Inspection on 06/08/04 for Ruskin Lodge

Care Home For Older PeopleRuskin LodgeSwinburne Road Dentons Green St Helens Merseyside WA10 6AWUnannounced Inspection6th August 2004 Commission for Social Care InspectionLaunched in April 2004, the Commission for Social Care Inspection (CSCI) is the single inspectorate for social care in England. The Commission combines the work formerly done by the Social Services Inspectorate (SSI), the SSI/Audit Commission Joint Review Team and the National Care Standards Commission. The role of CSCI is to: · Promote improvement in social care · Inspect all social care - for adults and children - in the public, private and voluntary sectors · Publish annual reports to Parliament on the performance of social care and on the state of the social care market · Inspect and assess `Value for Money of council social services · Hold performance statistics on social care · Publish the `star ratings for council social services · Register and inspect services against national standards · Host the Childrens Rights Director role.Inspection Methods & FindingsSECTION B of this report summarises key findings and evidence from this inspection. The following 4-point scale is used to indicate the extent to which standards have been met or not met by placing the assessed level alongside the phrase Standard met? The 4-point scale ranges from: 4 - Standard Exceeded (Commendable) 3 - Standard Met (No Shortfalls) 2 - Standard Almost Met (Minor Shortfalls) 1 - Standard Not Met (Major Shortfalls) O or blank in the Standard met? box denotes standard not assessed on this occasion. 9 in the Standard met? box denotes standard not applicable. X is used where a percentage value or numerical value is not applicable. ESTABLISHMENT INFORMATION Name of establishment Ruskin Lodge Address Swinburne Road, Dentons Green, St Helens, Merseyside, WA10 6AW Email address Name of registered provider(s)/company (if applicable) Pilkington Family Trust Name of registered manager (if applicable) Mrs Diane Swift Type of registration Care Home No. of places registered (if applicable) 23 Tel No: 01744 20010 Fax No: 01744 613081Category(ies) of registration, with (number of places) Dementia (4), Old age, not falling within any other category (13), Physical disability (6) Registration number F030000653 Date first registered 16th July 2002 Was the home registered under the Registered Homes Act 1984? Do additional conditions of registration apply ? Date of last inspectionDate of latest registration certificate 28th November 2003If Yes refer to Part CRuskin LodgePage 1 Date of inspection visit Time of inspection visit Name of inspector Name of inspector Name of inspector 1 2 36th August 2004 10:00 am Mrs Lynn PatersonID Code073532Name of inspector 4 Name of specialist (e.g. Interpreter/Signer) (if applicable) Name of establishment representative at the time of inspectionAnn SpannerRuskin LodgePage 2 CONTENTSIntroduction to Report and Inspection Inspection Visits Brief Description of the Services Provided Part A: Summary of Inspection Findings Inspectors Summary Statutory Requirements/Good Practice Recommendations from last Inspection Conditions of Registration Statutory Requirements/ Good Practice Recommendations from this Inspection Part B: Inspection Methods & Findings National Minimum Standards For Older People: Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management & Administration Part C: Part D: D.1. D.2. D.3. Compliance with Conditions (if applicable) Providers Response Providers Comments Action Plan Providers AgreementRuskin LodgePage 3 INTRODUCTION TO REPORT AND INSPECTION Every establishment that falls within the jurisdiction of the Commission for Social Care Inspection (CSCI), is subject to inspection, to establish if the establishment is meeting the National Minimum Standards relevant to that setting and the requirements of the Care Standards Act 2000. This document summarises the inspection findings of the CSCI in respect of Ruskin Lodge. The inspection findings relate to the National Minimum Standards (NMS) for Care Homes for Older People published by the Secretary of State under the Care Standards Act 2000. The Regulations applicable to the inspected service are secondary legislation, with which a service provider must comply. Service providers are expected to comply fully with the National Minimum Standards. The National Minimum Standards will form the basis for judgements by the CSCI regarding registration, the imposition and variation of registration conditions and any enforcement action. The report follows the format of the NMS and the numbering shown in the report corresponds to that of the Standards. The report will show the following: · Inspection methods used · Key findings and evidence · Overall ratings in relation to the standards · Compliance with the Regulations · Required actions on the part of the provider · Recommended good practice · Summary of the findings · Providers response and proposed action plan to address findings This report is a public document. INSPECTION VISITS Inspections are undertaken in line with the agreed regulatory framework with additional visits as required. This is in accordance with the provisions of the Care Standards Act 2000. The