Inspection on 13/06/05 for Nottingham Neurodisability Service Hucknall - Rosewood

This inspection was carried out on 13th June 2005.

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

Nottingham Neurodisability... 20/11/08

Nottingham Neurodisability... 22/11/06

Nottingham Neurodisability... 08/02/06

Nottingham Neurodisability... 31/01/05

Nottingham Neurodisability... 08/07/04

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

CARE HOME ADULTS 18-65 Nottingham Brain Injury Rehabilitation Ctr Rosewood Hankin Street Hucknall Nottingham NG15 7RR Lead Inspector Gail Kirby Unannounced 13 June 2005 @ 10:00 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Nottingham Brain Injury Rehabilitation Ctr Rosewood Hankin Street, Hucknall, Nottingham, Nottinghamshire, NG15 7RR 0115 9680202 0115 9642747 Address Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Lynn McLeish Four Seasons Homes (Ilkeston) Ltd Emerson Court, Alderley Road, Wilmslow, CRH 32 Category(ies) of PD registration, with number of places Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Service Users shall be within category PD Date of last inspection 31/01/05 Brief Description of the Service: The Nottingham Brain Injury Centre, Rosewood Unit is a 32 bed care home for residents with moderate to severe physical disabilities who need full care with nursing. The home is situated just off a main road entering the town of Hucknall, on a bus route. Within half a mile radius there are shops, superstores as well as the town centre, leisure activities, market and the parish church. All rooms are located on the ground floor. There is a designated activities room and independent living skills kitchen. There are 29 bedrooms, including 3 double rooms, many with en-suite facilities and access to a garden area via a patio door from their rooms. Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the first of two inspections the Commission is required to make in the Inspection year between April 2005 and March 2006. It was carried out throughout the day over an 8 hour period. The core standards were assessed on this occasion. For an in depth record of the overall standards reference must be made to the published inspection report following the announced inspection on the 8th July 2004. The main method of inspection used was called case tracking which involved selecting three service users (residents now) and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. The acting manager was present throughout the inspection; 4 staff and 5 service users were spoken to. A partial tour of the accommodation took place. The inspection found not all requirements set at the last inspection have been addressed. What the service does well: What has improved since the last inspection? Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 6 The acting manager has adopted a streamline approach to ensure systems are in place to improve the overall management of the home. Documentation has been referenced and staff allocation has been addressed. There is an improved atmosphere for staff to work in. Staff members feel supported and valued as individual key players. Staff members are working together as a team and with the added bonus of the acting managers experience working as the deputy she has a full understanding of all the residents needs. Training has been reviewed and the shortfalls have been identified and a programme of mandatory training has been prioritised for all staff. A matrix of training achieved and training which remains outstanding has been created for an effective guide for all to follow. The Providers have implemented the first stage of the refurbishment and redecoration programme to improve the overall accommodation. What they could do better: The Registered Providers must focus on the current resident population that live at the home as well as prospective residents to ensure the home is suitably registered and is able to meet individual needs. Staff communication for overseas nurses impedes on residents personal wishes. Residents are frustrated by not always being able to understand what is being asked of them but also they are concerned that they are not understood. Care plans and record keeping has improved but further detail is required of action to be taken by staff to ensure individual as well as holistic needs are to be met. Documentation for short-term care residents is inadequate as relevant information is not either obtained and or recorded. Essential information is omitted which potentially impedes on residents choices and wishes and essential instruction for staff to follow. Recruitment practices and staff training needs to be more stringent to ensure company polices, Care Home Regulations and the National Minimum Standards are adhered to. Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 Prospective residents and relatives have information about the home to enable them to make an informed choice about where they live. Consideration has not been made to address the ageing population of the residents living at the home. Full assessments are not being carried out prior to admission to ensure that resident’s care needs will be met. EVIDENCE: The company has produced a new Statement of Purpose to cover the three units at the Nottingham Brain Injury Unit. There is however no mention of the Registered Managers for each of these units, no information is recorded of the individual names, skills or experience. The only reference made is that of the Centre Manager who is not registered. As part of the inspection process 2 residents were identified over the age of 65 years. The homes category for registration is 18 – 65 years. The Statement of Purpose will therefore need to be updated to reflect the continuing care of older people. The acting manager reported information of new residents to be admitted to the home is obtained prior to admission. The Social Workers fax a copy of the Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 10 Community Care Assessment and the home conducts an independent assessment. The assessment process was seen in two out the three files chosen for case tracking. A plan of care is based on the assessment but had not been completed in one out the three files. Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9 Care plans for short-term care are inconsistent and do not provide sufficient information to meet their needs. Long-term care plans are more precise and lend to a more consistent approach. Information recorded in the care plans do not reflect personalised care and do not meet with individual needs and aspirations. Resident’s safety and well being is potentially compromised. EVIDENCE: Staff spoken with demonstrated knowledge of residents needs and how to meet individual needs. Care plans are practised based and not on resident’s individual wishes and choices. One care plan inspected for a respite resident was incomplete. Information previously obtained on a subsequent admission had been used but not updated and new needs were not provided with a specific plan of care. Staff members spoken with reported nursing intervention that was also carried out but no Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 12 record had been made into the plan of care. An immediate requirement was therefore set in respect of care planning. Risk assessment for moving and handling was incomplete for one resident and no tissue viability risk assessment had been put in place despite the resident being immobile. One resident reported knowledge of a care plan, which was made known in the last six months. It was reported that they are now actively involved and feel they have more control over their life. Residents spoken with reported care staff to be very good, kind, friendly, choices respected and valued. Residents reported how their privacy is respected and how the staff ‘offer a service with a smile’. One resident spoken with reported how the key worker system operates and confirmed they chose their own key worker. It was reported that on one occasion their key worker was changed without prior knowledge or consultation but it was confirmed the management rectified the situation. One resident reported the key worker system enables them to go out to the local shops and pubs and gives opportunity for independence. It was reported the Tram service has enhanced their choice and enabled frequent visits to the city of Nottingham. In addition there is a mini bus that belongs to the home for residents use. One resident confirmed they are given choices; a residents meeting is held and records are made by the activities co-ordinator. Committee members are appointed and opportunities are given to make decisions on the daily running of the home. Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 14, 16, 17 Staff members and the activities provided enable residents to integrate into community life to lead as full as life as possible. The independence living skills room does not meet its intended purpose, which compromises the potential development, maintaining or retaining the skills of people living independently. The inadequate record keeping offers no assurance that food is stored safely nor complies with other legislations. EVIDENCE: An activities programme is displayed in individual residents rooms. On the day of inspection the activities co-ordinator was off sick. Residents were observed to be at a loss of what to do. Residents were observed to sit in Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 14 the activities room but no alternative activities had been sought other than the television switched on. Residents reported positive comments about the activities routinely provided. The activities room was noted to be well equipped with games and craft items. Residents reported the activities person is part of the team, motivated and is enthusiastic in ensuring all individual needs are catered for. A number of residents and staff had been on a days outing two days prior to the inspection; residents were complimentary of the staff and their commitment. Residents spoken with reported their daily routine was flexible and their individual choices are respected. One resident did comment that communication issues with the overseas nurses leads to misunderstanding on some personal preferences. Residents are free to come and go from the home in accordance to an agreed risk assessment. One resident reported they never leave the home without an escort. The acting manager reported only a few residents have been on holiday which is paid for by themselves. Residents reported the staff to be very attentive to ensure their privacy is upheld. Staff was observed to enter service users rooms only with the individual residents permission. The independent living skills kitchen was inspected. The sink is not accessible by a wheelchair user. The cupboards are dirty and there is limited crockery and cutlery. Cereal boxes’ were open. Staff members spoken with were not aware who was responsible for keeping the fridge clean. The fridge monitoring record had not been completed for six months. The main kitchen was noted to be dirty, no records of cleaning, temperature records for the refrigerator or freezer. The freezer was also noted to require defrosting. Residents reported of their involvement in the weekly menus. Residents made positive comments of the food provided and confirmed a choice is always available. Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20 The people living at the home are provided with support to meet resident’s physical and emotional health care needs. EVIDENCE: A Clinical Psychologist is actively involved in the home; a weekly surgery is held. An assistant is based at the home daily to provide consistency. In addition all residents are registered with a local General Practitioner. A NeuroPhysiotherapists is also based at the home. All residents are assessed to determine physiotherapy needs. An Occupational Therapist is accessed via the local Community hospital in Mansfield. Other support from Tissue Viability, Dietician and Speech and Language is also accessed by the home. Care plans inspected demonstrate a multidisciplinary approach is taken. Residents reported health checks are carried out and visits are made to the dentist and the optician. One resident reported that out patient appointments to the hospital are always accompanied by their key worker. Staff reported no residents wish to self-medicate. One resident reported they were given the opportunity. Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 16 Random sampling demonstrated how the home maintains accurate records of all medicines received, administered and returned. On discussion with staff they reported how they would deal with drug errors. Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 The Registered Providers must review how disciplinary outcomes are dealt with to ensure people living at the home are protected. EVIDENCE: The home has invoked the Adult Protection procedure for incidents that have occurred in the home. Sixteen staff members have received training on Protection of Vulnerable Adults. Notifications have been made to the Commission. Staff spoken with reported how they would deal with an allegation of abuse. Staff members however were unable to confirm receipt of training in physical and verbal aggression. An incident of the company taking disciplinary action against one Registered Nurse has not been disclosed to the Commission. In addition on the day of inspection concern was made that the company has not taken all necessary action to address this matter. No supervision has been implemented whilst this person remains working at the home. The acting manager was made aware these issues and an action plan is to be submitted to the CSCI. Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 26, 27, 29 The ongoing redecoration and refurbishment programme has provided the people living at the home with comfortable surroundings. The ongoing issues of vandalism and residents rooms not lockable with a key does not offer residents the assurance of being safe. EVIDENCE: The Responsible Individual determines the rolling programme of redecoration and refurbishment. The Responsible Individual and personnel from the Estates department were conducting an overview of the building on the same day of inspection. Since the company took over in February 2004 all rooms have been fitted with new curtains. New dining room chairs and tables. The daily maintenance of the home is the responsibility of one maintenance person who is also responsible for the two other adjacent homes. As a result the gardens were observed to be overgrown. Resident’s rooms are personalised and residents reported overall satisfaction with the facilities offered. Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 19 A number of the resident’s rooms have been redecorated. Residents spoken with reported a choice was offered on how their rooms were decorated. The carpets in these rooms are stained and worn. In addition the carpets in the corridor is badly stained. No malodour was noted. Furnishings, fittings, adaptations and equipment are good quality and are domestic and fulfil their purpose. Specialist equipment was observed in resident’s rooms. The acting manager reported specialist professionals are brought into the home to advise and assess the individual needs of the residents. There are 2 showers and 2 bathrooms. The shower room (B1) was malodorous. A locking device is fitted to all the rooms but no key is available, allowing access to other staff, residents and potentially the public. One resident reported how concerned they are about the youths, which climb on the flat roof. A previous incident of youths throwing stones and breaking a window was not reported to the Commission for Social Care Inspection. A CCTV camera is fitted to the entrance area only for security purposes. Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36 The staff morale has improved and individual members feel valued. However, the employment of a high ratio of multicultural staff working at the home, which are not fully conversant with the English language potentially impedes on residents health, safety and welfare. The Registered Providers have failed to take adequate precautions to protect residents by undertaking references and obtaining proof of identity. EVIDENCE: The acting manager was on duty on the day of inspection. She demonstrated knowledge of the residents from her previous role as deputy for 7 years. Residents spoken with reported how confident they felt about her abilities to meet their needs and to effectively manage the home. Staff members spoken with were equally complimentary of the acting manager and the support she offered. Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 21 Residents reported they feel a part of the home with the successful key worker system. It was reported that they feel their opinions are valued and acted upon. The home is dependent on a high number of overseas Registered Nurses and Care staff to provide the minimum staffing levels. One resident reported of their concern that they could not understand the staff from overseas. Residents equally reported their concern and frustration that they could not be understood. A General Practitioner visited the home on the day of inspection; despite a Registered Nurse greeting his presence they were bypassed and information was sought from the acting manager. The acting manager reported communication has been a problem with the overseas nurses. The homes recruitment is the responsibility of the general manager. The general manager and a unit manager interview all applicants. A decision is determined which unit the applicant would be most suitable for. Residents spoken with were unable to report of their active involvement in staff selection. Three staff files inspected, demonstrated inconsistency in the company’s recruitment policies. One file had one reference, which provided limited information, no photograph or proof of identity. One file recruited by an employment agency for overseas staff provided no references. An immediate requirement was therefore set in respect of staff recruitment. Residents requiring one-to-one care have designated care staff who provide individual attention. Staffing levels have been increased on the morning shift to 8 – 10 care staff to meet the needs of the current population living at the home. Staffing levels in the afternoon have been decreased but residents reported that they felt this was more effective. The acting manager reported no staff meetings have been held since her appointment three months ago. No staff appraisals have been implemented. No formal supervision. A staff training programme has been implemented by the acting manager. Records demonstrate mandatory training has not been previously prioritised as a result a high number of staff working at the home have not received training or updates. No specialist training for dealing with challenging behaviour and controlled restraint. No skills in communication and in dealing with anticipated behaviours. Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, The Registered Providers must appoint a Registered Manager to manage the Home to ensure residents health and welfare. EVIDENCE: The deputy manager was appointed the acting position in March 2005, subject for review at the end of this month to determine if the position is to be made substantive. The Registered Provider must ensure a manager is appointed and registration must be made with the Commission for Social Care Inspection. Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 2 x x x Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 4 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x 3 3 3 x x Standard No 11 12 13 14 15 16 17 3 x x 3 x 3 3 Standard No 31 32 33 34 35 36 Score 3 2 2 2 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Nottingham Brain Injury Rehabilitation Ctr Rosewood Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x x x C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 24 YES Are there any outstanding requirements from the last inspection? 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 1 Regulation 4 Requirement The Registered Person must update the homes Statement of Purpose to reflect the Registered Manager The Registered Person must ensure all residents admitted to the home are assessed including short-term care The Registered Person must ensure care plans are updated to reflect residents changing needs The Registered Person must ensure all risks are identified and recorded: Moving and Handling and Tissue Viability risk assessments must be up to date The Registered Person must provide adequate failities for residents to prepare own food within the Independent Living Skills kitchen The Registered Provider must ensure all necessary supervision is in place for staff that have been disciplined The Registered Person must ensure staff employed can communicate with residents in thier first language The Registered Person must ensure all necessary checks are C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Timescale for action 31/07/05 2. 2 14 31/07/05 3. 4. 6 9 15 13 Immediate 31/07/05 5. 11 16 30/09/05 6. 23 ACT 30/06/05 7. 33 19 31/07/05 8. 34 19 Immediate Page 25 Nottingham Brain Injury Rehabilitation Ctr Rosewood Version 1.40 9. 35 18 10. 11. 36 37 18 8 undertaken prior to employment which includes two references and proof of identity The Registered Person must ensure staff training is completed - mandatory and specialist The Registered Person must ensure all staff are appropriately supervised The Registered Person must appoint a Registered Manager 30/09/05 30/09/05 31/07/05 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. 4. 5. 6. Refer to Standard 14 17 24 26 33 36 Good Practice Recommendations Residents in long term placements have the option of a minumum seven day annual holiday Fridges and freezers are to be monitored consistently to ensure food is stored at the correct temperatures To ensure the grounds / gardens are maintained additional maintenance hours are to be considered To consider an altenative door lock on residents rooms to enable a key to be fitted To re-initiate staff meetings Ensure staff have annual appraisals to review performance against job description and agree career development plans Nottingham Brain Injury Rehabilitation Ctr Rosewood C53C03S58988Rosewood BIU V233906 Stage 4 130605.doc Version 1.40 Page 26 Commission for Social Care Inspection Edegely House Riverside Buiness Park Tottle Road Nottingham NG2 1RT 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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