Inspection on 04/09/08 for Rufford Care Centre

This inspection was carried out on 4th September 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Rufford Care Centre 04/03/09

Rufford Care Centre 17/06/07

Rufford Care Centre 19/07/06

Rufford Care Centre 28/02/06

Rufford Care Centre 22/06/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 13/11/2008.

CARE HOMES FOR OLDER PEOPLE Rufford Care Centre Gateford Road Gateford Worksop Nottinghamshire S81 7BH Lead Inspector Stephen Benson Unannounced Inspection 4th & 8th September 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 Rufford Care Centre DS0000063345.V371747.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. Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rufford Care Centre Address Gateford Road Gateford Worksop Nottinghamshire S81 7BH 01909 530233 01909 533044 rufford@carecentre.wanadoo.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) Mimosa Healthcare Holdings Ltd Manager post vacant Care Home 100 Category(ies) of Dementia - over 65 years of age (35), Old age, registration, with number not falling within any other category (50), of places Physical disability (25) Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. 8. Welbeck unit may accommodate service users within categories Old Age not falling within any other category (OP) 25 beds Dementia over 65 years (DE/E) 25 beds Clumber unit may accommodate service users within category Physical Disability 18-65 years (PD) 25 beds Hardwick unit may accommodate service users within categories Old age not falling within any other category (OP) 25 beds Dementia over 65 years of age (DE/E) 10 beds Service users shall be within categories DE/E (35), OP (50) or PD (25) The registered manager must be a 1st level nurse and full time, with full time supernumery hours Unit managers are to have at least 2 days supernumery hours of work. Up to 4 beds for OP may be used for Terminally ill and up to 8 beds may be used for persons with dementia over 45 years of age. Thoresby Unit may accommodate residents within categories Old age not falling within any other category OP (25) beds 17th June 2007 Date of last inspection Brief Description of the Service: Rufford Care Centre is a purpose built care home first registered in August 2003. Rufford Care Centre is owned and managed by Mimmosa Healthcare who purchased the home in April 2008. The home is situated on the Worksop bypass along Gateford Hill approximately one mile from the centre of Gateford. Rufford Care Centre is registered to accommodate up to one hundred service users, all in single occupancy rooms with ensuite facilities. The home is divided into four units that offer a specific specialist care service. Clumber Unit provides accommodation for up to twenty-five younger adults between the ages of eighteen and sixty-five. Hardwick Unit accommodates up to twenty-five service users over the age of sixty-five who require twenty-four hour nursing care and who have Dementia. Thoresby Unit has a total of twenty five places for residential placements and the Welbeck Unit supports people suffering from varying degrees of Dementia, Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 5 The Care Centre has been designed so that each unit can run independently with their own communal settings. The catering and laundry services are based within the basement of the centre and they provide a service across the four units. The area manager confirmed the homes current weekly fees range from £394 to £1,600. Hairdressing and chiropody fees are not included. Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for people accommodated and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This was our first visit to the home since 1st April 2008. This inspection involved one inspector; it was unannounced and took place over 2 days in the daytime, including lunchtime. Prior to the visit an analysis of the home was undertaken from information gathered over the last year including that from the Annual Quality Assurance Assessment they completed. We sent survey forms entitled ‘Have your say about…’ to a sample of people and 8 of these were returned. The main method of inspection used is called ‘case tracking’ which involves looking at the quality of the care received by a number of people living at the home. We also use evidence from our observations; we speak with them about their experience of living at the home; we look at records and talk with staff about their understanding of the people’s needs who they support. The premises were not inspected in detail but various areas of the home were visited as part of the inspection. Due to safeguarding matters that arose during the visit it was not possible to assess each of the units for all of the key National Minimum Standards. What the service does well: The needs of any new people coming to the home are established through an assessment. Staff treat people with respect and understand about their right to privacy. There are staff designated to provide activities on each of the units and visitors are welcome to visit at anytime. Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 7 The majority of the building is in a good state of décor and everywhere is kept clean and tidy. There are good systems and records kept of all the health and safety tests and checks carried out at the required frequencies. What has improved since the last inspection? What they could do better: People returning for respite care must have an updated assessment to see if their have been any changes to their needs. All care plans must give clear details of how the person wants their care to be provided so people can have the care delivered in the way that they wish A risk assessment must be completed where anyone is identified as being at risk from themselves or others. When medication is administered to people living in the home it must be clearly recorded in the Medicine Administration Records. This will ensure that people receive the correct levels of medication. Staff must not leave medication with people to take later. This will ensure that people living in the home take the medication they are meant to. The dietary needs and preferences of all people living in the home must be taken into consideration when planning the menu. A record must be made of any complaints, which include any investigation and outcome of the complaint. This will ensure that any complaint made is fully investigated. The relevant procedures must be followed in the event of all allegations of abuse and staff must be aware of their responsibilities to alert abuse in accordance with these procedures. The décor and fabric of Clumber unit need to be bought to the standard of the rest of the home. There must be sufficient staff on duty on each unit at all times. This will ensure that staff are available to meet residents’ needs. Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 8 The correct recruitment process must be followed at all times, including obtaining a Criminal Records Bureau check and 2 written references. This will ensure that people living in the home are protected by the home’s recruitment process. Staff must be provided with the training they need to be able to do their work. This will ensure that people living in the home are cared for by suitably trained staff. People living in the home must have opportunities to express their views on how the home is run. This will ensure that people living in the home can have a say in the running of the home. All financial transactions made on behalf of people living in the home must be kept up to date, signed for and witnessed. This will ensure that people’s financial interests are safeguarded. 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. Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 9 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 Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 10 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): 3 and 6 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Anyone new moving into the home is assessed so their needs are known, however any changes to the needs of people who use the respite service are not picked up before they come to stay. EVIDENCE: Information provided on The Annual Quality Assurance Assessment (AQAA) states, ‘Prospective residents are encouraged to visit the home at any time and some have decided to stay over sometimes over a weekend to trial the home.’ A sample of six care files for people admitted to the home recently were seen. All of these contained pre admission assessments, either completed by staff from the home of a social worker. Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 11 Staff on all units said that someone normally goes out to assess anyone new wanting to come to the home where there is time to do so. There were some files that showed the person had been assessed the same day as they had been admitted. Staff explained that this had been because the person had been admitted in an emergency. On Clumber unit (for younger adults between 18 and 65) some people come in for respite breaks and there are assessments and care plans kept from their previous stay, however there is not a system for checking any changes or updates since their last stay. In our ‘Have your say about’ surveys we asked if people received enough information before they moved into the home and all 8 people said that they did. One person recently admitted onto the residential unit said that she had been visited in hospital by a member of staff from the home. There is no arrangement made for the home to provide an intermediate care service. Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 12 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 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service People’s personal and healthcare needs are not always clearly identified and are placed at risk by the lack of risk assessments and not following safe practices in the administration of medicines. People are treated with respect and their right to privacy is upheld. EVIDENCE: Information provided on The Annual Quality Assurance Assessment (AQAA) states ‘Care plans are written and shared to support and safeguard residents with privacy, dignity and gender in mind. Care plans have a specific format to include risk assessments e.g. moving and handling, nutrition, mental health, medication.’ Each of the units are changing over care plans to those used by the new provider. On each unit some have been changed and others are waiting to be Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 13 done. It was noted that entries made in care plans were of varying standard. Some were clear and specific, for example stating that ’a hoist must be used with two carers’, others too general, for example ‘needs assistance with all continence needs’. The care planning system allows for plans to be updated as changes occur. Some of the care plans seen showed that they are updated to take into account changes. There were standard risk assessments seen in care files for personal care tasks, for example pain relief, moving and handling and pressure area care. However there were not risk assessment s for individual concerns, for example one unit manager referred to problems caused by one person’s