Inspection on 10/12/07 for Ravenstone Nursing and Residential Home

This inspection was carried out on 10th December 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

Ravenstone Nursing and... 21/08/08

Ravenstone Nursing and... 19/01/07

Ravenstone Nursing and... 25/05/06

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Ravenstone Nursing and Residential Home 7 St Andrews Road Droitwich Worcestershire WR9 8DJ Lead Inspector Chris Potter Key Unannounced Inspection 10th December 2007 12:30 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 Ravenstone Nursing and Residential Home DS0000065965.V357146.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. Ravenstone Nursing and Residential Home DS0000065965.V357146.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ravenstone Nursing and Residential Home Address 7 St Andrews Road Droitwich Worcestershire WR9 8DJ 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) 01905 773265 01905 778890 ravenstone@schealthcare.co.uk www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited Vacant Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (46), Physical disability over 65 years of age of places (46) Ravenstone Nursing and Residential Home DS0000065965.V357146.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th January 2007 Brief Description of the Service: Ravenstone Nursing and Residential Home is a 46-bedded care home providing 24-hour nursing care to older people with physiological difficulties. It is situated within central Droitwich, close to local amenities and resources. Accommodation within the home is provided on three floors - the ground floor, the first floor, and a mezzanine level. Access to all areas within the home is provided through the provision of a passenger lift, a platform lift and two staircases. The home belongs to Southern Cross Healthcare, currently the home is without a manager, and operational managers from other areas are being seconded until a new manager is appointed. Fees range from £370.00 - £650.00 per week this depends on the care needs and the room provided. These fees were correct at the time of the inspection for more up to date information please contact the home directly. Additional charges are made for chiropody, hairdressing and newspapers. Ravenstone Nursing and Residential Home DS0000065965.V357146.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the home’s key unannounced inspection – this is where we look at a wide range of areas. The inspection was carried out over two days on the 10th and 11th of December 2007. The inspector spent a total of 11.5 hours in the home. To help us plan for the inspection we looked at pre–inspection information requested earlier in the year, this included the Annual Quality Assurance Assessment (AQAA). A range of evidence was used to make judgements about this service. This included: information from the provider, staff records kept in the home, medication records, discussion with people who use the service, discussions with the staff team, discussion with the designated manager, tour of the premises, previous inspection reports, quality assurance process, and observation of care experienced by people using the service. What the service does well: The home provides prospective residents with the appropriate information to assist them with their choice. All potential residents are assessed prior to admission to ensure that the home can fully meet their health and personal needs. The management of medication is well organised, and nurses adhere to their policies and procedures. Comments received from residents and relatives all confirmed that all the staff were very caring, and respected their dignity when providing care. Regular resident and relatives meetings are held to assist people to air their views about the home. The home takes all complaints seriously and follows their complaints procedure. Residents and relatives were aware of the homes complaints procedure and were confident that their complaint would be listened to. Residents and relatives were most complimentary about the laundry service provided at the home, and how efficient the operative was in returning washing to them. Residents have personalised their bedrooms and those asked stated that they were happy with their bedroom. Ravenstone Nursing and Residential Home DS0000065965.V357146.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ravenstone Nursing and Residential Home DS0000065965.V357146.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 Ravenstone Nursing and Residential Home DS0000065965.V357146.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): Standards 1,2,3 and 6 Quality in this outcome area is good. Prospective residents and their representatives have the information needed to choose a home, which will meet their needs. They have their needs assessed and a contract which tells them about the service they will receive. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the home has updated their Statement of Purpose and Service User’s Guide to reflect changes in the home’s management. Copies of the documents are available in the reception area of the home. Residents confirmed that they were provided with the appropriate information to assist them with their choice. The inspector was advised that relatives usually visit Ravenstone Nursing and Residential Home DS0000065965.V357146.R01.S.doc Version 5.2 Page 9 the home on their behalf. “The home was chosen for me”. To fully meet the standard the home needs to include their fee charges into their Service User’s Guide. Prior to admission all potential residents are assessed by a registered nurse. This assessment is to ensure that the home can fully meet their needs. This process is referred to as a pre–admission assessment which then forms the basis of the residents care plans. During the inspection three resident’s pre– admission assessments were reviewed. These showed that the assessments had been completed appropriately. One of the three assessments had not been dated at the time of the assessment, the designated manager was advised to remind all staff to date and sign the assessment. Service users are provided with a statement of terms and conditions before admission to the home. It provides information on what a service user can expect to receive for the fee they pay and sets out terms and conditions of occupancy. A service user spoken with stated that they were satisfied with the information she and her family had received about the home prior to admission. Ravenstone Nursing and Residential Home DS0000065965.V357146.