Inspection on 14/06/06 for Florence House (Ramsey)

This inspection was carried out on 14th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Florence House (Ramsey) 04/07/08

Florence House (Ramsey) 17/07/07

Florence House (Ramsey) 12/12/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Florence House (Ramsey) Westfield Road Ramsey Cambridgeshire PE17 1JR Lead Inspector Shirley Christopher Key Unannounced Inspection 14th June 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Florence House (Ramsey) DS0000065311.V298242.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. Florence House (Ramsey) DS0000065311.V298242.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Florence House (Ramsey) Address Westfield Road Ramsey Cambridgeshire PE17 1JR 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) 01487 812295 Alfonsa Jenita David Alfonsa Jenita David Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (13), Physical disability (1) of places Florence House (Ramsey) DS0000065311.V298242.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user under 65 years with physical disabilities (PD) for the duration of their residency 12th December 2005 Date of last inspection Brief Description of the Service: The property and ongoing business was sold in November of 2005 to Mr and Mrs David, having previously been registered as a care home. Mrs David is the registered manager and is supported by her husband, who is a businessman and manages the financial accounts and the maintenance of the home. They are currently living in private accommodation situated within Florence House, so are available to provide on going support to staff and residents. Accommodation is provided for up to fourteen service users over the age of 65. All the bedrooms are single and three have en-suite. The majority of bedrooms have external doors opening on to a terraced patio. There is a dining room and separate lounge. The home benefits from a large kitchen and generous outside space. The house is situated in a quiet residential area, which is accessed by a private road and is close to the town of Ramsey. The manager stated that the current fees were £370.00 to £395 a week. The difference in fees is because some have en-suite. Extras are charged for items of a personal nature, such as toiletries and chiropody. A small amount of personal allowance is kept on behalf of residents. Florence House (Ramsey) DS0000065311.V298242.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Mr and Mrs David currently live on the premises, in separate upstairs accommodation. They were both present during the inspection. The home was maintained to a high standard of decoration and cleanliness. There were two care staff on duty, who were only spoken to briefly, because they were busy throughout the morning assisting residents with personal care. Mr and Mrs David, a full time cook, and a domestic were also on duty. An activities officer is also in post but she was on annual leave at the time of the inspection. Most of the residents were at home on the day of the inspection and spoken to in the lounge and over lunch. Most were able to comment about different aspects of the home and comments were favourable. No relatives were met during the course of the inspection, but a number of resident/relative feedback forms were returned before and after the inspection. These made positive comments about the home. A number of records were inspected and the findings are summarised in the relevant sections of the report. The manager enclosed a pre inspection questionnaire, which is also cited as evidence in this report. The home appears to be well managed and evidence of good record keeping was seen. Many of the residents are from the local area and some had specifically asked to go to Florence House because of its good reputation locally. The owners are actively involved in the service and pay close attention to detail. They are in discussions with the architects to increase the size of the home by a further ten beds. This still makes the home a relatively small service. What the service does well: Residents were observed relaxing in the lounge and in the dinning room, where they were enjoying home cooked food in a congenial setting. The home itself provides ample communal and individual space and is set in pleasant grounds. Residents’, who are able to go outside safely, can enjoy the garden and all the residents have patio doors leading out onto the garden. There is a low turn over of staff and most of the staff employed are from the local area and are happy to pick up extra shifts when necessary. This means the home does not need to rely on agency staff to cover vacant hours. Florence House (Ramsey) DS0000065311.V298242.R01.S.doc Version 5.2 Page 6 Care plans gave a good indication of what the residents needs were and how they should be met and there was evidence of regular review. What has improved since the last inspection? What they could do better: The home must ensure that they are able to meet residents’ needs at the point of admission. It was recognised that some residents needs have changed, after they have been at the home for some years. The home are not registered to provide dementia care and where someone has a formal diagnosis of dementia as assessed by a psycho geriatrician they must apply for a variation to the homes main certificate of registration, or consider if they would like dementia as a permanent category for a limited number of beds. Changes in residents’ dependency levels must be recognised and staffing levels must be reviewed accordingly. On the day of inspection, care staff were busy assisting residents with personal care and the interaction and supervision of residents appeared limited to meal times and when drinks were being served. Risk assessments must be improved, as care plans and daily notes indicated potential risks or changes in behaviour for which risk assessments had not been put in place. Florence House (Ramsey) DS0000065311.V298242.R01.S.doc Version 5.2 Page 7 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. Florence House (Ramsey) DS0000065311.V298242.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 Florence House (Ramsey) DS0000065311.V298242.