Inspection on 25/05/05 for Ravenscourt Nursing Home

This inspection was carried out on 25th May 2005.

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

The inspector 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

Ravenscourt Nursing Home 29/07/08

Ravenscourt Nursing Home 26/04/07

Ravenscourt Nursing Home 21/04/06

Ravenscourt Nursing Home 16/09/05

Ravenscourt Nursing Home 19/01/05

Ravenscourt Nursing Home 09/09/04

Ravenscourt Nursing Home 21/01/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Ravenscourt Nursing Home 111-113 Station Lane Hornchurch Essex RM12 6HT Lead Inspector Rhona Crosse Unannounced 25 May 2005 09:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 G55 S15600 Ravenscourt V222340 250405 Stage 4.doc Version 1.20 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 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 CRH Care Home 70 Category(ies) of DE(E) Dementia (over 65) - 36 registration, with number OP Old Age - 34 of places Ravenscourt Nursing Home G55 S15600 Ravenscourt V222340 250405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: There are no conditions of registration placed on the home. Date of last inspection 19 January 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 G55 S15600 Ravenscourt V222340 250405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection service users files were looked at along with care plans, risk assessments, medication administration sheets and medication held in the home as well as the records of medication returned to the pharmacy. The building was inspected and a random selection of service users bedrooms were inspected. The home’s main kitchen was inspected. All records required to be held by regulations were inspected. The manager was not at the home as he was taking annual leave. The deputy manager assisted the inspector with the inspection. Documentation was easily accessible for all health and safety matters. Relatives visiting the home at the time of inspection had no concerns about the operation of the home and praised the manager and staff for the care they provide. Activities were taking place at the time of the inspection and the home celebrated Easter and also St George’s day. The next entertainment it to take place on the 28 April when an outside entertainer is booked to sing at the home. Posters advertising this event were on display around the home. Not all standards were inspected at this inspection these are identified in the report. However the remaining standards identified as not inspected will be inspected at subsequent inspections. Requirements were made for the home to improve in several areas. These requirements will be monitored to ensure the home make the changes necessary to improve the service they provide What the service does well: The recording and care of pressure sores is well documented with evidence of wounds healing. Appropriate equipment is provided for physically frail service users. Checks maintain this equipment to the accepted level. Health care professionals are contacted as needed and advice was documented being sought from the dietician, speech ad language therapist, physiotherapists and tissue viability nurses. Activities were taking place at the time of the unannounced inspection. Easter was celebrated with an organised party that relatives and friends were invited to and neighbours from the community also attended. A celebration of St George’s day took place on Saturday. Further entertainment is booked for the 28 April and posters were displayed around the home advertising the entertainer. Ravenscourt Nursing Home G55 S15600 Ravenscourt V222340 250405 Stage 4.doc Version 1.20 Page 6 Choices relating to service user’s daily life appear to be met from discussion and observation at the time of the inspection. What has improved since the last inspection? What they could do better: The recording of medication must improve, significant errors were found. These have been identified in the body of the report. It is recommended that the manager monitor both units to ensure that the regulations are complied with. It was of concern to the inspector that the nurse in charge of the downstairs unit did not take the errors made in his section seriously. This was raised with the deputy manager at the feedback of the inspection. This must be addressed. The majority of service uses files taken at random had some areas that had not been addressed. Closer monitoring and attention to detail, cross referencing records as a whole would enable standard 7 to be met if risk assessment were updated as changes occur and all areas of care plans were updated as changes occur. One service users privacy and dignity was not dealt with appropriately during the inspection. This concern was raised with the manager and the member of staff caring for the service user. However in discussion with relatives visiting both units it was stated that they felt their relatives were respected and Ravenscourt Nursing Home G55 S15600 Ravenscourt V222340 250405 Stage 4.doc Version 1.20 Page 7 privacy and dignity was respected. The concern was brought to the deputy manager attention and the inspector also spoke to the member of staff who was attending the service user. Refurbishment, decoration and repairs are required in some areas for the home. Requirements have been made due to these findings. