Inspection on 20/07/07 for Lakenham Residential Home

This inspection was carried out on 20th July 2007.

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

Lakenham Residential Home 06/03/09

Lakenham Residential Home 04/02/09

Lakenham Residential Home 12/07/06

Lakenham Residential Home 18/01/06

Lakenham Residential Home 02/08/05

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Lakenham Residential Home Lakenham Residential Home Lakenham Hill Northam Bideford Devon EX39 1JJ Lead Inspector Andy Towse Key Unannounced Inspection 11.30 19 and 20th July 2007 th 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 Lakenham Residential Home DS0000062626.V337528.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. Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lakenham Residential Home Address Lakenham Residential Home Lakenham Hill Northam Bideford Devon EX39 1JJ 01237 473847 01237 470790 cordelia.murphy@Hotmail.com 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 Timothy Oliver Murphy Mrs Cordelia Wai-Yu Murphy, Mr Christopher Charles Hampton, Miss Siobhan Catriona Hampton Mrs Cordelia Wai-Yu Murphy Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Lakenham Residential Home is a care home registered for 28 beds, providing personal care for service users in the category of old age (OP). The building is a detached former residence of the Duchess of Manchester and is situated on a large corner plot in the Northam area of Bideford. The home is sited in extensive well-kept grounds and has glorious sea and coastal views. Accommodation is provided on four floors and the home is extremely spacious with several large communal, reception and meeting areas. The home also has a Chapel on the ground floor of the home. The majority of rooms are single and en-suite, although two shared rooms are available if required. The home is accessible to all areas via a large, modern passenger lift. A copy of the previous CSCI inspection report was on the main notice board making it available to staff, residents, their relatives and any other visitors to the home. Fees charged range from £390.00 to £525.00 with additional charges being made for chiropody, hairdressing, newspapers and magazines and clothing. Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. It took place over a period of two days with the involvement of two inspectors. Information contained in this report was obtained from an assessment completed by the registered manager prior to the inspection, and information obtained during the course of the inspection from discussion with residents, staff and visitors. The inspection also included a site visit, a tour of the premises, observation of interaction between staff and residents and care practices, as well as the examination of records, including care files and some policies and procedures. What the service does well: What has improved since the last inspection? What they could do better: The medication procedure could be improved by ensuring that the medication administration record sheets are updated when a dosage is changed. Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 6 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. Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 7 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 Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 8 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): 3, 5 and 6 Quality in this outcome area is good. The home operates an appropriate admissions procedure which ensures that information on residents is obtained prior to their admission to the home. needs. Prospective residents are invited to visit the home as part of the admissions procedure allowing them to make an informed choice about whether to move in or not. This judgement has been made using available evidence including a visit to this service. Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 9 EVIDENCE: The home has a written admissions procedure. The registered manager is responsible for coordinating the admission of residents. In discussion the registered manager said that prospective residents and/or their relatives were invited to visit the home and wherever possible the registered manager visited the prospective resident at their home or, if applicable, in hospital. The files relating to three residents were examined. Whilst on the first day of the inspection assessments compiled by the registered manager could not be found, they were available on the second day of the inspection, confirming that assessments were made by the registered manager, of the needs of prospective residents and whether these could be met by the home. At the previous inspection information relating to these visits had been kept on notebooks, it is now retained on formatted sheets. Files were also seen to contain information from either social services personnel or from healthcare professionals. These included hospital discharge forms, nursing referrals, care plans outlining the needs of the resident compiled by social workers, and shared assessments compiled by both social services and healthcare staff. One file contained information from another establishment where the person had previously resided. This information was available together with information from the pre admission visit by the registered manager. Discussion at the time of the inspection did centre around whether the home was able to meet this resident’s needs and the need for specialist advice which could have been used when consideration was being made about admitting this resident. Discussion with a relative confirmed that he/she had visited the home, as part of an admission process, to assess that it would meet the needs of their relative. Lakenham Residential Care Home does not offer intermediate care. Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 10 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 and 10 Quality in this outcome area is good. Residents’ needs are set out in regularly reviewed care plans. Records and discussion showed that residents’ healthcare needs are met. Discussion with staff and residents confirmed that residents are treated with respect. The systems in place for the administration of medicines is adequate but systems need further improvement to prevent putting residents at unnecessary risk of harm. This judgement has been made using available evidence including a visit to this service. Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 11 EVIDENCE: The files of four residents were examined. All contained care plans. Care Plans outlined the needs specific to that resident and the action planned to meet them. There was also space on the care plan for comments to be made regarding and progress made or specific input required in addition to that included in the ‘planned action.’ The home operates a key worker system. This means that certain staff have designated responsibilities for specific residents. Two key workers were spoken to and were able to describe the responsibilities related to being a key worker. Care Plans are compiled by the registered manager. Where the resident had been involved in drawing up the care plan, these had been signed by the resident. In one instance where the resident lacked capacity the care plan had been seen by a relative who had signed to acknowledge agreement with its contents. The key worker also spoke about residents being involved in the reviews of their care plans. Examination of records showed that the home has regular contact with healthcare professionals. There were entries showing visits by district nurses and some residents had care plans drawn up by district nurses. Other entries on files referred to relative taking one resident for an opticians appointment and another having an appointment at a dentists. Another resident’s file had reference to psychiatric support which could be available again if required. Residents spoken to said that a member of the senior staff accompanied them on visits to the doctors or hospital. The home was seen to have the necessary equipment for supporting residents who had pressure sores and records showed success in working with one such resident who had arrived at the home with pressure sores. The medication procedures and records were looked at. Medicines are appropriately signed into and out of the home and a Monitored Dosage System (MDS) is supplied by a local pharmacy. Medicines which are prescribed externally, for example creams, are routinely ticked on the Medication Administration Record (MAR). We discussed keeping these records of creams in the resident’s own bedrooms so that staff can actually sign the record when they apply cream and sign and date when this took place. Creams and eye drops have a date of opening recorded on them. The medication recording was generally satisfactorily, with signatures of medications given. However, we saw that some medications had been given at a different time to that prescribed and that some medication had been given at a different dosage to Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 12 that prescribed. had happened. There was no clarification on the MAR chart showed why this Appropriate records were kept for controlled drugs and stock was stored and recorded correctly. A dedicated locked medicine fridge is used for those medications requiring cold storage. Only senior care staff dispense medication to residents in the home and all have undertaken suitable training. The home does not currently have any residents who self-medicate, with the exception of one resident who gives her own insulin with the assistance of staff. We discussed the subject of self-medication and the correct procedures and records that needed to be maintained and reviewed. Some records relating to medication are held in different places and we discussed with the owner/manager that keeping all these records in one place would provide a clear audit trail. The owner/manager agreed with this. Staff spoken to were able to give examples of how they respected residents’ rights to privacy and dignity. Files were seen to contain information about the term of address favoured by each resident. Staff were seen to knock on bedroom doors prior to entering and to talk respectfully to residents. Lakenham Residential Home DS0000062626.V337528.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 and 15 Quality in this outcome area is good. Residents benefit from the home offering varied activities throughout the week. Residents benefit from the home’s policy of welcoming visitors. The home offers its residents a menu which they enjoy and have agreed to look at ways of offering more choice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home offers its residents various activities on a daily basis. Residents confirmed that they had enough activities to meet their needs. Information supplied by the registered manager showed that residents had been consulted about what activities they wanted and as such. Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 14 Residents said that they were happy with the activities offered at Lakenham. Some went to a pantomime in Barnstaple over Christmas. Different activities are offered on different days. On Tuesdays residents can participate doing activities which include drawing, and arts and crafts, which includes making crafts for different occasions. One resident commented, regarding drawing, ‘I never thought l would like it but I do.’ On the day of the inspection residents were seen participating in musical movement and stretching exercises. This was organised by an outside professional brought in by the home. Residents were enjoying this and some were enabled to participate with support from staff. On Wednesday, bingo in arranged. Information supplied by the registered manager showed that this activity was arranged after residents had been consulted about activities they would like organised. Residents enjoy this activity and win prizes such as sweets/chocolates and toiletries. Several residents commented that they like walking outside to sit on a nearby bench in the grounds and enjoy the sea views. They said that they were always accompanied by a member of staff. The home’s ‘Statement of Purpose’ refers to encouraging residents to maintain social contacts and that there are no fixed visiting times. Residents confirmed that they could receive visitors when they wanted and a visitor confirmed that visiting times were flexible and that he/she was always made welcome. Another resident spoke about having ‘lots’ of visitors, who were made welcome and offered refreshments by the staff. Residents are encouraged to be as independent as they are able. Some residents have had telephones installed in their rooms and many manage their own financial affairs. Three residents were asked about the food available at Lakenham Residential Care home. All said that it was good. Residents enjoyed their food at mealtimes which were observed