Inspection on 24/10/05 for Riverlee Care Home

This inspection was carried out on 24th October 2005.

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

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

Other inspections for this house

Riverlee Care Home 29/05/08

Riverlee Care Home 03/07/07

Riverlee Care Home 21/06/06

Riverlee Care Home 05/10/04

Riverlee Care Home 20/05/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Riverlee Care Home Franklin Close Off John Penn St Greenwich London SE13 7QT Lead Inspector Ms Pauline Lambe Unannounced Inspection 24th October 2005 09:45 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 Riverlee Care Home DS0000006768.V256044.R01.S.doc Version 5.0 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. Riverlee Care Home DS0000006768.V256044.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Riverlee Care Home Address Franklin Close Off John Penn St Greenwich London SE13 7QT 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) 020 8694 7140 020 8694 7141 rebecca2@sanctuary-housing.co.uk Sanctuary Housing Association (trading as Sanctuary Care) Mrs Rebecca Francisco Sowle Care Home 75 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (60) of places Riverlee Care Home DS0000006768.V256044.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th April 2005 Brief Description of the Service: Riverlee Care Home is a purpose built home and was registered in December 2001 to provide care for 75 older people. It is located in the London Borough of Greenwich and is close to local shops and local amenities. Sanctuary Care manage the home and accommodation is provided over three floors. All bedrooms are for single occupancy with en-suite toilet and washbasins. Adequate assisted baths and showers are provided. The home is divided into four suites each providing a separate service, having its own staff team and communal space. Chelmer Suite accommodates 15 older people requiring dementia care, Yeading-Brooke Suite, accommodates 30 older people requiring dementia nursing care and Ravensbourne Suite has been divided into two, and accommodates 15 older people requiring nursing care and 15 for older people requiring dementia nursing care. A limited number of parking spaces are provided to the front of the property and to the rear of the property there are small garden areas with flower beds and lawns accessible to residents. Riverlee Care Home DS0000006768.V256044.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors completed this unannounced inspection on behalf of the commission over 8 hours. The home was last inspected on 13th April 2005. This inspection included a tour of the premises, talking to residents, visitors, staff and management, reviewing systems and records and observing practice. Following the inspection seven relatives were contacted by phone to obtain their views of the service. Their comments are included in the main body of the report. Some aspects of the inspection findings were disappointing as issues in relation to resident care identified at previous inspection were still evident. What the service does well: What has improved since the last inspection? What they could do better: Improvements were needed to ensure care plans were prepared for all identified needs included wound management. Unexplained injuries sustained by residents must be fully investigated and measures taken to prevent these occurring. More effort was needed to obtain resident’s social histories and to involve them or their relatives in care planning. The home must not admit residents outside its category of registration. The registered person must ensure a safe system is put in place for the disposal of medicines. Management must review mealtimes particularly on the dementia suites to ensure residents receive the assistance they need to have and to enjoy their meals. Attention must be given to improving the general hygiene in the home and to keeping the home free of offensive odours. Consideration must be given to providing a planned programme for the maintenance of the premises and equipment. Riverlee Care Home DS0000006768.V256044.R01.S.doc Version 5.0 Page 6 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. Riverlee Care Home DS0000006768.V256044.R01.S.doc Version 5.0 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 Riverlee Care Home DS0000006768.V256044.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Residents were admitted based on a pre-admission assessment of needs. EVIDENCE: Pre-admission assessments of needs were seen in the care plans viewed and for the residents on the new dementia suite these were supported with care manager assessments. From the care plans it was evident one resident had been admitted to YeadingBrooke Suite who was outside the home’s category of registration. The care plans and risk assessments for the resident did not reflect how risks identified would be managed. The registered person should have and must now apply to the Commission for a variation to registration for the resident concerned. Requirement 1. Riverlee Care Home DS0000006768.V256044.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 to 11. Care plans prepared varied in how well they showed how resident assessed needs would be met. Some of the care plans seen did not provide adequate information on how care needs were to be met. This applied particularly in relation to wound care management. Medication was generally well managed but systems were not yet in place to dispose of medications in view of the new NHS contract for pharmacy services. EVIDENCE: Eleven care plans in total were viewed. On Ravensbourne Suite care plans were well kept and included risk assessments supported by relevant care plans. Care plans were reviewed monthly. None of these files had evidence to show residents or relatives were involved with care planning however relative consent had been obtained to take photographs of residents and to use bedrails if needed. One care plan showed how staff encouraged the resident to maintain independence. On Yeading-Brooke Suite the care plans viewed varied. They included risk assessments and relevant care plans. There was no evidence to show that residents or relatives had been involved in the care planning. One