Care Home: Royley House

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What the care home does well Detailed assessments and care planning using a person centred approach are completed before people enter the home. One person said "I choose this home from recommendations from other people who said it was marvellous." Staff training is given a high profile to ensure they meet the needs of people in their care. Staff had a good knowledge of people`s care needs and felt supported by the manager`s open door policy and her approachability. One member of staff said, "We are a good staff team and all get on together" and "I have never enjoyed a job has much". This has had a positive outcome for people in their care. A key worker system is in operation that promotes staff accountability. One person said, "Nothing is too much trouble for staff" and "The manager asked if there was anything I did not like, I told her ice-cream so now I get cake or cheese and biscuits". Another person said, "Food is always good, suppers too" and "the dining room is like a restaurant". A newsletter is produced to keep relatives informed of events, which they are encouraged to participate in. One relative said "the care home has a very nice friendly atmosphere which has made the whole family feel at ease with our father being in care." A full-time activity co-ordinator is employed; one relative said, "People in the home have a lot of entertainment and stimulation". The manager and staff hold a lot of fundraising events to subsidise activities in the home. One relative said, "The home does really well in providing excellent care and allows the person to retain their privacy and dignity." People in the home confirmed this saying "Staff always respect my privacy and dignity." The manager recognises areas for improvement to promote equality and diversity. As part of the home`s future development, as stated on the AQAA, it hopes to encourage people in the home to take some part in the recruitment of staff and the need to employ male staff to reflect the gender group of the client group. What has improved since the last inspection? Person centred care planning and assessments have improved since the last inspection. Fourteen rooms have been decorated and four new bedroom carpets and a dining room carpet have been fitted. Thirteen new lounge chairs have also been purchased.A new water feature and gazebo have been bought for the garden through the home`s fundraising events. The one requirement made on the previous inspection had also been addressed. What the care home could do better: Although outcomes for people were very positive, there was one incident observed in relation to the administration of medication and staff not following the home`s policy and procedure. This was brought to the attention of the manager who acted upon it immediately. CARE HOMES FOR OLDER PEOPLE Royley House Lea View Royton Oldham OL2 5ED Lead Inspector Sandra Buckley Unannounced Inspection 28th January 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Royley House DS0000005518.V358520.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Royley House DS0000005518.V358520.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Royley House Address Lea View Royton Oldham OL2 5ED 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) 01616334848 0161 6339191 Roche Care Limited Valerie Ann Campbell Care Home 41 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (41), of places Physical disability over 65 years of age (10), Sensory Impairment over 65 years of age (5) Royley House DS0000005518.V358520.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 only: Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category: Code OP (maximum number of places: 41); Dementia over 65 years of age: Code DE(E) (maximum number of places: 15); Physical disability over 65 years of age: Code PD(E) (maximum number of places: 10); Sensory impairment over 65 years of ageCode SI(E) (maximum number of places: 5). The maximum number of service users who can be accommodated is: 41. 15th November 2006 Date of last inspection Brief Description of the Service: Royley House was opened in October 2000 and is a purpose built residential care home for 41 older people. The home is located off Middleton Road in Royton and is close to shops and amenities. Accommodation is provided over two floors, both floors having separate lounges, dining rooms and bathrooms. All bedrooms are spacious, single rooms and many provide en-suite facilities. The range of weekly fees are: £345-£470, which does not include the following: hairdressing; newspapers; magazines, and toiletries. A copy of the Commission’s most recent inspection report is available at the main office. Royley House DS0000005518.V358520.