Inspection on 18/05/06 for Remyck House

This inspection was carried out on 18th May 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Remyck House 15/07/09

Remyck House 25/07/07

Remyck House 28/09/06

Remyck House 10/10/05

Remyck House 28/09/04

Remyck House 22/04/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Remyck House 5 Eggars Hill Aldershot Hampshire GU11 3NQ Lead Inspector Mrs Michelle Presdee Unannounced Inspection 18th May 2006 10:00 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 Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 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. Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Remyck House Address 5 Eggars Hill Aldershot Hampshire GU11 3NQ 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) 01252 310411 Mr Thedchanamoorthy Kandiah Mrs Shanthini Kandiah Derek McCarthy Care Home 29 Category(ies) of Dementia - over 65 years of age (29), Old age, registration, with number not falling within any other category (29) of places Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Remyck House is a care home providing personal care and accommodation for up to twenty-nine service users, all of whom may be admitted with dementia. Mr & Mrs Kandiah own the home and Mr Derek Mc Carthy is the registered manager. The home is located on the outskirts of Aldershot town centre and is close to local amenities and bus route. The home has three communal lounges and a communal dinning room. Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. On the day of this unannounced inspection twenty-four service users were being accommodated. A senior care staff member assisted with the inspection as the manager and two deputies were not on the rota. The senior during this time also had to attend a review in the home; go out of the home to collect prescriptions and was also responsible for the administration of drugs. At the beginning of the inspection all records were not available, as the senior member of staff did not have access to records. It was only when one of the deputies came into the home as a visitor access was gained to most of the records. The deputy was not sure the key she held gave her access to all records. Records including assessments, care plans, staffing records and the fire log book were seen. On the day three service users were spoken to at length and most other service users were spoken to through out the day. It was not always possible to establish what service users were communicating due to the majority of service users having some degree of dementia. There were no visitors on the day of the inspection. No comment cards have been received from service users, their families or their representatives. Two comment cards have been received; one from an agency, which supplies staff to the home and one from social services. The agency felt the home was well run and had no concerns; the comment card from social services expressed some concerns over the home and the care service users received. A tour of the home was undertaken and various bedrooms were looked in, which were chosen at random. What the service does well: The home has a relaxed atmosphere and with the locked gates at the front service users have access both in and out of the home. Service users enjoyed the home cooked meals in the home. Assessments are carried out and give carers a clear view of the service user. Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 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. Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 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 Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The assessment process provides sufficient information for care staff to meet service users needs, although additional information for some service users would be of benefit. The home does not provide intermediate care. EVIDENCE: Each service user has a file where all their information is collated. Files usually have a photograph of the service user on the front; it was noted for the service users who had been admitted recently there was no photograph. Three service users files were looked at in detail and others were looked at more briefly. All files followed the same format. Assessments were clear and gave a good picture of the service users needs and abilities. For some service users a background profile had been completed on service users giving a lot more general information on the service user. It was agreed this would be good practice and useful for staff to complete for all service users. Risk assessments Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 Page 9 had been completed and included ways to minimise the risks identified. One service user in the home self medicated, no assessment had been completed and it was agreed this would be done as soon as possible. Whilst some service users spoken to were unable due to their senile dementia to talk about the home and it’s abilities, other service users spoke to confirmed they felt there personal care needs were met. Service users are not currently formally involved in the assessment process. Discussions were held on including service users, recording their views on the assessment and getting them to sign the assessment. The home does not provide intermediate care. Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10, Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Care plans give clear information to identify service users personal and health needs and show how the needs are to be met by care staff; care staff need to ensure they are familiar with these. Social interests and hobbies are not consistently recorded and are not met in the home. The medication records are not being completed satisfactorily to ensure service users safety. The core values in the home are not being promoted, service users are not treated in a dignified manner and their right to privacy is not upheld. EVIDENCE: The service users plans seen were clear and gave a good account of a service users personal care needs. Service users preferred form of address had been recorded. Information had been split up into the main areas of the day, morning, meal times, bedtimes and general. Information recorded gave carers a good picture of what help was required. For example under communication, Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 Page 11 speech, vision, hearing, religion and language had all been considered. When bathing was recorded as an area the service user needed help, this had been broken down to record if help was needed getting in the bath, the help needed in the bath and help needed getting out of the bath. Information was recorded whether one or two carers were needed for each task. Moving and handling assessments