Care Home: Rookstone

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What the care home does well The manager of the home has been in post for many years. The home has retained a number of it`s staff including the team leaders also for a number of years. This provides residents with staff who understand the workings of the home and provides consistency in care. The Salvation Army support the home and undertake regular quality assurance checks to ensure the home is working well. The Christian ethos in the home gives residents opportunities to continue their worship . Improvements have been made in respect of the environment with on going redecoration and refurbishment of communal areas, as well as upgrading of bedrooms. What has improved since the last inspection? The requirements arising out of the last inspection had been addressed namely care plans ,medications and information retained regarding staff. Care plans, risk assessment and all supporting documentation was completed on residents which provided staff with the information they need to address care. Staff administer medication safely and the majority of records were fully completed. Evidence of all recruitment procedures were retained on site. Since the last inspection there have been a number of areas where improvements have been made particularly in the environment with a full refurbishment underway What the care home could do better: The environment is subject to ongoing improvements although overall the building itself has limitations which prevents it from being wholly suitable. It is recommended that all staff who administer medication are up dated annually in medication training and are subject to annual competency assessments to ensure that they are safe to continue to administer medications. Missing items of clothing were commented upon in the residents comment cards- action to address this needs to be implemented. CARE HOMES FOR OLDER PEOPLE Rookstone 1 Lawrie Park Crescent Sydenham London SE26 6HH Lead Inspector Rosemary Blenkinsopp Key Unannounced Inspection 13:00 2 and13th September 2008 nd 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 Rookstone DS0000038682.V371019.R02.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. Rookstone DS0000038682.V371019.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rookstone Address 1 Lawrie Park Crescent Sydenham London SE26 6HH Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8778 0317 020 8778 0349 christine.fell@salvationarmy.org.uk Salvation Army Mrs Christine Fell Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Rookstone DS0000038682.V371019.R02.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 Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 31 21st September 2007 Date of last inspection Brief Description of the Service: The home is part of the Salvation Army Social Care Division and is a registered care home for 31 residents. The home is staffed by an experienced team of carers, with ancillary staff in support. The home accesses health care services in the local community including those of the GP and District Nursing services. Opticians, Dentist and Chiropodist services are supplied through a domiciliary service. Rookstone is a large detached property that has been adapted as a residential home. There are 29 single rooms, adequate bathroom and washing facilities. The home has a lift to the upper floor. The home is located in a very quiet road, close to shops and public transport. The home has a large garden that is accessed via patio doors from the lounge area. Fees range between £380-£495 this excludes hairdressing, chiropody newspapers toiletries and individual requisites. Rookstone DS0000038682.V371019.R02.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 stars. This means the people who use this service experience good. The inspection was conducted over two half-day periods. The manager facilitated the first site visit, the team leader in charge the second visit. The second visit was conducted on a Saturday as this was the day the administrator works and therefore access to financial records could be obtained. During the second site visit periods of observation were undertaken on the ground floor lounge area. Prior to the inspection the manager had completed the AQAA and forwarded this to the CSCI. Fourteen comment cards were provided and returned during the inspection including seven from residents and seven from staff. During the visit the inspector met with staff and several residents. Staff were interviewed as part of the site visit. All of the information obtained from the sources identified above has been incorporated into this report. A selection of documents were inspected including care plans, staff personnel files as well as health and safety records. Feedback was provided to the manager at the end of the two days of inspection. Other information which has been considered when producing this report and rating, is the information supplied and obtained throughout the year including Regulation 37 reports and complaints. Comments received from residents included “It was my choice to come here as I already knew the service”. Another resident commented “ it took a bit of settling in – food good with choice and enough “. What the service does well: The manager of the home has been in post for many years. The home has retained a number of it’s staff including the team leaders also for a number of years. This provides residents with staff who understand the workings of the home and provides consistency in care. Rookstone DS0000038682.V371019.R02.S.doc Version 5.2 Page 6 The Salvation Army support the home and undertake regular quality assurance checks to ensure the home is working well. The Christian ethos in the home gives residents opportunities to continue their worship . Improvements have been made in respect of the environment with on going redecoration and refurbishment of communal areas, as well as upgrading of bedrooms. What has improved since the last inspection? 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 Rookstone DS0000038682.V371019.R02.S.doc Version 5.2 Page 7 be made available in other formats on request. Rookstone DS0000038682.V371019.R02.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 Rookstone DS0000038682.V371019.R02.