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Inspection on 12/04/07 for Ringshill Nursing Home

Also see our care home review for Ringshill Nursing Home for more information

This inspection was carried out on 12th April 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Ringshill Nursing Home provides a well-maintained and friendly place for people to live. Residents receive care from staff who are kind and respectful.

What has improved since the last inspection?

Following the key inspection of November 2006 the following requirements made have been met and recommendations suggested have been considered: A requirement was made for care plans to guide staff in how to meet the assessed and changing needs of residents. This requirement has been met. Five requirements that had been made, with regards to medication, are now considered as met. A requirement was made for the dignity of residents to be respected at all times. This requirement has been met. A requirement was made for a survey to be carried out to find out what all residents would like to do with regards to activities. This requirement has been met. A recommendation was made for a review of the standard of food and this review to be carried out in consultation with residents. This recommendation has been considered. A recommendation was made for the communication between kitchen and care staff to be improved upon with particular regard about residents with unintentional weight loss. This recommendation has been considered.A requirement was made for the courtyard to be made safe and accessible by May 2007. This requirement has been met. An immediate requirement was made for full and satisfactory information to be obtained before staff work at the home. This requirement has been met. A recommendation was made for a manager to be registered with the Commission for Social Care Inspection. This recommendation has been considered. A requirement was made for emergency lighting checks to be carried out according to the Four Seasons` Health Care Limited policy. This requirement has been met. A recommendation was made for the names of people in attendance at fire drills to be recorded. This recommendation has been considered. A requirement was made for all staff to attend training in fire safety. This requirement has been met.

What the care home could do better:

The home could improve in the following areas: A recommendation has been made for an audit to be carried out of residents` needs to ensure that the home is not caring for people that it is not registered to do so. A recommendation has been made for residents to be offered choices of when, and how, to have their personal care provided. A recommendation has been made for existing methods, to protect residents clothing, from food and drink spillage, to be improved upon. A recommendation remains for the home to have 50% of care staff with NVQ in care, or equivalent. A recommendation has been made for existing training of staff to include staff training in activities appropriate for residents with communication difficulties and difficulties with memory. A requirement has been made for all staff to attend training in safe techniques for moving and handling. A requirement has been made for staff to attend training in infection control.A requirement has been made to ensure adequate supplies of medication are held in the home for residents to ensure continuity of treatment.

CARE HOMES FOR OLDER PEOPLE Ringshill Nursing Home Sallowbush Road Huntingdon Cambridgeshire PE29 7AE Lead Inspector Elaine Boismier Key Unannounced Inspection 12th April 2007 9:50 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 Ringshill Nursing Home DS0000024297.V333182.R02.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. Ringshill Nursing Home DS0000024297.V333182.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ringshill Nursing Home Address Sallowbush Road Huntingdon Cambridgeshire PE29 7AE 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) 01480 411762 01480 450940 www.fshc.co.uk Ringdane Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Mrs Audrey Thorpe Care Home 87 Category(ies) of Old age, not falling within any other category registration, with number (87) of places Ringshill Nursing Home DS0000024297.V333182.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than 61 nursing care beds Date of last inspection 1st November 2006 Brief Description of the Service: Ringshill Nursing Home is on the edge of a large housing estate on the outskirts of Huntingdon. There is a local bus service serving the area. It is a short walk from a general store and within easy driving distance of the town of Huntingdon. The accommodation is on two floors with the upper floor being served by two lifts. The ground floor accommodates residential care clients and the upper floor for those who need nursing care. Nursing and care staff are employed, night and day, and there are domestic, catering and maintenance staff also employed. Fees currently range from £351 to £478. Additional costs include hairdressing, toiletries, private chiropody and newspapers. A copy of the inspection report is available, on request, at the home’s main reception desk or via the CSCI website. An application to register the home manager was approved by the Commission for Social Care Inspection in January 2007. Ringshill Nursing Home DS0000024297.V333182.