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Inspection on 14/11/06 for Rakelands Nursing Home

Also see our care home review for Rakelands Nursing Home for more information

This inspection was carried out on 14th November 2006.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Prospective service users health and care needs, preferences and wishes are considered before any move to the home is agreed. People and their families are also given opportunity to visit beforehand. In this way they can make an informed decision as to whether the home is suitable for them. Care needs and any identified risks are well documented and are regularly reviewed with the involvement of care professionals and family members. This helps to ensure that information held about service users is accurate and up to date. Staff provide service users with as many choices as possible in their daily routines. Service users are well supported to access a variety of activities, both onsite and in the community. They have easy access to physiotherapy and hydrotherapy. Family involvement is welcomed and relatives have a say in the running of the home. Service users are offered a healthy diet and are given appropriate assistance at mealtimes. Staff offer good support to ensure that service users health care needs are met. The environment is homely and is suitable to meet current service users needs. Staff recruitment processes are thorough and training opportunities are good. This helps to protect service users and enables staff to provide good quality support and care. The manager demonstrates that she has a good understanding of her role, is approachable and offers good support to the staff team.

What has improved since the last inspection?

The main challenge to the service is to retain staff to ensure that service users are provided with as much continuity in care as possible. The manager continues to address this issue with support from Robinia.

What the care home could do better:

Statements of terms and conditions need to be discussed with representatives of service users to ensure that they are aware and agree with its contents. Some of the detail in the homes policies and procedures regarding the protection of vulnerable adults needs to be reviewed to ensure that it fully protects service users. Staff need to ensure that the homes procedures for storing oxygen are in line with professional advice.

