Inspection on 28/08/07 for Abbeywood Care Home

This inspection was carried out on 28th August 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

Abbeywood Care Home 21/07/09

Abbeywood Care Home 05/05/06

Abbeywood Care Home 19/04/05

Abbeywood Care Home 05/10/04

Abbeywood Care Home 20/04/04

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

CARE HOMES FOR OLDER PEOPLE Ribble Lodge Nursing Home Ribble Road Fleetwood Lancashire FY7 7BX Lead Inspector Mrs Jackie Riley Unannounced Inspection 28th August 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 Ribble Lodge Nursing Home DS0000006076.V343418.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. Ribble Lodge Nursing Home DS0000006076.V343418.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ribble Lodge Nursing Home Address Ribble Road Fleetwood Lancashire FY7 7BX 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) 01253 776761 Dr Shanmugam Subbiah Mr Tojo Mathew Care Home 28 Category(ies) of Dementia (28) registration, with number of places Ribble Lodge Nursing Home DS0000006076.V343418.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The service is registered to accommodate a maximum of 28 service users in the category DE (dementia) 5th May 2006 Date of last inspection Brief Description of the Service: This home is registered for twenty-eight residents who are over sixty-five. It provides nursing care to people who have dementia. It is in Fleetwood and is within easy reach of shops and the promenade. The home is purpose built on two floors and has a passenger lift for those who need it. The home has eight single bedrooms and ten double rooms. There are no en-suite facilities. There is one large lounge/dining area and a separate room for people who smoke. There is also a small external sitting area at the rear of the building that can be used by people who use wheelchairs. The home has a Statement of Purpose and Service User Guide providing information about the care provided, and the service available so that people can make an informed choice about moving into the home. A copy of the Service User Guide and the most recent inspection reports is made available to all users of the service to help them to make an informed choice about whether to move into the home. At the time of the visit the range of fees was from £3750 to £455.50 per week with additional expenses for hairdressing, chiropody and toiletries. Ribble Lodge Nursing Home DS0000006076.V343418.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and took place over a five-hour period, on the 28th August 2007. We spoke to the manager, four staff members, two visitors and a number of residents. We also spent three hours in the communal area of the home to get a flavour of how the home works on a day to day basis. The reason for this is due to the dementia levels of residents living there, who experience difficulties in how they can communicate. As part of the inspection process we used case tracking as a means of assessing some of the National Minimum Standards. The process allows us to focus on a small number of people living at the home. All records relating to these people are examined and the rooms they occupy are looked at. Other residents are invited to pass their opinions to the inspector if they wish. We received seven surveys prior to the inspection and comments in the surveys will be used throughout the report in order to reflect what people who use the service think of it. We looked at the records of three residents and three care staff as part of the inspection process. We carried out a tour of the premises and looked at the homes documentation, policies and procedures that formed the basis of the inspection process. What the service does well: What has improved since the last inspection? Ribble Lodge Nursing Home DS0000006076.V343418.R01.S.doc Version 5.2 Page 6 We found the homes written information has been reviewed and changes made to include all areas of how the service provides its care and what services are available to people who live their. This information is now available to all users of the service including relatives and advocates, so that people are informed about the service. Care plans now include reference to a residents personal profile, where information is gathered about individual likes and dislikes, hobbies and interests, which can then be used to inform staff of a persons interest and how that can be met by the home. We saw the home has in place a current electrical certificate, which confirms the homes electrical systems have been looked at and found to be safe, for the health safety and welfare of users of the service. We saw evidence that risk assessments are now in place for all residents who may require bed rails for their safety. There is a clear risk assessment plan completed in instances where bed rails are required and these risk assessments are reviewed so that people using them are monitored. What they could do better: We found the way meals are served do not provide a sociable event, in that the majority of residents receive their meals in their chairs, with tables brought up to them. We say this is not a stimulating experience, and in many cases residents have the potential for staying in their chairs for most of the day, thereby reducing the amount of mobility they have during the day. We discussed our concerns with the