report is based on the findings of the specified inspection dates.Ruskin LodgePage 4 BRIEF DESCRIPTION OF THE SERVICES PROVIDED. Ruskin lodge is a purpose built property set in large well-maintained grounds, close to the centre of St.Helens town. The home is owned and managed by Pilkington Trust who provide respite accommodation for Pilkington Pensioners and their carers. Ruskin Lodge is registered for a maximum of 22 older people and the bedrooms are positioned on both ground and upper floors. All bedrooms have en-suite facility with television and telephone and are furnished and decorated to a high standard. The home also affords a lounge, dinning room, laundry and reading/games area. The home caters for all dietary needs and all food is home cooked. All entry and exit areas are equipped with ramp facility to assure ease of access. The home also affords a sun patio area, which overlooks the spacious landscaped gardens. CCTV is sensitively positioned to provide full security to outer areas of the premises.Ruskin LodgePage 5 PART A SUMMARY OF INSPECTION FINDINGSINSPECTORS SUMMARY (This is an overview of the inspectors findings, which includes good practice, quality issues, areas to be addressed or developed and any other concerns.) The unannounced inspection of Ruskin Lodge took place on the afternoon of 6th August 2004 and the inspector was assisted in her remit by the senior carer on duty. The inspector met with service users, staff and perused documentation to include care plans, medication records, assessments, activity information, staff records and toured the premises to gain information for the report, a summary of which is recorded below. It should be noted that the service users wished to be addressed as guests for the purpose of this report and their wishes have therefore been respected. CHOICE OF HOME. Standards 1 to 6 . 2 Standards Assessed. 1 met. The inspector was unable to access the statement of purpose at the time of the inspection and guests advised that they were not aware of its existence. However guests advised they knew the background and the nature and purpose of the home as a consequence of previous visits. Assessment details on file were clear and relevant. HEALTH AND PERSONAL CARE. Standards 7 to 11. 2 Standards Assessed. 1 met The two standards assessed indicated shortfalls. Care plans examined appeared non specific about the degree of actual care and support needed and inconsistencies were noted in the recording systems. Medication management and recording was also inconsistent at the time of the inspection.Ruskin LodgePage 6 DAILY LIFE AND SOCIAL ACTIVITIES. Standards 12 to 15. 2 Standards Assessed. 1 met. Guests advised that routines were flexible and some activities were arranged, however the general consensus of opinion was that more activities needed to be put in place to meet individual need. Menus viewed appeared varied and guests stated the food preparation, presentation and taste was second to non. COMPLAINTS AND PROTECTION. Standards 16 to 18. 1 Standard Inspected. 1 met Staff interviewed evidenced knowledge and understanding of protection issues. Polices for the protection of vulnerable adults and whistle blowing were in place at the time of the inspection. ENVIRONMENT. Standards 19 to 26. 4 Standards Inspected. 4 met Four of the eight standards in this section were assessed and all met the stated requirements. The inspector noted that the home was very well maintained with the fabrics and furnishings being of good quality. All aspects of the internal and external environment were clean and hygienic at the time of the visit. Guests advised that the accommodation was better than most five star hotels. STAFFING. Standards 27 to 30. 1 Standard Inspected. Not met. The inspector noted from perusal of the staff roster that the requirement presented at the previous inspection had not yet been addressed. As a consequence the staffing levels recorded were not consistent with the actual care staff on duty. Guests advised that they had noticed that the staff had to work very hard to complete many varied tasks. Comments included it is a pity that the staff have so many duties, they are so nice and we would like to see more of them. MANAGEMENT AND ADMINISTRATION. Standards 31 to 38. No Standards Inspected. The registered home manager was not in situ at the time of the visit and the staff roster did not include the name of an acting manager. As a consequence the inspector did not assess any standards in this section.Ruskin LodgePage 7 Requirements from last Inspection visit fully actioned? If No please list belowNOSTATUTORY REQUIREMENTS Identified below are areas not addressed from the last inspection report which indicate a non-compliance with the Care Standards Act 2000 and accompanying Regulations. The code in Standard is a cross-reference to the Standards described in full in the section Inspection Findings. No. Regulation Standard Required actions Timescale for action 1 18 OP27 The registered person must ensure that the staff roster reflects the accurate number of care staff on duty. Immediate.Action is being taken by the Commission for Social Care Inspection to ensure compliance in regard to the above requirements. RECOMMENDATIONS