CARE HOME ADULTS 18-65 Russell House Hortham Lane Almondsbury South Glos BS32 4JH
Lead Inspector Paula Cordell Unannounced 6 April 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Russell House Version 1.10 Page 3 SERVICE INFORMATION
Name of service Russell House Address Hortham Lane Almondsbury South Glos BS32 4JH 01454 619131 sousanasef_evans@hotmail.com Aspects & Milestones Trust Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Sousan Asef-Evans Care Home with Nursing 6 Category(ies) of LD Learning disability 6 registration, with number PD Physical disability 6 of places Russell House Version 1.10 Page 4 SERVICE INFORMATION
Conditions of registration: May accommodate up to 6 persons with learning disabilities and physical disabilities who are receiving nursing care. Staffing Notice dated 13/10/1997 applies Manager must be a RN on Parts 5 or 14 of the NMC register Date of last inspection 30-Nov-2004 Unannounced Brief Description of the Service: Russell House is a care home registered to provide personal care and nursing care to six people with a physical and a learning disability. The home is situated in a rural location off the A38 in Almondsbury and has its own mini bus which, is essential to provide access to the local social and community venues. The home is set in its own grounds. There is an extensive garden with a patio area which provides level access for service users. Car parking is available. The home is a converted property and all accomodation is provided on the ground floor. This comprises of two single rooms and two double rooms. Whilst none of the rooms have ensuite facilities all rooms have a wash basin. Communal rooms include a lounge, dining room and a multi-sensory area. The bathroom and toilet areas have been fitted with adapatations to meet the care needs of the service users in the home. appropriate equipment is provided for individual use based on the assessed identified need. Russell House Version 1.10 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was an unannounced inspection. The purpose of the visit was to review the progress to the requirements and recommendations from the inspection in November 2004 and to monitor the quality of the care provided to the six service users. Evidence from this inspection was that the home had met two of the previous requirements and one remains outstanding relating to the reviewing of plans of care. Two inspectors conducted the inspection over a six hour period. This included observation of a meal, discussions with the manager and three members of care staff and the housekeeper. Inspectors looked around the building and a number of records were seen. Please note that due to profound and multiple disabilities, service users are unable to verbally communicate their views about the home. The inspectors had an opportunity to spend time with five of the service users. One service user was out for the day at a day centre. There is a high use of bank and agency in the home to cover the five staff vacancies. The manager and staff stated that this is having an impact on the care service provided to the six service users. What the service does well:
The environment is suitable for individuals with a physical disability. There is level access and adequate adaptations to ensure the safety of service users and the staff. All communal areas and the bedrooms were free from odour. Evidencing that the management of continence was satisfactory in the home. The service users appeared comfortable and well cared for. Service users require a high level of support with their personal care needs. From talking with staff and the manager the home was reviewing many of the practices in the home to ensure that they reflected current good practice. The manager stated that the organisation strives to provide services tailored to the individual and this was being incorporated into the business plan for Russell House. Staff stated the manager has made changes in the planning of the menus, activities, medication administration and the day-to-day routine of the home to ensure that it was person centred. This is good practice and shall be
Russell House Version 1.10 Page 6 monitored at future inspections. It was evident that the service users were the focus of the changes. Staff have available to them a prospectus of training including a National Vocational Award. Training records evidenced that staff had attended training relevant to the care needs of the service users. What has improved since the last inspection? What they could do better:
The home must focus on the recruitment of staff and ensure that the staff roles are clear. The manager stated that the qualified nursing staff are having to complete many of the tasks of the unqualified care staff due to the high level of bank usage in the home. This was evidenced in the lack of reviews of the care documentation, which is an outstanding requirement.
