CARE HOME ADULTS 18-65
Richmond Lodge 27 Bilton Road Rugby Warwickshire CV22 7AN Lead Inspector
Kevin Ward Announced 17 May 2005 08:00 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Richmond Lodge Address 27 Bilton Road Rugby Warwickshire CV22 7AN 01788 547781 01788 573410 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) RmH Homes Mrs Connie Violet Osborn PC 21 Category(ies) of LD 21 registration, with number of places Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 03 February 2005 Brief Description of the Service: Richmond Lodge has provided residential care for 21 adults with learning disabilities. This home is operated by Rugby Mencap Hostels, which is an organisation led by parents. The care home is made up of what the organisation describes as a hostel, for 14 adults. This is staffed while the residents are present. Part of the care home is two flats one in a separate building on the first floor the other is accessed through the main building. Three residents occupy one flat and four occupy the other and they receive lower levels of staffing support than people in the main house. The home does not routinely offer any day service and most residents use a social services’ day centre close to the home each weekday. The home no longer offers a respite service. There is some provision for people with physical disability in the main house and a lift serves the first floor. The premises are on the main road close to Rugby town centre. The organisation has offices on the premises and managers use it as a base. Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection involved looking around most areas of the home but did not include viewing all residents’ bedrooms on this occasion. The inspector talked with all residents during the course of the inspection, which took in breakfast time and teatime. The inspector spoke with staff and the manager and looked at a number of records, such as care plans, daily recordings and some policies were examined. A pre inspection questionnaire and staff training information was provided by the home and residents were issued with comment cards that were completed and returned to the Commission for Social Care inspection prior to this inspection. What the service does well: What has improved since the last inspection?
Just prior to this inspection a new manager was appointed at the home and has applied to be registered with the Commission for Social Care Inspection. Since the last inspection the home has started to meet with residents regularly to discuss issues that affect them, (e.g. holidays, activities, new pictures, payphone and new wheelchair ramp). Questionnaires have also been passed to residents and their relatives to complete in order that they comment on the work of the home. The deputy manager stated that where the questionnaires highlight any issues she will make plans to address them. Good work has taken place to arrange for staff to receive communication training from a speech and language therapist. Since the inspection the new manager has confirmed that 50 of the staff team have now received this training and the rest will be trained in June. This training should help to increase staff awareness of residents’ communication needs, which can then be recorded in their care
Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 6 plans. Since the last inspection the Responsible Individual for the home has written to Warwickshire Social Services Department to seek a review of the level of funding provided for residents care, so that this remains sufficient to sustain the long-term future of the home. 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 Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 The homes pre admission assessment procedures need to be adjusted so that people’s social workers are always involved in assessing residents’ need prior to their admission to the home. EVIDENCE: Since the last inspection (3/2/05) there have been no changes to the people living at the home. However one person from another home run by Rugby Mencap has spent weekend at the home very recently to recuperate from an ankle injury. The manager explained that a care plan was agreed with the involvement of a physiotherapist to ensure that proper assistance was provided. In the event that this situation occurs again the manager is advised to approach social services in order that they can assess the persons needs and decide where his needs may best be met. If all concerned believe that Richmond Lodge is the best place for this person to recuperate, residents should be consulted about this decision to ensure they are happy with this arrangement. Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7, 8 and 9 The home’s old care plans fall short of providing staff with the information necessary to address residents’ needs and aspirations. The home has made improvements to the way in which residents are consulted about everyday matters that affect them and the work of the home. The home does not provide a sufficient range of risk assessments to ensure that resident’s needs are met safely. EVIDENCE: Since the last inspection the home has devised a new care plan format with illustrations to make this information more accessible to residents. The new document is an improvement on the old one and covers a good range of headings to prompt staff to focus on residents’ routines and things that are important to them personally, as well as their needs. The manager and the deputy agreed that there is a need to support staff to get used to using the new care plans, so that all the essential information is recorded. Currently the old care plans contain limited information about residents’ needs and the support that staff need to give them. Comments made by staff indicate that they hold a reasonable understanding of residents’ everyday needs and the things they like/dislike.
Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 10 Since the last inspection residents meetings have taken place at the home. Comments made by residents suggest that most people have enjoyed meeting together. Records of the meetings show that residents have been consulted over a number of everyday issues that affect them, such as a new ramp for the front door, pictures for the home, pay phone and holidays. The manager agreed to consider how the residents meetings might be used for people to pass comment on the service, (e.g. complete questionnaires with the involvement of an independent advocate). Since the last inspection positive action has taken place to give residents and relatives the chance to complete questionnaires and to make comment about the home. The deputy manager stated that she will be reviewing this information and arrange for any action to be taken where necessary. The manager explained that residents’ monies are audited along with the home’s finances and undertook to write to the inspector to explain these arrangements in more detail. The manager explained that appointee arrangements for residents are currently being addressed with the Responsible Individual. Since the last inspection good work has taken place to devise risk assessments for staff to follow when supporting residents to undertake general outdoor activities, such as shopping, cinema, college etc. However there remains a need to devise risk assessments based on residents’ assessed needs and everyday hazards that they may encounter. The new manager confirmed that she has a good awareness of paperwork formats for addressing this matter. The manager expressed a commitment to devising environmental risk assessments to consider any hazards that may be present in the house and the grounds of the home. The manager agreed to write a risk assessment / guidelines for responding to one residents occasional behavioural outbursts, to ensure that staff respond in a consistent manner. Similarly the manager undertook to write risk assessments for any residents that spend periods of time unsupervised (e.g. in flat without staff) to confirm that appropriate safeguards, advice and support are available where required. Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 13 Day service opportunities are made available for residents but the scope for people to pursue personal leisure interests and hobbies is limited. EVIDENCE: The majority of residents attend planned day services or college between Monday to Friday each week. Conversations with residents indicated that they are generally happy at the home and receive some support to go out locally to the shops or for walks and go on occasional outings and trips to the pub, bowling alley and cinema. The home is situated within easy walking distance of Rugby town centre, where several people said they enjoyed going walking to at the weekend. Two residents are supported to go to a local pottery course one evening a week. There are 3 staff on duty in the main part of the home to support 11 residents as well as 2 in the semi-independent flat lets adjoining the home. Comments made by residents and staff indicate that the opportunities for going out are limited to some extent by staff availability in the main area of the home. Staff explained that they generally go out with residents in small groups in order to make the best use of the staffing. The manager undertook to review residents’
Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 12 leisure interests (to go in care plan) and to keep records of activities and outing undertaken by people. The manager undertook to consider if there is any scope for deploying staff differently in the various areas of the home to support this work. Residents stated that they enjoy their holidays and confirmed that they have recently discussed holiday plans in residents meetings. Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 Residents’ are provided with the care and support required to meet their needs. Overall residents’ healthcare is addressed by the home although more information is required for staff to be clear about their role and the role of others in monitoring residents’ specialist healthcare needs. Written guidance is required to advise staff when to give medication prescribed for behavioural reasons, anxiety and eplilepsy to ensure that everyone is clear about the circumstances under which it is necessary to administer this medication. EVIDENCE: Comments made by residents indicate that they find the staff to be friendly and helpful. Residents were observed to look comfortable and ease when approaching staff for advice. Comments made by residents confirm that they have flexible bedtimes and that some people enjoy to sleep-in later at the weekends. Comments made by staff indicate an appropriate awareness of the need to be mindful of residents’ privacy when carrying out personal care tasks. Some residents take part in grocery shopping and are assisted to shop for their own clothes. Residents are also encouraged to visit the local community hairdresser rather than becoming dependent on a having their haircut at
Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 14 home. Whilst a small number of residents have mobility problems, all residents can weight bear and are said not to require the use of any specialist moving and handling equipment. A lift is available in the home to help service users with mobility problems to get to their bedrooms and a parker bath is also available in the home. The design of the home makes it unsuitable for people who require the use of a wheelchair indoors. Information contained in residents health records indicates that people are being appropriately supported to make use of most general health services such as GP, dentist, chiropodist and opticians. The home is also working with community nurses to audit and review all residents health needs in greater detail and to support people to attend well person checks. However there is a need to record residents’ health needs in more detail, in their care plans and to include the names and roles of health professionals involved in monitoring their health care needs, as currently it is difficult to ascertain the level of monitoring and support being provided. The manager explained that a speech and language therapist was planned to visit the home to provide staff with communication training, to increase staff understanding of residents’ communication needs and help in the development of care plans. (Since the inspection the manager has reported that half of the team have now been trained). There is an outstanding requirement for written guidance to be devised for staff to advise them on the when to give PRN medication for behavioural reasons, anxiety and epilepsy. This must also be reflected in residents’ care plans / guidelines. Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The home is providing for people to raise concerns at residents’ meetings and procedures are in place for residents to complain. Overall there are suitable arrangements are in place at the home for protecting people from harm and abuse, although work is required to bolster some procedures. EVIDENCE: The manager reported that there have been no complaints since the last inspection. No complaints have been made to the Commission for Social Care Inspection about the home during the same period. A complaints policy is available in the home and illustrated information about how to complain is included in the service user guide. The deputy manager explained that this has been sent to relatives in order that they may raise concerns on residents’ behalf where necessary. Since the inspection the deputy manager has explained that further work is taking place to review the complaints information made available to residents. Residents meetings are now taking place at the home, which provide an opportunity for residents to make plans as well as offering an opportunity for residents to raise any concerns / complaints they may hold. Comments made by residents indicate that they feel able to raise any concerns with their keyworker or other staff in the home. An adult abuse policy and procedure is available in the home and staff training records indicate that 4 staff have received “action on abuse” training during the last year. The new manager also explained plans to approach Warwickshire Social Services Department for a new copy of the multi agency adult protection procedures. A well written abuse policy and procedure with illustrations, to make the information more accessible, has been produced for residents at the
Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 16 home. Three other staff have also completed NVQ level 2 training which includes a training unit on adult abuse. Comments made by the deputy manager and staff at the home indicate that none of the current people living at the home have needs that require staff to use any physical restraint techniques. Staff training records show that 3 of the current team have attended behaviour conflict training to equip them to understand and respond appropriately to any challenges they may encounter. A whistleblowing policy is available to encourage staff to raise any concerns they might hold about the running of the home. A gifts and gratuities policy is in place, which currently allows for staff to receive small gifts from residents e.g. Birthdays and celebrations. The manager agreed to review this policy to make the cash limits that residents may contribute to staff presents across the course of the year more explicit and to include the arrangements for keeping residents relatives/advocates informed, so that interests can be seen to be represented in these matters. The manager explained that appointee arrangements are being reviewed and a new policy is to be written on this subject. Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 The home organised in a manner that provides comfortable, traditional, large group living arrangements for residents to live in. Suitable arrangements are in place for maintaining clean and hygienic practices in the home. EVIDENCE: A partial inspection of the environment took place at this inspection including the ground floor of the main area of the home and the accommodation in two smaller living units attached to the home. A fuller inspection of residents’ accommodation will take place at the next inspection. The communal areas of the home are comfortable and clean although the way the downstairs is designed and organised means that lounge space is limited and rather congested with furniture. This necessitates that seating is situated tightly together against the walls. Much of the furniture, whilst comfortable is rather dated and very traditional in style. The new manager undertook to consider the scope for reorganising the downstairs furniture to try and make better use of the available space. The dining room dining area, whilst providing limited space has sufficient seating arrangements, at several tables, for the 11 residents who live in the main area of the home. The entrance hall and ground floor corridor has been decorated during the last year. The deputy manager explained plans to involve residents in choosing new décor / furniture
Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 18 downstairs in the home. A new ramp has been ordered for the front of the house to improve wheelchair access to the home. As previously mentioned the house is not designed to meet the needs of people who require the use of a wheelchair indoors. A lift is in place to enable residents with walking aids to move safely between the lower and upper floors of the home. A handyman is employed to attend to minor repairs and maintenance in the home. An infection control policy is in place in the home and since the inspection the manager has completed a new policy addressing the transportation of soiled laundry through the home to the laundry room. The home has a separate laundry room that is safely situated away from the kitchen and the dining room. Consequently there are no concerns regarding the transportation of soiled laundry through these areas of the home. Modern laundry equipment is in place with a high temperature washing facility for use with heavily soiled articles, where necessary for ensuring safe disinfection standards. Staff have access to disposable gloves and aprons for use when handling soiled linen and carrying out similar tasks. A suitable contract is in place for the disposal of clinical waste. The home was found to be cleaned to a satisfactory standard and to be free from any unpleasant odours. Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 19 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 and 35 Shortfalls in recent recruitment practices need to be addressed to ensure that residents are consistently protected by the homes recruitment procedures. EVIDENCE: The files of 4 recent starters were viewed which highlighted several anomalies in the recruitment procedures. These matters were brought to the attention of the new manager who demonstrated an awareness of the issues and plans to address these shortfalls. Information provided by the manager since the inspection indicates that the matters raised on the day are being appropriately addressed, including a means of ensuring that satisfactory information is held at the home for all agency staff used by Richmond Lodge. The manager undertook to ensure that recruitment practice includes recording the reasons for employing staff, where contra-indicators come to light as part of the recruitment process. Since the last inspection Criminal Record Bureau Checks have been completed for administrative staff working at the home. Staff training information provided by the home indicates that staff are being appropriately trained in food hygiene, first aid, and moving and handling. 3 staff have completed NVQ 2, 2 staff have completed NVQ level 3 and 2 staff, including the manager have undertaken NVQ level 4 in care training. 3 staff
Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 20 have undertaken the Learning Disability Award Framework Training. A number of people have also completed other practice related training courses, including 9 staff that recently attended supervision training. The training records indicate that there is a need to increase the numbers to be trained in some subjects, including fire safety, action on abuse and behaviour conflict. Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 21 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42 Improvements have taken place to the way that the home consults with residents, in order to take account of their views in the development of the home. EVIDENCE: As previously noted, since the last inspection positive work has taken place to start residents meetings at the home. Comments made by residents indicate that they have enjoyed the discussions that have taken place so far. Information contained in the notes of the meetings demonstrates that residents are being consulted about matters that are of relevance to them. Good work has also taken place to devise appropriate quality assurance questionnaires for completion by residents and relatives. A number of these have already been completed and returned and the deputy manager explained plans to address any matters raised by the consultation exercise. Comments made by staff indicate there has been some confusion regarding the frequency for testing fire alarms, consequently these have been tested
Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 22 monthly rather than weekly. Comments made by new staff confirmed a satisfactory awareness of the fire evacuation procedures at the home. Since the inspection the new manager has sent a timetable of future alarm test dates to the inspector to demonstrate that this matter is now being addressed. An examination of maintenance records confirmed that checks of gas and electrical equipment are being carried out as required. A legionella assessment is required at the home and arrangements are needed to flush taps not in frequent use (e.g. vacant bedrooms). The Responsible Individual has recently written to Warwickshire Social Services Department to seek a review of residents funding levels, necessary to sustain appropriate levels of care and support. Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 x x x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 2 2 3 2 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 2 3 x x x x Standard No 31 32 33 34 35 36 Score x x x 2 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Richmond Lodge Score 3 2 x x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 2 x E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 24 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 2 Regulation 14 Requirement Timescale for action 14/6/05 2. 6 15 3. 7 20,12 4. 9 13 (3) (c) Where service users transfer between home’s run by Rugby Mencap this must be on the basis of a social worker assessment and following consultation with the residents at the home the person is moving to. Proceed with plans to support 30/7/05 staff to record residents needs, routines and aspirations in the new care plans Inform the CSCI of independent 30/7/05 auditing arrangments for all people for whom the organistion continues to act as an appointee. Create a policy about the managment of service users money, acting as an appointee, consulation on finance and staff involvment in making or benefitting from wills. Devise risk assessments, based 7/7/05 on residents assessed needs, e.g epliepsy, mobility, behaviour and write environmental risk assessments to address hazards in the home. Write risk assessments for people in the flatlets, taking account of the time the flatlets are not staffed
Version 1.30 Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Page 25 5. 12 12 (1) (a) 6. 19 12 (1) (b) 7. 34 Schedule 2 8. 35 23 (4) (d) and indicting who the residents should approach for support, where necessary. Agree these risk assessments with residents social workers. Provide written guidlines for one resident, who has occasional outburts, with the involvement of other appropriate professionals, e.g. psychologist / behavioural therapist. Review the need for moving and handling assessments at the home Review residents leisure options/access to the community and consider means of increasing the scope for people to pursue personal inerests. Increase the level of detail about residents health needs and the role of health professionals involved in moniotoring any specialist needs, e.g. dementia. Provide written guidance for staff to advise them on when to give PRN medication for behavioural reasons, anxiety and epilepsy. This must also be reflected in residents’ care plans / guidelines. Ensure that all the checks and references required by Schedule 2 of the Care Homes Regulations 2001 are kept at the home for all staff. In the event that contraindicators are present on references or CRB checks the reasons for employing staff must be recorded and held on file. Provide fire safety training and Increase the numbers of staff trained in action on abuse and behaviour conflict. Send a copy of the revised training plan for the home to the Commission for Social Care Inspection. 30/7/05 30/6/05 30/6/05 31/7/05 Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 26 9. 42 23 (4) (v) Ensure that fire alarms are 14/6/05 routinely tested each week and carry out a legionella assessment in the home. 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 24 Good Practice Recommendations The manager is recommended to review the use of downstairs lounge areas, with residents. Richmond Lodge E53 S4290 RmH Richmond Lodge V222959 170505 stage 4.doc Version 1.30 Page 27 Commission for Social Care Inspection Imperial Court Holly Walk Leamington Spa CV32 4YB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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