Care Home: Ringstead House

What the care home does well Ringstead currently provides a good level of care and support to the person living there. The person told us that, "it`s ok here" and "staff are ok." It provides a comfortable, homely, safe and well-maintained environment for people who enjoy a relaxed and friendly environment and are protected from harm. Staff have good information about how they are to meet individual`s needs so that people are able to live the way they wish to.People are protected by staff who are checked thoroughly before being employed and are provided with training that enables them to keep individuals safe and to support them in their day to day needs. There are sound systems in place for ensuring any concerns or complaints are managed effectively and the service improved where necessary. People are protected from harm by robust adult protection procedures and systems for managing people`s monies. The home is well run by an experienced and qualified individual who looks to continuously improve the care provided. What has improved since the last inspection? Since the last inspection there have been a number of improvements with requirements made complied with. Information about how to meet the person`s needs, whilst balancing risk with independence is more comprehensive giving staff the information they need. Medication procedures and practices have also improved to ensure that there are robust systems in place for ensuring the health of the person. There is clearer information about how the person spends their days and their involvement in activities, particularly in the community. Rosters provide information on the staffing levels that are now more accurate and provide up to date information. Recruitment practices are also now more robust and staff receive a good standard of training to ensure people are protected from the employment of unsuitable staff and that they are in safe hands. People`s monies are also now more protected with the setting up of individual bank accounts for the person rather, than personal monies being paid into the organisation`s bank accounts. Adult protection procedures have been reviewed and include the role of social services in protecting people. What the care home could do better: It is positive that the manager/provider has ensured previous requirements are complied with speedily and fully. There are areas for improvement highlighted at this inspection that mainly focus on the health and safety of people living and working there. The fire drills must be separate from the weekly alarm test and include all staff throughout the year on at least two occasions and take place at various times of the day. This will ensure staff are able to deal with such emergencies and keep people safe. There must also be regular testing for legionella, particularly with the age of the property and the water system in place. This would ensure that people are protected from the risk of infection. Medication practices have improved and more robust than previously. These could be further improved by recording on containers when the medication commences. This would provide a clear audit trail. Staff should also be provided with accredited training in safe handling of medication to ensure they have the skills and knowledge to keep people safe and well. It would be beneficial to assess the needs of the person living there to determine their needs in the management of prescribed medication. CARE HOME ADULTS 18-65 Ringstead House 62 Ringstead Road Catford London SE6 2BS Lead Inspector Wendy Owen Key Unannounced Inspection 16th July 2008 10:30 Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 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 Ringstead House DS0000068744.V372030.R03.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 Adults 18-65. 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. Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ringstead House Address 62 Ringstead Road Catford London SE6 2BS 020 8285 1683 020 8314 1082 info@rightsupportmanagement.co.uk 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) Right Support Management Ltd Edith Eneanya-Bonito Care Home 4 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4) of places Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home care home are within the following categories: 2. Mental Disorder, excluding Learning Disability or Dementia - Code MD The maximum number of service users who can be accommodated is: 4 27th June 2007 Date of last inspection Brief Description of the Service: Ringstead is a home that was registered by the Commission in February 2007 to support and care for three individuals with learning disabilities. This has recently changed to providing care for four people with mental health problems. The premises have been adapted from a private residential home located in a residential area close to Catford town centre. There is a lounge, dining room and office on the ground floor. Bedrooms and bathrooms are located over the first and second floors. People using the service are supported 24 hours a day by a team of support workers and the manager. Information is provided to prospective users of the service in the form of a Service Users Guide and Statement of Purpose. Information on fees is included in the Service Users Guide with a minimum fee of £1500 per week. Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating of the service is 2 star. This means the people who use this service experience good outcomes. This inspection took place over the course of one day and a short period of time on one other day, to enable us to talk to the person living there. We had tried several occasions to visit the home but due to the routines and holiday commitment of the one person living there we were unsuccessful at those times in meeting with the individual and staff. We therefore made arrangements beforehand to visit. During the visits we spoke briefly to the person living in the home and the member of staff. On the second occasion we spoke to another member of staff and the manager and looked at records and briefly toured the home. As part of this inspection we considered the recent registration report recording the findings of the visit on 14th April 2008. The Commission agreed to change the number and category of registration to provide care and support for four people with mental health issues. We also considered the information provided in the Annual Quality Assurance assessment which tells how the how is meeting standards and how they have, or intend to improve the service. We looked at whether the home has complied with the requirements made at the last key inspection with the inspector recording in the registration report the following. “My site visit to the home on 14th April 2008, found all the requirements and recommendations had been complied with.” What the service does well: Ringstead currently provides a good level of care and support to the person living there. The person told us that, “it’s ok here” and “staff are ok.” It provides a comfortable, homely, safe and well-maintained environment for people who enjoy a relaxed and friendly environment and are protected from harm. Staff have good information about how they are to meet individual’s needs so that people are able to live the way they wish to. Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 6 People are protected by staff who are checked thoroughly before being employed and are provided with training that enables them to keep individuals safe and to support them in their day to day needs. There are sound systems in place for ensuring any concerns or complaints are managed effectively and the service improved where necessary. People are protected from harm by robust adult protection procedures and systems for managing people’s monies. The home is well run by an experienced and qualified individual who looks to continuously improve the care provided. What has improved since the last inspection? Since the last inspection there have been a number of improvements with requirements made complied with. Information about how to meet the person’s needs, whilst balancing risk with independence is more comprehensive giving staff the information they need. Medication procedures and practices have also improved to ensure that there are robust systems in place for ensuring the health of the person. There is clearer information about how the person spends their days and their involvement in activities, particularly in the community. Rosters provide information on the staffing levels that are now more accurate and provide up to date information. Recruitment practices are also now more robust and staff receive a good standard of training to ensure people are protected from the employment of unsuitable staff and that they are in safe hands. People’s monies are also now more protected with the setting up of individual bank accounts for the person rather, than personal monies being paid into the organisation’s bank accounts. Adult protection procedures have been reviewed and include the role of social services in protecting people. Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 7 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. Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People wishing to live in the home and staff have the information to make decisions on whether the home is right for them and that staff are able to meet their needs. EVIDENCE: A Statement of Purpose and Service Users Guide have been developed to provide information to those people who wish to use the service and are currently living in the home. This includes much of the information required by the Regulations and a copy of the “Guide” is kept in the individual resident’s file. The Statement of Purpose has been changed in light of the recent change in the category of people who the home is to provide care for. There have been no new people admitted since the last inspection, although the manager told us that she was looking to assess someone to see if they are suitable for Ringstead. She also assured us that people will have an opportunity to visit the home prior to admission to ensure they could make a decision if it is right for them. Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 10 The “Guide” contains information on the terms and conditions of residency with an individual contract. However, at the last inspection the information provided in the “Guide” and contract contained different information on notice periods. This has now been addressed. Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have comprehensive written information on how best they can meet the person’s needs so that the individual can lead the life they wish . EVIDENCE: As stated previously, there continues to be only one person living in the home. A care plan has been developed relating to the individual’s needs. It is comprehensive and details how the staff are to support the person in their identified areas. This could be improved by being a little more person centred and include issues around the person’s religious or other needs that are important and meaningful to them and shows how they wish to lead their life. We could see that the care plan had been reviewed and that amendments had been made to reflect the changes in their needs. Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 12 There was also comprehensive information relating to the risks identified and how these could be minimised whilst ensuring they are balanced with leading a “normal” life and not restrictive. It is clear from our short discussion with the person living in the home that he is able to make a number of decisions about how he wishes to lead his life and that he experiences good support from staff. The last inspection required that the care plan clearly show how finances are managed and by whom and the system in place for providing the resident with monies and where there may be restrictions on this such as reducing expenditure on gambling or alcohol. This has now been included as well as ensuring there are safer systems in place for management of the monies. Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers opportunities for the individual to lead an active and varied lifestyle that suits and is appropriate to their needs. Meals provided are of an adequate standard and offer some choice and involvement to the person living there to provide a satisfactory diet. EVIDENCE: We spoke to the individual living at Ringstead and they told us of their work in a local allotment as well as looking after the vegetable plot in the back garden. They obviously have “green fingers” because there back garden showed a number of successes in the growing of vegetables and there are a number of photograph taken of the person working on an allotment with other people. Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 14 This is positive as not only do they have the opportunity for fresh air and good exercise but also interacting with other from which they should experience a positive wellbeing. The care plan also detailed the work in the allotment, the importance to them of regular contact with family, going to the park, their enjoyment of betting, as well as other routines, such as shopping and domestic chores. Records are in place detailing these activities. At the last inspection we had some concerns about the quality of the food provided with the individual often preparing pizzas and other such food stuffs and staff finding it difficult to encourage them to eat health foods. They have had some success with this with more involvement by the individual in shopping and preparing food and eating a more balanced diet. They also have records in place detailing the meals taken in the home. Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported to maintain their health through robust medication practices and access to healthcare professional who are able to support them. EVIDENCE: The person living in the home is ambulant and physically able to undertake personal care tasks, as his interests suggests. His care plan details how his personal care is to be risks of self neglect have appropriate interventions. The last inspection detailed also issues around trying to register the resident with a local GP. This has now been resolved, making it easier to obtain repeat scripts for prescribed medication. Staff are supported by involvement by the mental health team responsible for the individuals care. Regular reviews are undertaken to ensure their mental heatth remains stable. Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 16 We can see from this inspection and the visit by the Commission previously that the individual has received good care and support improving their overall wellbeing. Medication has been prescribed and the systems in place have much improved since the last inspection. There are records in place for receipt, administration and disposal. Medication is stored appropriately with the medication being supplied for this person in box/bottle form. We would recommend that the date the medication is started is recorded on the container so that there is a clear audit trail The manager/Provider has reviewed the policies and procedures and used the Safe Administration of medication in Care Homes as guidance. There are still some areas not addressed that would provide further information and guidance for staff ensuring people are kept safe and well. We viewed staff training records and found that staff are provided with training in safe medication practices and also undergo a competency assessment before taking responsibility for this aspect of their job role. We would also recommend that staff receive accredited training, such as Safe Handling of Medication so that they can be assured of their practice. The manager/Provider has also reviewed some of the records used to ensure these are clear and can be audited more easily. There is limited information on the individual’s capacity to manage their medication and therefore we recommend that an assessment take place to determine if the individual is capable of taking responsibility for the whole or part of their medication regime. This would show how the home balances promoting independence with risk. Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures are in place to ensure people can raise concerns in a safe environment and they are listened and responded to so that lives are improved.. People are protected from harm by robust systems and procedures and staff understanding of their role in safeguarding people. EVIDENCE: A procedure for the management of complaints has been developed and a copy is contained in the Service Users Guide and on display in the hallway. There is also a complaints and comment book “strategically placed” in the hallway to enable people to write in if they feel they wish to raise a concern. The procedure is appropriate with timescales for investigation and CSCI address and telephone number. A complaint form has also been developed that states complainants name, nature of complaint action taken and “signed off” by the manager. There was no space for detailing whether the complainant is satisfied with the outcome or recording the route of the investigation. The Inspector suggested that this is added to the information and was subsequently completed Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 18 The Commission has received no complaints or any other allegations in the last twelve months and none have been reported in the information sent to the Commission. However, there was issue which was brought to the Commission’s and Social Services attention and investigated by the care Manager. The outcome was that the individual had the capacity to make decisions on the life and relationships he wished to follow. Whistle-blowing procedures are in place along with amended adult protection procedures as required at the last inspection. They now give staff clear guidance on what to do if they suspect abusive practices or if someone makes allegations which could alert to such treatment. Lewisham are currently updating their Inter-agency Guidelines on Protecting People from Abuse and are to send these out to providers in the near future and also provide guidance to registered services. The training matrix and AQAA shows all staff to have received training in this area and discussions with one member of staff shows them to have a basic understanding of their role in protecting people. The manager is also aware of her responsibility to refer to the Local Authority During this inspection we viewed the personal file of the one staff member recruited since the last inspection. This was found to be satisfactory with the checks completed as required. We also checked the personal monies of the one individual living in the home. There are now clear guidelines and records to show how the finances are managed through a guardianship and how this actually works. There were also records in place to show the income and expenditure. The manager has also arranged for a separate bank account for this person to keep their personal monies separate from the organisation’s monies. Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,27,28,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Ringstead provides a good standard of accommodation for people who will be able to live in a clean, comfortable and homely environment. EVIDENCE: Ringstead had the necessary policies and procedures, management and monitoring processes in place to meet the requirements set out in the Care Homes Regulations and stated in the NMS for Younger Adults Ringstead House has been registered since February 2007 and was registered for three people with learning disability. In April this year we agreed a change of registration to increase the number to four people with mental health problems. The registration report from the visit to the home at that time details the findings that “The premises at 62 Ringstead Road , Catford, London, Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 20 SE6 2BS is that they meet the requirements set out in the Care Homes Regulations and stated in the National Minimum Standards for Care Homes for Younger Adults”. The home is within a short walking distance of the shops, leisure activities and local transport links, making it easier for the people living there to access community activities. It is a comfortable, homely, well-decorated and well- furnished place to live. Communal space is of a good standard with a good size lounge and kitchen and the bedrooms are of a good size with some nice personal touches in place. Residents area able to bring in their own personal belongings to make them more comfortable and have familiar items around them. The bathrooms are also of a good standard. The home was found to be clean and fresh with laundry equipment located in the kitchen towards one end away from the food preparation area. Handwashing facilities had been placed in the kitchen minimising the risk of cross infection. This is reasonable for small care environments where resident involvement in daily activities core to their support. A visit by environmental health in 2007 also shows the home to be a three star service offering good standards for the preparation of food in the home. Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,32,34,35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are cared and supported by staff who are safe, competent and skilled to provide meet their individual needs. EVIDENCE: There are adequate staffing levels to support the one person living in the home at present. Staff have the flexibility to support them in their involvement in community activities during the day. The rosters detail the staffing level along with who is providing the “sleep in” and on call support. The AQAA and other records show that over all staff are qualified to NVQ 2 or above (or the equivalent). The manager has now developed a system for recording all staff training to monitor when updates are required and a copy of the training matrix was made available to us. This showed a good system in place for providing staff Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 22 with a variety of core and specific training through different sources and updating them as required. It is positive to note that staff are to undertake a qualification in mental health to ensure they are able to understand and support the client group under their registration. Two staff have already gained this qualification. Viewing of individual staff records and discussions with one staff member also showed there to be a variety of training provided. There was some evidence of formal supervision taking place and confirmed by the member of staff spoken to. We also viewed the staff file of the most recently recruited staff member to determine the quality of the recruitment procedures. The file showed that the required checks had been completed and that there were sound systems in place, including records of interviews, offer letters and induction of staff to ensure people being cared for are safe in their hands. The manager states there to be systems in providing induction to staff which meets with the Skills Sector Common Induction Standards. We reminded the manager of the need to ensure, even where staff have NVQ or have a certificate of induction from previous employment, there is a need to ensure modules specific to the home, such as policies and procedures or the type of client being supported are addressed. Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,40,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is well run and managed effectively to ensure people receive a consistent quality of care which looks to continually improve the service. Individuals are kept safe by maintaining health and safety in the home. EVIDENCE: The manager is registered with the Commission and she has the required qualifications and experience to manage a home of this size. She has achieved the Registered Manager’s Award, Diploma in Education, Diploma in Management Level 5, NVQ 4 in Health and Social Care, Mental Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 24 Health Level 3, has an NVQ assessors award and is planning to undertake the verifiers award. In the previous AQAA received they told us that they would be looking to accreditation with ISO and they have recently done so where their systems and processes will be monitored annually. We also noted that the service user and care manager have completed a survey about the quality of care provided showing the service to be meeting the individual’s needs. We note that the AQAA written in August 2008 and supplied to us a little needs to be reviewed as some of the information it contains should be updated to reflect the current situation. It could also be improved by ensuring it reflects evidence specific to each outcome group. Ringstead had the necessary policies and procedures, management and monitoring processes in place to meet the requirements set out in the Care Homes Regulations and stated in the NMS for Younger Adults. We sampled a few of the certificates in relation to the health and safety of the home. These were found to be satisfactory with gas, fire alarm, fire equipment, weekly checks and fixed wiring all satisfactory. There is a need to review the way in which fire drills are undertaken as the current situation shows that are part of the weekly fire alarm check. Fire drills must be separate to these and undertaken at different times of the day to ensure staff know how to act in such an emergency and they must include all staff. There is also a need to ensure there are regular checks in relation to the testing for legionella. There is evidence that staff have received core training, such as First Aid, infection control, food hygiene and moving and handling. We reminded the manager of the need to complete a risk assessment in relation to moving and handling if they wish to review the annual moving and handing training for staff. Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 3 3 2 x Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 26 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA42 Regulation 23 Requirement Fire drills must take place more regularly, and at different times from the weekly fire alarm check so that staff are able to keep people safe in the event of a fire. There must be regular checks on the water systems to ensure the risk of legionella is reduced. The AQAA must be completed in full and be current to ensure the Commission has the information it needs to judge the quality of care provided. Timescale for action 01/11/08 2 3 YA42 YA39 23 24 01/12/08 01/11/08 Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 27 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 YA6 Good Practice Recommendations Care plans should contain information on all aspect s of needs including religious, spiritual and cultural needs to ensure they are person centred and people live the way they wish to live. Staff should record on boxes and bottles the date prescribed medication is commenced. Accredited medication training to ensure people are kept safe and well with support from competent staff An assessment should be undertaken detailing the individual’s capacity to take responsibility for their prescribed medication. 2 3 4 YA20 YA20 YA20 Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 28 Commission for Social Care Inspection London Regional Office 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. Extracts may not be used or reproduced without the express permission of CSCI Ringstead House DS0000068744.V372030.R03.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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