Inspection on 28/09/06 for Remyck House

This inspection was carried out on 28th September 2006.

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

Remyck House 15/07/09

Remyck House 25/07/07

Remyck House 18/05/06

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 Mr Rodney Martin Unannounced Inspection 28th September 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.V307108.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. Remyck House DS0000012099.V307108.R01.S.doc Version 5.2 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 To Be Confirmed 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.V307108.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18 May 2006 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 Remyck House and currently the home is without a 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. The current fees are £327 to £470 per week. This information was contained in the pre-inspection questionnaire received in the Commission’s office on 5 September 2006. There are additional charges for hairdressing, chiropody, newspapers/magazines and toiletries. Remyck House DS0000012099.V307108.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second site visit since the beginning of this inspection year from April 2006. The purpose of the visit was to follow up the fifteen issues raised in the previous inspection report, dated 18 May 2006 that required action by the registered provider, as well inspect again the key standards. The Commission received a letter on 4 July 2006 from the registered provider confirming compliance with the matters raised. It was also confirmed on the day of the inspection that these issues had been satisfactorily dealt with. The unannounced inspection took place between 10am and 3.30pm. The two inspectors had an opportunity to look around the home, view records and talk to a visitor, several service users and staff members, including the cook, deputy manager and manager. On the day of the visit twenty service users were accommodated. Remyck House has six vacancies. Although Remyck House is registered for up to twenty-nine residents the management regard the home full with twenty-six service users as three double bedrooms are occupied as single bedrooms. Various records were inspected. These were relevant and up to date. Since the last inspection the manager has resigned. The home has recruited another manager, on 1 July 2006, from within the home. It was agreed that an application would be shortly submitted to the Commission for their registration as registered manager. In line with the Commission’s policy, all the key standards were inspected on this occasion. 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. Pre-admission assessments are carried out and give carers a clear view of the service user needs. Remyck House DS0000012099.V307108.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. Remyck House DS0000012099.V307108.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 Remyck House DS0000012099.V307108.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessment process ensures that residents move into the home after having their needs assessed. Prospective service users and or their relative(s) are able to make an informed choice about whether or not the home can meet their particular needs. Remyck House does not provide intermediate care. EVIDENCE: Remyck House was accommodating twenty residents, with three male and seventeen female residents, whose ages range from 79 to 87 years. All the residents were admitted since 2001. It was noted that half the residents have a diagnosis of dementia. There was evidence that the home is able to meet residents’ needs. Since the last inspection one new resident was admitted and during the same period one resident was transferred into a nursing home. During the inspection the manager received a referral from the daughter of a prospective Remyck House DS0000012099.V307108.R01.S.doc Version 5.2 Page 9 service user. It was agreed that the manager would speak to the service user’s care manager to obtain details before making an assessment visit. The manager reported the home was receiving referrals and a prospective service user was due to move in on 9 October and that there were a possible three further potential residents. One of these was by way of recommendation from a current resident’s family. The usual referral method is from Adult Services [previously referred to as Social Services]. The manager would then request they fax a copy of their assessment to the home. In the meantime the family usually visit to view Remyck House. The preferred way is for the prospective service user to visit the home and spend some time meeting the residents with the opportunity of having a meal, otherwise the manager will visit them in their own home or in hospital. A pre-admission assessment is completed by the home, detailing the relevant care needs of the prospective service user. Following receipt of the contract from Adult Services, the home would arrange an admission date and the placement is then reviewed after four to six weeks. Various files were viewed, including the last resident admitted and they contained a comprehensive pre-admission assessment, detailing relevant information for the home to make an informed judgment regarding whether they could meet the perceived needs of the resident or not. The home has two files for each resident. One containing a copy of the service users plan, financial details and contract from the local authority and record of the resident’s property and the other file contained the various risk assessment assessments, and care plan details. The former details are kept loose leafed and it was discussed putting these in a file or folder. The inspector spoke to a number of residents as well a regular visiting daughter. They were happy with the care they were receiving and evidence gained from their individual file, were appropriately placed in Remyck House. Other residents were full of praise for the staff stating that, “the staff are attentive to our needs”. Remyck House does not provide intermediate care, although prospective residents can come for a short respite stay, if there is a vacancy. Short stay residents are assessed in the same way as permanent residents. Remyck House DS0000012099.V307108.