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Summary of events for 2006 to 12th April 2007 Within the last 12 months, due to serious concerns about the standards of care and management of the care home, Ringshill Nursing Home has been subject to a number of inspections by the Commission for Social Care Inspection and monitoring visits by members of the local authorities. The care home has been also subject to a number of meetings, held under the vulnerable adult protection procedures (POVA). It is recommended that the reader of this report can access previous inspection reports from the CSCI website or on request from the home for further information. During December 2006 there was a POVA meeting held and findings indicated that the home had failed to provide proper care for vulnerable people. In addition it was also agreed by all attendees, including representatives of Four Seasons Health Care Limited, that the standard of record keeping was unsatisfactory. During March 2007 a POVA meeting was held and was attended by representatives of Four Seasons Health Care Limited. Allegations made were not proven. It was pleasing to note that the standard of record keeping had improved. Key Inspection 12th April 2007 This is the key inspection of Ringshill for 2007/8. The inspection was unannounced and was carried out by 3 Inspectors between 9:50 and 14:20 and took 4.5 hours to complete. Before the inspection 90 residents’ surveys were sent out and 14 of these were returned. Before the inspection 60 relatives’/visitors’ comment cards were also sent out although none of these were returned before this inspection. The Manager provided information before the inspection of which some of this information has been referred to in this report. At the time of the inspection 44 residents were living at the home and a number of these were spoken to. A tour of the premises was made, documentation was examined and staff, including the Manager, were spoken to. Staff were also observed in how they were carrying out their duties. Ringshill Nursing Home DS0000024297.V333182.R02.S.doc Version 5.2 Page 6 The standard of care and standard of management of Ringshill Nursing Home was assessed following the key inspection of November 2006 as to have improved from a poor performing service to that of a service assessed to have a quality rating of adequate. It is pleasing to note that improvements made have been sustained and although Ringshill Nursing Home has been assessed to have an adequate quality rating, following this key inspection of 12th April 2007, it is clear that there is the potential for the care home to achieve that of a quality rating of good should action be taken in response to the requirements and recommendations of this report and any improvements made are sustained. What the service does well: What has improved since the last inspection? Following the key inspection of November 2006 the following requirements made have been met and recommendations suggested have been considered: A requirement was made for care plans to guide staff in how to meet the assessed and changing needs of residents. This requirement has been met. Five requirements that had been made, with regards to medication, are now considered as met. A requirement was made for the dignity of residents to be respected at all times. This requirement has been met. A requirement was made for a survey to be carried out to find out what all residents would like to do with regards to activities. This requirement has been met. A recommendation was made for a review of the standard of food and this review to be carried out in consultation with residents. This recommendation has been considered. A recommendation was made for the communication between kitchen and care staff to be improved upon with particular regard about residents with unintentional weight loss. This recommendation has been considered. Ringshill Nursing Home DS0000024297.V333182.R02.S.doc Version 5.2 Page 7 A requirement was made for the courtyard to be made safe and accessible by May 2007. This requirement has been met. An immediate requirement was made for full and satisfactory information to be obtained before staff work at the home. This requirement has been met. A recommendation was made for a manager to be registered with the Commission for Social Care Inspection. This recommendation has been considered. A requirement was made for emergency lighting checks to be carried out according to the Four Seasons’ Health Care Limited policy. This requirement has been met. A recommendation was made for the names of people in attendance at fire drills to be recorded. This recommendation has been considered. A requirement was made for all staff to attend training in fire safety. This requirement has been met. What they could do better: The home could improve in the following areas: A recommendation has been made for an audit to be carried out of residents’ needs to ensure that the home is not caring for people that it is not registered to do so. A recommendation has been made for residents to be offered choices of when, and how, to have their personal care provided. A recommendation has been made for existing methods, to protect residents clothing, from food and drink spillage, to be improved upon. A recommendation remains for the home to have 50 of care staff with NVQ in care, or equivalent. A recommendation has been made for existing training of staff to include staff training in activities appropriate for residents with communication difficulties and difficulties with memory. A requirement has been made for all staff to attend training in safe techniques for moving and handling. A requirement has been made for staff to attend training in infection control. Ringshill Nursing Home DS0000024297.V333182.R02.S.doc Version 5.2 Page 8 A requirement has been made to ensure adequate supplies of medication are held in the home for residents to ensure continuity of treatment. 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. Ringshill Nursing Home DS0000024297.V333182.R02.S.doc Version 5.2 Page 9 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 Ringshill Nursing Home DS0000024297.V333182.R02.S.doc Version 5.2 Page 10 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): 3&4 Quality in this outcome area is good. There is a good standard of information for prospective residents to assist them in their decision where to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: 92.85 of respondents of the residents’ survey said that they had received enough information about the home before they moved in to be able to decide that it was the right place to live; 7.15 of respondents of the residents’ survey said that they had not received enough information about the home before they moved in to be able to decide that it was the right place to live. Ringshill Nursing Home DS0000024297.V333182.R02.S.doc Version 5.2 Page 11 Care records of a recently admitted resident were examined and these contained full information about the person and their needs. Staff, including the Manager, confirmed that prospective residents are assessed also by the home to make sure that the home could meet the person’s assessed needs. Following discussion with residents and the Manager and examination of care records a recommendation has been made for the home to carry out an audit of residents’ mental health needs to ensure that the home is not caring for any person that the home is not registered for. Ringshill Nursing Home DS0000024297.V333182.R02.S.doc Version 5.2 Page 12 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 Quality in this outcome area is adequate. People who use this service receive an adequate standard of health and personal care to safeguard their health and welfare. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A requirement was made for care plans to provide detailed guidance for staff in how to meet the assessed and changing needs of residents. A protection of vulnerable adults (POVA) meeting held during March 2007 demonstrated that the home had improved the standard of record keeping with regards to care records. Ten residents’ care records were examined during this inspection and evidence suggests that the requirement has been met. The care records contained clear guidance for staff in how to meet the Ringshill Nursing Home DS0000024297.V333182.R02.S.doc Version 5.2 Page 13 needs of the residents. It was also noted that this care was provided as evidenced in comparing care records with the care plan guidance and discussion with staff. 57 of respondents of the residents’ survey said that they always received the care and support that they need; 35.6 of respondents of the residents’ survey stated that they usually receive the care and support that they need; 7.4 of respondents of the residents’ survey stated that they sometimes received the care and support that they need. 92.85 of respondents of the residents’ survey stated that they always received medical support that they need; 7.15 of respondents of the residents’ survey stated that they usually received the medical support that they need. Examination of residents’ care records indicated that resident’s complex health conditions are well managed by staff including the management and treatment of pressure sores and diabetes. Records and discussion with staff also indicated that residents have access to a range of health care professionals including district nurses, GPs, physiotherapists and diabetes specialist nursing services. Examination of medication storage facilities, medication and associated records show considerable improvement in the procedures and practices for the safe handling and use of medicines. Medication is now generally well managed and records made appropriately and accordingly. Five requirements made following the previous inspection have been met. However, medication for a few residents had run out before new supplies had been ordered and received. This puts residents’ health at risk since they are not receiving continued treatment. A requirement has been made about this. One resident’s medication had been changed on the verbal, telephoned instruction from a district nurse but no written confirmation had been obtained to substantiate this. Although a written record was made of the content of the telephone call it is strongly recommended that written confirmation is obtained promptly when changes of medication are made verbally to minimise the risk of error and safeguard residents. A requirement was made for the dignity of residents to be respected at all times. Comments provided about staff in the residents’ surveys included “The carers are all very good” and “I think they are wonderful”. Staff were seen to interact with residents in a respectful and caring manner. This requirement has been met. Ringshill Nursing Home DS0000024297.V333182.R02.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 Quality in this outcome area is adequate. People who use this service are provided with opportunities to provide them with an adequate standard of quality of life. This judgement has been made using available evidence including a visit to this service. EVIDENCE: 42.85 of respondents of the residents’ survey stated that the home arranges activities that they can take part in; 57.15 of respondents of the residents’ survey stated that the home usually arranges activities that they can take part in. Comments included, “ There are lots of different things to do if we want to” and “ (I) really enjoy all the different things we do”. A requirement has been met as Four Seasons Health Care Limited has carried out a survey during 2006 to gain residents and relative’s views about the home. One area of the survey included residents’ views about the suitability of activities provided. Ringshill Nursing Home DS0000024297.V333182.R02.S.doc Version 5.2 Page 15 Residents said and residents’ care records indicated that residents are able to receive their guests in the home. Discussion with residents indicated that they are offered choices in what to where and when to get up and when to go to bed. Choices of when to receive personal care i.e. having a bath was not so clear. A recommendation has been made for existing practice of offering choices to residents to be developed to include this area of personal care. 50 of respondents of the residents’ survey stated that they always liked the meals; 28.57 of respondents of the residents’ survey stated that they usually liked the meals; 21.43 of respondents of the residents’ survey stated that sometimes they liked the meals. Comments in the surveys included a range of views such as, “Too many stews, too much mince….”;“I leave the meals I don’t like and then get hungry on occasions…”; Sometimes I don’t like the sandwich fillings but if I need anything else I can have it”; “Excellent food”; “The portions are too big sometimes” and “(I) would like bigger portions”. Lunchtime was observed on the ground floor during which it was noted