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Inspection on 16/04/08 for Ringway Mews Nursing Home

Also see our care home review for Ringway Mews Nursing Home for more information

This inspection was carried out on 16th April 2008.

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

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

A pre admission assessment of needs is carried out before a resident is admitted to the home to make sure that the home can meet all their needs. The menus showed that a varied diet was provided and on the day of this visit residents were seen to be enjoying a choice of meals at lunchtime. People thinking about moving in were invited to visit and spend time with the residents. The relationships between staff and residents appeared to be very good and the residents spoken to confirmed this. Residents said, "I am really happy here they look after me" and "the staff are very nice". Residents said the food is "very tasty and there is always a choice" and "they do very well catering for so many people". A variety of activities are provided at the home and residents told us that "there is a party for St George`s Day". We saw a list of planned activities displayed in each unit.We saw that they carried out a robust recruitment procedure to ensure the staff are safe to work with residents. Care plans gave good information to staff and daily records reflected the care delivered.

What has improved since the last inspection?

They have recruited fifteen members of staff and reduced the number of agency staff used in the home. An experienced relief manager has been managing the day-to-day running of the home.

What the care home could do better:

The radiator in the bathroom on Shackleton house was extremely hot and posed a risk of accidental burns. It was recommended that this bathroom is not used and the door locked until the thermostat is repaired. The emergency call system was not working properly and they were waiting for a new system to be fitted. It was recommended that staff make sure they cancel each call once it has been answered to prevent the system backing up. There was an offensive odour on Halifax house. Wellington unit failed to account for some medicines which contained low doses of Morphine and did not administer some controlled drugs used to control severe pain properly. All medicines must be able to be accounted for at any time and all medicines must be administered to residents as prescribed.

