Inspection on 14/08/06 for Limes Residential Care Home

This inspection was carried out on 14th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Limes Residential Care Home 04/12/07

Limes Residential Care Home 24/04/06

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

CARE HOMES FOR OLDER PEOPLE Limes Residential Care Home 11a Station Cresent Ashford Middlesex TW15 3JJ Lead Inspector Pauline Long Key Unannounced Inspection 14th August 2006 08:45 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 Limes Residential Care Home DS0000066830.V307893.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. Limes Residential Care Home DS0000066830.V307893.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Limes Residential Care Home Address 11a Station Cresent Ashford Middlesex TW15 3JJ 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) 01784 240114 0208 5783890 elmbank@talktalk.net Elmbank Residential Care Home Ltd Mrs Alena Vivian Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Limes Residential Care Home DS0000066830.V307893.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The named service users (as detailed in letter dated 6th March 2006) currently accommodated in the home who fall within the category of `dementia - over 65 years of age` may only continue to remain in the home subject to a full care management review and re-assessment of their individual care needs. No further admissions may take place in respect of that category. 24th April 2006 Date of last inspection Brief Description of the Service: The Limes is a care home for older people, which is located in a residential area in Ashford. The property is a detached older style dwelling, which has been sympathetically extended to provide accommodation for up to 16 residents. Rooms are arranged over two floors, the first floor having stair lift access. There is an adapted bathroom and a walk in shower. Individual rooms are of varying sizes and each one is fitted with a wash hand basin. There is a well-kept garden to the back of the property, where residents can sit out in the warmer months. The home is situated close to the town centre and has good road links: Ashford railway station is within walking distance. There is limited parking to the front of the property. The fees at the home range from £395.00 per week to £466.00per week. Limes Residential Care Home DS0000066830.V307893.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first site visit of a key inspection and was unannounced. The site visit was carried out by one inspector, was carried out over two days 14/08/06 and 22/08/06. The site visit on 14/08/06 commenced at 08.45 and finished at 15.00. The site visit on the 22/08/06 commenced at 13.30 and finished at 14.30. Discussions were had with the residents, managers and staff. Documents sampled included, resident’s files, care plans, risk assessments, daily observation records, staff files, training records, health and safety records and policies and procedures. A full tour of the building and garden were undertaken. Verbal feedback from residents was limited due to their communication difficulties, however observations of their facial expressions, body language and the conversations they were having with each other, indicated that they were comfortable and contented. CSCI would like to thank the residents, managers, and staff for their hospitality and co-operation during the inspection. What the service does well: What has improved since the last inspection? Most of the requirements made following the previous inspection have been met. The manager has developed and implemented a more robust care needs assessment process. Improvements have been made in the care planning process and documentation. Staff training is given a higher priority, with all of the staff undertaking a 6 month accredited course in dementia care. Limes Residential Care Home DS0000066830.V307893.R01.S.doc Version 5.2 Page 6 Discussions with the staff team indicated that professional relationships in the home have improved. The manager commented that the care staff team have a better understanding of the needs assessment and care planning process. Various audits have been introduced for example: medication, health and safety, and environment. Record keeping has improved. A service user questionnaire has been developed and circulated to resident’s relatives. What they could do better: All but one of the previous requirements have been met. The home still has to address the one outstanding requirement, which now must be a priority for attention. Failure to comply with this requirement may result in enforcement action. The homes statement of purpose, service user guide and policies and procedures must be reviewed and updated to reflect the current ownership and management arrangements at the home, which will help to ensure that residents/prospective residents have all of the information they require. Some areas of resident’s dignity and privacy must be better promoted. Risk assessments had been completed on each resident, but require further development to include action plans to minimise the identified risks and promote resident safety. There were concerns around various health and safety issues, appropriate equipment must be bought in order that residents can be weighed in a safe manner, food hygiene practices must improve in respect of food labelling and cleaning to ensure the residents health and wellbeing is promoted. Infection control must be improved and staff must wear the appropriate clothing. Fire procedures in respect of fire doors and fire extinguishers must be improved to ensure the safety of residents and staff. Risk assessments must be carried out on all liquid toiletries which residents have access to. The manager has not yet undertaken the local authority multi agency training in safeguarding adults, indicating that he may not be aware of the policies and procedures in this respect. The systems in place to ensure that resident’s monies are protected from abuse require further development. This will assure residents are protected from abuse. Requirements were made in these areas. Please refer to pages 26, 27 and 28 of this report. Please contact the provider for advice of actions taken in response to this Limes Residential Care Home DS0000066830.V307893.R01.S.doc Version 5.2 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Limes Residential Care Home DS0000066830.V307893.