that staff were interacting with residents in a sociable manner. Examination of records and discussion with staff confirmed that residents were provided with their choice of lunch. Discussion with staff indicated that two recommendations have been considered. These recommendations were about the standard of the food provided and the improvement in the communication between care staff and kitchen staff about any resident with weight loss. Staff reported that additional training has been provided by Four Seasons Health care Limited with regards to preparation and cooking of food. Staff reported also that care staff inform the kitchen staff should any resident need special diets to reduce the risk of unintentional weight loss. During lunchtime it was noted that some residents were wearing disposable tabards and plastic aprons during their mealtime. A recommendation has been made for the home to improve the existing method of protecting residents’ clothing from spillage of food. Ringshill Nursing Home DS0000024297.V333182.R02.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 Quality in this outcome area is good. Good systems are in place to ensure that people who use this service are listened to and safe from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: 85.7 of respondents of the residents’ survey stated that they knew who to speak to if they were not happy; 14.3 of respondents of the residents’ survey stated that they usually knew who to speak to if they were not happy. 100 of respondents of the residents’ survey stated that they knew how to make a complaint. According to information provided by the manager before the inspection there have been four complaints received in last 12 months; all were responded to within 28 days. One of the four complaints was proven and one of the four complaints was partly proven. The two other complaints are being investigated. The complaints record was seen and this was satisfactory. Ringshill Nursing Home DS0000024297.V333182.R02.S.doc Version 5.2 Page 17 A copy of the minutes of the residents’/relatives’ meeting, held on 7th March 2007, was seen and the minutes provided evidence that residents’ concerns and suggestions were listened to by the Manager. A POVA meeting was held in March 2007 and allegations made were not proven. Four Seasons Health Care Limited demonstrated co-operative working with the other agencies attending the POVA meeting. POVA training has been attended for staff and staff and Manager confirmed that arrangements have been made for other training in POVA. Ringshill Nursing Home DS0000024297.V333182.R02.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 Quality in this outcome area is good. People who use this service live in a clean and homely place to ensure that they are safe and comfortable. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well decorated and walls throughout the home were provided with pictures. Records and discussion with staff and Manager indicates that there is a refurbishment programme. Bedrooms that are waiting to be occupied are well presented with matching flannels, towels and complimentary bars of soap. Ringshill Nursing Home DS0000024297.V333182.R02.S.doc Version 5.2 Page 19 A requirement was made for the inner courtyard to be safe and accessible by May 2007. This area was visited and it was noted that it has been made safe and accessible for residents and their guests to visits. This includes an area that has a lawn area and paving slabs that are even. The requirement has been met. 85.7 of respondents of the residents’ survey stated that the home was always fresh and clean; 14.3 of respondents of the residents’ survey stated that the home was usually fresh and clean. Comments in residents’ surveys included “Very clean and nice” and “ Beautiful, really pretty.” Ringshill Nursing Home DS0000024297.V333182.R02.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 Quality in this outcome area is adequate. People who use this service receive care from well-recruited staff that are adequately trained so that they are protected from harm and receive appropriate care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: 42.85 of respondents of residents’ surveys stated that staff are available when they were needed; 57.15 of respondents of residents’ surveys stated that staff were usually available when they were needed. Comments in residents’ surveys included,” It always appears there is not enough staff”. At the time of the inspection care staff were meeting residents’ needs in an unhurried manner. According to information provided by the Manager before the inspection there has been 11 members of staff leave the home since the last inspection of November 2006. The reasons for there leaving employment varied from “Another job” to “Ill health”. Staff considered that Ringshill Nursing Home is a happy place to work and we noted that the atmosphere of the home was that to be a friendly one. Ringshill Nursing Home DS0000024297.V333182.R02.S.doc Version 5.2 Page 21 Information provided by the Manager before the inspection notes that of the 31 care staff 2 of these have NVQ level 2 or equivalent i.e.6.45 . This is the only recommendation that has not been considered although the Manager stated that arrangements are in place to increase the number of staff with this qualification in care. An immediate requirement has been met as examination of 3 staff records indicated that all the required information had been obtained about the person before they started working at the home. Examination of staff training files indicated that staff receive a detailed induction training to include values of choice, privacy and dignity. Ongoing staff training included intermediate care, wound care and taking of bloods. The Manager has developed a schedule for staff to attend training at later dates. Examination of residents’ care records and discussion with staff indicates that residents, with complex communication difficulties and difficulties in remembering, are not always provided with appropriate activities. Staff confirmed that this is due to a training issue. A recommendation has been made for existing staff training to include training in activities appropriate for people with communication difficulties and difficulties in remembering. Ringshill Nursing Home DS0000024297.V333182.R02.