sexualised behaviour which had not been risk assessed. Staff were seen on each unit approaching people in an individualised manner, which seemed to be how the person wanted them to. In our ‘Have your say about’ surveys we asked people if they receive the care and support they need. Four people said they always did and one said they usually did. One person said. “I can do some things for myself, I need help to stand at the moment” and another said, “I would like to have some help to get dressed, they have not told me why I cannot”. There is a section in care files to record all healthcare appointments. These showed that people have accessed a variety of healthcare services, including routine health checks, the falls team and district nurses. In our ‘Have your say about’ surveys we asked people if they receive the medical support you need and five said they did. One person said, “I have my health looked after” and another said, “They are encouraging me to walk as I am getting stronger”. The Medicine Administration Records were seen on each unit and they were mainly well completed, although there were a few gaps seen. Controlled drugs books seen were fully completed. Some drug administration was observed and correct procedures were being followed, however one case tracked person was seen with some tablets left in her room despite an assessment stating she was not capable of self administration. One person said, “I am sick of taking tablets, they are always bringing them to me!” Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 14 Staff were seen knocking on doors before entering and bedroom doors were shut when attending to any personal care. There were references seen in care files to maintaining privacy and dignity. Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 15 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 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with opportunities to meet their recreational and social. People are helped to exercise choice and control over their lives. There is not sufficient consideration given to people’s diverse dietary needs and wishes. EVIDENCE: Information provided on The Annual Quality Assurance Assessment (AQAA) states ‘Residents are stimulated by either being encouraged to take part in the daily activities programme or getting involved in the lively surroundings of the home.’ There is an activities coordinator employed on each unit, although for various reasons only one was working in this role during the visit. One activities coordinator is working as the hairdresser (having previously worked as one) as the home is currently without one. The area manager said it was hoped to return to a coordinator on each unit shortly. Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 16 Whilst visiting each unit there were various activities taking place, although no organised group activity. People were seen watching television, reading, colouring, knitting, playing dominoes and making birthday cards. One unit had coloured hats on people’s bedrooms they had made in craft sessions. People spoke of group activities taking place, including bingo, competitions and quizzes. In our ‘Have your say about’ surveys we asked if people there are activities arranged by the home they can take part in. Three people said there always are, one said usually are and another said there sometimes are. There were a number of visitors seen in the home, some in communal areas others in people’s rooms, and people spoke of having regular visits. One person said, “I have an electric scooter I get out and about on”. People were seen making choices of where they were and what they did. Staff were seen seeking people’s views and wishes. There is one central kitchen, which provides the meals for each unit and this is delivered in a heated trolley to a handling kitchen. There is a four week menu in operation and people are asked to select from a choice of two dishes the previous day. Whilst this is a varied menu it is the same for each of the four units which provide services to people with differing needs, likes and dislikes. A complaint has been received on the unit for younger adults about the catering arrangements, saying they are not suitable. Breakfast was seen served on one day and people had the choice of a cooked breakfast. Lunch was also seen served on one unit and people commented they enjoyed the meal. There was a choice of three types of juice and one person had a cup of tea. In our ‘Have your say about’ surveys we asked if people liked the meals at the home. Four people said they always did and one said they sometimes did. Various comments were made by people about the food, including, “I like the food I have plenty to eat”, “You cannot have rice with chilli or curry”. Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 17 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 People who use the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are some complaints raised that are not being dealt with as they are not recorded in the centralised complaints system. People are not being protected from abuse. EVIDENCE: Information provided on The Annual Quality Assurance Assessment (AQAA) states, ‘Protection of residents are of paramount importance and any complaints are immediately and effectively dealt with through the company’s complaints procedure.’ There is a centralised complaints book for all the units in the manager’s office. Staff who were asked about this were not aware of it. There was one complaint recorded sine the last inspection and the area manager showed two further complaints he was currently looking into. These concerned a reduction in the amount of time the hairdresser is available and the length of time someone had to wait for their buzzer to be responded to. Staff spoke of resolving complaints on the unit and did not make a record of these. One person spoke of some new underwear having gone missing and a Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 18 relative had told staff about this but nothing had been said since. There was no record of this complaint made and the unit manager was unaware of it. Later in the day the unit manager said that he had found some of the missing underwear. One unit manager decided to implement a complaints book on the unit and the area manager said he was going to introduce a complaints book on each unit. In our ‘Have your say about’ surveys we asked people if they knew how to make a complaint. Six people said they did and one said that they did not. One person spoke of having complained about drinks being served in dirty glasses and another spoke of one of the complaints being dealt with by the area manager. There were notices displayed around the home giving a telephone number anyone could use if they had any suspicion of abuse occurring. One unit manager said she had made a safeguarding adults referral following some alleged inappropriate sexual behaviour. There were further details of inappropriate sexual and physical behaviour and theft seen in daily notes, which had not been reported as safeguarding adults referrals. In addition they were not known to us and should have been reported under Regulation 37 Care Homes Regulations 2002. It was believed by some staff that these notifications had been sent to our Newcastle office rather than the one in Cambridge as required. The area manager said that there are currently some staff suspended whilst disciplinary investigations are being carried out in to alleged poor practices which have failed to fully protect people in the home. Information provided on The Annual Quality Assurance Assessment (AQAA) states in the section ‘What we do well’, Offer an individual personal allowance – safekeeping of money and valuables.’ However upon examination the system for managing people’s personal allowances was not being properly maintained and it could not be demonstrated that people’s money is being looked after safely. This was bought to the attention of the area manager and flowing advice from the Local Authority arranged for a full audit of finances to be carried out. Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 19 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 and 26 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst some people live in a safe, well-maintained environment, which is clean, pleasant and hygienic, some areas are in need of decoration and refurbishment. EVIDENCE: Since taking over ownership of the home the new providers have started refurbishing some areas through decoration and furnishings and carpets. Clumber Unit was not kept to the same standards as other units, and the area manager said work will begin shortly to improve the condition of this unit. Some people who use wheelchairs said they like being able to get around the building easily. Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 20 There were cleaners seen working on each unit and areas seen appeared to be clean and tidy. There is one central laundry and it was expressed by care and laundry staff that there are frequent problems with clothes not being returned to the unit. The most common problem for this was said to be items not being properly named. There was a considerable amount of clothing seen in the laundry that staff did not know who it belonged to. Laundry staff also said there was a shortage of some bedding and towels, which was passed onto the area manager who said he would arrange for some to be purchased. In our ‘Have your say about’ surveys we asked if people they thought the home was fresh and clean. Six people said it always is and two people said it usually is. People living in the home and some visitors commented that they thought the home was kept clean and tidy. Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 21 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 People who use the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are not being fully protected or having their needs properly met due to recruitment practices, staffing levels not being varied and staff not having all the training they require. EVIDENCE: The area manager said there was a need to recruit more care staff as there was a high usage of agency staff. Breakfast was not served to part of Hardwick unit until 10:00 am. Staff said that was because people on that part of the unit require a high level of personal care in the mornings which takes two staff and that is all there is allocated to that area so they are regularly serving breakfast at that time. One person said, “All the staff are very nice, if I press my button they come to see what I want”. It was stated by several staff that since the change of ownership there has been more training provided. The area manager said there was a backlog of required training when they took over the home as recent training had not Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 22 been provided and they were working to provide everyone with the training they require. Information provided on The Annual Quality Assurance Assessment (AQAA) states. All staff are in receipt of CRB/POVA plus two references.’ A sample of 6 staff files were looked at, all of whom had been appointed since the new provider took over the home. None of which had the two required references and two did not contain Criminal Records Bureau checks, although one of the staff concerned was on duty and had her copy, which had been sent to her home address. An immediate requirement notice was issued about staff having been properly vetted before they start work in the home. . Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 23 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 and 38 People who use the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are not being safeguarded by the management of the home, which does not allow for people to express their views on the running of the home. People’s health and safety is promoted EVIDENCE: The area manager said the registered manager left the home about three weeks ago, but did not know if we had been notified of this. A new manager has been identified who has the Registered Manager’s Award. The person has spent some time in the home already and is due to start full time when she returns from leave. Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 24 The area manager said the provider has a quality assurance system but this has not yet been introduced into the home. The provider returned the Annual Quality Assurance Assessment, which had not recognised the concerns highlighted in this report. The area manager said that there have been a number of actions taken by senior managers since taking over the home in order to improve people’s care. The arrangements for looking after people’s money were looked at and records were poorly maintained. Records were several months out of date, receipts were seen showing money received which had not been entered onto people’s finance record sheet and the majority of entries were only signed by one person. A letter expressing serious concerns about the management of people’s money has been sent to the provider. Whilst looking at these concerns a number of further issues came to light concerning the administration practices in the home and out patients appointments, unopened Birthday cards, cheques for fees, remittance advice from councils, Criminal Records Bureau checks that were never sent, reference requests and magazines were found in black bin bags. The handyman showed the records he keeps of health and safety tests and checks carried out in the home. These were well ordered and up to date showing that the required checks and tests are carried out. Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 1 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 1 X 1 X X 3 Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No 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 OP3 Regulation 14(1)(a) Requirement People returning for respite care must have an updated assessment to see if their have been any changes to their needs All care plans must give clear details of how the person wants their care to be provided so people can have the care delivered in the way that they wish A risk assessment must be completed where anyone is identified as being at risk from themselves or others When medication is administered to people living in the home it must be clearly recorded in the Medicine Administration Records. This will ensure that people receive the correct levels of medication Staff must not leave medication with people to take later. This will ensure that people living in the home take the medication they are meant to Timescale for action 01/10/08 2. OP7 15(1) 01/12/08 3 OP7 12(1)(a) 01/10/08 4 OP9 13(2) 01/10/08 5 OP9 13(2) 15/09/08 Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 27 6 OP15 16 (2)(i) 7 OP16 17 (2) 8 OP18 13(6) 9 10 OP19 OP26 23(2)(d) 16(2)(e) 11 OP27 18 (1)(a) 12 OP29 19 (1)(a) 13 OP30 18(1)(c) (i) 14 OP33 24 (1)(a) The dietary needs and preferences of all people living in the home must be taken into consideration when planning the menu A record must be made of any complaints, which include any investigation and outcome of the complaint. This will ensure that any complaint made is fully investigated The relevant procedures must be followed in the event of all allegations of abuse and staff must be aware of their responsibilities to alert abuse in accordance with these procedures. The décor and fabric of Clumber unit need to be bought to the standard of the rest of the home The current laundry arrangements must be improved so people’s clothes are properly looked after There must be sufficient staff on duty on each unit at all times. This will ensure that staff are available to meet people’s needs The registered person shall not employ a person to work at the care home unless he has obtained in respect of that person the information and documents specified in schedule 2. Staff must be provided with the training they need to be able to do their work. This will ensure that people living in the home are cared for by suitably trained staff. People living in the home must have opportunities to express their views on how the home is run. This will ensure that people living in the home can have a say in the running of the home. DS0000063345.V371747.R01.S.doc 01/12/08 01/10/08 15/09/09 01/04/09 01/11/08 15/09/08 09/09/08 01/02/09 01/01/09 Rufford Care Centre Version 5.2 Page 28 15 OP35 17 Schedule 4 (9) All financial transactions made on behalf of people living in the home must be kept up to date, signed for and witnessed. This will ensure that people’s financial interests are safeguarded 01/10/08 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 Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Rufford Care Centre DS0000063345.V371747.R01.S.doc Version 5.2 Page 30 - 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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