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ravenscourt Nursing Home G55 S15600 Ravenscourt V222340 250405 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Ravenscourt Nursing Home G55 S15600 Ravenscourt V222340 250405 Stage 4.doc Version 1.20 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 standard(s) 1,2,3,4,5, standard 6 does not apply to this home as they do not provide this service. The home is working within the guide lines and regulations set for care homes and shows that this area is well managed. Standard 6 looks at whether the home provides intermediate care. The home does not provide this service. EVIDENCE: The Statement of Purpose and the Service Users Guide have been updated since the last inspection with information about what service users relatives felt about the service provided by the home. These documents explain the service the home will provide to service users. Service users and their relatives are able to visit the home prior to admission this was confirmed by a recent service user’s relative spoken with. From a random selection of service users files it was observed that assessments are carried out by the home for any new service user and the assessments are held on service user’s files along with a copy of the assessment carried out by the social services department of the local authority. Service users are provided with a contract or terms and conditions of residence depending on whether they are privately placed or Ravenscourt Nursing Home G55 S15600 Ravenscourt V222340 250405 Stage 4.doc Version 1.20 Page 10 funded by the local authority. Standard 6 looks at whether the home provide intermediate care. The home do not provide this service. Ravenscourt Nursing Home G55 S15600 Ravenscourt V222340 250405 Stage 4.doc Version 1.20 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 and 10 Standard 11 will be inspected at further inspections. With more attention paid to all sections of the service users care plans standard 7 could be met fully. There is good recording identifying pressure sore care and good practice that shows wounds healing, this area of care is well managed and documented. Service users health care needs are well met with advice sought from health professionals as necessary. Some risk assessments were not appropriately updated as the service user’s needs changed. This places vulnerable service user’s at risk. Risk assessments must be updated as changes occur. Standard 9 (medication practice) needs to be improved. There were several areas where the home failed to meet the regulations in this standard. This must be addressed. It is recommended that the manager carries out an audit of medication recording for each of the two units. The nurse in charge of the downstairs unit at the time of inspection did not take the matter of miss-recording seriously. This is of concern to the Commission. Although privacy and dignity was said to be respected when relatives spoke to the inspector. The inspector saw poor practice taking place. Standard 11 (death and dying) was not inspected at this inspection but will be inspected at other inspections and reported on. EVIDENCE: Ravenscourt Nursing Home G55 S15600 Ravenscourt V222340 250405 Stage 4.doc Version 1.20 Page 12 A random selection of care plans were inspected. Pressure care was well recorded with all care plans continually updated as changes occur. Wound assessment forms were observed to be being completed each time a dressing change is made. However other areas of care plans were not always updated. For one service user who had had a fall, the risk assessment made no mention of this and was not updated to show how after a fall between the bed and the bed rails what action needs to be taken to prevent this occurring again. Turn charts inspected showed that an turn chart for one service user was not appropriately completed as per the care plan of 2 hourly turns. Records for the dates of 21/4/05 and 24/5/05 had gaps where no ‘turn’ was recorded as taking place on either dates between 18.00 – 22.00 and 19.00 – 22.00. The are plan also states that the person should not be turned onto the right side but nursed on the left side and back, however the turn chart recorded right sided turn taking place. Turning should always be undertaken in line the care plan. Medication recording showed errors in the recording of medication. A full medication audit of the 67 service users accommodated was carried out. For the downstairs unit the controlled drug book and the medication held by the home corresponded with each other. However regarding medication recorded as being received into the home on the 22/4/05 (erythromycin tablets), the amount received was recorded as 100 when only 28 tablets were dispensed from the pharmacy. This is a legal document and this error had not been picked up by any of the nursing staff, this is poor practice. On the instruction of the inspector the nurse in charge recorded on the back of the medication administration sheet the error made. Other medication was not signed as being administered. When a change to mediation was made after a visit from the GP the date of the instruction was not recorded. When medication is carried forward onto another medication administration sheet the amount of medication carried forward was not recorded to enable a clear audit trail to be shown. The medication for the upstairs unit was inspected. The controlled drug book stated that Temazepam 20mgs 25 tablets had been returned to the pharmacy but the drugs return book did not identify that this medication was returned. The drugs return book was at times not appropriately completed. For service user (A) the entry dated 25/4/05 recorded Quetiapine 25mgs tablets as being returned to the pharmacy but no quantity was recorded. For the same date service user (B) ‘Cavilon’ was recorded no other information was recorded as to exactly what was returned. The quantity of medication in mls or a count of tablets/capsules must always be recorded in the drugs return book. The medication administration sheets identified 7 times where medication was either not signed as being given or if a code had been used then it was not recorded on the medication administration sheet why this medication