manager and staff and it was agreed the home will review the way meals are served so that it is a positive experience for residents. We found no evidence of the home looking at ways in which residents with dementia need stimulating other than the usual games, TV, walks out, entertainers etc. There must be evidence the home provides more focused activities designed to meet the needs of people with dementia. We found the management of resident’s monies is handled well, with evidence of clear recording, auditing and storage of individual residents money. However, it is advised the management team make sure relatives are provided with receipts when depositing or collecting a resident’s money so that there is a clear audit trail. We saw areas of the environment requiring attention, so that people who live there are in a well maintained and equipped home. The areas we found requiring improvement were the need for more dining tables, to be set out to give residents a ‘dining experience’ rather than them receiving meals in their lounge chairs. Bedding needs to be replaced in some rooms as the quilts covers seen were worn and in some cases damaged. Valances should be in place so that divan bases are not exposed. There are a number of resident’s Ribble Lodge Nursing Home DS0000006076.V343418.R01.S.doc Version 5.2 Page 7 bedrooms, which need to be decorated, as in some cases wallpaper is damaged, or worn. We say consideration should be given to the bathing facilities in the home, in that the proposed ‘wet room’, would benefit all users of the service by making bathing a much less stressful task without the need for lifting equipment. We say residents who wear glasses, or have dentures, should always be observed by the staff team so that they have these things in place. It is appreciated residents living at the home do take glasses off and leave them around including dentures, but staff should be vigilant in making sure they are in place, in order to make sure they can see properly and eat properly. Comments received highlighted instances where this had caused some distress. 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. Ribble Lodge Nursing Home DS0000006076.V343418.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ribble Lodge Nursing Home DS0000006076.V343418.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission and assessment procedures were very clear and precise to ensure the needs of the residents are met. EVIDENCE: We looked at the records of three resident, they had assessment information recorded in detail, and so the needs of individuals are met. Most files seen had in place a social work assessment with information on file for the care staff at the home to develop a care plan to make sure all health, welfare and social and cultural needs are identified and recorded. Staff spoken to say, “before anybody comes into the home we carry out our own assessment to make sure we can meet a persons needs”. “we like to talk to the doctor or whoever has been responsible for looking after somebody before they are admitted so that we know they are going to be in the right place for the level of care they require”. Ribble Lodge Nursing Home DS0000006076.V343418.R01.S.doc Version 5.2 Page 10 We saw proof the home carries out its own assessment using a good assessment process when residents are admitted privately, so that nobody is disadvantaged in how their individual needs are assessed. We spoke to a relative who said they were involved in the assessment process and able to give their views of the support their relative needed. We saw proof on the three files of residents or their families being invited to be part of the assessment planning and review of the residents needs. It is recognised there are difficulties in how much information a resident can provide due to the levels of dementia, however this is not seen as a problem by staff who use a personal history profile to gain information about a persons likes and dislikes, comments included, “we get to know as much as we can from relatives and friends so that, we can build up a profile on the person that shows staff more about the person and their life prior to coming into the home”. Staff members spoken to said they have access to resident’s assessment plans and could describe in detail individual residents needs. We found the home has made changes to its Statement of Purpose and Service User Guide. It is now more informative and people who use the service including relatives are provided with the information at the time of admission to the care home. Comments included, “I was given the information about the home when my relative was admitted, so that I knew what they would provide and who to talk to”. The home does not provide intermediate care. Ribble Lodge Nursing Home DS0000006076.V343418.