Inspection on 28/01/08 for Rookwood Nursing Home

This inspection was carried out on 28th January 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rookwood Nursing Home 27/01/09

Rookwood Nursing Home 15/03/07

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Rookwood Nursing Home 4 Victor Road Bradford West Yorkshire BD9 4QL Lead Inspector Pamela Cunningham Key Unannounced Inspection 28th January 2008 10:30 Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 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 Rookwood Nursing Home DS0000068154.V360129.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 Adults 18-65. 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. Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rookwood Nursing Home Address 4 Victor Road Bradford West Yorkshire BD9 4QL 01274 547597 01274 549215 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) European Care Lifestyles (B) Ltd Care Home 20 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (20), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (4) Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th March 2007 Brief Description of the Service: Rookwood Care Home is registered to provide nursing care to 20 service users who suffer from enduring mental health problems. Qualified psychiatric nurses, nurses with general nursing qualifications, and trained care staff provide twenty-four hour care. It is owned and managed by European Care Lifestyles (B) Limited and is situated in the Manningham area of Bradford, close to Lister Park. Bus connections lead to Bradford, Bingley, Keighley, and Skipton. The property is a mid to late 19th century residence, and is located on a quiet road. The home has no passenger lift. A stair lift provides access to the first floor of the home. However due to the layout of the home, some areas are not accessible to service users who have mobility problems. The bedroom accommodation is on three levels in the home. This consists of twelve single rooms and four double rooms. Communal space includes a dining room, a large lounge, and a conservatory. At the time of writing this report the cost of staying at the home varied from £502 to £650 per week. Rookwood Nursing Home DS0000068154.V360129.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 1 star. This means the people who use this service experience adequate quality outcomes. One visit was made on 28th January 2008. The home did not know that this was going to happen. Feedback was given to the manager during and at the end of the visit. The purpose of the visit was to make sure the home was being managed for the benefit and well being of the residents. Before visiting the home the inspector asked for information from the manager (the Annual Quality Assurance Assessment - AQAA) which asks about what policies and procedures are in place and when they were last reviewed, when maintenance and safety checks were carried, staff details and training provided. Comment cards were sent to the home to be given to residents, their relatives and other visitors to find out what their views of the home were. The views of doctors and district nurses who visit the home were also asked for. At the time of writing this report nineteen resident, 3 service user, one health professional and one GP response had been returned. In order to find out how well staff knew residents, care plans were looked at during the visit and residents, visitors and staff were spoken to. Other records in the home were looked at such as staff files, training records and complaints received. What the service does well: Information about services provided by the home is available and lets the people who live there and their relatives decide if the home will be suitable for them. They can make trial visits to the home if they want to. The home is now beginning to look well maintained since the programme of redecoration and refurbishment had begun, and it is expected this will continue. Certain areas have been decorated and furnished to provide residents with a pleasant, comfortable and homely place to live. The people who live there said that they can bring in their own belongings to personalise their rooms and that the home was always clean and tidy and it did not smell. They said that the food was good, they enjoyed the meals and alternatives to the planned menu are offered if they want them. They said they could choose how and where to spend their time and whether or not they want to join in with planned activities. Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 6 Visitors said that they could visit the home at any time and they were made welcome. They said that staff kept them informed and up to date with any changes in their relatives care needs, and that they were satisfied with the services provided by the home. Relationships between staff and the people who live at Rookwood were warm and friendly. They said that the staff were pleasant, friendly and that hey could approach them at any time. They said that they respected their privacy and would listen to and act upon what they said. What has improved since the last inspection? What they could do better: Activities could be incorporated into the care plans to make the plans more person centred. The documentation did not contain care plans for identified medical problems. Plans of care need to be developed for those problems identified so that the staff can be aware how it affects them, and how they should be cared for. One of the people in the home had suffered a personal loss in the death of his mother. On speaking to him it was very obvious he was still affected by it, however there was nothing either in his plan of care or the daily care notes to help the care staff to help him to deal with how he was feeling. This needs addressing so that the staff are aware of the situation and can give the adequate support. Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 7 Risk assessments should not be filed away separately from the care documentation. They are not a once and for all activity and should be reviewed regularly to identify any deterioration or improvement in the people living at the home. Some plans of care contained a signature of the people they were about. Staff need to make sure they understand the appropriateness of the care plans. 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. Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the home and relatives are provided with information to enable them to make an informed choice about the home, EVIDENCE: Evidence was seen of contracts of terms and conditions, with any items identified to be paid for that are not covered by the fees. Pre admission assessments are done by the manager, and no person is admitted to the home unless the manager is sure their needs can be met. Trial visits are encouraged, and can take as long as it takes the service user to settle, and become used to their new surroundings, and the other people who live there. Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is able to meet the health and personal care needs of service users. Residents care needs are met but this is not fully evidenced in the care plans. EVIDENCE: There have been no new admissions to Rookwood since the last inspection, therefore the quality of information gathered by the acting manager in pre admission assessments could not be evaluated. I looked at the care documentation of three people who live at the home and spoke to one of them. In all cases there was evidence of a contract of residency. In two cases there was no religious preferences identified, in two there was no personal property list, and in all cases there was scant evidence of provided activities which would have helped to make the plans more person centred. Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 11 In care documentation 1 the following problems were identified. Of the problems identified by the qualified named nurse who had completed a post admission assessment, there was no care plans to instruct the staff how to care for the person following a special invasive procedure involving hospital admission. The only information was that he should not have a bath for 24 hours. There was also no information in the documentation to explain to staff why this person had a special x ray, how to alleviate any anxiety he might have had prior to it, or how to care for him after his return home. This person had also suffered a personal loss in the death of his mother. On speaking to him it was very obvious he was still affected by it, however there was nothing either in his plan of care or the daily care notes to help the care staff to help him to deal with how he was feeling. All risk assessments for this person were filed separately from the care documentation and all required re-assessment as had been last assessed twelve months previously. This person suffers from a particular mental disorder, but rather than the plan of care describing what must be done to help to alleviate the symptoms, it described what the condition is and stated’ maintenance of illness in community placement at Rookwood’. This was the common theme with all the care plan documentation The person had signed the care plans to indicate some involvement, however due to his mental health condition there must be some doubt as to how much he understands about his care plan being appropriate. In care plan documentation 2 the following problems were identified. This person was identified as having a serious medical problem involving hospital admission three days each week for treatment, and having special dietary needs. There was no care plan regarding this to instruct the staff about any special care needs either prior to or following his treatments in hospital. A recent post admission assessment identified ‘care needs to be taken regarding restriction of fluids due to treatment’, however there was no written instruction to the staff regarding this, nor was there any recent evidence of any check on his fluid intake and output, the last fluid balance chart being dated as 31/12/07. In care plan documentation 3 fewer problems were outlined than were identified in the pre admission assessment. Those care plans seen were very Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 12 informative. There was evidence of recent psychiatric review, and evidence of dental optical, chiropody and GP care. In all the documentation seen, the staff prescribing the care needs, need to be clear, and separate the diagnosis from the identified need. Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): All standards were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to be part of the decision making process and make choices about their lifestyle. Their social needs are met. EVIDENCE: I spoke to a number of people who live at the home during the inspection. On the whole they were pleased with how they live their lives at the home. They said they could have visitors at any reasonable time, and could go out of the home unescorted to the local shops, or into Bradford, as long as they told the staff where they were going. Some of them also said they had been to computer lessons. There is still no activities organiser employed, so the arranging of entertainment is left to two of the carers. They said they try to encourage the Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 14 people who live there to take pride in their rooms and help to keep them tidy, and the set the tables and clear up