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a consistent care planning system in place to provide staff with adequately detailed information they need to satisfactorily meet residents’ physical needs, however, this would be further improved with clear arrangements in place for supporting terminally ill residents in the way they prefer. Medication practices and procedures ensure that residents are protected. There are improvements still to be made in the area of ensuring the promotion of privacy for service users. EVIDENCE: Each resident has two individual files, one containing the personal details of the resident including a family history, the pre-admission assessment; various risk assessments, the care plan and review of the care plan. The other containing the service users plan, financial details and contract from the local authority and record of the resident’s property. The manager discussed changing the home’s care planning files to a ring binder filing system, which is indexed and has sub-headings for ease of reference. Remyck House operates a keyworker system as a means of enabling staff to get to know certain Remyck House DS0000012099.V307108.R01.S.doc Version 5.2 Page 11 residents much better, which in turn helps in the delivery of care to the individual resident. Two care plans were examined and contained information for staff to ensure that all aspects of health, personal and social care needs could be met. There were, for example, clear moving and handling assessments. Plans are reviewed on a regular basis and service users confirmed their involvement in this process. Staff and the service user sign reviews. Service users also said that staff knew how to help them. One person, for example, said that when their keyworker was on leave they still had their bath when they wished. Another service user said that she received a good service and that ‘they ring for the doctor if you need it’. Plans contained information regarding more specific needs such as chiropody and dentistry. The personal and oral hygiene of each service user is maintained and recorded. A record is kept of all health professional visits. Residents are registered with GP’s from Southlea surgery and Aldershot health centre. One resident is registered with Farnham health centre. The manager reported that there is very good support and relationship with the various GPs. There is also good support from the district nurses and community psychiatric nurses coming to Remyck House. The home has a relevant medication policy, which satisfactorily details the receipt, recording, storage, handling, administration and disposal of medicines. Although residents are able to self medicate within the home’s risk management framework, currently only one is self-medicating. The home operates a monitored dosage system, from a local pharmacy, for administering medication. The medication is kept in a drugs trolley, which is kept in a locked cupboard. The drug administration sheets were found to be satisfactorily recorded, with no omissions. There is photograph of each resident on the individual medication sheets as well as on the medication dossette box, to ensure, especially agency staff, the correct medication is given. The home does not currently have any controlled drugs. Remyck House has a locked small refrigerator for keeping certain medication at the right temperature. Staff were observed, at lunchtime, giving medication. This was given appropriately with attention to preserving the resident’s dignity. Since the last inspection staff members have received safe handling of medicines training, through the local pharmacist. A visitor to the home said that she was quite satisfied with the care provided for her relative, saying that he was ‘always well dressed’ and ‘was well cared for’. Staff were observed to be providing assistance to service users in a calm and dignified manner, although on one occasion a bedroom was entered by a Remyck House DS0000012099.V307108.R01.S.doc Version 5.2 Page 12 staff member who omitted to knock before doing so. Service users’ wishes regarding the way in which they are addressed by staff are recorded in their care plan and respected by staff. Although the home has a policy on death and dying there is not a procedure for staff to follow if a death occurs in the home. It was also noted that service users’ wishes concerning terminal care and arrangements after death are not routinely recorded, as some files had just “not known” noted. It was agreed that the manager would send a letter to residents’ relatives or advocate, to update the home’s records to include funeral arrangements as well as write a procedure for staff to follow if a death occurs in the home. Remyck House DS0000012099.V307108.R01.S.doc Version 5.2 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to engage in a variety of appropriate age-related activities in the home. Residents are supported to maintain contact and positive relationships with family and friends. Nutritional needs of residents are well managed and