Inspection on 15/07/08 for Richmond

This inspection was carried out on 15th July 2008.

CSCI found this care home to be providing an Adequate service.

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

Richmond 14/08/07

Richmond 05/06/06

Richmond 15/11/05

Richmond 17/05/05

Richmond 11/01/05

Richmond 17/05/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Richmond Collington Lane East Bexhill-on-Sea East Sussex TN39 3RJ Lead Inspector Mrs Sally Gill Unannounced Inspection 15th July 2008 09:25 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 Richmond DS0000021194.V368562.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. Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Richmond Address Collington Lane East Bexhill-on-Sea East Sussex TN39 3RJ 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) 01424 217688 01424 210424 home.bex@mha.org.uk www.mha.org.uk Methodist Homes for the Aged Manager post vacant Care Home 52 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0) of places Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 52. Date of last inspection 14th August 2007 Brief Description of the Service: Richmond is a purpose built home providing personal care and accommodation for fifty-two older people. It is owned and managed by Methodist Homes for the Aged (MHA). A manager is in day-to-day control although not yet registered with the Commission. Service users accommodation consists of fifty-two single rooms situated on the ground and first floor in two units. Heather Bank on the ground floor is for service users living with dementia and on the first floor is a residential unit for older people. Service users accommodation on the residential unit consists of thirty-one single bedrooms all of which have en-suite toilet and hand washing facilities. In addition nine bedrooms also have showers as part of the en-suite facilities and four bedrooms have baths. There are communal assisted bathing facilities. There are small ‘break out’ areas where service users can make hot drinks and a separate dining room and lounge are situated on the ground floor. Access to the upper floor is via a passenger lift and a stair lift is available to access a number of bedrooms only accessible by a further small flight of stairs. Service users accommodation on the Heather Bank unit consists of twenty-one single bedrooms all of which have en-suite toilet and hand washing facilities. In addition seven bedrooms also have showers as part of the en-suite facilities. There are communal assisted bathing facilities. An L shaped conservatory style walkway adjoins both wings of bedrooms on the unit. The walkway is spacious Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 5 enough to provide a pleasant seating area and provides ramped access to the secure garden. There is a separate lounge, dining room with a kitchen area and a further kitchen area to prepare snacks and hot drinks. Service users on each unit have access to a garden with a patio area. There is parking available in addition to on street parking. Local amenities are a short distance away. The staff compliment consists of the manager, deputy manager; two assistant managers (one for each unit) senior care assistants, care assistants and activities coordinators. Care staff’ work a rota 7am – 9pm with four members on waking night duty. In addition there are cooks, kitchen assistants, laundry person, domestics, maintenance person and administrator. The homes Inspection reports are available to view in the home or can be downloaded from www.csci.gov.uk. At the time of the inspection fees ranged from £464.00 to £567.00 per week. Additional charges are made for hairdressing, toiletries, chiropody, newspapers, and dry cleaning and outside activities such as visits to the theatre. Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection and was carried out over a period of time and concluded with an unannounced visit to the home between 9.25am and 5.40pm. The manager and staff assisted throughout the visit. Forty-seven people were living at the home on the day of the visit. There were five vacancies. Surveys were sent to the home for the manager to distribute to people that live there and relatives. Two were returned which were positive with answers indicating always or usually to questions asked. Various records were viewed during the inspection and parts of the home and garden viewed. The home returned the annual quality assurance assessment (AQAA) within the required timescale. It was clear and contained most of the information required. The quality rating for this service is 1 star. This means that the people who use this service experience adequate quality outcomes. What the service does well: What has improved since the last inspection? The manager advised that hot water safety valves have been fitted to systems to ensure a safe hot water temperature. She also advised that people are now able to control the temperature of their rooms. People are involved in care planning, which is now more detailed giving staff the information they need to deliver consistent care. To ensure peoples safety risks have been assessed and actions needed to reduce risks have been recorded. Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 7 The manager advised that the staffing levels have been reviewed and the rota pattern adjusted to ensure peoples needs can be met. Medication records have been improved to ensure a safer system is in place. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Richmond DS0000021194.V368562.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 Richmond DS0000021194.V368562.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): 1, 3 & 6 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who may use the service and their representatives have the information needed to choose a home that will meet their assessed needs. EVIDENCE: People receive the information needed to make a decision as to whether this home is right for them. The manager advised that people making enquiries about the home are sent a brochure and service user guide for information. A new welcome pack has been developed. This includes the service user guide and is left for people in their room together with a nice welcome card. A copy of the last inspection report is displayed within the front hallway of the home. People confirmed that they usually or always had sufficient information about the home to make decisions. People can be confident their needs will be assessed prior to moving in. The manager advised that people are visited in their own environment to assess Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 10 their needs. A copy of a recent detailed assessment undertaken by the manager was seen which is used to develop the care plan. Intermediate care is not provided at Richmond. Richmond DS0000021194.V368562.