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5,6 Quality in this outcome area is ‘good’. This judgement has been made using available evidence including: The pre inspection questionnaire, discussion with the manager, residents and looking at pre admission assessments and contracts. This is a small home, which benefits from a low staff turnover and staff quickly become familiar with residents needs. These needs are met comprehensively, but the home must not admit outside its main category of registration and staffing levels must be kept under review. EVIDENCE: The home is registered to provide residential care for people over 65. They have one person under 65, for whom they have a variation to their main category of registration. At least one person had a formal diagnosis of dementia, but has lived at the home for many years, and was admitted with dementia. A further resident has been admitted to the home outside its main category of registration. The home must describe the range of needs it is able Florence House (Ramsey) DS0000065311.V298242.R01.S.doc Version 5.2 Page 10 to meet within its statement of purpose and if they are going to accommodate residents with dementia, they must be registered to do so. The manager confirmed that the statement of purpose and service user guide has been updated recently. The last inspection report is displayed just outside the lounge on the notice board, which is also used to display other useful information. A number of residents confirmed that they were able to look around the home and come in on a trial basis before their permanent admission, but in practice a number of residents already had some knowledge of the home, and came from the surrounding area. Pre admission assessments are completed before new residents are admitted and their needs are kept under review. Needs are met in consultation and involvement of other agencies, but staffing levels must also reflect the level of needs. Most residents are categorised as having a low level of need, but this can quickly change throughout their period of residency. Contracts were seen and were satisfactory. Florence House (Ramsey) DS0000065311.V298242.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is ‘good’. This judgement has been made using available evidence including: Discussion with staff, residents, observation, resident/relative feedback forms and an inspection of a number of care records. Residents’ records give a good indication of how the residents needs should be met and these needs are kept under review, in consultation with the residents and other agencies. EVIDENCE: Residents spoken to were happy about different aspects of the home. The care documentation is generally very good. Daily notes are written and clearly illustrate changes in residents’ needs. These changes do not always result in the care plan being updated, or a risk assessment being put in place. It is not always practical for care staff to go back through the daily notes and these could be summarised monthly. Issues described in the daily notes include an increase in wandering, ‘aggressive behaviour’, and refusal of medication. It was not clear from the records of how care staff are expected to deal with these issues, although other professionals have been consulted. A clear care Florence House (Ramsey) DS0000065311.V298242.R01.S.doc Version 5.2 Page 12 plan/risk assessment would benefit new, or temporary staff. Care plans describe resident’s needs, preferred routines, likes and dislikes. Manual handling assessments and a falls assessment were in place. Evidence of a consultative approach to health care was seen. The home are well supported by a local GP surgery, and district nurses visit the home regularly. Evidence of medication, GP and community physiatrist reviews were also seen. Evidence must be provided of how falls are monitored and the steps put in place to minimise risks. This was not clear from records seen. Poor weight recording was noted at the last inspection and this was still the case for at least one file inspected. It was encouraging to see that residents are consulted about their plan of care and this is recorded even when it is felt a resident is unable to participate. Staff explain the process of review. Medication was observed as it was administered at lunchtime. This was done appropriately. The staff member confirmed that she had completed the safe handling of medication. Evidence was seen on the staff files inspected that the majority of staff had received appropriate training. It was noted whilst walking around the home, that some cream prescribed for individuals for external use, was left unlocked in communal bathrooms. This is unacceptable. Last wishes are recorded on residents’ files. A number of staff have identified ‘bereavement/palliative care’ as a training need. Some training has recently been provided. Florence House (Ramsey) DS0000065311.V298242.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is ‘good’. This judgement has been made using available evidence including: observation, discussion with the manager, residents and through records and resident/relative questionnaires. Care staff understand the social care needs of residents and the home facilitates these, through the employment of a member of staff who specifically provides activities and through engaging other groups in the community. EVIDENCE: The home employs an activities coordinator two afternoons a week. She provides a structured activity plan and is well qualified and held in high esteem. The hairdresser visits weekly and there is a religious service monthly. Some residents spoken to stated that they go out independently, or with relatives/friends. One person said she does not go out, as much as she use to as she needs assistance. The manager stated that in recent months there has been a mobile clothes shop visiting. There have also been visits from the Beavers and Scouts and the manager is looking into a number of volunteers, students and children on work placements visiting. This must be subject to appropriate checks being in place. The manager said that more able residents are able to do some gardening. Most residents felt that there were sufficient activities in the home. One resident attends a local day service and another Florence House (Ramsey) DS0000065311.V298242.R01.S.doc Version 5.2 Page 14 lady has recently stopped going because she was said to prefer the in-house activities. The activity file includes records entitled up close and personal, which give a brief social