Inspection on 20/01/06 for Ryedale Court Nursing Home

This inspection was carried out on 20th January 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ryedale Court Nursing Home 28/08/07

Ryedale Court Nursing Home 02/08/06

Ryedale Court Nursing Home 16/06/05

Ryedale Court Nursing Home 09/12/04

Ryedale Court Nursing Home 07/06/04

Ryedale Court Nursing Home 18/09/03

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Ryedale Court Nursing Home Victoria Road Barking Essex 1G11 8PE Lead Inspector Unannounced Inspection 20th January 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ryedale Court Nursing Home Address Victoria Road Barking Essex 1G11 8PE 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) 020 8514 2525 020 8514 2727 Avonpark Care Centre Limited Mr Selvenaden Tiagarassa Pillay Care Home 70 Category(ies) of Dementia - over 65 years of age (53), Old age, registration, with number not falling within any other category (17) of places Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 17 BEDS FOR ELDERLY FRAIL 53 BEDS FOR ELDERLY MENTALLY ILL MINIMUM STAFFING NOTICE To include one named person under 65 years of age. Date of last inspection 16th June 2005 Brief Description of the Service: Ryedale Court Nursing Home provides nursing care and accommodation for older people who have dementia or physical fragility due to the ageing process The home is registered to accommodate seventy service users. The registered providers are Avonpark Care Centre Limited. The home has three separate units, two of which accommodate older people with dementia and one smaller unit for the frail elderly. The majority of the rooms are single and en suite with three double rooms on the elderly frail unit. There is a passenger lift. The home employs an activities co-ordinator, catering, laundry housekeeping, administrative and maintenance staff. The home is situated in a residential area of Redbridge on the borders of Barking and is well served by public transport. Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 9.30am. It took place over eight hours during the morning and afternoon. Discussion took place with the registered manager, administrative staff, laundry, domestic staff, the maintenance person and several members of nursing and care staff. The Inspector spoke to several residents in the lounges and a number of residents on each of the three units who were in their rooms. In addition the relatives/ visitors of six residents were spoken to and asked their views and comments about the care in the home. A tour of the home was made and a number of care and staff records were looked at. The Commission is aware of a number of adult protection matters that are subject to ongoing investigation. The organisation is working co-operatively with the Commission and local authority to address these matters. This was the second statutory inspection visit in the inspection programme for 2005/2006. Over the course of the two visits, all key standards have now been assessed. The Inspector would like to thank the staff, residents’, and their relatives/ visitors for their input during the inspection. What the service does well: What has improved since the last inspection? A new senior nurse has been appointed with responsibility for Park Unit. This now means that there is a designated senior nurse on each of the three units. A handover protocol has been developed to ensure that there is an effective system for handing information over from shift to shift. Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 6 New documentation relating to wound management has been developed and includes a body map, which is reviewed weekly. Nursing staff have received training in the management of pressure wounds and their prevention and care staff have had training in the prevention of pressure sores. 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. Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not tested on this visit. However, evidence from the last inspection was that: • A comprehensive pre-admission assessment is undertaken for all residents prior to them moving into the home. Care plans are drawn up from this assessment, ensuring that the needs of the resident are identified, understood and met. The home does not offer intermediate care. EVIDENCE: The above standards were not specifically tested on this visit, as there were no outstanding requirements in relation to Standard 3. At the time of the inspection, all of the outcome standards were assessed as met. This standard will be re-tested at a future inspection. Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 Residents’ health and personal care needs are set out in individual care plans but not all plans accurately reflected the current needs and did not provide staff with sufficient information to ensure that care needs were being met on a daily basis. There are clear medication policies and procedures for staff to follow. However, the unsafe practice of some staff around the administration of medication is of concern and could result in residents’ being put at risk. Residents are treated with respect and the arrangements for their personal care ensure that their right to privacy is upheld. However, staff must review where the handover procedure takes place to ensure confidentiality for all residents. EVIDENCE: Garden Unit Individual care plans were available for each resident and the records of four residents were examined. The records for these residents were found to be generally detailed and comprehensive around the social, nursing and personal care needs, and followed on from a full assessment. There was evidence that Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 10 care plans are reviewed on a monthly basis and updated to reflect changing needs. The records indicated that residents are seen by other health