had been completed for each service user. At lunchtime it was noted one service user slept through lunch, the inspector was advised it was best to let him sleep and have lunch later. When looking at this service users care plan later, it was noted the service user was a diabetic and another carer explained it was important this service user had regular fluids for this reason. It is important all care staff are aware of service users needs and working together. The service user plan for some service users listed their hobbies and social needs, for others viewed there was no social needs recorded. However the plans gave no account of how if these needs were recorded they were met. Staff spoken to on the day felt this was an area which needed to improve, but felt there was insufficient time to always carry out social activities. It was noted and discussed that none of the service user plans had been signed or dated and none of them had been reviewed. There was no evidence service users had been involved in the plans. The inspector was advised the home is going to introduce a key-worker system and it will be the responsibility of the key-worker to review the care plan and keep service users and their families, representatives involved. The service users plans do not include details of visits by health professionals. These are currently recorded in the service users daily notes. It was agreed it would be easier if a list was kept in each service users file, as then the information was easily accessible. The inspector was advised staff will call a GP at the request of a service user. The district nurse and chiropodist call into the home on a regular basis. A date has been booked for an optician to come into the home and the home is still trying to find a dentist to visit the home. Since the last inspection the home has bought a medicine trolley, which the inspector was advised is usually stored in the drugs room upstairs, but on the day of the inspection it stayed in the lounge. The inspector watched the senior member of staff at lunchtime administer medication, the procedure was followed correctly. When looking at medication records it was noted medicine was signed as being administered, when the medication was still in the dossette box. The senior member of staff on duty stated all staff members involved with the medication had received one session of training on medication from the manager of the home. Medication had also been left in the dossettes upstairs in the locked drug room. The senior on duty was unsure why this had been left out and was unaware of a return drug book, which lists all medication returned to the pharmacist. From observation on the day it is difficult to support the homes claim that they treat service users with respect and respect their privacy. When the inspector Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 Page 12 was shown around the home it was noted the member of staff did not knock on service users doors, or on the communal toilet doors. This resulted in one service user being interrupted whilst on the toilet; her right to privacy was not respected. The inspector also noted locks on toilet doors did not work, one toilet door would not shut properly and in one toilet the windows were bare, so people could see into the toilet. The signs in the communal toilets asking for ‘nappy sacks’ to be used should either be removed of if needed to stay more appropriate terminology should be used. Staff on occasions were overheard talking to service users in a way, which did not upheld their dignity. One service user was told to sit down and stop annoying everyone and on another occasion when a carer called to a service user by name another user answered asking if she had called her, the carer responded by saying “only if you have changed your name”. These incidents were brought to the senior staff member’s attention. At lunch time it was noted by the inspector a service user in the lounge was asking to go to the toilet. Members of staff were in the dining room and the senior was administering drugs. When the inspector did find a member of staff, it was too late for the service user; this was not treating her with dignity. Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The routines of the home try to be flexible to meet service users needs and provide a choice. The range of social activities and stimulation in the home are not adequate to meet service users needs. Visitors are made welcome to the home. A varied menu with a choice and good quality food is served to service users in a pleasant environment. EVIDENCE: On the day of the visit it was difficult to establish if service users felt the home had matched their expectations. Some service users spoken to felt they were still in their own home, others had no memory of being in a care home. One service user spent time in a smaller lounge mainly on her own, stating she preferred to be away from the other residents who were looking for trouble. This service user did state she liked being at the home and would not like to go anywhere else. Other service users stated they liked the home and felt the girls worked hard. The home does have arranged social activities, which include exercise class, a singer coming into the home, sing-a-longs, bingo and board games. However staff are aware these are not individual needs and not Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 Page 14 specific to service users with dementia. One member of staff explained it was hoped her role would be to undertake social activities in the home, but she expressed concern as she feels there is never any spare time when she is on duty to fulfil this role. One service user expressed her pleasure at going out with her family on a regular basis. A hairdresser calls into the home and two service users go out to the hairdresser. A couple of service users go to a community club and the home is looking into the possibility of more service users going. The local community meets religious needs of the service users. Visitors are welcome at the home and can visit anytime. On the day of the inspection the only visitor to the home was a member of staff who was not on duty, so it was not possible to seek their views on the home. Service users and staff members reported service users are able to get up in the morning and go to bed at night at a time, which is suitable to them. On the day of the inspection choice was promoted by allowing a service user who did not want to go into the dining room have her lunch on a tray in the lounge. Service users can personalise their own rooms. Most service users spoken to enjoyed the meals in the home. One service user felt there was not always enough choice but did comment she was very fussy. The cook stated