Inspection on 31/08/05 for 19-21 Haymill Close.

This inspection was carried out on 31st August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

19-21 Haymill Close. 10/11/06

19-21 Haymill Close. 10/01/06

19-21 Haymill Close. 12/08/04

19-21 Haymill Close. 28/01/04

19-21 Haymill Close. 25/09/03

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Edenvale

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Chatsworth Care - Dawson House

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Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 19-21 Haymill Close Greenford Middlesex UB6 8HL Lead Inspector Sarah Middleton Unannounced 31st August 2005 9.45am 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 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. 19-21 Haymill Close G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 19-21 Haymill Close Address Greenford, Middlesex UB6 8HL Telephone number Fax number Email 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 8566 7060 020 8810 9531 Ealing Consortium Limited Mr Stuart McQueen Care Home 9 Category(ies) of Learning Disability (9) registration, with number of places 19-21 Haymill Close G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: NO Date of last inspection 12/8/04 & 23/9/04 Brief Description of the Service: 19/21 Haymill Close is a home for nine adults with learning disabilities. The home is two houses joined in the middle by a small office. There is a separate staff team who work in either number 19 or 21. The whole service is managed by one Registered Manager and one Senior in number 19 and one in number 21, other staff members are support workers. The service offers twenty four hour care and support for the service users. The bedrooms are single and there is a large communal garden to the rear of the property, with parking to the front of the service. The home is situated from a main road on a residential estate. The main road has public transport which from there is a short distance from the main town of Ealing Broadway. There is an tube and railway service from this town. The service is managed by Ealing Consortium and the building is owned by a housing association. 19-21 Haymill Close G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the regulatory process. A total of just less than five hours, 9.45am-2.35pm, was spent on the inspection. The Inspector carried out a tour of the home and inspected service user plans and maintenance records. Two service users and three staff were spoken with as part of the inspection. It is registered as one unit, but there are two distinct separate staff teams who either work in number 19 or 21. On each shift there is a designated shift leader for number 19 and another one for number 21 and they are responsible for particular areas of the running of the home for example the medication, petty cash and service users individual money. Both staff and service users appear happy now this change has been occurred, with staff knowing where they are working and whom they are responsible for. Service users are free to walk in either number 19 or 21 and there are no restrictions to this. This inspection covers both number 19 and 21 and the report reflects findings from both houses. An unannounced Pharmacy inspection had been carried out on 12/7/05, which focused on the medication systems in the home. Requirements had been set following this inspection. Previous timescales have been included in this report for requirements that are still outstanding. What the service does well: The home provides a variety of activities for service users to provide stimulation and occupation to their daily lives. Staff spoken with were aware of individual service users needs and sought to meet those needs. The staff work well as a team and feel the change whereby staff chose which house to work in offers continuity for the service users and staff. Staff are keen to learn and develop new skills for their professional development and for the benefit of service users. 19-21 Haymill Close G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc Version 1.40 Page 6 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. 19-21 Haymill Close G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 19-21 Haymill Close G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 & 4 Service users are assessed prior to admission to ensure the home can meet their needs. Prospective service users and their representatives are encouraged to visit the home in order to allow them to make an informed choice. EVIDENCE: A pre-admission assessment was viewed on a service user who had been admitted the previous year. This provided a clear picture of the service users needs, including their communication, social and health needs. The senior member of staff explained any prospective service user could visit the home. The last service user admitted had visited the home on several occasions, including overnight stays, prior to them moving in to the home. This enabled them to meet other service users and staff. 