Inspection on 27/09/07 for Redwalls Nursing Home

This inspection was carried out on 27th September 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Redwalls Nursing Home 09/10/08

Redwalls Nursing Home 13/02/07

Redwalls Nursing Home 16/02/06

Redwalls Nursing Home 13/09/05

Redwalls Nursing Home 14/02/05

Redwalls Nursing Home 12/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Redwalls Nursing Home Weaverham Road Sandiway Northwich Cheshire CW8 2ND Lead Inspector Helena Dennett Unannounced Inspection 27 September 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Redwalls Nursing Home DS0000018791.V346506.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. Redwalls Nursing Home DS0000018791.V346506.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Redwalls Nursing Home Address Weaverham Road Sandiway Northwich Cheshire CW8 2ND 01606 889339 01606 883287 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) www.redwalls.net Redwalls Care Services Ltd Miss Carole Mary Evans Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43), Physical disability (1) of places Redwalls Nursing Home DS0000018791.V346506.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing: Code N, to people of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category: Code OP (maximum number of places: 43). Physical disability: Code PD (maximum number of places: 1). The maximum number of people who can be accommodated is: 43. Date of last inspection 13th February 2007 Brief Description of the Service: Redwalls is a care home providing accommodation with nursing and personal care for up to 43 older people. It is a large converted property, the original being a grade II listed building, standing in its own grounds of 1.5 acres. It is close to the local amenities and the Cheshire village of Sandiway, which is approximately five miles from Northwich town centre. The home is a three-storey building. Residents’ accommodation is on the ground and first floors. There are 39 single and 2 double bedrooms. Thirty six of the single rooms and one of the double rooms have en-suite facilities. The rest of the bedrooms have hand-wash basins. There are two lounges and a conservatory on the ground floor and another lounge on the first floor. The dining room is on the ground floor next to the kitchen. There are separate toilets and a variety of bathrooms throughout the home. There is a hairdressing salon on the ground floor. A nurse call system is provided in all areas used by residents. The residents’ primary care needs are due to a physical frailty and infirmity or chronic physical disability in old age. The home is staffed with registered nurses, carers, and ancillary staff at all times. The scale of charges range from £466.89 - £630 per week. A copy of the latest inspection report is available from the manager. Redwalls Nursing Home DS0000018791.V346506.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was part of the key unannounced inspection of this service and took place on 27 September 2007. Before the visit the manager was asked to provide information as part of the inspection. The views of residents and relatives about the home were also sought; their comments are incorporated into this report. The CSCI is trying to improve the way we engage with people who use services so we gain a real understanding of their views and experiences of social care services. We are currently using ‘Experts by Experience’ who are an important part of the inspection team and help inspectors get a picture of what it is like to live in or use a social care service. The term ‘Expert by Experience’ used in this report describes a person who has been appointed by Help the Aged, under the direction of the CSCI, to take part in the inspection of services for older people. During the visit the inspector spoke to the manager, some staff members and residents. Three residents’ records were looked at to check the care they receive. Policies and procedures and records of medication, care plans and training records were also examined. What the service does well: An assessment of people’s needs is carried out before they move into the home so that residents know what care will be provided for them. All of the residents spoken with said that staff were good and kind and cared for them well. The following comment was made on a survey form received back to CSCI before the visit: ‘In my opinion staff do an excellent job’ A calm and friendly atmosphere exists in the home. Staff were seen to treat people with respect so that their privacy and dignity is maintained at all times. The home is well maintained, clean and tidy so residents live in comfortable surroundings. There are pleasant lounge and dining areas for residents to use. Meals are well balanced and residents are given a choice of alternatives so they can have a varied, healthy diet. Good links with the community continue to exist so residents should not feel isolated from the outside world. Residents said they continue to enjoy playing whist with the owner and the outings to the church hall for tea. Redwalls Nursing Home DS0000018791.V346506.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. Redwalls Nursing Home DS0000018791.V346506.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 Redwalls Nursing Home DS0000018791.V346506.