Care Home: Taymer Nursing Home

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What the care home does well Taymer provides people with a clean, friendly, well staffed home in which to receive the care they need. The home provides good nursing care to people using the service with some unique extra touches, such as the opportunity for people to have mixed fruit salad mid-morning and to have flowers in their room when they arrive. The manager informed us that she encouraged people to visit the home before making the decision to move in and if at all possible, they should have a meal with the other residents as part of the decision making process. Care records were well written and ensured that staff had clear instructions as to how care should be provided. The home had good relationships with all visitors, both professional and nonprofessional. Visitors were asked to give their opinion of the home and to consequently inform the running of the home and the improvements made. Everyone spoken to, spoke about the high quality of the meals and the opportunity to make choices. The chef was keen to ensure that all the meals were well presented and nutritious, as well as what the residents wanted. The staff compliment on each shift was adequate to support the care needs of the residents, and staff were encouraged and supported to attend training to keep themselves updated. What has improved since the last inspection? Since the last inspection staff have found a way to ensure that any aids or adaptations used by residents are available at all times. Wherever possible the resident has been able to agree how these should be used. Residents money has been kept under review and residents sign to state that they wish the home to hold small amounts of money on their behalf, if they are not able to manage this themselves. The call system has been upgraded and call bells can now be transferred to be around residents` necks when they are not in bed. One resident spoke of the confidence this gave her. What the care home could do better: This was a very good inspection and with the exception of the requirement made in relation to medication there were no problems identified. However, in order for the service to continue to provide a high standard of care the manager and the management must continually inspect and assess the care they are providing. CARE HOMES FOR OLDER PEOPLE Taymer Nursing Home Barton Road Silsoe Bedfordshire MK45 4QP Lead Inspector Sally Snelson Unannounced Inspection 24th September 2008 07:40 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 Taymer Nursing Home DS0000042234.V371298.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. Taymer Nursing Home DS0000042234.V371298.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Taymer Nursing Home Address Barton Road Silsoe Bedfordshire MK45 4QP 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) 01525 861833 01525 861889 matron@taymer.co.uk www.pressbeau.co.uk Pressbeau Ltd Mrs Margaret Collins Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33), Physical disability over 65 years of age of places (33) Taymer Nursing Home DS0000042234.V371298.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Up to 4 Adults 50 - 64 years Physical Disability over 65 years of age PD (E) 33. The home is permitted to accommodate one named service user in the category of DE(E) The home is permitted to accommodate up to and including 7 people who are 18 years of age and over within the category of Physical Disabilities (PD). Their admission is only within the intermediate care unit and does not exceed 8 weeks. Date of last inspection Brief Description of the Service: Taymer is a purpose built Nursing Home situated in the Bedfordshire village of Silsoe, which lies off the A6 road between the towns of Bedford and Luton. The home is situated in rural grounds overlooking the Bedfordshire countryside. The home has been extended to accommodate 33 service users. The home provides care for elderly people with physical disabilities and medical conditions. The home is staffed with qualified nurses and carers who provide a range of services to aid and improve the physical wellbeing of the service users. The home provides eight single bedrooms with en-suite facilities, 17 single bedrooms without en-suite facilities and five double bedrooms. Each room is fitted with an electronic nurse call system. The home has a variety of baths and bath aids to suit different needs. There are three main reception areas, including a TV lounge, a quiet study room and a conservatory. The home has attractive surrounding gardens with parking facilities available. The fees for this service at the time of the report were between £680.00 and £710.00 per week. Additional charges are made for hairdressing, chiropody, telephone calls and newspapers. Taymer Nursing Home DS0000042234.V371298.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 stars. This means the people who use this service experience good quality outcomes. This inspection was carried out in accordance with the Commission for Social Care Inspection’s (CSCI) policy and methodologies, which requires review of the key standards for the provision of a care home for older people that takes account of residents’ views and information received about the service since the last inspection. Information from the home, through written evidence in the form of an Annual Quality Assurance Assessment (AQAA) (this was requested earlier in the year) has also been used to assess the outcomes within each standard. Evidence used and judgements made within the main body of the report include information from this visit. Sally Snelson undertook this inspection of Taymer. It was a key inspection, was unannounced, and took place from 07.45am on 24th September 2008. Maggie Collins, the registered manager, was present from 08.30 hrs. Feedback was given throughout the inspection, and at the end. During the inspection the care of three people who use the service (residents) was case tracked in detail. This involved reading their records and comparing what was documented to what was provided. In addition to sampling files, people who lived at the home, visitors, and staff were spoken to, and their opinions sought. Any comments received from staff or residents about their views of the home, plus all the information gathered on the day was used to form a judgement about the service. In addition to long term nursing care the home also admitted people for intermediate care and rehabilitation. This area was staffed by the homes staff, but had a number of community staff, including physiotherapist and occupational therapists, visiting and assessing the service users throughout their stay. The inspector would like to thank all those involved in the inspection for their input and support. Taymer Nursing Home DS0000042234.V371298.