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 and 10 Quality in this outcome area is adequate. The health and personal care that people receive is based on their individual needs but care plans do not always support this. The home has an efficient medication policy supported by procedures and practise. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Six care plans were reviewed during the inspection. Some care plans required more information to provide an accurate detailed reflection of the residents’ health and personal needs. Appropriate assessments had been completed for any identified risks. The risk assessments had been reviewed and updated monthly. However the changes in the risk assessment had not consistently Ravenstone Nursing and Residential Home DS0000065965.V357146.R01.S.doc Version 5.2 Page 11 been updated in all of the residents’ plans of care. An example of this was a resident being fed via a tube directly into their stomach. The care plan was not clear as to whether any fluids could be given by mouth. Also, weight monitoring not being completed for all residents. The manager designate stated that this was because the scales were not suited for more dependant residents. It is recommended that scales are provided to enable the more dependant residents’ weight to be monitored. For a resident with MRSA (Methicillin Resistant Staphylococcus Aureus) a care plan had not been implemented. A resident’s care plan stated to record blood sugar twice a day, but this was being done once a day. The staff confirmed that they had been advised to do this, as the blood sugar recordings were stable, however they had failed to update the care plan. The organisation has a system in place for monitoring care plans to try and identify shortfalls with the member of staff responsible. A written comment from a relative recorded that the home could be more thorough with shaving and mouth care. It was also noted that fluid balance charts are not always completed. Residents’ have access to health care services that meet their assessed needs both within the home and in the local community. Residents’ have access to dentists, opticians and other community services as and when required. There is written evidence in the care plan of health care treatment and intervention by other specialists, for example the tissue viability nurse and the diabetic nurse. The home has a good range of pressure relieving equipment and lifting equipment in place, details of which are included within their care record. The home has a medication policy which is accessible to staff, medication records are up to date for each service user and medicines received, administered and disposed of are recorded. It is recommended that the nurse records the number of tablets given when the instruction states one or two tablets as required. On the second day of the inspection a medication error was made. The staff followed their policy correctly to ensure the well being of the resident and reported the incident to the appropriate authorities. Staff were aware of the need to treat residents with respect and to consider dignity when delivering personal care. Comments received from residents about the care was complimentary and included: “ Staff are polite, I get on very well with everyone” “All staff very good on the whole” “the core of care staff are very good and polite, but we have had many changes recently” “All staff are very nice”. Ravenstone Nursing and Residential Home DS0000065965.V357146.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 and 15 Quality in this outcome area is good. A range of activities are available in the home these are limited for some of the residents with more complex needs. Residents are offered a choice of food, this is acceptable for the majority of residents, and specialist diets are catered for. People living in the home are able to maintain open contact with family and friends. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The activities organiser works at the home 5 days per week. Many of the residents were able to refer to her by Christian name and advised the inspector of some of the activities which are arranged for them. “Quiz nights Ravenstone Nursing and Residential Home DS0000065965.V357146.R01.S.doc Version 5.2 Page 13 and relatives are invited to join in.” “Bingo with prizes” “sing songs” “Church service once a month” “ Board on display showing the activities at the home”. On the first day of the inspection staff were accompanying three residents on a Christmas shopping trip into Droitwich. Staff and relatives commented that not all residents are able to participate with the activities due to their poorly condition. Some residents who were spoken with stated that they chose not to join in with the activities, but preferred to stay in their room. It is recommended that the home review some activities / therapies which are more suited for residents with complex needs. Relatives and residents, who are able, are invited to regular meetings to assist them in airing their views about the home. The home has open visiting arrangements and service users spoken with knew that they could entertain their family and friends in their own room. If they