to be friendly and relaxed. Residents who required support were offered it in a discrete, helpful and respectful manner. The size of portions reflected individual appetites. Food was well presented, with residents being asked how many and what type of vegetables they would like and later, staff going round offering additional food if it was required. Whilst most residents chose to eat in the dining room, some chose to eat in their rooms. Discussion with one resident confirmed that it was his/her choice to have all meals in his/her room. All residents spoken with and in surveys said they were happy with the food served and one resident said that on one occasion last week she was offered ‘a Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 15 choice of 6 vegetables’ in one meal. Residents said they were happy with choice of meal offered and one said the food was ‘ample and varied’ and that they enjoyed traditional meals but also other food which was offered, such as curry. Discussion showed that the food shopping is done twice weekly by the owners who go to the local supermarket and hand pick food. The home always has fresh vegetables and a roast meal every week. The likes and dislikes of individual residents are well known and alternatives are offered. The kitchen was seen to be very clean and well organised. Residents commented that they have a lot of eggs. This was discussed with owner/manager who said that this was inherited from previous homeowner. No other variation was offered. Breakfast served consists of cereal, toast and boiled, poached or fried eggs. We discussed the idea of offering alternative cooked breakfasts such as sausage/bacon occasionally and the owner/manager thought this a good idea and would ask residents if they would like to have this offered. Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 16 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 and 18 Quality in this outcome area is good. The home has a clear complaints procedure of which residents and their relatives are aware. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a written complaints procedure. To ensure that residents and relatives and anyone visiting the home is aware of it, it is prominently displayed. There is also reference to the complaints procedure in the home’s ‘Statement of Purpose.’ This is available for residents, their relatives and anyone with an interest in the home. The Complaints Procedure includes the right of the complainants to contact the Commission for Social Care inspection (CSCI) at any time during the complaints process. Contact with relatives shows that they are aware of their right to contact the CSCI at any time in the complaints process if they wish to do so. Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 17 Since the last inspection the home has received one complaint which it investigated itself to a satisfactory conclusion. In addition to the complaints procedure the home also has a ‘Comments Book’. This allows residents or their representatives to make comments about the operation of the home or issues they would like the owners to consider. Since the last inspection one issue has been raised in this book and further entries show that the issue raised was responded to appropriately. Residents and visitors who were spoken to said that they would raise issues of concern or complaints with the registered manager. Comments made on the assessment form completed by the home, alluded to the fact that as complainants had come to the Commission for Social Care Inspection (CSCI) the prominent display of the complaints procedure must be effective in letting people be aware of their right to contact the CSCI at any time. The registered manager has purchased various training DVDs, amongst which is training relating to the Protection of Vulnerable Adults (POVA). Staff, in discussion, said that they had received POVA training. They were able to give examples of what constituted abuse and what they would do if they suspected that it was occurring. Staff were unfamiliar with the Whistle Blowing Policy and its purpose of protecting staff who, in good faith, reported abuse or poor practice. This situation will be rectified as further training, including that relating to the Whistle blowing Policy was seen to be scheduled. Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 18 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 and 26 Quality in this outcome area is good. Residents live in a clean environment which meets their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Lakenham Residential Care home is a large and imposing building. It stands in its own extensive and well maintained grounds and has sweeping views across the coastline. Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 19 The home is on four floors. These can be accessed either by use of passenger lift or by stairs. The home has adaptations and equipment, such as specialist bath, raised toilets, special mattresses and grab rails which make it a suitable environment for those who live there. Since the last inspection a new call system has been installed which is more efficient than the previous one, allowing staff to respond to residents quicker. There are various lounge areas affording residents choices about where to sit and relax. The majority of bedrooms have the advantage of en-suite facilities. Bedrooms were seen to have been personalised as they contained pictures and ornaments of sentimental value to their occupants. In discussion one resident said that they had requested a move to another room and this had been arranged by the manager. The home has a refurbishment programme. Evidence of this policy was shown demonstrating that when rooms become vacant they are redecorated and refurbished prior to being re occupied. Externally the home is surrounded by extensive, well maintained garden areas and an entrance courtyard with seating and flower displays. The home has a good standard of hygiene and cleanliness. Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 20 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 and 30 Quality in this outcome area is good. The home is staffed appropriately to meet the needs of those resident at the home. The home has purchased training materials in order that all staff have knowledge appropriate and relevant to the work they undertake. All staff have appropriate police checks and references to ensure the safety of residents and the manager is now aware of the need to ensure that staff are checked to ensure their names are not on the protection of vulnerable adults register, prior to their commencing employment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Rotas were seen displayed in the staff room. Currently the home is not full to its registered capacity. Staff were asked if they considered that the staffing Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 21 levels were adequate to enable them to carry out their duties appropriately. Staff confirmed that they considered staffing levels to be appropriate. The rota showed that there were usually four care staff on duty and at the time of the inspection there were 19 people accommodated in the home. Since the last inspection the home has purchased a series of training videos. These have included ones specialising in dementia, with the specific titles of, ‘Dementia in Care homes’ and ‘Understanding Dementia’. These, alongside others looking at a variety of relevant topics are part of the rolling programme of staff training available at Lakenham Residential Care Home. Records and discussion with the manager confirmed that all staff have had mandatory training such as that relating to Moving and Handling and the Protection of Vulnerable Adults. Staff files were examined. They were seen to contain documentation, such as copies of driving licences and passports which confirmed the identity of the staff member and police checks and references which confirmed their suitability to work in the care industry. There was no evidence, on file, to confirm that staff had been checked to see if their names had been placed on the Protection of Vulnerable Adults (POVA) register. The registered manager later confirmed that these checks had not been carried out but that they would be when further staff were recruited. Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 22 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 and 38 Quality in this outcome area is good. The home is run by a manager who has appropriate managerial experience and is achieving the relevant qualifications expected of a manager. The home has an effective Quality Assurance system. Staff benefit from being offered regular supervision. There are appropriate systems of maintenance to usually ensure that the health and safety of residents is promoted and protected. This judgement has been made using available evidence including a visit to this service. Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 23 EVIDENCE: The registered manager has been running this care home for two years and his previous managerial experience. She has obtained her Registered Manager’s Award and had anticipated having completed her NVQ 4 by this time. However this has been delayed due to issues relating to the training organisation and beyond the control of the manager. Appropriate procedures are in place to protect the financial interests of residents. The recording of disbursement of monies held by the home on behalf of residents was seen to be appropriate. The home has a schedule for supervision. The manager supervises the senior staff, and the cook, and the senior staff have delegated responsibility for supervising specific members of staff. Supervision is to be recorded on formatted sheets which cover training, client issues, professional development and, for continuity, a review of previous supervision. The home has appropriate policies and procedures. The home operates a Quality Assurance system. Questionnaires were forwarded in October 2006 to both residents and a range of stakeholders, which included relatives, staff, trainers, social workers, nurses and others with an involvement with the home. The home obtained a 39 response from the questionnaires forwarded. The responses showed an overall satisfaction with what was offered at the home. T he home was seen to be responding to issues where responses had not been as favourable as they would have expected. An example of this being the décor of the home which was as commented upon in the assessment returned by the home prior to the inspection. The findings of this survey were discussed at a ‘Partners Meeting’ and it is anticipated that a new, enlarged survey will be put into operation in October 2007. The home’s accident record book was inspected. This showed that the home records all accidents irrespective of their severity or whether they had been observed by staff or residents. There had been no information received from this home regarding incidents as required by the regulations, however this was shown to be due to an issue regarding incorrect addressing rather than forms not having been forwarded. This issue has now been addressed. Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 24 Staff undergo regular fire training with records showing that fourteen staff attended the most recent training which took place in June 2007, and was, we were informed, organised by a trainer accredited with the Devon Fire Rescue Service. Further training is scheduled. The home has a recently compiled Fire Risk Assessment which relates to the whole home. Records showed that the passenger lift had recently been serviced and that appropriate gas safety checks had been made. The registered manager produced certification confirming the safety of electrical installations in the home. Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 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 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard 1 OP9 Regulation 13[2] Requirement All medication must be given to residents at the dosage which has been prescribed for them. Any changes in this dosage must be recorded appropriately on the MAR chart, clearly showing the reason why this has changed and include a signature and date of the person making the recording. The MAR chart must be updated as soon as possible to include the correct dosage to be given. All medication must be given to residents at the prescribed time. Any changes in this time must be recorded appropriately on the MAR chart, clearly showing the reason why this has happened and include a signature and date of the person making the recording. The MAR chart must be updated as soon as possible to include the correct time to be given. Timescale for action 19/08/07 Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Lakenham Residential Home DS0000062626.V337528.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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