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): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs are assessed before they move into the home so that they can be confident that staff at Redwalls Nursing Home can care for them adequately. EVIDENCE: The manager confirmed that she or a senior nurse would visit a person in their own home or in hospital before they move into Redwalls. Information about the home is given to them at that time. In addition people are encouraged to visit and look around before they move in. This means that the person can make an informed decision on whether their needs can be met at Redwalls Nursing Home. Intermediate care is not provided at the home so standard 6 does not apply. Redwalls Nursing Home DS0000018791.V346506.R01.S.doc Version 5.2 Page 9 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): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents’ health, personal and social care needs are not always set out in an individual plan of care so there is a risk their needs may not be met. Poor management of medicines means that there are times when residents are not getting their medicines as prescribed. EVIDENCE: Three residents care records were looked at during the site visit. All had care plans in place. Some of the care plans were written to meet individual needs. For example: one resident had two detailed care plans, which were individual to their needs. These clearly set out what action staff had to take to help the person to become more comfortable and settled in the home. However some care plans were pre-printed, setting out the care to be provided for any resident suffering from a specific illness or disability. In one resident’s record, the assessment document showed that the person suffered from constipation and abdominal pain. A pre printed care plan for constipation was Redwalls Nursing Home DS0000018791.V346506.R01.S.doc Version 5.2 Page 10 in place. This stated that a daily stool chart should be completed – records showed this was completed weekly. The care plan did not mention abdominal pain or the action staff should take when this occurred. The daily records showed that staff were giving the person medication when they suffered from abdominal pain. In one resident’s records the information obtained on assessment was not put into the person’s care plan. One person had a small pressure sore (which had healed whilst in the home ) when they moved into the home; a plan of care had not been developed to deal with this. In addition, this pressure sore was not identified on the wound audit that is carried out regularly at the home. Staff must make sure that when a resident’s needs change the plan of care should be amended to reflect the change. People living in the home said they were very happy with the care provided. One person said, ‘this is my home’ another person said that staff were very good and tended to their needs well. One person said they appreciated the fact that a doctor visits the home every Thursday and although they might not see the doctor every week thought this was a good idea. There was good evidence in the care files looked at that staff consult other healthcare professionals such as the doctor, dietician etc when the need arises. Equipment such as pressure relieving mattresses and hoists was available to meet the needs of the people living in the home. There was evidence that staff try to meet the individual needs of the people living in the home. For example, arrangements have been made to enable one person to have their medicines early in the morning, given by night staff, as the person gets the most benefit from the medicines at this time. The management of medicines was looked at during the visit. The proprietors of the home have bought an additional medicine trolley to ensure that all medicines can be stored adequately. The recording and administration of medicines needs to be improved. There were several instances where medicines were still in their packet, but had been signed by the nurse as given to the person. This means that some of the people living in the home have not had their medicines as prescribed by the doctor. The inspector observed two nurses get a controlled drug from the cupboard and enter the amount into the controlled drug book. One nurse signed to say they had given it then the second nurse signed to say they had witnessed it being given. The medicine administration record sheet (MAR) was then signed Redwalls Nursing Home DS0000018791.V346506.R01.S.doc Version 5.2 Page 11 to confirm that the medicine had been given and the time recorded on the sheet. All this was done before the medicine was given to the person. The controlled drug book and the MAR sheet were left in the clinical room whilst both nurses went to give the person their medicine. This is considered poor practice. The privacy and dignity of people living in the home is maintained at all times. Staff closed bedroom and bathroom doors when helping people with their personal hygiene. Staff were also seen addressing people in a respectful way. All of the people living in the home said that staff were polite and respectful. Redwalls Nursing Home DS0000018791.V346506.