Care Home: Ridgewood Manor Nursing Home

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What the care home does well Ridgewood Manor provides an individual nursing care provision within a friendly homely environment. Residents and visitors expressed a high satisfaction with the care provided and with the staff working in the home. All residents said that they were happy in the home and liked the staff and their own rooms. Staff were approachable and were found to be kind and responsive to residents needs.Ridgewood Manor is a small home that allows for residents and staff to get to know each other very well and staff clearly care for the residents as individuals. What has improved since the last inspection? The appointed manager has been registered since the last inspection and has provided a much needed stable leadership and direction to the home. Staff training has been organised with a rolling programme for staff that is recorded on a training matrix. The care documentation continues to improve to provide more person centred plans of care. The bathing facilities have been upgraded and an attractive patio area has been provided. What the care home could do better: Although the care documentation has been improved it still needs to take into account residents and their representatives views. The systems for handling medicines need to be improved to ensure accurate, clear and up to date record keeping and to ensure all controlled drugs are stored and handled in accordance with Misuse of Drugs (safe custody) regulations 1973. Further attention needs to be paid in promoting residents choice and autonomy examples of this is ensuring residents can have a bath or shower as they wish and can have a choice of meal on a daily basis. The induction training needs to be given and documented to evidence that the Skills for Care induction has been completed in an appropriate manner. The system used to monitor quality in the home needs to include a way of recording action taken in response and a sharing of the information with interested parties. Staff need to receive regular supervision that is fully recorded, to monitor their performance and develop their skills. CARE HOMES FOR OLDER PEOPLE Ridgewood Manor Nursing Home Lewes Road Ridgewood Uckfield East Sussex TN22 5SH Lead Inspector Melanie Freeman Unannounced Inspection 21st May 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ridgewood Manor Nursing Home DS0000014034.V363458.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. Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ridgewood Manor Nursing Home Address Lewes Road Ridgewood Uckfield East Sussex TN22 5SH 01825 765744 01825 765055 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) Ridgewood Care Limited Mrs Barbara June Ratford Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability over 65 years of age (0) of places Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing - to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - (OP) 2. Old age with physical disability - (PD/E) The maximum number of service users to be accommodated is 17. Date of last inspection 13th June 2007 Brief Description of the Service: Ridgewood Manor is a care home providing nursing care for up to seventeen older people. The care home is a large converted detached property. There are some restrictions in providing a suitable layout for all people living in the home. Consequently, some rooms have been restricted to independently mobile people because of the layout. The home is situated within walking distance of Uckfield High Street. Everyone living in the home benefits from a single room, ten of which are en-suite. There is a lift for access between floors. The home has a pleasant garden at the front and rear of the building. The home is accessed by a private driveway, which provides some parking for staff and visitors. The fees vary from £511.00 to £730.00 a week depending on the room to be occupied and the level of care required. These fees include all services and facilities apart from hairdressing, chiropody some personal toiletries and newspapers, which are itemised separately on the monthly invoices. Ridgewood Manor Nursing Home DS0000014034.V363458.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 star. This means the people who use this service experience good quality outcomes. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term ‘service user’ to describe those living in care home settings. For the purpose of this report those living at Ridgewood Manor will be referred to as ‘residents’. This was a key inspection that included an unannounced visit to the home and follow up contact with visiting health and social care professional. The allocated inspector spent approximately six hours in the home and was able to discuss matters with the registered manager who facilitated the inspection visit. During the assessment visits the inspector was able to spend time meeting with the staff, visitors residents and observing practice in the home. A brief tour of the premises was undertaken and a range of documentation was reviewed including the homes statement of purpose and service users guide, pre-admission assessment procedures, the systems in place for handling complaints and protecting residents from harm, staff recruitment files, quality assurance systems and some health and safety records. The care documentation pertaining to three residents were reviewed in depth and the inspector ate a midday meal with the residents in the dining room. An Annual Quality Assurance Assessment (AQAA) was not requested before this inspection so the previous AQAA was referred to. What the service does well: Ridgewood Manor provides an individual nursing care provision within a friendly homely environment. Residents and visitors expressed a high satisfaction with the care provided and with the staff working in the home. All residents said that they were happy in the home and liked the staff and their own rooms. Staff were approachable and were found to be kind and responsive to residents needs. Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 6 Ridgewood Manor is a small home that allows for residents and staff to get to know each other very well and staff clearly care for the residents as individuals. What has improved since the last inspection? What they could do better: Although the care documentation has been improved it still needs to take into account residents and their representatives views. The systems for handling medicines need to be improved to ensure accurate, clear and up to date record keeping and to ensure all controlled drugs are stored and handled in accordance with Misuse of Drugs (safe custody) regulations 1973. Further attention needs to be paid in promoting residents choice and autonomy examples of this is ensuring residents can have a bath or shower as they wish and can have a choice of meal on a daily basis. The induction training needs to be given and documented to evidence that the Skills for Care induction has been completed in an appropriate manner. The system used to monitor quality in the home needs to include a way of recording action taken in response and a sharing of the information with interested parties. Staff need to receive regular supervision that is fully recorded, to monitor their performance and develop their skills. Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 7 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. Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 8 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 Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 9 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, 3 and 6 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provides prospective residents and relatives, with a good level of information about the home, its facilities, services and the costs involved. The admission procedures ensure that all prospective residents are fully assessed by a competent person before admission and are assured that their needs can be met by the home. Intermediate care is not provided at Ridgewood Manor. EVIDENCE: A copy of the homes statement of purpose is displayed in the front entrance and the service users guide and last inspection report was available on Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 10 request. A service user guide is placed in each person’s bedroom before they move in. This document needs to include a copy of the homes terms and conditions of residency, and the registered manager said that she would ensure that this was included. An assessment of the admission process included a review of the documentation used in respect of two recent admissions to the home. This demonstrated that all prospective residents are fully assessed prior to admission by the registered manager. These cover all areas of need, including nursing needs, and were signed and dated by the manager. Although it was confirmed that these residents and their representatives were told verbally that the home was able to meet their needs following their assessment, this needs to be confirmed in writing. The manager was aware of this and said that this would be completed in the future. The manager confirmed that intermediate care is not provided at Ridgewood Manor. Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 11 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 and 10 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Individual plans of care set out resident’s personal, health and social care needs with risk assessments being used to inform this plan. Resident’s health care needs are met with the advice and support of community health care professionals. The homes practice in respect to medicine administration could put resident’s at potential risk. EVIDENCE: The care documentation pertaining to two residents were reviewed as part of the inspection process and each of these residents were seen during the inspection visit to the home. Each resident had a plan of care and these were Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 12 found to be informative based on the activities of daily living and providing clear guidelines for staff to follow. When admitted all residents are assessed and the plan of care are developed from these and associated risk assessments that include; moving and handling, tissue viability, falls, nutrition and the use of bed rails. The care documentation in respect of residents social and psychological care needs is improving but further emphasis should be placed on promoting individualised care that promotes residents preferences, theirs skills and autonomy. An example of this is the availability and choices around bathing and meals. Records seen indicated that the plans of care are reviewed on a regular basis but there was no evidence to confirm that they are completed in consultation with the resident or their representative. All residents spoken to were very happy with the care and support provided to them. Relatives were also complimentary of the care one saying ‘everything is fine I cannot speak highly enough of the staff and the care’. The registered nurses in the home manage the medicines in the home. The storage arrangements were found to be satisfactory and the home use a monitored dosage system provided from a local pharmacist. Records however seen during the inspection identified a number of shortfalls that included: • The Medicine Administration Record (MAR)chart had a number of gaps so there was no clear audit trail. • When a medicine had been omitted a code was not used to record the reason why. • The MAR chart did not provide a clear record of the medicines currently prescribed with many being repeated on the one chart. • Those residents prescribed as required medicine had no clear criteria in use to ensure residents received the medicine as needed in a consistent way. There was however no evidence to confirm that residents were not receiving their prescribed medicines as and when they needed them. The storage arrangements and records relating to the controlled drugs in the home were also checked. It was noted that the controlled drug cupboard was very full with some drugs being held by the home despite the residents who owned these not being in the home for several months. These need to be disposed of safely and recorded accordingly. The controlled drug register was rather confusing and the records identified that there was one missing Fentanyl patch. The registered manager was unaware of this shortfall and said that it would be investigated. There was no record to confirm that a regular audit of the controlled drugs held in the home is completed and this was discussed with the registered manager who agreed to progress this matter. Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 13 Staff were seen to be kind and attentive to residents and their visitors and they had a very good understanding of resident’s needs. They clearly knew the residents and visitors well and a visitor commented on how important this was to her and her husband. Staff said that the size of the home allowed this depth of knowledge and understanding and the relationship between the staff and resident to be close and caring. Residents were seen to respond positively to the contact with staff. Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 14 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 quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People in the home enjoy the activities and contact with staff and the activities co-ordinator. People are supported to maintain contact with their family and friends and their local community. People in the home enjoy the meals but would benefit from a choice each day. EVIDENCE: All residents said how much they enjoyed the activities and entertainment arranged by the activities co-ordinator who comes to the home on Thursdays. She has regular contact with each resident and is able to arrange outings and group activities that are well attended and much enjoyed. The activities that are provided in the home are displayed on a monthly programme that is distributed to all the residents in the home. The programme includes a weekly hairdressing visit, massage and aromatherapy every two weeks, a fortnightly outing and activities within the home once a week. Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 15 Social plans of care are being developed and these need to fully reflect the social and psychological needs of all residents including those that are nursed and cared for in their own rooms. Residents enjoy contact with staff but individual time for this social contact is minimal due to the care needs of other residents living in the home. Visiting is very much encouraged and very important to residents, visitors seen and spoken to said that they were made to feel very welcome and that staff were always hospitable. The meal eaten by the inspector with the residents was found to be good and found to be appetising and nutritional with an emphasis on home cooking. A second choice is not provided although the registered manager said that this was to be progressed once staff sickness had been resolved. The inspector again noted that the dining facilities are limited and residents sit in the lounge area with small separate tables. The meal times are not a social event and ways of improving this should be investigated. Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 16 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 and 18 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a complaint procedure, residents and their representatives are confident that any complaint made would be listened to and acted on. People in the home are safeguarded from abuse, but will benefit from more Staff training. EVIDENCE: There is a complaints procedure that is displayed in the entrance hall and within the service user guide. People spoken to said that they would raise any concern with either the registered nurse or the manager. Residents meetings are now held enabling residents to bring up any concerns and thoughts about the home. The registered manager confirmed that there had not been any complaints since the last inspection report. The registered manager has a good understanding of adult abuse issues and has undertaken training on safeguarding vulnerable adults locally. The homes policies and procedures are full and include a whistle blowing procedure that records the Commissions contact details. Not all staff have received training on safeguarding vulnerable adults and the registered manager said that this was being arranged. Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 17 Staff employed at the home are required to have a Criminal Records Bureau check to promote residents safety. Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 18 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, 22 and 26 People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents live in an attractive home that is reasonably well maintained and is clean and homely. Whilst residents have specialist equipment to meet their mobility needs they would benefit from an improved call bell system. Residents do not have access to adequate dining facilities. EVIDENCE: Ridgewood Manor is a converted family home and has retained a homely looking environment. A tour of the home confirmed that a satisfactory Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 19 standard of decoration is maintained throughout along with a satisfactory standard of cleanliness. The bathing facilities have been improved since the last inspection and are now more suitable for people with mobility problems. A new patio area has also been provided that allows residents to enjoy the garden area in good weather. As a converted premise the home has some limitations and these include some small rooms and a steep ramp to one room. Residents therefore need to have full risk assessments completed to ensure they are accommodated in a room where their needs can be met safely. All rooms are single and residents spoken to all liked their accommodation. In the last two inspection reports it has been required that a suitable call bell system is available to residents in all areas of the home. The provision has not been improved and during this inspection visit it was again noted that there is no call facility in the dining area and the lounge area only had a call point on the wall that could not be reached by the four residents who were using this room. These residents had to call out loudly if they needed assistance, as the lounge was not staffed all the time. One resident also confirmed that she was not able to use the current call bell as she had difficulty in pushing it and had to call for assistance. The registered manager said that a more suitable call facility is to be provided for this resident. In addition it was noted that the trailing flexes from the current call bell system could represent a trip hazard to residents and staff. As the registered provider has not addressed this shortfall this matter is now being looked at with a view for the Commission to take enforcement action. Although Ridgewood Manor has an attractive lounge and conservatory there is limited room for dining tables and chairs. During this visit four residents had their meal in the lounge area with individual tables. An option to eat at a dining table should be available and promoted for good social interaction. It has been an ongoing recommendation to the home owner that the dining facilities are improved to ensure there is comfortable dining seating available for all people living in the home should they wish to use it. This has not been progressed. The home was found to be clean and odour free. Infection control practice was found to be appropriate with staff wearing appropriate protective clothing. Residents were seen to be well dressed in well-laundered and ironed clothing. Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 20 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 quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staffing arrangements currently ensure numbers and skill mix of staff provides a competent and well-motivated staff team that meets residents health and personal care needs. The homes recruitment practice was found to be robust. EVIDENCE: At the time of this inspection visit 13 residents were living in the home. The staffing arrangements at the time of this inspection visit were found to be appropriate with staff able to meet the needs of residents, although time for any social interaction was minimal. The dependency of residents in the home is high and staff were seen to be busy throughout the day. Clearly the staffing levels need to be flexible and responsive to the needs of residents with increased staffing available as necessary based on the needs of residents and not just the occupancy of the home. Staffing rotas are kept in the home and evidenced that staffing levels are maintained with a registered nurse on duty throughout the day and night. Additional catering and domestic staff are employed although the care staff are completing the personal laundry of residents. Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 21 Staff and most relatives spoken to thought that there was enough staff to look after the residents well although one relative felt more staff were needed to facilitate more frequent bathing and mobilisation programme. This was raised with the registered manager to follow up. All feedback received about the staff working in the home was very positive and comments received included ‘I cannot speak highly enough of the staff and the care, the sisters are marvellous’ ‘The staff are kind, caring and very good’. Discussion with the registered manager confirmed that the home has a commitment to supporting staff through their National Vocational Qualification with over 50 of staff attaining an NVQ at level 2 or above. Information provided and discussion with staff indicates that a programme of training is in place that includes health and safety topics, abuse awareness and training specific to the needs of residents. Although individual files confirmed that staff complete an induction programme that takes into account the ‘skills for care’ induction standards, it was noted that this was completed over a very short space of time many standards being signed off on one day for one staff member. This draws in to question the quality of the induction programme. The registered manager confirmed that she felt that the training was in place and that the records were completed at the end of the training and agreed to review the training to ensure suitable and appropriate. The recruitment files pertaining to the three staff were reviewed as part of the inspection process and were found to be full and included an application form evidence of two references and the required Criminal Records Bureau and POVA checks on all staff. Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 22 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, 36 and 38 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a qualified and competent manager who is approachable and provides clear leadership. Systems for monitoring the quality of care take account of resident’s views these now need to be used to improve the service. Resident’s financial interests are safeguarded. People in the home are protected by the home’s policies and procedures and their health and welfare are promoted and protected. EVIDENCE: Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 23 The home’s manager was appointed in November 2006 and was registered as the manager by the Commission in June 2007. She has provided a much needed stability and leadership to the service. Contact with staff working in the home confirmed that she is well respected, able to manage the home and knows the residents well and is willing to help with care when needed. Residents and visitors were seen to respond positively to her and she was found to be approachable and responsive to the inspection process. Systems are in place to monitor the quality of the service taking into account residents and their representative’s views with the use of questionnaires and residents meetings. Although the questionnaires have been audited they need to clearly record action taken in response to the findings and to be shared with all interested parties. Ways of progressing this was discussed with the registered manager who confirmed that she would ensure suitable recording systems would be set up and shared. The registered manager confirmed that the home has no dealings with resident’s monies and that any extras costs incurred are paid by the home and then individually invoiced on a monthly basis. Although individual staff supervision has not been held for the majority of staff the process for formal supervision sessions has been discussed with each staff member in preparation for these to take place. Systems are in place to implement staff supervision and to record this formally. All policies and procedures are reviewed and updated at the organisations head office, and these are shared and discussed within the home to ensure staff are aware of any new practice or guidelines. In general, there is evidence that the home is managed in a way that ensures as far as is reasonably practicable the health, safety and welfare of residents and staff. The home has a system for the monitoring of hazards and servicing equipment. Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 24 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 X 2 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 2 X 3 2 X 3 Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement Timescale for action 01/09/08 2 OP9 13 (2) Plans of care must be composed and reviewed with input from the resident and or their advocate, unless the offer is declined That all medicines are handled to 01/07/08 ensure residents safety with clear, accurate and up to date record keeping. That all controlled drugs are stored and handled appropriately in accordance with Misuse of Drugs (safe custody) regulations 1973. That a suitable call system is accessible to residents in all areas of the home. That a suitable quality monitoring system is maintained to ensure residents and their representatives views are taken into account and demonstrates ongoing review and improvement to the quality of care and services in the home. The results of formal feedback from the residents, their 01/07/08 3 OP9 17(1)(a)S chedule 3(3)(i) 23 4 OP22 15/08/08 5 OP33 24(1)(2) 01/09/08 Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 26 relatives and stakeholders, about the services provided by the home, must be published and made available to current and prospective users, and the Commission. 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 OP20 Good Practice Recommendations That the provision of communal space is reviewed with a view to improving the dining facilities. 2. OP22 That an assessment of the premises and facilities should be undertaken by a qualified Occupational Therapist, to advise on the suitability of disability equipment and environmental adaptations. Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Ridgewood Manor Nursing Home DS0000014034.V363458.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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