is suitable to meet the needs of the people using this service. The manager should ensure that satisfactory references are included in ALL staff files in a timely fashion. DS0000070881.V364070.R01.S.doc Version 5.2 Page 27 3 4 5 OP8 OP27 OP29 North Hill House 6 OP38 The provider should ensure that risk assessments are in place for any free standing radiators in use in the home. The provider should ensure that all window restrictors are in working order at all times. North Hill House DS0000070881.V364070.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 North Hill House DS0000070881.V364070.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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