Inspection on 01/08/05 for Sue Ryder Nursing Home

This inspection was carried out on 1st August 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

Sue Ryder Nursing Home 25/06/07

Sue Ryder Nursing Home 21/06/06

Sue Ryder Nursing Home 21/04/05

Sue Ryder Nursing Home 08/09/04

Sue Ryder Nursing Home 11/05/04

Sue Ryder Nursing Home 02/02/04

Similar services:

Claremont House

Sun Court Nursing Home

Bramley Avenue (73)

15 Bramble Close

Dolphin Court

Fen Road

Wakes Hall

165 Putnoe Lane

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

CARE HOME ADULTS 18-65 Sue Ryder Nursing Home The Chantry, Chantry Park Hadleigh Road Ipswich IP2 0BP Lead Inspector Kevin Dally Announced 1 August 2005 st 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. Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Sue Ryder Nursing Home Address The Chantry, Chantry Park, Hadleigh Road, Ipswich, IP2 0BP 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) 01473 295200 01473 231397 Sue Ryder Care Mrs Joanne Marshall Care Home 29 Category(ies) of Physical Disability PD (27), Physical Disability registration, with number over 65 PD(E)(2) of places Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 20.4.05 Brief Description of the Service: The Chantry is situated in a large old mansion house located in the grounds of Chantry Park. The house is owned by the Local Authority and managed by the Sue Ryder Care Group. It is registered for 27 young adult residents with physical disabilities and for 2 residents with physical disabilities over 65 years of age. The home specialises in providing nursing care for people who have a neurological condition, such as acquired brain injury or chronic neurological disease, and has been significantly adapted to provide for the needs of its residents. There is adequate space for wheelchair users, a large physiotherapy room fitted with suitable equipment, a snoozlem for relaxation therapy, and a large day centre area. The expansive, and well maintained grounds of the park can be easily accessed by service users. The premises has 17 single rooms and 6 double rooms. There is a large reception hall and dining room and a number of large lounges. There is a programme of internal and outside activities, and the home has its own wheelchair accessible minibus. Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report followed a routine announced inspection of the Sue Ryder Care Home. The registered manager, Mrs Joanne Marshall, and the Head of Clinical Care, Mrs Louise Fawkes, were present and fully contributed to the inspection process. This inspection revealed that of the 27 standards inspected, 22 were assessed as fully met and 5 standards as almost met. This inspection demonstrated the continued positive provision of a specialised nursing care service to residents with complex physical disabilities. Residents confirmed that the service met their care and support needs and that the quality of care was very good. They also confirmed that they felt consulted and included by the home. The inspection took place between the hours of 10.15am and 6.30pm. Documentation examined included care plans, staff files, the medication policy and administration records, staff rota, the complaints record and accident forms. Inspectors spoke with four residents and several staff, including four support workers, one registered nurse and one agency nurse. What the service does well: What has improved since the last inspection? Staff have recently been involved in a team effectiveness workshop and fully participated in an investors in people assessment. Consequently there was a Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 6 feeling amongst the staff that communication had improved, and the team were working together effectively. 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. Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3 & 5. Residents can expect to have their needs and aspirations assessed prior to admission and know whether or not the home is able to meet their needs. They can also expect to have a written agreement detailing the terms and conditions of the home. EVIDENCE: During the inspection three resident’s records were examined and these contained detailed and appropriate assessments undertaken to ensure that the home could meet their needs. The assessment of daily living, which assessed 12 areas of care needs, included social, emotional and physical needs. It was evident that service users and their relatives had participated fully in the assessment process and their needs and wishes had been reflected in their care plans. There were also resident agreements detailing Terms and Conditions for each of the residents whose records were examined. One of the service user’s, whose records were looked at during the inspection, was spoken to at length. They said, “The care here is excellent, I can’t praise it enough”. They also confirmed that they had been consulted about their needs and wishes and were able to make decisions about their daily life. Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, & 9. Residents can expect to have a plan of care in place, which is regularly updated and reflects their needs and wishes. Furthermore, they can expect to be enabled to make decisions about their life and be consulted on matters within the home. The absence of an individual’s moving and handling and risk assessments potentially places staff and residents at risk. EVIDENCE: Three care plans were looked at during the inspection. They were found to reflect the needs identified in a range of assessments including waterlow assessments, manual handling assessments, nutritional assessments, neurological assessments, daily living assessments and physiotherapy assessments. The care plans were comprehensive, detailed and had been regularly monitored and updated by staff. The moving and handling and personal risk assessments were found to be in place for two service users but were missing for one resident. Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 10 Residents spoken with during the inspection confirmed that life at the home and the quality of care provided was very good. They confirmed that they felt consulted about their lives and life within the home and were able to make their own decisions. Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 13, 15, 16 & 17. Residents can expect to have opportunities for personal development, participate in activities within the local community, and be consulted about their daily life and routines. Relatives and friends can expect to be made welcome when visiting the home. Residents can expect to receive meals that are nutritious, balanced and meet their needs. EVIDENCE: The residents records checked contained social profiles which included detailed information in areas such as their likes / dislikes, interests and social and family background. The care plans examined during inspection reflected the residents needs and wishes in relation to their personal development, social and leisure needs and daily routines. The residents spoken with during the inspection said that their social life was good. One resident confirmed that they particularly enjoyed getting out in the home’s minibus for pub lunches and shopping trips. There were also photographs on display in the home of residents enjoying various excursions. A notice board in the dining room listed forthcoming trips planned including a pub lunch in Shotley and days out on the coast at Felixstowe. Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 12 Twelve relatives/visitors had completed comment cards prior to the inspection and they all confirmed that they were made welcome when visiting. Residents spoken with agreed that they were able to maintain relationships with their friends and families and could meet with them in private if they wished. One, spoken with in depth, confirmed that they felt consulted and able to make decisions about their daily life. The home’s menu showed that residents were provided with a balanced, varied and healthy diet with appropriate meal choices. The lunch time menu on the day of inspection was stuffed peppers and savoury rice or ham, mashed potato and beans followed by pineapple upside down pudding with custard. Residents spoken with during lunch said that the meal was “very nice” and confirmed that appropriate alternatives were available if they didn’t want the main options. The dining room itself was pleasant, spacious and clean and residents were seen to be enjoying lunch and one another’s company. Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 & 20 Residents can expect to receive good quality personal and healthcare support. EVIDENCE: The service users records examined during the inspection showed that residents had been consulted about their personal care and their wishes were reflected in their care plans. Healthcare needs had also been assessed and records evidenced that health needs were addressed and monitored consistently. Residents spoken with on the day of inspection said that they were happy with their care. One said that they would give the home “11 out of 10 for good service”. Another said “The care here is excellent, I can’t praise it enough”. Residents and staff spoken with confirmed that staff maintained privacy and respect by knocking on doors before entering and with the use of screening where appropriate. Residents were also supported to choose their personal clothing for each day and personal support was provided sensitively and appropriately. The home has been significantly adapted & technical aids and equipment was in place to meet the needs of the residents, such as hoists and shower trolleys. Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 14 The home also had its own physiotherapy department and staff provided comprehensive individual assessments and treatment plans. Policies and procedures were in place for the control and administration of medication. On the day of inspection medication was appropriately stored and administered by a qualified member of staff. The staff member also demonstrated a sound knowledge about how medication was ordered and disposed of, and how stock was controlled. The medication was transported in a lockable trolley, and records checked were accurate and up to date. Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Residents can expect to have their complaints taken seriously and acted upon. Residents safety, including by recruitment checking, can mostly be expected, but this cannot always be guaranteed if staff do not undertake appropriate CRB checks. EVIDENCE: The home had a complaints policy, which included appropriate details about the stages of the complaint process and the timescale for response. The procedure stated that any complaint received will be acknowledged in writing within 2 days and a full response and outcome will be provided within 20 days. The home has had one recorded complaint in the last twelve months. The complaints log did not detail the nature of the complaint, or the action taken as a result and the outcome of the complaint. However, the manager was able to find electronic records containing the relevant information relating to the complaint during the inspection. Resident and relative questionnaires indicated that most people know about the complaints procedure and who to complain to if they are not happy. Two relatives, out of the fourteen that had replied, said that they had made minor complaints in the past but indicated that they had felt listened to and issues had been resolved. Another said that they had never had cause to complain but the nurse in charge was always ready to listen. On the day of inspection one resident, spoken with at length, said that they felt safe at the home and felt confident that they could talk to someone, if they had any concerns. Staff training records included abuse awareness and staff Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 16 spoken with confirmed that they had training, and had an awareness of protection of vulnerable adults procedures. Two staff records were examined, and both included Criminal Bureau Record checks (CRB). One CRB had been undertaken by a previous employer and not by the home. As CRBs are not transferable from one employer to another, the home was required to immediately reapply for a new CRB check for this employee. Further, whilst the CRB check was being obtained, home staff must supervise the employee. Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 17 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, 29 & 30 Residents can expect the home to be clean, hygienic and odour free. They can also expect to have the aids and equipment to meet their individual needs. The size and style of the building and the need to provide extensive, often large equipment, does not lend itself to creating a homely environment. However, apart from some areas that have heavy wear and tear, the home is generally well maintained, comfortable and safe. EVIDENCE: The Chantry is a large old mansion house located in the expansive grounds of Chantry Park. It has been significantly adapted to provide for the needs of the residents, and there is plentiful space for wheelchair users. The expansive and well-maintained grounds of the park can be easily accessed by the residents. The premises has 17 single rooms and 6 double rooms. There is a large reception hall, a number of lounges and large dining room. The buildings fixtures, fittings and general décor are in a practical style for the residents and appropriate to the style of the mansion. Most of the areas seen on the day of inspection were well maintained. Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 18 Recommendations were made relating to minor maintenance work of the building as inspectors found significant wear and tear to the front door, the drug cupboard door in the stable block, the windowsill in the walkway and various doors & coving on the first floor. There was also a large hole in one of the bath panels in the stable block. Specialist equipment, aids and adaptions were found throughout the home to meet the needs of the residents including shower trolleys, lifts and hoists. Regular service checks had been carried out on one of the hoists checked. All of the bedrooms seen had call systems in place and water temperatures were tested at 41 and 42 degrees Celsius. On the day of the inspection the home was found to be clean, hygienic and odour free. The bathrooms, toilets and bedrooms seen were provided with liquid hand wash and paper hand towels. Residents and staff confirmed that the home was clean and hygienic. Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 19 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) 33, 34, 35 & 36 Residents can expect to have their needs met by appropriately trained staff but staffing ratios need to be re assessed to ensure that there are adequate staff numbers to meet need at all times. Staff are supervised and supported but the omission of an appropriate Criminal Records Bureau check may not always ensure complete residents safety. EVIDENCE: Examination of staff rotas and conversation with the manager and staff confirmed that the home has a minimum of 2 trained nurses on duty for each shift in addition to 6 support workers in the mornings, 4 in the afternoon and 2 at night. The home also employs domestic, kitchen and maintenance staff, day centre and activity staff and a physiotherapist and assistants. On the day of inspection the manager and head of clinical care were also on duty. Questionnaires from fourteen relatives/visitors all indicated that they felt that there was always sufficient numbers of staff on duty. However, staff spoken with said that they felt ratios needed to be increased at certain times, usually around meal times, depending on the needs of people staying at the home for respite care . Staff also felt that there were issues in relation to gender that sometimes put pressure on them, as male staff could not always provide personal care to female residents. The manager confirmed that the Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 20 management team were currently looking at these matters to ensure that care staff ratios could adequately meet service users needs. One resident said that they felt that there was always sufficient