Identified below are recommendations from the last inspection that have not been implemented No. Refer to Good Practice Recommendations StandardCONDITIONS OF REGISTRATION THAT APPLY (OTHER THAN NUMBERS AND CATEGORY OF SERVICE USERS).Met (Yes / No)Ruskin LodgePage 8 STATUTORY REQUIREMENTS IDENTIFIED DURING THE INSPECTION Action Plan: The Registered Person is requested to provide the Commission with an Action Plan, which indicates how requirements are to be addressed with the time scale within which such actions will be taken. This action plan will be made available on request to the Area Office.STATUTORY REQUIREMENTS Identified below are areas addressed in the main body of the report, which indicate noncompliance with the Care Standards Act 2000, and accompanying Regulations 2001 and the National Minimum Standards. The Registered Provider(s) is/are required to comply within the given time scales. The code in Standard is a cross-reference to the Standards described in full in the section Inspection Findings. No. Regulation Standard * Requirement Timescale for action 1 4 OP1 The registered person ensures that the statement of purpose is available to all service users and their representatives. The registered person must ensure that a comprehensive service user plan of care is drawn up in partnership with the service user The registered person must ensure that the medication policy and procedures within the home are adhered to at all times. The registered person must ensure that the routines of daily living are made flexible to suit all needs. The registered person must ensure that the staffing levels of the home reflect the levels of care necessary to meet all assessed need. Immediate.215OP76.9.04 Immediate.317OP9416OP126.9.04.518OP276.9.04Ruskin LodgePage 9 RECOMMENDATIONS Identified below are areas addressed in the main body of the report, which relate to National Minimum Standards and are seen as good practice issues which should be considered for implementation by the registered Provider(s). The code in Standard is a cross-reference to the Standards described in full in the section Inspection Findings. No. Refer to Good Practice Recommendations Standard ** Note: You may refer to the relevant standard in the remainder of the report by omitting the 2-letter prefix e.g. OP10 refers to Standard 10.Ruskin LodgePage 10 PART BINSPECTION METHODS & FINDINGSThe following inspection methods have been used in the production of this report Direct observation Indirect observation Sampling · Pre-inspection questionnaire · Records · Care plans / Care pathways · Meals · Activities · Other (Specify) `Tracking care and support Group discussion with service users Individual discussion with service users Group discussion with staff Individual discussion with staff Discussion with management Service user survey Relatives/significant others survey/feedback Visiting professionals survey / feedback Tour of premises Formal interviews Document reading Additional inspection information: Number of service users spoken to at time of inspection Number of relatives/significant others the inspectors had contact with Number of letters received in respect of the service CRB check for the responsible individual seen CRB check for the manager seen Certificate of registration was displayed at the time of the inspection Certificate of registration accurately reflected the situation in the service at the time of inspection Total number of care staff employed (excluding managers) Total number of staff with nursing qualifications employed Date of inspection Time of inspection Duration of inspection (hrs) YES YES NO YES YES NO NO NO YES YES YES YES YES NO NO NO NO YES YES YES 18 0 0 NO NO YES YES X X 6/8/04 2.40PM 3Ruskin LodgePage 11 The following pages summarise the key findings and evidence from this inspection, together with the CSCI assessment of the extent to which the National Minimum Standards for Care homes for older people have been met. The following scale is used to indicate the extent to which standards have been met or not met by placing the assessed level alongside the phrase Standard met? The scale ranges from: 4 - Standard Exceeded 3 - Standard Met 2 - Standard Almost Met 1 - Standard Not Met (Commendable) (No shortfalls) (Minor shortfalls) (Major shortfalls)0 or blank in the Standard met? box denotes standard not assessed on this occasion. 9 in the Standard met? box denotes standard not applicable. X is used where a percentage value or numerical value is not applicable.Ruskin LodgePage 12 Choice of HomeThe intended outcomes for the following set of standards are: · · · · · · 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.Standard 1 (1.1 ­ 1.3) The registered person produces and makes available to service users an up to date statement of purpose setting out the aims, objectives, philosophy of care, services and facilities, and terms and conditions of the home; and provides a service users guide to the home for current and prospective residents. The statement of purpose clearly sets out the physical environmental standards met by a home in relation to standards 20.1, 20.4, 21.3, 21.4, 22.2, 22.5, 23.3 and 23.10: a summary of this information appears in the homes service users guide. Range of fees charged From (£) X To (£) XAny charges for extrasNOIf yes, please state what the extras are: 2 Key findings/Evidence Standard met? The inspector was unable to access the statement of purpose or the previous inspection report at the time of the visit. Guests of Ruskin Lodge advised that they did not know about the statement of purpose, however they were aware of the nature and purpose of the home due to them having enjoyed previous respite visits. The inspector advised the senior carer to ensure that the statement of purpose was visible and accessible at all times.Ruskin LodgePage 13 Standard 2 (2.1 ­ 2.2) Each service user is provided with a statement of terms and conditions at the point of moving into the home (or contract if purchasing their care privately). 