Care Home: Queen`s Lodge,

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What the care home does well Overall, the home provides a good standard of care and support, and service users spoken to expressed satisfaction with the home. One commented that "The food is always very good." While another said "The staff here look after you ok." Staff were seen to have a good understanding of their roles and responsibilities, and to interact with service users in a friendly and respectful manner. There was evidence that the home seeks to meet the equalities and diversity needs of service users, for instance through the provision of food and activities. The home was generally well maintained, and record keeping was of a good standard. What has improved since the last inspection? There have been improvements to the home since the previous inspection, and the inspector was pleased to note that all eight of the outstanding requirements were found to have been met during this inspection. In particular, the storage and administration of medications has been improved, and service users now have routine access to dental care. Care planning is now of a better standard, and the home carries out CRB checks on all staff prior to them commencing work at the home. What the care home could do better: There is some room for improvement, and a total of three requirements have been made in this report. Despite the improvements in medication, the home must still pay attention to ensure that information on Medical Administration Charts and medication labels is consistent. The home must notify the CSCI of any significant events, and ensure that hot water temperatures are regularly checked to help ensure the safety of service users. CARE HOMES FOR OLDER PEOPLE Queen`s Lodge, 13 Queens Road Leytonstone London E11 1BA Lead Inspector Rob Cole Unannounced Inspection 8th May 2008 09:15 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 Queen`s Lodge, DS0000007224.V363864.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. Queen`s Lodge, DS0000007224.V363864.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Queen`s Lodge, Address 13 Queens Road Leytonstone London E11 1BA Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8558 6548 020 8558 6548 queens.lodge@btopenworld.com Mrs Miriam Binns Mr David Binns Mrs Miriam Binns Mr David Binns Care Home 16 Category(ies) of Dementia (6), Learning disability (3), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (16), Old age, not falling within any other category (16) Queen`s Lodge, DS0000007224.V363864.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th September 2007 Brief Description of the Service: Queens Lodge is a family-run residential care home offering care and support to sixteen older people. The home is situated in a residential area in Leytonstone, in the London Borough of Waltham Forest. The home is close to local amenities and shops are within walking distance. The home has easy access to public transport; Leytonstone underground station is within walking distance of the home. The current range of fees charged by the home is between £535 and £590 per week. Queen`s Lodge, DS0000007224.V363864.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 2 stars. This means the people who use this service experience good quality outcomes. The inspection took place on the 8/05/08 and was unannounced. The inspector had the opportunity of speaking with service users, their relatives, staff from the home, and the homes joint managers were both present throughout the course of the inspection. The inspection also included an examination of records and other documents, along with a tour of the premises. The inspector had the opportunity of observing staff carrying out their duties, including interacting with service users. Prior to the inspection, the home completed an Annual Quality Assurance Assessment (AQA) at the request of the CSCI. Surveys were also sent out by the CSCI to both service users and their relatives. All of this was included in the overall inspection process, and has contributed to the judgments made within this report. What the service does well: What has improved since the last inspection? What they could do better: Queen`s Lodge, DS0000007224.V363864.R01.S.doc Version 5.2 Page 6 There is some room for improvement, and a total of three requirements have been made in this report. Despite the improvements in medication, the home must still pay attention to ensure that information on Medical Administration Charts and medication labels is consistent. The home must notify the CSCI of any significant events, and ensure that hot water temperatures are regularly checked to help ensure the safety of service users. 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. Queen`s Lodge, DS0000007224.V363864.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 Queen`s Lodge, DS0000007224.V363864.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): 1,2,3,4 and 5. