Care Home: The Old Rectory [Nunney]

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What the care home does well People living at the service all spoke positively and said they were very satisfied with the care and service they receive. One person said the `food isexcellent and they wouldn`t want to be anywhere else` as they `like it very much`. This family run home is comfortable and homely. The home has been adapted to accommodate older people. The catering is good with home cooked and home baked food. The food served looked appetising and was attractively presented. Special diets are catered for. Staff were heard to be polite and respectful at all interactions throughout the day with the people living at the home. What has improved since the last inspection? The requirements made at the last inspection have been addressed. There are now regular group activities held at the home. Improvements to the environment have been made these include new lounge armchairs and a handrail outside the front door to help people safely negotiate the ramped incline up to the door. Care planning has been further developed and staff have received further training and development. CSCI were notified that the home have reviewed, updated and amalgamated their statement of purpose and service user guide. What the care home could do better: The activities co-ordinator was at the home; they are employed on a casual basis and not as a member of the staff team. Mr Hill said he would review this in order to develop the role and the opportunity for one to one activities as well as group activities to be undertaken. This will involve a need for full recruitment checks. The registered person should ensure that social needs plans are developed so that activities are provided to meet service users individual needs and interests. Two medication records required photographic identification.Care should be taken to ensure that the needs of people living at the home are within the categories of care and expertise of the staff as defined in the home`s statement of purpose. The home should consider establishing quality assurance systems such as residents meetings or service user surveys to seek feedback on the service provided. Where hand written changes are made to variable dose prescribed medicines staff making the entry should sign the MAR and a second competent staff member should sign to confirm the accuracy of the entry. This is a good practice recommendation. CARE HOMES FOR OLDER PEOPLE The Old Rectory [Nunney] High Street Nunney Frome Somerset BA11 4LZ Lead Inspector Barbara Ludlow Unannounced Inspection 23rd September 2008 11:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Old Rectory [Nunney] DS0000016007.V372181.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 Old Rectory [Nunney] DS0000016007.V372181.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Rectory [Nunney] Address High Street Nunney Frome Somerset BA11 4LZ 01373 836747 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) Mr Ronald Hill MRS MARIAN CONSTANCE HILL Mr Ronald Hill Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places The Old Rectory [Nunney] DS0000016007.V372181.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th July 2008 Brief Description of the Service: The Old Rectory is a large detached property located in the village of Nunney, approximately four miles from Frome. Service user accommodation is provided over two floors. There is a passenger lift, assisted bathrooms, and a call system available. The Old Rectory is registered with the Commission for Social Care Inspection to provide care for up to 24 service users over the age of 65 years. The proprietor is Mr Ronald Hill. Mr Hill is also the Registered Manager. The home has been decorated and furnished to a high standard. The garden has been well maintained and is accessible to service users. The fees are £373 - £450 per week, with additional charges for hairdressing, private chiropody and toiletries. The Old Rectory [Nunney] DS0000016007.V372181.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of this inspection visit was to inspect relevant key standards under the CSCI ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are: - excellent, good, adequate and poor. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This unannounced inspection visit was made by one inspector for the Commission for Social Care Inspection (CSCI) over a five and a half hour period. The inspection was well received. Mr Hill had completed and returned to CSCI their Annual Quality Assurance Assessment (AQAA) and data set. Surveys had been sent out to the staff and service users at the home. The registered owner/ manager Mr R Hill and his care manager, who plays a significant part in the homes management and holds an National Vocational Qualification at Level 3 in care; came to the home to assist with the inspection process. The inspector met with all people in residence and the staff on duty. A tour of the premises was made; communal rooms and a sample of bedrooms were seen. The kitchen and catering staff were seen as lunch was being prepared. The serving of lunch and tea was observed during the inspection. The inspector had chance to sit with people in the lounge and dining room to chat about life at the home. Records including care plans, maintenance, staff recruitment and supervision records were sampled. The inspector would like to thank the people living and working at the home for their contribution to the inspection process. What the service does well: People living at the service all spoke positively and said they were very satisfied with the care and service they receive. One person said the ‘food is The Old Rectory [Nunney] DS0000016007.V372181.R01.S.doc Version 5.2 Page 6 excellent and they wouldn’t want to be anywhere else’ as they ‘like it very much’. This family run home is comfortable and homely. The home has been adapted to accommodate older people. The catering is good with home cooked and home baked food. The food served looked appetising and was attractively presented. Special diets are catered for. Staff were heard to be polite and respectful at all interactions throughout the day with the people living at the home. What has improved since