0 Key findings/Evidence Standard met? This standard was not inspected on this occasion.Standard 3 (3.1 ­ 3.5) New service users are admitted only on the basis of a full assessment undertaken by people trained to do so, and to which the prospective service user, his/her representatives (if any) and relevant professionals have been party. 3 Key findings/Evidence Standard met? The inspector examined 4 care plans and noted that the assessment documentation was in place for all 4. The assessment information included personal care, physical wellbeing, diet, continence, mobility and mental cognition. Guests spoken with during the visit advised that they received regular visits from external Pilkington Welfare Officers who updated their information when necessary. Standard 4 (4.1 - 4.4) The registered person is able to demonstrate the homes capacity to meet the assessed needs (including specialist needs) of individuals admitted to the home. 0 Key findings/Evidence Standard met? This standard was not assessed at this time.Standard 5 (5.1 ­ 5.3) The registered person ensures that prospective service users are invited to visit the home and to move in on a trial basis, before they and / or their representatives make a decision to stay; unplanned admissions are avoided where possible. 0 Key findings/Evidence Standard met? This standard was not assessed at this time.Ruskin LodgePage 14 Standard 6 (6.1 - 6.5) Where service users are admitted only for intermediate care, dedicated accommodation is provided together with specialised facilities, equipment and staff, to deliver short term intensive rehabilitation and enable service users to return home. 9 Key findings/Evidence Standard met? This service was not available at this time.Ruskin LodgePage 15 Health and Personal CareThe intended outcomes for the following set of standards are: · · · · · The service users health, personal and social care needs are set out in an individual plan of care. Service users make decisions about their lives with assistance as needed. Service users, where appropriate, are responsible for their own medication, and are protected by the homes 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.Standard 7 (7.1 ­ 7.6) A service user plan of care generated from a comprehensive assessment (see Standard 3) is drawn up with each service user and provides the basis for the care to be delivered. 2 Key findings/Evidence Standard met? The inspector examined 4 care plans and held discussion with staff and guests of the home to gain evidence for this standard. Care plans viewed appeared inconsistent and without full details of the level of care and support necessary to meet assessed need. Guests advised that they did not feel that they were fully involved in drawing up care plans but advised that they were well looked after anyway. It was noted that not all care plans viewed held signatures of the people involved in the development of the plan. The inspector gave advice and instruction at the time of the inspection to address these shortfalls. Full details can be found in the requirement section of this report.Ruskin LodgePage 16 Standard 8 (8.1 ­ 8.13) The registered person promotes and maintains service users health and ensures access to health care services to meet assessed needs. No. of incidents where service users have been taken to Accident and Emergency during last 12 months No. of service users with pressure sores at time of inspection (from information taken from care notes) Key findings/Evidence This standard was not inspected at this time. X X Standard met? 0Standard 9 (9.1 ­ 9.11) The registered person ensures that there is a policy and staff adhere to the procedures for the receipt, recording, storage, handling administration and disposal of medicines, and service users are able to take responsibility for their own medication if they wish, within a risk management framework. 2 Key findings/Evidence Standard Met? The inspector viewed policies and procedures, medication storage and administration systems, medication recording mechanisms and spoke with staff to gain evidence for this standard. The inspector noted that the medication systems in place did not comply with the home policies to include recording and disclaimer information. Storage of controlled drugs also appeared inconsistent. The inspector gave advice and instruction at the time of the inspection, information of which can be found in the requirements section of this report. Standard 10 (10.1 ­ 10.7) The arrangements for health and personal care ensure that service users privacy and dignity are respected at all times, and with particular regard to: personal care giving, including nursing, bathing, washing, using the toilet or commode, consultation with, and examination by, health and social care professionals, consultation with legal and financial advisors, maintaining social contacts with relatives and friends, entering bedrooms, toilets and bathrooms, and following death. 