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 Limes Residential Care Home DS0000066830.V307893.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): 1,2,3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A statement of purpose and service user guide are in place providing prospective residents with the information they need to make a decision about the suitability of the home, however these documents require review and updating to reflect the current management arrangements. Residents are issued with a contract of the care service provided by the home. Improvements have been made in the homes care needs assessment process, which indicated they would not admit a resident whose needs could not be met. The home does not provide for intermediate care service. EVIDENCE: The statement of purpose and service user guide are comprehensive documents and provide prospective residents/residents with information about the home. However the home has undergone changes in management and these details are not reflected in the documents, this leads to inaccurate information being presented regarding the management of the home. Limes Residential Care Home DS0000066830.V307893.R01.S.doc Version 5.2 Page 10 Resident’s contracts were sampled and evidenced that they had been signed by a resident’s representative, indicating that they had understood and agreed with the terms and conditions at the home. Improvements have been made in the homes care needs assessment process. A new care needs assessment tool has been developed to include all activities of daily living, giving the reader a good insight to a residents needs. One new resident has been admitted to the home since the previous inspection, and there was evidence to indicate that a social care management team community care assessment of needs was sought prior to the homes own care needs assessment. Discussions were had with the resident and her relative around the care needs assessment. They commented that the manager carried out a detailed assessment before she was admitted to the home. The home does not provide for intermediate care. A requirement has been made in respect of the statement of purpose and service user guide. Please refer to pages 26,27 and 28 of this report. Limes Residential Care Home DS0000066830.V307893.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements have been made in care planning documentation to ensure a holistic view of all needs. The staff had a good understanding of the resident’s health and personal care needs, which were evidenced as met. Residents are protected by the homes medication policies and procedures, which are adhered to. Resident’s commented that they are treated respectfully and with dignity based on the feedback provided, however some improvements are required to ensure that resident’s dignity is promoted in all aspects of daily living activities. EVIDENCE: The manager has implemented a new care plan format, which provides a more comprehensive view of a residents care needs. The new format allows for a much more detailed and holistic view of a residents needs and appeared to be less cumbersome. The care plan covers all activities of daily living needs and incorporates a risk assessment related to each activity. The risk assessments require further development to ensure that action plans are in place for any identified risks. The manager commented that he and the deputy manager Limes Residential Care Home DS0000066830.V307893.R01.S.doc Version 5.2 Page 12 had completed the care plans, and that once the care staff were assessed as competent they would be expected to complete the care plans. Discussions were had with the care staff, who commented that they had received further training in this area, and were much more confident in their abilities and their understanding of a residents care needs. They also commented that the manager had worked with them in this respect. Resident’s healthcare needs were documented and there were records to demonstrate visits from general practitioners and community nurses. Records in respect of food and fluid intake and weight charts were kept on identified residents. There was evidence in the records sampled that residents care plans had been reviewed on 08/08/06. Daily records were kept in a daily logbook and individual resident daily notes sheet. These records were documented across the 24 hour period and provided a holistic view of a residents day. Discussions were had with the manager in respect of the appropriateness of the coloured ink used throughout the daily records. Medication procedures and practices were discussed with the manager. He commented that the deputy manager was responsible for overseeing the homes medications. It was evident that the homes medication systems were well managed. All of the medication record sheets were in good order and no gaps in the recording were noted. The day-to-day medication is stored in a wheeled medication trolley, which in turn is stored in a locked cupboard. The manager commented that this was not an ideal place to store the medications and was in discussions with the providers in this respect. The manager has implemented a monthly audit of medication procedures, practise and storage. Staff were observed providing support to residents