was not administered. In discussion with relatives visiting at the time of the inspection confirmed that their relatives were treated with respect and that their privacy and dignity was respected. However a service user was seen being taken to the bathroom already undressed and was only partially covered with a sheet, his legs were on full view. This is unacceptable practice there is no need for any service user to be taken by wheelchair in a state of undress to a bathroom. Clothing should Ravenscourt Nursing Home G55 S15600 Ravenscourt V222340 250405 Stage 4.doc Version 1.20 Page 13 be removed in the bathroom. The inspector spoke about this with the deputy manager and also the male member of staff caring for the service user at the time. Ravenscourt Nursing Home G55 S15600 Ravenscourt V222340 250405 Stage 4.doc Version 1.20 Page 14 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 standard(s) 12,13,14and 15 The standards in this section were all met at the time of the inspection. Choices were seen to be given to service uses in all aspects of daily life. This area of the standards is being well managed. EVIDENCE: Relatives visiting at the time of the inspection stated that there are no limits placed on visiting or any specific visiting times stated. Relatives said they were free to come and go when they wished. From inspection of a random selection of bedrooms it was seen that service users are able to personalise their rooms and therefore their preferences are taken into consideration. In the initial assessment forms service user’s likes and dislikes were recorded along with religious and social interests. From the inspection of meal choices these showed that service users make choices and can have other meals over and above the stated menu if there is nothing to their liking on any particular day. Meals provided were varied. Choice about going to bed and rising was spoken about with relatives. Service user were seen to be given choice with some service user who like to rise later given breakfast in bed. The activities coordinator was commencing activities at the time of the unannounced inspection. Ravenscourt Nursing Home G55 S15600 Ravenscourt V222340 250405 Stage 4.doc Version 1.20 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17 and 18 There has been a marked fall in complaints made to the home and to the Commission about the operation of the home. The home appear to have improved their communication with relatives in relation to concerns raised. This is seen as good practice. EVIDENCE: There has been one complaint recorded since the last inspection. The complaint was appropriately recorded, investigated and the action taken recorded. The complainant was happy with the outcome of the investigation and this was also recorded as the standards require. Staff have received training in adult protection and there are policies and procedures for the protection of service users. Ravenscourt Nursing Home G55 S15600 Ravenscourt V222340 250405 Stage 4.doc Version 1.20 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25 and 26. The majority of the home was clean and well maintained. Evidence was seen by the inspector that maintenance is ongoing. Several areas have been refurbished and bathroom ‘2’ is being decorated. The inspector found some areas of concern. Staff must report any work needed to the maintenance men to ensure that this is dealt with speedily. EVIDENCE: The home is continually being refurbished as rooms become vacant. The shower room has been decorated and bathroom floors have been replaced as well as some lavatory floors. The work top in the servery has been replaced. Work is due to start in the dry store cupboards with the decoration and replacement of worktops. A random selection of service users bedrooms were inspected. Bedrooms inspected were clean and appropriately decorated with evidence of personal possessions in all bedrooms. In the en-suite of bedroom 8 there appeared to be a leak at the soil pipe behind the lavatory. This information was passed onto the maintenance men to be dealt with that day. The bathroom identified as number 1 had no plug for the wash hand basin this Ravenscourt Nursing Home G55 S15600 Ravenscourt V222340 250405 Stage 4.doc Version 1.20 Page 17 must be replaced. However in an area not used by service users a repair to uneven flooring by the main kitchen and an exit door requires urgent attention as it is a trip hazard. In bedroom 16 the bed was made up ready for re-use that night, the pillow case was stained and the pillow was lumpy and should be disposed of. In bedroom 32 the en-suite requires a crack in the wall behind the lavatory repairing and the room decorated. The carpet in the bedroom is very stained and requires shampooing to remove the stains or replacing if the stains cannot be removed. The remaining rooms inspected were found to be clean and tidy with no unpleasant odours. There are sufficient bathrooms and lavatories for the service users. Most bedrooms have en-suites. The home provide specialist equipment such as lifting aids, both portable and fixed bath hoists. Equipment such as specialist mattresses and cushions to relieve pressure and specialist beds should it be deemed necessary for the care of individual service users. Ravenscourt Nursing Home G55 S15600 Ravenscourt V222340 250405 Stage 4.doc Version 1.20 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28 and 30. Standard 29 will be inspected at further inspections. The home provides appropriate training for staff. Ongoing training courses are being obtained. There is a good skill mix within the staff group. However these standards were not fully inspected at this inspection but will be inspected at the next inspection. This are is now being well managed. EVIDENCE: The home has policies and procedures