Russell House Version 1.10 Page 7 There was lack of risk assessments on the use of restraint in the form of bedsides and wheelchair straps. The home must ensure that there is information in the home to enable service users to chose whether to live at Russell House. The home must ensure that the kitchen is clean. The fire records were inadequate. There was no evidence that staff were attending the appropriate training or fire drills. There were gaps in the fire checks that should be completed on a weekly and a monthly basis. The manager stated that the home only has one driver working in the home and a day care worker who can use the mini-bus and this has imposed restrictions on the use of the vehicle. However, the manager is planning to recruit staff that are able to drive. The inspector was concerned that the cost of the vehicle was high compared to the usage. However, the additional cost was clearly documented in the contract and the terms and conditions. It is strongly recommended that an independent person is involved in the decision-making process and to act as an advocate for the individuals to ensure it is equitable. Concerns were raised in the organisation of support to service users during a mealtime. Staffing must be reviewed to ensure the home can meet the assessed needs of the service users and a review on how care support is allocated. This would ensure the safety of service users. The organisation should ensure that the records relating to staff are held in the home and available for inspection. This would provide evidence that a robust process of recruitment of staff is being completed ensuring the safety of service users. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Russell House Version 1.10 Page 8 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 Standards Statutory Requirements Identified During the Inspection Russell House Version 1.10 Page 9 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 standard(s) 1,2,5 The home was meeting the assessed needs of service users. There is inadequate information to enable service users to make an informed choice about living in the home. EVIDENCE: A statement of purpose was available but this was in a draft format. The manager stated they were unable to find an up to date statement of purpose or a service user guide. The inspector sent the home a copy of the information that was held on file including a service user guide and a statement of purpose. This requires updating to ensure compliance with the legislation. Other information seen included a contract, which contained the rules of the home, and what is included in the fees. Contracts were written in plain English and evidence was provided that these had been read to the service users by a named care worker responsible for the individual’s care (a key worker). These were not in an accessible format for the service users. Suggestion would be that these include photographs and symbols. The assessment process was in place for each service user’s care records seen. This included an assessment of need, which had been completed by the home and involved other professionals including the placing authority. The home has an admission policy to guide them, clearly describing the process to follow. Russell House Version 1.10 Page 10 The manager stated that the home has had an established service user group for the past two years. The last person to move to the home was an emergency and did not visit the home as much as was liked prior to making a decision to move there. However, it was evident from talking with the manager she was aware of the legislation and the organisational policy on understanding the importance of the assessment process. Visits evidently would normally be encouraged to enable all parties to be sure that the home is appropriate. Russell House Version 1.10 Page 11 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 standard(s) 6,7,9,10 The home is committed to person centred care and whilst addressing communication with service users, it fails to demonstrate fully that there are safe working practices. EVIDENCE: Care plans reviewed included a range of information showing how to assist service users with physical care needs. These were tailored to the individual. Care plans were not being reviewed a minimum of six monthly. There were no plans of care or risk assessments on the prevention of pressure area care. There were some fundamental areas not included in the care plan, which included a risk assessment on the use of restraint in the form of wheelchair straps and bedsides in accordance with the Department of Health’s guidelines. It was evident that the home was meeting the complex communication needs of the service users. It is difficult for the service users to make decisions on every day living due to the individual’s limited verbal communication. However, the home has sought support from independent advocates in making complex decisions. This is good practice.
Russell House Version 1.10 Page 12 Service users at Russell house communicate using gestures and sounds. Staff have interpreted this and recorded this in the care plan. This is good practice. Evidence was seen that the home was accessing support from the speech and language therapist where relevant for individuals. It was evident that the home was maintaining the safety of service users but this could have been further enhanced if risk assessments were being reviewed. Russell House Version 1.10 Page 13 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 standard(s) 11,12,13,14,16,17 Service users have individual lifestyles that include participation in community events. However, the use of nicknames could be interpreted as failure to demonstrate respect. EVIDENCE: Service users had opportunities to go out on the day of the inspection with staff and a community day care worker. Service users were seen leaving the home in the mini bus, which is funded by the service users. There was a trip in the morning to Severn Beach and in the afternoon two service users went to Chew Valley lake. Staff stated this would involve a short stroll around the lake and a cup of tea with a cake. One service user was out at a day centre. Staff stated that activities are arranged in the home. This tends to focus on listening to music and relaxation due to the level of physical disabilities of the individuals living in Russell House. An area of the home has been set-aside as