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): 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 the service. All prospective residents are appropriately assessed prior to admission; and further information received from members of the multi disciplinary team, provides staff with a good knowledge of the residents care needs from which they can deliver care. Intermediate care is not provided by this service. EVIDENCE: On the day of the first site visit there were 27 residents on site, there were four vacancies. There are six residents who self fund. The manager advised that there were no residents with MRSA or Clostridium Dificile. Rookstone DS0000038682.V371019.R02.S.doc Version 5.2 Page 10 Assessments confirmed that relatives and healthcare professionals had been involved in the pre admission assessment. Residents spoken to during the inspection said that they had been asked for their views on care needs and their expectations of the service to be provided by the home. Staff spoken to said that the information contained within the assessment helped them to formulate care plans and risk assessments individual to the health, personal and social care needs of the person. Staff also said that the information provided gave them an insight into the persons needs enabling them to care for the person. In particular, information relating to their physical needs, presenting problems and information on specific issues which may need particular equipment or further input were felt to be useful. In addition, information on the resident’s wishes and preferences enabled them to provide care specific to them. Documents to confirm assessment information included forms from the referring Local Authority, in the form of the Community Care Assessment, which provided good information. The home conducts its own pre assessment and trail visits are offered. Relatives often visit prior to placement. Following the home’s assessment they confirm the placement in writing including the trial period. Residents spoken to confirmed that they received enough information about the home and the services offered, this included a visit to the home prior to admission enabling them to make an informed decision as to whether it was the right place for them to be and that they felt the assessed health, personal and social care needs of their relative could be met. The Statement of Purpose had been updated May 2008 and this was available in the hall and to all residents along with the Service User Guide. Information in a residents’ comment card confirmed information had been provided prior to placement and that the residents had used this as part of her decision making process. Another comment card stated that the resident had known the home for twenty years in her work with the Salvation Army. Residents are subject to a “residency agreement “those seen were signed by the individual resident and the manager. The resident’s handbook had been updated July 08 Rookstone DS0000038682.V371019.R02.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 using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The care plans seen reflected the assessed health, personal and social care needs of the individual and gave clear guidance on how these needs were to be met. All healthcare needs can be met by staff in the home supported by the multi disciplinary team. The people who use the service feel confident that they will be treated with respect ensuring that their privacy and dignity is maintained at all times The medication policies, procedures and practice ensure that the people who use the service are given the correct medication at the correct time by competently trained staff. EVIDENCE: Rookstone DS0000038682.V371019.R02.S.doc Version 5.2 Page 12 Healthcare is provided by the staff in the home supported by the multi disciplinary team. Each resident has an individual plan of care that details the care that they require. Several care plans were looked at in detail on the second day of the inspection. The care plans were well presented and information easy to access. The care plans were personalised to the individual resident and identified their specific personal, health and social care needs. They provided information on specific ways in which these needs were to be met respecting the independence, privacy and dignity of the individual being cared for in the home. The care plans also included risk assessments relating to moving and handling, nutrition, falls and mobility, behaviour problems, and skin integrity. These had been subject to regular reviews. All care plans seen were signed by the resident and staff member and had a monthly review recorded. Occasionally sections were incomplete although the overall standard of record keeping was good. In one file the care plan could not be located on two issues which would significantly impact on the resident’s health, although staff were fully aware of how to address the resident’s needs. All information must be available for staff to access. The home operates a key working system. Key workers and their names were referred to in comment cards and known by residents, which provides confirmation that this system is operational and not just a token representation. Records relating to weight checks were in place as well as those relating to visits made by the multi disciplinary team members. Tippex should be avoided on all legal documents. The medications were inspected with the assistance of a team leader. Medications were safely stored in the office and two medication trolleys are available for medication administration. All medications were stored in an orderly fashion. All staff who administer medication must be NVQ 3 or above, to ensure that they are safe and competent to do medications. However there is no annual competence assessment or annual training of staff giving medications. This should be reviewed. Training is internal and through the supplying chemist Boots. Prior to staff being allowed to undertake medication administration they must be familiar wit the policies and procedures around medication and have had periods supervising medication rounds. Self medication assessment forms are used for those residents’ who administer their own medication. This covered the main points although could have included further information to satisfy that the residents was safe and competent to do this. Rookstone DS0000038682.V371019.R02.S.doc Version 5.2 Page 13 Medication records confirmed medications received and destroyed were checked. The medication administration charts were completed without gaps and included residents photographs and any allergies that they may suffer.. Some medications are used “ as required” . Those medications which are to be given “ as required”, need to have full instructions on reason for administration, maximum dose , frequency and where applicable duration, these instructions were on some, not all. Medications are checked weekly by staff in the home. In addition audits are conducted by Lewisham Primary Care Trust. Rookstone DS0000038682.V371019.R02.