Inspection on 01/02/06 for Rufford Court Care Home

This inspection was carried out on 1st February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rufford Court Care Home 15/01/07

Rufford Court Care Home 21/06/05

Rufford Court Care Home 14/03/05

Rufford Court Care Home 18/01/05

Rufford Court Care Home 08/03/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Rufford Court Care Home 3-5 The Cliff Cinderhill Nottingham NG6 8SA Lead Inspector Jayne Hilton 1 st Unannounced Inspection February 2006 09:45 Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 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 Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rufford Court Care Home Address 3-5 The Cliff Cinderhill Nottingham NG6 8SA 0115 9753100 0115 9764623 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) Active Care Partnerships Limited Miss Jacqueline Elizabeth Johnson Care Home 20 Category(ies) of Learning disability (20) registration, with number of places Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st June 2005 Brief Description of the Service: Rufford Court is a care home, also providing nursing care, to adults who have a learning disability and additional complex needs such as autism, sensory impairment, physical disabilities or behaviour that challenges services. It is registered to accommodate 20 people. The home is situated in the Bulwell area of Nottingham and is within easy access to various local amenities as well as bus routes into the city centre. The home is split into three distinct areas – a ground floor “unit” for eight service users, another split-level, self-contained unit for four, and the first floor for a further eight people. The home has adequate communal space as well as a fully equipped music room and snoozelan room. There is a large attractive main garden as well as a sensory garden. The home has its own car and wheelchair accessible mini-bus. The manager is committed to maintaining a high standard of service to a group of service users who might not be easily provided for elsewhere. The standards and principles of the service have been effectively communicated to the staff team, who are knowledgeable about the service user group as a whole and sensitive to the needs of individuals. Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and conducted by Jayne Hilton on 1/02/06, lasting three hours. A majority of residents were unable to verbally take part in the inspection process, however they all appeared to the inspector to be well supported and cared for. The main focus of the inspection was to assess the remaining key standards not assessed at the previous visit. Staff were observed interacting with residents. A tour of the building was conducted, selective information was assessed from two service users personal files, Four staff personal files, accident records, training records, food, safety record, The Statement of Purpose and service user guide, menu etc. Staff practices were observed also. Several staff were spoken with throughout the inspection. What the service does well: What has improved since the last inspection? Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 6 The outcomes for service users, remains positive. New furniture has been purchased and the activity/snoozlan/relaxation room completed, providing an excellent resource. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 Prospective Service users/representatives have the information they need to make an informed choice about where to live and have their aspirations and needs assessed. EVIDENCE: A Statement of Purpose and Service User Guide is available which meets the Regulations and Standards. Two service users files were examined and contained well- documented individual assessment of needs and goals. Comprehensive risk management plans are evident and any restrictions are recorded in the residents care plan and environmental risk assessments. Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, The care planning and risk assessment framework are well organised. Staff at Rufford Court are well informed and aware of individual service users needs and plans, which promote and assist service users with choice and decisionmaking. EVIDENCE: The inspector examined selective information from two care plans. The plans are based on the activities of daily living, include all appropriate risk assessments and demonstrate that reviews were undertaken as needs changed and every six months. Each plan was easily referenced and describes how staff support the resident with daily living. Service users are unable to be involved in the development of the care plans due to their complex needs. Annually, relatives of the residents are invited to a complete care plan review, undertaken by the manager and professionals involved in the care of the individual. There is evidence that service users are weighed monthly and have their nutritional needs assessed. Each resident has a named key worker allocated to manage his or her individual care plans. Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 10 Care plans evidence the preferences and individual needs of service users wherever possible to endeavour to encourage basic choices. An example of this being service users offered choice of clothing with support for seasonal weather etc. Advocacy services are used when needed and the manager and organisation are working with Care Aware, which is an older person advocacy agency to engage in work and tailor services for with people with specialist services such as people with a learning disability. Two service users have independent advocates. Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,15,16,17 The home provides a range of daily internal and external activities, the homes management and staff are clearly committed to providing a stimulating environment. Service users are supported to have appropriate personal family relationships. Service users rights are clearly recognised and overall enjoy a healthy and nutritional diet. EVIDENCE: Most of the service users are unable to hold jobs or participate in formal education or training. However, the home employs an activities co-ordinator who is responsible for organising and undertaking a broad range of activities with service users both within and outside the home. Evidence of participation is documented. Service users are provided with opportunities to maintain and develop social, emotional, communication and independent living skills, mainly through interaction with staff and their families and through the broad range of activities they can take part in. Some service users attend a day centre outside the home. Some service users periodically attend church. The response of individual service users to particular activities is recorded on activity sheets so that this can be monitored. Activities include use of the home’s excellent resource Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 12 centre, which provides a range of stimulating and relaxation facilities i.e.; music therapy. External activities include day trips, pub visits, lunches out, swimming, walking, shopping, ten