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. It is the inspectors judgement that service users are provided with sufficient information about the home to enable them to make an informed choice about moving in. This information is provided through written documentation and the opportunity of visiting the home. EVIDENCE: The home has a Statement of Purpose and Service User Guide in place. Both documents are written in plain English. The Statement states that “The aim of Queens lodge is to provide a caring, comfortable, and as far as possible a homely atmosphere.” The Statement is of a good standard, and includes details of the aims and objectives of the home and of the management and staff team. Queen`s Lodge, DS0000007224.V363864.R01.S.doc Version 5.2 Page 9 Likewise, the Service User Guide is also of a good standard, and is in line with National Minimum Standards (NMS). It includes details of the homes complaints procedure and of the facilities and services provided. All service users or their relatives are provided with a copy of the Guide. All service users are provided with an individual contract/statement of terms and conditions. These are signed by the service user and the homes proprietor. They include details of fees payable, what they cover and what is not included in the fees, along with details of the services and facilities provided. The home has an admissions procedure in place. This makes clear that service users and their relatives are able to visit the home before making a decision as to move in or not. This is in line with information provided in the AQAA that was completed by the home and on the day of inspection, relatives visiting the home were able to confirm that they had indeed had this opportunity, as were service users. Service users initially move into the home on a six week trial basis, after which a placement review meeting is held, attended by the service user, their relatives and social worker along with staff from the home. Pre admission assessments are carried out on prospective service users by senior staff in the home. These cover needs around mobility, communication and personal care. The home does not provide intermediate care. Queen`s Lodge, DS0000007224.V363864.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): 7,8,9,10 and 11. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. It is the view of the inspector that the home is able to meet both the personal and health care needs of service users. Care planning is of a good standard, and service users have access to health care professionals as appropriate. EVIDENCE: Individual care plans are in place for all service users. These are of a good standard, and have improved since the last inspection. Whereas before they tended to concentrate on what the needs of the service user are, they now also contain detailed information on how the home is able to meet those needs. Care plans are drawn up with the involvement of the service user and staff from the home, and their social worker also attends an annual review, which feeds into the care planning process. Care plans cover needs around Queen`s Lodge, DS0000007224.V363864.R01.S.doc Version 5.2 Page 11 medication, mobility, social and leisure needs and also needs around equalities and diversity issues, such as around disabilities and needs related to age. Care plans are subject to regular review, and daily records are maintained. Each service user has a risk assessment in place, which again are subject to regular review, and of a satisfactory standard. Assessments identify any potential risks, and include strategies to manage and reduce those risks. Examples of risk assessments include around falling and dietary needs linked to diabetes. Staff spoken to demonstrated a good understanding of risk assessments in place. All service users are registered with a GP. The manager informed the inspector that service users are able to retain the GP they had prior to admission, where practical. Clear records are maintained of medical appointments, including details of any follow up action necessary. Records indicated that service users have access to health professionals as appropriate, including CPN’s psychiatrists, and on the day of inspection district nurses and chiropodists were observed to visit service users. The inspector was pleased to note that since the last inspection service users now also have routine access to dental care. The home makes use of the Continence Advisory Service, who are involved in drawing up continence management plans for service users. They also supply the home with continence products. During the course of the inspection it was found that used continence products were put into yellow bags, and then left in the yard. The inspector had concerns that this was a potential breach of service users dignity, and also a risk to infection control. It was positively noted that the home addressed these issues during the course of the day, and obtained bins to store used continence products in. The home has a medication policy in place, and all staff undertake training before they are able to administer medications. Medications are stored securely in a locked cabinet, and since the last inspection any medications stored in the fridge are now kept in a locked container. The home tests the fridge temperature on a daily basis. Records are maintained of medications entering the home and of those that are returned to the pharmacist. It was noted that the storing, recording and administration of medications has improved since the last inspection. However, one service user has been prescribed SENNA tablets. The label on the medication bottle states take one or two tablets when required, while the information on the Medication Administration Record (MAR) chart states take two tablets at night. It is required that the information on MAR charts is consistent with the information on the medication label, and that both are in line with the instructions of the medical practitioner who prescribed the medication, to ensure that service users are always provided with the correct dose of medication. Queen`s Lodge, DS0000007224.V363864.R01.S.doc Version 5.2 Page 12 Through observation and discussion there was evidence that the home seeks to promote the privacy and dignity of service users. For example, staff were observed to knock and wait before entering bedrooms. Care plans make clear that service users are encouraged to manage their own personal care as much as possible, and screening is provided in double bedrooms. The manager informed the inspector that service users would be able to remain in the home with a terminal illness, as long as the home was able to meet their medical needs. Queen`s Lodge, DS0000007224.V363864.