Russell House Version 1.10 Page 14 a relaxation area and includes specialist equipment. Staff have been creative in making this area comfortable. Staff stated that service users enjoy particular music, which ranges from classical to rock. Service users have attended concerts and trips to the theatre. Another service user has attended a football match. From discussions with staff it was evident that service users were not discriminated against because of their physical disability. Mealtime was a group activity. Two staff were supporting five service users. One member of agency staff was assisting two service users with their meal. This was further complicated as he was eating his meal. This member of staff had not worked in the home previously and received a handover of individual’s skills in front of the other service users. This is poor practice. During the meal service users were included in general conversation. The use of nicknames are used within the home and used as a term of endearment. However, the term used during the meal could be interpreted derogatively. The manager demonstrated that the nicknames are recorded in the plan of care but discussion with the team should be generated to ensure that they are appropriate and not part of institutionalised practice. Service users were supported by staff throughout the morning, staff were patient and sensitive to service users care needs. Staff had a good understanding of the individuals preferences in aspects of daily living including personal care, social activities and food likes and dislikes. Evidenced through conversations with staff, observations and care records. Russell House Version 1.10 Page 15 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 standard(s) 18,19,20 Service users personal, social and health needs including the management of medication is well met. EVIDENCE: Records were informative about the personal care needs of individuals given clear direction to staff. This included individual preferences on how they wanted to be supported. Service users are supported to attend appointments with the GP, opticians, dentist and hospital appointments. Service users nursing care needs are being met. The home is supporting one service user with artificial feeding (PEG Feed). The registered nurses have received training on the use of a PEG feed. Evidence was seen of this in the form of a certificate and two nurses confirmed their attendance. District nurses were supporting the home with advice on the PEG feed. Registered nurses support Service users at all times. The staff rota provided evidence that a registered nurse staffs the home 24 hours a day in accordance with the home’s certificate of registration. The home is registered to provide nursing care. There is potential for service users to be at risk of pressure sores. From talking with staff and the manager the home was managing this well. No service users had a pressure sore at the time of the inspection. The home has adequate
Russell House Version 1.10 Page 16 equipment to prevent skin breakdown including special seating, pressure relieving mattresses and evidently good personal care. However, there was no documentation to support this in the form of an assessment, care plan or risk assessment. On the day of the inspection staff responded to the care needs of the service users in a sensitive and patient manner. Personal care was administered in the privacy of the individual’s room or the bathroom behind closed doors. The manager ensured that the individual’s privacy was maintained by checking with staff who was being assisted prior to showing the inspectors around the home. This is good practice further evidenced that the culture of the home including maintaining service users privacy and dignity. Staff were seen knocking on doors before entering. Service users are supported daily with their personal care needs. Service users had very distinctive style in clothes and haircuts. Service users seen on the day of the inspection had the appearance of being well cared for. Medication was satisfactory. The home has developed medication risk assessments and protocols for each individual involving the doctor. This included a homely remedy protocol for each individual. This is good practice. The information was informative and detailed to enable new staff to support individuals. Russell House Version 1.10 Page 17 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 standard(s) 22,23 The home has robust procedures for the protection of service users and responding to complaints. However, the home failed to demonstrate how it would recognise and deal with a complaint from a service user. EVIDENCE: In this particular home it is difficult for service users to make verbal complaint due to their degree of physical disability. However, the staff in the home had a good knowledge of the service users and their preferences. However, it was difficult to fully judge how the home would respond to a complaint. The home has not had a complaint since the new manager commenced in post, last June 2004. The home did not have a record of complaints. However this was rectified at the time of the inspection. Relatives and visitors have available to them a list of contacts. This was on display in the hallway of the home and next to the visitor’s record. Care records included communication methods for each individual. This could enable staff to interpret when service users are not happy and complaining about the activity being undertaken or the care service. Staff on the day of the inspection demonstrated how non-verbal communication was interpreted to ensure that a service user was happy. A procedure for responding to allegations of abuse was not seen on this inspection. The manager stated that all staff have attended a half a day course
Russell House Version 1.10 Page 18 on abuse and the procedure. This is compulsory training given to all staff annually. The home has procedures and checks in place that protect service user moneys. Record of transactions on all expenditure, receipts and two staff signatures were in place. Staff check money on a daily basis. This is good practice. Russell House Version 1.10 Page 19 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 standard(s) 24,25,26,27,28,29,30 Service users are provided with a homely environment, which meets its stated purpose. However, not all areas of the home were clean. EVIDENCE: The inspector had an opportunity to view the home. All areas seen except the kitchen were clean and free from odour. The kitchen had thick grease on the tiles behind the sink and the cooker and a lot of dust and marks on the wall in high to reach areas. This must be addressed so as not to pose a risk to service users. Maintenance was being responded to promptly ensuring a safe place for service users to live. The home has a number of aids and adaptations including hoists, high low bath and beds that can be raised to assist an individual with a physical disability. The manager is a manual-handling instructor. Records seen evidenced that staff had attended training in manual handling. There were clear instructions in care records tailored to the individual on the equipment to be used.