she had a good budget and always bought good quality food. The cook enjoys talking to the service users and finding out their likes and dislikes. Special diets catered for were one vegetarian and diabetic diets. Most dishes are home cooked with a selection of fresh vegetables. Meals are served in the dining room, which is pleasantly decorated and furnished with small tables. Fresh fruit was available in dishes on the tables in the dining room. Service users have a choice at breakfast with a cooked breakfast being offered three times a week. All service users choices are being recorded. On the day of the inspection minced beef pie, gravy, mashed potatoes and a selection of vegetables was served, with rhubarb and custard for pudding. It was noted the menu board in the dining room stated something completely different was being served and the day was Wednesday not Thursday. Two service users regularly had their dinner in the lounge. The inspector noted with a little help and prompting these two service user ate far more, but there were no staff available to carry out this task. Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 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 the following standard(s): 16,18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users felt confident their complaints would be listened to and acted upon. Staff do not have the knowledge to protect service users from abuse and staff would benefit from guidance on adult protection. EVIDENCE: The home has a complaints procedure, which details all the relevant information, including phone numbers, address and timescales. The commission has received correspondence from two sources since the last inspection raising concerns. Service users on the day felt their complaints would be listened to and acted on. Service users stated they would speak to the manager if they had a complaint. Details of the complaint procedure are included in the service user guide, which service users keep in their room. The inspector was advised the home does have a copy of the following documents; Hampshire County Council Protection of vulnerable Adults procedure, No Secrets and a whistle blowing procedure. No training has been provided for staff on abuse and the adult protection procedure. The senior member of staff on duty did have some knowledge of the procedure and who to inform if abuse was suspected. However when the four members of staff were asked it was clear they had no knowledge of Hampshire Adult Protection Procedure. Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 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 the following standard(s): 19,26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Most areas of the home are clean and safe, but some areas need improving to be brought up to this standard for service users enjoyment. EVIDENCE: The inspector was shown around the home and certain bedrooms were picked at random to view. The bedrooms and general décor in the new extension is of a good quality and matching. However the general feel of the main building is of a poorer quality. Bedrooms are patchy in their decoration and furnishings. Some rooms need re-painting, one bedroom viewed had only one wardrobe door and in another room the paint work on the windows was flaking. The carpet in the smaller lounge is very badly stained and gives a poor appearance. The majority of areas were clean, although it was noted some areas in the home were in need of hovering and dusting. It was noted in one bedroom Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 Page 17 there was an unpleasant smell of urine. The radiators in service users bedrooms are not fitted with thermostats so the heating has be on in all areas of the home and on the day of the inspection some area were very hot. The inspector was advised the home is trying to bring the entire home up to the same standard and has recently purchased 12 new beds. Other improvements to the environment include the painting of the hallways and the banisters, which staff felt had much improved the environment of the home. In the morning the cook informed the home was due a new kitchen and thought it was due to be started that day. Later in the day after lunch, two men arrived and started stripping the kitchen. No contingency plans had been made with staff, on how they were to cope, during this period. The workmen explained they would work till the early evening and then not arrive until after lunch the next day. However staff were unsure how this would work under current health and safety legislation. All cleaning materials were locked away and fire exists were free. The toilet, which has the shower area, needs to be cleared, as there is a lot of junk stored in this area. Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home has low staffing levels that do not ensure service users basic needs can be met. The provision of further specific training would ensure staff members have the knowledge and skills to improve their practice. Staffing records need to be complete to ensure service users are not being put at risk. EVIDENCE: From the evidence seen on the day and from speaking to care staff it was very clear the home needs to provide more staff on duty at all times. The duty rota sent to the Commission was confusing and at times suggested only one member of staff was on duty. From the rotas seen it would appear on most shifts there are three members of care staff. At night there are three members of staff on duty, two work a waking duty and one a sleep-in duty. However it was clear this was not adequate. At lunch time the majority of service users went into the dining room with the majority of staff. Three service users stayed in the lounge and one member of staff administered medication. One service user in the lounge expressed the need to go to the toilet, unfortunately no staff members could be found. When a staff member was found it was too late for the service user. Another incident also supported the need for more staff. Two service users in the lounge having dinner were given no help, encouragement or interaction. When they were both offered help they were both pleased to Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 Page 19 accept and ate more. The care practices witnessed by staff including the way service users were spoken to at times and the lack of respect for privacy all indicate staff are too busy. All care staff spoken to felt they would be able to do a better job if there was more staff on duty, giving them more time with each service user. From the duty rota it would appear the home only has a cook and cleaner on weekdays, at weekends when there are no extra staff the care staff are also responsible for preparing, cooking and serving the meals