0 Key findings/Evidence Standard met? This standard was not inspected at this time.Ruskin LodgePage 17 Standard 11 (11.1 ­ 11.12). Care and comfort are given to service users who are dying, their death is handled with dignity and propriety, and their spiritual needs, rites and functions observed. 0 Key findings/Evidence Standard met? This standard was not assessed at this time.Ruskin LodgePage 18 Daily Life and Social ActivitiesThe intended outcomes for the following set of standards are: · · · · 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.Standard 12 (12.1 ­ 12.4) The routines of daily living and activities made available are flexible and varied to suit service users expectations, preferences and capacities. 2 Key findings/Evidence Standard met? The inspector met with guests and perused care plans, daily records and activity information to gain evidence for this standard. Guests advised that daily routines were flexible and they were able to come and go as they pleased. They also advised that some activities were arranged to include a bingo session. Guests also stated that they were able to access reading material and jigsaw puzzles and join in the day centre activity if they wished. Guests with whom the inspector spoke said that they would like some evening activity to be arranged as they felt that nothing happened in the evenings. Guest also said that because staff, were so busy they were not able to interact as much as the guest would like. Records viewed indicated that the home did not have a full activity programme and advice was given to ensure full compliance with the requirements of this standard. Details can be found in the requirements section of this report. Standard 13 (13.1 ­ 13.6) Service users are able to have visitors at any reasonable time and links with the local community are developed and/or maintained in accordance with service users preferences. 0 Key findings/Evidence Standard met? This standard was not assessed at this time.Ruskin LodgePage 19 Standard 14 (14.1 ­ 14.5) The registered person conducts the home so as to maximise service users capacity to exercise personal autonomy and choice. 0 Key findings/Evidence Standard met? This standard was not assessed at this time.Standard 15 (15.1 ­ 15.9) The registered person ensures that service users receive a varied, appealing, wholesome and nutritious diet, which is suited to individual, assessed and recorded requirements, and that meals are taken in a congenial setting and at flexible times. 4 Key findings/Evidence Standard met? The inspector met with guests, viewed menus, observed guest dining and inspected the kitchen area to gain evidence for this standard. The daily menu appeared varied and reflected that guests had differing tastes with full choices being available for all meals. The inspector observed the guests dining and noted that the food appeared well prepared, well presented with many available choices. The inspector noted that the dining room was well furnished and the tables were decorated with clothes and table ornaments which created a most pleasant atmosphere. The kitchen was well managed and most clean and hygienic at the time of the visit. Guests advised that the food provision was of a high standard and always very appetising. Guests also advised that food was available at al times with drinks, sandwiches, cakes and biscuits being provided between meals. The inspector noted that the home had provided cool drinks of varying juices for the guests who advised that they were always available. Guests again advised that they could not get better food provision in a five star hotel. The inspector commends this service provision.Ruskin LodgePage 20 Complaints and ProtectionThe intended outcomes for the following set of standards are: · · · 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.Standard 16 (16.1 ­ 16.4) The registered person ensures that there is a simple, clear and accessible complaints procedure which includes the stages and time-scales for the process, and that complaints are dealt with promptly and effectively. No. of complaints made to the home during last 12 months No. of these complaints fully substantiated No. of these complaints partly substantiated No. of these complaints not substantiated No. of these complaints not yet resolved No. of complaints sent direct to CSCI Percentage of complaints responded to within 28 days Key findings/Evidence This standard was not assessed at this time. X X X X X X X 0Standard met?Standard 17 (17.1 ­ 17.3) Service users have their legal rights protected, are enabled to exercise their legal rights directly and participate in the civic process if they wish. 0 Key findings/Evidence Standard met? This standard