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. It is the view of the inspector that service users are supported to live valued and fulfilling lives. A varied activities programme is in place, and the quality of food provided is of a good standard. EVIDENCE: Service users have access to a variety of social and leisure activities, both in house and in the community. Mobility London visits the home once a fortnight, and engages service users in differing activities, including gentle exercise and mobility sessions, sing-a-longs and reminiscence groups. Service users have access to television, videos, music, dancing, puzzles and artwork. On the day of inspection, staff were observed to be involved in a sing-a-long with some service users, who appeared to be enjoying this. Some of the service users are involved with the homes gardening, and other daily routines such as setting the table for meals. The home also has a selection of large print books which Queen`s Lodge, DS0000007224.V363864.R01.S.doc Version 5.2 Page 14 helps to meet service users needs around equality and diversity issues with regard to visual impairments. The home also seeks to meet equality and diversity needs through the access to the community that service users have. For instance some service users attend the Disability Resource Centre, a social club where service users have the opportunity of meeting other people and developing friendships. Service users also attend a MENCAP centre, which arranges various activities including arts, crafts, lunch club and shopping trips. One service user goes to a local African-Caribbean hairdressers. A priest visits the home regularly, indeed, they were visiting service users at the time of this inspection, thus helping to meet equality and diversity needs around religion. Relatives are welcome to visit the home at any reasonable time, and service users can see visitors in private if they so wish. The inspector spoke with a visiting relative during the course of the inspection, who said “I could not really ask for anything more.” Prior to the inspection, the inspector received several surveys from relatives, which contained generally positive feedback, one commented that “We are more then pleased with the care my mother is receiving. Her welfare is catered for in every aspect of her life, with kindness and consideration.” Service users are given their own mail to open, and have access to a telephone. Indeed, service users are able to have their own phone installed in their bedroom, or to have a mobile phone. Records are maintained of menus, these indicated that service users are offered a varied, balanced and nutritious diet. The home seeks to meet the equality and diversity needs of service users through the provision of food, and traditional British and Jamaican dishes are regularly prepared. Service users spoken to expressed satisfaction with the food, one commented that “It’s really good.” On the day of inspections meals looked appetising and healthy, and mealtimes were observed to be relaxed and unhurried, with support provided in a sensitive manner. Fresh fruit was available, and service users are offered drinks and snacks throughout the day. The kitchen was clean and tidy, and food was stored appropriately. Records are maintained of fridge temperatures. Queen`s Lodge, DS0000007224.V363864.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): 16,17 and 18. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The inspector was satisfied that the home has taken reasonable steps to help ensure service users are safeguarded from the risk of abuse. Staff have undertaken training in adult protection, and the home has appropriate policies in place around protection and complaints. EVIDENCE: The home has a complaints procedure in place. This includes timescales for responding to any complaints received, along with contact details of the CSCI and the ombudsman. All service users are provided with a copy of the procedure, and a copy was also on display within the home. The home has a complaints log, although the AQAA indicated that the home has not received any complaints since the previous inspection. Service users demonstrated a good understanding of whom they could complain to if they so wished, one commented that “I can always talk to the manager about anything.” The home has a copy of the Local Authorities adult protection procedure, and it was positively noted that it’s own adult protection procedure has been amended since the last inspection, and is now in line with current legislation. It Queen`s Lodge, DS0000007224.V363864.R01.S.doc Version 5.2 Page 16 now makes clear the homes responsibility to report any allegations of abuse to the host Local Authority. It was further noted that since the previous inspection staff working at the home have undertaken training in adult protection issues. Staff spoken to by the inspector generally demonstrated a good understanding of their roles and responsibilities with regard to adult protection. There was evidence to suggest that the home has taken steps to promote the legal rights of service users. As mentioned, all service users are registered with a GP, and have access to health care professionals. Service users are all on the electoral register, and are able to vote in elections if they wish. Queen`s Lodge, DS0000007224.V363864.