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Since the last inspection staff have found a way to ensure that any aids or adaptations used by residents are available at all times. Wherever possible the resident has been able to agree how these should be used. Residents money has been kept under review and residents sign to state that they wish the home to hold small amounts of money on their behalf, if they are not able to manage this themselves. The call system has been upgraded and call bells can now be transferred to be around residents’ necks when they are not in bed. One resident spoke of the confidence this gave her. Taymer Nursing Home DS0000042234.V371298.R01.S.doc Version 5.2 Page 7 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. Taymer Nursing Home DS0000042234.V371298.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 Taymer Nursing Home DS0000042234.V371298.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): 1,2,3,4,5,6. People who use this service experience good quality outcomes in this area. Each resident was provided with a Service User Guide that gave full details of the home, including information about what was provided. This meant that residents, and prospective residents, knew what they could expect from living at Taymer. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The manager informed us that she encouraged people to visit the home before making the decision to move in. When relatives were doing the viewing on behalf of a loved one, the manager suggested, that if at all possible, they should bring the prospective resident for a visit to have a meal with the other Taymer Nursing Home DS0000042234.V371298.R01.S.doc Version 5.2 Page 10 residents as part of the decision making process. One person we spoke to said “I knew as soon as I came here, this was the place for me”. When making an enquiry about the home people were given information in the form of the Statement of Purpose and a Service Users Guide. Those who were admitted for a period of rehabilitation were provided with a different Service Users Guide than those who were admitted for continuing care. These documents were clear, kept updated, and provided the reader with the information they needed. The company also had a web site to support these documents. The manager visited all those residents who were referred for continuing care, prior to admission. This visit was to assess the prospective residents’ needs and to ensure that the staff team had the skills, and the home had the equipment, to provide the necessary care. The residents who came to Taymer for intermediate care were assessed by the Primary Care Trust (PCT), who were funding their places and responsible for much of the care package. However the PCT worked with the manager and would ask her opinion of possible admissions, so that the staff team were not put into the position of having to provide care to people that they did not have the experience for. Training files (see staff section of this report) confirmed that collectively the staff team had the necessary skills and qualifications to care for the people living at Taymer. The home had a gym and a kitchen area that was used to assess the people being rehabilitated. In the last report it was suggested that an extension would be built. This was to house the rehabilitation centre but until it was built, the registration for intermediate care had been granted allowing the people admitted for rehabilitation to be cared for in bedrooms throughout the home and not all together in one area. The manager confirmed that this was not causing any problems and the long-term residents enjoyed meeting new people. Taymer Nursing Home DS0000042234.V371298.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 People who use this service experience good quality outcomes in this area. Care records were well written and ensured that staff had clear instructions as to how care should be provided. Medications records were fully completed and signed appropriately by staff. However reconciliation was difficult in some cases. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: All of the residents care plans were kept in their bedrooms. Where people shared a room they were encouraged to keep their record in a drawer or a wardrobe, in order to protect their privacy, otherwise they could be kept anywhere the person using the service wished. Taymer Nursing Home DS0000042234.V371298.R01.S.doc Version 5.2 Page 12 Care plans had been written for all of activities of daily living. They were written in sufficient detail to ensure that staff had enough information about how to provide care. There was evidence that some of the people using the service had been consulted about their plans. The care plans had been reviewed monthly and were updated as needs changed. Each care plan had any associated risk assessments and guides. For example if a person using the service needed help with eating and drinking there was clear instructions as to how this help should be given, plus a nutritional risk assessment that lead to other assessments, such as tissue viability (prevention of pressure areas). The risk assessments also resulted in appropriate equipment being sought for people, such as pressure relieving mattresses and hoists. During the inspection we witnessed staff moving and handling people correctly. Some staff had been trained in the use of a syringe driver and the Liverpool Care Pathway; this is a plan used at the end of life to ensure the residents receive the best care. Since training this had not had to be used. The service had a good relationship with three local GP surgeries and because they took people for rehabilitation, community health professionals were frequent visitors to the home. We observed a staff handover and witnessed the night nurse giving a detailed account of the care needs of the residents to all the day staff. We checked the Medication Administration Record (MAR) sheets for the