Russell House Version 1.10 Page 20 Service users have access to a large, well kept garden. There is sufficient off street parking. There are two shared bedrooms and two single rooms. Rooms that were shared had screening to ensure the privacy of each person. The manager stated the organisation is exploring options to address the shared living arrangement. As yet no plans have been confirmed. The manager has agreed to keep the Commission for Social Care Inspection informed of the situation. Western Challenge (a housing association) owns the home and this is then leased to Milestones and Aspects. On the day of the inspection Weston Challenge were visiting the home and completing some initial investigations into future plans for the home and the shared occupancy of two of the bedrooms. This would be good practice. Service users have access to a large open plan lounge; part has been sectioned off to provide a sensory area. At the end of the lounge is the dining room and kitchen. Bedrooms had been furnished and decorated to reflect the service users interests. This helped in giving an individual feel to the rooms. Adequate furnishing was provided as per the standard. There was sufficient space for staff to assist with personal care. Service users were seen making full use of their home supported by staff. Service users were either in the lounge areas or their bedrooms. Service users were engaged in listening to music or watching the television and sitting with staff. Service users have available to them adequate bathrooms and toilets available to them. These areas were lockable and there was a safety override device if necessary. The home had policies on infection control and individual guidelines in care plans. There was a supply of plastic gloves, aprons, liquid soap and paper towels in toilets and in bedrooms. The home has a separate laundry and sluice facility. This was adequate for the size of the home. The laundry doubled up as storeroom for wheelchairs and hoists were stored in the bathrooms. Whilst this was not perfect there was no other storage facilities available to the home. Staff stated that this does not pose a risk to service users. Russell House Version 1.10 Page 21 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35 Staffing is inadequate at times that led to low staff morale. EVIDENCE: The home has five staff vacancies, which are being covered by bank or agency staff. Whilst the home is legally meeting the staffing numbers and ensuring adequate staffing on a daily basis the home is using a high level of bank and agency staff. On the day of the inspection two out of the four staff were permanent. The agency staff had not worked at the home prior to the day of the inspection and was expected to assist two service users with lunch with the other bank member of staff. During the meal the two staff were handing over information that could be seen as personal to the service user on the way that they like to be fed. This information should have been shared during a handover in the office and not during the mealtime. It later came to light that one of the individuals should have been assisted by a competent and familiar member of staff due to a high risk of choking. This poor allocation of staff could pose a potential risk to service users and clear guidance should be given to all staff to ensure they are aware of the potential risks. An immediate review of mealtimes is required.