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): 31,32,33,35 & 38 Quality in this outcome area is adequate. People who use this service benefit from a home that is friendly and adequately managed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Manager was appointed in June 2006 and an application to be registered was approved on 3rd January 2007. She is a first level registered nurse who has had previous managerial experience within a care home setting. Ringshill Nursing Home DS0000024297.V333182.R02.S.doc Version 5.2 Page 23 A recommendation was made for a home manager to be registered with the Commission for Social Care Inspection. An application to register as the Manager of Ringshill Nursing Home was approved by the Commission for Social Care Inspection on 3rd January 2007. This recommendation has been considered. Staff stated that Manager is approachable and listens to suggestions made. Positive comments were made about the friendly atmosphere of the home. Residents spoken to considered that they liked living at the home and had no complaints to make. The home currently safeguards 4 residents’ personal allowances; 2 of these balances were examined and staff were spoken to. Information provided indicated that residents’ balances were well-kept and residents received any interest earned on their monies. Four Seasons Health Care Limited carried out a survey during 2006 to gain the views of both relatives and residents. The outcome of this survey was seen and what action the Manager had taken in response to these results. The main area of action needed was that of improving the home environment of which arrangements have been made to continue to improve the home environment. Copies of regulation 26 visit reports were seen for November 2006 and January 2007. These reports included audits of care records, audits of staff files, including staff training, and the environment. The copies of the reports also included views of residents about the home. Records for fire safety checks, checks of temperatures of hot water, service checks (water, gas and electricity), PAT tests and records of accidents occurring in the home were examined and these were satisfactory. A requirement was made for emergency lights to be checked according to the Company policy. Emergency lights were checked twice each month and as a result this requirement has been met. The Environmental Health Officer (EHO) visited the home on 20th December 2006. Requirements and recommendations had been made by the EHO and it was considered, by the EHO, that generally the home was managing to a generally satisfactory standard. Staff reported that action had been taken in response to the EHO inspection of December 2006. The outcome of this action was not assessed during this inspection. A Fire Safety Officer (FSO) inspection was carried out on 12th July 2006. A copy of the report of this inspection was seen and the FSO inspection findings were satisfactory. Ringshill Nursing Home DS0000024297.V333182.R02.S.doc Version 5.2 Page 24 A recommendation was made for the names of those people attending fire drills to be included in the fire drill records. Records for fire drills were seen and these contained the names of people in attendance. This recommendation has been considered. A requirement was made for all staff to attend training in fire safety. Discussions with staff and examination of staff training records indicate that this requirement has been met. Staff confirmed that they had attended training in health and safety including moving and handling and COSHH. Examination of staff training records indicated that not all staff have attended updated training in infection control and moving and handling. Two requirements have been made about this. Ringshill Nursing Home DS0000024297.V333182.R02.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 x x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 x x 2 Ringshill Nursing Home DS0000024297.V333182.R02.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? NO 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 OP9 Regulation 12(1) Requirement The Registered Person must ensure that sufficient supplies of medication are held in the care home to ensure continued treatment of residents. The Registered Person must ensure that all staff attend training infection control to safeguard residents from the risk of infection. The Registered person must ensure that all staff attend training in safe techniques for moving and handling to protect residents from the risk of harm. Timescale for action 30/04/07 2. OP38 18(1)(c) 30/09/07 3. OP38 18(1)(c) 30/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000024297.V333182.R02.S.doc Version 5.2 Page 27 Ringshill Nursing Home 1. 2. 3. 4. 5. 6. Standard OP4 OP9 OP14 OP15 OP28 OP30 The Registered Person should consider carrying out an audit of service users’ needs to ensure that the home is not caring for people that it is not registered for. The Registered Person should consider the need to obtain prompt, written confirmation of verbal instructions to changes in medication. The Registered Person should consider ways to offer the choice of how and when service users wish to have their personal care provided. The Registered Person should consider ways to improve existing methods to protect service users’ clothing from food and drink spillage. The Registered Person should consider ways to ensure that 50 of care staff have an NVQ level 2 or equivalent in care. The Registered Person should consider ways for the training of staff in how to provide appropriate activities for service users with communication difficulties and difficulties with remembering. Ringshill Nursing Home DS0000024297.V333182.R02.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Ringshill Nursing Home DS0000024297.V333182.R02.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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