staff on duty but they preferred to have staff that they knew, supporting them. They were not happy about having agency staff that did not work with them regularly. The home’s pre inspection questionnaire confirmed that there had been high numbers of agency workers on duty at the home within the last eight week period. The home’s manager, and staff spoken with, confirmed that there is normally consistency in the agency workers used and there seemed to be a good working relationship between the management team and the agency which enables the effective induction of agency staff. The manager explained that there have recently been staffing issues in relation to vacancies, sickness absence and maternity leave. Further, the manager confirmed that recruitment was ongoing. Two staff member’s recruitment records were examined and suitable recruitment and employment procedures were found to be in place. However, one staff member’s records did not have an appropriate Criminal Record Bureau check on file. The manager had records of the relevant form being sent off but not of it being processed and returned. Staff training records seen and the homes training and development plan all confirmed that staff receive sufficient training to meet service user need. Staff confirmed that some of the recent training included First Aid, Multiple Sclerosis, Manual Handling, Infection Control, team effectiveness and fire safety training. One of the support workers spoken with said, “The training is good here actually” and confirmed that they had received essential core training. Another confirmed that they were working towards their NVQ2. Staff also confirmed that they had regular supervision and appraisal meetings with their mentors and there was evidence of this on the staff records seen. Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 21 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) 38, 39 & 42 Residents can expect to contribute to matters relating to the home and feel that the home has an honest and open atmosphere. They can also largely expect a safe environment although the absence of an individual’s manual handling and risk assessments on the day of inspection potentially puts people at risk. EVIDENCE: Investors in people have recently assessed the home and the manager produced a copy of the report during inspection. These, together with the recent team effectiveness day, are examples that the management team are keen to adopt an open, positive and inclusive atmosphere within the home. During the inspection, the Head of Clinical Care explained that residents complete annual quality assurance questionnaires, and that she had recently attended a residents committee meeting to summarise results and develop an action plan in response. The home was planning on consulting with relatives in the near future. The Chantry also has bi monthly residents meetings and bi Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 22 monthly committee meetings to ensure residents are kept informed and consulted about life in the home. Records confirmed that staff had received moving and handling training, and 2 out of the 3 service user records seen included manual handling risk assessments and individual risk assessments. There was also evidence of first aid and infection control training and there is always a minimum of two qualified nurses on duty. Water temperatures tested did not exceed 43 degrees Celsius. The accident book was checked during the inspection. There was a record of 8 minor incidents/accidents since the previous inspection. Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x 3 3 Standard No 11 12 13 14 15 16 17 3 x 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Sue Ryder Nursing Home Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x 3 3 x x 2 x I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 24 No 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 9 Regulation 13(4) (b & c) Requirement A moving and handling and personal risk assessment must be provided for the one service user identified during the inspection, and a record maintained within their file. An enhanced CRB and POVA check must be obtained for all employees. This must be undertaken before the employee can work unsupervised. Timescale for action 9th August 2005 2. 34 3. 24 19(7)(8)( 9)(10), Schedule 2(7) of the Miscellane ous Amendme nts Regulation s 2004, 23(2)( c ) The broken bath panel on the first floor (stable block) must be made good. immediate 19th 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. Refer to Standard 24 Good Practice Recommendations The homes maintenance programme should allow for I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 25 Sue Ryder Nursing Home 2. 3. 4. 22 prompt repair on areas that suffer from consistant wear and tear or accidental damage. This includes the front door, various doors and coving on the first floor, the drug cupboard door (stable block) and the windowsill in the walkway. The home should review how they record complaints, including details of any investigation, action taken and outcome. Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection 5th Floor, St Vincent House Cutler Street Ipswich IP1 1UQ 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 Sue Ryder Nursing Home I54-I04 S24508 Sue Ryder V218519 050801 Stage 4.doc Version 1.40 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. 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