in various aspects of personal care. Bedroom and bathroom doors were not left open, staff were observed to knock on doors before entering. One resident commented that the staff were always respectful and would never enter a room before knocking. It was noted that continence aids were stored in the downstairs bathroom. There was no way of knowing which resident these belonged to as there was no name on the pack, this indicated that the aids would be used for any resident who required one. Towels were stored in the bathroom and also indicated communal use. Discussions were had with the managers in respect of, the need for each resident to have their access to their own towels and continence aids in order to ensure their privacy and dignity is promoted. Requirements and a recommendation have been made in respect of these standards. Please refer to pages 26,27 and 28 of this report. Limes Residential Care Home DS0000066830.V307893.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 adequate. This judgement has been made using available evidence including a visit to this service. Improvements are required in respect of social and recreational activities to ensure residents social, cultural, religious and recreational needs are met. Improvements have been made in respect of the choice of meals offered in the home and residents are provided with a balanced diet. Improvements are required in respect of kitchen practices and procedures to ensure the continued health, safety and well being of the residents. EVIDENCE: On the day of the site visit which commenced at 08.45am, it was noted that all of the residents were up and ready for the day. Some of the residents had already had their breakfast, others were enjoying theirs. One resident was observed eating breakfast in his bedroom, the television was on and he was enjoying watching the news. He commented that he preferred to spend the day in his bedroom and likes watching his selection of DVD’s. Residents were observed being supported into the conservatory. Some of the residents were watching television others were reading newspapers or chatting to their neighbour or staff. A requirement was made at the previous inspection for the home to develop an activity programme by taking in to consideration the residents preferences. Limes Residential Care Home DS0000066830.V307893.R01.S.doc Version 5.2 Page 14 Discussions were had with the manager in this respect and he commented that activities were discussed with the residents on a daily basis. There was no documented evidence of these discussions. One resident commented that she enjoyed playing bingo, going to the shops and joining in with sing-a-longs. She also commented that she observed the staff taking other residents for walks to the local high street. She commented, that the staff were very good and at times get the residents involved in exercise activities. Food provision on the day was a cause for concern. The fridges, freezers and cupboards were checked at 10.00am and were found to be low on supplies. The deputy manager was observed returning from the local shops at 10.30am with a small amount of shopping. This was discussed with the managers, who stated that under normal circumstances the provider would do the shopping on a weekly basis. The provider had been on holiday for three weeks, and the staff at the home had been doing the shopping on a daily/weekly basis. The deputy manager stated that she would be stocking up the frozen provisions later in the day. She did produce several receipts, which evidenced regular trips to the local supermarket. Fridges were checked and were observed to have various opened foodstuffs, which had not been labelled or dated on opening. The second site visit on 22/08/06 evidenced that food storage had been improved. The lunchtime activity at the home was not observed. Residents commented that the lunch was lovely. The second site visit on 22/08/06 evidenced that the food provision and storage had improved. The freezers were well stocked, the fridges were stocked with bread and milk, but there was no fresh meat or vegetables. This was discussed with the chef, who stated that fresh meat was bought and then frozen on the day. Requirements were made in respect of these standards. Please refer to pages 26,27 and 28 of this report. Limes Residential Care Home DS0000066830.V307893.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 adequate. This judgement has been made using available evidence including a visit to this service. The arrangements in place for dealing with complaints are not satisfactory and require updating, to ensure complaints are taken seriously and acted upon. Service users are protected from abuse by the homes policies and procedures, although improvements are required in respect of staff training in this area. EVIDENCE: The CSCI have received no complaints about the home since the last inspection. The complaints procedures were discussed with the manager. He described scenarios about a complaint being received. Complaints would be recorded in a resident’s daily notes, however there was no process in place for recording the investigation and outcome of the complaint. One referral has been made in respect of safeguarding adults since the last inspection. Meetings have been held in this respect and are ongoing. The manager has yet to undertake the local authority multi agency training in respect of safeguarding adults. All of the care staff have undertaken training in respect. Discussions were had with them in which various scenarios were put to them, there responses demonstrated a good understanding of what constitutes abuse and what they would do if faced with an abusive situation. Requirements have been made in respect of these standards. Please refer to pages 26,27 and 28 of this report. Limes Residential Care Home DS0000066830.V307893.