pin bowling and attending church, football matches, concerts pantomimes and nightclubs. Staff confirmed that each person has their wishes considered and support is provided daily for people to undertake activities and access the local community. The home provides a mini bus to transport service users in pursuit of their individual lifestyles and activities. Risk assessments are in place for any restrictions that may need to be imposed for health and safety reasons or because of the individuals complex needs, however it is recommended that these decisions are supported by relatives or outside professional such as a social worker or Community psychiatric nurse and their signature obtained as such. Relatives are involved as much as possible and the home operates an open door policy with consideration of reasonable times to visit. All relatives are issued with the entry code and there are no reported restrictions for visiting currently. Friendships/personal relationships are encouraged and one service user has mutual visits with a close friend from another care environment. Staff opens Service users mail, as they are not able to open this themselves. Service users have access to all communal areas in each specific unit and in the large enclosed gardens. Menus are changed seasonally. The current menu appeared varied and nutritious and details individual options/likes/dislikes/special needs. Three service users require a softer diet and two a diabetic diet. Food served appeared well presented and appetising. Cooked breakfasts are available once the cook is on duty at 8am. The manager reported that suppers and snacks are varied and that supplement drinks are given as prescribed by the GP or dietician. Dietician input is accessed by referral as needed. Nutritional tools are used; weight charts examined were up to date. Food stocks were ample. There are some food safety issues highlighted and covered in Standard 42 Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Service users receive personal support in the way they prefer and require and their physical and emotional needs appear to be met. The system in place for medicine management appears satisfactory. EVIDENCE: Care plans evidence that service users receive personal support in the way they prefer wherever possible. Speech and language therapists, physiotherapists, dietician, occupational therapists, psychology and psychiatric services are accessed as needed. Because the home has links to the local mental health services, appropriate referral and access is obtained promptly. Male staff does not provide personal care to female service users and support for service users is arranged in partnership with advocates, relatives etc. The home has links with the continence advice service that provide full assessments for service users and who visit the home regularly. Nursing staff undertake medical observations for example blood pressure monitoring and urinalysis, pulse, blood sugar monitoring etc. All service users have annual well person checks and six monthly blood tests and required. Treatment reviews were also evidenced. Care should be taken in relation to ensuring follow ups are chased for blood tests and a system for highlighting this is recommended. Seizures, menstrual cycles and challenging behaviour are monitored and evaluated. Input is accessed for tissue viability as needed, assessment tools are used and any Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 14 specialist equipment in place is documented. Routine health checks such as dental, optician and routine reviews are well documented overall. Medication profiles are in place, however there needs to be a statement in relation to the service users capacity to consent to medication and which should be supported by a community Psychiatric nurse or GP. The treatment room was examined and the system for medication management randomly checked. The medication administration records were noted to be satisfactory, have photographs, staff sample signatures and GP signature where appropriate. The treatment room was clean and tidy and the temperature of the room and the medicine fridge recorded as taken. There are no Controlled Drugs in use currently but appropriate storage is provided. There are appropriate policies and procedures in place for ordering, receipt and return, for homely remedies and a drug error policy in place. Keys are held by the nurse in charge and are kept separate to other keys needed in the home. Dressings were stored separately. Medication is administered by Registered Nursing Staff only and it is recommended that refresher training be accessed periodically and documented. Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The home has appropriate complaints and adult protection procedures in place. EVIDENCE: The home has a written complaints procedure. No formal complaints have been recorded but there is a recording system in place. Both managers discussed the Adult Protection framework within the home. Staff undertake training in adult protection and the home has an effective video for assisting with this. Both managers are trained in non-violent management of aggression. Training for staff in non-violent crisis intervention is implemented at the home, the training schedule and course certificates were observed. Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24-30 The home provides a clean, domestic and generally well-maintained environment. There are some infection control issues to address and any mal odour needs to be eradicated. EVIDENCE: The home was clean and generally well maintained. A programme of refurbishment is underway and needs to be continued. Communal areas were homely with good quality furnishings and adaptations. Some new furniture had been purchased but has been found not to be waterproof and some malodour has arisen due to this. The care manager reported that this is being dealt with and some parts of the furniture will be replaced. The premises were on the whole safe, comfortable and bright, however there was some mal odour noted particularly on the first floor hallway, possibly due to the carpet needing replacement. It was reported that regular cleaning/shampooing of carpets is undertaken however it is possible that this is ineffective regarding permeability over time. Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 17 The communal space appears to be within existing environmental standards, but this includes a conservatory area which really can be only used in the warmer weather and which restricts space for service users within a small lounge area for eight service users most of the year. The manager explained that there are plans to extend the lounge at a later date. As the room is overcrowded when all service users are using the small lounge, it is recommended that this work be considered sooner rather than later to improve space and comfort for service users. The home and grounds are accessible to wheelchair users. There is continuous maintenance of all areas, with planned decoration and renewal programmes. Low surface temperature radiators are in situ or covered. Lighting is domestic in style and water systems were assessed at the previous inspection and found to be satisfactory. Laundry and sluice facilities were satisfactory. CCTV operates outside of the building for security purposes only. The home is inspected by the local Fire and Environmental agencies. A store room for continence pads, bedding etc, was found to have staff personal clothing and bags also stored, which posed a risk for cross contamination of opened continence products. Infection Control strategies were otherwise in place. A staff room is provided and staff should use this area for storing their belongings. Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34,35 The homes recruitment systems and practices require some improvement. Service users individual and joint needs are met by appropriately trained staff. EVIDENCE: A sample of four staff members’ personal files was examined. Evidence of Criminal records Disclosure and Protection Of Vulnerable Adults List checks were in place, however there were gaps in other documentation held for example, no photo, no ID/Proof of address, and one was missing a reference. A requirement is set for the registered person to ensure that all staff files contain the relevant documentation as required by schedule 2 and 4 of The Care Home Regulations 2001 and amended Regulations. The Recruitment folders need to be organised so information is filed in a standard order and the administrator has already formulated a checklist to have on the front of the file, although this was not yet in use. A training budget is held both locally and organisationally and evidence of staff training was seen for manual handling, fire awareness, basic food handling and hygiene, health and safety, basic first aid, infection control, COSHH, Abuse, POVA and whistle blowing, nutrition, Non Violent Crisis Intervention. Other training is accessed if beneficial to the home such as Dementia and Challenging Behaviour. Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 19 All new staff undertakes an induction to skills for work standards, and this is currently being further developed to widen its scope of topics. The induction process takes on average 6 weeks and training needs are assessed on starting and depending on what the employee has already attained, training or refreshers are arranged according to need. All staff have a training and development plan. Five out of twenty one staff have achieved NVQ 2, four will have completed in the next few weeks which will make 42 of the staff team trained in NVQ 2 and five to six staff are ready to enrol. There is no training provision for equal opportunities as specified in Standard 35.4 and this should be addressed. Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39,42 Service users and their representatives can be confident their views underpin all self monitoring, review and development of the home, however service users health and safety may be compromised by unsatisfactory food safety practices and procedures EVIDENCE: Quality monitoring systems are in place and include Regulation 26 visits by the provider, six monthly service user/relative/supporter questionnaires and audits. The manager has recently obtained The Quality Tree assessment tool. Health and Safety practices in general appeared satisfactory, however food safety practices were assessed and found to require improvement. Several items of food stocks were found to be outside of the use by dates, food/sauces with use by guidance was found not have been followed as opened Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 21 and not date labelled and some foods had been removed from the original packaging and had no visible ‘use by’ guidance. Not all staff was wearing aprons when serving lunch, although hand washing was observed. The meals are cooked in the main kitchen and transported to each unit on trolleys; the plated food is reheated in a microwave if not served immediately. The Environmental Health Officer made a visit in December 05 who made reference to this process, making a requirement for food temperature probing and recommendations in relation to the purchase of a Bain Marie trolley and in relation to the purchase of an upright freezer. The manager reported that action had been taken in relation to all of the issues. On the day of the inspection there was no record of the food temperatures of the meals that had left the kitchen, although the cook confirmed these had been taken and another random test of the food trolley in the kitchen was satisfactory. On two of the units, food probes and wipes were provided, however observations of practice was that a plated meal was reheated and not food probed prior to serving and on the other unit no records were found in relation to food probing. Fridge temperature records were evident. Service user health and safety may be compromised and therefore a requirement is made for practices in food handling to be improved. Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 2 LIFESTYLES Standard No Score 11 X 12 4 13 X 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X 2 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rufford Court Care Home Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score X X 3 X X 1 X DS0000055281.V280711.R01.S.doc Version 5.0 Page 23 N/A 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 2 Standard YA30 YA30 Regulation 13,16 13,16 Requirement Eradicate the mal odour present on the first floor. Ensure service users health and safety is not put at risk in relation to appropriate provision for staff belongings [Prohibit staff from using the store room for continence aids] Ensure all staff files are completed as required by Schedule 2 and 4 of the regulations Ensure the systems in place for food handling are safe. Date labelling of opened food items. Stock rotation and use by dates. Reheating of food and food probing. Personal protective clothing Timescale for action 30/03/06 30/03/06 3 YA34 7,9,19 30/03/06 4 YA42 13,16 30/03/06 Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 24 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 YA18YA19 Good Practice Recommendations Minor additions/ amendments are recommended within the care plan systems. A system should be put into place to prompt staff to follow up blood tests. A statement should be included in relation to the service users capacity to consent for medication. Service users representatives should be consulted about any limitations/ restrictions imposed/risk assessments etc and sign to state they are in agreement. 2 3 4 5 YA20 YA24 YA24 YA35 Nursing staff should have refresher training in medicines management. Service users would benefit from extension to the lounge facilities on the ground floor. Carpets, particularly on the first floor should be replaced. Provide training for staff in equal opportunities. Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Rufford Court Care Home DS0000055281.V280711.R01.S.doc Version 5.0 Page 26 - 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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