Inspection on 01/09/05 for Southlawns

This inspection was carried out on 1st September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Southlawns 26/02/09

Southlawns 23/01/07

Southlawns 12/01/06

Southlawns 26/01/05

Southlawns 20/08/04

Southlawns 26/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Southlawns Highfield Road Street Somerset BA16 OJJ Lead Inspector Judith Roper Unannounced 1st September 2005 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 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. Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Southlawns Address Highfield Road Street Somerset BA16 OJJ 01458 443635 01458 448860 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) Somerset Care Limited Mrs Vera Margaret Fellows Personal Care Home Only 40 Category(ies) of Old Age (40) registration, with number of places Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 26th January 2005 Brief Description of the Service: Southlawns is a care home providing up to 40 places for older people. It is owned by Somerset Care Ltd, a Somerset based company with 25 care homes and a domiciliary care service. The home is based in a residential area in Street, close to the High Street where there are shops and other amenities. The home is in two floors and the first floor is accessible by a through-floor lift. All bedrooms are single, with either en-suite facilities or with wash hand basins. The home has undergone extensive upgrade over the last two years, considerably improving the whole physical environment. The home is currently being redecorated internally in several areas. Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one inspector and took place over one day between the hours of 9.00 am – 3.45 pm. 40 residents were at the home on the day of the inspection. Day care provision is also provided at the home. There are currently no vacancies at the home. The inspector was able to interact with 23 residents and see most others. Some residents went out at times during the inspection visit into Street or for a walk or to the local pub for lunch. There were several relative visitors at the home during the inspection visit. Staff on duty were able to give time to speak with the inspector. The registered manager Ms. Fellows and he deputy Mrs. Reeves were available for comment during the inspection. The inspector would like to thank the staff for their time and hospitality shown to the inspector during her visit. The atmosphere at the home was relaxed and informal. Staff carried out their duties in a friendly and professional manner. This is the first inspection using the new CSCI reporting format, which focuses on outcome statements for National Minimum Standards. The inspector’s aim on this inspection visit was to seek views on the quality of the service from as many service users as possible and to speak to staff and any visiting relatives. Records examined during the inspection were 4 resident care and support plans, 4 resident risk assessments, medication records, accident records, activity records, Statement of Purpose and Service User’s Guide, staffing rosters, resident’s personal monies managed by the home, the company standard contract for private residents, 2 staff recruitment files and the new company induction training package; other records will be examined at subsequent inspection visits. What the service does well: What has improved since the last inspection? At the last inspection 2 recommendations were made. The company has not acted on the recommendation that the room to be occupied is stated on the resident’s contract. The recommendation was made so that resident’s know Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 Page 6 that they have an allocated room that will not be subject to change without proper consultation. The second recommendation made regarding two staff signing for hand transcribed entries on medication records was complied with during this inspection visit. The home’s environment continues to be upgraded and improved. Since the last inspection lighting has been upgraded and extensive redecoration has taken place and is still on going. The home is more light and attractive. Residents said that they appreciated the improvements made. 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. Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 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 standard(s) 1,2,3,4,5. Information about the home in a Statement of Purpose and Service User’s Guide is available for prospective residents along with the most recent inspection report. This provides residents with comprehensive details about the home to enable them to make an informed choice about the suitability of the home. Pre-admission visits and a trail visit are encouraged, without obligation. Staff training is good and is focused to meet the range of resident needs in the home. EVIDENCE: The Statement of Purpose and Service User’s Guide are available in the foyer at the home. New residents receive an individual ‘Welcome pack’, further describing the routines and facilities at the home. The home also produces its own brochure giving a brief overview of the service. Contracts are in place with the placement authority. Privately funded residents receive a private contract. One set of relative expressed some anxiety that the frequency of fee review was not stated in the contract. This will be discussed by the CSCI with Somerset Care to gain clarity on this point. Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 Page 9 Residents are reassessed when their dependency level rises in conjunction with social workers and the community nursing team to determine continued appropriateness of the placement. The home accepts both respite and ‘Step Down’ placements as well as permanent admissions. Southlawns also has a ‘block contract’ with Somerset Partnership for 14 of its beds. Day care provision is provided for an average of 6 –7 persons per day. Due to staffing pressures a bath is not offered for new day care clients so that staff can concentrate resources on permanent residents in the home. The 3 current ‘Step Down’ beds are for rehabilitative treatment over a maximum of 6 weeks. The home has expressed concerns to the Primary Care Trust (PCT) recently regarding the criteria for ‘Step Down’ patients being discharged from hospital for this type of rehabilitation care as some recent admissions have been for permanent or palliative care. Although the home can meet the needs of both types of residents, this is not how they expected the use of the ‘Step Down’ facility to be used. The manager or deputy manager completes a pre-admission assessment of a new resident prior to admission along with requesting a community care plan from the placement authority. 3 residents admitted since the last inspection said that they or their families had made visits to the home before admission and that they were aware of the month trial period of settling in before a decision of a permanent bed was agreed. Of the residents the inspector spoke with during the inspection, all reported satisfaction with the care they receive at the home. One resident said that the care provision was 10/10. Another resident sat next to the first disagreed and said that it was 11/10. Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 Page 10 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 standard(s) 7,8,9,10. Care plans reflect individual’s health care, social and emotional needs. Care needs are reviewed monthly in writing and by a verbal daily shift handover. Residents and visitors during the inspection reported satisfaction with the standard of care delivered at the home. Medication is generally managed well but a requirement is made regarding variable dose recording in order to ensure that the recording of medicines administered is accurate. EVIDENCE: A sample of 4 care plans were inspected. Care plans contained good information about health needs and recorded clearly where community health care professionals had been sought for advice or had carried out treatments. The community nurses attend to nursing needs and keep notes at the home, available to staff. Resident care plans inspected had risk assessments and manual handling assessments. These assessments were due for review this month. Activity records are completed daily by the activity staff. Residents receive nutritional screening assessments and professional dietetic advice is sought if a resident is at risk of poor or under-nutrition. The home uses two local GP practices and evidence was seen in care plans of regular GP consultation over resident changing needs. Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 Page 11 Medications were inspected. The management of cold storage of medicines was inspected and advice given regarding recording the ideal temperature range of the medicines drug fridge on the daily temperature chart, so that staff can be directed to the range that medicines should be stored at. The manager said she would arrange for the medicines fridge to be defrosted, as there was a build up of ice at the top of the fridge. This was not affecting the safe storage of medicines yet. Medications Administration Records (MARs) were inspected for the current and last month. The general completion of MAR charts was satisfactory but staff did not always record the amount of medication given when a variable dose was prescribed. This was in relation to analgesics and laxatives. It was discussed with the managers the requirements for staff administering medications to record the dose given when a medicine is prescribed as a variable dose. The requirement made is that the management conducts a training session with staff that administer medicines on this issue. Residents spoken with said that staff respect their privacy and residents feel safe at the home. Residents may carry the key to their rooms. They said that staff knock before entering rooms and this was observed during the unannounced inspection. Residents said that the home was friendly. There are several lounges and private outdoor spaces at the home for residents to use. There is an enclosed phone booth for residents to make calls in peace and privacy. There is a treatment room offering privacy when a community health care professional visits for a resident individual consultation. Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 Page 12 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 standard(s) 12,13,14,15. There is a relaxed atmosphere at the home where resident’s choices are respected and encouraged. Residents spoken with said that they felt safe at Southlawns. The home is situated in Street with good short walking access to many shops and amenities, which many residents use. The revised menus at the home reflect good nutritional practices with a choices of meals offered throughout the day. EVIDENCE: There is a part-time activities coordinator employed at the home. The schedule of monthly activities, day-by-day, is displayed in the home. The activities for August included in-house group sessions such as bingo or quizzes, a monthly holy communion and a trip out to Burnham-On-Sea. Several residents are able to arrange their own activities such a days out with families or lunch trips to the local pub or shopping in Street. Key worker care staff also have 1:1 allocated time to spend with their residents in order to do in-house activities or time for a chat. There is a small shop at the home and during the inspection a volunteer was taking a mobile trolley with items for sale around the home and to residents choosing to spend time in their bedrooms. Visitors spoken to during the inspection said that the staff and management at the home were very welcoming, offering refreshments to visits and keeping them informed of changing needs of their loved ones. Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 Page 13 Some residents said that they choose to vote in the May elections. Residents said that their personal choices are respected by staff. Southlawns has recently revised its menu system. It has consulted extensively with a dietician in the menu choices. This is good practice. There is now more fresh seasonal produce on the daily menu. The Company, Somerset Care has an internal meal planning group, of which the manager Vera Fellow is part of. Lunch was observed at the home. The dining room is attractive and spacious. Choices were available for the lunch menu, which is displayed on each dining table. Residents can serve their own vegetables from the tables. The meal appeared to be enjoyed by residents and feedback to the inspector following the meal about the food at the home was positive. The home until fairly recently also used to provide community meals. This has now stopped in order to concentrate on meal provision for the home only. At lunch time staff on their lunch break sat with residents to eat their meals. This seemed to add to the relaxed social informality of the occasion. Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 Page 14 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 standard(s) 16,18. There have been no complaints received since the last inspection. The number of complaints generated at the home is low. Residents and visitors said that staff and managers at the home are approachable and listen to concerns raised. Appropriate policies and practices are in place to protect vulnerable adults from pre-employment checks carried out for staff and staff training. EVIDENCE: The home has not received any complaints since the last inspection. The complaints procedure is in the ‘Seeking Your Views’ policy in the Statement of Purpose, Service User’s Guide and Welcome pack. The name of the regulatory authority reflected the NCSC, which is now the CSCI. The manager arranged for this to be changed during the inspection. Somerset Care has appropriate policies and procedures for the protection of vulnerable adults. Staff training in abuse detection starts during induction and is carried forward via the NVQ process and in-house training. The 2 staff recruitment files inspected demonstrated appropriate pre-employment checks on staff to protect vulnerable adults had been carried out. The home advertises and utilises the advocacy services of Age Concern. Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 Page 15 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 standard(s) 19,20,21,22,23,24,26. The environment at Southlawns is attractive and maintained well. There are appropriate facilities for disabled residents. The home is clean and the staff team adheres to infection control measures. Communal space is plentiful, offering a range of lounges for residents. Resident’s bedrooms are personalised reflecting individual personalities and choices. EVIDENCE: The premises at the home are modern in design and are adapted to the needs of disabled people. The community nursing team advises the home when equipment is needed such as for pressure relieving purposes. Somerset Care also employs an occupational therapist who can advise on mobility aids. There are a number of small quiet lounges at the home in addition to a large central communal lounge that is situated off from the dining room. Recent redecoration has made the home more light and attractive. Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 Page 16 There is a treatment room for consultations, office space, staff room and hairdressing room. The outside grounds are maintained well and there is level access around the perimeter for wheelchair users. All bedrooms are for single occupancy and rooms are routinely decorated when a room vacancy occurs. Bedrooms are personalised by residents. Somerset Care has a programme of increasing the percentage of en-suite facilities at the home as part of scheduled maintenance works. There are three communal bathrooms at the home. Two are adapted for disabled use. There are other sufficient numbers of toilet facilities at the home. The number of bathrooms falls below the National Minimum Standards requirement but as day care bathing is being phased out this means that the bathing facilities at the home can meet needs of current residents. There are robust infection control measures in place at the home. Visitors are requested to use alcohol gel on their hands that is provided in the foyer when entering and leaving the home. There are liquid soap, paper hand towels and flip top bins provided in bathrooms, toilets and bedrooms where personal care is provided. Staff wear gloves and aprons when attending to personal care tasks. The laundry is equipped sufficiently to manage cross infection and infection control in the home. There are two sluices with bedpan washers for managing commode hygiene. Staff receive statutory training in the Control of Substances Hazardous to Health (COSHH). The standard of domestic cleanliness on the day of the unannounced inspection was good. Residents and visitors said that the home maintains a high level of cleanliness and that there is no malodour at the home. Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29. The numbers of staff rostered for each shift are sufficient to meet current resident need requirements. Waking night staff are employed. Staff training is planned well and the percentage of staff holding a professional qualification in their job role is pleasingly high. Recruitment practices demonstrate that resident’s are protected by adherence to the Company’s recruitment policies and procedures. In order to demonstrate equal opportunities, it is advised that interview notes should be recorded for all applicants. EVIDENCE: There is a staffing structure of management, administrator, care supervisors, care staff, care support and ancillary workers. The management is supported by an area manager, who conducts at least a monthly visit, where a report is generated for the home and Company (Regulation 26 report). Copies of two weeks staffing rosters were requested to taken away by the inspector to examine staffing levels. Some residents thought that there had been some shortness of staffing levels recently. The management reported that they had been covering vacant shifts and covering staff holidays over the last few weeks. This was recorded on the staffing rosters. The staff rosters take into account day care provision at the home in addition to permanent resident numbers. There is a very low amount of agency staff usage at the home. There is a fulltime care assistant vacancy and a part-time kitchen assistant vacancy. More than 50 of the care staff hold the NVQ level 2 award in care. Supervisory staff go on to complete level 3. Kitchen staff and other ancillary Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 Page 18 workers are also supported to achieve NVQ awards in their job disciplines. There are NVQ care assessors as part of the staff team. There are manual handling trainers on the staff team and supervisory staff are given specific role training such as for health and safety or infection control to enable them to advise staff or complete health and safety or infection control risk assessments for the home. The manager and deputy manager both are studying to obtain the NVQ level 4 awards in care and management. 2 staff recruitment files were inspected of recently appointed staff. The documentation was maintained in accordance with Schedule 2 of the National Minimum Standards. Interview notes are completed at most staff interviews. It is advisable to demonstrate equal opportunities that interview notes are maintained for all appointments. Where staff have taken an employment break or have not worked until after raising children it is advisable that this be recorded as part of the interview to explain gaps in applicant’s employment history. Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36,37,38. The home is managed well with residents and visitors reporting that the managers are approachable and listen to concerns. Formal quality assurance processes are adhered to in order to critically assess the quality performance of the service for further improvements that could be made at the home. Resident’s monies were handled safely. Staff are supported and supervised. This can contribute to low levels of staff turnover that the home experiences. Resident’s safety is risk assessed and this is reviewed to ensure that resident’s exposure to hazards or injury is appropriately controlled. EVIDENCE: The home has a full-time manager and deputy manager, both of whom have worked together for sufficient time to establish managerial specific responsibilities for the home. Residents and relative spoken with during the inspection said that the managers were friendly and approachable. The managers often work alongside care staff for shift cover. This can be either day or night duty. This allows mangers to have hands on knowledge of Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 Page 20 resident’s needs and staffing pressures, if any. One resident described the managers as ‘not standoffish at all. They are part of the team’. The home holds regular staff meetings and relatives and resident meetings. All have minutes produced. Staff receive and annual appraisal and 1:1 supervisions with supervisors. Staff receive a form of supervision 6 times per year, in line with the National Minimum Standards. The home produces an annual internal quality assurance questionnaire. This is sent to relatives and a questionnaire is also produced for residents. The home was Quality Rated by Somerset County Council in 2001 and Somerset Care achieved the Investors In People award in 2003. There had been significant investment in the structure and environment at the home over the last 2 years and occupancy levels are maintained at a high level. The management of resident’s personal monies held in the home was inspected. The administrator demonstrated that robust procedures are followed in order to protect residents entrusting the home to handle their personal spending money from financial abuses. Records in the home were stored in a way that respected resident confidentiality and confidentiality is addressed at induction for all new staff. Risk assessments for residents were completed and were due for review now. Accident records were inspected and the manager audits accidents for trends or further risk assessment review. Chemicals used in the home were locked away appropriately. Care supervisory staff receive first aid training. There is a care supervisor rostered for each shift. Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 x 3 STAFFING Standard No Score 27 3 28 4 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 4 3 3 3 3 3 3 Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 Page 22 N/A. Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 (2) Requirement It is a requirement that where a medicine is prescribed at a variable dose, that the amount given is stated. The registered manager must arrange for staff administering medications to receive a training session to educate such staff to the reasons why, in order for medication administration charts to be properly maintained. Timescale for action 29/09/05. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations No subsequent recommendations were made at this inspection. Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier Taunton TA1 4AL 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 Southlawns D53 - D02 S16004 Southlawns V231681 210605 Stage 4.doc Version 1.30 Page 24 - 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. 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