following meals. They are also said they get them involved in making snacks and using the new skills kitchen. Activities offered and chosen by the people who live there include going out for meals, playing dominoes and ten-pin bowling. Trips to the nearby market at Skipton to buy clothes. Some have been away on holiday to Cumbria and Cockermouth, and one person is involved with the local park and Bradford Council. The cook told me she has the advanced food hygiene certificate. She showed me the records she keeps and these were all in order. She also told me she was aware of the special dietary needs of the person who attends hospital three times each week. However the kitchen was dirty. The grill was coated in grease, and the cooker was encrusted with grease and burned on food. Kitchen cupboards were also dirty inside. The cook said the kitchen shelves were cleaned weekly, however these were also found to be very dirty. The kitchen walls also needed washing. Menus were reviewed. These were rotated every four weeks, and appeared to be nutritious in value, however there was still no indication of a hot alternative provided for the main meal of the day. On speaking to the cook, she said the people who live at the home are regularly consulted on the menus, and had indicated at a recent residents meeting they would like a brunch on Saturday, and this was being considered. She also confirmed she was aware about the special dietary requirements of one of the people who attends hospital three times a week, and showed me the records she keeps which were all in order. Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): All standards were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is able to meet the health and personal care needs of people who live there. EVIDENCE: Care is provided in the privacy of the people’s bedrooms or bathrooms when required. Currently there are fifteen people who need help with washing and bathing. People spoken to said bath times are not routine, and that they could have a bath when they wanted. Systems are in place to monitor health care needs, and the home works closely with consultant psychiatrists and out reach services to make sure peoples mental health needs are met. A chiropodist visits the home every four months. Interaction between staff and the people who live there was observed during the inspection. People were obviously very comfortable in approaching staff and the acting manager with any problems they had. Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 16 The medication system was reviewed. All the people receive their medication from blister type packs heat-sealed and prepared by the dispensing chemist of their choice. Certain medication had not been signed for as given, and there was no record of the medication taken for those who self medicate. Hand washing facilities have now been provided in the medical room. Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at Rookwood are protected and said they feel safe living in the home. EVIDENCE: There has been no complaints made either directly to the commission or to the home since the last Inspection. The complaint procedure is displayed in the entrance to the home and is clear and easy to follow. I was shown the complaints book, which was void of any entry of any day-today complaints made by either anyone living at the home or their relatives. The acting manager said everyday ‘grouses’ and concerns made by the people who live there are not normally documented as they are dealt with immediately by whoever is charge of the shift at the time. He was advised they should be documented as evidence of how the home deals with any concerns the people who live there might have. He also said any major concerns were reported to his line manager, and depending on the severity, they would either instruct him to deal with it or investigate it themselves. Training records reviewed said there were still five staff employed at the home who have not received training in safeguarding adults, one of these already attending training. The record also states training should be reviewed every three years. Refresher training should be given annually to ensure that staff Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 18 are up to date in how to recognise safeguarding issues and how to follow the correct policy and procedure in dealing with them. Certain staff on duty at the time of the inspection said they were aware of the procedure and would certainly report any suspected abuse to the manager or person in charge at the time. Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 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 people who live at Rookwood live in a home that is clean, tidy, well maintained and suitable for their needs. EVIDENCE: A tour of the home identified certain areas had been upgraded, redecorated, and provided with new furniture bedding and carpets. The bathroom near bedroom 1 has been replaced and new non-slip floor provided. A new bath hoist has also been fitted in this room. There is dispensed soap and paper towels in this area. The ceiling however and the walls still need decorating. Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 20 All bedrooms were visited with the exception of those that had been locked by the people as they were out of the home. Since the last inspection radiator guards have been fitted in those rooms identified as being without guards. All people living at the home have lockable space in their rooms in which to keep items of value to them. The room used as a smoking room for the people who live there needs furniture replacing as most of it is damaged and torn in places. Strip lighting has been changed and lighting more fitting a homely atmosphere has been provided, however the ceilings in these areas should be decorated and made good where the old lighting has been removed. Whilst touring the premises it was noted that cleaning mops were stored inappropriately with mop heads down in a bucket not allowing them to dry, and therefore creating the possibility for cross infection to occur. The cleaning lady was advised of the correct way to store the mops at the time of the visit. During the tour of the premises, the health and safety issues identified at the last inspection were no longer apparent. Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): All standards were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff demonstrated awareness of the individual needs of the people living at Rookwood and are trained and competent to do their jobs, however formal supervision must be fully addressed. EVIDENCE: Two weeks duty rotas were obtained during the visit. These showed that there were enough staff on duty to meet the needs of residents. Information from residents and their relatives confirmed this. From talking to the acting manager and staff it was clear that staff are encouraged to attend training sessions and events. The AQAA said that three support workers have commenced NVQ at level 2, will complete within eight weeks and then all support workers will have completed the training. It also said the cook was due to commence an advanced food hygiene certificate, which she confirmed she had completed. Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 22 Over • • • the last twelve months training sessions have included: Fire safety, Moving and handling, First Aid and health and safety. Staff have also received training in other subjects such as managing violence and aggression, challenging behaviour and Infection control. Looking at other records regarding training however, it was identified that not all staff are receiving formal supervision, which they should have approximately every six weeks. Staff were clear about their roles, and the roles of others within the team, and said they were familiar with the policies and procedures, and would ask about anything they were not sure of. There has only been one new employee since the last inspection. His recruitment documentation was checked and found to be in order with all necessary safety checks done before he commenced work at Rookwood. Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is managed and run in the best interests of the people who live there, however the providers need to address the fact there is no registered manager in post EVIDENCE: Currently there is no registered manager at Rookwood, and the providers must address this shortfall. At the present time, the deputy manager is taking on this role, with support from the Mental Health Director. Since the last inspection policies and procedures have been reviewed. Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 24 Regulation 26 visits have taken place and where shortfalls have been identified these have been rectified. Residents meetings are held every month and appear to be fairly well attended. Staff meetings are also held every two months along with monthly managers meetings. At one of the residents meetings they said they would like a brunch type meal on Saturdays, and this is being considered. Health and Safety in the home has been fully addressed. Rookwood Nursing Home DS0000068154.V360129.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 x 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 x 27 x 28 x 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 2 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 2 3 x x 3 x Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 26 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 YA6 Regulation 15 Requirement Timescale for action 01/04/08 2. YA30 12 3. YA36 18 4. YA37 9 The registered provider must ensure that problems identified in the pre admission assessment of needs are carried forward to the care plans. Previous timescale of 01/06/07 unmet. The registered provider must 01/03/08 promote and make proper provision for the health and welfares of the service users, with special regard to the main kitchen which must be kept clean to an acceptable standard at all times. The registered provider must 01/04/08 ensure all staff working in the care home receive formal supervision at least 6 times each year and that this is documented. The registered provider having 01/06/08 regard to the size of the home, the Statement of Purpose and the number and needs of the service users appoint a manager who has the qualifications, skills and experience necessary for managing the care home. The registered provider must also DS0000068154.V360129.R01.S.doc Version 5.2 Rookwood Nursing Home Page 27 make sure the person appointed is mentally fit to manage the care home. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations The manager needs to makes sure people living at Rookwood fully understand the content of their care plans before being asked to sign them as an indication they have been involved in the prescribing. The manager must make sure medicines are signed for when given, and that a record is kept of when people administer their own medications. The manager must make sure people living at the care home receive adequate support and counselling on experiencing the death of a close relative. A programme that identifies decoration and refurbishment should be sent to the commission. 2. 3. 4. YA20 YA21 YA24 Rookwood Nursing Home DS0000068154.V360129.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Rookwood Nursing Home DS0000068154.V360129.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. 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