was not inspected at this time.Ruskin LodgePage 21 Standard 18 (18.1 ­ 18.6) The registered person ensures that service users are safeguarded from physical, financial or material, psychological or sexual abuse, neglect, discriminatory abuse or self harm, inhuman or degrading treatment, through deliberate intent, negligence or ignorance, in accordance with written policies. The home has an Adult Protection procedure (including Whistle Blowing) which complies with the Public Disclosure Act 1998 and the Department of Health Guidance No Secrets No. of staff referred for inclusion on POVA lists YES 03 Key findings/Evidence Standard met? The inspector noted that the home had policies and procedures in place for the protection of adults and staff interviewed evidenced that they had received training in this area.Ruskin LodgePage 22 EnvironmentThe intended outcomes for the following set of standards are: · · · · · · · · 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.Standard 19 (19.1 ­ 19.6) The location and layout of the home is suitable for its stated purpose; it is accessible, safe and well maintained; meets service users individual and collective needs in a comfortable and homely way and has been designed with reference to relevant guidance. 4 Key findings/Evidence Standard met? The inspector toured the building and noted that the location and layout of the home appeared most suitable for its stated purpose to provide respite placements for Pilkington retirees and their families, The interior and exterior of the building presented as being very well maintained to include the interior furnishings fabrics and decoration and landscaped grounds. Guests advised that the home more than fulfilled their expectations for quality, safety and comfort. The inspector commends this service provision. Standard 20. (20.1 ­ 20.7) In all newly built homes and first time registrations the home provides sitting, recreational and dining space (referred to collectively as communal space) apart from service users private accommodation and excluding corridors and entrance hall amounting to at least 4.1 sq. metres for each service user. 0 Key findings/Evidence Standard met? This standard was not assessed at this time.Ruskin LodgePage 23 Standard 21 (21.1 ­ 21.8) Toilet, washing and bathing facilities are provided to meet the needs of service users. 4 Key findings/Evidence Standard met? The inspector toured the premises and spoke with guests to gain evidence for this standard. Guests advised that they had en-suite facility in their rooms and that communal baths and toilets were fitted with adaptations to ensure that all needs were met. Guest also advised that all these facilities afforded good space and were always clean, hygienic and free from malodorous smells. All facilities viewed at the time of the unannounced inspection presented as spacious, modern and well maintained. The inspector commends this service provision. Standard 22 (22.1 ­ 22.8) The registered person demonstrates that an assessment of the premises and facilities has been made by suitably qualified persons, including a qualified occupational therapist, with specialist knowledge of the client groups catered for, and provides evidence that the recommended disability equipment has been secured or provided and environmental adaptations made to meet the needs of service users. 0 Key findings/Evidence Standard met? This standard was not assessed at this time.Ruskin LodgePage 24 Standard 23 (23.1 ­ 23.11) The home provides accommodation for each service user which meets minimum space as prescribed Total number of single bedrooms with at least 10 sq.m usable space or additional compensatory space Pre-existing homes only (1 April 2003) - single bedrooms below 10 sq.m usable space or additional compensatory space Total number of wheelchair users accommodated for in rooms at least 12sq.m Total number of wheelchair users accommodated for in rooms at less than 12sq.m Total number of shared rooms at least 16 sq.m Total number shared rooms less than 16 sq.m Percentage of places within single rooms: 100 80 - 99 Less than 80 Total number of single bedrooms Total number of single rooms with en suite Total number of double rooms Total number of double rooms with en suite NO YES NO X 0 X X X XX X X X4 Key findings/Evidence Standard met? The inspector viewed the rooms and spoke with guests to gain evidence for this standard. The inspector noted that the room dimensions and layout options were more than adequate to meet all assessed need to include wheelchair access. Guests advised that they had lots of space in their rooms which were comfortable and exceeded their expectations and certainly met all their requirements. The inspector commends this service provision.Ruskin LodgePage 25 Standard 24 (24.1 ­ 24.8) The home provides private accommodation for each service user which is furnished and equipped to assure comfort and privacy, and meets the assessed needs of the service user. 4 Key findings/Evidence Standard met? The inspector met with guests and viewed rooms to gain evidence for this standard. The inspector noted that all rooms were very well furnished with the provision of good quality beds, bedding and bedroom furnishings. All rooms had a television and telephone and were equipped with lockable storage, outer door locks and en-suite facility. Some bedrooms were equipped with adjustable beds to met assessed need. All rooms viewed appeared bright and equipped to assure comfort and privacy to all guests to Ruskin Lodge. Guests advised that they were more than happy with their accommodation, which they stated was better than a five star hotel. The inspector commends this service provision. Standard 25 (25.1 ­ 25 8) The heating, lighting, water supply and ventilation of service users accommodation meet the relevant environmental health and safety requirements and the needs of individual service users. 