CARE HOME ADULTS 18-65 Rakelands Nursing Home London Road Rake Liss Hampshire GU33 7PH Lead Inspector Kathryn Kirk Unannounced Inspection 14 and 27 November 2006 10:30 Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 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 Rakelands Nursing Home DS0000011536.V317718.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 Adults 18-65. 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. Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rakelands Nursing Home Address London Road Rake Liss Hampshire GU33 7PH 01730 894621 01730 890036 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) Robinia Care Limited TO BE CONFIRMED Care Home 16 Category(ies) of Learning disability (16) registration, with number of places Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st February 2006 Brief Description of the Service: Rakelands is a care home providing accommodation and nursing care for up to sixteen younger adults with learning and physical disabilities. Rakelands is a large detached home set back off the main road on the outskirts of a village called Rake. Rake has a village shop, post office and garden centre. The home is owned by Robinia Care Limited, a national company who own a number of care homes within Hampshire. The home also provides day service facilities which include physiotherapy, horticulture, music therapy a sensory room, cookery, and a craft room. The home has a hydrotherapy pool and a large trampoline which service users use on a regular basis. Current fees range from £1120 to £1520 per week. This information was provided by the manager in November 2006. Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The findings of this inspection are that the overall care provided continues to be good. No requirements or recommendations have been made as a result of this inspection as the manager has verbally agreed to ensure that the areas for improvement identified will be addressed. Judgements made in this report were made after reviewing written documentation. Two visits to the home were also made on 14 November 2006 and on 27 November 2006. All bedrooms and communal areas were seen. The needs of current service users are such that they are unable to contribute verbally to the inspection process. Time was therefore spent in their company, and interaction between service users and staff was observed. The manager and six staff members spoke about their experience of working in the home and one visitor provided some information about the service. What the service does well: Prospective service users health and care needs, preferences and wishes are considered before any move to the home is agreed. People and their families are also given opportunity to visit beforehand. In this way they can make an informed decision as to whether the home is suitable for them. Care needs and any identified risks are well documented and are regularly reviewed with the involvement of care professionals and family members. This helps to ensure that information held about service users is accurate and up to date. Staff provide service users with as many choices as possible in their daily routines. Service users are well supported to access a variety of activities, both onsite and in the community. They have easy access to physiotherapy and hydrotherapy. Family involvement is welcomed and relatives have a say in the running of the home. Service users are offered a healthy diet and are given appropriate assistance at mealtimes. Staff offer good support to ensure that service users health care needs are met. The environment is homely and is suitable to meet current service users needs. Staff recruitment processes are thorough and training opportunities are good. This helps to protect service users and enables staff to provide good quality support and care. The manager demonstrates that she has a good understanding of her role, is approachable and offers good support to the staff team. Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5 Quality in this outcome area is good A comprehensive procedure for assessing the needs and aspirations of potential new service users is in place to ensure the service will be appropriate for them. Service users representatives need to be more involved in the drawing up to statements of terms and conditions. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The most recent service user to be admitted moved to Rakelands just over two years ago. At the inspection visit in September 2005, it was found that pre admission assessments had been completed by care managers and by staff from the home. In this way a persons needs, wishes likes and dislikes were known before any move to the home was agreed. Prospective service users are also invited to spend some time at the home before a move is finally agreed. The manager said that this would continue to happen in the future. Robinia have issued a contract of terms and conditions for each resident at Rakelands. One seen had been signed by a representative of Robinia but had not been signed by a representative of the resident concerned. It was discussed with the manager that as no current service users are able to sign Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 9 for themselves, all contracts must be discussed with service users representatives, who if in agreement with the contents could sign on their behalf. The manager agreed that this would be done. There was a previous requirement made that the home should have copies of social service contracts, so that the manager could monitor contractual obligations. Although these are not available at the home, there was evidence that representatives from social services attend detailed care reviews and so can monitor the service provided in this way. Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good Service users assessed and changing health social and care needs are reflected accurately in their individual care plan and appropriate action is taken to minimise any identified risks. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Detailed care plans and risk assessments for service users have been seen during previous visits to the home. On this visit, two further care plans were looked at to check whether staff still document information in sufficient detail. Care planning continues to contain information about health and care needs, about likes and dislikes, communication methods, and there are a number of detailed risk assessments, including fire safety and maintaining a safe environment. Care plans and risk assessments are regularly reviewed and any Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 11 changes are recorded. Staff said that any differences in care plans are discussed during staff handovers so that the changes are known by all. Records show that care plans are discussed and reviewed with relatives and relevant health care professionals. Staff were observed to give service users choices in their everyday routines, for example they observed reactions when music was playing and changed it to what service users preferred. A service user who showed that they did not want their dinner was seen to be provided with an alternative. Staff were also observed to communicate well with each individual. The needs of some service users are such that staff have installed a monitor in their bedroom so that their wellbeing can be closely checked at night. Where this is the case it is well documented in the care plans and there is evidence that family members and involved professionals have been consulted. Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good. Service users have a good range of activities to choose from and are well supported by staff to access them. Family and friends are welcomed and their involvement in the development of the service is encouraged. Nutritional needs are well catered for. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the visit some service users were out bowling, others were taking part in activities in the attached day care facility. Staff said that they support service users, in line with their care plan and risk assessments, to participate in social activities, both within the home and the community. Activities include art, games, awareness of the world by looking at stories in newspapers/magazines, listening to stories on audiotape and Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 13 cooking , as well as visits to the cinema, theatre and shopping in Portsmouth and Basingstoke. Some service users also attend a further education college. Staff record every day what each service user has done and whether or not they have enjoyed it, this information then feeds into the service users review where a timetable of activities is discussed and devised. The home has its own transport so that service users can be supported to go out into the community. There are sufficient staff on duty to ensure that service users are able to pursue their interests. Staff said that there are no restrictions on visiting, unless stated in an individuals care plan. Family members are very involved in the running of the service. They have for example developed an area of the garden and on the day of the visit, were attending a relatives meeting at Rakelands. They participate in discussions of care for their relative, and staff welcome their involvement. A copy of Service users rights and responsibilities are held in the service users guide and in the home’s statement of purpose. Menus seen show that service users are offered a variety of nutritious meals, which includes a vegetarian alternative. Catering staff said that the kitchen is suitably equipped to enable them to do their jobs. Records are kept of individual’s food intake, staff said this helps them to ensure service users are receiving a balanced diet. Records show that dieticians are involved where necessary to provide staff with specialist support and guidance. Staff were observed to provide service users with appropriate support at mealtimes and let service users eat at their own pace. Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good Personal and healthcare needs are well monitored. There are appropriate procedures in place for the safe management of medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans and risk assessments state how the individual wishes to receive their personal support These are reviewed on a monthly basis or as needs change. Technical aids and equipment to provide service users with maximum independence were seen in the home. Staff consult with relevant professionals to ensure that the equipment provided is appropriate to meet needs, for example, one staff member was observed liaising with outside agencies to arrange for a wheelchair for one service to be replaced. Specialist support is available on site from a physiotherapist and records showed that service users also receive other specialist intervention, for example, in the management of epilepsy. Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 15 The manager said that the home has good support from health care professionals and records checked showed that service users have regular checks with dentist and optician and that they have an annual check with their GP. The manager said that all staff that administer medication have received training to do so. Medicines were observed to be securely stored. Records seen were accurate. A pharmacist visits annually to review the homes medication procedures. Staff said that they feel that the system for managing medication is good. A risk assessment has been completed for drug administration errors. Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Complaints are listened to and acted upon. Service users are largely protected by the homes adult protection policies and practices although one area of guidance needs to be reviewed for greater clarity. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a written complaints procedure on display in the hallway and a complaints procedure was seen in symbol form in a service users file. Staff said that this is in place for all service users. Staff were observed respond to service users non-verbal communication during the course of the visit. Family members are very involved in the service provided to their relative, for example a relatives meeting was held during the visit. A record is kept of all complaints. Records seen indicated that one complaint had been made within the last year and that this had been fully investigated. There is a whistle blowing policy on display. Staff spoken with knew about this policy and confirmed that they had completed training in adult protection issues. The home has an adult protection procedure, which includes the Department of Health “No Secrets” guidelines. The home also has a copy of Hampshire’s guidelines for the Protection Of Vulnerable Adults. The homes adult protection procedures were discussed in detail at the time of the visit with the area manager and the manager. It was agreed that some clarification is needed Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 17 regarding when to involve external agencies to ensure the safety and protection of service users. The homes policies and practice regarding service users money were discussed and two financial records were seen. Detailed records are kept of service users money spent and accounts are regularly audited. Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good The home provides a suitable environment to meet current service users needs and effective systems are in place to control the spread of infection This judgement has been made using available evidence including a visit to this service. EVIDENCE: Home has four single and six double bedrooms. There are three lounge/diners and a separate day care area and hydrotherapy pool. All bedrooms were brightly decorated and had personal effects in, such as posters and photographs on the walls. The manager explained service users are encouraged to furnish the room with personal belongings, furniture and pictures to make it feel like home. The rest of the home appeared clean, warm and no offensive odours were detected. Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 19 Some bedrooms had special adaptations to ensure the safety of the service user, risk assessments and care plans seen confirmed this. The garden is well maintained by Friends of Rakelands and is accessible to service users. A maintenance person comes once a week or more often if necessary. The manager said that they come quickly if a maintenance problem is really urgent. Records show that a fire officer visited in April 2006 and that the Health and Safety officer from Robinia visited in May 2006. Records show that recommendations made have been implemented, although the manager agreed to seek clarification about safe storage of oxygen cylinders. Staff were seen to use protective clothing whilst completing their cleaning and food preparation and serving duties. The inspector saw certificates of staff that have attended Infection control and food hygiene training; staff confirmed they found the training useful. Laundry Facilities are sited away from areas where food is stored, prepared, or eaten. Hand washing facilities are prominently sited and alcohol gel and paper towels were available. Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33 34 35 and 36 Quality in this outcome area is good There are sufficient staff on duty to support residents effectively. Training provided for staff is appropriate. Recruitment procedures are thorough, although at times the service has struggled in retaining staff and in recruiting suitable replacements. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff were observed to be comfortable with service users and provided support in a calm and unhurried way. One visitor said that they found staff to be generally very good, and that some very good staff had remained at the service for years, however they said that that they worried about the high rate of staff turnover. Records show that six staff have left since the last inspection in February 2006. The manager said that it has been difficult to recruit staff to the service, partly because the home is not on a public transport route. A number of overseas staff have been recruited to replace staff that have left. Records show that some have previous experience in the field of care and Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 21 some have professional qualifications. The manager said that there has been at times some language difficulties. The manager said that Robinia have recognised this as a training need and provide support for this through the NVQ programme. Records show that 57 of current staff have achieved an NVQ in Care Level 2 or above. The staff rota shows that there is one trained nurse on duty every night and two care staff that sleep in. During the day there is a Registered nurse on duty at all times, five or six care assistants, and during the week a physiotherapist and an activities co coordinator. The home also employs domestic staff and catering staff seven days a week. The manager said that there are sufficient staff on duty to meet the current residents health and personal care needs and to support them in their daytime activities, this appeared to be the case during the visits. Morale in the staff team varied, some staff did not express any concerns, others said that morale is detrimentally affected because it is difficult to train new staff all the time. Staff confirmed that they attended staff meetings. Two files of recently appointed staff members were looked at to check whether the home operates a thorough recruitment procedure. They contained all supporting documents needed, this included evidence that a satisfactory Criminal Records Bureau check had been completed, evidence of identity, two written references, a copy of the contract of employment and evidence of training including a detailed induction programme. All staff asked said that the range of training provided is good and that it is appropriate to their role and responsibilities. Records show that staff are given training in all key health and safety areas, including moving and handling, fire safety infection control and first aid. They are also provided with training to assist them in caring effectively for needs identified in current service users, for example, in management of epilepsy and epistet administration. Staff also have training in values and standards and the manager said that the service is looking to provide training in diversity. Staff supervision sessions have taken place in the past, although the manager said that this has been on hold whilst the service was trying to recruit senior staff that could assist in the staff supervision programme. This has now been done and so the manager said that staff supervision sessions would recommence. Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good The home is well managed and the quality of the service is effectively monitored. Good systems are in place to help to protect the health and safety of service users This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a new manager who has been in post since March 2006. She has worked for Robinia in the past and so is aware of their policies and procedures. She has successfully obtained the Registered Managers Award and has applied to be Registered as the Manager of Rakelands with the Commission for Social Care Inspection. Staff described her as supportive and a visitor said that she was very approachable and a good manager. Through discussion it was evident Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 23 that she has a good understanding of her role and responsibilities and that she has undertaken periodic training to update her skills and knowledge. As discussed earlier relatives are actively involved and their views on the service are welcomed. The manager said the provider sent a satisfaction survey to service users, their families/representatives, social workers and staff on an annual basis. The results of this survey were not available to read during the visits. A visit takes place once a month to the home by a senior manager to review the quality of care provided, and to inspect the premises and records. A written report is compiled. The most recent visit to the home for this purpose was carried out on 30/10/06. The resulting written report was very detailed and comprehensive. The manager confirmed that all action points identified had been completed. Any accidents in the home are recorded and are reviewed by the manager and Robinias health and safety representative. Records show that equipment in the home is regularly maintained and serviced Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 24 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 Standard No Score 1 X 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 25 No 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. Standard Regulation Requirement Timescale for action 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 Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. Extracts may not be used or reproduced without the express permission of CSCI Rakelands Nursing Home DS0000011536.V317718.R01.S.doc Version 5.2 Page 27 - 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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