Inspection on 26/02/07 for Ranvilles Nursing & Residential Care Home

This inspection was carried out on 26th February 2007.

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

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

Other inspections for this house

Ranvilles Nursing & Residential... 23/02/10

Ranvilles Nursing & Residential... 28/01/10

Ranvilles Nursing & Residential... 03/11/09

Ranvilles Nursing & Residential... 14/01/09

Ranvilles Nursing & Residential... 07/10/05

Ranvilles Nursing & Residential... 23/06/05

Ranvilles Nursing & Residential... 01/10/04

Ranvilles Nursing & Residential... 18/06/04

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

CARE HOMES FOR OLDER PEOPLE Ranvilles Nursing & Residential Care Home 5/7 Ranvilles Lane Fareham Hants PO14 3DS Lead Inspector Val Sevier Unannounced Inspection 26th February 2007 09:30 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 Ranvilles Nursing & Residential Care Home DS0000011471.V328878.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. Ranvilles Nursing & Residential Care Home DS0000011471.V328878.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ranvilles Nursing & Residential Care Home Address 5/7 Ranvilles Lane Fareham Hants PO14 3DS 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) (01329) 842627 (01329) 847743 admin@ranvillesnh.fsnet.co.uk Visram Limited Denise Susan Trott Care Home 53 Category(ies) of Dementia (53), Dementia - over 65 years of age registration, with number (53), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (53) Ranvilles Nursing & Residential Care Home DS0000011471.V328878.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. From time to time the home may admit service users under 65 years of age with dementia. 10th January 2007 Date of last inspection Brief Description of the Service: The home offers nursing care to older people with mental health difficulties. It is a large converted house in a quiet rural area near Titchfield. The home offers accommodation in both single and double rooms. The house is set in its own gardens with car parking for visitors at the front of the house. The fees for the home are £625 per week and will be reviewed later in the year. Ranvilles Nursing & Residential Care Home DS0000011471.V328878.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. The findings of this report are based on several different sources of evidence. These included: an unannounced visit to the home, which was carried out on the 26th February 2007, during which there were discussions with staff, residents, relatives and visitors to the home. In addition 7 relatives had completed questionnaires prior to the visit. During the visit to the home a tour of the premises was carried out with where possible, permission of the residents at the home, this also included their rooms. Staff and care records were sampled and in addition to speaking with staff and residents, their day-to-day interaction was observed. All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the Commission for Social Care Inspection. What the service does well: The home welcomes both service users, and their friends and families, to visit the home and assess the facilities and suitability of the home. The manager actively seeks information from external healthcare professionals as part of the assessment, to ensure that the home is able to meet assessed needs. Service users moving into the home are assured that the home that they are entering will meet their needs. For example, staff members are well trained in dementia and mental health care and show great perception and professionalism in the way they deliver care, which enables service users to feel safe and enjoy a varied and companionable way of life. This feeling of well being is enhanced by the close links, which are maintained with local healthcare professionals and the recording systems which support this. Many of the service users present with very challenging behaviour. For one service user who was admitted from a psychiatric unit the staff have managed their care extremely well and they have been able to remain resident in the home rather than be cared for in a hospital setting. Staff members treat service users with great respect; they share their companionship and give support sensitively. Detailed records were in place that gave nursing and care staff information that enabled them to provide the help that residents’ needed. Residents felt safe and secure and happy that staff could look after them properly and treated them with respect. Ranvilles Nursing & Residential Care Home DS0000011471.V328878.R01.S.doc Version 5.2 Page 6 Residents’ health care was promoted through the use of among other things monitoring the nutritional needs of individuals when that was necessary. The home had also developed good working relationships with healthcare specialists. Residents and relatives described the staff group as friendly and relationships between staff and residents were relaxed and informal. Daily routines in the home were flexible and residents were encouraged to make choices for themselves and exercise personal autonomy as far as was reasonably possible. Residents were positive about the food that the home provided and were pleased with the range of activities in which they could participate and the condition of the accommodation that they occupied. Staff, residents and relatives had confidence in the effectiveness of the home’s manager. Systems and procedures in the home worked well including, the management of medication, dealing with complaints, staff recruitment, quality monitoring, and health and safety. 