0 Key findings/Evidence Standard met? This standard was not inspected at this time.Standard 26 (26.1 ­ 26.9) The premises are kept clean, hygienic and free from offensive odours throughout and systems are in place to control the spread of infection, in accordance with relevant legislation and published professional guidance. 0 Key findings/Evidence Standard met?Ruskin LodgePage 26 StaffingThe intended outcomes for the following set of standards are: · · · · 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 homes recruitment policy and practices. Staff are trained and competent to do their jobs.Standard 27 (27.1 ­ 27.7) Staffing numbers and skill mix of qualified/unqualified staff are appropriate to the assessed need of the service users, the size, the layout and purpose of the home, at all times. Number of staff /hours in respect of service user needs based on guidance recommended by Department of Health. Personal Nursing Care No. service users High No. staff hours X X X needs allocated No. service users Medium needs No. service users Low needs No. of staff hours required No. of full time equivalent first level registered nurses No. of care staff No. of ancillary staff Key findings/Evidence X X X No. staff hours allocated No. staff hours allocated No. of staff hours provided X X X X X XX X X Standard met? 2Ruskin LodgePage 27 The inspector met with staff and guests and perused care plans and staff rosters to gain evidence for this standard. The staff roster showed the number of staff who were on duty, however the roster did not identify their remit. Staff advised the morning roster showed that 4 care staff were on duty although their remit was that 2 staff were employed to provide care and support to guests whilst the other 2 staff were required to provide domestic duties. Guests advised that staff were required to cover many roles and they were therefore spread thinly across the home. Guests stated that they would like to see more of the staff and enjoy interactions. The inspector advised that it was essential for the staff roster to provide accurate information appertaining to staffing levels to ensure that staff were provided in adequate numbers and skill mix to meet the assessed need of all guests of the home. Full details can be found in the requirements section of this report. Standard 28 (28.1 ­ 28.3) A minimum ratio of 50 trained members of care staff (NVQ Level 2 or equivalent) is achieved by 2005, excluding the registered manager and/or care manager, and in care homes providing nursing, excluding those members of the care staff who are registered nurses. No. care staff (excluding registered nurses) with NVQ level 2 or equivalent of care staff with NVQ level 2 Key findings/Evidence This standard was not assessed at this time. X X Standard met? 0Standard 29 (29.1 ­ 29.6) The registered person operates a thorough recruitment procedure based on equal opportunities and ensuring the protection of service users. 0 Key findings/Evidence Standard met? This standard was not inspected at this time.Ruskin LodgePage 28 Standard 30 (30.1 ­ 30.4) The registered person ensures that there is a staff training and development programme which meets the National Training Organisation (NTO) workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users. 0 Key findings/Evidence Standard met? This standard was not inspected at this time.Ruskin LodgePage 29 Management and AdministrationThe intended outcomes for the following set of standards are: · · · · · · · · 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 homes record keeping policies and procedures. The health, safety and welfare of service users and staff are promoted and protected.Standard 31 (31.1 ­ 31.8) The registered manager is qualified, competent and experienced to run the home and meet its stated purpose, aims and objectives. 0 Key findings/Evidence Standard met? The registered home manager was not available at the time of the inspection and therefore this standard was not assessed.Standard 32 (32.1 ­ 32.7) The registered manager ensures that the management approach of the home creates an open, positive and inclusive atmosphere. 0 Key findings/Evidence Standard met? The registered manager was not available at the time of the inspection and therefore this standard was not assessed.Standard 33 (33.1 ­ 33.10) Effective quality assurance and quality monitoring systems, based on seeking the views of service users, are in place to measure success in meeting the aims, objectives and the statement of purpose of the home. 0 Key findings/Evidence Standard met? This standard was not assessed at this time.Ruskin LodgePage 30 Standard 34 (34.1 ­ 34.5) Suitable accounting and financial procedures are adopted to demonstrate current financial viability and to ensure there is effective and efficient management of the business. 