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes This was a key inspection that included a site visit to the home. The manager was not told beforehand that we were coming to inspect, this is called an unannounced inspection. This inspection looked at all the key standards and included a review of all available information received by the Commission for Social Care (CSCI) about the service provided at the home since the last inspection. During the site visit information was taken from various sources, including observing care practices and talking to people in the home. The manager, relatives and some members of the staff team were also interviewed. A tour of the home was undertaken and a sample of care, employment and health and safety records were seen. Comments from questionnaires returned from residents and their relatives are also included in this report. The CSCI requires the home to complete an Annual Quality Assurance Assessment (AQAA) in order to demonstrate the level of care provided. The manager had completed this in detail and comparisons were made with this document at the time of inspection. On this inspection the outcomes for people in the home did reflect that indicated by the manager in the AQAA, especially in relation to daily life, personal care and protection. The manager acknowledges the home’s strengths and weakness and areas for improvement. They have sustained a period of proactive management in addressing quality issues in the home and the promotion of person centred planning. There had been one incident which was investigated under the protection of vulnerable adults guidance regarding access to appropriate health care professionals. The CSCI is satisfied that this was dealt with appropriately and measures have been put in place to ensure no further occurrences. Royley House DS0000005518.V358520.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Person centred care planning and assessments have improved since the last inspection. Fourteen rooms have been decorated and four new bedroom carpets and a dining room carpet have been fitted. Thirteen new lounge chairs have also been purchased. Royley House DS0000005518.V358520.R01.S.doc Version 5.2 Page 7 A new water feature and gazebo have been bought for the garden through the home’s fundraising events. The one requirement made on the previous inspection had also been addressed. 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. Royley House DS0000005518.V358520.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Royley House DS0000005518.V358520.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People’s needs are assessed before entering the home, ensuring the facilities and services are sufficient to meet their needs. EVIDENCE: Four case files were examined and found to contain detailed assessments of needs from professionals. In addition to this, the manager undertakes home or hospital visits and completes their personal assessment in order to ensure people’s needs can be met by the facilities and services the home offers. One relative said, “I chose this home for my mother from recommendations from other people who said it was wonderful here.” “Having visited other homes before deciding on Royley House, there was no comparison, Royley shines above the rest, I would recommend it to anyone.” Royley House DS0000005518.V358520.R01.S.doc Version 5.2 Page 10 The AQAA stated that not enough information was being given to people who view at weekends. This will be addressed by the completion of a brochure alongside the statement of purpose and service user guide. This forms part of their improvement plan over the next 12 months. Royley House DS0000005518.V358520.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People’s care plans were person centred and reflected individual preferences. Staff training and accountability ensured outcomes for people were positive and their needs were met. EVIDENCE: Improvements have been made to care planning since the last inspection. Individual care plans are person centred and reflect their assessments of need. Care plans were reviewed on a regular basis and upgraded where needed. Families and their relative were consulted on admission on the level of involvement they wished to have in care planning. Detailed instruction was provided to staff on assessments. Daily notes reflected the care given. care delivery and risk Royley House DS0000005518.V358520.R01.S.doc Version 5.2 Page 12 Care planning focused on people’s positive capabilities and how to manage negative behaviour. Social histories and family trees had been completed with photographs as an aide memoire. Several people had completed life storybooks with the help of Age Concern. The manager said it was hoped that, eventually, all people would have this in place. This would encourage staff to be aware of people’s previous lifestyles, hopes and capabilities and how this may impact on their daily life in the home. People’s preferences were recorded in care planning, likes and dislikes of food and bedtimes were recorded. Spiritual needs were also addressed and, in several cases, people’s wishes on the end of life had also been discussed. How people express their sexuality was recorded. For example, do ladies like to wear makeup, one person preferred to wear bright clothes. Regular health visits, e.g., podiatrists, opticians and GP, addressed people’s physical needs. There was evidence that when weight loss had been identified the manager implemented a nutritional screening tool (MUST) to monitoring the situation effectively. Accidents were recorded and analysed; these were also being included in daily notes and care planning. On occasions when people were resistant to personal care, this was well recorded with the required interventions, e.g., staff to keep returning to people when their mood changes or offer alternative forms of care (wash or bath). Aids and adaptations are provided to give people independence. There was evidence of one person being provided with a motorised wheelchair. A key worker system promotes accountability for staff. Key worker notes were on file indicating one to one work. A picture of the people’s key worker is also pinned up in their bedrooms. All people looked clean and well cared for. One person said “‘I get a bed bath if I am not up to a bath, I am very lucky.’ ‘My key worker’s name is Hilda, photo’s in the room.’ Ten staff had undertaken moving and handling training, eight in infection control and seven in dementia care since the last inspection. One person said, “Staff respect my privacy and dignity,” and another said, “The staff always listen and act on what I say. I always get medical support.” Royley House DS0000005518.V358520.R01.S.doc Version 5.2 Page 13 Relatives commented, “The home does really well providing excellent care and allows the person to retain some dignity” and “The care is dignified and of a high standard”. Other comments included “We visit every day and they get in touch with us as soon as we need to know anything.” Another said “The staff are very efficient in keeping me up to date on hospital admissions or accidents”. Medication policies and procedures were appropriate. Observations made on the day of inspection found that staff were not following procedures due to requests from people to leave medication with them until they were ready to take it. In this instance, medication must be held securely - with people who did not wish to take medication at the time having it administered at a later time by staff. This would ensure medication is signed for at the point of administration and promotes the safety of people in the home. This was brought to the manager’s attention who acted upon advice immediately. The manager had acknowledged what they could do better on their AQAA stating that staff’s knowledge on the prevention of pressure sore care could be improved. They had contacted district nurses to arrange training. Possible improvements in equality and diversity were recognised. The recruitment of male staff to give male residents the opportunity of a male carer would reflect the gender of the client group. Royley House DS0000005518.V358520.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence, including a visit to this service. A person centred approach to daily life in the home results in fulfilment for the people who live there. EVIDENCE: The home has ground and first floor accommodation, with each floor having permanent staff to maintain continuity of care and allow key workers to gain a better knowledge of people’s preferences and lifestyles. Although staffing is separate for each floor, people have freedom of movement. Two people with bedrooms upstairs preferred to use the downstairs dining room and another person the lounge areas. Royley House DS0000005518.V358520.R01.S.doc Version 5.2 Page 15 The was evidence of local churches visiting to give communion and a special events board stating outside entertainment and activities, lunch at the Park Hotel and entertainers Memories, for example. Chippy teas and suppers were also arranged. Photos of special events were displayed around the home. The manager and staff are not provided with a budget for recreation, with fund raising and activities being due to staff goodwill. A candlelight dinner party was held at Christmas for people in the home and a limited number of relatives. Those relatives who attended said it was very special and another said they really wanted to go but it was booked up. A minibus is available for transporting people to public events. One person said “everything is good about this place, I have been out on the bus for lunch I would not change a thing”. A full-time activity co-ordinator is in post who maintains the programme of activities. Wine is offered or a drink of their choice during activities and with meals at weekends. The manger said this was to give a different perspective on the days. Relatives have access to a monthly newsletter keeping them informed of any developments and activities, which they are encouraged to join in. The manager holds regular meetings with people in the home to gain their views and discuss issues that may impact on their daily lives. One relative questionnaire said “The care home has a very nice friendly attitude that has made the whole family at ease with our father being in care.” Another said “My mother leads a very quiet life and has no restrictions, she appears to be quite contented” and “The people in the home receive a lot of entertainment and stimulation.” The person centred approach to care planning is implemented in addressing people’s preferences of choices in their daily lives. One person said, “We go to bed and get up when we want, I go to bed about 11pm.” People were well presented and those ladies who wanted, had their nails painted and hair done regularly. One person said “I use an electric shaver but staff give me a wet shave when I need one.” Another person said, “I like to dust around the house.” We (The Commission) dined with a group of people in the home who were complimentary of the food on offer and the choices available to them. People were offered a choice of mug or cup of tea and water was available. One person said, “Food is always good, suppers too.” Another said, “The dining room is like a restaurant.” The mealtime was a pleasant experience and staff dealt with people who needed assistance sensitively. Royley House DS0000005518.V358520.R01.S.doc Version 5.2 Page 16 The manager had stated on the AQAA that they felt the teatime menu could be more imaginative and were going to review this; also that they need to strive to create a menu to suit all tastes. Royley House DS0000005518.V358520.