and keeping the home clean. At the beginning of the inspection the senior on duty did not have access to staff records. It was only when a deputy came into the home to visit the service users that a key was found which gave access to records. The deputy was not sure she could gain access it was only through trail and error. Three staff member’s records were sampled. For two staff members all necessary checks had been completed and the file contained all necessary information. For the third member of staff no records or checks could be found suggesting none had been undertaken or completed. It was difficult to establish what training members of staff had undertaken. Staff could remember undertaking training on dementia, medication, moving and handling and fire safety. The manager had completed train the trainer course and provided training on medication, dementia and moving and handling. It was not possible to establish if staff had received training on first aid, food hygiene and adult protection. The inspector was advised nine members of staff have registered on National Vocational Qualification (NVQ) courses. Two staff members undertaking NVQ Level 4, one undertaking NVQ Level 3 and the rest undertaking NVQ Level 2. Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The new manager is having difficulty implementing the necessary needed changes. The home is not always run in the best interests of service users, which is sometimes to their detriment. Health and safety issues are not promoted in the home, which could leave service users at risk. EVIDENCE: The manager was appointed in November and staff spoken to on the day felt he was trying to make positive changes with the limited resources he has at his disposal. However issues have been raised throughout this report, which question the manager’s capabilities. It was not possible to establish that the home is run in the best interests of service users. It was clear service users are not currently consulted regarding Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 Page 21 their assessments and car plans. The senior on duty was not aware of any quality assurance surveys being undertaken. Only two comment cards have been received, one from an agency stating the home has worked well them and one from social services which indicated they had concerns over the home. The senior on duty was not aware of any regulation 26 reports in the home and the Commission has received none. The senior member of staff on duty did not think the home was involved in managing any of the service users finances. However the previous report indicated the home was managing the personal allowance of two service users. It was not possible to establish if this was still the current situation, clarification should be sent to the Commission. The home is not taking all the necessary health and safety precautions for the protection of service users. Staff need up-to-date training in areas such as infection control, first aid and fire training. Coshh (control of substances harmful to health) assessments need to be completed. It was noted care staff did not always make appropriate use of plastic gloves and aprons. It was noted in all the toilets the liquid soap dispensers were empty. The accident book was seen, which still had a large percentage of completed sheets in it. Discussions were held on the need to put these in each relevant service users folder. It was noted there was an incident in the accident book where a service user had been admitted to hospital, but no regulation 37 notification had been sent to the commission. When looking at the last 22 incidents in the accident book it was noted 18 had occurred during the night staff shift; supporting the need for increased staffing levels at all time. The fire logbook indicated all the necessary checks were being carried out in the agreed timescales. The fire alarm had last been serviced in May 2005 and the fire extinguishers in May 2006. Staff had not received sufficient sessions on fire training. It was not possible to view any other service records of equipment, as these were not available. All staff spoken to confirmed they are now receiving regular supervision. The inspector was advised a record is maintained and signed by both parties. Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 Page 22 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 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X 2 X X 2 Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 Page 23 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 (b) Requirement All staff must have knowledge of the care plans. Care plans should include social activities and hobbies. Care plans should be signed dated and reviewed. All medication records must be accurate. Previous timescale of 10.11.05 not met. A plan of activities must be devised that reflects the interests and needs of residents. Previous timescales of 6/7/05, 23/11/04 and 10/12/05 not met. 4. 5. OP10 OP33 12 (4) (a) 24 (1)(3) Care practices in the home must ensure service users dignity and right to privacy are respected. The home must have a formal quality assurance system in place. Previous timescale of 10/01/06 not met. Staff must receive training on adult protection and the necessary procedures. DS0000012099.V289026.R01.S.doc Timescale for action 01/08/06 2. OP9 13 (2) 01/07/06 3. OP12 16 (2)(m)(n) 01/08/06 01/07/06 01/08/06 6. OP18 13 (6) 01/10/06 Remyck House Version 5.1 Page 24 7. OP21 16 (f) 8 OP24 16 © 9 OP25 23 (p) 10 11 12 OP27 OP37 OP38 18 (g) 17 Schedule 2 13 (4) Toilets must have locks which work, privacy curtains should be fitted where necessary. All toilets should have soap available. All furnishings in the home should reach the same standard. All doors should close, wardrobes should have doors and carpets should not be very badly stained. Radiators should be fitted with thermostatic valves, which would allow service users to choose the temperature of their rooms. Staffing levels must be adequate to meet the needs of service users. Records must be available at all times. Health and safety training is needed in the areas of infection control, food hygiene and first aid. Staffing records must contain all the necessary checks and references to ensure service uses are protected. Regulation 26 visits and reports must be carried out and maintained. Staff must receive adequate sessions on fire training. 01/08/06 01/10/06 01/10/06 01/07/06 01/10/06 01/10/06 13 OP29 19 01/08/06 14 15 OP33 OP38 26 (1)(4) 23 (4) (d) 01/09/06 01/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Remyck House DS0000012099.V289026.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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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