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. Ranvilles Nursing & Residential Care Home DS0000011471.V328878.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ranvilles Nursing & Residential Care Home DS0000011471.V328878.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 (Standard 6 is not applicable to this service) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admissions process provides prospective residents and their families with details and opportunities to enable them to make an informed decision about admission to the home. EVIDENCE: All care is taken in assessing prospective residents to fill any vacancies at the home as this ensures a well-balanced community. The staff are aware of the needs of service users and how their needs and aspirations can best be met. Information is given to individuals where an interest in the service has been received. It contains all the information necessary for an individual or more often a relative, to make informed decisions as to whether the care offered at the service is for them. Ranvilles Nursing & Residential Care Home DS0000011471.V328878.R01.S.doc Version 5.2 Page 9 The inspector sampled five care plans which contained pre admission assessments and information from other professionals such as social services and health, which helped the home assess whether they could meet the needs of the individual. The manager also explained how recently a nurse and carer went on two occasions to care for an individual in the hospital so that they could see what support was needed and ensure that Ranvilles was appropriate. A review of the admission for each individual after a month ensures that the home can meet the needs and this was seen to be an active part of the assessment of individuals and to the care planning for them. Ranvilles Nursing & Residential Care Home DS0000011471.V328878.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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. The home had systems in place to ensure that the personal and healthcare needs of residents were met and medication was managed safely and effectively. Staff working practice helped to ensure that residents’ privacy and dignity was promoted. EVIDENCE: The inspector sampled five care plans on this occasion in conjunction with a sample of medication records and other health-monitoring tools used at the home. The care plans that have been developed for the residents were seen to be a working tool, with records of daily life and monthly evaluations by the key worker. The documents examined and the plans were based on the assessments the home carried out in order to identify what help individuals needed. Assessments included a range of potential risks to residents e.g. pressure Ranvilles Nursing & Residential Care Home DS0000011471.V328878.R01.S.doc Version 5.2 Page 11 sores; falls; moving and handling; malnutrition; etc. Where a pressure sore assessment indicated that an individual was at risk it was noted that the corresponding plan of care for the person concerned referred to the use a pressure relieving aid. The plans examined also set out clearly the actions staff had to take and what specialist equipment was needed to provide the support and assistance each person required. From written evidence of care plans and speaking with staff it would appear that the staff are equipped with knowledge and skills to care for the needs of people at the home. It would also seem speaking with staff and relatives that no one is afraid to ask questions about issues of concern about needs. It was seen in the care plans that physical health needs are also addressed with recent residents having moved to the home with comprehensive information from health and other specialists; this information has been incorporated into the care plan at this home. It was also seen that residents have access to opticians and dentists as needed. Relatives spoken with were involved in the care planning having meetings with the manger. They felt this was important, as the residents although involved, due to their personal issues are not always able to give information or informed consent. The consultation was also appreciated, as the relatives spoken with had been the carers for in some cases years, and they felt that this kept them involved in the care. Two visitors spoken to commented about how the home’s staff promoted the healthcare needs of their relative: • “The staff all seem very attentive and they all know him and his ways … they always tell me if he is unwell, or if anything is needed.” Where care plans referred to the use of equipment or how a specific need was to be met this was observed to be available, provided or in place e.g. pressure relieving aid; Zimmer frame; or hoist. Records indicated that care plans were reviewed at least monthly and daily notes referred to the actions taken by staff to provide the needs set out in those plans. Staff spoken to knew the needs of the individuals whose records were sampled and they were able to describe the contents of the care plans. The residents have a wide range of mental health issues which need constant support from staff to prevent or minimise what would be regarded as “challenging” behaviours elsewhere, to do this staff need up-to-date knowledge of each resident. Staff were observed speaking and assisting the residents with dignity and respect. Affection was given appropriately to those residents who sought it. It had been seen on care plans that the preferred choice of name had been recorded