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 adequate. This judgement has been made using available evidence including a visit to this service. On the whole the standard of the environment within this home is satisfactory and meets the needs of the residents, providing a clean and homely place to live. Improvements are required in the overall maintenance and decoration of the home, which would help to provide a more pleasant place to live. To ensure that residents are enabled to maximise their independence, the home must review some of the specialist equipment provided. EVIDENCE: On the day the home was found to be clean and homely and free from any malodour. The fabric and decoration of the communal areas was satisfactory but will require attention in the very near future. The walls and paintwork were found to be somewhat soiled and chipped. The wallpaper in the downstairs hall was torn and this appeared to be as a result of a water leak. It was also noted that one of the hall carpets was badly stained, possibly due to a water leak under the floor, this was also highlighted at the previous inspection. The Limes Residential Care Home DS0000066830.V307893.R01.S.doc Version 5.2 Page 17 handrail on the first floor landing was broken and had been removed, however the holes in the wall had not been repaired. The garden was well maintained, with garden furniture and various areas of shade for residents to enjoy the sun in safety. It was noted that a commode had been left sitting outside one of the sheds, which was unsatisfactory and should be disposed of. The home has a chairlift, for residents to access the upper floor and a hoist for those residents with limited mobility. Both these pieces of equipment had recently been serviced. The equipment in place for weighing the residents is not appropriate for those residents who have mobility problems and must be replaced with more appropriate seated scales. Resident’s bedrooms were clean, tidy, and personalised. The beds and mattresses were checked and were found to be in good condition. One resident commented that he “liked spending time in his bedroom it made him feel like he was at home”. Requirements have been made in respect of these standards. Please refer to pages 26,27 and 28 of this report. Limes Residential Care Home DS0000066830.V307893.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 a visit to this service. The staffing arrangements in place on the day of inspection were sufficient to meet the needs and the dependency levels of the residents. Improvements have been made in recruitment practices and staff training to ensure that the residents are protected and supported by trained and competent staff. EVIDENCE: Following an adult protection issue at the home staffing levels were increased and have been maintained. On the day the staffing numbers were observed as being adequate for the dependency levels of the 11 residents. The staff team consisted of a manager, a deputy manager, three care assistants, and one cleaner. It should be noted that the chef was on annual leave and the deputy manager was working in the kitchen providing the meals. Discussions were had with the manager around the need to maintain the current staffing levels in the home, particularly when the chef is on leave. No new members of staff have been recruited since the last inspection. Concerns were raised at the previous inspection around one staff member being employed prior to all checks being completed. This file was sampled and evidenced that recruitment practices had improved and that all checks had been completed. Limes Residential Care Home DS0000066830.V307893.R01.S.doc Version 5.2 Page 19 Several staff training days have been introduced for example: safeguarding adults, fire training, malnutrition screening, dementia care, first aid, medication administration, care planning and manual handling. Further training in care planning and risk assessment have also been undertaken. It is positive to note that the dementia care course is a 6 month accredited college course and that the provider is also undertaking this course. Limes Residential Care Home DS0000066830.V307893.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): 31,33,35,37,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the residents with their views being sought. Resident’s best interests are not safeguarded by the homes record keeping or the policies and procedures, which do not reflect the new ownership and must be reviewed and updated. The health, safety and welfare of the resident’s are not promoted in respect of some kitchen practices, infection control and fire procedures. EVIDENCE: The manager has been in post for almost 4 months. He is a qualified enrolled nurse and has worked in a large care home as the care manager of a dementia unit. He has recently undertaken National Vocational Qualification (NVQ 4) and the registered manager award. An application has yet to be submitted to the CSCI office in respect of his registration, this must now be submitted as a matter of priority. Limes Residential Care Home DS0000066830.V307893.R01.S.doc Version 5.2 Page 21 Discussions were had with the staff group, who commented that whilst things had been difficult, with the change of provider and manager, they were more optimistic for the future of the home. They commented that the manager had implemented many changes in the home, and whilst these changes meant more paperwork for them, it provided them with a better insight and understanding in to the residents needs. Records were sampled and evidenced that the manager has implemented a formal staff supervision process. Staff also commented that they had received a one to one supervision meeting with the manager. Team meetings are also held, the most recent one dated 17/06/06. Residents meetings have also been held the