Inspection on 05/06/06 for Richmond

This inspection was carried out on 5th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Richmond 15/07/08

Richmond 14/08/07

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Richmond Collington Lane East Bexhill-on-Sea East Sussex TN39 3RJ Lead Inspector Gwyneth Bryant Unannounced Inspection 5th June 2006 08:00 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 Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Richmond DS0000021194.V289810.R01.S.doc Version 5.1 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 home.fxg@mha.org.uk Methodist Homes for the Aged Mrs Debra Macklin Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is forty (40). Service users will be aged sixty five (65) years of age or over on admission. 15th November 2005 Date of last inspection Brief Description of the Service: Richmond is a purpose built home providing personal care and accommodation for forty older people. It is owned and managed by Methodist Homes for the Aged. Service users accommodation consists of forty single rooms all of which have en-suite toilet and hand washing facilities. In addition twelve rooms also have showers as part of the en-suite facilities and four have baths. The building has two floors with nine rooms on the ground floor and thirty-one rooms on the first floor. Access to the upper floor is via a passenger lift. There are two lounge areas and four small ‘break out’ areas where service users can make hot drinks. The home has seven communal toilets and five bathrooms of which four have assisted baths. Meals are served in the dining room or in individual bedrooms if required. There is a programme of regular activities for service users. The service provides prospective service users with a copy of the service users agreement and a brochure as part of the pre-admission process. Copies of inspection reports and the homes Statement of Purpose are made available if requested. The range of fees charged as from 1 April 2006 is from £424 to £477. Additional charges are made for hairdressing, toiletries, chiropody, newspapers, dry cleaning and outside activities such as visits to the theatre. Intermediate care is not provided. Heatherbank is the ‘sister’ home on the same site and is registered in its own right as a care home for a maximum of for up to twelve service users with a dementia type illness. Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001 uses the term ‘service users’ to describe those living in care home settings. For the purpose of this report, those living at Richmond will be referred to as ’residents’ at their own request. This was an unannounced inspection and took place over seven and a half hours. The purpose of the inspection was to check compliance with the requirements made at the last inspection and inspect additional standards. There were thirty-nine residents in residence on the day of which six were spoken with. This was in addition to the four residents whose care was tracked from admission to the current time. A number of staff were spoken with including the maintenance person, deputy manager, assistant manager, the chef and two care staff. A tour of the premises was carried out and a range of documentation was viewed including care plans, personnel and medication records. Surveys received from four residents and one relative were generally positive and that both groups were satisfied with the services provided. Most of the residents spoken with spoke highly of the care given and the dedication of staff, but there was a general consensus that staffing levels were inadequate. The Registered Provider makes monthly visits and the subsequent reports made available to the CSCI. The organisation provided a pre-inspection questionnaire, however not all of the information was specific to Richmond and included reference to Heatherbank, in particular, information relating to staffing numbers, staff training and administration. What the service does well: What has improved since the last inspection? Of the shortfalls identified at the last inspection those addressed are that satisfactory risk assessments are now in place for those at risk of tissue breakdown. A programme to train all staff in adult protection and fire safety Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 6 has been implemented. A suitably qualified person has made an assessment of the premises to ensure suitable aids and adaptations are made to protect residents independence. Systems have been developed to consult with residents more regularly and recruitment practice is now robust ensuring that residents are protected. 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. Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 4. Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with sufficient information to enable them to decide whether or not the home can meet their needs, however some residents have been admitted who may be outside of the homes’ registration category, therefore it is unclear if their needs can be met. EVIDENCE: Discussion with the deputy manager found that the prospective residents are provided with a brochure and a copy of the residents’ agreement. The Statement of Purpose and a copy of the last inspection report is provided on request. The home has an open visiting policy to encourage relatives and family to visit regularly. Residents confirmed they and their families had the opportunity to visit the home prior to admission. Pre-admission documents demonstrated that satisfactory assessments of residents care needs are carried out prior to admission. Care plans showed that two residents have been admitted who have a diagnosis of a dementia type illness, on the basis that they will spend their day Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 9 times in Heatherbank. However, these residents will spend the rest of the time at Richmond. This could be disorientating and few staff in Richmond have received satisfactory training in dealing with those with dementia therefore both staff and residents may be at risk. Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 , and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care planning systems do not provide staff with clear direction in how to meet all aspects of residents personal and health care needs. Residents are protected by satisfactory systems for the recording, handling and storing of medication EVIDENCE: Five care plans were viewed and improvements were noted in that staff now clearly identify residents changing needs including increased levels of dependency, however this needs to be expanded to include clear direction as to how these increased needs will be met. One care plan showed that one resident presents challenging behaviour, however there was no direction to staff on how to deal with this to ensure both staff and residents are protected. It was in relation to this care plan that inappropriate language was used in that it was recorded that a residents ‘had a tantrum’. Basic risk assessments had been carried out in respect of the environment but they did not clearly identify the hazards nor include sufficient detail for the management of risks, this is especially true for those who are at risk of falls or have particular disabilities. It was observed that a small number of residents whose physical frailty and Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 11 significant confusion may place them outside the homes’ registration category. It was observed that at least four residents needed to transfer from their rooms to communal areas using a wheelchair. In discussion with staff they said that the numbers of residents requiring assistance with all personal care has trebled and this increased dependency has been identified in care plans. Due to the increased dependency and deterioration in mobility of these residents, risk assessments need to be reviewed monthly. This increased dependency is making additional demands on staff time and their skills and it is unclear if the service can continue to meet their needs, alternatively a more appropriate placement should be sought. Information on continence management needs to be sought from an appropriate person as care plans stated that at least one resident was ‘not really incontinent’ but wore protection anyway. Residents are not weighed regularly and where they have lost weight there is no information to direct staff on how to address this need. Not all care plans had evidence that residents or their representatives had been involved in compiling and reviewing the plans. Residents spoken with were not aware of the contents of their care plan and none could recall being asked about their care. During the staff handover session and in discussion with the deputy and assistant managers it was evident that staff are aware of residents individual care needs but this system relies on good verbal communication and good staff memory. Residents are at risk if these informal systems breakdown. Care plans and the daily diary showed that satisfactory arrangements are in place to provide residents with access to chiropodists, dentists, opticians and GP’s to ensure their healthcare needs are met. The home has policies and procedures in place in respect of the safe handling, storage and administration of medicate and all staff who administer medication have been appropriately trained. Staff were observed to follow the correct procedures when administering medication and medication recording charts were accurate and up to date. Medication is stored in a locked cabinet in a locked room ensuring that they cannot be accessed by unauthorised persons. Throughout the inspection staff were noted to treat residents with care and respect. Residents spoken with said that staff were very good and they felt they ‘could not get better care’. However, all those spoken with said they felt that staff were rushed and it would be nice if they had time for a chat. Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected 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. There are systems in place for residents to experience a lifestyle that matches their expectations, choice and references in respect of both leisure and meals. EVIDENCE: There is a full programme of activities, including exercises, word games, arts and crafts for both the morning and afternoon periods, unless the activity coordinator is unavailable. Residents spoken with said they enjoy the activities although some said they preferred not to participate in all activities. They also confirmed they go out alone into the community or local church services and that their friends and families were always made welcome. Visitors were noted to be comfortable with staff and those visiting on the day took residents out for the day. Visitors may join residents for meals or take tea in residents’ rooms. The ethos of the home is to maximise residents’ independence and ensure they are able to continue with their chosen leisure activities for those residents who are physically and mentally able to do so. All residents spoken with were unanimous in that meals were excellent and there was plenty of choice. The chef was knowledgeable about residents diabetic and vegetarian dietary needs. He confirmed that if residents did not like any of the set menus he would endeavour to provide a further alternative if required. He added that he consults residents on menus and tries to include Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 13 favourites whenever possible. Menus showed that meals were varied, balanced, however one resident said that they would like more fresh vegetables instead of frozen ones. Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be 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 good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure with evidence that residents feel that their views are listened to and acted upon and residents are further protected by satisfactory adult protection systems. EVIDENCE: The home has detailed policies and procedures on complaints, a copy of which is in the homes’ hallway. No complaints have been received since the last inspection. Residents said that they would be happy to speak to the manager or staff if they had any concerns, although most said they had no reason to complain about anything in the home; one said they did not feel comfortable making a complaint. This issue was discussed with the deputy manager who said she would ensure all residents know they can complain in writing anonymously. The home has policies and procedures on adult protection and staff are expected to be familiar with this document. A staff training programme has been implemented in respect of adult protection and staff spoken with were aware of the procedures. Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 25 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of decor within the home is generally satisfactory, with most areas homely, safe and comfortable for residents but could be improved if minor repairs were carried out promptly and all areas kept clean. EVIDENCE: A tour of the premises was carried out and most parts of the home are well maintained and décor is generally good. Most residents’ bedrooms were clean, tidy and attractive, although some furniture in residents’ bedrooms need to be cleaned and/or refurbished. One survey received said that due to a shortage of domestic staff, rooms do not get a ‘spring clean’ very often and during the tour of the premises it was noted that some bedrooms needed to be cleaned including carpets and en-suite facilities. In addition there is a damp patch in one of the communal rooms that needs to be attended to as it detracts from the general appeal of the home. A small area around one toilet in an en-suite facility was bare concrete and this too looks unsightly and poses a potential risk of infection. The maintenance person explained that there is a maintenance book in which staff record minor repairs needed, however he said there he is unable to respond as promptly as he would wish as he also tends Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 16 the gardens. The gardens both at the front and rear of the building are attractive and well maintained and some residents said they enjoyed sitting or walking in the gardens. The inspector tried to speak to a cleaner in respect of her routine but this person managed to explain with very limited English that they did not know sufficient English to hold a conversation and this may impact on her ability to undertake her role effectively. The deputy manager confirmed that a suitably qualified person had assessed the premises in respect of aids and adaptations, however she was unable to locate the report and was unaware of any recommendations made. In some en-suite toilet facilities the toilet paper and/or grab rail can not be reached while the resident is sitting on the toilet. This needs to be addressed as it puts residents at risk of falling if they overreach. Hot water delivery temperatures were erratic ranging from 38.60C to 45.90C. Water needs to be delivered at a temperature of 430C ensuring that it is comfortable for service users but not so hot as to place them at risk. Individual controls need to be fitted to residents bedroom radiators in order to ensure service users bedrooms remain at a comfortable temperature. The laundry was clean with equipment that can wash soiled laundry at high temperatures. Staff training in infection control continues to be provided, staff were observed to be working in ways that minimised the risk of infection, by wearing gloves and aprons when required. Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected 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 poor. This judgement has been made using available evidence including a visit to this service. Care staffing levels are not sufficient to ensure that residents’ needs are always appropriately met. The recruitment practice is robust and provides sufficient safeguards for the protection of residents and staff have sufficient training to ensure they are competent to do their jobs. EVIDENCE: Staff rotas showed that there were four care staff on duty during each shift and two waking night staff. In addition there are a chef, domestic, laundry and maintenance staff. The administrative, maintenance and activities staff are shared with Heatherbank, the adjoining home. A total of 621 care hours are provided. The Residential Care Forum staffing tool recommends a minimum of 899.97 hours based on service users dependency levels, the layout of the home and those residents who need particular care. This shortfall indicates that not all residents’ care needs can be met with current staffing levels. As mentioned under other Standards both staff and residents are aware that there are insufficient staff. Residents repeatedly say that staff do not have time for one-to-one interaction and this limits the time available to provide personal care during peak/busy times. Staff are also aware that they do not have the time to be more sociable with residents. It was observed that residents’ dependency levels have increased with at least four needing to be mobilised with the use of a wheelchair and care plans showing that some residents need two carers for transfers. Staff spoken with also mentioned the increased dependency levels with over half the residents needing full assistance with personal care. These shortfalls impinge on residents ‘ quality Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 18 of life’ and have the potential to impair the comfortable working relationships that currently exists between staff and residents. The language barrier was another area that was raised by those who returned surveys in that communicating with some staff was difficult where English is not their main language, although the same staff were kind and caring. Currently five care staff in Richmond have achieved NVQ level 2 in care and a plan needs to be created to ensure 50 gain this qualification by April 2007. All staff have comprehensive induction and foundation training that meets the Care Skills Sector specifications. Evidence was available to demonstrate staff also received additional training in infection control, manual handling and the safe handling of medication. In order to meet service users changing needs all staff need to be trained in dementia care and dealing with challenging behaviour. Recruitment records were viewed and it was found that all staff had provided the required two written references, satisfactory identification and all other documents as required. Protection of Vulnerable Adult first checks are carried out for all new staff and they do no work unsupervised until a satisfactory Criminal Records Bureau check is received. Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff and residents benefit from clear leadership and direction. All aspects of residents’ health, safety and welfare need to be protected and promoted. EVIDENCE: The Registered Manager was not available on the day and the deputy manager was the person in charge, who has the skills and qualifications to effectively deputise for the Registered Manager. Both the Registered Manager and the deputy take responsibility for both Richmond and Heatherbank. In addition there is an assistant manager for each of the units on the site. Throughout the inspection it was noted that both residents and staff felt comfortable in approaching the deputy and assistant manager with any concerns. Staff meetings are carried out monthly and minutes viewed showed there are consulted on how the home is run. These meetings are in addition to a ‘hand over’ at the end of each shift. The ‘handover’ session was observed and it was clear that these sessions are used as an effective means of verbally Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 20 communicating residents daily care needs and that staff were familiar with the needs of each resident. The Registered Provider undertakes monthly visits as required and the results made available to the Commission. Quality monitoring is achieved via a twice yearly audit carried out by staff from the Methodist Homes for the Aged regional office. Residents are responsible for their own finances if appropriate; relatives and solicitors support others, while the home does not handle the financial affairs of service users. When items are purchased on behalf of residents, receipts are obtained and satisfactory records maintained. Evidence was available to demonstrate that electrical and gas systems and appliances have been serviced and are safe. Documents relating to safe working practices and Health and Safety were available and found to be satisfactory. The accident book showed that during the months of April and May there were a number of unobserved falls, indicating that more detailed risk assessments need to be carried out to attempt to reduce the risks of residents falling. It was of concern that the domestic spoken to who was unable to converse in English, is using substances that are included in the Control of Substances Hazardous to Health regulations (COSHH) and she may not be able to read/understand product labels that are written in English. There were cleaning fluids left in one bathroom and this contravenes COSHH guidelines and puts residents at risk. Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 3 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 3 2 X X 2 X X 2 3 STAFFING Standard No Score 27 1 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP4 Regulation Requirement Timescale for action 05/06/06 2 OP7 (14)(1)(d) A reassessment of all service users who appear to be outside of the homes’ registration category needs to be carried out. Only those service users who are within the homes registration category are to be admitted to the home. 15(1)(2)( Wherever practicable service 05/06/06 a) users or their representatives should be involved in the preparation and review of their care plans. (timescale of 17/05/05 and 15/01/06 not met) 13(4bc) (c)(5) Detailed risk assessments need 05/07/06 to be undertaken in respect of those service users at risk of falls and for moving and handling. (timescale of 15/01/06 not met). All parts of service users care 05/07/06 plans need to include clear direction to staff as to how needs will be met. (timescale of 15/01/06 not met). All risk assessments need to be 05/07/06 reviewed monthly for those service users who are most DS0000021194.V289810.R01.S.doc Version 5.1 3 OP7 4 OP7 14(4bc)15 (1)(2bc) 5 OP7 13 (c)15 (2b) Richmond Page 23 6 OP8 7 OP8 8 9 OP19 OP22 10 OP25 11 12 OP25 OP27 13 OP28 14. OP30 dependent. Advice needs to be sought from an appropriate healthcare professional in respect of continence management. (timescale of 15/01/06 not met). 14 (1a) All service users need to be (2ab) weighed regularly and action taken when weight is lost or gained as required under Regulation 17 (1) (a) Schedule 3 (m). 23(1a)(2b All minor repairs need to be carried out promptly and the cleaning programme reviewed. 16(1)(2c) Grab rails and toilet paper 23(2n) holders in en-suite facilities must be easily accessible to service users. 13 (4ac) That hot water delivery temperatures in service users bedrooms are maintained at or near 430C. 23(1)(2p) Individual controls need to be fitted to service users bedroom radiators 18 (1) (a) Staffing levels must be increased with a view to providing additional care time. (timescales of 31/07/05 and 15/12/05 not met). 18(1)(a-c) A plan needs to be developed to (i) demonstrate how 50 of care staff will achieve NVQ 2 by April 2007. 18(1)(ac) All staff need to be trained in (i)(ii) dementia care and dealing with challenging behaviour. 13(1)(b) 05/07/06 05/07/06 05/07/06 05/07/06 05/07/06 05/07/06 05/07/06 05/07/06 05/07/06 Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 24 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 Refer to Standard OP7 Good Practice Recommendations That appropriate language be used in care plans. Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Richmond DS0000021194.V289810.R01.S.doc Version 5.1 Page 26 - 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!