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People and their relatives felt that any concerns they may raise would be listened to and acted upon. Staff training in the protection of vulnerable adults ensures people are protected from abuse. EVIDENCE: A log of complaints is maintained and a flowchart with log numbers to ensure complaints are acted upon. The complaints procedure is displayed in bedrooms. The last complaint to be logged related to a person who was resistant to care at times, which concerned the family. The manager had advised staff to continually observe and offer different approaches until successful. The CSCI had not received any complaints since the last inspection. One person said, “I would tell the manager if I were not happy about anything. The manager asked me if I was not happy about anything and I said I did not like ice cream, so now I get cake or something else like cheese and biscuits.” Another person said, “The complaints procedure is in my bedroom but I would go to Val (manager). I am very happy here and feel thankful that I was able to come here.” Royley House DS0000005518.V358520.R01.S.doc Version 5.2 Page 18 Questionnaires received from relatives said, “I know the complaints details are within a booklet I have”. Also “I have read the instructions on how to make a complaint.” Ten staff have undertaken protection of vulnerable adults training since the last inspection. There has been one investigation under adult protection procedure in December 2006 relating to accident procedures not being followed. This was upheld. The CSCI is satisfied that the home improved policies and procedures and has maintained professional standards through a sustained period of management. Royley House DS0000005518.V358520.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People are provided with a well-maintained, homely and safe environment that they are encouraged to personalise. EVIDENCE: Royley House has 32 single rooms with en-suite facility and nine single rooms with vanity units. All communal areas were looked at and a selection of bedrooms. People have a good standard of homely accommodation that was clean, tidy and free from odours. One relative said “The home is always very clean and staff always offer us a tray of drinks when we come in.” Royley House DS0000005518.V358520.R01.S.doc Version 5.2 Page 20 A number of improvements had been made to the environment, both inside and outside of the home, since the last inspection. Fourteen rooms had been decorated, four new carpets purchased for bedrooms and one for the dining room. Thirteen new chairs had also been bought and a large screen television for one of the lounges. Redecoration in the corridors was ongoing at the time of this inspection. The outside of the building was well maintained with pleasant garden areas. The manager and staff had raised monies to provide a water feature and gazebo, making an attractive feature area for people to sit. Eight people’s rooms were viewed, with their permission, and were found to be homely and personalised to their own standard. Several had brought in a personal chair, curtains and bedding from home and televisions. Two people had a personal telephone lines. The manager demonstrated an awareness of how the environment might impact on people’s lifestyle and independence, for example, a double bed had been purchased for a person who found sleeping in a single bed difficult. One person told the inspector that she had told the home she liked gardening and could not see one so the manager had arranged for a small garden area to be built outside the person’s window to give a pleasant view, one which they may maintain to the level of their capability. A hairdressing room is also available for people to use. Aids and adaptations are in place, e.g., grab rails, nurse call system and hoists, to promote independence. There are three spacious bathrooms and a shower. Two of the bathrooms are equipped for people with physical disabilities. The manager had stated on the AQAA that in the last 12 months a tuck shop had been created, selling sweets, drinks and toiletries. The manager felt this provided an opportunity for people to be independent and shop for themselves. Royley House DS0000005518.V358520.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Staff training, induction and recruitment are robust and ensure the safety of people in the home. EVIDENCE: The duty rota showed the numbers and deployment of staff were sufficient to meet the needs of people in the home. The deputy manager has supernumerary hours to cover for sickness, annual leave and management cover. The home provides care on the ground and first floors, which are staffed independently in order for staff to build a professional relationship with the people living there. Staff training is given a high profile, leaving them feeling confident in their role. The manager has introduced senior staff on to night duty who have completed training in the administration of medication. Staff induction was in line with skills for care and 50 of staff had achieved NVQ level 2 through the manager accessing Oldham Social Services training department. Royley House DS0000005518.V358520.R01.S.doc Version 5.2 Page 22 One relative said, “Nothing is too much trouble for staff”; another said “Staff are great