CARE HOMES FOR OLDER PEOPLE
Ravenscourt Nursing Home 111-113 Station Lane Hornchurch Essex RM12 6HT Lead Inspector
Ms Rhona Crosse Unannounced Inspection 16 September 2005 09:15 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 Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 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. Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Ravenscourt Nursing Home Address 111-113 Station Lane Hornchurch Essex RM12 6HT 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) 01708 454 715 01708 458 469 Lukka Care Homes Ltd Jean-Claude Seevathean Care Home 70 Category(ies) of Dementia - over 65 years of age (36), Old age, registration, with number not falling within any other category (34) of places Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 25th April 2005 Brief Description of the Service: Ravenscourt is a purpose built care home. The building has been improved and extended by the current owners of the home, Lukka Care Homes Ltd. The home accommodates 70 older people requiring nursing care. All accommodation is in single bedrooms, the majority have a lavatory and wash hand basin of their own. Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was an unannounced inspection therefore the home did not know the inspector was coming. The manager was not at the home at the beginning of the inspection, the inspector was assisted by the nurse in charge, (he was supernumerary to the rota on the day). The manager arrived later in the morning but had to leave to attend a meeting half way through the inspection, but returned after the meeting. The area manager arrived at the home later in the day. What the service does well: What has improved since the last inspection? What they could do better: Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 Page 6 Care plans need greater attention as not all areas are being updated as changes occurred. The inspector noted changes recorded in the daily record for one service user, when these were cross referenced with care plans several changes had taken place that had not been updated. This must be addressed. Where a turn chart was in use for one service user there was no entry to identify that a ‘turn’ had taken place at 10am. All nursing records must identify the care carried out. A drop in weight for another service user (who is fed by staff) was evident from the good weight monitoring that the home carries out. However this weight loss was not reported on in the daily records therefore no follow up of this loss of weight was made. Where there is a consistent weight loss a food chart should be commenced and a referral to the GP or dietician may need to be made. It was a requirement at the last inspection in April 2005 that the home must ensure that bedding is suitable for use at all times. It was observed at this inspection when a random selection of bedrooms were inspected that bedding was stained and in one room a torn pillowcase had been used, (beds inspected had been made up ready for re-use). Beds should not be made up with dirty linen, it is quite acceptable for a bed to be aired and made up later in the day. The home should have appropriate stocks of linen to allow a completed change of all beds within the home (70 beds = 140 sets of linen as a minimum.) As a result of these findings an Immediate Requirement Notice was served on the home to ensure compliance. Should the home fail to meet this requirement then further formal action will be taken against the home. Infection control was not good in the laundry room. Tea towels were observed on the floor of the laundry room. Tea towels should be placed in a bin that is used for this sole purpose while waiting to be laundered. A pair of net pants (used to keep incontinence pads in place) had faeces on them, these pants were lying on the floor of the laundry room under a plastic bag. All foul laundry must be placed in red bags. One washing machine was so full of laundry that there was no space in the drum for the laundry to be washed appropriately. Laundry and clothing is being left with stains on items (this was seen on linen on beds and also on service users clothing that had been newly laundered and ironed). The operation of the laundry must be monitored closely. Several areas of maintenance are required around the building these are reported on in the body of the report. The main kitchen of the home requires a deep clean as the ceramic tiles, blinds and woodwork are greasy and dirty. Fixed kitchen equipment also needs cleaning. The food trolley were dirty (metal frames covered with food splashes and food debris). These trolleys were laid up for the evening meal. Fly screens on one side of the kitchen were open (3 windows were open), fly screens must be kept closed when windows are open. Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 Page 7 The fridge had a puddle of water next to it on the floor. The cook said that this had been leaking. This requires attention. The food stores off the kitchen require decorating as paint is flaking from the ceiling. Cereals decanted into plastic containers were observed with no lids on them. All food decanted from it’s original container must be stored in a sealed container. 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. Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 does not apply to this home as they do not provide this This standard is well managed. EVIDENCE: From a random selection of service users files it was evident that a written pre assessment is carried out by the home prior to any admission that takes place. These held appropriate information. Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 10 and 11. Standard 9 will be inspected at further inspections. Closer monitoring of care plans is required. Not all care plans were updated as changes occurred therefore the home is not evidencing they are providing appropriate care. For one service user the nutritional care plan had not been updated to identify the changes that the inspector found recorded in the daily records. This information changed the nutritional score considerably from being a high risk to very high risk. Standards 10 and 11 were well managed. EVIDENCE: From a random selection of care plans it was observed that the majority of care plans are being updated and held the appropriate information. The wishes of service user at the time of death were also recorded in the care plans. However not all areas of care plans are being updated as changes occurred. All documentation must support the changing needs of service users. For a further service user a continual weight loss was recorded weekly from August to September. This is of concern as the service user has dementia and has to be fed by staff at meal times. There was no food chart commenced for
Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 Page 11 this person and no referral to a dietician. The care plan stated that this person ‘wandered’, however this person is now being nursed in bed and is not able to move about independently. The care plan had not been updated to reflect this. Turn charts for this service user were inspected. Turns are carried out 4 hourly due to the type of specialist mattress that is used. The turn chart had a gap on the 15/9/05 between 06.00 hours and 14.00 hours where no record was made of a turn taking place. Nursing records must reflect the care provided at all times. The care of pressure areas was well documented. Whilst the home is very good at taking and recording weights of service users they are not taking the appropriate action when a drop in weight continues. This was discussed with the manager and the nurse who is caring for the particular service users. Food charts may need to be commenced and referrals to the GP or dietician may need to be made. For another service user the care plan for maintaining a safe environment had not been updated since July 2005. This service user had had 2 falls in 5 days in August but there was no mention of this made in the care plan. Although the accidents were recorded on the accident forms, the accident on the 13/8/05 there was no mention of the fall in the daily records. All information must be recorded in the daily records to ensure continuity of care. Infection control was well managed for one service user whose file was inspected where particular care is required. It was observed that there were referrals to the Tissue Viability Nurse and clear instructions for staff to follow. This was seen as good practice. Health care needs with referrals to GP’s, diabetic specialist nurse, tissue viability nurse, optician, chiropodist and hearing aid clinic were observed to be well recorded. One service user was referred by relatives to a specialist ‘Parkinson’s’ nurse, the home should have seen the need to make this specialist referral. Staff were observed to treat service users with respect. Service users who required personal attention were observed to be assisted appropriately. In discussion with service users who were able to give a view of the care being provided it was stated that: “ staff treat me well, they are kind and help me to get washed and dressed”. “ The staff respect you when they are bathing you they don’t make you feel embarrassed”. Several service users were observed in the upstairs lounge to have stains on their clothing. Any clothing that has had food or drink spilt on it should be changed. It is poor practice to not take into consideration the dignity of service users who are unable to change their clothing themselves. This was brought to the attention of the manager, (problems observed in the laundry may relate to some of the staining observed. This is discussed in standard 26).
Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): All of the above standards were inspected at the last inspection and were well managed therefore they were not inspected as part of this inspection. EVIDENCE: Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Complaints are recorded and the action taken to address these is also recorded. A relative stated there appeared to be a lack of communication between staff in relation to some concerns raised. The home should ensure all concerns are communicated to all staff to ensure the complaint is appropriately dealt with. This action will ensure that relatives do not need to raise complaints a further time as all staff are aware of the situation that needs addressing. EVIDENCE: The home has a complaints procedure and policies that staff must adhere to, to support this procedure. The Commission’s address and contact number are identified. There has been one anonymous complaint since the last inspection this was sent to the Commission. This complaint was investigated by the Commission by an unannounced visit and further information was also looked at during this inspection. Some areas of the complaint were able to be substantiated others were not. An action plan was required to be sent to the Commission by the home to show how they would address the substantiated areas of the complaint. This is a separate document from this report and it is not a public document. Relatives spoken with at the time of the inspection were in the main happy with the care provided. One relative stated that concerns when raised are dealt
Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 Page 14 with although it was said that there was sometimes a lack of communication between staff about concerns when they were raised. The home has policies and procedures for the protection of vulnerable adults. Staff have had training in the detection and reporting of suspected abuse. Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 Page 15 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 24 and 26. The above standards were inspected. Standard 24 is poorly managed. Bedding on beds was found in some rooms to have stains and have torn linen. As this was a requirement that has not been complied with from the last inspection in May 2005 an Immediate Requirement Notice was served on the home. EVIDENCE: An inspection of a random selection of bedrooms was made on both floors. The majority of the bedrooms were clean and tidy. Domestic staff were in the process of cleaning the bedrooms. Bedding was found to be stained and unsuitable for use in three rooms, (although the beds had been made up ready for re-use). Bedroom 8 had two dirty stained pillowcases. Bedroom 11 had 4 dirty pillowcases and a torn pillowcase. Bedroom 12 had one dirty stained pillowcase. Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 Page 16 In bedroom 8 the cot side protectors were dirty and required cleaning. The carpet in this room also requires cleaning as it is stained. If the staining cannot be removed then this carpet will require replacement. Two ventilation fans in the en-suites of bedrooms 8 and 10 were not working, this must be addressed. A plug was missing from the sink in bathroom 2. This must be replaced. The bin in bathroom 1 had no lid. All bins in bathrooms must have a lid. Clinical waste was appropriately stored awaiting collection. Wheelchair were observed to be dirty having food debris on them these need to be cleaned more thoroughly and kept clean. In the laundry room infection control was not good. Tea towels were observed placed on the floor. Tea towels should be held in their own container whilst waiting to be laundered. A pair of net pants that hold incontinence pads in place were observed on the floor of the laundry room these had faeces on them. All foul linen/clothing should be stored in red bags. The washing machines were in use at the time of the inspection. One machine was so full of linen that it would not wash the linen in the machine appropriately. As the home has problems with staining this may be the cause. Both linen on beds and newly ironed clothing in the laundry has staining on them. The laundering of clothing and linen must be to an adequate standard this must be monitored as clothing is being spoiled. Maintenance of the building was taking place at the time of the inspection (the home employs 2 maintenance men). The maintenance books were inspected these books record all the repairs that require attention and records when the jobs have been dealt with. One bathroom was in the process of being decorated and a bedroom was being decorated and almost completed. The carpeting in the entrance hallway is stained in many places. Although this carpet is regularly shampooed the stains are not being removed this requires replacing. This is a requirement from the inspection in May 2005 that has not been complied with. The floor under the carpet has areas where the floor is not level. The floor below needs to be resurfaced to one level prior to a new carpet being fitted. A new timescale will be given for this requirement to be complied with. The doorframe around the door of room 24 requires making good and repainting. The wall of bedroom 16 requires repair and redecoration where it has been damaged by the wheelchair. Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 Page 17 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30. The manager must be able to evidence what training that staff have undertaken for the current year. This standard could be managed more appropriately with a system of yearly planning recorded on a flow chart to evidence the training the home is providing. EVIDENCE: The staffing levels at the time of the unannounced inspection were appropriate. Staff training is taking place and 7 staff have achieved the NVQ level 2 qualification. A further 5 staff are attending NVQ level 2 training commencing this month. Other training that has taken place this year is Manual handling (4/3/05), Nutrition (25/8/05). The manager had been using a computer programme to identify training needs for staff. A problem had arisen that needed attention from the provider of the training disc therefore information was not readily available. The home must ensure that hard copies of all training needs are held in each staff members file and are available for inspection. A random selection of staff files were inspected it was observed that one staff member did not have an induction programme held on file. The home must ensure that all files hold the appropriate employment information. Staff had appropriate CRB checks taken up. All had 2 written references.
Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 Page 18 Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 Page 19 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 36 and 38. Standard 35 will be inspected at further inspections. Closer monitoring of the weekly fire alarm checks and the recording of these checks must be made by the manager to ensure compliance with regulations. Monitoring of the cleanliness of the kitchen, equipment and practices must also take place. Poor standards could place frail elderly service users at risk. EVIDENCE: The manager is suitably qualified to manage a care home with nursing and keeps his training up to date. Staff are being given formal written supervision sessions. The home is aware that these must take place 6 times within one rolling year. Staff performance appraisals are also taking place. Fire alarm call points are being checked, however there was no record of the alarm being checked for the week between 1/9/05 and 16/9/05. These tests must be carried out weekly and recorded. The fire alarm was last serviced on the 29/3/05. The last fire drill took place on the 10/5/05 (22 staff). Emergency
Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 Page 20 lighting was tested on 28/7/05. Fire extinguishers had their annual safety check on the 29/4/05. A basket of coat hangers was restricting access to the fire extinguisher in the laundry room. No items must block assess to fire extinguishers. The annual gas safety certificate was dated 16/3/05. The bath hoists and portable hoist were serviced on the 3 & 4 April 2005. The nurse call system was tested serviced on the 28/7/05. The passenger lift was serviced on the 27/1/05. The cleanliness of the kitchen was poor. The ceramic tiles, blinds and woodwork requires deep cleaning to remove the dirt and grease, as does the fixed kitchen equipment. All equipment was said by the cook to be in working order. However a puddle of water lay on the floor by the fridge. It was then stated that the fridge was loosing water. This must be addressed. The food stores require decorating as the paint is flaking off the ceiling and could fall into food. Cereals that had been decanted into plastic containers had no tops to them. These lids could not be found by the cook. All food must be covered or sealed in appropriate containers. Feeding beakers were on trolleys for re use. These beakers were very stained. When the inspector raised this with the kitchen staff they were rewashed and the stains removed. Feeding beakers should be appropriately washed after each meal. Any scored or stained beakers that cannot be cleaned must be disposed of and new ones provided. The kitchen staff stated that there were no stocks of spare feeding beakers. The home must hold in stock a sufficient supply of equipment. Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 Page 21 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 2 8 2 9 X 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 X 2 X X 2 X 2 STAFFING Standard No Score 27 3 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X 3 X 1 Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP7 OP8 Regulation 15(1) & (2) 17(1)(a)s chedule3( k) 17(1)(a)3 (k)13(1)( b) 17(1)(a)s chedule3( k) Requirement Care plans must be updated as changes occur. Turn charts must be appropriately completed. The nursing records must show the care provided at all times. Any continued weight loss should be documented in the daily record and advice must be sought from health professionals. Any accident should be recorded in the daily records as well as on the accident form to ensure continuity of care and ensure staff are aware to look for signs and symptoms after a fall that may develop later. Service users clothing should be kept free of stains. Clothing should be changed when food spills occur. Sitting in dirty clothing affects their dignity (particularly where the person has dementia and are not able to make the decision to change their clothes themselves). Ensure that all staff are aware of concerns raised as complaints
DS0000015600.V250814.R01.S.doc Timescale for action 30/11/05 30/11/05 3 OP8 30/11/05 4 OP8 30/11/05 5 OP10 12(4)(a) 30/09/05 6 OP16 17(2)(11) 30/09/05 Ravenscourt Nursing Home Version 5.0 Page 23 7 8 OP19 OP19 23(2)(b) 23(2)(b) 9 OP19 23(2)(b) 10 11 OP21 OP24 23(2)(p) 23(2)(d) 12 13 14 OP24 OP24 OP24 23(2)(c) 23(2)(d) 16(2)(c) 14 15 OP26 OP26 13(3) 13(3) (handling of the laundering of clothing) made by relatives is compounded by the lack of good communication and recording. Replace the missing plug in bathroom 2. Replace the carpet in the entrance way as this is stained. This was a requirement at the last inspection that had a compliance date of 30/8/05. the home must comply with this by the new date set. Level the floor in the entrance hallway prior to the new carpet being fitted as this floor is uneven. Repair the ventilation fans in the en-suite of bedrooms 8 and 10. Ensure that all fans are working. Shampoo the stained carpet in bedroom 8 if the stains cannot be removed then this carpet requires replacing. Shampoo the carpet, if the stains are not removed then replace the carpet. Repair the plaster work around the door frame of bedroom 24 and decorate the wall. Decorate bedroom 16 where the wall has been damaged by the wheelchair. Bedding should be suitable for use at all times (no torn or stained bedding should be used). This was a requirement at the last inspection that was not complied with. An Immediate Requirement Notice was served on the home. Foul linen/clothing should be put into red bags prior to laundering. Tea towels should not be left on the floor of the laundry room this is poor infection control. A container used only for tea towels should be used until they
DS0000015600.V250814.R01.S.doc 30/09/05 30/11/05 30/11/05 30/09/05 30/11/05 30/10/05 30/10/05 15/09/05 30/09/05 30/09/05 Ravenscourt Nursing Home Version 5.0 Page 24 16 OP26 13(3) can be laundered. Cot side protectors should be kept clean at all times. Wheelchairs must be cleaned and then be kept cleaned. All staff must have a written training plan to identify the training they have undertaken and their new training needs. Do not obstruct access to fire extinguishers (basket of coat hangers placed underneath the fire extinguisher in the laundry). Deep clean the kitchen walls, woodwork and blinds to remove dirt and grease. Also degrease kitchen equipment. Keep fly screen closed when kitchen windows are open. Decorate the 3 food stores If food is decanted from the original packaging it should be kept in sealed boxes (cereals left in boxes with no lids). Keep food trolleys clean and free from food stains (metal frames of both trolleys should be part of the daily cleaning schedule). 30/09/05 17 OP30 18(1)(c) (i) 13(4)(b) 30/11/05 18 OP38 30/09/05 19 OP38 13(3) & 23(2)(d) 13(3) 23(2)(d) 13(3) 30/10/05 20 21 22 OP38 OP38 OP38 30/09/05 30/12/05 30/09/05 23 OP38 13(3) 30/09/05 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 Refer to Standard OP26 OP38 Good Practice Recommendations Monitor the laundry systems (machines over loaded and clothing/linen has stains that are not being removed. Add the cleaning of the metal work of food trolleys to the daily cleaning schedule. Ravenscourt Nursing Home DS0000015600.V250814.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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