Care Home: The Adelaide Nursing Home

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What the care home does well The service provides general nursing care to older people. The documentation supporting the care given, which included care plans and medication charts, was up to date, informative and included the current and changing care needs of the residents.Residents said that the staff were kind and courteous and that they were happy living at the home. The standard of catering met resident`s approval and provided a varied menu, which included the use of fresh fruit and vegetables and offered choices at each meal. What has improved since the last inspection? Many improvements have taken place since the last inspection and these included the care planning, medication administration and the quantity of specialised equipment provided for those residents that require this. A bed and mattress audit has been undertaken and new pressure relieving mattresses are being purchased. The home is building an extension to enable the current double rooms to be replaced by single rooms. The original building has been redecorated and re carpeted insofar as building works will allow. Staff have taken part in mandatory training, which includes moving and handling, and safeguarding adults training, and other training relating to the care of the residents takes place. The current manager showed awareness of what is required to enable the home to progress further and provide a good standard of service, which meets resident`s needs and expectations. The requirements from the last inspection have been complied with. CARE HOMES FOR OLDER PEOPLE The Adelaide Nursing Home 203 - 205 New Church Road Hove East Sussex BN3 4ED Lead Inspector Elizabeth Dudley Unannounced Inspection 3rd June 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Adelaide Nursing Home DS0000065729.V365170.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. The Adelaide Nursing Home DS0000065729.V365170.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Adelaide Nursing Home Address 203 - 205 New Church Road Hove East Sussex BN3 4ED 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) 01273-410530 01273 423413 Seaway Nursing Home Limited Vacant Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places The Adelaide Nursing Home DS0000065729.V365170.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That service users should be aged sixty-five (65) years or over on admission The maximum number of service users to be accommodated is thirtyfive (35) Only older people requiring nursing are admitted to the home. Date of last inspection 31st May 2006 Brief Description of the Service: Adelaide Nursing Home is a care home providing care for up to thirty-five (35) residents over the age of sixty-five (65) and requiring nursing care. Rooms are located over two floors and are accessible by stairs. A passenger shaft lift is available for those residents unable to independently mobilise. Communal areas consist of a lounge/dining area and access to garden. Assisted bathing facilities are in place. It is located in a quiet residential area of Hove. Local amenities and the seafront are within walking distance of the home. There is nearby access to public bus routes and rail links to Brighton. The home provides parking for approximately four cars and further car parking is available in adjacent roads, which is unrestricted. Weekly fees range between £530 and £700. There are additional charges for hairdressing, Chiropody, newspapers/magazines, and personal toiletries. The home provides physiotherapist services to all residents and the cost of this is borne by the home. This is based on information given by the provider on 3rd.June 2008. The Adelaide Nursing Home DS0000065729.V365170.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 key unannounced inspection took place on the 3rd June 2008 over a period of seven hours and was facilitated by the appointed manager. Methods used to collect information about the home included examination of documentation in the home, observation of staff working with residents, the serving of lunches and conversations with residents, staff and visitors to the home. All residents were spoken with during the inspection, and six residents were spoken with in depth and gave their views on life in the home. Documentation examined included care plans, personnel files, staff training and supervision records, catering records and health and safety files. Prior to the inspection questionnaires were sent out to residents and seven were returned. These gave information about the daily life in the home and helped to inform the judgements made in this report. Thanks are extended to those people who responded. The Annual Quality Assurance Assessment, required by the CSCI, which gives an overview of what has been achieved in the home and issues to be addressed, was received by the CSCI prior to the inspection. This accurately reflected the current status of the home and was used as part of the inspection process. Comments received from residents included “ I cannot fault the management, care and dedication of the staff and I feel very lucky to have chosen to live here”. “I would like the home to arrange occasional outings to the countryside”. “ There has been a noticeable improvement to the home over the past six months”. What the service does well: The service provides general nursing care to older people. The documentation supporting the care given, which included care plans and medication charts, was up to date, informative and included the current and changing care needs of the residents. The Adelaide Nursing Home DS0000065729.V365170.R01.S.doc Version 5.2 Page 6 Residents said that the staff were kind and courteous and that they were happy living at the home. The standard of catering met resident’s approval and provided a varied menu, which included the use of fresh fruit and vegetables and offered choices at each meal. What has improved since the last inspection? What they could do better: Whilst the provision of meals and standard of catering is good, improvements could be made to the serving of meals to ensure that they are presented in an attractive manner and therefore further stimulate resident’s appetites. There are risk assessments in place when bed rails are required to be used, these should be expanded to take in the directions provided by the Medical Devices Agency. The Adelaide Nursing Home DS0000065729.V365170.R01.S.doc Version 5.2 Page 7 It is considered good practice to ensure that ‘as required’ medications have specific instructions regarding when they will need to be used for individual residents to prevent them being given unnecessarily. The manager must ensure that the CSCI is informed of any adverse incidents affecting residents. 