19-21 Haymill Close G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 & 9 The health and personal care needs of service users had been identified and were being met. Regular monthly summaries keep staff informed. The regular reviews held offer the opportunity to ensure the current needs of the service user are identified and their opinions are noted and acted on by members of staff. Risk assessments were detailed and aimed to minimise incidents and accidents occurring. These assessments are reviewed and aim to safeguard both service users and others. EVIDENCE: Individual service user plans were available and samples were viewed. Overall these were comprehensive and detailed how the service users identified health, personal and social care needs would be met. Service user plans were up to date and had been reviewed on a regular basis. Keyworkers complete a monthly summary to ensure all staff are aware of the current situation for all the service users. Daily records were available and detailed the care provided and what service users had done that particular day. Assessments for eating and drinking and moving and handling were in place. There were guidelines in place on preferences individual service users had and how to support each service user in a manner that they responded to positively. 19-21 Haymill Close G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc Version 1.40 Page 10 Likes and dislikes were clearly noted and the abilities of each service user were recorded and reflected the current situation. Each service user has different capabilities and understanding of verbal communication. The staff team encourage service users to demonstrate their choices and discuss ways as a staff team to enable service users to make their own decisions. Staff spoken with described how service users showed their interest or disinterest in activities or routines. Two service users have advocates, one advocate is in contact regularly. Staff stated it is difficult to find advocates for all the service users who would like one or might benefit from an independent person in their life. Risk assessments are in place and cover all the relevant areas of a service users life. This includes both in the home and out in the community, for example cooking, going up/down the stairs and absconding when out in the community. These were reviewed on a regular basis and altered and updated where necessary. The assessments were individual to the service user and gave detailed information to staff about what areas in every day life that could pose a risk to the service user and how to minimise the risk. 19-21 Haymill Close G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 & 17 Social and educational activities are in place and reflect the abilities and interests of the service users. Community and leisure resources are accessed regularly to include service users in the community. The varied activities offer variety and occupation on a daily basis. Visiting is encouraged for service users to maintain contact with family and friends. Meal provision is satisfactory and offers a balanced choice of food. Temperatures of fridges/freezers must be within the appropriate range to ensure the health of service users is not jeopardised. In addition, all foods prepared or opened and stored in the fridge/freezer must have clear dates of opening on them. EVIDENCE: Service users wishing to attend a place of worship are encouraged and supported by staff to do so. Due to service users learning disabilities they are not able to seek employment. 19-21 Haymill Close G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc Version 1.40 Page 12 Those able, attend local colleges and study various courses over the college year. One service user in particular has just finished a year full-time course at a nearby college and is now looking to start at a new college in September 2005. All the service users living in the home have a weekly activity plan that incorporates time both in and out of the home. This might include attending a day centre once or twice a week or the local activity resource centre where there is for example drama or massage. In addition, service users use local shops, restaurants and other leisure resources. One staff member spoken with stated where possible public transport is used to access community facilities. Day trips are part of the home’s activities, as are holidays. Some service users might go with another service user, if they appear to enjoy each other’s company, or alone with one or two members of staff. One member of staff spoken with stated they go on several holidays with service users and that these are successful. Those service users who have family or friends are encouraged to see them either in their home or spend time at the family home. One service user has a worker from Mencap who takes them out on a regular basis. Daily routines are individual for service users and staff described how they know when a service user is happy to take part in an activity or not. Service users can have a key to their rooms but it is noted if they do not wish/or understand to lock their rooms or use a key. No service users living at the home hold keys to their rooms. Staff were seen to interact positively with the service users throughout the inspection. Where able or interested service users are supported to take part in doing their personal laundry and cooking. Guidelines were seen for one service user who enjoys taking part in cooking. These guidelines indicated where the service user would need guidance and advice as to how to prepare to cook, for example hygiene practices, handwashing and how to assist with cooking a meal. Menus were available and reflected choices. Any changes to menus are noted and records are kept of service users meals. Staff stated where possible fresh food is cooked on a daily basis. One service user said they did not always like the food, but that they do have a choice of alternatives. Both kitchens were clean on the day of the inspection. Temperatures of fridges/freezers were taken on a daily basis but on several days for both kitchens the recording of temperatures were too high for both fridges. A requirement was made that temperatures are recorded and action is taken if the temperatures are above eight degrees. In one