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 using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home endeavours to provide appropriate activities to the residents supporting and encouraging them to maintain their chosen lifestyle in their home environment. Residents have choices incorporated into their day. Meals are served in congenial surroundings with choices, preferences and portion size directed by residents which supports independence. EVIDENCE: The periods of observation were in the main lounge area. Signs of well being amongst residents included engagement with one another, engagement with staff and their surroundings. The home has an activities person employed two days a week doing varied sessions with residents, including those which require active participation and others such as videos. Residents choose what activities if any, they want to participate in. The home supplies a selection of newspapers and magazines which on the two site visits residents were reading. Rookstone DS0000038682.V371019.R02.S.doc Version 5.2 Page 15 Residents who spoke to the inspector made favourable comments regarding the home staff and the service that they received. This was echoed in the residents comment cards all of which were favourable except one comment regarding missing laundry items. Visiting is open an encouraged to maximise family contact. The League of Friends is very active in this home and raises money to benefit residents’ lives, paying for items which would not normally be part of usual expenditure. The home had had a garden party June 08 which was well attended. There is a minibus for outside activities. The garden is well used in warmer weather and has a gazebo for shelter. Residents meetings provide feedback on the type of activities residents want planned and where possible thee are provided. Rookstone DS0000038682.V371019.R02.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 using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The people who use the service are able to feel safe and protected in the home. This is evidenced by way of the homes’ policies and procedures; staff training relating to complaints and protection issues, and their knowledge on how to action such matters. In addition the open ethos of the home encourages concerns to be raised openly. EVIDENCE: Information was available to residents and relatives on how to raise concerns or make a complaint in several documents, including the Statement of Purpose. The complaints procedure was on display and this was available in large print. Complaints are recorded using standard Salvation Army documentation which includes a record of the compliant and a response form. The complaints book had no entries. It is important that all complaints no matter how trivial are recorded and actioned appropriately. The reason why there have been no formal complaints is because at residents meetings any issues raised are recorded and action taken, which may prevent them escalating into a complaint. Rookstone DS0000038682.V371019.R02.S.doc Version 5.2 Page 17 Residents who spoke to the inspector cited the manager or staff member as the first port of call for referring concerns/complaints. They said that they had no hesitation in referring matters on. During the course of the site visit staff were asked about adult protection procedures and all demonstrated a good grasp of this to include reporting and recording of such matters. They cited internal reporting systems as well as Social Services departments to refer allegations onto. Staff confirmed that they receive training in adult protection and whistle blowing. Rookstone DS0000038682.V371019.R02.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 and 21, 26. 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 the service. The accommodation is satisfactory to meet the needs of the people who live there. The people who use the service live in a home that is clean, pleasant, hygienic, safe and maintained, with access to safe and comfortable indoor and outdoor communal facilities. EVIDENCE: The home is in a quiet area of Sydenham. It has parking to the front and a large garden to the rear. A tour of the home was undertaken and all areas of the home were found to be clean and odour free. Equipment was stored under the ground floor stairs although unsightly it was safely stored in this area. Rookstone DS0000038682.V371019.R02.S.doc Version 5.2 Page 19 The home has an ongoing programme of refurbishment and redecoration. A number of areas have benefited from upgrading to provide more comfortable surroundings for residents to live in. There is a schedule of work which is due for completion by the end December 2008. New curtains are to be purchased through money raised by the League of Friends. Bathrooms and toilets if not already are due for redecoration. Some resident’s bedrooms have been redecorated and in many cases, personalised with furnishing to the residents requirements including wall decorations, pictures etc. In some bedrooms resident’s had their own telephones, TV’s and radios. Some clocks and calendars were evident. Communal areas which have been redecorated were bright and pleasant On the ground floor there were a number of areas, which required attention. These were all part of planned redecoration. Rookstone DS0000038682.V371019.R02.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, 28,29and 30. 