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): 7, 8, 9 & 10 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s needs are identified within a care plan and risk assessments but these lack review. Minor improvements to the medication systems would fully protect people. People are treated with dignity and respect. EVIDENCE: People’s health and care needs are detailed in a care plan. Three care plans were examined. Generally they contained sufficient information to inform staff as to how they wished to be supported. Although people said they were not aware of their care plans there was evidence within the plan to show they had been involved in writing them up. The manager has improved the structure and layout of the care plans making them easier for staff to use. Staff felt the care plans were informative and when they described a person’s routine this was reflected in the care plan. Some care plans lacked regular review and some had only been reviewed in parts. Many documents had last been reviewed in April 2008. Care plans should be reviewed at least monthly. One care plan showed that a person was last weighed in May 2008, had lost weight Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 12 and a note ‘please observe’ but no information since. In discussion with the manager the person had been weighed in June 2008 but the car plan not updated. In the same care plan the person now needed more help when bathing and although this was recorded in one part of the plan it had not been updated in other sections that also talked about bathing. Care plans must be up to date. Recording by staff to evidence care needs are being met as recorded in the care plan is not daily and does not appear to have a clear process. In some cases recording appeared to be in the wrong section of the care plan. Risk assessments are in place and a variety of risks have been assessed. These also lacked reviewed none examined had been reviewed since April 2008. Review of risk assessment has been raised at the last three inspections since June 2006. A statutory requirement notice will now be served. The risk assessment for self-administration of medication was discussed with the manager in detail. This must be specific to each person and all steps in place to reduce risks must be recorded including arrangements to hand over medication, storage, returning medication and it should be linked to the assessment of abilities to handle medication safely. A risk assessment for use of bedrails is in place but it does not indicate the rational for their use. Risk assessments are more reader friendly and training in risk assessment is planned for September. The manager advised she is aware of the problems with care plans and is planning further training for staff. To try and address this she is undertaking a sample audit each month, discussing care plans at all team meetings and during individual supervisions. It is acknowledged that this action is filtering to aid further improvements and if sustained would impact. One person was happy with the care they receive and feel they get the support they need. Another person felt their relative needed more help although acknowledged they were reluctant to accept help and this was discussed with the manager. People’s health care needs are met. Records and discussions confirmed people have access to health care services including doctors, district nurse, chiropodist, optician and dentist. Some people access their own services. The manager advised where health professionals visit the home the communication has improved to aid joint working. People are generally protected by safe medication systems and where possible encouraged maintaining responsibility for their own medication. The Medication Administration Record (MAR) charts were examined. MAR charts were completed using appropriate codes and signatures. Handwritten entries were not always dated, signed and witness which is good practice. Administration of one-person medication was observed and followed good practice. The cupboard used to store one medication trolley and excess stocks was registering a temperature of 26 degrees, which did not drop during the time the cupboard was open and it was not a particularly hot day. Staff advised the temperature is monitored and recorded however the recording sheets could not be found. The home must take action to ensure that medication is storage at the correct temperature. The manager advised that Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 13 all staff that administers medication have received training. Four staff’ are booked on a course which will enable them to assess staffs competency in medication administration. The manager advised that currently competency checks are carried as part of supervision. Further medication training is planned. The manager is due to undertake her own audit shortly. People feel they are treated with dignity and respect. All people spoken to confirmed they staff are very kind and sensitive when undertaking personal care and they are happy with the care received. Observations also confirmed good interactions with people who are treated with dignity and respect. Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are encouraged to make choices about their dayto-day lives. Social and recreational activities could be more varied to meet all individual’s expectations. EVIDENCE: People have opportunities for social and recreational activities. Two activity coordinators are employed. In addition to this volunteers are used to also provide activities such as bible study, hymn singing and run a trolley shop each week. An activity programme is displayed. Activities on the day of the visit were exercise, hand massage, bible reading and hymn singing. Discussions highlighted that some activities are very much enjoyed and attendance at the hymn singing certainly confirmed this. Comments also indicated that activities could be monotonous and have previous been more imaginative or that individuals who do not join with groups would benefit from one to one time just for a chat. The variety of activities was discussed with the manager who acknowledged this is an area for improvement and has started to address this. Recently animals such as snakes and lizards had been bought into the home and people were able to handle these. Artwork undertaken by people was Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 15 displayed on the walls. One person talked about an outing to Merriments Garden Centre, which was enjoyed. Leaflets of local attractions within the community are displayed. The home has a minibus, which can