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): 12, 13, 14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents find that the lifestyle experienced in the home meets their expectations so they can stay active and in touch with friends and family. A good balanced diet is provided to ensure the health of residents is maintained. EVIDENCE: People living in the home were positive about the activities provided. An activity co-ordinator has been employed since the last inspection so there is a more structured activities programme in place. People’s life history is not currently recorded. This would provide information on their interests and activities they would like to take part in. Some of the people in the home were very positive about the activities provided; one person who had recently moved in said they enjoyed the game of whist that took place weekly with the owner of the home. Redwalls Nursing Home DS0000018791.V346506.R01.S.doc Version 5.2 Page 13 Two people spoken with said they enjoyed going out to the local church hall for afternoon tea every week. They felt this involved them more in the community. The expert by experience spent some time speaking to people living in the home. He visited both lounges during the morning and also had some lunch. There was a relaxed atmosphere in the smaller lounge, as people went to and from the hairdresser. One person pointed out a watercolour they had painted to the expert by experience and thought they might try painting again if they had the necessary paper and paints. The activity organiser confirmed that she had stocks of paints, which anyone could use if they wished to. The large lounge contained a large television, a well-stocked library and a music centre. The music centre was playing modern music on the morning of the site visit. One person who spoke with the expert by experience said that they considered the home, ‘alright, better than some’. During the morning tea, biscuits, and fruit were offered to people in the lounge areas. The person dealing with the teas and biscuits had a good rapport with the residents and all agreed that he was ‘a jolly nice chap’. Visitors can come and go as they please. People spoken with said they attend church if they wish. One person said she goes to church with her relatives regularly. One person told the inspector that they were going out for the day. The chef had organised a packed lunch for the resident to take with them. There are two dining areas in the home for residents to use. There is a small table upstairs in the lounge area for residents who do not wish to go downstairs. There is a large dining room downstairs. Residents can also eat in their bedrooms if they wish. Lunch appeared to be a social occasion with several of the residents using the dining room. The menu was clearly displayed. The expert by experience had lunch with the residents. The meal was well cooked and well presented. Several of the residents were helped in a discreet manner to eat their meals. One resident was offered an alternative when it was noted that they hadn’t eaten their main meal. People living in the home were very positive about the meals provided. Adapted cutlery is provided as necessary to help people maintain their independence during mealtimes. Redwalls Nursing Home DS0000018791.V346506.R01.S.doc Version 5.2 Page 14 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): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are satisfactory complaints and protection policies and procedures in place at the home to make sure that residents’ concerns are listened to and that they are protected from possible harm. EVIDENCE: Residents spoken with said they knew whom to approach if they had any concerns or complaints. The complaint procedure is displayed in the home. This provides information to residents and relatives on what to do if they are not happy with any aspect of the care or facilities that are provided. Information on the complaints procedure is also given to residents. The home has a procedure on adult protection. This identifies the action to be taken by staff should an allegation of abuse be made. There is also a whistle blowing policy in place. Training files are kept for each member of staff. There was insufficient evidence available to suggest that all staff have attended safeguarding adults training. Redwalls Nursing Home DS0000018791.V346506.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is generally well maintained, clean and tidy and so provides a safe and comfortable place for residents to live in. EVIDENCE: Redwalls Nursing Home was found to be clean and tidy on the day of the visit. The gardens were tidy and well maintained and provide a pleasant area for residents to use, weather permitting. There are two lounges, with a conservatory situated off the smaller lounge. On the day of the visit, several items were stored in the conservatory, giving a less homely feel; none of the residents were using the conservatory. The lounge and dining areas were pleasant and appeared comfortable. There is also a room which is used permanently as a hairdressing salon in the home. Redwalls Nursing Home DS0000018791.V346506.R01.S.doc Version 5.2 Page 16 Several of the residents were seen visiting the salon and the hairdresser appeared to know them well. Residents’ bedrooms were well decorated and contained personal items. A new shower has been installed thus ensuring that the needs of all the residents can be met. One of the bathrooms needs some attention as some of the tiling was chipped and the floor covering behind the toilet was raised. All of the residents said their rooms are cleaned regularly. They were happy with the laundry service. Redwalls Nursing Home DS0000018791.V346506.