and staff were heard to speak to residents by the name they wished. There are several residents at the home whose behaviour does on occasion give concern. One care plan seen evidences that these behaviours are Ranvilles Nursing & Residential Care Home DS0000011471.V328878.R01.S.doc Version 5.2 Page 12 managed verbally although there have been incidents with broken property and verbal shouting. The staff are not trained in any physical holding and do not do it. They have been trained in verbally calming someone or other action such as safety in people’s personal rooms. The home had written policies and procedures concerned with the management and administration of medication. Medication was kept in locked and secured medicine trolleys, cupboards and where required in a medical refrigerator. Controlled drugs were stored securely and appropriately. A sample audit of controlled drugs indicated that the records were accurate and up to date. A monitored dosage system for the management of medication was operated by the home. A local pharmacist provided most prescribed medication every 28 days in blister packs for each person concerned. Other medicines that could not be put into these packs because they could spoil, such as liquids or those that were to be taken only when required were dispensed from their original containers. The only staff in the home that dispensed and were responsible for the management and administration of medication on a day-to-day basis were registered nurses. The inspector observed that the staff spoke with the residents in an appropriate way and ensured that privacy and dignity were offered in the manner that they supported the residents. Ranvilles Nursing & Residential Care Home DS0000011471.V328878.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home organised a range of social activities that provided stimulation and it also promoted residents self-determination, enabling residents to exercise choice about all aspects of their daily life. Residents were able to maintain links with relatives and the community. The dietary needs of residents were well catered for with a balanced and varied selection of food available that met their tastes and choices. EVIDENCE: A list of social activities that were organised by the home was on display in its entrance hall and they included the following: Bingo; reminiscence; music and movement; art works; sing-a-long; board games; quizzes and manicures. A harpist was scheduled to visit the home in the near future to provide entertainment, and a regular monthly party is held with an entertainer who residents remember by his character. Ranvilles Nursing & Residential Care Home DS0000011471.V328878.R01.S.doc Version 5.2 Page 14 One individual is supported to maintain previous links with the community and attends clubs three days a week; the same taxi driver provides transport, which helps, as they know the individual well. The same individual is also supported in their visits to friends at the weekend. A relative spoken with said that they take their relative out whenever possible and the staff are always helpful in supporting this. Relatives spoken with confirmed that there were no restrictions concerned with visiting the home and relatives said that they were always made welcome. There was information in the entrance of the home with details about an organisation that could provide impartial advice, information and guidance to residents and/or their families. Residents were able to bring personal items into the home including furniture and it was apparent from discussion with residents and observation during a tour of the building that some individuals had taken trouble to personalise their bedroom accommodation. Sensitive information that the home held about residents was kept secure and the home had written policies and procedures about maintaining confidentiality and residents rights to access their personal files and case notes. All residents spoken who were able to pass comment were complimentary about the food provided. The relatives spoken with said that the food always looked nice when they were there and they could have a meal as well if they wanted. The menus and records of food provided indicated that the food was nutritious and there was a wide range of meals provided with a selection of choices every day. In addition special diets and individual preferences and needs were catered for e.g. soft and pureed meals and diabetics. Residents could choose where to eat and some preferred to eat in their rooms. Individuals were asked what choices they wanted from the menu a day in advance. Food preferences, dislikes, food related allergies and nutritional and dietary requirements were recorded in residents care plans and the information was also readily available to catering staff. The main meal of the day was observed and it was unhurried and staff were sensitive when providing assistance. Ranvilles Nursing & Residential Care Home DS0000011471.V328878.