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. The Adelaide Nursing Home DS0000065729.V365170.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 The Adelaide Nursing Home DS0000065729.V365170.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 the service experience good quality outcomes in this area Prospective residents receive sufficient documentation to enable them to decide whether they wish to live at the home. The manager assesses residents prior to their admission to ensure that the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents receive a copy of the Service User Guide. The Statement of Purpose was unavailable to be seen at the inspection but was emailed to CSCI the following day. Both documents have been recently reviewed. Residents who wished to be admitted to the home are assessed by the manager to ensure that the home can meet their needs; they receive written confirmation of the homes decision. The Adelaide Nursing Home DS0000065729.V365170.R01.S.doc Version 5.2 Page 10 Residents confirmed that they had been seen by the manager prior to being admitted to the home and also that they or their representatives were able to visit the home before making a decision over whether they wish to live there. Three preadmission assessments were seen, these provided sufficient basic information about the person and their health and social care needs to enable the care planning process to be commenced. These may benefit from being expanded to inform staff of any specialist equipment that will be required. All residents have a contract and terms and conditions of residence on admission to the home. The home accepts residents for respite care but not for intermediate care. The Adelaide Nursing Home DS0000065729.V365170.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11. People who use the service experience good quality outcomes in this area Care planning reflects the current and changing needs of the residents in the home and ensures that they are receiving the care that they require. Failure of staff keeping their records relating to nursing tasks performed up to date, could have implications for resident care. The standard of medication administration safeguards the resident. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of six care plans were examined, these reflected 17 of the total care plans in the home. These showed that the resident or their representative had been consulted during the formation of the care plan; they had been reviewed regularly and reflected current and changing needs. The Adelaide Nursing Home DS0000065729.V365170.R01.S.doc Version 5.2 Page 12 There were specific care plans in place to address each assessed need of the individual. Care plans included nutritional continence and wound care plans, and incorporated care tools such as the Waterlow scoring system for assessment of likelihood of pressure damage and the Malnutrition Universal Screening Tool. Residents are weighed regularly and actions taken to address any issues found. The bed rail risk assessments, whilst identifying the obvious risks to residents, should be expanded to identify risks as recommended by the Medical Devices Agency. There was evidence of involvement of the wound care nurse, speech and language therapist and other health care professionals. Residents and relatives spoken with, and surveys received, identified that they were pleased with the care received, one resident said ‘ I feel very lucky to have chosen this home’. Both residents and relatives said that General Practitioners were accessed in a timely manner, as were other health care professionals. The home employs a physiotherapist who visits all of the residents and also received physiotherapy services from the nursing home support team for those residents that require this. The manager arranges for dental and optical services to visit the home. One resident has acquired pressure damage since being admitted to the home but this involved other factors other than the care given by the home. The home has detailed wound care notes and these were up to date with the specialist wound care nurse advising on treatment. The wound care nurse has recently undertaken a mattress audit and the home is in the process of replacing beds and mattresses as recommended. The home has a quality monitoring survey in place and recent responses from General Practitioners showed that they were pleased with the standard of care offered and the communication with the home. It was noted that some fluid and turning charts in the home had not been filled in regularly making it difficult to assess how often some residents had received this care. The manager gave assurances that these would be addressed and staff must be made aware of the importance of this information that reflects on resident’s wellbeing. One relative said that a resident ‘likes the home so much she won’t go for visits home any more’, that the new management had made ‘such a difference to the home’ and that the staff were ‘dedicated and caring’. The feedback gained generally was that there had been significant improvement in the care in the past year. The Adelaide Nursing Home DS0000065729.V365170.R01.S.doc Version 5.2 Page 13 Residents said that their call bells were kept within reach and answered promptly and that staff responded to their requests willingly and treated them with dignity and courtesy. The medication policies have been reviewed and reflect current practice in the home. Records identifying the receipt disposal and administration of medication were accurate and signed in the appropriate places and storage and recording of controlled drugs meet regulation. Instructions for when specific ‘as required’ medication is to be given should be included in all medication records and should be tailored to individual residents. Homely remedies are not generally kept at the home, this is recommended for times when residents may need mild analgesia or laxatives, and permission should be gained from General Practitioners to use homely remedies on individual residents. Staff should be aware of the Nursing and Midwifery Council and also the CSCI guidelines on the administration of homily remedies. Liquid medication should have its date of opening recorded. The clinic room cupboards will need replacing in the near future, but at present the security of medication is not compromised. The home provides some end of life care but has not yet commenced the Liverpool Care Pathway and Gold Standards Framework (nursing tools to help control pain and measure suitability of care given to terminally ill residents) but some staff have attended palliative care study days at the hospice. Residents nursed in bed were comfortable and letters from bereaved relatives were seen that expressed satisfaction with the care given. End of life care plans are in the process of being put in place and the home is aware of the preferred place of death initiative. The Adelaide Nursing Home DS0000065729.V365170.R01.S.doc Version 5.2 Page 14 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 the service experience adequate quality outcomes in this area The home does not provide sufficient leisure activities, outings or social stimulation for the residents and some staff do not appear to be aware of the importance of this part of holistic care. Residents are able to make choices of how they spend their days and their times of rising and retiring. A varied menu is provided but residents’ meals are not always served in a manner that will stimulate the resident’s appetite. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Following the resignation of the previous activities co-ordinator, the home has recently arranged for a care assistant to take responsibility for activities and she was in the process of identifying what activities people would like to take part in. However this will result in few hours being provided for activities and The Adelaide Nursing Home DS0000065729.V365170.R01.S.doc Version 5.2 Page 15 this will not be sufficient for either the size of the home or for the needs of the residents in the home. A requirement was made around the provision of activities at the last inspection and although this was met to a degree, with the home employing a person, a further requirement will be made. Records showed that residents had taken part in a small selection of activities in recent months Whilst some activities take part in the home, such as games and visit from an art therapist once a month, there needs to be improvement in these areas. Many residents spend a large part of the day with nothing to do and building of an extension has restricted access to the garden. One resident and a relative expressed the wish for residents to be able to go on outings and one resident is able to go out to the shops on his own. Residents who stay in their rooms receive little in the way of stimulation or company. It was noted that staff members who were in the lounge were not attempting, apart from one member of staff, to engage residents in conversation or to sit and talk to residents. The manager should ensure that staff are made aware of the importance of stimulating leisure activities and communication on the residents health and well-being. Activities and sufficient stimulation form part of the holistic care of the resident and the provider and manager must ensure that attention is given to providing these. Residents in the home said that they had choices over what time they get up and go to bed and said that the way that they plan their day is up to them and that the staff were very helpful. Visitors are made welcome at any time and two visitors spoken with said that staff were communicative and always let them know if there were any concerns about the resident. A religious service is held monthly and the manager said that ministers of other religions accessed as required. The home has a varied menu, which includes fresh fruit and vegetables. Residents have a choice of menu and are assisted in making this choice by either the care staff taking menus around or by a choice of menu displayed in the lounge. A cooked breakfast is provided on request. . Presentation of meals could be improved. Whilst pureed meals are presented in a manner which enables the resident to distinguish what they are eating, residents are not encouraged to sit at the dining table and the presentation of the trays is not attractive or conducive to encouraging an appetite. The supper menu would benefit from reviewing and incorporating more home cooked items. The Adelaide Nursing Home DS0000065729.V365170.R01.S.doc Version 5.2 Page 16 Residents spoken with said that the meals were good, well cooked and provided in sufficient quantities. Beverages are available throughout the day and on request and many cakes are made in the home. All members of catering staff have the food hygiene certificate and the kitchen gained four stars in the Environmental Health ‘Scores on Doors’ initiative. The Adelaide Nursing Home DS0000065729.V365170.R01.S.doc Version 5.2 Page 17 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 the service experience good quality outcomes in this area Residents are confident that any complaints that they raise will be dealt with in a confidential and open and transparent manner. Staff have received training in adult safeguarding and were aware of how to ensure the safety of those in their care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints policy, which is displayed in the entrance hall and included in the service users guide. There have been nine complaints since the last inspection, six of which were relatively minor and were upheld and addressed by the manager. Records of actions taken to address complaints were in place and up to date, and showed that these had been addressed in an open and transparent manner. The majority of residents spoken with were aware of how to make a complaint and said that they were comfortable to do this. Some said that they had raised minor concerns and these had been dealt with quickly and in an open and transparent manner. All staff have had training in safeguarding adults. This is done in house by an approved trainer and encompasses the latest reporting protocols as required The Adelaide Nursing Home DS0000065729.V365170.R01.S.doc Version 5.2 Page 18 by the Multi agency guidelines. The manager has attended adult safeguarding training with the local authority. There have been no adult safeguarding issues in the past twelve months. The adult safeguarding policy requires reviewing to show the action the home would take if faced with an adult safeguarding issue. The Adelaide Nursing Home DS0000065729.V365170.R01.S.doc Version 5.2 Page 19 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): 19,20,21,22,24,25,26 People who use the service experience good quality outcomes in this area The home is pleasant, clean and comfortable. Current building works prohibit residents accessing the garden but little disruption has otherwise being caused to the running of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An extension to the home providing extra single rooms for resident’s accommodation and additional lounge space is in the process of being built. The current lounge has been extended by the removal of an office and has been re-carpeted and redecorated. The Adelaide Nursing Home