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Promotion of health is taken seriously. Resident’s welfare is closely monitored and health needs are identified and met. EVIDENCE: We looked at the care plans, medical notes for three residents who live there. We found they were complete, accurate, and up to date and had good information relating to the health and welfare of the individual residents. Significant events had been recorded and followed through so that resident’s needs were being met by a competent workforce. We saw care plans are well structured and were being reviewed monthly or whenever a significant event had taken place, so that information is up to date. Care staff are involved in the process and those spoken to said, “we are shown how to record a residents needs, and how they are going to be met, it’s really important to make sure everything is recorded”. A relative said, “they ask about my relatives health and different things so I know they are looking after them”. Ribble Lodge Nursing Home DS0000006076.V343418.R01.S.doc Version 5.2 Page 12 Health care records showed there is a good link between the home and healthcare professional including doctors, district nurses, chiropody, and optical services, so that residents are not disadvantaged in any way and their individual health needs are met. Records looked at confirmed risk assessments have been completed and are reviewed when required and updated reflecting any changes that may have occurred individually and in the environment ensuring the resident’s needs are being monitored. Individual risk assessment regarding the use of bed rails are now in place, so that there is proof of why a bed rail is needed by any resident living in the home. Medication practices we saw at lunchtime were safe and good records had been kept making sure residents health is maintained. Only trained nurses are responsible for the administration and management of medication procedures. It is recommended they receive updated training in the processes of medication management so that they are up to date with current clinical guidance the protection of users of the service. We saw resident’s dignity and privacy was upheld during the visit by way of watching how staff talk to and respond to residents needs making sure residents are treated with respect. We also observed staff members knocking on doors before entering rooms. A relative spoken to said, “they’ve always got time for you”. Staff said, “we always make sure a residents dignity is protected just like I would like my own to be”, “if people want to be in their own room and be private then we respect that but we do need to keep an eye on everyone because of the level of dementia for their own protection”. Residents who wear glasses, or have dentures should always be observed by the staff team so that they have these things in place. It is appreciated residents living at the home do leave tese things around but staff should be vigilant in making sure they are in place, in order to make sure they can see properly and eat properly. Comments received highlighted instances where this had caused some distress. Ribble Lodge Nursing Home DS0000006076.V343418.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Daily life and social activities are flexible to meet individual needs, however there was little evidence of activities designed to meet the needs of people with dementia, and the dining experience is not designed to be a sociable event. EVIDENCE: We spoke to the cook and staff members who take nutrition seriously, so that all resident’s nutritional needs are met. We looked at a varied menu, which is flexible to meet the individual needs of residents living in the home. Staff spoken to are aware of the individual likes and dislikes of residents, so that they can make sure people get the right meals for them. We saw staff acting in a sensitive manner when encouraging residents with confusion to eat, so that they make sure it is done in a dignified way. Special diets can be catered for including low fat and diabetic controlled diets. Evidence on individual files noted this where necessary. Staff spoken to say, “we cook as much as we can with fresh produce, so that we know they are getting a balanced diet”, “we have diet supplements if people are struggling to eat, but we always get advice first”. Ribble Lodge Nursing Home DS0000006076.V343418.R01.S.doc Version 5.2 Page 14 We found the way meals are served do not provide a sociable event, in that the majority of residents receive their meals in their chairs, with tables brought up to them. We say this is not a stimulating experience, and in many cases residents have the potential for staying in their chairs for most of the day, thereby reducing the amount of mobility they have during the day. We discussed our concerns with the manager and staff and it was agreed the home review the way meals are served so that it is a positive experience for residents. There is an activity programme in place, but it is not necessarily followed due to the flexibility of the home. Staff said they like to take things day by day depending on the choice and mood of the residents. We found the activity programme does not necessarily take account of the specific ways entertainment or stimulation can be provided to people with dementia. This is an area which we say needs to be looked at so that people living in the home will have access to activities which are designed to meet the needs of people with dementia. Comments to support this included, “residents like to do their own things, their attention span is short because of the dementia, but we know what sort of activities they like to do”, “staff always seem to be very busy, caring, toileting and feeding”. “Could benefit from an extra member of staff to socialise with residents i.e. walking, going out into the garden, making things, TV. or music room”. We found there were no restrictions on visiting