most recent on 29/06/06 the minutes recorded that one of the residents attended. The manager has developed a service user survey, which has been distributed to all of the families. Discussions were had around the need to include all of the residents and other social and health care professionals in the surveys. The manager commented that only two of the residents would be able to understand the survey and their views had been sought. Whilst some improvements have been made in respect of resident’s personal monies. Further improvements are needed in respect of retention of receipts and in the storage of the actual monies, to ensure financial interests are safeguarded. The homes policies and procedures have been carried forward from the previous owners. To date they have not been reviewed and updated. This was discussed with the manager, who stated that he was aware that this issue should be addressed. He discussed the difficulties he perceived in his abilities to develop new policies and procedures and stated he would discuss this with the providers. It is evident that the manager has focused his energy and attention on the well-being of the residents and making improvements in care needs assessments and care planning. Improvements are required in respect of some health and safety issues. One of the fire doors was closing very quickly and could have the potential to knock down a frail resident. Fire extinguishers were last serviced 06/05. Some kitchen practices were poor, foodstuffs in the fridge had not been dated on opening and the kitchen requires a deep clean. The cleaner was observed coming and going from the kitchen and it was noted that she was wearing the same blue apron she was wearing whilst cleaning other areas of the home, this was unacceptable and was brought to the managers attention. Health and safety checks are carried out at the home and records kept in respect of this. Fridge, freezer and food temperatures were up to date. Limes Residential Care Home DS0000066830.V307893.R01.S.doc Version 5.2 Page 22 Requirements were made in these areas. Please refer to pages 26,27 and 28 of this report. Limes Residential Care Home DS0000066830.V307893.R01.S.doc Version 5.2 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 2 3 3 X X 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 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 3 3 3 3 3 2 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 2 3 3 2 2 3 2 2 Limes Residential Care Home DS0000066830.V307893.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP12 Regulation Requirement Timescale for action 14/09/06 2. OP1 3. OP10 4. OP19 16(2)(m(n The registered person(s) must ensure that an activity programme is developed and implemented in conjunction with resident’s choices. Previous timescale of 26/06/06 not met. 4 The registered person(s) must 14/09/06 5 ensure that the homes 5a statement of purpose and service user guide are reviewed and updated to reflect the current ownership and management arrangements. 12(1)(a) The registered person(s) must 21/08/06 13(3)(4)( ensure that all residents are c) provided with their own continence aids and towels. 23(2)(b) The registered person(s)must 14/11/06 ensure that all areas of the home are maintained in a good state of repair and are kept reasonably decorated. The torn wallpaper must be replaced, the handrail on the first floor landing must be repaired. A programme for maintenance, repair and redecoration must be produced and a copy submitted to the DS0000066830.V307893.R01.S.doc Version 5.2 Limes Residential Care Home Page 25 5. OP10 23(2)(n) 6. OP38 12(1)(a) 13(4)(c ) 12(1)(a)1 3(6)18(1) (c ) 22 7. OP18 8. OP16 9. OP35 12(1)(a)S chedule 4(9) 10. OP26 13(3) 11. OP38 12(1)(a) 13(3) 12. OP38 13(4)(c ) 23(4) 13. OP33 24 CSCI. The registered person(s)must ensure that the home supplies appropriate equipment for weighing residents. The registered person(s) must ensure that food is stored in compliance with food hygiene regulations. The registered provider must ensure that the manager undertakes the local authority multi agency safeguarding adults training. The registered person(s) must ensure that a system is in place for recording, investigating and giving feedback to complaints received at the home. The registered person(s) must ensure that a robust system is in place to protect and safeguard resident’s monies. Staff must ensure that receipts are retained and kept with resident’s personal accounts. The registered person(s) must ensure that suitable arrangements are in place to minimise the risks of infection in the home. Staff must wear the appropriate protective clothing. The registered person(s) must ensure that risk assessments are carried out and documented on all liquid toiletries which residents have access to. The registered person(s) must ensure that fire procedures are followed, all fire fighting equipment must be properly maintained and serviced. All fire doors must close appropriately. The registered providers must ensure that the homes policies and procedures are reviewed and amended to reflect the new ownership. DS0000066830.V307893.R01.S.doc 14/09/06 15/08/06 14/11/06 14/09/06 21/08/06 15/08/06 21/08/06 21/08/06 14/11/06 Limes Residential Care Home Version 5.2 Page 26 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. Refer to Standard OP35 OP37 Good Practice Recommendations The registered persons should consider the appropriateness of keeping residents monies in paper envelopes. The registered person should consider only using black ink in all handwritten records. Limes Residential Care Home DS0000066830.V307893.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Limes Residential Care Home DS0000066830.V307893.R01.S.doc Version 5.2 Page 28 - 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. 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