resident admitted to this unit was outside the home’s category of registration and a Riverlee Care Home DS0000006768.V256044.R01.S.doc Version 5.0 Page 10 care plan had not been prepared to show how a specific identified risk to the resident’s well being would be managed. On the new dementia unit on Ravensbourne Suite concerns were noted in relation to wound and pressure sore management. There was no evidence to show that adequate follow up investigations had been done into a number of unexplained injuries sustained by residents when they were receiving care or being assisted to mobilise. Care plans had been prepared in relation to some of these wounds but these did not provide adequate information on the condition of the wound, the type of or frequency of wound dressing. Poor follow up to unexplained injuries sustained by residents has been an ongoing concern in this home. Staff ensured residents had access to a GP, dentist, optician, chiropodist and other medical services as needed. Residents on the dementia suites were unable voice their views of the service. Two relatives seen on the suite said they were satisfied with the quality of care provided and the attitude of staff. Some residents on the nursing suite made positive comments about the staff and the service. One relative on the nursing suite said ‘the staff are lovely’. Medicines were inspected on Yeading-Brooke Suite only. None of the residents managed their own medicines. Systems in place to manage medicines, with the exception of medicine disposal, were considered safe and medicines were properly stored. A record must be kept for all medicines brought into the home and those waiting disposal. Two members of staff must sign hand written entries on the administration charts. Accurate records must be kept for homely remedies. Inaccuracies were noted in the recording of one homely remedy. Administration charts were well maintained and included a photograph of the resident. Management had not arranged for disposal of medicines since the changes to the NHS and community pharmacy contract. A large stock of medicines were awaiting disposal but there were no records made of these. The inspector was shown an email the manager received from head office showing that the issue of disposal of medicines was being addressed by the organisation. Residents on both suites were well presented with some of the ladies wearing their jewellery. Several residents on Yeading-Brooke Suite presented as being in a state of ‘well-being’, they were chatty, smiling, singing to the music and watching what was going on round them. There was however very little interaction observed between staff and residents in the lounge. Staff were seen in the lounge but they were sitting away from the residents completing paperwork. When assisting residents to move about staff tended to ‘lead them’ by holding their wrists rather than walking with them and talking to them. Riverlee Care Home DS0000006768.V256044.R01.S.doc Version 5.0 Page 11 On Ravensbourne Suite a member of staff assisted a resident to transfer to a wheelchair with minimal verbal interaction. The member of staff completed the task by tapping the seat and saying to the resident ‘let go’ and ‘sit properly’. Some relatives said staff expected residents to sit down all the time and when residents did get up to walk about they were told to ‘sit down’. Residents can stay in the home in their final days provided their needs can be met. Staff supported relatives to be with the resident at this time. Requirements 2,3,4,5 and 6. Riverlee Care Home DS0000006768.V256044.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and15. Adequate plans and material were in place to provide social activities for residents. More effort was needed to obtain social histories for residents to enable staff to meet resident’s social and leisure interests. The management of mealtimes, particularly on the dementia suites, must be addressed to ensure all residents get the help they need to have their meals. EVIDENCE: Not all records seen included a social care plan. Some social histories were very sparse. The manager said that staff relied on relatives to provide them with the resident’s social history. Activities provided included videos, bingo, playing cards, listening to music and watching T.V. Adequate material was provided to stimulate residents and included a nicely prepared reminiscence box. The activity organiser ensured residents’ birthdays were recognised and two residents were enjoying a planned birthday party at the time of this inspection. Lunch was observed on Yeading-Brooke and Ravensbourne Suites. The daily menu was displayed but in word form only. On the new Ravensbourne dementia suite the dining room was chaotic. Four members of staff were in attendance but in view of the needs of the residents this seemed either inadequate or poorly managed. From observation some of the staff expected residents to sit at the table, use a knife and fork and eat Riverlee Care Home DS0000006768.V256044.R01.S.doc Version 5.0 Page 13 their meal without any assistance or encouragement. Staff took little notice of a resident who was moving a chair about unsteadily and the resident eventually fell over. The same resident was not given a main meal until the inspector pointed this out to a member of staff. Only one resident was given a plate guard and spoon. Others may have been able to manage their meal better with these items. Some staff showed a good understanding of the residents needs and interacted appropriately with them but not all staff present showed this level of understanding. The meal consisted of potatoes, a savoury pastry pie and a pastry pie for pudding. The meal was very high in carbohydrates and a very heavy meal for older people. The evening meal that day included a further pastry dish. Very large portions were served to all the residents. A choice of meal was included but none of the residents on this suite were given or offered this. However one resident who did not want the meal was given a salad. On Yeading-Brooke suite a high proportion of residents needed help to have their meal. Again there were not enough staff to do this or it was not well managed. Staff were seen feeding two residents at the same time. Some residents needed more assistance than was available. The meal looked and tasted appetising and residents seemed to enjoy it. A choice of meal was provided on this suite and residents did have the choice of having the alternative vegetarian meal. A relative said ‘the food here is fantastic. Its nicely presented’. The management of mealtimes in the dementia suites has been an ongoing issue in the home and management must find a way to resolve this and ensure the resident’s needs are appropriately met at mealtimes. Requirement 7 and Recommendations 1 and 2. Riverlee Care Home DS0000006768.V256044.