offer variety and choice. EVIDENCE: Care plans clearly detail what each service user’s interests are and service users themselves confirmed, variously, that they enjoyed activities such as listening to music and reading. The home aims to provide a wide range of opportunities for stimulation and the inspectors noted that staff were able to spend time with service users in the main lounge. The home has a comprehensive activities schedule for every day of the week. Remyck House has a selection of reminiscence material as well as the Alzheimer activities book as previously noted, half of the residents have a diagnosis of dementia and maintaining interest and concentration span is important in providing a fulfilling life, as the use of activities can significantly improve the quality of people’s lives. Remyck House DS0000012099.V307108.R01.S.doc Version 5.2 Page 14 All residents have friends or family visiting. Visitors to the home are welcomed at all times and the inspector spoke briefly with a visitor in private. Service users themselves confirmed that relatives could visit whenever they wished. Service users are able to move freely around the building and were seen to be making use of all communal areas as well as their bedrooms. The inspector noted that service users had chosen to bring into the home treasured personal items with which to decorate their bedrooms. Two residents have their own telephone installed. Remyck House has a portable telephone and so residents can receive calls in the privacy of their own room. Service users are on the electoral roll and had postal votes for the local election on 4 May 2006. Apart from three residents, the majority of residents come down for breakfast. Residents are able to have a cooked breakfast each day, which is served from 8am in the dining room. On the day of the inspection, eight residents had a cooked breakfast. Residents are offered a choice for the midday meal. Menus at the home were varied and the inspectors joined service users at lunchtime. The majority of residents had liver and bacon for lunch, three residents had diced chicken and two residents just had bacon. Staff were observed to be providing assistance in a discreet and dignified way to service users who needed help in dealing with their food. The dining room was well-decorated and it was clear from observation that meals were very much a social occasion with a great deal of conversation taking place. Since the last inspection the kitchen has been re-modernised and the larder enlarged. Although the kitchen is fitted with sufficient equipment a larger cooker would be more beneficial in the cooking of meals. Fresh meat is ordered each day from a local butcher, with milk and bread from the milkman. There was plenty of fresh fruit and vegetable available. The cook, on duty, has worked in the home five years. She is suitably qualified and interested in her role. On the day of the inspection the home was also employing a kitchen assistant. Remyck House DS0000012099.V307108.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure, which residents feel able to use and an adult protection procedure, which protects and safeguards residents from abuse. EVIDENCE: The home has a detailed and relevant complaints procedure. Residents, spoken to, were aware of whom to complain should they have a need to. One resident told the inspector, “I would speak to my keyworker first and then go up the line if I was not satisfied”. The Commission has not received any complaints, since the last inspection, and there were none recorded in the home. Remyck House has a complaints log. Although there were previous letters of complaints, it was noted that there was no evidence of what action the home had taken and the outcome. Also there were no blank complaint sheets in the log. It was discussed producing detailed sheets to record a complaint satisfactorily, with each sheet numbered and initialled by the manager, for security and continuity. Remyck House has all the relevant documentation relating to adult protection, including a whistle blowing, the ‘No Secrets’ document and the adult protection policy. Since the last inspection staff have received adult protection training, in-house, on 10 August 2006. There have been no incidents of abuse notified to the Commission since the last inspection. Remyck House DS0000012099.V307108.R01.S.doc Version 5.2 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, 20, 21, 23, 24, 25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A comfortable standard of accommodation is provided for residents in both communal and private areas, with improvements to the building continuing. EVIDENCE: A tour of the building was undertaken. Remyck House is over three floors with a passenger lift to the first floor. There are two rooms on the second floor, which are available to staff. Remyck House has twenty-three single bedrooms and three double bedrooms, with twelve rooms provided with en suite toilet facilities. Another bedroom has a separate bathroom attached. Nine single bedrooms in the extension have an en suite shower installed. Although the home is registered for twenty-nine residents the home is full with twenty-six residents accommodated, as it is a management decision to use the three double bedrooms as single bedroom accommodation. Remyck House DS0000012099.V307108.R01.S.doc Version 5.2 Page 17 Since the last inspection the kitchen has been refitted, new locks have been fitted to communal toilets, radiators have been provided with thermostatic valves, flooring and blinds fitted, new carpets provided in rooms 8 & 9, bedroom 10 redecorated, four new sets of bedroom furniture provided, new carpet fitted in