and surveys received confirmed, ”we can call anytime”. Surveys also confirmed staff keep relatives informed of any changes, so that they are aware of the changing needs of their relatives at any time and how this might affect them. We saw and spoke to a number of visitors throughout the site visit. Comments were positive about how the staff work for the benefit of residents. “Ribble Lodge nursing home scores top marks for myself. Many other people I have spoken to in Fleetwood strongly recommend it as the nursing home others should strive to match”. “Offers specialised nursing care for residents with dementia, confusion and Alzheimer’s”. Staff spoken to understand the need to make sure residents have access to family and friends beyond the home and they make every opportunity available for this to be continued. Ribble Lodge Nursing Home DS0000006076.V343418.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for recording and reporting of complaints are good making sure people feel listened to. Staff have access to safeguarding adults training for the protection of users of the service. EVIDENCE: We looked at the homes complaints procedure, which is made available to residents or their relative or advocate during the admission process. Seven relative surveys confirmed they are aware how to make a complaint, or discuss any areas of concern with the management team. Comments we gathered during the site visit confirmed relatives feel confident in raising any concerns and feel they are always dealt with in a timely manner. Comments from staff included, “Its difficult for many of the residents to say if they are not happy about something but we know what to look for so that we can put it right”. “ It’s difficult for residents, as they can be distressed due to their condition, but we understand this and try to make things right for them”. There have been no complaints recorded by the home in the last twelve months and there have been no complaints or concerns raised with the Commission since the last inspection 5th May 2006. We saw the home has a procedure in place for dealing with allegations of abuse. Staff spoken to are aware of the procedures to be followed in the event Ribble Lodge Nursing Home DS0000006076.V343418.R01.S.doc Version 5.2 Page 16 of any allegations of suspicion of abuse or neglect, and have received training in this area. Staff comments included, “I have had training for it, and it’s covered in NVQ training”. We found training in induction covers the homes procedures in safeguarding adults, and staff are then enrolled onto training so that they can take their responsibility in this area with a good knowledge of the procedures to follow. Ribble Lodge Nursing Home DS0000006076.V343418.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is designed to be homely and comfortable, however the need for decoration and replacement bedding as well as a lack of dining tables means this has the potential to have a negative impact on people living at the home. EVIDENCE: We looked at the homes layout and design and found to be a homely and comfortable environment in which to live. There are two lounge areas used by residents, One is the main lounge, dining room and the other is a small quite lounge, often used by visitors. Both lounges are pleasantly decorated. Comments included, “most people like to sit in here as this is where things tend to be going on”. We looked at how residents move around and what they like to do when sat in the lounges. It showed us residents were comfortable in the lounge areas, and some residents chose to move around and were not restricted in any way, with space being available for this. Ribble Lodge Nursing Home DS0000006076.V343418.R01.S.doc Version 5.2 Page 18 We found the lounge is large and generally well spaced out, however the lack of table provision for most residents means that there is no designated area for them to eat together. We discussed this with the manager and staff and the home must review this issue, so that residents are provided with specific dining room to have their meals in a setting, which is designated for dining. We toured the home and looked at individual rooms. Most of the rooms are personalised with resident’s own personal belongings, which helps them to feel comfortable with familiar things around them. We found resident’s rooms require some attention to decoration and replacement bedding as much of this looked worn and in some instances the divan was visible. Valances would improve this. Window restrainers were in place on all first floor rooms for the safety of residents. The number of bathing facilities are adequate to meet the needs of residents living in the home, however two of the first floor facilities are not used. The home finds the use of the ground floor bathroom more suitable and accessible for staff and residents. Discussion took place with the manager regarding a ‘wet room’ facility, which would improve access for both residents and staff. This facility will help people who have poor mobility to enjoy a bathing experience, without the need for hoisting equipment, thereby being much less stressful. This is currently being considered. We looked at the homes health and safety procedures, as well as the health and safety certificates, which were seen to be up to date, and thereby protect people living and working at the home. Ribble Lodge Nursing Home DS0000006076.V343418.