for the recruitment and selection of staff. There was sufficient staff on duty at the time of the inspection to meet the needs of the service users. Some staff training had taken place about the completion of care plans since the last inspection. Challenging behaviour training is to take place this week. Currently 5 staff are undertaking NVQ level 2 training. The standards in this section were not fully inspected at this inspection but will be inspected at subsequent inspections. Ravenscourt Nursing Home G55 S15600 Ravenscourt V222340 250405 Stage 4.doc Version 1.20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33, 37 and 38. Standards 34, 35 and 36 will be inspected at further inspections. Records required by legislation are kept and were accessible for inspection. Health and safety records were found to be in order. This area is well managed However the 3 standards not inspected at this inspection will be inspected at further inspection. EVIDENCE: The manager is suitably qualified to undertake the role of manager of the home. He is a registered nurse and has taken the Registered Managers Award and updates his training as required. Standards 34 and 35 were not inspected at this inspection but will be inspected at the next inspection. Records required by legislation are kept and were accessible for inspection. The last fire drill took place on 24/3/05. Fire alarms service was carried out on 29/3/05. Fire call points are being tested weekly. Fire extinguishers are due Ravenscourt Nursing Home G55 S15600 Ravenscourt V222340 250405 Stage 4.doc Version 1.20 Page 20 for their annual test this month (April). Water temperatures are being tested and a record is kept. The call alarm system was serviced on the 13/9/04. The lift was last serviced on the 27/1/05. The Gas safety certificate is dated 16/3/05. The 5 year electrical safety certificate is current with the date of 10/12/03. The pharmacy inspection took place on the 14/4/05. Wheelchair checks on tyres and foot plates are taking place and a record was dated 12/4/05. Wheelchair cleaning also takes place . However one wheelchair in the downstairs unit was found to be very dirty and covered in food stains, this wheelchair needs to be cleaned more regularly. The environmental health officer visited on the 11/4/05 and is due to return to check work that was requested to be done has been carried out. The portable hoists and lifting equipment was served over 2 days the 4/4/05 and the 5/4/05. The clinical waste storage outside the home was poor. The home have 4 large clinical waste bins three were overflowing so that the lids could not be closed and the fourth was ¾ full with the lid open. This is poor practice the home must ensure that clinical waste bin lids are kept locked at all times and that they have sufficient bins to meet the needs of the home. As the collection of these bins does not take place until Thursday (now Monday) of this week there is not sufficient storage space for this waste. There was food found in the fridge that was not dated and labelled. This was brought to the attention of the cook and the deputy manager. All food must be dated and labelled. Ravenscourt Nursing Home G55 S15600 Ravenscourt V222340 250405 Stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 2 3 3 2 3 2 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 x x x 3 2 Ravenscourt Nursing Home G55 S15600 Ravenscourt V222340 250405 Stage 4.doc Version 1.20 Page 22 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 17(1)(a) schedule 3(k) 15 13(2) 12(4)a 23(2)(b) 23(2)(b) 23(2)(d) 23(2)(b) 23(2)(d) 23(2)(d) 16(2)(c) Timescale for action Turns must be completed as per 30/4/05 the care plan and if not the and reason for this is documented. ongoing action. Care plans and risk assessments 30/6/05 must be updated as changes occur. Medication records must be 30/4/05 appropriately completed at all times. The home must ensure they 25/4/05 respect privacy and dignity at all times.30/4/05 Replace the carpet in the main 30/8/05 hallway/entrance as the backing has come away from the carpet. Replace the carpet in edroom 32 30/7/05 if the stains cannot be removed. Repair the uneven flooring 4/5/05 between te kitchen and the side entrance door. Replace the missng plug to the 30/4/05 ash hand basin in bathroom 1. Repair the leak to the soil pipe 30/4/05 behind the lavatory in the ensuite of bedroom 8 Repair the crack in the wall of 30/7/05 the en-suite of bedroom 32 and redecorate. Ensure bedding is suitable for 30/4/05 use and free from stains at all and Version 1.20 Page 23 Requirement 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. OP7 OP9 OP10 OP19 OP19 OP19 OP21 OP21 OP21 OP24 Ravenscourt Nursing Home G55 S15600 Ravenscourt V222340 250405 Stage 4.doc 12. OP26 13(3) 13. 14. OP38 OP38 16(2)(j) 13(3) & 16(2)(K) 16(2)(k) 15. OP38 times. (pilow cases and pilows in bedroom 16) Ensure the cot side protectors are clean at all times. (Clean the cot side protectors in bedroom 11). Ensure that all food is dated and labelled in the fridge. Ensure that clinical waste is only placed in yellow bags for dicposal (continence pad in black bag in bathroom). Ensure that the home has sufficient clinical waste bins to deal with the amount of waste accumulated. Keep all clinical waste bins locked at all times. ongoing action. 30/4/05 30/4/05 30/4/05 30/5/05 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. Refer to Standard OP9 Good Practice Recommendations The manager is recommended to monitor the medication recording on both units and keep a record of thsis monitoring. Ravenscourt Nursing Home G55 S15600 Ravenscourt V222340 250405 Stage 4.doc Version 1.20 Page 24 Commission for Social Care Inspection 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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