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 the service. The management of the home ensures that there are sufficient numbers of competent staff to meet the personal, health and social care needs of the residents in their care. This outcome is achieved by implementing thorough recruitment and selection procedures, supported by ongoing training, supervision and appraisal systems. EVIDENCE: The home employs care staff a number of ancillary workers to ensure the home is working effectively. The staff compliment of care staff includes male and female working both day and night duty, to ensue gender preferences can be met during personal care. The home had three vacancies, including one for a care staff, one laundry person and a tea time helper. These were being actively recruited to. Staff were observed to demonstrate patience during care procedures and engaging with residents whilst doing so. There was evidence of good team working and a good staff morale prevailed. Staff seemed confident in what they were doing. Rookstone DS0000038682.V371019.R02.S.doc Version 5.2 Page 21 All staff have completed NVQ level 2 or above. The three team leaders have completed NVQ level 4. Staff are updated in mandatory topics on an annual basis to ensure that they remain competent in these areas. Staff files were selected including those staff with whom we had spoken to. The personnel files were well organised and information easy to access. They contained evidence to show that robust recruitment procedures were in place including identity checks, references, CRB clearance and completion of the application form. Staff are issued with job descriptions contract and terms and conditions of employment. All staff do “Skills for Care”, induction, which takes approximately eight weeks to complete. Every staff member is subject to a twelve week probationary period to establish is the are suitable for the job they are doing. Staff have a” supervision contract”, which outlines the responsibilities for both parties. Staff confirmed supervision took place and that they were provided with a copy of the supervision notes. Staff stated within comment cards received, that a high standard of care was provided, other comments were that residents were treated as individuals and equally. Staff felt that there were enough staff employed to meet the needs of residents. In the event of a vacancy agency staff would be obtained. Staff had a good knowledge of the residents for whom they cared, and specifically those for whom they were key workers. The confirmed induction and on going training which equipped them with the skills they need to do the job. Other topics such as infection control and dealing with MRSA were also well understood by staff we spoke to. The current appraisal system is currently being improved upon to benefit staff. Rookstone DS0000038682.V371019.R02.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 and 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 the service. The home, the residents, relatives and advocates benefit from having a qualified, competent, accountable, and committed manager and management structure in place. The home has open and transparent quality assurance systems in place ensuring that the aims and objectives can be measured and are achievable. The home has systems in place to ensure the health and safety of the residents, relatives and staff are met. EVIDENCE: Rookstone DS0000038682.V371019.R02.S.doc Version 5.2 Page 23 Mrs Fell is the Registered Manager for this facility and has been for a number of years. She is a qualified nurse and has completed the Diploma in Management and NVQ level 4. She also holds a social work qualification. Ms Fell has many years experience of managing this service which has provided great stability and consistency to the staff and residents providing safe management in the home. This is to be commended. The inspector sampled a number of maintenance and service certificates to evidence that the building and the equipment within it were safe and suitable to use, all those seen were satisfactory. Fire prevention measures included the fire risk assessment and an emergency plan. Evidence of weekly alarm and checks on the emergency exits were recorded. Fire drills included a list of those present and signatures to confirm their attendance at the training. Quality assurance is addressed both in house by way of regular staff meetings as well as management meetings. All meetings are minuted. Residents meetings are recorded, and a list of action points arising out of these meetings is actioned by Mrs Fell, who then feeds back on at the next meeting. Residents’ meetings are held approximately every 6- 8 weeks as more frequently is seen to be too frequent. Ms Fell had conducted an in house staff survey July 08 and six were returned completed generally positive comments, regarding their working lives was included in the responses. In addition quality audits are conducted through the Salvation Army head office including Regulation 26 visits. Reports in respect of Regulation 26 visits were on site and the content of these was to a good standard. The annual quality assurance audit was conducted 18/19 July. This is a thorough audit of all the workings and services provided by the home. Feedback had been received verbally by the home manager although the full written findings had not yet been produced. Two resident’s finances were checked and found to be correct with supporting receipts and records on the balance sheet. All expenditure is invoiced including that for chiropody. Finances’ are audited weekly by the manager and the administrator. Money and valuables are securely stored in a safe. Petty cash is made available for any expenditure in the home. Rookstone DS0000038682.V371019.R02.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 X X 3 X X x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 2 X X X x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Rookstone DS0000038682.V371019.R02.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 OP9 Refer to Standard Good Practice Recommendations Staff who administer medications should be annually updated in medications and subject to regular checks on their competence . Rookstone DS0000038682.V371019.R02.S.doc Version 5.2 Page 26 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 Rookstone DS0000038682.V371019.R02.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!