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): 19,20,21,22,23,24,25 and 26. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. It is the view of the inspector that the home is suitable to meet its stated purpose with regard to its physical environment. The home is generally well maintained, both internally and externally, and service users are provided with adequate private and communal space. EVIDENCE: The home is situated in a quiet residential area of Leytonstone, in the London Borough of Waltham Forest. It is close to shops, transport networks and other local amenities. The home is built over four floors, and is in keeping with other homes in the vicinity. The home is generally well maintained, both externally and internally. Queen`s Lodge, DS0000007224.V363864.R01.S.doc Version 5.2 Page 18 The homes communal areas consist of a sitting room, a dining room, a kitchen and a well maintained garden. This contained garden furniture, and was seen to be used by service users on the day of inspection. Service users were observed to move around communal areas freely. The homes décor was of a satisfactory standard, while furniture and fittings were well maintained and domestic in character. There has been some work carried out to the environment since the last inspection. The outside front of the home has been redecorated. In the lounge/dining area a new flooring has been stalled, and this room has also been redecorated. The manager informed the inspector that service users were involved in choosing the new décor. The home has two bathroom/toilets, two shower room/toilets, and two toilets on their own, which are sufficient in number to meet the needs of service users. Toilets have been adapted with hoists and rails to make them accessible to service users, thus helping to meet their needs with regard to equalities and diversity issues. All bathrooms were fitted with a working lock, which included an emergency override device. Bathrooms were clan, tidy and free from offensive odour. The home is registered to provide care and accommodation to sixteen people, and comprises of two double bedrooms and twelve single bedrooms. Double rooms have screening in them to provide privacy. All bedrooms have hand basins fitted. Bedrooms meet NMS on size requirements. Service users have been able to personalise their bedrooms to their own individual taste, for instance with televisions and family photographs, and service users are able to bring their own possessions to the home with them, such as book cases. Rooms contained adequate furniture, including table, chairs, wardrobes and a chest of draws. Curtains, carpets and bedding were well maintained and domestic in character. All bedrooms contained central heating, and heating appliances had appropriate safety coverings. Rooms had adequate natural light and ventilation. Two of the bedrooms have been redecorated since the previous inspection, in line with the wishes of the service users. The home has various adaptations in place to make it more accessible to service users. As mentioned, bathrooms and toilets have been adapted, and a stair lift has been installed. There is a ramp leading up to the front door of the home. The homes laundry facilities are appropriate in scale for the home, and hand washing facilities are situated around the home. Staff are provided with protective clothing, such as gloves and aprons to help prevent the spread of infection. COSHH products were stored securely. Queen`s Lodge, DS0000007224.V363864.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): 27,28,29 and 30. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. It is the inspector’s judgement that the home is staffed in sufficient numbers to meet the needs of service users, and that staff are sufficiently qualified and experienced to carry out their duties appropriately. EVIDENCE: The home provides 24-hour staff support, including waking night staff and an emergency on-call procedure. There was a staffing rota, and this accurately reflected the staffing situation on the day of inspection. Through observation and discussion there was evidence that the staff team have a good understanding of the collective and individual needs of service users, and that they have built up good relations with service users. Staff were seen to interact with service users in a friendly and respectful manner, and there were instances throughout the day of positive staff interactions with service users, for example with supporting service users to have lunch. Service users spoken to expressed satisfaction with the staff, one commented that “They are very good here the staff.” The home holds regular staff meetings, and all staff are able to contribute agenda items. Staff have been provided with Queen`s Lodge, DS0000007224.V363864.R01.S.doc Version 5.2 Page 20 a staff handbook, and a copy of the General Social Care Council codes of conduct. The home has