the last inspection? What they could do better: The activities co-ordinator was at the home; they are employed on a casual basis and not as a member of the staff team. Mr Hill said he would review this in order to develop the role and the opportunity for one to one activities as well as group activities to be undertaken. This will involve a need for full recruitment checks. The registered person should ensure that social needs plans are developed so that activities are provided to meet service users individual needs and interests. Two medication records required photographic identification. The Old Rectory [Nunney] DS0000016007.V372181.R01.S.doc Version 5.2 Page 7 Care should be taken to ensure that the needs of people living at the home are within the categories of care and expertise of the staff as defined in the home’s statement of purpose. The home should consider establishing quality assurance systems such as residents meetings or service user surveys to seek feedback on the service provided. Where hand written changes are made to variable dose prescribed medicines staff making the entry should sign the MAR and a second competent staff member should sign to confirm the accuracy of the entry. This is a good practice recommendation. 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 Old Rectory [Nunney] DS0000016007.V372181.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 Old Rectory [Nunney] DS0000016007.V372181.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): 2,3, Quality in this outcome area is good. People are assessed pre admission to ensure that placement is only offered if the care home can deliver the service that will meet their assessed needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People were seen in private and were asked about their admission to the service. People had come here from hospital and from home; they spoke positively about their choice of the Old Rectory. One person knew the home and had been here for respite care and enjoyed their stay and had chosen to come back. The care plans were sampled as part of the case tracking process. These contained pre admission assessment; hospital discharge information and the The Old Rectory [Nunney] DS0000016007.V372181.R01.S.doc Version 5.2 Page 10 Single Assessment Process (SAP) form completed by the community care professionals assisting them with their placement. People also said they had visited the home and had received help from their families with their decisionmaking. Contracts were sampled; these clearly demonstrated the cost of care per week at this home. The AQAA indicated that the home knows it offers value for money and places are competitively priced. CSCI were notified that the home have reviewed, updated and amalgamated their statement of purpose and service user guide. The Old Rectory [Nunney] DS0000016007.V372181.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. Each person has a care plan identifying his or her health and personal care needs and states how these can be met. People are treated kindly and with respect and are encouraged to retain control of their daily lives. Medications are safely managed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All people had a care plan. Relevant personal information was recorded. The care plans are developed from the pre admission assessment and records of any identified health care needs such as catheter care and any wound dressings. The Old Rectory [Nunney] DS0000016007.V372181.R01.S.doc Version 5.2 Page 12 Special dietary needs are documented such as diabetes and intolerances such as gluten and preferences such as a vegetarian requirement. People asked said they had seen the doctor when needed and the district nurse for continuing health care treatments such as their regular injections and dressings. People explained how there care needs are met and the equipment they have to meet their particular needs such as a turning circle and adjustable bed. These aids and equipment were seen ready for use. Visits by health professionals such as the chiropodist were confirmed, people also confirmed having had their eyes tested. Hospital appointments are supported, the inspector heard that Mr Hill had accompanied one person to their appointment and had waited with them and then brought them home. This was appreciated. One person was seen whose needs have changed and it was not clear that the home was necessarily best placed to meet the demand of their changing health. Care must be taken to ensure that the needs of people living at the home are within the categories of care and expertise of the staff as defined in the statement of purpose. Medication Administration Records (MAR) were seen and examined, there was photographic identification on the records for the majority, and two were not in place. Other information included the individual’s date of birth and room number, allergies were recorded and important information such as a person’s ability to swallow medication. There were no omissions on the MAR charts but there was only one signature for a hand written dial up dose of insulin. Two signatures to demonstrate that a handwritten entry has been checked and confirmed as accurate by another competent person is recommended. Medication requiring refrigeration had been stored securely and appropriate records were maintained of the fridge temperature checks. Controlled drugs had been stored securely. An opening date had been recorded for prescribed creams. Lockable storage is available for those who are self medicating. The AQAA indicates that the home has a policy for the receipt, storage and handling, administration and disposal of medication. This was not inspected. A member of the care staff explained the medication administration process and this sounded to be both satisfactory and safe. The Old Rectory [Nunney] DS0000016007.V372181.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. People can choose how they spend their time. Families and visitors are welcomed. The food is home cooked and nutritious. Meals are nicely served in the dining room. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At this inspection a group of seven people were sitting together in the large lounge, some were chatting together, others were sitting quietly or dozing. The chairs were arranged to make the seating area more homely and private from the office and rooms leading into it. This high ceiling room has large sky light windows above the seating area, which provide a good level of natural light. The Old Rectory [Nunney] DS0000016007.V372181.R01.S.doc Version 5.2 Page 14 This lounge is a central point in the house and has some bedrooms and the office opening onto it. Activities were held here during the afternoon, bingo was played and enjoyed by those participating. People asked said they have activities on Tuesday and Friday and which included ‘bingo, games and sometimes music’. The activities organiser was seen during the afternoon, they had been in post for a few months but because they are employed on a casual basis they only held group activities and did not carry out any one to one with people choosing to spend their time in their rooms. Mr Hill agreed to consider how this role could be developed. The AQAA indicated that community events such as plays in the village hall are accessed. Mr Hill had also reported the support he gives to people attending appointments in the community. Community access was also an area where Mr Hill felt the home could develop. People asked said their relatives and visitors are made welcome. One person spoken with said the food is ‘very good’; they had breakfast in bed, which was usually cereal, prunes or grapefruit and toast served with a pot of tea. Coffee is served at 11 am they said lunch is at ‘12 midday’. Lunch is two courses, today a choice of chicken supreme and vegetables or vegetable curry, a dessert (Bakewell tart or stewed apple) and fruit squash to drink. A drink of tea is served in the afternoon at 2:15pm to 2:30pm, we heard that tea is served at 5pm and is either a cooked or cold meal. At teatime the inspector observed as people were assisted to seat themselves at the dining tables. The tables were nicely laid with tea served in china cups and saucers. Tea was seen as served at the dining tables; this was a mixed sandwich platter for people to choose to from and cake to follow. Catering staff demonstrated a good knowledge of individual service users dietary needs and preferences. The home is able to cater for specialist diets. The AQAA indicated that a food processor had been purchased for special soft diet preparation. The Old Rectory [Nunney] DS0000016007.V372181.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. There is a complaints policy and procedure. People are protected from abuse by safe recruitment practice and staff awareness of good practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The AQAA indicated that a copy of the home’s complaints procedure is displayed in the hallway and has been updated. There have been no complaints made to the service and one complaint has been received by CSCI in June 2008 and this was fully investigated, recommendations for practice were made. The home has an appropriate whistle blowing policy. The AQAA indicated that this is displayed. For the protection of vulnerable adults the home has ensured that an enhanced Criminal Records Bureau (CRB) and two references have been received prior to a staff member commencing employment at the home. The manager confirmed that they have obtained an updated copy of the Somerset Safeguarding procedure. Those people spoken with confirmed that they would feel able to raise any concern with staff and management at the home. The Old Rectory [Nunney] DS0000016007.V372181.R01.S.doc Version 5.2 Page 16 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): 19,26 Quality in this outcome area is good. The environment used by people living at the home is clean and well maintained. The kitchen is looking worn. There are hand-washing facilities and there is good infection control practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a sloping entrance and a handrail has been installed to make the access safer. The accommodation is on two floors with either stairs or an appropriately serviced passenger lift for access between floors. The Old Rectory [Nunney] DS0000016007.V372181.R01.S.doc Version 5.2 Page 17 Bedrooms have en suite facilities, some are shared between rooms or there may be sole use of a nearby bathroom. The AQAA indicates that bedrooms are redecorated when they become vacant. There are two assisted communal bathrooms. The home has a call system throughout and people asked said that they receive a prompt response when they call for staff assistance. The communal ground floor accommodation is a large lounge, a large dining room, and a quiet room. The home has been decorated and comfortably furnished to a good standard, some carpets were renewed last year and new armchairs have been purchased since the last inspection. Access around the home is level with the exception of very small step risers into one or two bedrooms on the ground floor. Radiator guards are fitted in all parts of the home and window openings are restricted on the first floor. The home has fire safety equipment with fire alarm, emergency lighting and fire extinguishers. All servicing of the equipment was up to date. The home was generally clean, the exception was one bedroom carpet and one armchair, which were in need of cleaning, and one bedroom table were not as clean as expected. The home generally has two cleaning staff on duty each weekday but only one was on duty at the time of this inspection. No complaints or concerns were heard about the cleaning of the home. Hand washing facilities consisting of liquid soap, paper towels and foot operated flip top bins for staff are available around the home. Staff were seen to have access to protective clothing such as gloves and aprons. The AQAA indicated that requirements made at the last inspection for the environment, have been addressed. The homes kitchen was looking worn with damaged drawer fronts and a slippery and worn floor covering. The advice of the Environmental Health inspector should be taken at their next visit, which was determined to be due. Mr Hill confirmed to CSCI after the inspection that the kitchen has been redecorated and new floor covering has been ordered. The Old Rectory [Nunney] DS0000016007.V372181.R01.S.doc