Inspection on 11/08/08 for Royston Nursing Home

This inspection was carried out on 11th August 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 but made no statutory requirements on the home.

Other inspections for this house

Royston Nursing Home 10/02/10

Royston Nursing Home 11/12/09

Royston Nursing Home 10/08/09

Royston Nursing Home 17/07/07

Royston Nursing Home 07/02/07

Royston Nursing Home 24/05/06

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/11/2008.

CARE HOMES FOR OLDER PEOPLE Royston Nursing Home Brighton Road Clayton Hassocks West Sussex BN6 9NH Lead Inspector Annie Taggart Unannounced Inspection 11th August 2008 09:30 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 Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Royston Nursing Home Address Brighton Road Clayton Hassocks West Sussex BN6 9NH 01273 845603 01273 842018 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) Care Reminiscence Limited Mr Rajkumarsingh Gunowa Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category - (OP) The maximum number of service users to be accommodated is seventeen (17) 17th July 2007 Date of last inspection Brief Description of the Service: Royston is a care home, which is registered to accommodate up to seventeen residents in the category (OP) old age, not falling within any other category. It provides personal and nursing care. Royston is located in the rural village of Hassocks and is a detached threestorey property, which provides accommodation in single, and double bedrooms located on the ground, first and second floors. There are also two lounges, which are located on the ground floor. A vertical passenger lift provides access to all floors. The registered provider of this service is Care Reminiscence Ltd, who has appointed Mr Ramprakash Beeharry as the responsible individual to supervise the management of the care home. The Registered Manager is Mr. Rajkumarsingh Gunowa Current fees are from £587.00 to £625.00 per week. Royston Nursing Home DS0000065926.V369305.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. In order to plan for this unannounced visit, an Annual Quality Assurance Assessment (AQAA) was sent to the manager for completion and satisfaction surveys were sent to service users and professionals involved with the home. The AQAA was returned following a reminder letter and gave us basic information about the home. Four service users, two professionals and three staff surveys were returned and positive comments about the home were recorded in the replies. The unannounced inspection was carried out at 9.30am on 11th August 2008 and lasted for 4.5 hours. During the visit we spent time talking to service users both in communal areas and in their private bedrooms and we spoke to the staff on duty and observed staff practice and interactions with service users. We tracked four care plans and all supporting documents such as daily records and health plans and we spoke to the staff on duty about how they were aware of the needs and wishes of the people they are supporting. We also saw the main meal of the day being prepared and served. We looked at four recruitment files, staff training files and evidence of supervision and we asked the staff about the training and support they receive. Records for the running of the business were seen and these included complaints and comments, incident and accident recording, fire records, health and safety records and the home’s insurance and registration certificate. The Registered Manager, Mr. Gunowa was on leave but he came into the home to assist with information for the inspection and received feedback following the visit. What the service does well: Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 6 People have their needs and wishes assessed and recorded and service users, families and other professionals tell us that the manager and staff team are kind and caring and that people are happy living in the home. Communal areas of the home are comfortable and homely and people have personalised heir bedrooms with their own belongings. Visitors are made welcome at any time and some activities are provided What has improved since the last inspection? What they could do better: Information about the services being provided should be reviewed and updated to reflect all of the room sizes in the home. In order to ensure that the home is meeting the needs of the people living there, improvements are needed to the process of care planning and recording daily notes, some improvements are needed to the quality of the activities on offer and the home must ensure that advice is sought from a nutritional expert regarding people’s dietary needs. To ensure that the people living in the home are protected from risk of abuse or harm all of the staff team must attend safeguarding training and the staff team must also attend all mandatory training and records must be kept in the home. Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 7 Further improvements are needed to record keeping to the quality of the environment and the home must be kept clean and hygienic at all times. 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. Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 8 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 Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 3 and 6 Quality outcomes for service users in this area are adequate. This judgement has been made using available evidence including a visit to this service. Pre-admission assessments are carried out to ensure that the home can meet people’s needs but information about the home still needs to be updated so people can be sure of the facilities on offer. EVIDENCE: There is a Statement of Purpose and Service User Guide in place to give prospective service users and their families information about the facilities available in the home. The registered manager, Mr. Gunowa told us that these documents are currently being reviewed and updated to reflect room sizes and changes made to the environment. In order to ensure that the home can meet people’s needs, pre-admission assessments are carried out with input from families and other professionals. We saw that assessments were in place for three people recently admitted to the home and there were also comprehensive NHS assessments where people had been admitted directly from hospital care. Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 10 In the AQAA we were told that contracts are in place detailing the room to be occupied and the fee to be paid but these were not available at the visit. Royston does not provide intermediate care. Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 and 10 Quality outcomes for service users in this area are adequate. This judgement has been made using available evidence including a visit to this service. Although there is a care planning and monitoring process in place, these need to be improved to ensure that the staff team have clear and detailed information about services users needs and wishes. EVIDENCE: For each person living in the home there is a plan of care in place that has been completed using information from the assessment process. We looked at the care plans for four service users and saw that areas such as personal care, nursing care, nutritional needs and pressure area care had been recorded and there were dates recorded for regular reviews. There were also moving and handling assessments and risk assessment regarding falls and mobility needs. Although the care plans contained information about people’s nursing and care needs there were improvements needed so that staff have clearer instructions as to how people’s needs are to be met. Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 12 Examples of this are that several people are being nursed on pressure relieving mattresses but the care plans do not detail assessments to say what the pressure beds should be set at. In one care plan it says, “ needs hoisting, make sure the correct sling is used”, but then does not say which type slings this should be. For some people the care plans identify that the person, “ has a need for stimulation” but does not go on to say how this is being provided. Daily records are in place but are basic saying for e.g. “all care given”, “eating and drinking well” or “ all nursing care given”, without detailing what this means in practice. Since the last inspection several more nursing beds have been purchased and the manager told us that all bedrooms rooms except one that is currently not in use, now have nursing beds . For one person who was being cared for in bed, turning and fluid charts were being kept and were up to date. There are polices and procedures in place regarding the administration of medication and we were told that only trained nurses administer the medication in the home. We saw that generally medication was being well managed but all of the Medication Recording Sheets (MAR) had been handwritten. The manager explained that this was an exceptional circumstance as the MAR sheets had not come from the pharmacy with the medication and he had telephoned the pharmacy to ask for them to be sent. We checked with the Commission’s pharmacist inspector regarding hand written MAR sheets and were told that although this is permissible, as good practice, there should be the signature of the person writing the sheets and another checking to ensure that errors are not made when they are copied. As the old MAR charts were not on file we could not check to see of they matched. Feedback from professionals in surveys showed that they were satisfied with the standard of care being provided in the home. Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 and 15 Quality outcomes for service users in this area are poor. This judgement has been made using available evidence including a visit to this service. Activities need to be improved to provide interest and stimulation for people and there is no evidence to show that all service users dietary and nutritional need are being met. EVIDENCE: We saw that there is a programme of activities in the home but these are very basic and include such areas as hairdressing, chiropody and nail care as activities. There is also a music person who visits and a person who carries out gentle exercise with people. When people join in the activities this is recorded and for some people we saw that no activities were recorded at all. We asked the manager how these people and especially people being cared for in bed were provided with interest and stimulation and were told that staff spent time with them on a one to one basis. Records did not show any evidence of this and there was also no recorded evidence that outings into the community are provided. In returned surveys, families told us that they are made welcome in the home at any time and service users told us that they enjoyed having visitors. Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 14 On the day of the visit we were told that the chef had not arrived and that another person would be in later to do the cooking. There are menus in place that the manager told us had been devised with service users and these showed that a variety of home cooked meals are provided. When lunch, which is the main meal of the day was served we saw that it was not the meal recorded on the menu and the same meal was given to everyone. This was frozen, shop bought cottage pie, oven chips and frozen mixed vegetables with a small bowl of chopped lettuce on the side, which we were told was a “side salad”. The manager told us that the staff member had gone around to people and asked them if this was the meal they wanted but we saw no evidence of this. During an observation made over the lunchtime we saw that a number of people needed support with eating their meals. Apart from people eating in their rooms all meals were served in the lounge areas with the television on and very loud. One staff member assisting a person hardly spoke to them all during the meal. We saw that another person had their meal put in front of them, they were asleep and the meal went cold and another person ate none of their meal. We asked the staff on duty about this and were told that this person “only likes porridge or soup”, when asked why these had not been offered the staff member said they would ensure some soup