various employment related policies in place, including on recruitment and selection, equal opportunities and disciplinary and grievance procedures. The inspector checked several staff employment files at random, these were found to contain all required documentation, including proof of ID, references and CRB checks. All staff undertake a structured induction on commencing work at the home, this includes health and safety and service user issues. Staff have access to regular training, and recent training has included working with mental health, adult protection, dementia, elderly awareness and manual handling. Five of the nine care staff currently employed at the home have successfully achieved an NVQ Level 2 in Care or equivalent qualification, above the 50 minimum set by NMS. The AQAA indicates that several more staff are currently working towards such a qualification. Queen`s Lodge, DS0000007224.V363864.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): 31,32,33,3537 and 38. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. It is the inspector’s view that the this is a well run home, and that the managers are sufficiently experienced and competent to carry out their duties. EVIDENCE: The home is jointly managed by the two proprietors of the home, and both are registered with the CSCI. The have managed the home since 1985. Both have many years experience of working in social care, and both have successfully achieved the Registered Managers Award. Staff were seen to interact with the Queen`s Lodge, DS0000007224.V363864.R01.S.doc Version 5.2 Page 22 management team in a relaxed manner, and service users and their relatives informed the inspector that they found the managers to be approachable and accessible. The manager informed the inspector during the course of the inspection that two service users have passed away since the previous inspection. The CSCI has not received any Regulation 37 notifications around these two deaths, and the manager confirmed that none had been sent. It is required that the home notifies the CSCI of any significant events which occur in the home, in line with Regulation 37 of the Care Homes Regulations 2001. This includes the death of a service user. Care plan reviews and staff meetings contribute to the Quality Assurance process in the home, and copies of previous inspection reports are available to view. Surveys are issued to service users and their relatives to gain their feedback on the running of the home. Completed surveys seen by the inspector contained generally positive feedback, one commented, “I am truly satisfied.” There was evidence that feedback was acted upon, for example one completed survey said they would like their bedroom painted white, this has subsequently been arranged. The home a set of policies and procedures in place. Those checked by the inspector were of a satisfactory standard, including the polices on equal opportunities and medication, and they were in line with NMS. Record keeping was of a generally good standard. Confidential records are stored securely, staff and service users can access their records as appropriate. The home keeps clear records and receipts of financial transactions involving service users money, those checked by the inspector were satisfactory. Fire extinguishers were situated around the home, these were last serviced in May 2007. Fire exits were clearly signed and free from obstruction. Fire alarms are checked weekly, and were last serviced on the 3/3/08. The stair lift is regularly serviced. The home had in date safety certificates for PAT testing, electrical installation and gas safety. The home has in date employer’s liability insurance cover. COSHH products are stored securely, and the home tests fridge and freezer temperatures. However, the home does not routinely check hot water temperatures on water outlets used for personal care. In order to help ensure that service users are safe, it is required that the home tests all hot water outlets at least once a week to ensure that the temperature is 43 degrees centigrade. Queen`s Lodge, DS0000007224.V363864.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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 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 2 3 X 3 X 3 2 Queen`s Lodge, DS0000007224.V363864.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. 1. Standard OP9 Regulation 13 Requirement Timescale for action 31/05/08 2. OP32 37 3. OP38 13 and 23 The registered person must ensure that any information on Medication Administration Record charts is consistent with the information on the medication label, and that both are in line with the instructions of the medical practitioner who prescribed the medication. The registered person must 31/05/08 ensure that the CSCI is notified of any significant events in the home in line with Regulation 37 of the Care Homes Regulations 2001, including the death of a service user. The registered person must 31/05/08 ensure that all hot water outlets used for personal care are tested at least once a week, to ensure the water temperature is 43 degrees centigrade. Queen`s Lodge, DS0000007224.V363864.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Queen`s Lodge, DS0000007224.V363864.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection London Regional Contact Team 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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. 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