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had a clear complaints procedure to address the concerns of residents and relatives/representatives. Procedures were in place to protect service users from the risk of abuse. EVIDENCE: There have been no complaints made since the last inspection to either the home or to the CSCI. Relatives spoken with and those who returned comment cards, were aware of how to complain and said they felt comfortable in speaking with the manager or deputy about any issues. The home had written procedures available concerned with adult protection. These were intended to provide guidance and ensure as far as reasonably possible that the risk of residents suffering harm was prevented. Staff spoken to said that they received training about protecting and were also able to demonstrate an awareness of the different types of abuse and the action they would take if they suspected or knew that it had occurred. As part of their contract of employment all staff working in the home had to read and sign a statement about the abuse of vulnerable adults. It required Ranvilles Nursing & Residential Care Home DS0000011471.V328878.R01.S.doc Version 5.2 Page 16 them to report any incidents they witnessed or suspected that they believed constituted abuse. There has been one allegation regarding adult protection at the home since the last inspection, which has been investigated. The allegations were unproven however the home used the example to review its recording procedures and care issues. The manager undertakes training the staff in this area, and staff spoken with were aware of the whistle blowing policy and the training. The home had written policies and procedures about the use of bed rails, where subsequent to an assessment it was considered necessary for a resident’s safety to use bed rails written permission/consent was obtained and their use was reviewed regularly. Ranvilles Nursing & Residential Care Home DS0000011471.V328878.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s environment was safe and well maintained. There was an infection control policy and procedures in place and staff practice ensured that as far was reasonably possible residents were protected from the risk of infection. EVIDENCE: The home has been extended and the older areas have been refurbished. The inspector undertook a partial tour of the home sampling rooms. The exterior and interior of the premises, its décor, furnishings, fittings and equipment were in good repair. There was also no unpleasant odour anywhere in the building. Ranvilles Nursing & Residential Care Home DS0000011471.V328878.R01.S.doc Version 5.2 Page 18 The home employed maintenance personnel to; undertake minor repairs and re-decoration; keep the grounds and garden maintained; and ensure that safety systems were checked and serviced. Comments from residents and relatives about the condition of the premises included: • “Oh! yes they are particular about keeping it clean, the windows ands so on, I think they also look after the building”. • “It is kept spotless and the building itself is kept up with decoration”. • “I am a painter and decorator and I think that it is well looked after and maintained, everything the gardens and so on. They certainly keep the place clean”. There are good internal and external facilities. Communal areas enable service users and staff to have space, comfort and privacy. The inspector observed that the temperature throughout the home was alright for the residents and not too hot. It was quite an airy building. Residents can individualise their rooms with paintings, pictures etc. Individuals can control the lighting in their room. Some liked the lights off and the room dim. The common areas and passageways had numerous paintings and pictures to stimulate interest. Some bedrooms are locked which the home says is to protect the belongings of the individuals, although two residents have keys to their own rooms. It was observed that some residents are able to access the different floors of the home and were attempting to open doors that were not to their rooms. As part of the outcome form the Protection of Vulnerable Adults meeting recently the home is reassessing this policy and alternative ways of enabling access for all to their rooms. If is felt that this is not possible then the home intends to have this in their statement of purpose and discuss with relatives and residents where possible, the policy for each individual. It was noted that in accordance with best practice all communal WCs that were seen were provided with liquid soap dispensers (that were full and working), alcohol gel sanitizers and paper towels. Protective clothing was readily available and staff were observed using gloves and aprons appropriately. The home’s laundry was appropriately sited and equipped and effective procedures were in place for the management of soiled laundry items. Ranvilles Nursing & Residential Care Home DS0000011471.V328878.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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. Residents are well looked after by an effective staff group. Staff morale is high resulting in an enthusiastic workforce that works positively with residents to maintain and improve their quality of life. The home had clear staff recruitment, training and development procedures that ensured that service users were protected and supported. EVIDENCE: The staffing structure provides a broad spread of experience and professionalism: manager, deputy, nurses and support workers. Other health care professionals support the team from outside the home. The duty rota showed how staff are deployed at the home with two nurses and six support workers during the day and one nurse and four support workers at night. The manager explained that staffing is being reviewed as the occupancy increases following the extension. The following are the expected staffing levels as the numbers of residents increase: No of residents 07:30 - 19:30 19:30 – 07:30 48 2 nurses 7 carers 1 nurse 5 carers 50 3 nurses 7 carers (pm 2 8) 2 nurses 5 carers 53 3 nurses 9 carers (pm 2 9) 2 nurses 5 carers Ranvilles Nursing & Residential