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Adequate systems were in place to manage complaints and adult protection. More attention must be given to investigating how unexplained injuries sustained by residents occurred and could be prevented. EVIDENCE: Since the last inspection the Commission had not received any complaints about the service. Records seen showed one complaint had been made to the home and this had been managed appropriately. A number of letters of thanks from relatives for the care provided were seen. Staff who spoke to the inspectors displayed an understanding of adult protection and how they would manage allegations or suspicions of abuse. They also showed their awareness on managing challenging behaviour displayed by residents. Please see requirement 5 and the comments under the Health and Personal Care section and the requirements made in relation to wound management and unexplained injuries sustained by residents on the new dementia suite. Riverlee Care Home DS0000006768.V256044.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,22,24 and 26. Attention was needed to ensure the environment was kept clean, free of odours and adequately maintained. Attention was also needed to ensuring wheelchairs provided were safely maintained. EVIDENCE: Since the last inspection work had been done to ensure the bedroom doors on Chelmer Suite closed properly. A maintenance programme for the home was not seen and parts of the environment would benefit from repair and redecoration. For example damage to bedroom walls and doorframes had not been addressed and some bedrooms needed repainting. Lounge and dining areas were generally clean and tidy. An audit of the premises should be done and a planned maintenance programme prepared to ensure the home is routinely redecorated and refurbished. The home had adequate bathing and toilet facilities and these areas were signed with the use of pictures to help with orientation. Those seen were clean and tidy and hot water checked was within safe limits. On the first floor the Riverlee Care Home DS0000006768.V256044.R01.S.doc Version 5.0 Page 16 ventilation system in bathrooms 1 and 2 was not working effectively and in shower room 2 it was not working at all. A number of wheelchairs seen in bedrooms did not have footplates fitted and no footplates were seen in the bedrooms. Staff were observed transporting residents in wheelchairs without the use of footplates. Bedrooms were fitted to meet the needs of the residents and included personal items. In bedroom 19 on the first floor the flooring in the en-suite was coming away from the wall behind the WC pan and the pan needed descaling. More attention was needed to ensuring the room was kept clean and hygienic. The new dementia suite lacked any particular signage to assist residents. A calendar was seen in one bedroom but had the wrong month showing. An unpleasant odour permeated throughout the first and second floors. This was more unpleasant in the new dementia suite on the top floor. The inspectors were told that carpets were shampooed regularly but due to the behaviour of some residents it was difficult to control the smell. Management must find a way to manage this and ensure the home is kept free of unpleasant odours. A number of relatives commented on the malodour. One domestic staff worked till 14.00 on each floor. In view of the need to address the overall cleanliness of the home these hours should be reviewed. Domestic staff did not feel they had enough time to give attention to detail when cleaning. Areas such as doors, skirting boards, light switches, plugs, ensuites and WC pans must be kept cleaner. Requirements 8,9,10 and 11 and recommendation 3. Riverlee Care Home DS0000006768.V256044.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29 and 30. Staffing rotas seen showed the home was staffed to the levels set by the previous registration body. Records showed that recruitment was undertaken to meet regulation and staff were provided with training relevant to their roles. EVIDENCE: The staff rotas for the two weeks prior to and the week of the inspection were inspected and showed staffing levels were maintained as set by the previous registration body. In view of the comments made under standard 15 in relation to mealtimes the registered person must review the management of mealtimes or the staffing levels on the dementia suites particularly around these times. See requirement 7. Staff who spoke to the inspectors were positive about their roles and the support and training they received. Staff displayed an understanding of adult protection and the care needs of the residents. Four staff personal files were inspected. These were well kept and included the information required by regulation. Individual staff training files were not inspected. Staff training was provided on Tuesdays and the inspectors were given a copy of the training programme. This included topics such as moving & handling, fire safety, food hygiene, first aid and infection control. Riverlee Care Home DS0000006768.V256044.