CARE HOMES FOR OLDER PEOPLE Ringway Mews Nursing Home Stancliffe Road Sharston, Wythenshawe Manchester M22 4RY Lead Inspector Sue Jennings Unannounced Inspection 16th April 2008 09:15 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 Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ringway Mews Nursing Home Address Stancliffe Road Sharston, Wythenshawe Manchester M22 4RY 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) 0161 491 4887 0161 428 6991 www.bupa.com BUPA Care Homes (CFHCare) Ltd Stephanie Maginn Care Home 150 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (120) of places Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. All service users require nursing care. The number of service users for whom accommodation is provided at any one time shall not exceed 150 patients of either sex aged 60 years or over. Up to 30 service users who are over the age of 60 and who additionally have dementia may be accommodated on Halifax Unit. The service should, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 8th January 2008 Date of last inspection Brief Description of the Service: Ringway Mews is a care home providing nursing care and accommodation for a maximum of 150 older people. Within this maximum number, accommodation is provided for 30 older people with dementia type illnesses. However, one of the houses that provided nursing care was currently closed. The home is owned by BUPA Care Homes. The home is situated in the residential area of Wythenshawe, which is to the South of the City of Manchester. There is easy access to the Manchester ring road motorway system as well as easy access to public transport systems, which are within walking distance of the home. There is ample parking within the grounds of the home. Wythenshawe Civic centre is easily reached by car and there are local shops, which are within walking distance of the home. The home is purpose-built and consists of 5 separate single storey houses. Each house provides accommodation for 30 residents and stands within its own garden area. The administration area, laundry, hairdressers, and central kitchen are housed in a central building that is accessible by a covered walkway. The charges for fees range from £392-00 to £618-00 per week. There are additional charges for magazines, papers, hairdressing and Chiropody. Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2. This means the people who use this service experience good quality outcomes. This visit was undertaken as part of a key inspection, which includes an analysis of any information received by the Commission for Social Care Inspection in relation to this home prior to the site visit. Two regulation inspectors and the pharmacist inspector carried out the inspection. The visit was unannounced and took place over the course of 8.5 hours on Wednesday 16th April 2008. During the course of the site visit time was spent talking to the manager, 8-day staff and 6 of the residents to find out their views of the home. Time was spent examining records, documents and the resident’s and staff recruitment files. What the service does well: A pre admission assessment of needs is carried out before a resident is admitted to the home to make sure that the home can meet all their needs. The menus showed that a varied diet was provided and on the day of this visit residents were seen to be enjoying a choice of meals at lunchtime. People thinking about moving in were invited to visit and spend time with the residents. The relationships between staff and residents appeared to be very good and the residents spoken to confirmed this. Residents said, “I am really happy here they look after me” and “the staff are very nice”. Residents said the food is “very tasty and there is always a choice” and ”they do very well catering for so many people”. A variety of activities are provided at the home and residents told us that “there is a party for St George’s Day”. We saw a list of planned activities displayed in each unit. Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 6 We saw that they carried out a robust recruitment procedure to ensure the staff are safe to work with residents. Care plans gave good information to staff and daily records reflected the care delivered. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 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 Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides sufficient information and has systems in place to make sure that people’s needs are assessed before admission. EVIDENCE: Prospective residents were able to visit the home before making a decision to move in. Where this was not possible families were invited to visit on their behalf. One resident said “I could not visit because I can’t get around but my social worker came and looked at the home for me”. They had an information pack that contained a Statement of Purpose and Service User Guide specific to Ringway Mews. This gave prospective residents and their families information about the home. Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 9 As stated in the last report prospective residents or their representatives are given the pack and then on admission to the home residents are given a welcome pack. As stated in previous reports a documented pre-admission assessment form is in use. One of the managers visited prospective residents in his or her own home or in hospital to carry out an assessment before admission. This is done to make sure that people are only admitted on the basis of a full assessment. Residents placed by the local authority had a care manager’s assessment of needs. Wellington house provides intermediate care for twelve people who no longer require hospital treatment but who need additional rehabilitation before returning to their own homes. Hospital staff support the staff at the home and the residents are under the care of a consultant. Wellington house also provides nine transitional care places for people who are not quite ready to return home from hospital either because they are waiting for adaptations at home or a care package. These residents have access to physiotherapy and occupational therapy provided by the Primary Care Trust and are under the care of a consultant. They also provide five continuing care places where the Primary Care Trust funds the care. Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans addressed the health, personal and social care needs of individuals and medication practices EVIDENCE: Each resident has a named key worker and we spoke to a member of staff on Halifax house who had a great deal of knowledge about the resdients’ history and significant events in their life. It was pleasing to see the compassion and understanding shown by this particular member of staff. We saw a sample of care plans for six people which contained enough information about how resident’s needs were to be met. We saw that the care plans were being reviewed regularly. This made sure residents’ changing needs were being identified and addressed. Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 11 Risk assessments around areas such as falls, pressure areas and nutrition had been carried out. Where necessary other healthcare professionals were asked to visit. Care plans gave details of the resident’s preferences and some residents’ families had written the life history section of the plan. Daily records were kept with the care plan these were detailed and reflected the care delivered to residents. This gave a full picture of residents’ care needs and helped to identify any concerns about residents’ health. In general staff were seen to encourage independence, choice and maintain the dignity of the residents. However there were some concerns regarding care practices on Halifax house. These concerns were raised at the time and the manager told us that the issues would be addressed with the member of staff in supervision. All residents were registered with a local GP and where possible residents had retained their own GP. Records of visits from other healthcare professionals were held in each resident’s file. As stated in the last report an initial care plan is generated within 72 hours of the resident’s arrival and the deputy manager reviews the care plan after 72 hours to make sure all the information has been recorded. The care plans are then monitored every month to make sure the nurse has evaluated them. Residents who have been assessed as requiring funded nursing care have their nursing needs reviewed every 3 to 6 months and the purchasing local authority undertakes an annual review of the care package. A formal in-house review is undertaken every six months. The resident and their representatives/family are invited to attend and this involvement is recorded in the resident’s file. The manger monitors these reviews on a regular basis. To ensure that the home can continue to meet residents’ needs all residents who return from a hospital stay are reviewed and their nursing needs reassessed. During the inspection the pharmacist inspector looked at how medication was handled on three units, Halifax, Lancaster and Wellington. We found that in general records regarding medicines were accurate and they could show that residents were being given their medicines as prescribed by the doctor. Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 12 At the last inspection we saw that medication handling had greatly improved and that residents were safe. During this inspection we found that this improvement had mainly continued. Regular checks (audits) continued to be carried out on medicines, which helped to show that most medicines could be still be accounted for and had been administered as prescribed. The general standard of record keeping was good on all the units. The records usually showed how much medicine was in the home for each resident and there were usually accurate records of how much medicine was administered to each resident. If a dose of medicine had to be missed or not given the reasons for this were usually well recorded. If doses of medicines were changed or discontinued by the doctor, staff also recorded this information clearly. We also noted staff wrote clear information on the records about where creams should be applied and when to give ‘as required’ medicines. When clear and accurate records of medicines are kept it helps to show that people are being given their medicines properly and their health is not at risk. Medicines and records for eight residents were looked at and we found that each resident had been administered most of their medicines as prescribed by the doctor. It was a concern that some residents did not have their medicines at the correct times or with a safe time interval between doses because the morning medicine round on of the units took a long time. We also noted that some medicines were unavailable to be given to residents because they had run out. If medication is not given at the right time or is not available to be given, residents’ health could be at risk from harm. We looked at how safely controlled drugs were handled. It is important to be able to account for controlled drugs to show that they are not mishandled or misused in any way, which may put residents’ health at risk. We found that Halifax did not have any controlled drugs on the day of inspection and that Lancaster unit could account for all the controlled drugs and the records of receipt, administration and destruction were clear and accurate. However there were serious concerns about how well controlled drugs were accounted for and administered on Wellington unit. Prior to this inspection the home had told us that they were unable to account for some liquid medicine containing a low dose of Morphine. On the morning of inspection a further loss of 10mls of the low dose Morphine mixture was discovered. When medication is unaccounted for residents’ health could be placed at potential risk. We also noticed that Fentanyl patches, strong pain relieving medication, were not being administered every 72 hours as prescribed. On one occasion a Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 13 resident was potentially without pain relief for almost 8 hours, which could have put their health at risk from harm. Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers a range of recreational activities. A well-planned and varied diet is provided and resident’s choice is very well catered for. EVIDENCE: Lunch was observed in Halifax house. The meal on the day of the site visit was yellow pea soup, a choice of sandwiches, cheese bakes, cheese and ham on toast, cheese and tomato on toast or turkey salad. The sweet was a choice of fresh fruit or ice cream. We saw that a number of residents needed staff to help them with their meals either by prompting or with physical help. We saw that one resident on Halifax house was quite agitated during lunchtime and this person may benefit from one-to-one support at this time. It is recommended that staff cover on this unit at mealtimes be assessed. Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 15 We saw that the date board on Lancaster had not been updated for 3 days, which is confusing for residents. We also saw a large faced clock in the lounge on Halifax house. At lunchtime the clock read 6:30 and this could be confusing residents as to the correct time. To make sure residents are orientated to time and place it is strongly recommended that the day and date boards be updated to show the correct date and that the large clock on Halifax be set at the correct time. Where dementia care is provided it is important that residents have positive communication with staff, routines with meaning, family involvement and good orientation of the building. One resident told us their visitors were always made to feel welcome and can visit at any time. Other residents said that they were able to have friends and family visit when they liked. The menus were displayed in the dining room so that residents knew what the meal choices were for each day. Residents were able to choose an alternative to the set menu if they did not like the menu choice for the day. The menu was written in normal size print and may be difficult for some residents to read. Staff told us that they did tell residents on a daily basis what the meal choice was. People spoken with said, “the food is good” and “the meals are usually very good, very tasty”. Ministers from local churches visited the home on a regular basis. The managers told us that arrangements would be made to support residents from other religious backgrounds as and when required. One resident told us that they can have visitors whenever they wish and that visitors are welcomed into the home. They told us that there is one activity organiser covering activities in all houses and they have one vacant post. Residents told us that they enjoyed different in-house recreational activities on offer. One resident said, “I like to play bingo and they have videos for us to watch”. A relative told us “my husband likes to play bingo and I read to him” It is recommended that the unit manager look into obtaining talking newspapers or book in the residents’ first language. We saw a programme of activities that included a celebration party for Saints days, art classes, discussion groups, and professional entertainers visiting the home. Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 16 As stated in the last report the activity coordinator is involved in the Induction programme for new and existing staff to emphasis the importance of activities and the role staff play in supporting residents to take part. This is seen as good practice. Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 17 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was a complaints procedure and policies and procedures were in place to make sure residents were protected from harm. EVIDENCE: Since the previous inspection in June 2007 the home have received 17 complaints. There was a written complaint procedure and all complaints received were recorded. This record included details of the complaint, the investigation and the outcome. Residents spoken to said that if they had a complaint they would first speak to the manager. The complaints policy and procedure was displayed in the home and information about how to make a complaint was included in the service user guide. There was a copy of the Manchester Multi-Agency Policy on the Protection of Vulnerable Adults available for staff to reference. There had been no adult protection referrals made. There was an ongoing Protection of Vulnerable Adult (POVA) investigation that was being investigated by social services. We saw a training matrix that showed that staff received training in safeguarding adults so that they were able to recognise abuse and report it. Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 18 There was a whistle-blowing policy so that staff knew that the organisation would support them. Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 19 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 and 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The premises are safe and the home’s environment, including the standard of hygiene, was generally well maintained both internally and externally. EVIDENCE: A sample of bedrooms were seen and residents spoken to on Lancaster house said “I like my room I spend a lot of time in here”, “the place is very clean”, “it is always very clean and tidy they work very hard” and “I am really happy here”. Residents told us that they were able to come and go as they please. On the day of this visit the home was generally clean and tidy, which created a pleasant environment for the residents and their visitors. Most units were in a good state of repair and were comfortably furnished and decorated. Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 20 Some bedrooms on Halifax house were not personalised and appeared a little institutional. On Shackleton house the new unit manager was in the process of making the unit more homely by providing soft furnishings etc. The radiator in one bathroom on this unit was extremely hot. We were told that a request had been made for it to be checked. In the meantime we asked that this bathroom be locked for the safety of residents. We saw a housekeeper shampooing corridor carpets. They told us that this was done about every 3 days. The home was generally odour free but despite regular cleaning of carpets there was a strong offensive odour on Halifax house, which created an unpleasant environment for the residents, staff and visitors. It is strongly recommended that action be taken to deep clean the carpets and improve the environment in this area for residents. They should look at replacing carpets if they cannot be kept clean and fresh. Dispensers containing a bacterial hand cleanser were available outside the main doors on each unit. This was to minimise the risk of cross infection and was seen as good practice. Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 21 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff have access to training and numbers and skill mix of staff was generally sufficient to meet the needs of the residents. EVIDENCE: A sample of staff files was examined. These were well maintained and contained all the necessary checks including Criminal Records Bureau (CRB) and checks that had been made against the Protection of Vulnerable Adults list (POVA). Staff files provided evidence of vocational training in service related areas, e.g. moving and handling, food hygiene, safe administration of medicines and fire safety. The manager told us that where necessary they use the services of two agencies. All nurse trained agency staff use an orientation pack instead of having induction. Staffing rotas showed that there were enough staff to meet residents’ general care needs, although as previously mentioned, some residents may benefit from one-to-one support at meal times. Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 22 Staff spoken to said that they had access to training. A training plan was seen that showed training in relation to manual handling, medication, fire safety, first Aid, and Protection of Vulnerable Adults had been provided. The manager reported that regular staff supervision was provided and all staff completed an induction period. One member of staff told us her manager gives regular supervision “he is a good manager – no problems on the unit – really good team work”. They told us that a number of new staff has been employed since the last key inspection visit. New staff received 3 full days training with the organisation’s trainer then work as an extra person on the units. We spoke to a new member of staff who confirmed this. The manager told us that ‘new staff have bonded together’ and the mix was really good and was working well. Residents told us that staff were “ kind and caring”, “very helpful” and “quite friendly”. We saw that staff were caring and approached residents in a polite and respectful manner. Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s quality monitoring systems protected residents and the home had systems and procedures in place which safeguarded and protected residents’ financial interests. EVIDENCE: The manager has a great deal of experience of running a care service for older people. There was an open door policy and residents and staff had access to senior staff at all times. Staff spoken to said that the manager was always ready to listen to concerns and answer questions. Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 24 Care staff told us they have supervision with their line manager that helps them to develop their own practice. Regular audits are carried out to monitor areas such as accident reports, staff training and Health and Safety. Health and Safety records are well maintained by the maintenance person. We had some concerns that the emergency call system was not working properly. One resident we were talking to rang the bell for assistance and waited several minutes for a response and when staff did arrive they went to another bedroom. This indicated that calls were not being cancelled and this posed a risk to residents who may need help quickly. The manager told us that a new system had been authorised by BUPA and would be fitted soon. As stated previously the radiator in a bathroom on Shackleton house was extremely hot to touch and posed a risk of accidental burns to resident. It was strongly recommended that the bathroom be locked until the thermostat is repaired. As stated in the previous report there is a clear and transparent system for managing and recording the personal finances of residents. The system in place is that, the resident, their family/representative or the relevant local authority is responsible for their personal finances. All transactions and documentation was regularly audited by the administrator, the manager and through the main organisation (BUPA). Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Ringway Mews Nursing Home DS0000021656.V361486.R01.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 13 (2) Requirement Medicines must be available for administration as prescribed to ensure the health and well being of residents is not at risk. Medicines should be offered at the right and best time for residents to ensure their health is not placed at risk All medication including controlled drugs must be able to be accounted for at all times to ensure residents’ health is not put at risk by medicines being mishandled or misused. Timescale for action 16/04/08 Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 27 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 Good Practice Recommendations To make sure residents are orientated to time and place it is strongly recommended that the day and date boards be updated to show the correct date and that the large clock on Halifax be set at the correct time. The radiator in the bathroom on Shackleton house was extremely hot to touch it is strongly recommended that the bathroom be locked until the thermostat is repaired. It was recommended that the unit manager look into obtaining talking newspapers or book in the residents 1st language. It is recommended that mealtimes on Halifax house be reviewed to make sure that they are a positive occasion for the residents. This is to make sure there are always adequate numbers of staff available to assist residents with their meals and looking at the way people receive this assistance. 2 3 OP12 4. OP15 Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Ringway Mews Nursing Home DS0000021656.V361486.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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