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Care Home: Four Rivers Nursing Home

  • Bromfield Road Ludlow Shropshire SY8 1DU
  • Tel: 01584813500
  • Fax: 01584813501

Four Rivers is a care home with nursing situated on the outskirts of Ludlow. It is managed by Shropshire County Council and offers single accommodation with en-suite facilities. It has good transport links to the town and local amenities. The home is set in newly established secure grounds that are accessible to service users and car parking facilities are provided for visitors. Access in and out of this home does not restrict liberty. The dementia suite is accessed via a swipe card system. Four Rivers has a statement of purpose and service user guide which provides people with information about the services of the home. The fees for Four Rivers are: £662.68-689.12

  • Latitude: 52.373001098633
    Longitude: -2.720999956131
  • Manager: Ms Christine Patricia Thomas
  • Price p/w: £663
  • UK
  • Total Capacity: 40
  • Type: Care home with nursing
  • Provider: Shropshire County Council
  • Ownership: Local Authority
  • Care Home ID: 6659
Residents Needs:
Dementia, Old age, not falling within any other category

Previous Inspections

This may not be the latest inspection for this service as we are having techinical problems updating from CQC - please check directly on the regulators website for the most recent report; bestcarehome hopes to be back to regular updates shortly.

For extracts, read the latest CQC inspection for Four Rivers Nursing Home.