here, you cannot fault them”. One person in the home said, “Staff are very good and civil”. The notice board in the home listed staff training days for fire drills. Two dates were listed, one for day staff and one for nights. Two staff were interviewed who demonstrated a good knowledge of people in their care. They discussed training they had received which included: food hygiene, health and safety, moving and handling, dementia care, falls prevention. Infection control training was also booked for 13th March 2008. Both staff members said they received supervision, attended regular staff meetings and felt supported by the manager’s open and inclusive approach. One staff member said, “It is a good staff team, all staff get on” another said “I have never enjoyed a job as much.” Recruitment procedures ensured the safety of people in the home by obtaining three references and appropriate Criminal Record Bureau checks. The home’s AQAA stated that they could improve by employing male staff to reflect the gender of the client group but have had limited applicants. Plans for the future were to include people in the home in the staff recruitment procedures. One person in the home said, “This is a very nice home, nice people who run it, I am very settled here.” Royley House DS0000005518.V358520.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence, including a visit to this service. A sustained period of management using a person centred approach for people, relatives and staff in the home that is open and transparent has vastly improved outcomes for people. EVIDENCE: The manager has seven years’ experience in care and management and has achieved NVQ level 4 and the registered manager’s award. She has continued her professional development through training in the protection of vulnerable adults, MUST nutritional screening tool and fire procedures, especially for people with disability. The manager has been in post since 31st July 2006. On taking up the post, a number of problems in relation to staffing and health care needs of people in the home needed to be addressed. Royley House DS0000005518.V358520.R01.S.doc Version 5.2 Page 24 The manager has successfully, moved the home forward in reducing sickness levels, improving record keeping and introducing a person centred approach throughout the home which has been sustained for a period of time. The manger takes a proactive approach in addressing quality issues in the home. The AQAA completed by the manager was completed fully and acknowledged what they had achieved, for example, review and upgrade care planning, improvements in staff morale and support. Attendance and sickness levels have improved, staff are consulted in order to make them feel more valued and staff training has improved. They also acknowledged what they could do better and also what they hoped to achieve over the next 12 months. One relative said, “The manager always keeps me informed of any changes” and one person in the home said, “The way this home is managed makes people feel comfortable.” A relatives meeting was held in 2007 when the environment, food, care and staff deployment were discussed. The last residents’ meeting was held on 21st January 2008 with the agenda discussing food, environment and entertainment. A staff meeting was held on 24th January 2008 which 22 staff attended. The agenda consisted of ensuring all details are recorded on care planning for handovers, check safety of the building at night and the importance of turning people who need it to prevent pressure areas. Staff were thanked for their reliability and hard work. The importance of attending staff training in infection control was stressed and staff were informed to ensure snacks are made available in between meals for people in the home, advising them of what is being offered. A quality assurance system was operational in order to seek the views of professionals, families and people in the home. Staff supervision occurred on a regular basis in order to aid staff development. Health and safety checks were carried out on equipment, for example, gas and electric, nurse call system and hoist. Staff received training in health and safety. Each person in the home had an individual fire risk assessment and evacuation procedure. Monies held on behalf of people in the home were examined. Record keeping was accurate and matched balances held by the home. Receipts were kept of expenditure and any outgoings were recorded. Royley House DS0000005518.V358520.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 X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X x 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 X X X X X 4 Royley House DS0000005518.V358520.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 OP9 Regulation 13(2) Requirement Medication must not be left with people unattended and only signed for at the point of administration. This will ensure people take medication safely and the manager can be confident that the right person has had the medication. Timescale for action 26/02/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Royley House DS0000005518.V358520.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Manchester Local Office Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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 Royley House DS0000005518.V358520.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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