Care Home DS0000011471.V328878.R01.S.doc Version 5.2 Page 20 Apart from registered nurses and care assistants the home employs other staff and these comprised of: Registered manager, Administrator, Chefs, Kitchen assistants, Domestics, Laundry assistant & Maintenance personnel. Records were examined of four staff that had been employed to work in the home since the last fieldwork visit to the home. It was apparent that all statutorily required pre-employment checks, intended to ensure that people unsuitable to work with vulnerable adults were not employed, had been completed before the individuals concerned actually started working in the home. All new staff received comprehensive induction and health care assistants completed a programme that satisfied the requirements of the training body for the social care workforce i.e. “Skills for Care” (previously the Training Organisation for Personal Social Services [TOPSS]). Conversation with staff indicated that in addition to their induction training they attended training in subjects that ensured that they kept their clinical and other skills up to date. One registered nurse said that she was hoping to start a course on older person at the University; two staff are currently working to wards the Registered Managers Award and hope to finish soon. The staff work in two teams overseen by a senior nurses the tams consist of four and five nurses, and eight care staff. Of the 16 care staff eight have achieved either Level 2 or 3 NVQ in care with a further 3 working towards this qualification; four staff have achieved skills for care foundation. Ranvilles Nursing & Residential Care Home DS0000011471.V328878.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s manager provides effective leadership There were systems and procedures in place for monitoring and maintaining the quality of the service provided and promoting the safety and welfare of everyone living and working in the home. EVIDENCE: From discussion with staff, residents and relatives it was apparent that the registered manager was; highly motivated; enthusiastic; concerned; sensitive and empathic. The term most used to describe her was “very caring”. Ranvilles Nursing & Residential Care Home DS0000011471.V328878.R01.S.doc Version 5.2 Page 22 Examination of the home’s documentation and management systems indicated that she was organised, kept up to date with developments in health and social care and was committed to staff training and development. The home had systems in place for monitoring the quality of the service that it provided that included the use of questionnaire to obtain the views of residents and relatives. The responses from these and details of any action that that was taken as a result, was summarised in the home’s “Residents Guide”. Representatives of the company that owned the home conducted monthly visits to the home in accordance with Regulation 26 of the Care Homes regulations 2001. These visits were also used to monitor the quality of the service the home provided and the persons visiting completed audits of the home’s systems including; plans of care; staff training; and the environment. There were a range of written policies and procedures available for staff to refer to as guidance and to inform their practice. These included the following: • Admission, discharge and transfer of residents • Human Rights • Confidentiality and access to personal records • Abuse of the person • Restraint • Guidelines for use of mechanical restraint • Drug administration • Self administration of medication • Infection control • Complaints procedure • Whistle-blowing • Sexuality • Health and safety at work The home looked after personal monies for some residents that has been given by relatives or representatives. On this occasion a sample of monies held on behalf of residents and the corresponding records was examined and all were accurate and up to date. Records examined indicated that the home’s equipment, plant and systems were checked and serviced or implemented at appropriate intervals i.e. passenger lift and hoists; fire safety equipment portable electrical equipment; hot water system; etc. There were contracts in place for the disposal of clinical and household waste. Records were kept of accidents. Staff said that they attended regular and compulsory fire and other health and safety training. There was a fire risk assessment for the premises, tests of Ranvilles Nursing & Residential Care Home DS0000011471.V328878.R01.S.doc Version 5.2 Page 23 equipment and regular risk assessments of the premises and working practices were undertaken regularly. Guards covered all radiators in the home and all windows above the ground floor were fitted with restrictors. There were two staff employed in the home who were accredited moving and handling trainers and there were hoists, and other equipment in the home to promote safe working practices. Ranvilles Nursing & Residential Care Home DS0000011471.V328878.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X 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 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Ranvilles Nursing & Residential Care Home DS0000011471.V328878.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard 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 Ranvilles Nursing & Residential Care Home DS0000011471.V328878.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 Ranvilles Nursing & Residential Care Home DS0000011471.V328878.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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