three residents we case tracked, plus four more. Medications were appropriately stored in a locked trolley that was secured to the wall in a locked room. Monthly deliveries had been appropriately signed in. However there were some instances where medication remaining from the previous month, had not been carried forward. Reconciliation was not possible for these. On the whole charts had been accurately completed with signatures and omission codes where appropriate. We did note that a pain relieving medication that had been prescribed to be given four times a day was only being administered three times a day. Staff confirmed that it was offered and not needed, but in this case the correct code was not being used as the medication was being treated as PRN (this means given as needed). Controlled drugs (CD’s) were stored appropriately and all administrations had been recorded accurately with two signatures in the CD register. Throughout the inspection we saw resident’s being treated with respect and dignity and offered choices at all times. Some residents had written advanced directives about their end of life wishes. In order to ensure that these are legally binding and grant the people using the service the care and protection they want, staff must ensure that they comply with the Mental Capacity Act. Taymer Nursing Home DS0000042234.V371298.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 People who use this service experience good quality outcomes in this area. The service enabled people to participate in meaningful activities in order to provide stimulation. Meals were well planned and highly nutritious and enjoyed by all. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: An activity co-ordinator was employed, but she had been off sick for sometime and it was not clear when she would be returning. The manager encouraged the care staff to organise activities and to spend time with the people using the service. There was a plan of different activities including entertainers, quizzes and themed meal nights. Other activities, that took less organising, were arranged as people wanted them. These activities took place in the lounge or individuals bedrooms. One person told us she looked forward to playing scrabble with a particular carer. The home had purchased a new flat screen TV and since then had introduced cinema afternoons when the blinds were pulled down, and the pop-corn made, and a film enjoyed. Some residents that had Taymer Nursing Home DS0000042234.V371298.R01.S.doc Version 5.2 Page 14 been at the home for a number of years told us of their enjoyment of the recent barbeque to which the previous homeowner and manager had been invited. The manager had also introduced interactive computer games (wii) which were enjoyed and provided exercise and stimulation to those less physically able residents. Throughout the home were displayed arts, crafts and photographs done by, or taken of, the people living at the home. Every resident and staff had been involved in a giant mural which was almost complete. This was a large picture of the home and grounds made using different craft techniques. It was to be hung in the hall. Also on display were ‘dolly peg people’ that had been made by residents: some representing members of staff or residents. The home had good links with the local community and on the day of the inspection a church visitor was visiting some of the residents as a ‘be-friender’. The visitor told us “I love coming here, it is so friendly, I would be happy for a relative of mine to live here”. The various churches in the area also provided regular religious services for those who wanted it. The home was part of the mobile library link stop. This allowed people to have easy access to books, including talking books and large print books and for villagers to use the service. One lady who was reading her daily newspaper at the breakfast table said “ I can’t imagine life without my telegraph”. She told us that she and some others had their papers delivered daily and were billed for this separately. The head chef, who also managed the house keeping team, arranged for small useful items such as birthday cards to be on sale to the residents. Every one spoken to enjoyed the meals and it was apparent that the head chef planned the menus well and ensured that people using the service had the type of food they enjoyed. The meals were well presented and most people took their lunch in the dining room. The dining room looked nice with flowers on each table. At breakfast time most people choose to have their meal taken to their bedroom. Mid morning, in addition to coffee and biscuits, residents were offered a fruit salad or a ‘smothie’ drink made with the fruit. One lady said “this is such a lovely idea I will continue it when I get home”. In the communal areas were squash dispensers offering orange or blackcurrant drinks at anytime. Taymer Nursing Home DS0000042234.V371298.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 People who use this service experience good quality outcomes in this area. A robust complaints procedure and staff awareness of safeguarding ensured people were kept safe at all times. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: This homes’ complaints policy was displayed in the reception area and was easily accessible to residents and visitors to the home. It confirmed the expected timescales for responses, and advised people of the process if they were dissatisfied with the outcome. In addition to the twice-yearly relatives meetings, relatives and people using the service were provided with dates that they could meet with the manager, and dates they could meet with the cook. Each person gave a monthly weekend date that was published well in advance. There had been a number of compliments about the service. All staff had undertaken safeguarding training and the staff spoken to appeared to know how and when to make safeguarding referrals. Taymer Nursing Home DS0000042234.V371298.R01.S.doc Version 5.2 Page 16 Recruitment processes ensured that staff employed were ‘fit’ to work with vulnerable adults and the manager was vigilant about checking visiting staff, such as those from the PCT, had had the same checks. Taymer Nursing Home DS0000042234.V371298.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): 19,23, 26 People who use this service experience good quality outcomes in this area. The home provided a clean, comfortable and safe environment for the people who lived there. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The manager and the inspector toured the building. It was clean, well maintained, well furnished and free from offensive odours. Individual rooms had been decorated and furnished to meet with personal tastes. Photographs and ornaments on display in some of the rooms clearly reflected the family and personal history of the residents. One person using Taymer Nursing Home DS0000042234.V371298.R01.S.doc Version 5.2 Page 18 the service had moved her piano into her bedroom when she had been admitted, and was very grateful to be able to do this. Other rooms that had been double rooms and were currently used as singles allowed a resident to have a summer and winter wardrobe. The manager ensured that all new admissions had flowers in their room on arrival, another touch which residents told us they appreciated. This last report stated that there were plans to extend the home. The manager told us that these plans had been put on hold. However the call bell system had been upgraded and people had bells in their bedrooms, which they could transfer to wear around their necks when they were not in bed. The system also allowed the manager to track how long it took for staff to answer call bells. There was a variety of bathing facilities throughout the home but not showers. The home was all on one level and situated in well-tendered gardens that were enjoyed by residents and visitors when the weather allowed. Taymer Nursing Home DS0000042234.V371298.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 People who use this service experience good quality outcomes in this area. A variety of training was offered to all of staff to ensure that collectively, they had the skills and experience, to meet the needs of the people living at the home. Recruitment procedures were fully adhered to so that residents are protected. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: At the time of the inspection the manager informed us that the home was fully staffed, and only recruiting to its ‘bank’. The staff team were well established and there were two nurses and five carers on the day shift in addition to the manager, the chef, laundry and cleaning staff. At night there was one nurse and two carers. During the day one of the qualified nurses was responsible for supporting those people receiving the intermediate care and the other was responsible for medications and dressings. The care staff worked in teams and were allocated the people to care for during the handover. We examined the personal files of three members of staff. All contained fully completed application forms, appropriate references, induction checklists and Taymer Nursing Home DS0000042234.V371298.R01.S.doc Version 5.2 Page 20 training records and certificates. Criminal Record Bureau (CRB) checks had been carried out on all staff, and home office paperwork was present where required. The staff that we spoke to during this visit was confident and competent in their roles, and were able to talk in depth about individual residents needs and the care that they required. Training records indicated that staff attended a variety of mandatory and specialist training, which the manager ensured was kept updated. All of the staff working at Taymer either held an NVQ or were working towards it. Staff were rewarded with a voucher on completion of NVQ training. All new staff had a period of induction whether they had worked in care or not. Taymer Nursing Home DS0000042234.V371298.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): 31,32,33,35,36,38 People who use this service experience good quality outcomes in this area. The manager had a clear understanding of the key principles and focus of the service and worked with the staff team to continually improve and evaluate the care that was provided. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: One person using the service when referring to the manager stated, “ she is a saint, she has time for everyone”. Staff also told us that they felt the manager was approachable and fair. The managers’ ethos for the home, and a phrase Taymer Nursing Home DS0000042234.V371298.R01.S.doc Version 5.2 Page 22 she ensured staff worked to was, ‘ the residents are not here for us, we are here for them’. Throughout the inspection we witnessed the manager speaking and interacting appropriately with staff, residents, visitors and health professionals. The manager believed in leading by experience and would work ‘hands on’ shifts at times. The quality of the care provided was monitored by resident, staff and visitors, including visiting health professionals, being given questionnaires to complete. This was done annually and a report detailed any problems and how they would be addressed. We viewed the supervision records for the three members of staff whose personal records we looked at and this confirmed that they were receiving regular supervision. We looked at health and safety documentation, including the fire log and maintenance book. There was evidence to indicate that fire call points and the emergency lighting were being tested on a regular basis, and that fire drills were carried out periodically. Maintenance issues and redecorations were being addressed in a timely fashion. Taymer Nursing Home DS0000042234.V371298.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X 3 3 X 3 Taymer Nursing Home DS0000042234.V371298.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? 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 OP9 Regulation 13 (2) Requirement Staff must ensure that when medication is received into the home any balance of stock is recorded or returned so that is possible to reconcile the medications and that when a dose of medication is prescribed to be given four times a day it is clearly recorded why a dose is not administered. Timescale for action 18/10/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP10 Good Practice Recommendations The manager should ensure that any advanced directives written by people using the service conform to the mental capacity act. Taymer Nursing Home DS0000042234.V371298.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Taymer Nursing Home DS0000042234.V371298.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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