history, likes, dislikes and interests. Activity records state what has been provided and who joined in. It would be good to see information about residents’ family tree and past history developed further as some of the information recorded was very basic and did not really address their social needs. Throughout the inspection there was limited evidence of social interaction between staff and residents. Residents sat for long periods of time in the lounge unoccupied. The inspector was told that more activities are provided in the afternoon, but there is only one care staff on duty in the afternoon. This increases to two early evening. No relatives were met on this occasion but residents confirmed that relatives are always made welcome. Regular consultation takes places with relatives, but this is informal. The manager had suggested introducing a suggestion box. The cook was spoken to and has been employed at the home for many years. The premises were clean and appropriate records were being kept. The menus were displayed and offered some choice. The food is home cooked and the meal was observed being served up to residents. There was little wastage, but the inspector felt the quantity of food may be insufficient, should anyone want a second helping. Home made cakes and puddings are made and there was fresh fruit in the kitchen. A numbers of residents were observed as having cold drinks in their bedrooms. Florence House (Ramsey) DS0000065311.V298242.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is ‘good’. This judgement has been made using available evidence including: The pre inspection questionnaire, the complaints procedure and staff files. The home has adequate policies and procedures in place for addressing complaints and adult protection issues. EVIDENCE: The home has adequate policies and procedures in place, which are accessible and staff have had training on adult protection issues. There have been no written complaints since the last inspection, but the manager is proactive in discussing any concerns relatives or residents have and dealing with them straight away. Lots of compliment cards were seen. Florence House (Ramsey) DS0000065311.V298242.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 Quality in this outcome area is ‘excellent’. This judgement has been made using available evidence including: A tour of the home, comment cards completed by residents/relatives and the pre inspection questionnaire. The environment is appropriate for need and is homely, comfortable and well maintained. EVIDENCE: The home is purpose built, on one level and all bedrooms are single, some have en-suite facilities. A number of bedrooms were inspected and were pleasantly furnished, with lovely views and were light and airy. Extremely high standards of cleanliness and maintenance are observed and the home employ a number of domestic staff, who have received appropriate training and are very much part of the team. The lounge is comfortable and chairs were appropriately arranged. Information is provided around the home, indicating what the day is, what the menu is and what activities are available. Newspapers and books are provided. Florence House (Ramsey) DS0000065311.V298242.R01.S.doc Version 5.2 Page 17 The external grounds are attractive, well maintained and secluded. They are easily accessible from residents’ bedrooms. There is ample parking. The home has three toilets and two bathrooms, which are domestic in style with no specialist equipment, other than portable hoists. Gloves and liquid soap were seen in toilets and bathrooms, but it was noted that hand towels are being used instead of paper towels. This is of a concern because of spreading infection from one person to another. The other issue identified was creams for external use being left in bathrooms and toilets. These must be locked away. Florence House (Ramsey) DS0000065311.V298242.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is ‘good’. This judgement has been made using available evidence including: Inspection of staff files, resident/relative comment cards, the pre inspection questionnaire and staff rota. The home benefits from a relatively low turn over of staff, and staff were generally held in high regard. EVIDENCE: The home has no staffing vacancies and do not rely on agency staff. There is a core team of local staff who cover any vacant hours. Mr and Mrs David also provide a lot of support to staff and Mrs David is involved in the assessment and review of residents needs and provides regular staff support. Mr David plays and active role in maintaining the environment, and keeping maintenance and finance records up to date. Staffing levels have been discussed throughout the report. There are two care staff on in the morning and evening and one in the afternoon and night. This must be reviewed according to the dependency levels of residents, (currently most are described as low dependency.) Mrs David did state that where residents are ill or require one to one, additional staff will be provided. There is a full time cook, and domestic staff. It was noted that all staff took their break at the same time, this included care and domestic staff. The residents were left Florence House (Ramsey) DS0000065311.V298242.R01.S.doc Version 5.2 Page 19 unsupervised and one resident in particular was walking in and out of the kitchen. Evidence was seen of regular staff supervision, which has recently been introduced, regular staff meetings and the introduction of annual staff appraisals. Supervisions include identifying training undertaken and training still to be provided. There is also a practical element to supervision, where care staff are observed performing care tasks, such as ‘administering medication,’ and a summary of their performance is assessed. Two staff files were inspected and were satisfactory. All the pre requisite checks were in place before the employment of new staff. On a second staff file, although there were two references in place, one gave very limited information and the referee often put unable to comment. In this instance it would be good practice to take up a third reference. Evidence of induction was seen on some files and particularly for new staff, a very basic induction was seen. The manager confirmed that a full induction is provided and is linked to TOPPS, (Skills for care.) Interview notes are kept. One lady had a gap in her employment history and no written explanation for this was seen. The manager confirmed that most of the training is up to date, but staff have identified particular training needs including: dementia care and bereavement issues. Some gaps in mandatory training was identified including first aid, food hygiene and moving and handling, The manager confirmed that recent training had been undertaken and included: bereavement, infection control, POVA, moving and handling, fire training, medication and NVQ is ongoing. Individual training files should be updated. Future training will includes health and safety, dementia, nutrition and communication. Florence House (Ramsey) DS0000065311.V298242.