be used for trips out. Several people go out to church each Sunday. People from various religions also visit the home. The home is currently recruiting for a permanent Chaplin. A garden party and dog show was being held at the home the following weekend. Some people are happy with their own company or to wander and enjoy the garden. Others are able to access the community independently. People have a choice of meals, which are enjoyed. A four-week menu is in place, which has recently been reviewed. Breakfast is cereals, toast and fruit. The main meal is at lunchtime with a choice of main meal followed by a desert. Supper is a choice of light meal or sandwiches etc followed by something sweet. On the day of the visit lunch was chicken pie or gammon and parsley sauce with vegetables and banana boats to follow. The manager advised that everything is home cooked and vegetables are delivered regularly to ensure they are fresh. People felt they had enough food and it was good. One felt the menu was monotonous with roasts on Sunday and Wednesday and fish on Friday. Special diets are catered for. The manager advised that records of individual food consumption, to monitor that people have had an adequate diet where now in place. Small kitchen areas are situated around the home so people if able can make their own drinks as they wish. Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns and the manager is committed to resolving these. People feel safe and planned update training will further protected them from abuse. EVIDENCE: People felt confident they knew who to report any concerns to and would feel comfortable in doing so. A complaints procedure is displayed. Four complaints were recorded as received with a record of action taken to address areas of concern. One person said they had complained under the previous manager but felt things had not really improved. Their areas of concern were discussed with the manager and a senior. The manager was aware of one area and is taking action to try and address this. The other area the manager was unaware of but agreed to look into. The Commission has not received any concerns in relation to Richmond. Several compliments letters and cards have been received by the home. People feel safe living at the home. The home has policies and procedures in place in relation to safeguarding people and a whistle-blowing policy. The manager advised she has ordered a copy of the updated local adult protection protocols. The manager and another member of staff are trained trainers in adult protection. Only five staff’ are currently trained. It is planned that all staff will have adult protection training in July and August. All new staff’ now Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 17 receive adult protection training as part of their induction. In discussions with staff they were clear about how to report abuse within the organisation but unclear of the routes outside. This needs to be addressed. Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in comfortable and homely environment, which will benefit from the major refurbishment planned. The home is generally clean but one area needs improvement. EVIDENCE: People live in a comfortable and homely environment although a bit tired in places. A part tour of the home was undertaken. There is evidence of wear and tear in places and some areas look dated. The manager is very aware of this. Work discussed at the previous inspection has not yet taken place such as décor and carpets in corridors. The manager advised there is a major plan and budget in place to extend the home and also refurbish areas. Planning permission for the extension has already been applied for. Better storage for wheelchairs and walking aids would enhance the environment. Handwritten notices were displayed around the home, which looked a bit tatty. People Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 19 confirmed that they were generally happy with their rooms, which were personalised with belongings. One said they had been in their room several years and it would be nice if the décor could be freshening up. Another had requested a move, which had just been accommodated, and they were busy organising their new room. They said the room had been recently decorated and had a new carpet. People are able to take advantage of the maintained garden on the residential side of the home, which has been enhanced by a fishpond and fountain. The other enclosed garden is not well maintained at present. Work discussed at the previous inspection has not yet taken place but the manager advised that quotes for making the garden more accessible to people have now been sought. Generally the home was clean and tidy although one area was not cleaned to the required standard. The manager is aware of this shortfall and has started to take action to address this. Some waste bins were lacking lids/tops. A wooden/material chair was being used in a bathroom, which is unhygienic, and the manager had it removed immediately. One kitchen area was being used to store a box and hood on the floor, which were dusty. In addition to the main laundry operated by staff there is a residents laundry where people can launder their own clothes. This area is also used to store a standing hoist and slings. Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff’ in the home are qualified, trained and skilled. Staffing numbers need to be kept under review to ensure the needs of people continue to be met. Recruitment practices need to be more robust to fully protect people. EVIDENCE: Most people felt there are sufficient staff’ on duty. One member of staff felt staffing numbers should increase. The manager confirmed that four staff’ are on duty in both units each day and two members of staff are on waking night duty in each unit. In addition to this there is an assistant manager on duty each day 6.45am – 9.15pm and an activity coordinators on each unit for 20-25 hours per week. Ancillary staff’ include a chef, kitchen assistants, laundry, domestics and a maintenance person. One comment received was that when people do not attend activities it would be nice if staff could spend some one to one time with them. The manager advised that although the rota numbers has not changed the pattern of working has been reviewed. Staffing numbers need to be kept under review to ensure the needs of people continue to be met. The manager also advised that although there have been recruitment problems these have improved and agency use has decreased. People spoken to felt staff were very kind. Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 21 People could be better protected by more robust recruitment procedures. Three staff files were examined. The application form does not lend itself to asking for a full employment history. For one employee a telephone reference had been accepted in place of a written reference and an ex member of staff instead of the establishment had supplied the other reference. In another file a letter from the benefits agency had been accepted as a reference, which really it was not. The home must ensure two written references are obtained before employment can commence. All staff had either a Protection of Vulnerable Adults (POVA) check or Criminal Records Bureau (CRB) in place. Interviews are carried out by two people and notes maintained. The manager has introduced people being involved in recruitment with an opportunity to give their opinion as to prospective employees. People are trained to undertake their roles. All staff’ have undertaken an induction which is to Skills for Care specification. The manager is putting together a training matrix to enable better monitoring of training and updates to ensure all staff receive the required training. E-learning training has been introduced and increased training opportunities for staff to aid this. Some staff’ have received training in dementia and further is planned for August. People receive care from a qualified staff team. Figures stated in the AQAA show that over 50 of staff have obtained a National Vocational Qualification (NVQ) level 2 or above and four others are working to wards this qualification. Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect and has effective quality assurance systems in place for people to voice their views. Systems to ensure staff’ are following procedures need tightening. EVIDENCE: People live in a home, which is managed by a person who is enthusiastic and committed and encourages an open and relaxed atmosphere. The manager took up post in April 2008. She has considerable experience of managing care homes and dementia care. She is qualified in NVQ level 4 in management and is currently undertaking an Open University degree in care management and science. The manager has worked hard since taking up post and people confirmed that she is starting to change things for the better. Comments Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 23 included she has not been here long but everything is amicable, she is firm but fair, she is approachable and easy to talk to but can pull rank and sorts things out and recently she is ironing out problems. Discussions highlighted that communication between staff has improved, a team-building day has been held, there are more meetings and everyone is able to voice their opinions and feelings. It is clear the manager is already beginning to have an impact but in some areas it is disappointing progress over the last eleven months, which the manager now has to address. Discussions took place with the manager regarding the management of staff’ following procedures being implemented in their day-to-day work such as care plan & risk assessment reviews and the variety of activities delivered. The home is generally run in the best interests of people. People confirmed that they complete an annual quality assurance questionnaire. An independent company conducts this, the results analysed and an action plan put in place. People are able to join a governing body and the manager advised that three people at Richmond have. This enables them to contribute to the organisations decision-making. There is an annual support group meeting made up of people who live at Richmond, relatives and volunteers. An internal newsletter is used to keep people in touch and one person talked of their contributions to this. Regular quality assurance visits by a representative of the organisation are completed and recorded to meet the requirement under Regulation 26. Systems should ensure they are picking up shortfalls such as those highlight during this inspection. Regular residents meetings are held and minutes maintained. One person spoken to confirmed people do have the opportunities to give their views. People’s financial interests are protected. Where a small ‘float’ of money is held for some people a sample of the financial records to support this activity were examined and adequate. The administrator regularly audits these. Suggestions to make records more robust were discussed. Staff’ feel supported. Staff spoken to felt well supported although not all felt they had regular supervision. The manager advised this was in place. People’s health, safety and welfare are promoted. The manager advised that the Environmental Health Office had visited the home in December 2007 and returned in April 2008. All work required had been completed. Accidents are recorded. Incidents reportable under Regulation 37 were discussed. The manager advised that she was aware these had not been reported but had addressed this since taking up post. The manager advised that hot water safety valves were now fitted to ensure water is at a safe temperature and people are able to control the temperature in their bedrooms. One cook is booked on a food hygiene course in August and thirty other staff’ are trained. All staff’ have received fire training and a further course is booked for July. Forty staff’ are trained in moving and handling, twenty-one in infection control and sixteen in first aid. Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 24 Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 25 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 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 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 3 X 3 Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 26 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 (2) (b)(c) Requirement The registered provider must ensure that care plans are regularly reviewed and kept up to date The registered provide must ensure all risk assessments are regularly reviewed. Previous timescales 15/07/06, 15/03/07 and 14/08/07 not met 3 OP9 13(2) The register provider must provide a safe system for medication. In particular Safe temperature control for storage, detailed risk assessments for self administration of medicines and handwritten entries on the MAR charts dated, signed and witnessed 4 OP29 19 & schedule 2 The registered provider must ensure that a robust recruitment process is followed. In particular 20/08/08 20/08/08 Timescale for action 20/08/08 2 OP7 13(4) (c) 15(2) (b) 20/08/08 Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 27 Two written references are obtained prior to the commencement of employment 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 Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Richmond DS0000021194.V368562.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!