Inspection on 26/10/05 for Guysfield Residential Home

This inspection was carried out on 26th October 2005.

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

Guysfield Residential Home 06/04/09

Guysfield Residential Home 07/04/08

Guysfield Residential Home 26/04/07

Guysfield Residential Home 13/12/06

Guysfield Residential Home 19/05/05

Guysfield Residential Home 07/10/04

Guysfield Residential Home 22/06/04

Guysfield Residential Home 17/12/03

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

CARE HOMES FOR OLDER PEOPLE Guysfield Residential Home Willian Road Willian Letchworth Hertfordshire SG6 2AB Lead Inspector Mr Tom Cooper Unannounced Inspection 26th October 2005 14.50 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 Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 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. Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Guysfield Residential Home Address Willian Road Willian Letchworth Hertfordshire SG6 2AB 01462 684441 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) Guysfield House Limited Karen Julie Darlington Care Home 50 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (50) of places Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th May 2005 Brief Description of the Service: Guysfield was originally a large Victorian house, subsequently sympathetically converted and extended to provide residential care for elderly people. It is situated in the quiet village of Willian, within a few minutes walk of the village amenities and about two miles from Letchworth town centre. The accommodation comprises forty-eight single bedrooms and one double bedroom, all with en-suite sink and toilet facilities, located on three floors. There are two passenger lifts, which serve all three floors. Three lounges, a large central conservatory and two dining rooms are on the ground floor as well as the main kitchen, laundry facilities and the managers office. There is ample car parking space to the front of the property and a large garden to the sides. Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second inspection for the year 2005/6 under the National Minimum Standards for Care Homes for Older People and the Care Homes Regulations 2001. The last inspection was carried out on 19th May 2005. Guysfield is a residential care home, owned and operated by Guysfield House Limited, a subsidiary of Caring Homes Limited. The establishment is registered to accommodate up to 50 people over 65 years of age of both genders, including 8 persons who have dementia. The unannounced inspection took place over one afternoon/evening on a weekday. Discussions were held with service users, visiting relatives and members of staff on duty including the manager, senior care assistants and care assistants. Documentation examined included samples of service users’ care plans, staff recruitment and supervision records, the staff rota, complaints, medication and accident records and some equipment service records. Staff were observed working with service users and a brief tour of the premises was made, including visiting a dozen residents’ bedrooms and the laundry. The inspection indicated that the home was being run smoothly, with contented and well cared for service users and good staff teamwork, lead by the manager. What the service does well: Prospective service users and their relatives have detailed information available to assess the facilities offered at this home. The home’s preadmission process remains satisfactory. The care planning and review process ensures that individual service users’ needs are identified and addressed and regularly monitored. Service users consulted said that they were satisfied with the home and had confidence in the ability of staff to care for them in the way they would wish. Several praised the level of activities available and the quality and variety of the food provided. Service users felt they were treated with dignity and respect, and that staff upheld their privacy. Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 Page 6 The home employs two activities coordinators who with staff support provide a wide range of social and recreational activities service users to participate in as they choose. Contact with family and friends is actively encouraged and supported and visitors spoken with said they were made to feel welcome. A good variety of nutritious food is provided that all but one service user consulted rated highly. Service users are consulted over menu planning. Alternative meals are always available as well as snacks and drinks. The premises are accessible, clean, comfortable, and well presented with smart décor and furniture suitable for the needs of elderly people with restricted mobility. Individual bedrooms are spacious and residents have personalised them with pictures and ornaments to produce a homely effect. The home has an adequate complaints procedure. Most service users spoken with were aware of how to go about making a complaint and felt that the manager and other senior staff would take their views seriously and act quickly to try to resolve any problems. Examples recorded in the complaints file had been dealt with promptly. The home has detailed policies and procedures on the protection of vulnerable adults. The “Whistle Blowing” policy is also available to the staff team. The manager is very aware of the principles involved. The home also follows robust staff recruitment and vetting procedures that should ensure the protection of service users. Staffing levels remain satisfactory. Staff spoken with said that teamwork and communication in the home were good and they felt well supported by the management. The manager is very experienced and well qualified to run the home. What has improved since the last inspection? The kitchen was repainted a few days prior to the inspection. Following a requirement made in the last inspection report to improve the inclusion of the more highly dependent service users in recreational activities, efforts had been made to encourage greater involvement by them as well as introducing more activities appropriate for people with dementia. Individual participation is recorded daily. The manager stated that the percentage of NVQ qualified staff was currently at 25 , having been as high as 50 earlier in the year before several qualified staff left the home. Six staff were undertaking the NVQ2 course at present. A photograph of each new member of staff is now held on file. Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 Page 7 The home employs a number of foreign staff whose first language is not English. Concern was raised at the last inspection about their ability to communicate effectively, with a statutory requirement made in the subsequent inspection report. On this occasion, discussions with staff on duty and service users indicated that staff were able to communicate in English sufficiently well to work safely together and with residents. The manager said that several staff had been taking English lessons. Therefore the requirement made in the last inspection report to ensure that staff with limited verbal communication skills should not be rostered to work on the same shift has been met. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 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 Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 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 & 5 Information is available to enable prospective service users and their relatives/advocates to determine whether the home would suit them. The home’s assessment and admission process adequately ensures that prospective service users’ needs could be met by the home. Prospective service users and their relatives and friends have good opportunities to assess the care principles and facilities of the home prior to admission. EVIDENCE: It has previously been established that the home has a statement of purpose and a service user’s guide that contain the information required to meet the standard. Service users and relatives spoken with said they had been given a copy of the service user’s guide. Service users’ care plan files examined included contracts of occupancy and full details of pre-admission assessments undertaken by a senior member of staff. Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 Page 10 Service users and staff consulted said that prospective service users and their relatives/friends generally visited the home prior to admission. They would spend time looking around, speaking to other service users and would be offered a meal. The new resident is admitted for a trial period to enable mutual assessment by service user and staff. A review meeting is held at the end of the trial period involving the service user, relatives and social worker (where applicable) and if all are agreed the placement is finalised. The trial period can be extended if considered appropriate. Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 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 Service user care plans are in place detailing individual health, personal and social care needs and are regularly updated. Service users are involved in care planning. Staff continuously monitor service users’ health and well being and record individual progress. The home has sound medication policies and procedures that should protect service users. However staff must improve the recording of medicines administered to service users as many gaps were found on MAR sheets. Service users feel secure in the home and feel that staff treat them with respect and promote their privacy. EVIDENCE: The individual needs of service users, including health, personal and social care are identified on care plans, with instructions to staff on how to proceed. Care plans seen had been reviewed and updated monthly. Service users and where possible relatives participate in the process. Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 Page 12 Each resident is registered with a local GP who visits as and when required. District and community nurses visit frequently and their input is well documented. Outside health professionals are involved as appropriate, including nutritionist, dentist, optician, audiologist, chiropodist and community psychiatric nurses as required. Service users spoken with felt that staff were alert to their day to day condition and quick to address any health problems. Medication is securely stored and there are sound policies and procedures in place for handling, administration and recording, that properly operated would ensure that service users remained safe. All areas of medication practice examined were satisfactory except for the recording of individual medicines administered to service users. Numerous gaps were found on the medication administration record (MAR) sheets. It was also of concern to note that some items of medication had not been given because the supply had run out. This is clearly unacceptable and suggests a flaw in stock monitoring and re-ordering procedures. The manager had recently arranged for the staff responsible for administering and recording medication to receive refresher training from the supplying pharmacist therefore it was disappointing to discover such lax performance. The GP’s prescriptions must always be followed and accurate records must be kept (see requirements). The home has appropriate policies and procedures covering maintaining dignity and respect for service users. Observation of staff at work, feedback from service users and three visitors and commentary in care plan files demonstrated that residents were being treated in accordance with the company’s policies. Service users said that staff always knocked and waited at their bedroom doors before entering. Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 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 & 15 Staff ensure that service users have good opportunities to take part in stimulating and therapeutic recreational activities. Service users can maintain contacts with relatives, friends and are supported by staff as appropriate. The home has good links with the local community. Service users receive a well balanced diet that suits their particular tastes and needs. EVIDENCE: Many service users consulted said that they were able to participate as they chose in a variety of activities. Two activities coordinators are employed who between them work full time during the week. A long list of suitable activities was posted on the notice board, including poetry, bingo, chair exercises outside entertainers, a trolley shop, nail care, quizzes and so on. Staff are aware of the need to include the more dependent service users and some activities are organised specifically for residents with dementia, including sensory bags, touch and smell exercises, food tasting and other initiatives. Records are now kept of residents taking part. All service users spoken with expressed satisfaction with the opportunities available. Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 Page 14 The home continues to assist service users to maintain very good contacts with family, friends, representatives and the local community. Strong links are maintained between the home and the Advocacy Service as well as the local school and various religious groups. Visitors are welcome at any reasonable time and may be entertained in any of the communal areas or in service users’ bedrooms according to individual preference. As reported in previous inspection reports service users remain very satisfied in this area and therefore the home has retained its commendable rating. Care plans contain details of individual food preferences and dietary needs. These influence weekly menu planning. Staff said that the catering and care staff members often consult service users for menu suggestions and alternative meals are available to residents if they do not want the dishes on the menu. Mealtimes are seen as social occasions and service users are allowed to eat at a reasonably relaxed pace. Hot and cold drinks are served throughout the day and staff said that snacks are available outside mealtimes on request. Residents interviewed all praised the food provided both for quality and variety. Although the kitchen was not inspected on this occasion, the positive feedback received means the home has retained its commendable rating. Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 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 Information on how to make a complaint is available and service users feel confident that any complaint they make will be listened to and acted upon by the manager. Complaints records show that matters raised are dealt with speedily and satisfactorily. Adult protection policies and procedures are in place that should ensure the safety of service users. EVIDENCE: The complaints procedure is accessible to all staff, who clearly understand their responsibilities regarding any complaints received. The procedure is also included in the service user’s guide given to all residents. Service users and visitors spoken with said that they were confident that any complaint they made would be sympathetically received and acted on quickly by the manager. The complaints file contained details of three complaints made to the home since the last inspection in May 2005. The documentation available indicated that the manager had responded to them appropriately and promptly, providing outlines of any remedial actions taken. The home has comprehensive procedures on the protection of vulnerable adults, including a “Whistle Blowing” policy available to staff. The manager demonstrated a clear understanding of the above procedures. Most staff have received training on the protection of vulnerable adults, a subject also covered on the NVQ 2 course being undertaken by Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 Page 16 several members of the team. The systems in place should adequately protect service users. Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected 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 The premises are safe, comfortable and well maintained, providing a suitable environment for elderly service users who may have restricted mobility, some sensory loss and other factors associated with advanced old age. Various well appointed communal areas are available to service users, providing them with a good choice of where to spend time. Bathroom and toilet facilities are sufficient and suitable for the needs of service users. Special equipment is provided as necessary that ensures the safety and mobility of service users. Service users’ bedrooms are spacious and personalised to suit individual needs and preferences. Heating, lighting and ventilation are adequate, creating a comfortable and safe environment for service users. Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 Page 18 The home is clean, pleasant and hygienic, and kept free from unpleasant smells. Laundry facilities are well organised. EVIDENCE: The building is suitable for the needs of elderly service users, with wide corridors and doorways. There is a suitable fire detection and alarm system that meets the requirements of the fire and rescue service. There is a rolling programme of maintenance and redecoration and this ensures that good standards are maintained throughout the home. All areas seen were smart and well presented. The various lounges and the central conservatory are decorated in subtle tones that reflect light and produce an airy, homely effect. Furniture and fittings are comfortable and suitable for the use of people with restricted mobility. The gardens are maintained well and provide a useful amenity for service users in fair weather. Suitable equipment is provided such as bath hoists, grabrails, toilet adaptors, zimmer frames and so on that ensure the safety of individuals and help to sustain their independence. All bedrooms bar one are singles. All the space standards are met. Bedrooms seen were well appointed, with staff-call alarms and suitable furniture and lighting, and personal items to suit the individual occupant. All bedroom doors are fitted with locks. Central heating radiators are covered to prevent burns. Windows can be opened by residents. Hot water temperatures are controlled within safe limits to prevent scalding. All areas viewed were clean and tidy and free from unpleasant smells. The home has health and safety and infection control policies and procedures in place, which are known to staff members. Suitable arrangements are in place for the storage and collection of domestic and clinical waste. Laundry facilities are sited well away from the kitchen and are adequate to cope with the workload created by fifty residents. The washing machine has a sluice cycle. Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Staffing levels and deployment are satisfactory to meet service users’ needs. Although at present the home does not have 50 NVQ2 qualified care staff, training is ongoing to restore the required proportion. The home has rigorous recruitment and staff selection policies and procedures that protect the interests of service users. The home’s induction, supervision and ongoing training policies ensure that staff are adequately trained and competent to do their jobs. EVIDENCE: Examination of the staff rota, and discussions with the manager, staff and service users indicated that day and night care staffing levels were adequate to care for the current service users in the home. Normally, seven care staff are deployed on each day shift. Sufficient ancillary staff are provided for catering, laundry and housekeeping. The home has rigorous procedures for the recruitment, induction and training of staff members. The recruitment files for the last two employees were viewed. These contained all the information and documents required by regulation including photographs, Criminal Records Bureau disclosures and references. Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 Page 20 Mandatory training in moving and handling, fire safety, first aid etc is ongoing. The manager stated that at the time of the inspection approximately 25 of care staff were at least NVQ2 qualified, the home having previously achieved the 50 standard whereupon several qualified staff left. Six staff were currently undertaking the NVQ2 course and the manager was optimistic that the standard would be met again in the future. A minimum ratio of 50 of the care staff team should achieve NVQ level 2 or equivalent by 2005 (see recommendations). Following a requirement made in the last inspection report to address the communication abilities of some of the foreign staff employed at the home, some individuals had attended English classes. It was also recommended that poor English speakers should be deployed in restricted numbers on shift to reduce the likelihood of communication problems. On this occasion no communications problems were evident, with all staff approached able to speak adequate English and no concerns raised by service users or visitors. The manager was confident that staff deployment was satisfactory. The evidence of induction and ongoing training for staff, coupled with the staff/resident interaction observed, supported the conclusion that staff were competent to care for service users. Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 36 & 38 The manager is experienced and well qualified to manage the home and provides strong leadership consistent with the ethos of the home. Staff are adequately supervised and supported by more senior staff to ensure that the aims of the home are met. All records required by regulation are maintained satisfactorily, except for the records of medication administered to service users. The home has a health and safety policy and safe work practices are followed. Maintenance records and risk assessments are completed, with control measures taken as necessary to ensure that the health, safety and welfare of service users and staff are safeguarded. EVIDENCE: Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 Page 22 The Manager is a qualified nurse, has relevant management experience in the nursing and residential care fields and has been a registered manager for eight years. Most recently she has achieved NVQ4 in management and care. She is therefore very well qualified to manage the home. The lines of accountability within the home and external management are clear and well understood by staff. Staff interviewed confirmed that they receive one to one supervision from the manager, albeit on a slightly irregular basis. The inspector discussed the possibility of spreading supervision responsibilities across the senior team to make it more practical to achieve the standard of six sessions per year for all care staff. All staff spoken with said they felt well supported by management and found the manager approachable. A generally high standard of record keeping was found. However, as reported elsewhere in this report numerous unexplained gaps were found on MAR sheets, therefore a requirement has been made. The home has good procedures to ensure the health and safety and welfare of service users and staff. Mandatory training is provided as appropriate e.g. fire safety training. Accidents and incidents occurring are recorded, with any follow up action taken recorded. Hot water temperatures are monitored regularly to ensure they remain within safe limits (close to 43 degrees Centigrade at outlets). Windows have been fitted with restrictors for the safety of service users and security of the building. Portable electrical appliances are checked, tagged and a record maintained. COSHH records are held and all hazardous substances are kept locked away. No health and safety hazards were noted at this inspection. Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 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 3 3 X X X 2 2 3 Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 Page 24 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 OP9OP37 Regulation 13(2) 17(1)(a) Requirement Accurate records of medicines administered to service users must be kept on the medication administration record sheets. Each dose administered must be signed for by the responsible member of staff. All noncompliances with the GP’s prescription must be explained in writing on the MAR sheet. Timescale for action 26/10/05 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 OP28 OP36 OP38 Good Practice Recommendations NVQ training for care staff should be continued so that a minimum ratio of 50 of the care staff team achieve NVQ level 2 or equivalent. All care staff should receive one to one supervision six times per year. The manager should delegate some of the responsibility to other members of the senior team. The manager should place copies of accident record forms together in one file held securely to facilitate the regular DS0000019399.V259548.R01.S.doc Version 5.0 Page 25 Guysfield Residential Home monitoring process. Guysfield Residential Home DS0000019399.V259548.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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. 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