the front lounge, the dry food larder extended and new shelving put in. The issues raised in the previous inspection, dated 18 May 2006, have been addressed. Residents, spoken to, were happy with their rooms and the home’s facilities. During a tour of the building, apart from one bedroom, the home was clean and free from unpleasant smells. The manager reported that the carpet in the bedroom in question was regularly cleaned but it was a never-ending problem to stay on top of keeping it free from an unpleasant smell of urine. It was agreed that the resident’s family would be contacted to discuss having more appropriate flooring fitted. It was noted also that some carpets are showing wear and tare. The manager reported a new landing carpet is to be fitted, three upstairs bathroom windows, in the old part of the house, are to be replaced, three bedrooms are to have new furniture and that the registered provider is working through the house to bring it up to the required standard. As noted above, there are two rooms on the second floor, which are available for staff to use. However, there are no designated staff lockers. Staff currently leave their handbags et cetera in the main office, which is not always convenient as they may need to disturb the manager, who may be privately talking with someone. It is recommended that one of the rooms upstairs be designated as a staff room, where staff can change into their uniform and leave their personal belongings in a locked cabinet. The home has a separate laundry room, which is situated away from food preparation. The laundry room was clean and tidy. Remyck House has an industrial washing machine and an industrial dryer. Residents have a laundry basket in their room. The keyworker is responsible for the personal laundry of residents and the night staff ensure bedding and towels are washed. One resident told the inspector, “I just put my dirty laundry out and it comes back very quickly, clean and ironed”. There was evidence of COSHH [control of substances hazardous to health] policies and procedures in place. Staff, spoken to, were aware of infection control procedures and practices. Remyck House DS0000012099.V307108.R01.S.doc Version 5.2 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are supported by staff in sufficient numbers to ensure their physical needs are met, although this would be further improved when all staff have received training in dementia. The home’s recruitment process ensures that service users are protected. EVIDENCE: Since the last inspection the home has recruited six carers, as four carers have left. There were reasonable explanations for these departures. The home has had to use agency staff to ensure that the staff rota was met. Although the home had been using agency staff it was noted that only one shift was being filled by the agency, for the week of the inspection. The manager reported that the home now has a full complement of staff. Remyck House employs twenty-seven staff members, which includes catering and domestic staff. The majority of the staff are full-time. The inspectors spoke privately with two members of staff and a visitor and there was evidence that the staff team worked well together. A visitor spoken to said, “the staff were very helpful”. Three staff files were examined. These contained evidence of a sound and comprehensive recruitment process and further details of short courses undertaken. Remyck House has one bank staff member and another has been recruited, with just the CRB [criminal records bureau] check to come through. Remyck House DS0000012099.V307108.R01.S.doc Version 5.2 Page 19 The home now operates a comprehensive training programme for staff, through a recognised training organisation, which includes a comprehensive induction programme, fire safety, food safety, manual handling, first aid, health and safety, infection control, diet and nutrition, risk assessment, coping with aggression and adult protection. Not all staff have yet had training in dealing with service users with dementia although staff spoken with were aware of plans to address this training need. It is understood that four staff have obtained an NVQ [national vocational qualification] in care at level 2 and that a further three staff intend to start this training shortly. The home is looking at Farnborough College for funding for the rest of the staff. The manager reported that the deputy manager has nearly completed NVQ level 3 and that the cook is to start an NVQ level 2 in food processing and hospitality. During the inspection the inspector observed staff interacting with service users in a friendly yet professional manner. The staff rota indicated that there are usually four carers on duty during the day. There are three waking members of staff on duty at night. Staff spoken with said that there were generally enough of them on duty to meet service users’ needs. Remyck House DS0000012099.V307108.R01.S.doc Version 5.2 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, 32, 33, 35, 36, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is approachable and has an open style of management. She provides good leadership that ensures staff are supported and residents’ welfare and finances are promoted and protected through the home’s practices. EVIDENCE: Since the last inspection the manager resigned. Another manager was appointed on 1 July 2006. She has worked in Remyck House since February 2002. The manager is due to complete NVQ level 4 in care on 4 November 2006 and then will start the registered managers award for NVQ level 4 in both management and care. She is also enrolled on a foundation degree in health and social care. The manager