Version 5.2 Page 18 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. There was a sufficient staff number on duty to meet the needs of people living at the home. Staff are safely recruited to protect people from the risk of harm from unsuitable people being employed to work at the home. Staff receive induction and appropriate training to enable them to work competently in their roles at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At this unannounced inspection there were three staff on duty to care for twenty people with varying degrees of need. The registered manager and the care manager, who assists with the management of the home, both came to the home to assist with the inspection process. The cook was on duty and a member of the domestic staff was seen. The Old Rectory [Nunney] DS0000016007.V372181.R01.S.doc Version 5.2 Page 19 The duty rota was displayed in the office. At night there is a waking member of staff on duty and the Registered Manager or the care manager are ‘on-call’ for emergencies or ‘if required’. People spoke highly of the staff and management. We heard that ‘they are all very nice’ ‘very good’ and ‘good humoured’. We heard that staff are available when needed and no concerns about staff numbers or availability were raised. Staff were spoken with, they confirmed having had a criminal record bureau (CRB) check and references taken up before they started working at the home. They confirmed having induction and training which included first aid and manual handling. Staff said they were happy working at the home and opinions of working at the service that were shared included ‘it’s a very good home’ and ‘love it here’. Staff meetings are held, they include some training, at the most recent meeting, staff looked at the role of key working. Staff files were sampled for two more recently employed staff. These demonstrated safe practice, with photographic identification, two references, CRB with POVA First check undertaken before employment commenced. Induction was evidenced and training including fire safety, manual handling, and first aid. Supervision records were seen for these staff and indicated that it is undertaken at three monthly intervals. This needs to be more frequent to meet the six times per year as stated in the care home national minimum standards; this was discussed at the inspection with the care manager. The homes data set submitted to CSCI indicates that the home has fourteen care staff, four have a National Vocational Qualification (NVQ) and four staff will be working towards achieving an NVQ in the coming year. The AQAA indicated that shift patterns had been reviewed to have more staff available at peak times. The AQAA also indicates that infection control training has been introduced and that staff have received training in dementia care and mandatory fire training. The Old Rectory [Nunney] DS0000016007.V372181.R01.S.doc Version 5.2 Page 20 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. The home is well managed. Quality Assurance monitoring needs to be developed. Regular maintenance of the home and equipment is carried out and this is recorded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Old Rectory [Nunney] DS0000016007.V372181.R01.S.doc Version 5.2 Page 21 The home was noticed to have a National Care Standards Commission certificate of registration displayed; this should have been updated to CSCI, a note will be sent to inform the CSCI registration team. The quality assurance at the home remains informal and could be developed. There are staff meetings and staff supervision. The staff supervision is three monthly, this should be more frequent the goal being at least six times per year in line with the National Minimum Standard. The AQAA indicated that Mr Hill listens and responds to any thing any one raises and in it he stated that ‘people are encouraged to speak out quite freely about their likes and dislikes’. The maintenance records for the home were sampled and inspected: The homes electrical installation has been checked in April 2007. The homes fire alarm weekly testing is carried out on a regular basis, was recorded and was up to date. The homes emergency lighting is checked each month. The passenger lift had been serviced on 8/09/08 and the patient Arjo hoisting equipment was serviced on 21/08/08. The Old Rectory [Nunney] DS0000016007.V372181.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 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 X 2 X 3 2 X 3 The Old Rectory [Nunney] DS0000016007.V372181.R01.S.doc Version 5.2 Page 23 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 OP26 Regulation 23(2)(a) (d) Requirement The kitchen must be reviewed for upgrading of the floor covering and damaged drawers in line with any advice taken from the local environmental health officer. Timescale for action 30/11/08 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 OP8 Good Practice Recommendations Care should be taken to ensure that the needs of people living at the home are within the categories of care and expertise of the staff as defined in the home’s statement of purpose. The home should consider establishing quality assurance systems such as residents meetings or service user surveys to seek feedback on the service provided. Staff should receive supervision at least six times each year. Where hand written changes are made to variable dose prescribed medicines staff making the entry should sign DS0000016007.V372181.R01.S.doc Version 5.2 Page 24 2. OP33 3. 4. OP36 OP9 The Old Rectory [Nunney] the MAR and a second competent staff member should sign to confirm the accuracy of the entry. This is recommended as good practice. 5. OP12 The registered person should ensure that social need plans are developed so that activities are provided to meet service users individual needs and interests. The role of the activities organiser should be further developed. 6. OP12 The Old Rectory [Nunney] DS0000016007.V372181.R01.S.doc Version 5.2 Page 25 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 The Old Rectory [Nunney] DS0000016007.V372181.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. 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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