was made. We looked at this person’s records and saw that they had nutritional difficulties and had lost weight. A person who was served their meal in their bedroom, called the inspector in and said, “ Some people do not have any sense at all, I have been left here with this meal on my chest, flat on my back and can’t eat it. I keep telling them this bed is not right for me, I need to be sitting up to eat a meal but only the head goes up on this bed, I have nothing against the meal but how am I supposed to eat it”. The person had pushed the untouched meal to one side and was quite upset. We saw that records are kept of food taken by people each day but all that is recorded is the meal and tick boxes to say that all the meal has been eaten every day. No alternatives could be identified from these records and they did not address the amounts of food that people are actually consuming. This was brought to the attention of the manager who spoke to the staff member responsible and a Requirement has been made for the home to contact a nutritional expert in order to assess people’s nutritional needs and give advice on suitable, healthy diets. Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality outcomes for service users in this area are adequate. This judgement has been made using available evidence including a visit to this service. The recording and staff training in the home does not provide evidence to show that the staff team have the training and skills to ensure that the people in their care are protected from all forms of harm or abuse. EVIDENCE: There is a complaints procedure in place and a copy of this is posted in the home. We looked at the complaints books and saw that complaints and concerns are recorded and investigated by the manager and outcomes are fed back to the complainant. However the method for recording complaints is at present in a small notebook, that is not numbered and difficult to track and Mr Gunowa said that he would improve the system. There has been one safeguarding referral that has been investigated by West Sussex Safeguarding Team and this identified that a number of improvements were needed to the environment and to the care being provided in the home. From looking at training records we saw that some of the staff team have attended safeguarding training but this could not be confirmed for all of the staff team. One staff member, who was new, told us that she has received some safeguarding information from the manager and would report any suspected abuse. A Requirement has been made for safeguarding training for all staff to be provided as this could also not be evidenced at the last inspection visit. Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 16 Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 22 and 26 Quality outcomes for service users in this area are adequate. This judgement has been made using available evidence including a visit to this service. In order to ensure that the home is providing a clean, safe and comfortable home for people, improvements are needed to the standards of furnishing, decoration and cleanliness of the environment. EVIDENCE: The accommodation in the home is over three floors with two lounges on the ground floor and a garden to the rear. There is no dining room in the home and meals are usually eaten in the lounges. In the AQAA we were told that a number of improvements had been made to the environment and this has included the purchase of more nursing beds, some new furniture and redecoration in some areas. Although we saw that some improvements have been made, the overall impression of the home is still that it looks shabby and in need of updating and some refurbishment. Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 18 The lounges are quite comfortable and homely but furniture is old and some is in poor repair. Bedrooms have been personalised by the people living there but many are still in need of updating and redecoration and much of the furniture is old and needs replacing. Some bedrooms on the upper floor are very small and are not suitable for the use of nursing equipment such as hoists. New carpets have been fitted to some communal areas but carpets in many of the bedrooms and on the stairways are old and stained and in need of deep cleaning or replacing. There was a cleaner working in the home but as they were quite new they had not attended infection control or health and safety training and we saw that the standard of cleanliness throughout the home needs to be improved. Examples of this were stained sinks with taps that were not working properly and in one bedroom that we were told was not in use, there were old stained bed bases and mattresses being stored. Bedding is very thin and old looking and in the laundry we saw pillows that had been washed and were waiting to go back on beds but were stained. These areas of concern were brought to the attention of the manager Mr. Gunowa, who said that there was an ongoing programme of updating the home underway and these issues of concerns would be addressed. Recently a large conservatory has been added to the home at the rear of the building and is described in the AQAA as a “multi function” room that could also be used as a dining area. When looking at this room we saw that there is no entrance to it from the house and the manager explained to us that people had to be brought out of the house via a ramp and across the garden to access the conservatory. We asked the manager if this was suitable for the use of frail, elderly people in colder or wet conditions and the manager agreed that it would not be suitable in these conditions. There was no furniture in the conservatory building apart from a worn dining table and four straight-backed chairs. Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 and 30 Quality outcomes for service users in this area are adequate. This judgement has been made using available evidence including a visit to this service. To ensure that the staff team have the skills and knowledge they need to support the people in their care, mandatory training and regular supervision must be provided and training records should be kept up to date and in good order. EVIDENCE: There was one RGN, two carers, a cleaner and a cook on duty during the day and the registered manager told us that this was meeting the needs of the twelve people currently living in the home. Service users who could communicate with us verbally told us that the staff team were kind and caring and that they felt well looked after. All of the care staff on duty were from differing cultural backgrounds and had English as a second language and although we saw that they were kind and patient in their dealings with people, there was very little verbal communication with service users and as detailed in other parts of this report, all staff did not always display an awareness of people’s needs. Mr Gunowa told us that there had been a high turnover in staff and that he was finding it very difficult to recruit staff in the local area, especially trained nurses and a relief part time chef. Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 20 We looked at the recruitment files for four members of staff and saw that for all of these people there was an application form, a current Criminal Bureau Check (CRB) and references in place. In the AQAA, we were told that new staff members now have both an in house induction and an induction in line with Skills for Care and that 48 of the staff team have or are working towards an NVQ qualification. As the records were so dispersed and difficult to track we could not confirm this but saw that some records were in place. Training records were also very difficult both to locate and to track and although we saw training records for some people we could not find evidence that they had all attended mandatory training such as first aid, infection control, safeguarding adults and moving and handling. Mr Gunowa told us that some staff had recently attended dementia awareness training but as no certificates could be found we could not evidence this. There were some records of supervision and personal development meetings between the manager and staff and these showed that care practice issues are discussed but these were not all up to date and they were again difficult to locate and to track. The manager said he was aware that improvements were needed and he said that he was in the process of re-organising record keeping in the home. Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 37 and 38 Quality outcomes for service users in this area are adequate. This judgement has been made using available evidence including a visit to this service. Improvements are needed to the quality of the service being provided to ensure that the home is being run in the best interests of service users. EVIDENCE: The manager is a registered nurse and has previous experience of managing a care home. Since the last visit, the manager has completed the Registered Manager’s Award and has been registered by the Commission. Mr Gunowa told us that he operates an “open door” policy of management and the staff on duty told us that he was accessible and knowledgeable. A quality assurance process has been carried out by surveys being sent to families, local doctors and other professionals involved with the home and we Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 22 saw that the outcomes from these were positive and the provider and manager had completed a report outlining the improvement that would be made to the service being provided as a result of the surveys. Regulation 26, Registered Providers visits are carried out and recorded monthly. Where the home holds monies on behalf of service users we saw that records are in place and the manager told us that receipts are sent to families or legal representatives. We looked at the records for two people and they were correct. We saw records for the running of the business including incidents, accidents and the fire records and this showed us that incidents and accidents are recorded and are monitored by the manager. Although there are records in place, these were kept in an unorganised manner in different parts of the home and were difficult to locate and track. Fire records were up to date and fire training is provided for the staff team every three months. As identified in other part of this report, improvements are needs to the care planning process, to meeting service users identified needs, to nutritional needs, staff training and development and the cleanliness and quality of the environment. Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 23 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X 3 X X X 2 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X 3 2 2 Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 25 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 OP1 Regulation 4 (1) (c) Schedule 1 (16) 15.(1) and (2) Requirement The statement of purpose must state the number and sizes of rooms in the care home. Outstanding from last visit Care plans, risk assessment and daily records must be improved to give clear information to the staff team regarding the individual care needs of each person and to monitor the care being provided. The registered manager must ensure that advice is sought from a nutritional expert to assess and advise on service user’s dietary needs. To ensure that service users are protected from risk of all forms of abuse and harm, the staff team must attend safeguarding training and records must be kept in good order. The premises to be kept in a good state of repair externally and internally and should be kept clean and hygienic. The registered manager must ensure that all staff attends mandatory training and records must be kept in good order to monitor courses attended. DS0000065926.V369305.R01.S.doc Timescale for action 20/09/08 2. OP31 20/09/08 3. OP15 16. (2) (i) 20/09/08 4. OP18 13. (6) 20/09/08 5. OP19 23. (2)(b) 20/09/08 6. OP30 18. (1) ( c) 20/09/08 Royston Nursing Home Version 5.2 Page 26 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 Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Royston Nursing Home DS0000065926.V369305.R01.S.doc Version 5.2 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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