prefer they can use communal areas of the home to talk to visitors. The homes menu was displayed in the home. The home works to a menu, which rotates every 4 weeks. This is then reviewed monthly with the input of the residents to ensure that it is providing enough choices for them. A food register is also provided for any complaints to be recorded following each meal. This was empty at the time of the inspection. The chef on the day informed the inspector that given the recent increase to food prices the budget needs to be reviewed. Since the last inspection the home has introduced the “nutmeg system” this is a method of monitoring the nutritional contents for each meal served. It is appreciated that this is a time consuming system for the catering staff to maintain. The catering staff appeared well organised and all relevant records were available and up to date at the time of the inspection. The kitchen was inspected by the Environmental Health Officer earlier in the year, and has carried out the recommendations from this. Comments from residents, staff and relatives about the food were generally good and included: “Would like more variety” “food has improved with the latest cook” “food is very good” “Food is good” One resident went through a typical day in respect of food and drinks that the home provided. Breakfast can have a choice of cooked, toast and or cereal Lunch – two main choices or jacket pots with any filling or salad. Pudding, ice cream/ cheesecake or gateaux Tea /coffee /juices Tea – choice of hot food or assorted sandwiches – or egg on toast, mushrooms on toast Ravenstone Nursing and Residential Home DS0000065965.V357146.R01.S.doc Version 5.2 Page 14 morning tea trolley with fruit or biscuits every day. afternoon tea trolley with cakes and or tarts. The meals viewed during the inspection were well presented, a carer was observed feeding a resident in bed in a respectful and unrushed manner. The home also provides complimentary refreshments for visitors to the home. Ravenstone Nursing and Residential Home DS0000065965.V357146.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 and 18 Quality in this outcome area is good. The service has a complaints procedure, which is accessible and used according to the procedures in the home. Thus, residents are assured that their concerns will be dealt with appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes complaints register was reviewed - four complaints were recorded since the last inspection, two of these were also reported to the CSCI. From examining the complaints records the service have followed their complaints procedure, and with the exception of one all complaints have been resolved satisfactory. In contrast, the home have many compliments and thank you’s which were shared with the inspector at the time of the visit. The home has been without a manager for some time and this had affected the staff morale this has been acknowledged by the organisation who are now seconding a manager designate until a new manager is appointed. Residents and relatives confirmed that they were aware of how to make a complaint and spoke highly of the manager designate who was covering at that time. Ravenstone Nursing and Residential Home DS0000065965.V357146.R01.S.doc Version 5.2 Page 16 60 of staff have received safeguarding training and staff spoken with during the inspection were confident that they would not hesitate reporting any concerns, which they might have. Ravenstone Nursing and Residential Home DS0000065965.V357146.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 19,21,22,23,24 and 26 Quality in this outcome area is adequate. The physical design and layout of the home has continued to improve which enable residents to live in a safer, better-maintained and comfortable environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector toured the home with the manager designate, all areas of the home were observed to be clean and tidy. The management of odours was commended. Residents’ bedrooms had been personalised and those spoken with said that they were happy with their rooms. Ravenstone Nursing and Residential Home DS0000065965.V357146.R01.S.doc Version 5.2 Page 18 Since the last inspection Southern Cross Healthcare has continued to provide resources to upgrade the home. It now has a rolling programme for improving the decoration, fixtures and fittings. The shower room on the first floor appeared to be in need of urgent decorative upgrade. Choice of communal areas is good with a choice of dining rooms and lounge areas. There are quiet areas apart from the residents’ bedrooms where service users can sit and/or entertain relatives/friends in private. Some bathrooms are small and bathing would be difficult for residents with more complex needs. It is recommended that the home review the bathing facilities to ensure that the residents can be bathed / showered safely. A staff member advised the inspector that only one bath could be used at the moment because the other bath’s hoist was not working. The home has a good range of specialist equipment to assist staff in meeting the residents care needs. Servicing records were available for these. The residents and relatives were very complimentary about the quality of the laundry and one stated “wonderful service”. Ravenstone Nursing and Residential Home DS0000065965.V357146.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 and 30 Quality in this outcome area is adequate. To ensure that the residents care needs can be fully met; appropriate skilled staff should be available on all shifts. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has gone through a difficult period with staff leaving and problems recruiting resulting in staff shortages. This has resulted in staff working additional hours and agency staff being used to try and maintain safe staffing levels. The manager also left resulting in the staff feeling low and demoralised. Following a complaint about the staffing levels and staff morale, the organisation are providing a manager designate from another area until a new manager is appointed. On the days of the inspection the home was accommodating 37 residents and the duty rotas showed that sufficient staff were being rostered for that number. On discussion with the residents and staff about staffing levels, staff responded that if all staff turned up they were all right. One resident commented “because of the staffing numbers they had to wait a long time to go to the toilet” “Always short of staff especially at week ends” “No problems when needing assistance at night.” Ravenstone Nursing and Residential Home DS0000065965.V357146.R01.S.doc Version 5.2 Page 20 It is recommended that in the absence of a registered manager the home maintain a regular review of staffing levels taking into account the dependency levels of the residents. The home has met the standard of providing 50 of staff with an NVQ level 2 qualification. Three staff files were reviewed during the inspection and these showed that the home had followed their recruitment procedure, and completed all the appropriate safety checks. Staff training records were examined and these showed that generally the mandatory training was up to date, some shortfalls were evident in clinical areas for the nurses. The home’s in house trainer had left in the summer and the organisation are looking to appoint to this position. Staff who were spoken to felt that the training provided was good and they felt competent to meet the care needs of all the residents. A comment was made about new staff how it took a while for them to become experienced to meet the care needs of the residents. Generally all residents spoken with felt that staff were appropriately trained to meet their needs. Ravenstone Nursing and Residential Home DS0000065965.V357146.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 31,33,35,37 and 38 Quality in this outcome area is good. The home is currently without a registered manager; however, systems are in place to ensure that the health and safety of the residents, staff and visitors are maintained, An effective quality audit system is in place to monitor the organisational systems and listen to the resident’s views. This judgement has been made using available evidence including a visit to this service. Ravenstone Nursing and Residential Home DS0000065965.V357146.R01.S.doc Version 5.2 Page 22 EVIDENCE: The home is currently without a registered manager; the organisation is providing a designated manager to deal with the day-to-day running of the home. The residents and staff spoken with during the inspection spoke very highly of the acting manager and described how approachable she was and listened to them. The inspector was advised that the organisation is in the process of recruiting a permanent manager for the home and is in the process of waiting for safety checks. The organisation provides regulation 26 reports to the CSCI, this is a monthly overview of the home and monitoring of the service provision. All records requested were available at the home, and the administrator was in the process of updating systems and records to assist with monitoring. The home had appropriate systems in place for managing resident’s money. Two staff checks the balances weekly, and all residents transactions are receipted. The home had completed their annual quality survey in July 2007 and the results from this had been collated. Accident forms were reviewed during the inspection, these were being appropriately completed, and a monthly audit by the manager designate was being completed. All appropriate servicing and maintenance of the systems and equipment was being completed, and the home employs a maintenance operative to assist with this process. The fire records were available and up to date at the time of the inspection. Ravenstone Nursing and Residential Home DS0000065965.V357146.R01.S.doc Version 5.2 Page 23 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 2 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 2 3 3 3 X 4 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X 3 3 Ravenstone Nursing and Residential Home DS0000065965.V357146.R01.S.doc Version 5.2 Page 24 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. 1 2 Standard OP1 OP7 Regulation 5 (1) (b) 15 (1) (2) (b) Requirement The service users guide should contain the fees for the potential residents. To ensure that the residents care needs can be fully met; the Care plans need to provide a detailed plan of care for every assessed need. This should be reviewed and updated for any significant change to their condition. Timescale for action 28/02/08 28/02/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP21 OP22 OP9 Good Practice Recommendations To assist in meeting the resident’s needs it is recommended that the bathing facilities be reviewed. The baths are not suited for the more dependant residents. To monitor resident’s weights accurately it is recommended that more appropriate scales be provided. For medication that is prescribed one or two tablets the number of tablets administered should be recorded on the medication administration record. DS0000065965.V357146.R01.S.doc Version 5.2 Page 25 Ravenstone Nursing and Residential Home 4 5 OP12 OP30 To assist residents with more complex needs the home should review more suitable activities / therapies. To further protect the residents, the organisation should ensure that mandatory training for all staff is prioritised, including clinical updates for the nurses. Ravenstone Nursing and Residential Home DS0000065965.V357146.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Coming Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Ravenstone Nursing and Residential Home DS0000065965.V357146.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!