0 Key findings/Evidence Standard met? This standard was not available at this time.Standard 35 (35.1 ­ 35.6) The registered manager ensures that service users control their own money except where they state that they do not wish to or they lack capacity and that safeguards are in place to protect the interests of the service user. Number of service users subject to Power of Attorney processes Number of service users subject to Enduring Power of Attorney processes Number of service users subject to Guardianship Orders Key findings/Evidence This standard was not assessed at this time. Standard met? 0 X X XStandard 36 (36.1 ­ 36.5) The registered person ensures that the employment policies and procedures adopted by the home and its induction, training and supervision arrangements are put into practice. 0 Key findings/Evidence Standard met? This standard was not assessed at this time.Ruskin LodgePage 31 Standard 37 (37.1 ­ 37.3) Records required by regulation for the protection of service users and for the effective and efficient running of the business are maintained, up to date and accurate. 0 Key findings/Evidence Standard met? This standard was not assessed at this time.Standard 38 (38.1 ­ 38.9) The registered manager ensures so far as is reasonably practicable the health, safety and welfare of service users and staff. 0 Key findings/Evidence Standard met? This standard was not assessed at this time.Ruskin LodgePage 32 PART C(where applicable)COMPLIANCE WITH CONDITIONSCondition CommentsComplianceCondition CommentsComplianceCondition CommentsComplianceRegulation Inspector Second Inspector Regulation Manager DateLynn PatersonSignature SignatureAnn GoreSignaturePublic reports It should be noted that all CSCI inspection reports are public documents.Ruskin LodgePage 33 PART DD.1PROVIDERS RESPONSE TO IDENTIFIED STATUTORY REQUIREMENTSRegistered Persons comments/confirmation relating to the content and accuracy of the report for the above inspection.We would welcome comments on the content of this report relating to the Inspection conducted on 6/8/04 and any factual inaccuracies: Please limit your comments to one side of A4 if possibleRuskin LodgePage 34 Action taken by the CSCI in response to provider comments: Amendments to the report were necessary NOComments were received from the provider Provider comments/factual amendments were incorporated into the final inspection report Provider comments are available on file at the Area Office but have not been incorporated into the final inspection report. The inspector believes the report to be factually accurateNONote: In instances where there is a major difference of view between the Inspector and the Registered Provider both views will be made available on request to the Area Office. Please provide the Commission with a written Action Plan which indicates how requirements are to be addressed and stating a clear timescale for completion. This will be kept on file and made available on request. You will also note that the Commission has identified in the inspection report good practice recommendations and it would be useful to have some indication as to whether you intend to take any action to progress these. Status of the Providers Action Plan at time of publication of the final inspection report: Action plan was required YES D.2Action plan was received at the point of publicationNOAction plan covers all the statutory requirements in a timely fashion Action plan did not cover all the statutory requirements and required further discussion Provider has declined to provide an action plan YESOther: enter details here Ruskin LodgePage 35 D.3PROVIDERS AGREEMENT Registered Persons statement of agreement/comments: Please complete the relevant section that applies.D.3.1 I Mr Paul Morgan of Ruskin Lodge confirm that the contents of this report are a fair and accurate representation of the facts relating to the inspection conducted on the above date(s) and that I agree with the requirements made and will seek to comply with these. Print Name Signature Designation Date Or D.3.2 I Mr Paul Morgan of Ruskin Lodge am unable to confirm that the contents of this report are a fair and accurate representation of the facts relating to the inspection conducted on the above date(s) for the following reasons: Responsible Individual 13th September 2004 Mr Paul MorganPrint Name Signature Designation DateMr Paul MorganResponsible Individual 13th September 2004Note: In instance where there is a profound difference of view between the Inspector and the Registered Provider both views will be reported. Please attach any extra pages, as applicable.Ruskin LodgePage 36 Ruskin Lodge / 6th August 2004Commission for Social Care Inspection 33 Greycoat Street London SW1P 2QF Telephone: 020 7979 2000 Fax: 020 7979 2111 National Enquiry Line: 0845 015 0120 www.csci.org.ukS0000022408.V147706.R01© This report may only be used in its entirety. 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