care professionals. Risk assessments are routinely undertaken for all residents. Fluid monitoring charts were being maintained accurately and up to date. Park Unit Individual care plans were available for each resident and the records of five residents were examined. The records for these residents were found to be generally detailed and comprehensive. However, there were inconsistencies in the practice and standard of some care plans and the following was discussed with the nurse in charge of the unit. • On examination of one care plan it was noted that cot sides were indicated for use whilst the resident was in bed. There was no evidence that a risk assessment had been undertaken for their use. There was no record to show that discussion had taken place with the resident’s relative/ representative or permission sought. On examination of the care plan for a resident with diabetes, there was insufficient detail about the action required by staff to ensure that this aspect of her health would be fully understood and met. Entries in daily recordings did not always relate to specific care plans and entries made gave little indication of the actual care given. Comments made included: “Spent a good day, comfortable”. • • The records indicated that residents are seen by other health care professionals for example, Tissue Viability Nurse. Food/ fluid monitoring charts were being maintained accurately and up to date. Oaklands Unit Individual care plans were available for each resident and the records of five residents were examined. The records for these residents were found to be generally detailed. However, there were inconsistencies in the practice and standard of some care plans and the following was discussed with the nurse in charge of the unit. • On examination of the care plan of a resident admitted in February 2005 with a diagnosis of dementia, there was no evidence of a mental health assessment having been undertaken. None of the pro forma risk assessments included in the care plan had been completed. No body map had been completed following a recent fall and no risk Assessment undertaken. A referral had been made to a surgical consultant and the resident had attended an out patient appointment. There was no record in the care plan of the outcome of this referral. Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 11 • On examination of the care plan of a resident being nursed in bed it indicated that the resident must be turned every two hours. However, the turning chart was not being maintained accurately or up to date. Daily entries by nursing staff into care plans gave little indication of the actual care given and did not relate to specific care needs as detailed in care plans. • A number of fluid intake/ output charts were examined. This included recordings for the day of the visit and the preceding week. Some charts had the first fluid intake of the day recorded as 9.30am and the last fluid intake of the day recorded as 4.30pm. For some residents this would indicate that fluids had not been given for periods of some seventeen hours. This concern was discussed with the nurse in charge and she indicated that she would raise this with the care staff, as it was their responsibility to maintain these charts. If the recordings of fluid intake are indicated for a resident then this must be considered a clinical record and must be monitored by nursing staff. It is essential that all monitoring records for individual residents are maintained accurately and up to date. Discussion with staff suggested that residents were receiving fluids but that staff were failing to record this on each occasion. The Inspector also observed fluids being given to residents regularly throughout the visit. The Inspector observed the handover from the AM to PM shift. The handover took place at the nurse’s station. The nurse in charge made no reference to written care plans only to a list of residents by name. This approach is dependent on staff memory and good verbal communication systems, which the Inspector did not evidence on the day. Residents are at risk of not having their health care needs met by the use of such an informal system. At the time of the handover a resident interrupted the handover to make an enquiry regarding his finances. The nurse in charge initially dealt appropriately with his enquiry but the resident remained insistent and concerned. The nurse in charge then ignored this resident and continued to communicate information about other residents in his presence until the Inspector stated that this was not appropriate. During a visit to one of the lounges the Inspector noted thirteen residents in the lounge and no staff were present. The Inspector was concerned for all residents but in particular for one resident who was wandering and attempting to move furniture. The Inspector went to look for a member of staff and could not find any. The Inspector informed the nurse in charge, who was seated at the nurse’s station, that residents in the lounge had been left unsupervised. Her response was that there were two staff in that area but the Inspector informed her that these staff were attending to another resident in the bathroom. The response by the nurse in charge was not immediate and she only went to deal with the situation when requested to do so by the Inspector. Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 12 During a visit to Oaklands unit with the registered manager, the Inspector and registered manager noted that medication contained in blister packs had been left unattended on the nurse’s station. The nurse administering medication was in the dining room, which is adjacent to the nurse’s station. This issue was addressed immediately. The practice of leaving medication unattended is of serious concern. All nursing staff must abide by the home’s medication policy and the Nursing and Midwifery Council (NMC) Standard for administration of medication. All the above concerns were discussed directly with the registered manager. The organisation has actively addressed all these concerns. General Handover between shifts is currently undertaken at the nurse’s station. The manager must review where the handover between shifts takes place, in order to ensure confidentiality for all residents. New care planning documentation has recently been introduced and is in various stages of implementation across the three units. Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12 and 14 There is a varied programme of activities available, which suit individual needs, preferences and capacities. The programme provides daily variation and interest for people living in the home. Standards 13 and 15 were not tested on this visit. However, evidence form the last inspection was that: • Visiting times are flexible and people are made to feel welcome in the home so that residents are able to maintain contact with their family and friends as they wish. • The meals in the home are good, offering both choice and variety for residents living in the home. EVIDENCE: The above standards were not specifically tested on this visit, as there were no outstanding requirements in relation to Standards 13 and 15. At the time of the last inspection, all of the outcome standards were assessed as met. These standards will be re-tested at a future inspection. The Inspector observed members of staff allowing time for residents to express their wishes and supporting individuals to make choices in their daily lives, for Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 14 example choosing a drink, newspaper, type of music to listen to or where they wish to eat their meal. The home employs a full time activity organiser. Since the last inspection a review has been undertaken of the activities programme and the activity organiser has taken into account the needs, preferences, expectations and capabilities of all residents in the home. There are a variety of small and large group activities and outings for example to theatres and other outside entertainments. Each resident has a social care plan however, a record should be maintained of the activities the individual resident is involved in and their level of participation. The choice of those residents’ not to be involved in some or any activities is respected. Relatives and friends are encouraged and welcomed to be involved in special events in the home so that residents are able to maintain contact with their family and friends. Activities include trips to external venues such as theatres. The manager must ensure that the home develops an appropriate policy for staff when escorting residents and risk assessments for these activities. Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 were not tested on this visit. However, evidence from the last inspection was that: • The manager and staff make every effort to sort out any problems or concerns and make sure that residents and relatives feel confident that their complaints and concerns are listened to and will be acted upon. Staff working in the home have received training in Adult Protection/ Abuse Awareness to ensure that there is a proper response to any suspicion or allegation of abuse. • EVIDENCE: Standard 18 was not specifically tested on this visit, as there were no outstanding requirements in relation to this standard. At the time of the last inspection, all of the outcome standards were assessed as met. This standard will be re-tested at a future inspection. The Commission is aware of a number of adult protection matters that are subject to ongoing investigation. The organisation is working co-operatively with the Commission and local authority to address these matters. At the last inspection a requirement was made for the complaints policy to be amended to include information for referring a complaint to the Commission, at Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 16 any stage, should the complainant wish to do so. The Inspector was able to evidence that this requirement has been met. Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26. The overall atmosphere in the home is welcoming, with access to indoor and outdoor communal facilities which adequately meet the needs of the people living in the home. Residents on the dementia units would benefit from improvements in the environment in order to meet the specialist needs of people living with dementia. EVIDENCE: Standard 26 was not specifically tested on this visit, as there were no outstanding requirements in relation to this standard. At the time of the last inspection, all of the outcome standards were assessed as met. This standard will be re-tested at a future inspection. There is an ongoing programme for the re-decoration of bedrooms, which will provide more comfortable surroundings for residents. Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 18 The standard of the décor, furnishings and fittings are generally being maintained to a good standard. There are well-maintained garden areas to the front and rear of the home, which are accessible to residents. The home employs a maintenance person and there is a system in place for staff to report items requiring repair or attention. There are a number of residents on the dementia units who are independently mobile. As the ability of people with dementia to communicate with words decreases, the use of non-verbal cues and the environment is important in enabling them to cope better with daily life. The general environment on the dementia units must reflect good practice on dementia care within care homes. Consideration must be given to utilising the existing design and layout of this unit to meet the specialist needs of people living with dementia. For example, through the use of visual cues such as colour and signage. “Memory” boxes fitted to resident’s bedroom doors with photos or items that have some significance to the individual may assist them in locating their rooms. Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 29 and 30 The home employs staff in sufficient numbers however, the Commission cannot be confident that all staff have the training and competence to meet all residents needs. The procedures for the recruitment of staff are robust and provide safeguards for people living in the home. EVIDENCE: Health and personal care needs were discussed with some staff, and staff were observed carrying out their duties during the visit. A number of concerns around the training and competency of some staff in the provision of health and personal care to residents, particularly on Oaklands Unit were discussed directly with the manager. The organisation has actively addressed these concerns. These concerns have already been detailed in this report. (See Standards 711 Health and Personal Care) The registered providers must ensure that staff individually and collectively, have the required skills, experience and training to deliver the service and care which the home offers to provide to all residents. Those residents who were able to express a view, were very happy with the care they were receiving in the home. Several relatives spoken to during the Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 20 visit were very complimentary about the care and spoke favourably about the nurses and care staff. Since the last inspection all qualified nurses have undertaken training in Pressure Sore Management and Prevention and all care staff have received training in Prevention of Pressure Sores. An examination of the files of two staff employed since the last inspection showed that the home is undertaking all the necessary recruitment checks to ensure the protection of residents. Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 36, 38 The manager is a very experienced and well qualified person. However, because of the size of the establishment it is essential that the lines of accountability within the home are robust enough to ensure that the manager is, at all times, fully appraised of any issues relating to the day to day running of the home, and of the specialist needs of residents. Monitoring visits are undertaken regularly by the responsible individual to monitor and report on the quality of the service provided in the home. Standard 35 was not tested on this visit. However, evidence from the last inspection was that: • Since the last inspection the manager has reviewed the home’s system for recording money and valuables held in the safe. The new system ensures that secure facilities are provided for the safekeeping of money and valuables held on behalf of residents. Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 22 EVIDENCE: From discussions with staff and records inspected it was evident that staff receive regular formal supervision and staff meetings take place on a regular basis. Concerns around the provision of health and personal care to residents by some members of nursing staff have already been detailed in this report. (See Standards 7-11 Health and Personal Care) All these concerns are being actively addressed by the registered organisation. The registered manager must put in place effective monitoring systems to enable him to maintain informed day-to-day control of the delivery of care in this large establishment. Regulation 26 reports are undertaken regularly by a representative of the organisation and a copy of the report is sent to the Commission. A wide range of records were looked at, including fire safety, emergency lighting, recording of water temperatures, accident/ incidents and portable appliance testing (PAT). These records were detailed, up to date and accurate with the exception of the PAT, which is currently out of date and must be reviewed. Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 3 X X X X X X STAFFING Standard No Score 27 2 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X 3 2 2 Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 OP9 Regulation 13 Requirement All nursing staff involved in the administration of medication must abide by the homes medication policy and the Nursing and Midwifery Council (NMC) Standard for administration of medication. (Timescale of 16/06/05 not met) All residents must have individual plans of care, which show how all their health, personal and social care needs are to be met. Staff individually and collectively must have the required skills experience and training to deliver the service and care which the home offers to provide and to ensure the health and welfare of all residents. The existing layout and design of the environment on the dementia units must reflect good practice guidance on dementia care within care homes, to ensure that the specialist needs of residents on these units are met. The manager must put in place DS0000015602.V278691.R01.S.doc Timescale for action 20/01/06 2 OP7OP8OP 37 12 & 15 31/03/06 3 OP4OP27O P30 12 & 18 31/03/06 4 OP19 23 30/04/06 5 OP31 9 & 24 31/03/06 Page 25 Ryedale Court Nursing Home Version 5.1 6 OP38 23 7 OP8 12 an effective monitoring system to enable him to maintain informed day-to-day control of the delivery of care in the home. The manager must arrange for Portable Appliance Testing (PAT) to be undertaken at the required intervals. Where the record of fluid/ food intake, turning regimes etc., is indicated for a resident, these recordings must be accurately maintained and up to date. 31/03/06 20/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 Ryedale Court Nursing Home DS0000015602.V278691.R01.S.doc Version 5.1 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!