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,35 and 38. Adequate systems were in place to manager resident’s personal finance. More attention was needed to ensuing attention was given to safety in relation to wheelchair maintenance, unexplained injuries sustained by residents and wound management. EVIDENCE: The management team comprised of a full time manager, deputy manager with each suite having a separate team leader. Staff spoke positively about the ‘good team working’ in the home. Staff said they attended staff meetings and had the opportunity to voice their views on the service and to make suggestions. Minutes of the meetings were not viewed on this occasion. Relative meetings were held about every three months. Minutes of the July 2005 meeting were viewed. These showed the relatives of five residents attended and the home had arranged for a volunteer from the Alzheimer’s Society to attend. Riverlee Care Home DS0000006768.V256044.R01.S.doc Version 5.0 Page 19 Following the inspection seven relatives were contacted by phone to get their views of the service. Most of the relatives said they were satisfied with the care provided, that there was enough activities provided, residents were always clean and well presented, the food was good, staff were pleasant and communicative and they felt their relatives were treated with respect. One relative said there were times when staff when no staff were visible and another said care plans were never discussed. Two relatives said lots of their resident’s went missing despite being labelled and added replacing these was quite a cost. Several relatives commented on the unpleasant smell particularly in the upstairs corridors. Systems in place to manager resident’s personal finances were assessed as adequate. Resident personal allowances were held in a designated bank account and the money not combined with that of the organisation. As up to date safety certificates were not available to view for the lifts, hoisting equipment, assisted baths and the fire alarm system an immediate requirement was left with the manager to address this. At the time of writing this report the Commission had received written evidence that the equipment had been serviced. The immediate requirement was therefore met. A selection of other safety records were viewed and found to be up to date. As concerns were noted in relation to unexplained injuries sustained by residents, wound management and the maintenance of wheelchairs. See requirements 4,5 and 9. The manager displayed an awareness of the need to comply with other legislation relevant to running a care home. Riverlee Care Home DS0000006768.V256044.R01.S.doc Version 5.0 Page 20 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 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 x 2 2 x 2 x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 3 X X 3 X x 2 Riverlee Care Home DS0000006768.V256044.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP4 Regulation 14 Requirement The Registered Person must not admit residents outside the home’s category of registration. An application for a variation to registration must be made to the Commission for a resident admitted to Yeading-Brooke Suite who was outside the home’s category of registration. The Registered Person must ensure a care plan is in place for all care needs identified and shows how the need will be met. (Timescale of 31/05/05 was not met.) The Registered Person must ensure efforts are made to involve residents or their representatives in preparing care plans. The Registered Person must make proper provision for the care and treatment of residents. Wound management records must be in place and reflect the treatment provided, the condition of the wounds and the involvement of any specialist professionals. DS0000006768.V256044.R01.S.doc Timescale for action 28/11/05 2 OP7 15 28/11/05 3 OP7 15 28/11/05 4 OP8 12 21/11/05 Riverlee Care Home Version 5.0 Page 22 5 OP8 13 6 OP9 13 7 OP15 12 8 OP21 23 The Registered Person must ensure all unexplained injuries sustaind by residents including those sustained during transfer or when receiving care are fully investigated and procedures put in place to prevent or reduce these occurring. (Timescale of 31/05/05 was not met.) The Registered Person must ensure a record is kept for all medicines brought into the home including those brought in by residents. Accurate records must be kept for the administration of homely remedy medicines. Hand written entries on administration charts must be supported by two signatures or signed by the GP. A system must be in place for the safe disposal of medicines and accurate records must be maintained for these medcines. (The manager agreed to ensure records were kept of medicines in the home awaiting disposal from the date of the inspection). The Registered Person must ensure the home is conducted so as to promote the health and welfare of the residents. The management of meals, particularly on the dementia suites must be reviewed. Meals must be managed in such a way as to ensure each resident gets the assistance, encouragement and utensils they require to eat and enjoy their meals. Staff training must address how to understand the needs of dementia residents in relation to eating and drinking. The Registered Person must ensure the premises are kept in DS0000006768.V256044.R01.S.doc 21/11/05 28/11/05 28/11/05 28/11/05 Riverlee Care Home Version 5.0 Page 23 9 OP22 23 10 OP26 16 11 OP26 23 a good state of repair. The ventilation systems in the bath and shower rooms on the first floor must be serviced and kept in working order. The Registered Person must ensure equipment provided is maintained in good working order. Wheelchairs provided must have footplates fitted and used when transporting residents. The Registered Person must ensure all parts of the home are kept clean and reasonably decorated. More attention must be given to ensuring paintwork, skirting boards, WC pans, light switches and plugs in resident’s bedrooms are properly cleaned. Damage to walls in bedrooms must be repaired. The Registered Person must ensure the home is kept free of offensive odours. 21/11/05 28/11/05 28/11/05 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 3 Refer to Standard OP12 OP15 OP19 Good Practice Recommendations The Registered Person should ensure all efforts are made to get a social history for residents. The Registered Person should obtain the advice of a nutritionist to ensure the menus prepared provide residents with a balanced diet. The Registered Person should complete an audit of the premises and prepare a planned maintenance and refurbished programme for the home. The programme should be update annually. Riverlee Care Home DS0000006768.V256044.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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