has a returned CRB on the CSCI’s registration number. It was agreed that an application form would be sent to Remyck House DS0000012099.V307108.R01.S.doc Version 5.2 Page 21 enable her to start the registration process to become the registered manager at Remyck House. There was a relaxed atmosphere in Remyck House and staff, spoken to, appreciated the manager’s style of leadership and management. Residents spoken to also said that the manager was approachable and that she had a positive impact upon the home. Following on from the fifteen actions the registered provider was required to make, there was evidence that the home has taken steps to improving the standards within the home for both residents and staff. This was evidenced by more staff on shift, the home ensuring the health and safety of residents by fitting thermostatic mixer valves, covering radiators and replacing old furniture and redecorating the communal areas of the home. The certificate of employers liability insurance was due for renewal on 15 January 2006. The manager was unaware if this had been renewed and a new certificate sent. The home needs to confirm that a new certificate is in place. There are regular monthly visits by the proprietor under Regulation 26 [there is a condition that where the registered provider is not in day to day control there needs to be regular unannounced monthly visits to Remyck House, with a report made and to supply a copy of the report to the Commission]. The manager is not agent or appointee for any service user. Service users and/or their relative/representative manage their finances. Two service users’ finances are managed by Adult Services. The home provides safe storage for residents’ money, which is held for incidentals such as hairdressing et cetera. Money belonging to two residents were checked and tallied with the records kept. A system of supervision is in place and there were records to confirm that staff had received supervision. The inspector discussed appraisals and the various forms of supervision to include one-to-one, work practice issues dealt with in group supervision or supervision covering all aspects of the staff member’s practice. It was also discussed delegating supervision so that the manager was not responsible for all the staff supervision sessions. Various records were inspected during the course of the inspection including, care records, staff records, medication, fire, financial, food and a record of furniture brought in by the resident. These were all satisfactorily maintained. The fire log book was inspected and the records indicated that the fire safety equipment had been tested and serviced within the guidelines. The manager said that she found the fire log book too small and not suitable for the purpose of recording the relevant fire matters. A fire risk assessment was completed on 10 July 2006. It is recommended that all records regarding fire safety, including service certificates and staff fire safety training, are kept in one file, Remyck House DS0000012099.V307108.R01.S.doc Version 5.2 Page 22 which is indexed and sub-divided for ease of reference. Staff have received fire safety training on 12 June 2006 and 31 July 2006. The manager ensures the safe working practices by planning courses on health and safety within Remyck House, including first aid, adult protection, manual handling, food hygiene, fire and medication. Risk assessments are in place. There are current and up to date contracts on electrical equipment as well as kitchen and domestic appliances et cetera. COSHH [control of substances hazardous to health] policies and procedures are in place. Window restrictors are in place on the windows above ground level, to ensure safety for residents. From a check of the records and practices observed in the home during the inspection, the health and safety measures taken in the home ensure the welfare and safety of the residents. Remyck House DS0000012099.V307108.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 X X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 3 3 X 3 3 2 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 Remyck House DS0000012099.V307108.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP11 Regulation 17(1)(a) Requirement The home needs to up date the care plan regarding the service users wishes concerning terminal care and arrangements after death and produce a procedure for staff to follow in the event of a resident’ death within the home. The complaints log book needs to have sufficient detail and record the outcome of a complaint. The home needs to ensure that all staff receive adequate training in dementia Timescale for action 01/12/06 2. OP16 17(2) Schedule 4.11 13 (6) 01/11/06 3 OP30 01/12/06 Remyck House DS0000012099.V307108.R01.S.doc Version 5.2 Page 25 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 OP37 OP22 OP37 Good Practice Recommendations Residents’ personal details are kept in a file or folder. It is recommended that the home have a larger cooker. It is recommended that all records regarding fire safety, including service certificates and staff fire safety training, be kept in one file, which is indexed and sub-divided for ease of reference. It is recommended that staff are provided with suitable facilities and accommodation for the purpose of changing and storing personal items. 4 OP19 Remyck House DS0000012099.V307108.R01.S.doc Version 5.2 Page 26 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. Extracts may not be used or reproduced without the express permission of CSCI Remyck House DS0000012099.V307108.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. 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