fridge there was an opened packet of meat with no date of opening on it, a requirement was made that all food opened/prepared must have a date of opening on it. 19-21 Haymill Close G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 20 Service users receive personal care from staff in private and their routines and preferences are acknowledged and respected by staff. Health needs are recorded and met to ensure the health of service users is monitored on a daily basis. There are shortfalls in the medication systems within the home. Medication must not be used if out of date and liquid medication must have a date of opening on it to ensure the services users health is protected. Aromatherapy oils used must have guidelines on how and when to use them on service users. This must be visible and staff must be aware of the usage of these essential oils. EVIDENCE: Staff talked about how service users communicate their preferences about receiving personal care. It is also noted on service users plans as to their choice over gender specific care. Personal care is given in private and where service users are able to undertake this activity independently this is encouraged. One service user described how they are encouraged to wash unaided by staff. They have poor mobility and use a bell to call staff when they need assistance with particular aspects of personal care. All service users have keyworkers who work closely with the service user to ensure all their needs are identified and addressed. 19-21 Haymill Close G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc Version 1.40 Page 14 Health appointments are noted with any outcomes on service users plans. Each service user sees a variety of health professionals’ dependant on their particular need, for example Psychiatrists, Speech and Language therapists and Dentists. These are accessed on a regular basis or as and when required. Staff accompany service users to appointments. Samples of the medication administration records were viewed. There were gaps on these records where signatures should have been once medication was administered. One bottle of liquid had no date of opening on it and one bottle of eye drops was opened and out of date. The Aromatherapist who offers massages in the home had mixed up essential oils for a few service users. These had the names of the service users on the bottles. Guidelines on how to use them correctly were only available for some of the service users, others were not available to inspect. A requirements were made for the above. The Pharmacy Inspector had visited the home the month before this inspection. Most of their requirements were met at this inspection. Staff receive training on administering medication and shadow staff before they administer medication alone. One staff member stated there were fewer errors now the home works as two separate units with two separate staff members responsible for the medication on each shift. The medication policy had been updated. 19-21 Haymill Close G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 The home has a complaints procedure in place for service users or family members. Systems were in place for the protection of vulnerable adults. There was a shortfall in training in this area for staff. EVIDENCE: The home has a clear complaints procedure. The last complaint was recorded in October 2004. This was recorded and the outcome was noted. The CSCI has not directly received any complaints since the last inspection. The home has a procedure for the protection of vulnerable adults (POVA). New staff receive training on POVA issues but existing staff stated they had not been on any training regarding this subject. A requirement was made that this must be addressed. Staff asked said they would report any POVA concerns to the Registered Manager. 19-21 Haymill Close G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26, 28 & 30 The environment provides a pleasant home for service users to live in. It was bright with appropriate furniture and fittings to offer a homely atmosphere. Bedrooms are adequate in size and offer the opportunity for some personal items of furniture and personal belongings to be in individual’s bedrooms. This offers service users time and space in private with their own possessions. The rooms viewed were clean and procedures were in place to minimise the spread of infection. This aims to safeguard service users health and safety. EVIDENCE: A tour of the home was carried out and a sample of rooms viewed. These were being satisfactorily maintained. Furnishings and furniture were to a satisfactory standard. One service user showed their bedroom and stated they had been able to make it personal. Photos and pictures were evident in the bedrooms and the rooms viewed were light and spacious. 19-21 Haymill Close G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc Version 1.40 Page 17 There is a communal lounge and separate dining room and kitchen. Service users are able to access any of these areas. There is also a large communal garden to the rear of the home, which has a patio and lawn area. The laundry facilities are in a separate room. The washing machine has a sluicing programme for any soiled items. The home was clean and bright and free from offensive odours on the day of the inspection. 