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Inspection on 17/05/05 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 17th May 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.

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

Service users are able to visit the home prior to making a decision as to move in or not, and the standard of pre admission assessments carried out was generally good. Visitors are made welcome, and families spoken to by the inspector gave some positive feedback about the level of support provided in the home. The home employs a full time activities coordinator, and details of planned activities were displayed in the home. These included car boot sales run by service users and singing sessions. Service users have access to the local community, for example visiting churches and parks.

What has improved since the last inspection?

There have been some improvements to the home since the previous inspection, this is demonstrated by the overall number of requirements set, which has fallen from thirty four to twenty nine. Pre admission assessments have improved greatly, while care plans have also improved, but to a lesser degree. Staffing levels have increased, and on the day of inspection were adequate to meet service users needs.

What the care home could do better:

Despite some improvements, there is still much that the home must do better. The physical environment is in a very poor state of decoration, and bedrooms were often found to be dirty. Bedrooms must have locks fitted and service users offered keys subject to satisfactory risk assessment.The inspector believes that some areas of concern are potentially putting service users at risk. Staff need a greater understanding of their roles and responsibilities, and many are still in need of training in adult protection. The homes recruitment procedures must be tightened up, for example the home could not evidence having carried out CRB checks for all staff. There were several issues of concern around medication, and requirements have been set for these. Risk assessments need to be far more comprehensive.

CARE HOMES FOR OLDER PEOPLE Ross Wyld Nursing Home 458 Forest Road Walthamstow London E17 4PZ Lead Inspector Rob Cole Announced Inspection 17th May 2005 10:00am 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 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 Version 1.10 Page 3 SERVICE INFORMATION Name of service Ross Wyld Nursing Home Address 458 Forest Road, Walthamstow, London E17 4PZ Telephone number Fax number Email 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 8521 8773 020 8520 0690 Tamaris Healthcare (England) Ltd (wholly owned subsidiary of Four Seasons Health Care) 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 Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 2nd December 2004 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 Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 17/5/05 and was announced. The inspectors had the opportunity of speaking with service users and staff, and the homes manager was present throughout the inspection. Despite some improvements since the last inspection, and some areas of good practice found, overall the inspector believes that much needs to be done before the home meets National Minimum Standards. There are serious health and safety issues that must be addressed, and the homes physical environment is in need of attention. What the service does well: What has improved since the last inspection? What they could do better: Despite some improvements, there is still much that the home must do better. The physical environment is in a very poor state of decoration, and bedrooms were often found to be dirty. Bedrooms must have locks fitted and service users offered keys subject to satisfactory risk assessment. Ross Wyld Nursing Home Version 1.10 Page 6 The inspector believes that some areas of concern are potentially putting service users at risk. Staff need a greater understanding of their roles and responsibilities, and many are still in need of training in adult protection. The homes recruitment procedures must be tightened up, for example the home could not evidence having carried out CRB checks for all staff. There were several issues of concern around medication, and requirements have been set for these. Risk assessments need to be far more comprehensive. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ross Wyld Nursing Home Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Ross Wyld Nursing Home Version 1.10 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 standard(s) 1,2,3,4 and 5 The inspector positively noted developments made to improve the effective assessment and admission of service users to the home. However, further work is required to evidence how or whether identified needs can be met by the home. Improvement in this area would provide more appropriate information to support development of an initial care plan during the early days of a placement. EVIDENCE: A Statement of Purpose and Service User Guide was available for inspection and it was noticed that copies were seen in some service users rooms and in common areas of the home. Both documents contained current information and were appropriately and clearly presented. Pre-admission assessments were available on service user files and were generally of an acceptable standard. There were examples of significant conflict between the assessment undertaken by the home and that produced by the referring agency, however there was supporting information available to demonstrate that the homes assessment was accurate. An example of an assessment leading to an inappropriate admission was noted and is referred to later in this report. Ross Wyld Nursing Home Version 1.10 Page 9 Greater emphasis had been placed on consideration of social activities and interests as part of the pre-admission