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There were enough suitably qualified staff on duty to meet the needs of the residents but there were problems with recruitment practices which means people could be placed at risk of possible harm. EVIDENCE: On the morning of the visit there were enough staff working in the home to meet the needs of the residents. Residents spoken with said that all of the staff were good and met their needs. Staff were seen using different aids correctly to help people who live in the home to move around. Two additional domestic staff have been employed in the evening to assist in the kitchen and help with the evening drinks given out to residents so leaving carers more time to carry out their duties. A sample of recruitment files was looked at during the site visit. There were no references available in one person’s file. The records showed that these had been requested two days after the person had started working in the home. The manager confirmed that all registered nurses’ PIN numbers are checked regularly to make sure they are still registered to practice as nurses. However, she could not find the check done for one nurse recently employed at the home; this was rechecked following the inspection visit and found to be satisfactory. Redwalls Nursing Home DS0000018791.V346506.R01.S.doc Version 5.2 Page 18 The company that runs the home employs a trainer who works twelve hours per week. She covers induction training and any other course that staff may find beneficial. The induction records were looked at for one person who had been working at the home for one month. These were not completed so it was difficult to be sure what was covered and how the person’s competency was measured. Information provided to the inspector before the site visit indicated that over 50 of care staff have an National Vocational Qualification (NVQ) level 2 or level 3 which means that staff are trained to care for residents’ needs. Appraisals and supervision are carried out regularly so staff feel supported in their role. Redwalls Nursing Home DS0000018791.V346506.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Redwalls Nursing Home is generally well managed although audits need to be improved to ensure that residents’ needs are met at all times. EVIDENCE: The manager of the home is registered with the Commission for Social Care Inspection. She is a registered general nurse with management experience. All of the residents said they knew the manager and that she was approachable. One resident said the manager visits her most mornings to find out how her health is. The following comment was received by CSCI before the site visit: ‘I consider that the management are fully committed to and take on responsibility for providing both physical care and the social needs of the residents’ Redwalls Nursing Home DS0000018791.V346506.R01.S.doc Version 5.2 Page 20 Members of staff were also positive about the manager. Good relationships appeared to exist. The manager confirmed that residents’ views about the home are sought by means of a questionnaire. The questionnaires were not available on the day of the inspection visit. The owners were collating the results so that any issues identified could be addressed and staff and residents informed of the result. A letter commending staff and the care they had provided to a resident was seen. There were no minutes of residents/relatives meetings available as the manager said it had been some time since a meeting had been arranged. However, the manager confirmed that a meeting is to be held shortly. Audits are carried out regularly to ensure that standards are maintained. However one person who had a pressure sore had not been identified on the wound audit. Although audits on care plans were carried out problems were still identified in recording of some information. Staff meetings are held every 2-3 months. Residents or their relatives manage their own money. As reported under previous standards, procedures regarding the recruitment of staff need to be improved to ensure that all the necessary information is obtained so a judgement on the suitability of the person to be employed in care can be made. The manager confirmed that all essential equipment has been serviced in accordance with legislation. Redwalls Nursing Home DS0000018791.V346506.R01.S.doc Version 5.2 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 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 X X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X 2 3 Redwalls Nursing Home DS0000018791.V346506.R01.S.doc Version 5.2 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 Standard OP7 Regulation 15(1)(2) Requirement Where a specific risk is identified an individual plan of care must be developed setting out the action staff should taken to address the needs. Should a resident’s needs change the plan should be changed to ensure the resident’s needs will be met. (Timescale 16/03/06 and 30/04/07 not met) Medicines must be given as prescribed by the doctor. Timescale for action 30/11/07 2 OP9 13(2) 08/10/07 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 OP8 OP9 Good Practice Recommendations The care of residents’ wounds should be recorded clearly. Nursing staff should ensure that they administer medicines in accordance with the Nursing and Midwifery Council guidelines and in accordance with the policy and procedures of the home so residents are not placed at risk. All staff should receive training on adult protection so they DS0000018791.V346506.R01.S.doc Version 5.2 Page 23 3 OP18 Redwalls Nursing Home 4 OP33 have the necessary skills and knowledge to deal with any allegations of abuse. A review of audits should take place to make sure that the system in place is robust enough to identify problems as they arise so that staff can address these thus maintaining the quality of services provided. Redwalls Nursing Home DS0000018791.V346506.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Redwalls Nursing Home DS0000018791.V346506.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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