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37 Quality in this outcome area is ‘good’. This judgement has been made using available evidence including: A tour of the home, discussion with manager/owners, an inspection of some maintenance records, the pre inspection questionnaire and residents finances were inspected, (2) Servicing records are kept up to date and the home is maintained and cleaned to a high standard. The home has systems in place to review the quality of its care provision. EVIDENCE: The manager is suitably qualified and appears to be doing an excellent job. She manages by example and is pro active in the home. Both her husband and herself are currently living at the service and there is an on call procedure in place. There is a senior care worker in post, who has a wealth of experience and expertise. Florence House (Ramsey) DS0000065311.V298242.R01.S.doc Version 5.2 Page 21 The manager completed a pre inspection questionnaire and in this indicated that all the relevant policies and procedures are in place, most have been reviewed recently. The questionnaire also indicated that the maintenance records are up to date. Some of these were inspected including: fire-servicing records, water temperatures, gas safety records and a recent health safety report. Portable appliance testing was due for renewal this month. A copy of the environmental health inspection, report dated November 2005 was seen and was satisfactory. A tour of the kitchen was satisfactory and records of food and fridge/freezer temperatures were seen. The manager confirmed that she has circulated questionnaire to residents asking for their comments on the standards of care at the home. Ten had been returned and were complimentary. The manager was asked to consider introducing cards for relatives to complete and a space on the questionnaires for free text. Staff are well supported through a good supervision and appraisal systems. The manager was asked for audited accounts, but these were not available as the owners have not been at the home for a year yet, but evidence of their financial viability was seen at the point of registration. They confirmed that they remain financially viable and only had one current bed vacancy, due to a recent hospitalisation. A small amount of money is held on behalf of residents and finances were properly accounted for with receipts being kept and issued to families. The inspector questioned the homes fire policy, which spoke of investigating the fire and then evacuating where necessary. The policy should be reviewed with the fire officer and risk assessments for each resident reviewed, as some of the residents no longer live in the home and it may not be realistic for staff to evacuate residents. This responsibility may be best left up to the fire authorities, particularly when there is only one member of staff on duty at night and would be needed to provide information to the fire office and not put them-selves in danger by trying to evacuate residents. Accident records were seen, but there was little evidence that falls are monitored or staff have received training in this area, although the senior care worker has. This should be extended to all staff. A number of risks were identified whilst going through residents daily notes and care plans, but risk assessments are not always implemented. One example was a resident who was leaving the patio door open at night. The action taken was to remove the key. This in itself would pose a risk and an assessment should have been completed. Some residents are prone to wandering and there was documented evidence of some residents being uncooperative with different aspects of care. Although care staff seemed to be able to manage this and adopted similar approaches it was not clearly documented. Florence House (Ramsey) DS0000065311.V298242.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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 3 3 3 3 3 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 4 3 3 3 3 3 3 3 Florence House (Ramsey) DS0000065311.V298242.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 OP4 Regulation 18(1)(a) Requirement The home must be registered to meet ‘specialist need’ and demonstrate that staffing levels and staffs skill mix is adequate to meet residents’ needs. Residents’ health must be promoted through regular weight records and appropriate nutritional screening. Particular attention must be paid to the management of falls and any activity, which may be put residents at risk, or where staff may need clear guidelines to manage a particular behaviour. Medication must be stored according to the prescriber instruction and cream prescribed for external use must be locked away. Systems must be in place, to the control the spread of infection. Communal hand towels are not appropriate. Fire risk assessments and the fire procedure must be reviewed and the fire officer consulted. Timescale for action 30/07/06 2. OP8 12(1)(a) 30/07/06 3. OP9 13(2) 30/07/06 4. OP26 13(3) 30/07/06 5 OP38 23(4)(iii) 30/07/06 Florence House (Ramsey) DS0000065311.V298242.R01.S.doc Version 5.2 Page 24 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 OP12 Good Practice Recommendations Social histories/life stories could be developed further as records in the home were quite basic for some residents. Florence House (Ramsey) DS0000065311.V298242.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE National Enquiry Line: 0845 015 0120 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 Florence House (Ramsey) DS0000065311.V298242.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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