Russell House Version 1.10 Page 22 Staff stated that the home tries to ensure that bank staff are familiar to the home. The rota further demonstrated that a core bank team supported the home. The home maintains records of bank inductions when information is shared with them on the running of the home and the care needs of the individuals living at Russell House. A staff member confirmed that they had completed an induction with the staff on duty. However, this could have been improved if this included information about the mealtime and support needs of service users. The meal time was discussed with the manager, who stated that she intervened and this is not common practice in the home. Staff should only assist one service user at a time and all staff should have been in the lounge to assist with the lunch. The inspector was informed that all six service users need assistance with feeding. The home must ensure that there is adequate staff to meet the assessed needs of the service users during peak times including meal times. The home must review the staffing during meal times. Staff have received training relevant to the care needs of service users. Discussions with staff and training records confirmed that staff had attended a variety of training since the last inspection and there was a prospectus of future training available relevant to the home. Training attended included PEG feed for the registered nurses and all the team have attended a course on communication and the protection of vulnerable adults. Training was appropriate to the care needs of the service users. The inspector spoke with a registered nurse. She was able to demonstrate that she had attended periodic updates to meet her continuing registration as a registered nurse. This was in response to a previous requirement. Records relating to recruitment are held at a centrally office. Legislation is clear that these should be held in the home. Discussions have taken place between the provider and the Commission for Social Care Inspection. Russell House Version 1.10 Page 23 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,40,41,42,43 The manager is motivated and enthusiastic about her role. However, as yet has to address issues of fire safety. EVIDENCE: Ms Asef-Evans manages the home. She is passionate about her role as manager and the rights of the individuals living in the home to an individual tailored lifestyle. Ms Asef-Evans shared with the inspectors her long-term goals of the home and ensuring that care is tailored to the individual. This has meant a cultural change for the home and in her words has been a “slow up hill struggle”. Staff spoken to during the inspection were aware of the changes and saw many of them as being positive. The manager stated that the process has been slow due to the high usage of bank and agency staff making up half the staff numbers and the high sickness. Russell House Version 1.10 Page 24 Concerns were raised about the day-to-day management of the home in that an agency staff was supporting an individual with complex feeding and was prone to choking and that a handover of service users skills was given during a meal. There were good routine checks on the property and equipment to ensure that service users and staff are safe. Fire records did not demonstrate that staff were attending regular training as prescribed by the fire officer or that staff were attending fire drills. There were gaps in the routine fire checks. This could pose a risk to all living and working in Russell House. The manager stated that she has a budget, which is reviewed monthly and discussed, at regular intervals with the Service Development Manager. The service development manager meets with service users, staff and the manager on a monthly basis in accordance with the legislation. Copies of the report are being sent to the Commission for Social Care Inspection. 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4
Russell House Score 2 3 x 3 Standard No 22 23
ENVIRONMENT
Version 1.10 Score 2 3 Page 25 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 2 x x 2 2
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 3 3 3 2 Standard No 11 12 13 14 15 16 17 3 3 3 3 x 2 2 Standard No 31 32 33 34 35 36 Score 3 3 2 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 2 x 3 3 2 3 Russell House Version 1.10 Page 26 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 4 (1) (c) Schedule 1 Regulation 5 Requirement For the home to have a statement of purpose and a service user guide. A copy to be sent to the Commission for Social Care Inspection. Service user plans to be kept under review at least six montly. (Previous timescale of 25th January 2005 still outstanding) For the home to document how they minimise the risks to service users from pressure sores. For this to be kept under review. For the home to document and review the use of restraint in the home including the use of bedsides and wheelchair straps. for this to include consent from a relative or an independent representative. For the home to review the staffing to ensure it can meet the care needs of the service users mainly at meal times. For the home to deep clean the kitchen. For all staff to attend a fire drill every six months. For staff to attend fire training-: 3 monthly for night staff and six
Version 1.10 Timescale for action 6th Ocotber 05 2. 6 15 (2) (b) 6th June 2005 6th May 2005 3. 9,19 17 (1) (a) Schedule 3 (3 (n) 13 (8) 4. 9 6th May 2005 5. 33 18 (1) (a) 6th April 2005 6th May 2005 13th April 2005 6th April 2005
Page 27 6. 7. 8. 30 42 42 23 (2) (d) 23 (4) (e) 23 (4) (d) Russell House monthly for day staff. 9. 10. 42 34 23 (4) (v) schedule 4.6 17 (2) To ensure that the checks on the fire equipment are in accordance with the fire brigades advice For the records relating to the recruitment of staff as per schedule 4.6 to be held in the home 6th April 2005 6th August 2005 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. 2. Refer to Standard 16 23 Good Practice Recommendations To ensure service users are addressed in an appropriate manner. To ensure the use of nick names is appropriate. To review the cost of the vehicle to ensure it is equitable. For a representative independent of the home to advocate for service users on issues of consent to the contribution to the vehicle. For the organisation to explore options for service users to have a single bedroom Staff to be aware of the need for confidentiality and whether it is appropriate to share information in front of other service users 3. 4. 5. 25 16 Russell House Version 1.10 Page 28 Commission for Social Care Inspection 300 Aztect West Almondsbury South Glos BS32 4RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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