19-21 Haymill Close G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 & 36 There has been an improvement in staffing. There is a full staff team with permanent staff employed in the home. Agency/relief staff are only used if a permanent member of staff is on holiday or sick. This has brought some continuity of care for the service users and promoted good teamwork. Staff employment files were not inspected as the Registered Manager was not present during this inspection. These files are locked in a secure place. Training is available for staff to ensure the team is competent and can effectively meet the needs of the service users. Staff are supported and meet with their supervisor on a regular basis. EVIDENCE: Staff are encouraged to study the NVQ courses. As the Registered Manager was not present during this inspection it was not clear if the home has at least fifty percent of the staff team undertaking or had completed an NVQ course. One staff member stated they would have preferred to study NVQ level 3 but was informed as they were support workers they would have to start at level 2. They are not clear if they would then be encouraged to study level 3. One senior member of staff is waiting to begin training to become an NVQ assessor. 19-21 Haymill Close G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc Version 1.40 Page 19 One staff member said they would like to undertake specialist training in areas such as Autism, but they were not sure if there would be opportunities to study different areas of disabilities. The home previously had staff vacancies and permanent staff had to work on a regular basis with agency staff. The home now has no vacancies and aims to use regular relief or agency staff only when necessary. There is recognition that it can prove stressful for service users if new agency staff work in their home, therefore this is avoided. One staff member spoken with stated it could be difficult trying to find staff cover for shifts if they are only given short notice. Regular staff meetings occur weekly and monthly. Staff receive training in communicating effectively with service users. This might be using objects of reference or using Makaton signs or symbols. The Registered Manager was not present at the inspection therefore staff employment files could not be viewed on this occasion. This is an outstanding requirement. Staff receive mandatory training and refresher courses on relevant areas such as moving and handling, fire safety and first aid. The home does not allow new members of staff to work in the home unsupervised until they have attended the induction. Three staff members are currently completing the Learning Disability Award. All staff spoken with stated they receive regular supervision and that this was a useful way of seeking advice and guidance. 19-21 Haymill Close G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 & 42 Staff stated the Registered Manager works in an open and approachable manner that supports the staff team working in the home. The shortfalls in the servicing records and checking the temperature of the water must be addressed to ensure the health and safety of service users is monitored and any risk identified is acted on to minimise incidents occurring. EVIDENCE: Staff spoken with stated the Registered Manager was approachable and has a visible presence in the home. Servicing records were viewed at random. Fire equipment and call points had been inspected and were tested on a regular basis. Fire drills had been held twice in 2005. The Portable Appliance Testing was up to date. However checking the water temperature for all areas where service users have access was overdue and had not been carried out for several weeks. The Gas Safety Certificate and the testing for Legionella was out of date. 19-21 Haymill Close G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 2 Standard No 31 32 33 34 35 36 Score x 3 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 19-21 Haymill Close Score 3 3 1 x Standard No 37 38 39 40 41 42 43 Score x 3 x x x 2 x G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc Version 1.40 Page 22 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard 17 17 20 Regulation Requirement Timescale for action 31/8/05 30/9/05 31/8/05 4. 5. 6. 7. 20 20 20 23 8. 34 9. 42 13 (4) (c ) All prepared or opened food & 16 (2) must have a date of opening on (i) them. 13 (4) (c ) Action must be taken if fridge & 16 (2) temperatures are recording (f) above 8 degrees. 13 (2) Medicines must be recorded accurately when administered. (Previous timescale 13/7/05 not met) 13 (2) Liquid medicines must have dates of opening clearly on them. 13 (2) Medicines must be checked to ensure out of date medicines are not used. 13 (4) (b) Guidelines must be available when using aromatherapy essential oils. 13 (6) The Registered Person must ensure that all staff receive training, or through other measures, on the protection of vulnerable adults. 17 (2) & The records required in Schedule 19 2 & 4 of The Care Homes Regulations must be available for inspection. (Previous timescale 1/1/05 not met) 13 (4) (a) Water temperatures in all areas G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc 31/8/05 31/8/05 30/9/05 30/11/05 3/10/05 31/8/05 Page 23 19-21 Haymill Close Version 1.40 10. 11. 12. 42 42 13 (4) (a) 13 (4) (a) of the home must be taken and recorded on a regular basis. Gas Safety Certificate must be up to date. The testing for Legionella must be up to date. 31/10/05 31/10/05 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. 19 Refer to Standard Good Practice Recommendations There should be a clear record of the status/position of the health professional service users see at each health appointment. 19-21 Haymill Close G61-G10 s27739 19-21 Haymill Close v214855 310805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Ground Floor 58 Uxbridge Road Ealing, London W5 2ST National Enquiry Line: 0845 015 0120 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. 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