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Inspection on 11/05/06 for Ross Wyld Nursing Home

Also see our care home review for Ross Wyld Nursing Home for more information

This inspection was carried out on 11th May 2006.

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.

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

The home offers a varied activities programme, and there was evidence that service users are able to access the community. Service users informed the inspector that they felt the food on offer was of a good standard.

What has improved since the last inspection?

There have been some improvements since the last inspection, and the overall number of requirements set has fallen slightly from twenty six to twenty three. The home no longer admits service users from outside its category of registration, and staff are now recruited in line with the homes recruitment procedure. Fire exits were found to be free from obstruction during this inspection.

What the care home could do better:

Despite limited improvements, there is still much that must be addressed. Care plans and risk assessments must be comprehensive. The home must ensure that all staff receive appropriate training in health and safety matters and adult protection issues. Medications must be administered and recorded appropriately.

CARE HOMES FOR OLDER PEOPLE Ross Wyld Nursing Home Ross Wyld 458 Forest Road Walthamstow London E17 4PZ Lead Inspector Rob Cole Unannounced Inspection 11th May 2006 10:00 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 Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 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. Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ross Wyld Nursing Home Address Ross Wyld 458 Forest Road Walthamstow London E17 4PZ 0208 521 8773 0208 520 0690 ross.wld@fsch.co.uk 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) Tamaris (South East) Limited (a wholly owned subsidiary of Four Seasons Health Care Limited) Lutchemee Hele Care Home 54 Category(ies) of Dementia - over 65 years of age (22), Old age, registration, with number not falling within any other category (25), of places Physical disability (7) Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. To allow the home to provide continuous care for two named service users and to permit admission of one named service user with mental health needs. 31st October 2005 Date of last inspection Brief Description of the Service: Ross Wyld is a care home registered to provide care for a maximum of 54 service users. This includes 25 places for those requiring nursing care, 22 places for older people with dementia and 7 places for younger adults with physical disabilities. The registered provider is Tamaris Ltd, part of the Four Seasons Health Care Group. The home is a large purpose built, three storey detached house with 48 single bedrooms and three double bedrooms located across all three floors. All floors are accessible via a lift. The home is situated on Forest Road, in the London Borough of Waltham Forest. The home is close to shops, transport networks and other local amenities. Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 11/5/06 and was unannounced. The inspector had the opportunity of speaking with service users and staff from the home, and the inspection included a tour of the premises and examination of documentation and records. Although there has been some limited progress at the home since the last inspection, the inspector believes that the home still has some way to go before it is fully in line with National Minimum Standards and the Care Home Regulations 2001. What the service does well: 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. Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 Page 6 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 Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 Page 7 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): 1,2,3 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The inspector was satisfied that service users are provided with sufficient information to make an informed choice about the home. This information is provided through written documentation, and the opportunity of visiting the home. EVIDENCE: The home has a Statement of Purpose and Service User Guide in place. Both documents are written in plain English and all service users are provided with their own copy of the Guide. The Statement of Purpose includes details of the management and staff team, the philosophy of care and the aims and objectives of the home. The Guide includes details of the services provided and a copy of the homes complaints procedure. However, neither document is dated, nor is there any indication of when they are due to be reviewed, or indeed were last subject to review, and this must be addressed, and is a repeat requirement. All service users have been issued with a contract/statement of terms and conditions. Contracts contain information on fees payable, conditions of occupancy and the rights and responsibilities of Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 Page 8 both parties, and are in line with National Minimum Standards (NMS). Contracts have been signed by the service user or their representative were appropriate. A senior member of the staff team carries out a pre admission assessment of service users needs prior to them moving into the home. The inspector was pleased to note that these have improved considerably since the previous inspection, and are now of a satisfactory standard. Assessments cover needs associated with mobility, medication and social and leisure needs. The home has an admissions procedure, this states that service users will be given the opportunity of visiting the home prior to admission. Service users spoken to confirmed that they had indeed been given this opportunity. The home does not provide intermediate care. Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 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): 7,8,9 and 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. Care plans and risk assessments need to be more comprehensive, and work needs to be done to ensure that medications are appropriately administered and recorded. Furthermore, the home must ensure that staff are treated with dignity and respect at all times. EVIDENCE: All service users have care plans in place. However, as at the last inspection, these are not always comprehensive. Plans tend to concentrate on service users needs around mobility, medication and personal care. There is often very little if any information around there cultural, social or leisure needs, and it is required that care plans set out how the home can meet all the assessed needs of service users. Similarly, risk assessments are far from comprehensive. Assessments tend to be very basic, merely stating what the risks to service users are. For example, the risk assessment for one service user states that they are at risk from absconding and falling, yet there are no guidelines or strategies in place on how these risks are to be managed and reduced. This must be addressed. Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 Page 10 All service users are registered with a GP. Records are maintained of medical appointments. These evidenced that service users have access to health care professionals as appropriate, including physiotherapists, chiropodists, and since the last inspection dentists and opticians. The home makes use of the Continence Advisory Service, and used continence products were disposed of appropriately. The home has a comprehensive medication policy in place. Medications are stored in locked cabinets on each of the two units. Medications are only administered by nursing staff, or those staff who have received training on the administration of medications. Records are maintained of medications entering the home and of those that are returned to the pharmacist. Medication Administration Record (MAR) charts were maintained. However, these contained several instances of unexplained gaps in them. Further, there were instances of medications been signed for as been administered, when in fact they had not been administered. As at the last inspection there were no guidelines in place around the administration of medications prescribed on a PRN basis, all of this must be addressed. While the inspector noted some instances of appropriate personal support being provided to service users, there was not a consistently high standard throughout the home. For example, during lunchtime the inspector was sitting with a service user, discussing the home with them. A member of the care staff was at the other end of the busy room, and repeatedly shouted out to the inspector that there was no point talking to this particular service user as they did not understand anything. The staff member also made various hand gestures to indicate this point. All this was done in front of the service user, along with several other service users and members of the staff team. The inspector considered this to be an example of extremely poor practice, and that it significantly compromised the dignity of the service user. The matter was brought to the attention of the senior staff member on duty. As at the last inspection, the inspector was disappointed to note that several bedrooms still do not have any locks fitted to their doors, and consequently service users are not offered keys to their bedrooms. It is a repeat requirement that all bedrooms are fitted with working locks, and that all service users are offered keys to their bedrooms subject to satisfactory risk assessments. Continued failure to meet this requirement may lead the CSCI to take enforcement action against the home. Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 Page 11 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): 12,13 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The inspector was satisfied that the home is meeting service users needs in relation to social and leisure activities, and food was of a satisfactory standard. EVIDENCE: The home employs a full time activities coordinator, and there is a designated activities room. A poster was on display in the home advertising the weekly activities programme, which included quizzes and bingo. Service users also have access to TV, video, music and board games. The home regularly holds car boot sales in its grounds, profits made from these go towards further activities. Service users spoken to informed the inspector that they very much enjoyed been involved in running these events. The home has a visitor’s policy in place. Service users and relatives informed the inspector that visitors are welcome at any reasonable time, and that they can see service users in private if they so wish. Records are kept of menus, these indicated that service users are offered a varied, balanced and healthy diet. On the day of inspection food appeared appetizing and nutritious, and service users were offered a choice of a meat or fish dish. Service users are offered drinks and snacks throughout the day, and Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 Page 12 are able to help themselves were possible. Service users informed the inspector that they are happy with the quality and quantity of food provided. The kitchen was clean and tidy, and food was stored appropriately. Records are kept of fridge and freezer temperatures. Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 Page 13 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): 16,17 and 18 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. The inspector was satisfied that service users have access to appropriate complaints procedures, but more needs to be done around adult protection issues. EVIDENCE: The home has a complaints procedure, this was prominently displayed within the home and made appropriate reference to the CSCI. The home also has a complaints log. There was evidence that the home appropriately records and investigates any complaints received. The home has a copy of the Local Authorities adult protection procedures, and also its own policy on adult protection. However, this policy dates from March 2003 and is not in line with current legislation. For example, it states that the homes manager or regional manager will be responsible for carrying out any investigation into allegations of abuse, yet the decision as to who should carry out any such investigation rests with the Local Authority. It is a repeat requirement that this policy be amended to be in line with current legislation. The inspector was informed that not all staff have undertaken training in adult protection issues. Staff spoken to demonstrated a poor understanding of their responsibilities with regard to adult protection issues. This must be addressed as a matter of priority. The inspector was satisfied that service users legal rights are protected, for instance all service users are entered on the electoral register, and service users informed the inspector that they are able to vote in elections. Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 Page 14 Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 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): 19,20,21,22,23,24,25 and 26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. Many bedrooms were sparsely decorated, and furniture in bedrooms was often of a poor standard. EVIDENCE: The home is situated in the Walthamstow area of the London Borough of Waltham Forest, and is close to shops, transport networks and other local amenities. Whilst it was positively noted that some redecorating work has been carried out, there is still some to do. Throughout the home there are instances of peeling and faded wallpaper and cracked paint. Communal areas consist of sitting rooms, dining rooms and two designated smoking rooms, and are sufficient in numbers to meet service users needs. Likewise the inspector was satisfied that the home has sufficient numbers of bathing and toilet facilities to meet service users needs. However, the lock on the first floor shower room did not have an emergency override device fitted, and this must be addressed, and is a repeat requirement. The homes garden Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 Page 16 was generally well maintained, although there were several items of discarded furniture in the garden that must be removed. Bedrooms were also found to be in a generally poor state. Many contained broken items of furniture, and were often sparsely decorated and bleak in appearance. Furniture in bedrooms was often found to be in a poor state, and several bedrooms had a strong offensive odour. Bedrooms met NMS on size requirements, and had adequate natural light and ventilation. There was no evidence of any assessment of the premises by a suitably qualified person having taken place and no evidence of aids and adaptations being provided, despite this being identified in previous inspection reports. It is a requirement that such an assessment is undertaken and that the registered person provides any necessary aids, adaptations and equipment to meet the needs of service users. This is a repeat requirement. Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 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 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. Service users were at times left unsupported, and the home must ensure that staff receive all appropriate health and safety training. EVIDENCE: The home provides 24-hour care including an emergency on-call procedure. There was a staffing rota on display, this accurately reflected the actual staffing situation on the day of inspection. The inspector was satisfied that the home is staffed in sufficient numbers to meet service users needs. However, as at the last inspection the inspector had concerns about the way staff were deployed at times. For instance, on several occasions throughout the inspection the inspector noted that the main downstairs lounge was left unattended by staff, despite the fact that several service users were present. Further, some of those service users had risk assessments stating that they were at risk from falls, and should be closely observed. It is required that all service users are provided with adequate levels of staff support at all times. The home has policies in place on equal opportunities and recruitment and selection. The inspector was pleased to note that since the last inspection the home now carries out all staff recruitment in line with it’s recruitment procedure, i.e. all recruitment interviews are now carried out by at least two staff. The inspector checked several staff employment files at random, all contained evidence of satisfactory CRB checks and proof of ID. However, it is Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 Page 18 required that the home has a full written record of staff’s employment history, including an explanation of any gaps in there employment. Staff undertake a structured induction programme on commencing work at the home, which includes the environment and service user issues. Records are maintained of staff training, these indicated that staff have recently undertaken training in palliative care, dementia and wound dressing and healing. However, not all staff have undertaken all necessary statutory health and safety training, such as first aid, fire safety and manual handling. This must be addressed. Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 Page 19 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): 33,35,36and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Health and safety management is of a satisfactory standard, as are the quality assurance systems in place within the home. EVIDENCE: The home has various quality assurance systems in place. There was evidence of monthly unannounced Regulation 26 visits taking place, and copies of previous inspection reports were available to view in the home. The manager carries out an internal monthly audit, which covers service users rights and the environment. Since the previous inspection the home now issues questionnaires to service users and their relatives to gain their feedback on the running of the home. Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 Page 20 As at the last inspection, several service users have their money held in a pooled bank account, and they do not receive the interest paid on their money. Staff informed the inspector that it is planed that a new system is to be set up, whereby service users will receive all interest generated by their savings, and this is required. The home holds money on behalf of service users. Records are maintained, however, several of those checked did not tally with the actual sums held. For example records indicated that one service user should have £5.22, but they had £10.32. It is required that clear systems are in place to check and record service users monies, to ensure that it is stored and spent appropriately, and to help reduce the risk of financial abuse occurring. At the last inspection a requirement was set that all staff receive regular formal supervision, at least six times a year. As the homes manager was not present during this inspection, the inspector was unable to check whether this requirement has been met. It is therefore repeated in this report, and will be checked as part of the next inspection. The home had various fire extinguishers situated around the home, and since the last inspection fire exits were free from obstruction. There was evidence of routine health and safety checks been carried out, for instance fridge/freezer and hot water temperatures were tested, and the home regularly tests its fire alarms. There was evidence of recent PAT, gas safety and electrical installation testing. COSHH products were stored securely. The home had in date employer’s liability insurance cover. Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 Page 21 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 2 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 1 2 2 2 2 3 2 3 3 STAFFING Standard No Score 27 2 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 2 2 X 3 Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP22 Regulation 23 Requirement Timescale for action 31/08/06 2. OP7 14 3. OP10 12 The registered person must demonstrate that an assessment of the premises and facilities has been made by suitably qualified persons, including a qualified occupational therapist with specialist knowledge of the client group catered for; and provide evidence that the recommended disability equipment has been secured or provided and environmental adaptations made to meet the needs of service users. (Timescale 28/2/06 not met) The registered person must 31/08/06 ensure that all care plans demonstrate how each of the assessed needs of the service users are met. (Timescale 28/2/06 not met) The registered person must 31/08/06 ensure that all service users bedrooms are fitted with suitable locks, and service users provided with a key unless a completed risk assessment indicates otherwise. This must be recorded in the individual plan of care detailing the reasons why. DS0000025960.V293422.R01.S.doc Version 5.1 Ross Wyld Nursing Home Page 23 4. OP18 18 5. OP19 23 6. OP19 23 7. OP9 13 8. OP18 13 9. OP8 13 10. OP9 13 11. OP24 16 (Timescale 28/2/06 not met) The registered person must ensure that all staff working in the home receive training in adult protection issues and the protection of vulnerable adults. (Timescale 28/2/06 not met) The registered person must ensure that all parts of the care home are kept in a good state of repair and reasonably decorated. (Timescale 28/2/06 not met) The registered person must ensure that all incidents of peeling wallpaper are redecorated. (Timescale 28/2/06 not met) The registered person must ensure there are clear guidelines in place for the administration of all medications prescribed on a PRN basis. (Timescale 28/2/06 not met) The registered person must ensure that the homes adult protection procedures are in line with current legislation. (Timescale 28/2/06 not met) The registered person must ensure that comprehensive risk assessments are in place for all service users, covering all areas of potential risk to themselves and others. (Timescale 28/2/06 not met) The registered person must ensure that all medications administered are accounted for, and that there are no unexplained gaps left on MAR charts. (Timescale 28/2/06 not met) The registered person must ensure that all bedrooms contain adequate furniture, and that this furniture is in a good state of repair. (Timescale 28/2/06 not DS0000025960.V293422.R01.S.doc 31/08/06 31/08/06 31/08/06 31/08/06 31/08/06 31/08/06 31/08/06 31/08/06 Ross Wyld Nursing Home Version 5.1 Page 24 12. OP35 20 13. OP36 18 14. OP21 12 15. OP1 6 16. OP24 16 and 23 17. OP27 18 18. OP35 16 met) The registered person must ensure that service users receive all interest paid out on monies held in accounts by the home on their behalf. (Timescale 28/2/06 not met) The Registered person must ensure that all staff receive formal supervision at least six times a year and that a written record is maintained which details the nature of the discussion and topics discussed. (Timescale 28/2/06 not met) The registered person must ensure that all bathrooms and toilets have suitable locks fitted with an override device for staff to use in an emergency. (Timescale 28/2/06 not met) The registered person must ensure that the homes Statement of Purpose and Service User Guide are both dated and subject to regular review. (Timescale 28/2/06 not met) The registered person must ensure that all bedrooms are free from offensive odours. (Timescale 28/2/06 not met) The registered person must ensure that all service users are provided with appropriate and adequate levels of care from nursing and care staff at all times. (Timescale 28/2/06 not met) The registered person must ensure that appropriate checks are in place to ensure that service users monies are spent appropriately, and to reduce the risk of financial abuse. (Timescale 28/2/06 not met) 31/08/06 31/08/06 31/08/06 31/08/06 31/08/06 31/08/06 31/08/06 Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 Page 25 19. OP9 13 20. OP10 12 21. OP20 23 22. OP29 19 23. OP30 13 and 18 The registered person must ensure that all prescribed medications are administered appropriately. The registered person must ensure that all staff treat service users with respect and dignity at all times. The registered person must ensure that all items of discarded furniture are removed from the homes grounds. The registered person must ensure that the home has a full written record of staff’s employment history, including an explanation of any gaps in employment. The registered person must ensure that staff undertake all required statutory health and safety training as appropriate. 31/08/06 31/08/06 31/08/06 31/08/06 31/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ 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. Extracts may not be used or reproduced without the express permission of CSCI Ross Wyld Nursing Home DS0000025960.V293422.R01.S.doc Version 5.1 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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