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The procedures for the recruitment of staff are good ensuring the safety and protection of the residents. Training for staff is good and enables staff to have the skills and competencies for their roles. EVIDENCE: We looked at duty rotas and discussed staffing levels with the manager. They confirmed there are enough staff on duty to make sure resident’s are supported and their needs are met. On the day of the site visit we saw, the registered manager, a training officer who is also a qualified nurse, one trained nurse and three carers, as well as a cook and laundry person. Comments included. “We all work well together as a team”. “I feel really supported in what I do” We looked at three staff files; they confirmed the recording procedures of the home are good. Staff records include, application forms, Criminal Records Bureau (CRB), Protection of Vulnerable Adults (POVA) disclosures and references, so that people living in the home are protected by the homes recruitment procedures. We saw the training records and staff spoken to confirmed there is a wide range of training opportunities for all levels of staff. Comments included “We are encouraged by the management team to attend training”. Another said, “ Ribble Lodge Nursing Home DS0000006076.V343418.R01.S.doc Version 5.2 Page 20 I’ve done my N.V.Q (national vocational qualification) and really enjoyed it”. We had a discussion with the manager and looked at records which showed 50 of care staff have completed National Vocational Qualification (NVQ) level 2 in care so that the workforce is trained and competent in caring for users of the service. One member of staff said, “I’ve really enjoyed the NVQ training it was really useful”. Dementia care training is focused upon so that the staff team are equipped with the knowledge and skills to care for residents who display a wide range of dementia type conditions. Ribble Lodge Nursing Home DS0000006076.V343418.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed well and systems and policies in place for the protection and safety of staff and residents are good. EVIDENCE: We saw that the manager has the necessary skills and experience required to support the staff and residents and enable the home to meet its stated purpose and objectives. Staff spoken to say they found the management team to be supportive providing clear leadership. Comments included, “we are well supported by the manager”, “we have regular meetings and things get sorted out then”, “I know I can tell the manager anything and it is seen to if at all possible”, Ribble Lodge Nursing Home DS0000006076.V343418.R01.S.doc Version 5.2 Page 22 There is ongoing quality monitoring carried out through informal discussion with all users of the service including staff. We saw that there are regular staff meetings, which are recorded and where people who use the service can make any comments they feel necessary. Comments included, “we have regular meetings and things get sorted out then”. We found the management of resident’s monies is handled well, with evidence of clear recording, auditing and storage of individual residents money. However, it is advised the management team make sure relatives are provided with receipts when depositing or collecting a resident’s money so that there is a clear audit trail. All appliances in the home are checked regularly for the health and safety of all users of the service, we saw this by looking at the appliance certificates. Ribble Lodge Nursing Home DS0000006076.V343418.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 3 2 3 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 X X X X 3 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 X 3 X 2 X X 3 Ribble Lodge Nursing Home DS0000006076.V343418.R01.S.doc Version 5.2 Page 24 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 OP12 Regulation 16(2)(n) Requirement Social activities must be designed to meet the needs of people with dementia, so that they have the opportunity to be stimulated in a way, which meets their specific needs. (Previous timescale of 5.6.06 not met) The way residents receive meals must be reviewed so that it is a more social event taken together for the benefit of residents. (Previous timescale of 5.6.06 not met) Timescale for action 31/10/07 2. OP15 16(2)(i) 31/10/07 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 OP9 OP19 Good Practice Recommendations All staff should receive up to date training on safe management of medication. Bedrooms should be upgrading in respect of decoration and replacement bedding to make it a comfortable and DS0000006076.V343418.R01.S.doc Version 5.2 Page 25 Ribble Lodge Nursing Home 3. 4. OP21 OP35 suitable environment for residents living at the care home. Consideration should be given to review the current bathing facility to make it a more positive and pleasant experience for residents with limited mobility. We recommend the home makes sure it provides relatives or advocates with receipts each time money is deposited or withdrawn so that there is a clear audit trail. Ribble Lodge Nursing Home DS0000006076.V343418.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Ribble Lodge Nursing Home DS0000006076.V343418.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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