assessment. Whilst these details had been obtained at this stage, there was little evidence to demonstrate that they were acted upon as part of the care plan. Randomly sampled service user files provided evidence of signed contracts, however one did not contain a statement of terms and conditions, this was a previously made requirement. From observation and discussion with service users and staff it was clear that a range of specialist needs were represented among service users. Although many of these needs were described as having been present from admission, records did not always identify them at that time. Records showed where service users had visited the home prior to admission where this had happened. Where such a visit was not possible for whatever reason, the manager would visit the prospective service user – generally as part of the pre-admission assessment - prior to their coming to the home. This was well documented and provided an example of good practice. Ross Wyld Nursing Home Version 1.10 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 and 11 The inspector was not satisfied that the home is meeting service users health and social care needs. Care plans and risk assessments need further development, and the home must ensure that service users have access to relevant health care professionals. Further, considerable work needs to be done to ensure that medications are recorded and administered appropriately. Additionally, very basic care principles need to be instilled in all staff. EVIDENCE: All service users have care plans in place, these are regularly reviewed. Although some work has been done to improve care plans since the last inspection, they are still not comprehensive. For example, plans make no mention of how the home can meet service users cultural needs, and those checked by the inspector merely said service user social and leisure needs will be met through watching TV. Another service user has been diagnosed as having paranoid schizophrenia, but there was no mention in their care plan on how the home can meet this persons needs in relation to their mental health. This persons care plan did not make clear when they were admitted to the home, the manager was also unsure on this. As the home is not registered for service users with mental health needs, it is required that the home does not admit service users from outside its category of registration. Ross Wyld Nursing Home Version 1.10 Page 11 There was evidence that the home attempts to promote service users dignity, staff were observed to interact with service users in a respectful and sensitive manner. There were however instances where staff failed to respond to the obvious distress of a service user. In a common area where several service users and staff were present a service user was crying aloud continuously. Two staff were observed to stand by without interacting with any service user. The inspector approached and spoke with the service user, noting that her hands were very cold. Only when specifically requested did staff attempt to respond to her needs. It was most dissatisfying to observe this degree of negligence. Service users all have their own basket in the laundry room to help ensure that they only wear their own clothes, and on the day of inspection service users were dressed appropriately. However, several bedroom doors do not have locks fitted, despite this being contrary to the organisations policy, which states that all service users must have lockable doors, and be offered keys subject to satisfactory risk assessments. All service users are registered with a GP, and the inspector was informed that since the last inspection service users now see visiting health professionals in private. Records are maintained of medical appointments, but these need to be more comprehensive, for example they merely state who the appointment is with and the date, but make no mention of what the appointment was for or any follow up action necessary. Records indicated that several service users have had no access to dental or eye care in the past year, and it is a repeat requirement that service users have access to health care as appropriate. On the day of inspection one service user was observed to be badly bruised on their chin. Staff informed the inspector that they thought the service user had had a fall, and there was an accident form completed. However, there was no risk assessment in place around this service user falling, and it is required that comprehensive risk assessments are in place for all service users, covering all areas of potential risk to themselves and others. The inspector had some serious concerns over the storage, recording and administration of medication in the home, and several separate requirements have been set around this. Ross Wyld Nursing Home Version 1.10 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 standard(s) 12,13,14 and 15 The inspector was satisfied that the home is able to provide suitable and sufficient social and leisure activities for service users, and that service users have appropriate access to visitors and the community. EVIDENCE: The home employs a full time activities coordinator, and details of the homes activities programme was on display within the home. This evidenced regular activities, including bingo, quizzes and singing sessions. Indeed, on the day of inspection several service users were observed to be involved in a singing group led by the activities coordinator. The home holds regular car boot sales in its grounds, these are run by service users, and the profits made go towards future activities. Families donate items for the sale, and other items are purchased from local charity shops. The inspector was informed that service users are able to access the community, and regularly attend live music concerts in a local park. Several service users attend church, while a priest visits