CARE HOMES FOR OLDER PEOPLE Four Rivers Nursing Home Bromfield Road Ludlow Shropshire SY8 1DU Lead Inspector Pat Scott Key Unannounced Inspection 26th June 2008 10:00 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 Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 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. Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Four Rivers Nursing Home Address Bromfield Road Ludlow Shropshire SY8 1DU 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) 01584 813500 01584 813501 christine.thomas@shropshire.gov.uk Shropshire County Council Christine Patricia Thomas Care Home 40 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (30) of places Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The dementia unit must have a secure and service user friendly garden within two months of registration – 25th December 2006. The home may accommodate upto 5 service users between the ages of 60 and 65 years. 16th August 2007 Date of last inspection Brief Description of the Service: Four Rivers is a care home with nursing situated on the outskirts of Ludlow. It is managed by Shropshire County Council and offers single accommodation with en-suite facilities. It has good transport links to the town and local amenities. The home is set in newly established secure grounds that are accessible to service users and car parking facilities are provided for visitors. Access in and out of this home does not restrict liberty. The dementia suite is accessed via a swipe card system. Four Rivers has a statement of purpose and service user guide which provides people with information about the services of the home. The fees for Four Rivers are: £662.68-689.12 Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is *TWO star good service. This means the people who use this service experience good quality outcomes. We, the commission, used a range of evidence to make judgements about this service. This includes: information from the manager in the annual quality assurance assessment (AQAA), staff records kept in the home, medication audits, survey results from people who use the service, discussion with the manager, tour of the premises, previous inspection reports, quality assurance processes, Fire Authority reports, Environmental Health Office reports, observation of care experienced by people using the service. An ‘expert by experience’ participated in this inspection. This is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector, to help them get a picture of what it is like to live in, or use the service. What the service does well: What has improved since the last inspection? Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 Page 6 Staffing numbers and skill mix have been changed to ensure a better balance of the service’s own staff and the use of agency staff has been reduced. Staff training is well organised and the options open to staff ensure that they develop on a professional level as well as receiving mandatory updates. Staff supervision has improved with group and individual support available. Care planning has improved as the management has changed the format to make it more person centred, clear, and readable and so residents (if able) and their families can understand the information better and be involved in the care process. The manager is good at involving people in all aspects of the service. Management have a good day-to-day rapport with residents to ascertain their satisfaction and well being that is also backed up by a formal quality assurance process. Some people spoken with welcome the chance to be involved in the home and like to know what is going on. Significant examples of this is in the way the assessment, new care plan, staff practice and quality assurance measures in place in the home all come together to provide good outcomes for those living at Four Rivers. 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. The summary of this inspection report can be made available in other formats on request. Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 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 Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standard 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be confident that the care home can support them. This is because there is a complete assessment of their needs that they, or people close to them, have been involved in. People will be able to feel that they can live the life they choose in the home. This is because the assessment is now more person centred and shows an understanding and respect for their diversity. EVIDENCE: Two people spoken with told us that when admitted, staff gave them information, good attention and enabled them to ask questions about life in the home. The written information provided reinforces this personal approach. The service user guide is being updated. Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 Page 9 Admission assessments of three people needing dementia care and two requiring nursing care were read. These confirm that the service is taking into account the individual physical care needs of a resident in a person centred way. Detailed information is written about the person’s ‘map of life’ and staff assess a person’s values, beliefs and hopes in their life. All clinical assessments are very clear. Four Rivers admits people with dementia and provides staff with training and guidance to enable them to be responsive to individual needs. This dementia service is now more established with staff having gradually built their expertise in this area of care. The provider has invested in good training resources for staff to build on current knowledge and best practice. Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Peoples’ care needs and risk assessments are set out in their individual plans of care which ensures that all care needs have been addressed and will be fully met. The manager understands the need to comply with safe medication systems and staff practice ensures that the home’s procedures are complied with and that residents’ health matters are safely addressed. The actions of staff and their approach to care ensures that people are treated with respect and their right to privacy is upheld. EVIDENCE: The new documentation, called a person centred plan (PCP), was examined in detail for 5 residents. All have care plans derived from the initial assessments. Each plan has a recorded monthly evaluation of the elements of care. They Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 Page 11 provide clear detail as to how care is to be delivered by staff in a way that the person prefers. The recording of clinical interventions in care has significantly improved. Staff spoken with state that the PCP provides them with a clear picture of the person’s needs and progress. Keyworkers also spoke of how they involve people with their care planning, which those able to comment confirm. Visiting relatives commented: ‘we visit weekly, staff are lovely and it couldn’t be better. The home notifies us when things happen to mum and she is always well presented. We look at mum’s care records weekly.’ We heard staff discuss problems arising during the shift with the qualified nurse. People are attended to promptly that need any clinical follow up. Daily records monitor the progress of individuals and provide clear indications of how a person has spent their day. The plans demonstrate contact with healthcare professionals such as the community psychiatric nurse or general practitioner. People spoken with stated that support is flexible as they spoke of the various bed/rising times which are accommodated and always delivered in a way that respects their privacy. Another comment includes ‘the staff are pleasant and you can talk to them.’ The expert by experience spoke with a resident and her daughter about privacy issues and she was told that the resident is always treated with respect and dignity and that she was able to retain her privacy. She was told that carers were attentive to her mother’s needs, were kind and responsive. She was able to choose when to get up and when to go to bed normally and that staff ‘went that extra mile’. Service users all appeared well groomed with their hair, nails and clothes looking clean. No issues were identified in discussions regarding approach of staff or being assisted with intimate tasks. The service accepts responsibility for administering medication to residents and has improved practice in this area. The service has suitable storage facilities for all prescribed drugs and for homely remedies. Written records for receipt, administration and disposal of medication are in place. The service audits the medication system on a bi-monthly basis for compliance and errors. A daily record of an individual resident indicated that medication had been refused on the 21/6/08 and 22/6/08 but with no written follow up of action taken. Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff support people to keep in touch with family, friends and representatives so that they have appropriate relationships. People state they are as independent as they can be, and the service demonstrates that they lead their life in a chosen way so that they have the opportunity to make the most of their abilities and interests. The food in the home is of good quality so that the dietary needs of people are met. EVIDENCE: Menus seen are nutritionally balanced and food and drinks are readily available. There is choice and a relative’s comment on a survey is: ‘great effort has been made by the kitchen to meet my husband’s likes/dislikes.’ People tell us they like the food and staff state they use flash cards to aid memory re preferences when choosing a meal from the menu. We saw staff deal with a challenge from a resident about where he wanted to eat his meal. They used Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 Page 13 different approaches and respected the person’s view at all times. Staff managed this situation well. The service conducts 6 monthly audits on the hospitality service in the home and has achieved the gold award in healthy eating. The expert by experience makes the following comment: ‘The residents I talked with were unanimous in their praise of the food. ‘Beautiful’ and ‘lovely’ were some of the comments. They said that there was sufficient choice, that the food was good and I saw a printed menu for today on the tables. I was told that some residents prefer to take meals in their rooms.’ The provision of activities has significantly improved and events are displayed on the notice board on the ground floor. The manager now holds an activity budget. People tell us they can choose to participate in events and that they preferred the ‘main attraction’ rather than the daily pursuits on offer. E.g. some were going to the garden centre the next day. However, two people the expert by experience spoke with stated that choice was limited and they would like to go out into the garden or away from the home. The newsletter recently produced and the way the manager is addressing activity provision, should improve the understanding by residents of what is available. Computer facilities are available with one resident being encouraged to manage his own internet banking. The service has three activities coordinators (current care staff) who arrange the leisure time for individuals. There is a varied choice from art therapy, therapeutic massage, visits from local schools and use of local day centres. The hairdresser was on site. The expert by experience after talking with 6 residents and one relative considers that: ‘The policy which the home adopts is one of a ‘person-centred’ approach to activities, where instead of providing structured, organised activities, they prefer to try and find out what the individuals need or would like to do, and hopefully provide some of these things. I would have liked to see more specific examples of this approach in practice, but I appreciate that it could work well in meeting individual choice and preferences effectively, provided adequate resources are available to enable choices to be taken up and residents encouraged to do so. I was shown a new care plan design (by Shropshire County Council) which is now being adopted at the home, which includes a table of options for residents to say what they would or could enjoy doing, which seems a good starting point.’ Residents look content and relaxed. Families are at ease when they visit. Staff have a good interaction with the people they look after. Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 Page 14 The service is supported by the league of friends who have assisted in improvements such as; the trolley shop, provision of bird tables, afternoon tea parties and coffee mornings and a gardening project. Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure that is up to date and accessible so that anyone associated with the service can complain or make suggestions for improvement. EVIDENCE: People spoken to say they would go to the manager or one of the staff if they had a problem. All expressed confidence that issues would be dealt with. Concerns spoken about by people had been promptly dealt with and a satisfactory outcome reached. There is a good level of accessibility to the management at this home which ensures that concerns can be dealt with very quickly. The manager has opened new communication channels such as resident meetings, complaint, comments and compliment leaflets, day to day contact and care plan reviews. Numerous written booklets are available in the hall to provide advice about the services of external agencies such as Shropshire County Council, Age Concern etc. Adult protection is covered after recruitment and discussed at supervision. Staff training records seen show that staff are provided with regular updates in adult protection. Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 Page 16 The management is clear about when incidents need external input and who to refer the incident to. Links with external agencies are satisfactory and include the commission, police and adult protection teams. There has been one recent incident requiring referral through the safeguarding procedures which is now resolved. We spoke with this person who informed us of the agreed safety measures in place and is happy with the way the incident was dealt with. People who use the service and their supporters state within surveys that they are satisfied with the service provision, and feel safe and supported. Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Personalisation of the home has improved, through service user choice, so that people feel they live in a comfortable, clean home with modern furnishings and facilities which suit their individual needs and preferences EVIDENCE: Residents tell us they like their environment and individual bedrooms. A comment on a survey stated; ‘the home is always clean and fresh and if it is not it is put right quickly.’ The home is comfortable and clean. There are new pictures that have been put up which were taken by a local landscape photographer. Paintings of local scenes are on display that belong to residents. Furnishings and fittings are well presented. Every bedroom has a nursing bed. Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 Page 18 The home has a large well presented garden and a secure large courtyard area. The management have plans for changes as a result of listening to people who live in the home. E.g. resolving a problem with the nurse call system for better access in the lounge, providing a larger TV screen for one of the units. The expert by experience, on her walk around the home, makes the following comment: ‘I was very impressed by the standards of cleanliness and décor throughout the home. The atmosphere and environment at the home overall was restful and orderly. There was no trace of any odour, the rooms were fresh and bright and carpets clean. I saw two rooms occupied by residents and they were both ‘ensuite’ with pleasant, modern facilities. The bathrooms too were excellent and I learned from one resident, who has used this facility, that one bath doubles as a ‘jacuzzi’. ‘ Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff get access to training, supervision and support they need from the manager so that people receive planned care. Staff in the home are trained and recognise the importance of care planning so that peoples’ changing needs are identified and acted upon. EVIDENCE: There are NVQ, qualified and experienced staff employed to provide care to people at the home. Care staff without NVQ qualification have received all mandatory training and completed the common induction standards. The staff have good managerial support to develop their experience in the service they are delivering. The manager altered the shift start times as residents had expressed that they felt there were not enough staff around when they wanted to get up early. The manager reported some problems in providing a full staff complement but agency staff have been deployed across the rota with better effect. Recruitment has been successful and so agency use has now reduced considerably. Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 Page 20 There has been debate between staff and management including views of supporters about the correct level of staffing for caring for people with dementia. Residents’ needs fluctuate considerably and from observation for 1.5 hours during the inspection there were two occasions when residents were left unsupervised when the two staff needed to attend to another resident. Staff did inform the residents they had to leave the lounge. Staff spoken to state they are aware that residents are vulnerable when they have to leave them unsupervised. The manager acknowledged this issue and has plans in place to review the staffing so that the good quality of care is not compromised at any time. Staff comments include: ‘since I first worked here the change is fantastic, there’s been a big change, everything is really good now and residents are getting out more, ’’we have a good manager who listens to our concerns,’ ‘ best home I have ever worked in, honestly, we deliver the best care. I like it here.’ Staff are also aware of the procedures that affect their roles such as complaints and adult protection. Care plans show that there is understanding of the person centred way of delivering care and support which is supported by training. People using the service tell us that staff working with them provide safe and appropriate support. A relative commented; ‘the family cannot fault any member of staff at any time’. Two staff personnel files were selected for inspection. All the necessary identity checks have been carried out but one criminal record check did not have the date it was returned recorded. Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home is based on openness and respect. The service has quality assurance surveys in place so that people are assured that the overall conduct of the home is taking into account their views. People’s opinions are more central to how the home develops and reviews it’s practice, and the service is developing appropriate ways of making sure they get things right. So, people have confidence in the care home because it is run and managed well. EVIDENCE: Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 Page 22 The manager’s practice is resident focussed and customer satisfaction is high on the agenda. This is evidenced by the commitment to conducting surveys (last one January 2008), bi-monthly resident meetings that are minuted, staff surveys and meetings, league of friends meetings and provision of a monthly newsletter. The manager and her staff have attended many training events and updates to complement their roles within the home. Staff files seen record all training activity. Through discussions with the manager, she demonstrates that she is confident in her ability to lead a staff team whilst being fully aware of the individual needs of the people living at Four Rivers. The home actively encourages people, where able, to manage their own money. Accurate records are kept and audited. Equality and diversity for service users is promoted throughout the home within the assessments, care plans and activities. Equality for staff is promoted through the opportunities for training at all levels. The service is exploring starting up working groups for various aspects of care with the elderly e.g. dementia care, Parkinson’s disease and falls. Quality assurance takes place throughout the service in both a formal and informal manner. Meetings, surveys, audits, day to day contact all provide records to show that resident satisfaction is at the heart of the service. The manager and her deputy with administrative support implement plans for improvement The provider produces a monthly report to the manager to demonstrate that the overall conduct of the service is being managed well. It covers areas such as; interviewing residents, relatives, staff, catering, complaints, health and safety. The home keeps records to show that the health and safety of service users is promoted and protected. The service conducts four fire drills per year (last being night staff January 2008), has regular alarm tests and is reviewing its fire risk assessment. Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 OP9 Good Practice Recommendations Care plans should indicate action taken by staff if medication has been refused. Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Four Rivers Nursing Home DS0000068660.V366754.R01.S.doc Version 5.2 Page 26 - 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. 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