DS0000065729.V365170.R01.S.doc Version 5.2 Page 20 Due to the building of the extension residents are currently unable to access the garden but this will be re planned and maintained when the extension is complete. Following completion of the extension there will be no increase in the number of residents accommodated but those cared for in double rooms will be accommodated in single rooms. There will be no double rooms in the home. The extension will also offer further lounge and bathroom facilities. A requirement was made at the last inspection regarding the maintenance, decoration and cleanliness of the home. Maintenance and redecoration has been ongoing as far as building works will allow. A new kitchen floor has been put in place, ongoing redecoration of rooms has taken place and there some new beds purchased. New lounge and dining room furniture is planned and refurbishments to the laundry will take place. Resident’s rooms are comfortable and residents may have keys to their rooms if they wish and a risk assessment shows that this is suitable. This information should be added to care plans. Residents can bring in their own possessions to make their rooms homely and express their individuality. Water temperatures to resident’s outlets have been monitored regularly and records show that these are within recommended parameters. Bathrooms are clean and in working order and there are sufficient bathing facilities for the number of residents in the home. There is a range of aids to maximise resident’s independence and a survey by an occupational health professional has recently been undertaken. The home is clean and free from odours. Staff have had infection control training and policies and procedures regarding infection control are in place. The Adelaide Nursing Home DS0000065729.V365170.R01.S.doc Version 5.2 Page 21 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 the service experience good quality outcomes in this area There are sufficient staff on duty over a twenty-four hour period to meet the needs of the residents currently in the home. Staff receive training to enable them to update and add to their existing knowledge of the care required by the residents in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staffing rotas, discussions with staff and observation of the service provided by the home showed that there are sufficient staff to meet the needs of the number of residents currently living in the home. The manager and provider should keep this under review. Four members of staff have currently attained their National Vocational Qualification level 2 in care and a further six staff are in the process of attaining this. Staff receive an induction course, which is line with the nationally approved ‘Skills for Care’ induction course, and all staff have the General Social Care Code of Conduct. The Adelaide Nursing Home DS0000065729.V365170.R01.S.doc Version 5.2 Page 22 Staff have received ongoing mandatory training and this is continually updated and includes moving and handling, safeguarding adults and fire training. Training relating to the care of the residents is provided and registered nurses have the opportunity to update their skills. Six staff personnel files were examined and these showed evidence of robust recruitment procedures that safeguard the residents. The Adelaide Nursing Home DS0000065729.V365170.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,37,38. People who use the service experience good quality outcomes in this area Management systems within the home ensure that the services provided meet the expectations of the residents, and that their safety and well being is upheld. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The appointed manager has been in post for six months. She was previously manager of the sister home and has experience in managing other care The Adelaide Nursing Home DS0000065729.V365170.R01.S.doc Version 5.2 Page 24 homes. She is an RGN and holds the Registered Managers Award and other qualifications relating to the mentorship of care and staff in training. She is not yet registered with the CSCI. The ethos in the home was good, the home is calm and organised with staff saying that they have been improvements under the current manager. Relatives and residents spoken with spoke highly of the home and the management. The home maintains a quality monitoring programme and has recently received back surveys sent out to the residents, relatives and other stakeholders. These were seen and showed that the majority of people were satisfied with the services offered by the home. The provider is in the process of collating these. The home does not act as appointee for residents but keeps some money for safekeeping. Records were seen of these and were in order. Staff supervision takes place on a regular basis and records of Regulation 26 visits were seen at the home (provider visits to the home required by regulation). The manager must ensure that the CSCI receives reports relating to any incident that affects residents in the home. Accident records were in place and correlated with the accidents recorded in care plans. Staff have mandatory training and servicing of utilities and equipment has taken place. The home had a fire officer’s inspection prior to building works commencing and some requirements were made which have been addressed. All resident’s rooms have automatic closures fitted for use in case of fire. The Adelaide Nursing Home DS0000065729.V365170.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 2 3 3 x 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 x 3 3 3 3 The Adelaide Nursing Home DS0000065729.V365170.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. 1. Standard OP12 Regulation Requirement Timescale for action 10/08/08 Reg That service users are provided 16(2)(m & with suitable and fulfilling n) activities. The provider must review the amount of time that are provided for activities. Reg 37 That the CSCI is informed of any incident or injury affecting a service user. 2 OP38 30/06/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP8 OP9 OP15 Good Practice Recommendations That bed rail risk assessments are expanded in line with the Medical Devices Agency. That specific instructions for reasons for administering ‘as required’ medications are in place for each individual service user prescribed these. That staff ensure that the presentation of meals regarding trays and setting up of tables is of a standard to ensure that service users receive the maximum stimulation to appetite. DS0000065729.V365170.R01.S.doc Version 5.2 Page 27 The Adelaide Nursing Home Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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