the home once a fortnight to give communion. Relatives of service users spoken to informed the inspector that they were able to visit the home as they chose, and did not have to arrange a visit in advance. They informed the inspector that they were always made welcome, and found the staff to be very helpful. They were provided with written information about the home, and demonstrated a good understanding of whom they could Ross Wyld Nursing Home Version 1.10 Page 13 complain to if they so wished. Service users said they were able to see visitors in private. Service users provided variable comments on the food provided by the home; “it’s not as nice as you’d get at home, but I can’t grumble”, “it’s lovely” and “not all that exciting”. Menus showed that there was a variety of food on offer and a choice was presented for the main meal. The choices available on the day of inspection were nutritionally balanced and on the whole appeared appetising. It was however noted that vegetables were frozen rather than fresh and that only a very limited supply of fresh fruit was available in the home. It was observed that one service user whose meal required blending had been served all three components of the meal blended together. This is not appropriate. Assistance for eating was sensitively provided for those service users requiring it and service users were given choice as to where they took their meals. It was pleasing to observe that the service of lunch was unrushed and relaxed. Ross Wyld Nursing Home Version 1.10 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 standard(s) 16,17 and 18 The inspector believes that service users are being placed at risk by a lack of staff training and understanding of adult protection issues. This is further compounded by the homes policy which is not in line with current legislation. EVIDENCE: The home has a complaints procedure, this was on display within the home. It included appropriate timescales for responding to any complaints and contact details of the CSCI. The home also maintains a complaints log, this evidenced that complaints are recorded. However, the log did not record details of any investigations into the complaint, or outcomes of the investigation and any action taken, and this must be addressed. The home has a copy of the Local Authority adult protection procedures, and also its own policy on the protection of vulnerable adults. However, this policy is not in line with current legislation, for example, it suggests that the homes manager will be responsible for carrying out investigations into any suspicions of abuse, whereas the decision as to who will carry out such an investigation lies with the Local Authority. Further, many of the staff employed in the home have yet to receive any training on adult protection issues, and staff spoken to demonstrated only a limited understanding of their roles and responsibilities with regard to adult protection. The inspector was satisfied that service users have their legal rights protected. For instance, the manager informed the inspector that all service users are on the electoral register, and many voted in the recent general election. Ross Wyld Nursing Home Version 1.10 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 standard(s) 19,20,21,22,23,24,25 and 26 It is the view of the inspector that a considerable amount of work needs to be done to the homes physical environment. It is in need of redecorating, both internally and externally, and more must be done to ensure the homes cleanliness. 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. The inspector believes that a considerable amount of work needs to be done to the building in order for it to meet National Minimum Standards. At the previous inspection on 2/12/04 the manager had informed the inspector that the home was due to be redecorated in February of this year, yet this has not happened. Throughout the home there are instances of peeling and faded wallpaper and cracked paint, there were also instances of neglect of cleaning, exuding a general air of shabbiness, both internally and externally. Some progress with Ross Wyld Nursing Home Version 1.10 Page 16 the environment has been made, for example discarded furniture has been removed from the garden, and all chairs in the communal areas are now in a good state of repair, however, there is still a lot more that must be done. 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, these facilities were not well maintained, for instance there were cracked tiles, broken extractor fans and locks without an emergency override device, and all of this must be addressed. 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. Bedrooms were often unclean, for example discarded tissues and latex gloves were seen under one bed, and some rooms had an offensive odour. One of the double rooms only had one chest of draws, and there was no means of dividing the room for privacy. 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. Some easily resolved concerns around health and safety were noted; a fire door was wedged open, a nurse-call point showed a bared wire, a cushion on a service users chair had been replaced with a sharp zip protruding from the front rather than placed at the rear, and some light switches were cracked. It is felt that general awareness raising and vigilance to health and safety matters among all staff would ensure that service users are better protected from avoidable environmental hazards. Ross Wyld Nursing Home Version 1.10 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30 Although the inspectors were satisfied that staff were employed in sufficient numbers, it is their belief that service users would benefit if staff received appropriate training to help them carry out their roles and responsibilities. Further, recruitment practices need to be tightened up, for instance CRB’s must be sought. EVIDENCE: The home provides 24-hour support, including an emergency on-call procedure. Since the last inspection staffing levels have increased in the dementia unit, and on the day of inspection there appeared to be sufficient numbers of staff on duty throughout the home to meet service users needs. The home produces a staff rota, although this did not record the hours worked by the manager, and must be amended accordingly. As well as care and nursing staff, the home also employs domestic staff including cooks, cleaning staff and laundry staff. The home has policies in place on equal opportunities and recruitment and selection. The inspector checked several staff files at random. For the most recent person employed by the home there was no evidence that a satisfactory CRB check had been carried out on them, and it is required that CRB checks are carried out on all staff prior to them commencing work in the home. Further, the interview records for this member of staff indicated that they had been interviewed by the homes manager alone. This is contrary to the homes recruitment and selection policy which clearly states that all recruitment interviews must be carried out by at least two people, and it is a repeat Ross Wyld Nursing Home Version 1.10 Page 18 requirement that the home recruits staff in line with its own policy and good practice with regard to equal opportunities. Records are maintained of staff training, and these indicated that staff had recently had training in moving and handling, food hygiene and fire safety. At the last inspection it was identified that staff working in the dementia unit had not had any training in this field. Since then the manager has now had training in working with dementia, and is working towards becoming an accredited trainer for the home. As yet, however, not all staff have received appropriate training in dementia care, and the requirement that they do so is repeated. Of the thirty care staff employed at the home, the manager informed the inspector that eleven either have or are currently working towards a relevant NVQ qualification, and a further twelve staff are scheduled to start their NVQ later this year. Formal supervision of staff must be improved in terms of frequency and quality as evidence demonstrated deficiencies in these areas. The registered person must ensure that individual staff hours imposed by the Home Office – where students from overseas are employed - are complied with by the home. Ross Wyld Nursing Home Version 1.10 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31-38 It is the inspectors view that the effectiveness of the operation of the home would be greatly enhanced by better time management by the manager, improved systems of supervision for staff and heightened awareness of health and safety matters by all. Although some improvements were noted, service users have yet to benefit from advances made. EVIDENCE: The manager is a first level qualified nurse with in excess of twelve years clinical experience in the field of care of older people. She had undertaken recent training relevant to her post. The manager evidenced a comprehensive and detailed awareness of the individual needs of service users. This level of knowledge obtained from ‘hands-on’ experience was viewed positively as a valuable asset to the team. In addition to clinical activity the manager commented on having prepared meals in the home from time to time, as well as doing shopping for service Ross Wyld Nursing Home Version 1.10 Page 20 users. Whilst this shows great commitment to service users and does much to evidence a positive and open atmosphere, it is currently at the cost of attention to matters which are within the sole remit of the manager. These have been highlighted throughout this report. The financial viability of the service was discussed briefly with the Area Manager. The business was described as sound and capital investment into Ross Wyld was described as ‘now overdue’. This has also been the view of the Commission and implementation of now repeated requirements is therefore expected. Staff supervision was viewed as lacking. Records inspected showed that the supervision offered to staff was of a poor quality, with little attention being devoted to identification of training needs, ongoing practice issues, or development of key skills. Where staff had identified a training need, this had not been followed up. Much work is required in order to improve the quality of supervision in order to meet National Minimum Standards. Record keeping required for the protection of service users was satisfactorily maintained. Accident books viewed were accurate – though could be developed to provide greater detail of follow up action. Staff were able to describe how a service user would access maintained records relating to them, and records were held in sufficiently secure accommodation. In addition to the health and safety issues highlighted elsewhere in this report, it was noted that some staff showed little regard for routine health and safety practice. A member of staff pushing a service user in a wheelchair through a doorway neglected to pay attention to his protruding elbows and was only prevented from causing injury by the intervention of the inspector. Staff were unconcerned at the hazard posed by a wedged open fire door when this was pointed out. The home holds money on behalf of several service users in a pooled bank account. This account bears interest, yet this interest is not given to service users, despite the fact that some of them have several thousand pounds in the account. It is required that service users receive all interest generated by their savings that the home holds on their behalf. The home maintains records and receipts of financial transactions involving service users money, and those checked by the inspector appeared to be satisfactory. Since the last inspection monies held