Care Home: Rodley House

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What the care home does well Residents have their health care needs met through good liaison with healthcare professionals. Residents are able to join in a range of activities and maintain links with their family, friends and the local community. The home has obtained information and some staff have received training in the Mental Capacity Act 2005. Staff receive training in protecting vulnerable people. The home has demonstrated its awareness of the procedures for safeguarding people with a referral to the adult protection unit of the local authority. The home was well-maintained and very clean providing residents with a safe and comfortable environment. The home uses a range of quality assurance tools to check that it is meeting the needs of the residents. There are thorough safety checks in place in the interests of residents` well being. What has improved since the last inspection? An audit of all external medications had been carried out to check that all residents were receiving this as prescribed. There have been improvements to the record keeping where money or valuables are returned to a resident after being held in safekeeping. What the care home could do better: The home must check that it has all the information that should be supplied by funding authorities before a resident is admitted into the home. Care planning should improve so that all care plans give clear and specific instructions to staff on the actions required to meet residents` needs. There needs to be more attention by staff administering medication towards signing the Medication Administration Record (MAR) All staff recruited must be subject to robust recruitment practices with particular attention to the receipt of written references. In addition one other procedure around the recruitment of registered nurses should improve. Key inspection report CARE HOMES FOR OLDER PEOPLE Rodley House Harrison Way Lydney Glos GL15 5BB Lead Inspector Mr Adam Parker Unannounced Inspection 21st August 2009 08:25 DS0000064588.V375566.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rodley House Address Harrison Way Lydney Glos GL15 5BB 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) 01594 842778 01594 845047 manager.rodley@osjctglos.co.uk The Orders of St John Care Trust Hilary Bridget Mitchell Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43) of places Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category 2. Old age, not falling within any other category (Code OP) The maximum number of service users who can be accommodated is 43 28th August 2007 Date of last inspection Brief Description of the Service: Rodley House is a purpose built Care Home, situated in a large housing estate close to Lydney town centre. The Home, managed by The Orders of St. John Care Trust, provides nursing and personal care to older people. The accommodation, consisting of forty-one single rooms and one double room, is on two floors and has been fitted with a shaft lift to provide access to the first floor. Although none of the rooms has en-suite facilities, there are several assisted bathrooms and separate toilets throughout the property. There are four comfortable lounges within the Home, plus a large dining room and a number of smaller sitting areas where residents and their visitors may meet. The gardens are easily accessible and have attractive shaded areas where residents may enjoy good weather. The Home is part of the local community and links are maintained wherever possible. Information about the home is available in the Service User Guide, which is issued to prospective residents, and a copy of the most recent inspection report is available in the home for anyone to read, along with the Home’s Statement of Purpose. The charges for Rodley House range from the basic Local Authority rate of £377.00 to £750.00 per week. Hairdressing, Chiropody, Newspapers, Toiletries and Transport are charged at individual extra costs. Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 5 Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two stars. This means the people who use this service experience good quality outcomes. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. One inspector carried out this unannounced inspection on one day in August 2009. A check was made against the small number of requirements that were issued following the last inspection, in order to establish whether the home had ensured compliance in the relevant areas. Care records were inspected, with the care of four residents being closely looked at in particular. The management of residents’ medications was inspected. A number of residents and visitors were spoken to directly in order to gauge their views and experiences of the services and care provided at Rodley House. Some of the staff were interviewed. Survey forms were also issued to a number of residents, staff and visiting health and social care professionals to complete and return to CQC if they wished; some of their response comments are featured in this report. We received surveys back from five residents, two staff and two health care professionals. The quality and choice of meals was inspected, and the opportunities for residents to exercise choice and to maintain social contacts were considered. The systems for addressing complaints, monitoring the quality of the service and the policies for protecting the rights of vulnerable residents were inspected. The arrangements for the recruitment and training of staff were inspected, as was the overall management of the home. A tour of the premises took place, with particular attention to health and safety issues, the maintenance and the cleanliness of the premises. We required an Annual Quality Assurance Assessment AQAA from the home, which was provided; the contents of this informed part of this inspection. Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 7 What the service does well: Residents have their health care needs met through good liaison with healthcare professionals. Residents are able to join in a range of activities and maintain links with their family, friends and the local community. The home has obtained information and some staff have received training in the Mental Capacity Act 2005. Staff receive training in protecting vulnerable people. The home has demonstrated its awareness of the procedures for safeguarding people with a referral to the adult protection unit of the local authority. The home was well-maintained and very clean providing residents with a safe and comfortable environment. The home uses a range of quality assurance tools to check that it is meeting the needs of the residents. There are thorough safety checks in place in the interests of residents well being. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 8 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 9 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 Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home’s admission procedure generally ensures that all service users are admitted to the home on the basis of a full assessment of their needs so that they can receive the care that they require. However written information from funding authorities has not always been obtained prior to admission. EVIDENCE: The assessment documentation completed for two residents recently admitted to the home was looked at. Both residents had been admitted from hospitals where relevant information had been obtained. Both had also had comprehensive pre-admission assessments completed by the home. The homes AQAA document told us that the assessment would be completed by “The Home Manager or other qualified individual”. Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 11 The first resident looked at was self funding although a care needs assessment had been obtained. The second resident was funded by the local authority and their care plan was dated on the day that the resident was admitted to the home indicating that this was not obtained before admission. Residents who responded to our survey confirmed that they had received enough information about the home to help them decide if it was the right place for them. The home does not provide intermediate care and so Standard 6 does not apply. Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 12 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Further development of care plans and medication administration records would ensure that staff have the information to fully meet residents health and personal care needs whilst working to uphold their privacy and dignity. EVIDENCE: Care plans for four residents were looked at as part of the case tracking exercise. Care plans were variable in content; some provided simple yet clear instructions for staff to follow to meet residents’ needs. One care plan for a resident’s mental health needs was particularly good in that it was clear and made links with input from mental health professionals. Other care plans were less specific and clear with such instructions as “Encourage fluids”, “Check (the resident) often throughout the day.” And “Staff to monitor mood”. Information from assessments of residents needs should enable clearer and more specific plans to be written. Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 13 The home’s AQAA document told us how the home was planning to introduce new care plan documentation and care plan training for staff. One resident’s risk assessment for pressure area care had produced a score that would have indicated the need for a care plan. On further examination there was no care plan for this area of need however the care plan file had been subject to an audit and this issue had been picked up for action. Care plans had been reviewed on a monthly basis. Residents had risk assessments completed for pressure areas, moving and handling, falls and nutrition. Residents were also being weighed on a monthly basis and their weight recorded. The home’s AQAA told us how following staff training a new nutritional assessment tool was planned for introduction in September 2009. Records showed that residents had been receiving visits from health care professionals such as General Practitioners (GPs) Community Psychiatric Nurses and a continence advisor as well as attending hospital appointments. Residents responding to our survey told us that they received the care, support and medical care that they needed. One of the resident’s representatives wrote that ‘staff should pay more attention and accept when people needed to use the toilet’. Another said that staff ‘kept residents clean and contented’. One person told us that the home did ‘everything well’. Staff who responded to our survey confirmed that they were given ‘up to date information’ about residents’ needs. Health care professionals who visited the home and who responded to our survey raised no concerns about care in the home. One resident spoken to during the inspection visit said that they were “Very well looked after.” Medication, storage administration and recording arrangements were looked at. Storage was secure and temperatures were being monitored and recorded for the storage room. Some temperatures in June and August 2009 had been recorded that were over 25 degrees centigrade. The manager reported that a fan would be used if temperatures were found to be too high. Recorded temperatures for the medication refrigerator were within appropriate limits. Controlled medication was being stored correctly and a check on the amount held for one resident showed that this correctly tallied with the record kept. At the time of the inspection visit three stock checks were being carried out each day on the amount of controlled medication stored. Examination of the Medication Administration Charts showed that where hand written directions had been made two staff signatures were present indicating that entries had been checked. Although the MAR charts showed that medication was generally being signed when given or an appropriate omission code was being used there were some gaps on the charts. Medication audits were in place and these had recently Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 14 picked up gaps on the MAR chart as an issue. Given the findings of audits and of the inspection more attention needs to be given to checking that staff administering medication are completing an accurate record. One resident had been prescribed Diazepam with the directions “one at night when required up to three nights a week.” The resident was being given the medication on set nights through the week as opposed to being given when any anxiety was observed. The registered manager was advised to check these arrangements with the GP to ensure that the resident was receiving the medication as the GP had intended. The issue of protocols for medication prescribed on an ‘as required’ basis was discussed in relation to this issue and this was in the process of being introduced by the registered provider. Two residents were self medicating their own eye drops and risk assessments were in place and lockable storage arrangements provided. One resident spoken to confirmed that they received their medication at the correct times. Two of the residents spoken to during the inspection visit confirmed that staff respected their privacy by knocking on the door before entering their rooms. The home had no shared rooms. Staff were observed treating residents with respect. Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a varied activities programme, good social contact and a variety of meals. EVIDENCE: The home offers a wide range of activities for residents both inside and outside of the home; these including gardening. An activity programme displayed on notice board lisited visits to residents in rooms, patio games, films, sport on TV, DVDs, games and quizzes. There had been visits to the home by the ‘pat a dog’ visiting dog scheme, There is a Christian service held on Sundays as well as Holy Communion. Residents who responded to our survey told us that there were social activities in the home that they could join in with. One resident spoken to during the inspection visit stated that they “Keep occupied most of the time.” They also appreciated the visits from the hairdresser and had enjoyed the recent Summer Fete held at the home. Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 16 The home’s AQAA document told us how no restrictions were placed on visitors to the home except at the request of the resident. Two visitors spoken to during the inspection visit described how staff made them feel welcome when they visited the home. Although the home does not have its own vehicle, residents had used a local ‘dial-a-ride’ service to access the wider community. The home had information about advocacy services available for residents. Evidence was seen of residents having brought in their own furniture and electrical equipment into the home. At lunchtime residents were eating lunch in the dining room on the ground floor. Tables were laid with drinks, salt and pepper and cutlery and there was a quite atmosphere. However it was noted that it took quite a while to get everyone sitting for lunch which meant that some residents were waiting for nearly twenty minutes before they received their meal. A new four week menu had been introduced in March 2009, it was reported that this would be reviewed after six months and also in the light of any comments from residents. Dietary preference charts were in use so that staff had information about residents’ likes and dislikes at mealtimes. One resident spoken to described the meals provided as “very nice” and another commented on how well the staff helped those residents who needed some assistance with eating. Residents told us that they liked the meals provided in the home, although one resident’s representative wrote that the menus were repetitive, and that ‘a few more fresh vegetables wouldn’t go amiss’. The registered manager reported how more effort was being made to introduce more fresh vegetables into the meals. Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information is available if any resident or their representative should wish to make a complaint and the home’s approach to training staff should ensure that residents are protected from abuse. EVIDENCE: The home had a record of complaints and had received two in the twelve months prior to the inspection visit. One of these complaints we were aware of and the documentation for the second showed how this had been investigated as well as the response to the complainant. The complaints procedure was on display in the home. Residents who responded to our survey indicated that staff could be relied upon to listen and act on what they said, although one person wrote this was ‘sometimes’. Each person confirmed that they knew how to raise concerns if they needed to, and that there was someone they could speak to informally if they were unhappy. In relation to resident’s legal rights, the home has information available on the Mental Capacity Act 2005 and staff have received training in this subject. The home has a policy for protecting residents from abuse as well as a ‘whistle blowing’ policy. Training in protecting residents from abuse has been given to all staff employed in the home. The home has demonstrated that it will act to Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 18 protect residents making a referral to the local authority adult protection unit when information was received about the possible financial abuse of one resident by a person outside of the home. Staff had also received training in dealing with challenging behaviour. Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are accommodated in a comfortable and very clean environment that is well maintained and furnished to suit their needs. EVIDENCE: A tour of the premises was undertaken. All areas of the home inspected were found to be clean, well maintained and decorated and smelt fresh throughout. The freshness and cleanliness of the home was commented on by one of the residents and one of the visitors spoken to during the inspection. As well as a variety of communal space inside the home there was an enclosed rear garden with a patio area, seating and raised garden beds for planting. Resident’s individual bedrooms contained various degrees of personalisation including some with their own furniture. Some of the bedrooms were slightly Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 20 below the recommended minimum standard in terms of size, and had no ensuite facilities although were equipped with wash basins. The laundry had washable floor surfaces and arrangements for hand washing. It was noted that in some places the wall surfaces had started to become worn and consideration should be given to repainting these in the future to provide a readily cleanable surface. Residents and visitors indicated in their survey responses that the home was kept clean and fresh. Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a well trained staff group although recruitment practices need some improvement to ensure that residents are fully protected. EVIDENCE: Staffing in the home is arranged so that on a typical weekday there were two registered nurses on duty all day with seven care staff in the morning and six in the afternoon. At night there was one registered nurse and three care staff. As well as the registered manager there were domestic, laundry, catering maintenance and administration staff. The home had twelve out of thirty care staff trained to NVQ level two or above in Care or Health & Social Care. The homes AQAA document reported that the level of all staff with an NVQ continues to increase. The recruitment documentation for five recently recruited members of staff was looked at. Two of those recruited were registered nurses and although the home had checked their registration on the Nursing and Midwifery Council’s (NMC) website this had been done on the public ‘Search the Register’ section. The home should make use of the ‘Employer Confirmation Service’ section that would give them more information about any registered nurse that they were Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 22 considering for employment. One of the registered nurses employed had not provided information on the application form about reasons for leaving some past employment and there was no evidence that this had been discussed at interview. Another member of staff had been employed with no written references being obtained before employment with one reference dated over two months after the person started work in the home. Two further staff had been recruited with all the correct documentation and information obtained prior to employment in the home. Staff are provided with induction training in line with the Common Induction Standards that is a nationally recognised standard of training for staff new to working in care. Training had also been completed in various subjects relevant to the needs of residents in the home such as catheter care, falls prevention and dementia. Staff who responded to our survey confirmed sound recruitment practices, induction and support. One member of care staff spoken to during the inspection visit confirmed the training they had received and commented on how easy it was to access training courses. Residents who responded to our survey confirmed that staff were available when they needed them, although one person wrote that they were only ‘sometimes available’. This person also told us that staff were ‘reasonably friendly’. Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 23 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, & 38 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed with a variety of quality assurance audits in operation and safety checks to ensure that the home is run in the best interests of residents. EVIDENCE: The registered manager had been registered since October 2008. She is a Registered General Nurse with the Registered Manager’s award. She has had experience both in working in hospitals and as a registered manager at a residential home. She had recently completed training in the Mental Capacity Act 2005 and fire safety training. Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 24 Internal audits were in operation on medication, care plans and the environment with an additional annual audit. Annual surveys were carried out of residents, relatives & health care professionals. Original responses are sent to the head office of the registered provider and feedback is given to the registered manager through a summary and a comparison with the results from the previous year. The home had achieved a quality assurance accreditation and Investors in People Award. Reports made of visits by a representative of the registered provider were looked at; these had been completed for each month of the year. The home provided secure facilities for residents money and looked after money for a number of residents. Appropriate records were kept for any residents money or valuables held. Following a requirement made at the previous inspection, the home had adopted the practice of obtaining written acknowledgement when money or valuables were returned to a resident from safekeeping. Staff had received training in safe working practices in the areas of fire safety, infection control, food hygiene, moving and handling, first aid and health and safety. Central heating boilers had been serviced in February 2009. The electrical wiring in the home had been checked in September 2008 and portable electrical appliances in April 2009. Checks were in place on window restrictors. Work has been carried out in the home by an outside contractor in order to reduce any risk from Legionella. The home had completed a fire risk assessment in March 2009 which has to be subject to a 6 monthly review. The home had not had a recent inspection from the fire safety officer. A food hygiene inspection had taken place in July 2009 and the home was expecting a follow up visit in December 2009. The inspection identified a number of issues that required attention and the home had been awarded a two star rating. Cleaning materials were securely stored with no decanting from large to small containers evident. Staff had attended training in handling hazardous substances. Accidents had been appropriately recorded and one which had been notified to us was looked at in detail. This involved an injury to a resident during a moving and handling procedure. Records showed that this had been thoroughly investigated by the home. As a follow up to this incident more moving and handling training was being planned. Rodley House DS0000064588.V375566.R01.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X 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 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 3 Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 26 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 OP29 Regulation 19 (1) (b) Schedule 2 Requirement Before a person starts work in the home, all the information and documents specified in Schedule 2 of the Care Homes Regulations must be obtained to ensure that residents are protected through robust recruitment procedures. Timescale for action 30/11/09 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. 2. 3. Refer to Standard OP3 OP7 OP9 Good Practice Recommendations Care plans from funding authorities should always be obtained before a prospective resident is admitted to the home. All care plans should contain more specific instructions for staff to follow to meet residents’ needs. More attention should be paid to ensure that an accurate record is made by staff signing the medication administration record when giving residents their medication. Consideration should be given to repainting the laundry DS0000064588.V375566.R01.S.doc Version 5.2 Page 27 4. OP26 Rodley House 5. OP29 wall surfaces. Employment checks on the registration of nurses should always be carried out using the Employer Confirmation Service. Rodley House DS0000064588.V375566.R01.S.doc Version 5.2 Page 28 Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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