in the home itself on behalf of service users are now stored in individual wallets. Ross Wyld Nursing Home Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 2 2 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 1 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 2 2 2 3 2 3 2 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 3 1 3 3 3 3 2 2 3 2 Ross Wyld Nursing Home Version 1.10 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 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 31/3/05 not met) The registered person must ensure that all care plans demonstrate how each of the assessed needs of the service users are met. (timescale 31/3/05 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 31/3/05 not met) The registered person must ensure that all service users bedrooms are fitted with suitable locks, and service users provided Version 1.10 Timescale for action 31/8/05 2. OP7 14 31/8/05 3. OP21 12 31/8/05 4. OP10 12 31/8/05 Ross Wyld Nursing Home Page 23 5. OP18 18 6. OP19 23 7. OP29 19 8. OP8 13 9. OP19 23 10. OP9 13 11. OP9 13 with a key unless a completed risk assessment indicates otherwise. This must be recorded in the individual plan of care detailing the reasons why. (timescale 31/3/05 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 31/3/05 not met) The registered person must ensure that all parts of the care home are kept in a good state of repair and kept clean and reasonably decorated. (timescale 31/3/05 not met) The registered person must ensure that all staff files are maintained in accordance with Schedule 2 of the Care Homes Regulations 2001. (timescale 31/3/05 not met) The registered person must ensure that all service users have access to relevant health professionals as appropriate, and that records are kept of appointments, and any follow up action required. (timescale 31/3/05 not met) The registered person must ensure that all incidents of peeling wallpaper are redecorated. (timescale 31/3/05 not met) The registered person must ensure that only medications in current use are entered on MAR charts. (timescale 31/3/05 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 31/3/05 not met) Version 1.10 31/8/05 31/8/05 31/8/05 31/8/05 31/8/05 31/8/05 31/8/05 Ross Wyld Nursing Home Page 24 12. O18 13 13. OP29 18 14. OP30 18 15. OP4 14 16. OP8 13 17. OP9 13 18. OP16 22 19. OP21 23 20. OP24 16 The registered person must ensure that the homes adult protection procedures are in line with current legislation. (timescale 31/3/05 not met) The registered person must ensure that all staff recruited to the home are done so in line with the homes recruitment and selection policy. (timescale 31/3/05 not met) The registered person must ensure that all staff who work in the EMI unit receive appropriate training in working with people with dementia. (timescale 31/3/05 not met) The registered person must ensure that the home does not admit any service users from outside its category of registration. 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. The registered person must ensure that all medications administered are accounted for, and that there are no unexplained gaps left on MAR charts. The registered person must ensure that the homes complaints log records all complaints made, and details any investigastions taken, the outcomes and any action taken. The registered person must ensure that all bathrooms and toilets are kept in a good state of repair and cleanliness. The registered person must ensure that all bedrooms are kept clean, tidy and free from offensive odours. Version 1.10 31/8/05 31/8/05 31/8/05 31/8/05 31/8/05 31/8/05 31/8/05 31/8/05 31/8/05 Ross Wyld Nursing Home Page 25 21. OP24 16 22. OP27 17 23. OP29 19 24. OP35 20 25. OP2 5 26. OP3 14 27. OP15 16 28. OP36 18 The registered person must ensure that all bedrooms contain adequate furniture, and that this furniture is in a good state of repair. The registered person must ensure that the homes staffing rota clearly records the hours worked in the home by the manager. The registered person must ensure that satisfactory CRB checks are carried out on all staff prior to them commencing work in the home. The registered person must ensure that service users receive all interest paid out on monies held in accounts by the home on their behalf. The registered person must ensure that service users statement of terms and conditions contain all information required by National Minimum Standard 5 (timescale 31/03/05 not met). The registered person must ensure that comprehensive pre admission assessments are conducted and that all information is fully considered prior to the admission of a service user (timescale 31/03/05 not met). The registered person must ensure that all food (including blended meals) is presented in an appetising a manner in accordance with best practice. The Registered person must ensure that all staff receive formal supervision at least six times a year that a written record is maintained which details the nature of the discussion and topics discussed (timescale 31/03/05 not met) Version 1.10 31/8/05 31/8/05 31/8/05 31/8/05 31/08/05 31/08/05 31/06/05 31/08/05 Ross Wyld Nursing Home Page 26 29. OP38 13 The registered person must ensure that all staff are aware of their responsibilities towards the health and safety of service users, and take action in response to identified risks. 31/06/05 30. 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 OP11 Good Practice Recommendations It is recomended that the home seeks and records the views of service users, or their family where appropriate, on arrangements to be made in the event of their death. Ross Wyld Nursing Home Version 1.10 Page 27 Commission for Social Care Inspection Gredley House 1-11 Broadway 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 Version 1.10 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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