Inspection on 02/06/05 for Waterloo House

This inspection was carried out on 2nd June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Waterloo House 18/08/08

Waterloo House 25/02/08

Waterloo House 14/09/06

Waterloo House 14/06/06

Waterloo House 10/08/05

Waterloo House 11/08/04

Waterloo House 04/05/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Waterloo House Waterloo Road Bidford On Avon Warwickshire B50 4JH Lead Inspector Deirdre Nash Unannounced 2 June 2005 13:15 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 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. Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Waterloo House Address Waterloo Road Bidford on Avon Warwickshire 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) 01789 773359 Alpha Health Care Group Mrs P Vernon PC 35 Category(ies) of OP 20 registration, with number DE(E) 14 of places PD 1 Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23 March 2005 Brief Description of the Service: Waterloo house is registered to provide personal care for 35 older people. The registration is for 20 older people, 14 with dementia and one person with a physical disability. The main house is a large Victorian house, which has been converted to house 21 service users. All bedrooms have en suite facilities. The first floor is accessible via a chair lift only. Avon lodge is a purpose built building behind the main house and accommodates 14 people with dementia. There is a passenger lift to the first floor as well as stairs. The home is within walking distance of Bidford Upon Avon where there are shops, churches and a bus service to Stratford Upon Avon. Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspector arrived without notice. The registered manager was on duty and the Inspector was able to tour the buildings and have access to all records and files. The Inspector talked with two members of staff during the tour of the house and interviewed one other in private. Four residents had a conversation with the Inspector either in private or in the communal rooms. The Inspector talked to another three residents with a high degree of mental impairment. There were two vacancies at the home at this time, one in each house. What the service does well: What has improved since the last inspection? We made an extra visit the home because of concerns about proposed changes in staffing levels during the evening and at night. The visit was on 23rd March 2005 at 7.30pm. The home was told to make some improvements as a result of this visit. Since then night staff have not been expected to do any domestic chores but to concentrate only on what residents need in the night. Staff working afternoons and early evenings are now able to tell those coming on the night Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 6 shift what has happened in each residents day by the introduction of a formal period of ‘handing over’. We are still going to monitor the evening and night staffing arrangements to make sure that residents are getting what they need. The method that the home uses to find out information about prospective residents needs has improved. Written Care plans for individual residents continue to improve in quality. 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. Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 7 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 Standards Statutory Requirements Identified During the Inspection Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3 and 4 The home has improved its pre admission assessments and its written care plans. People are allowed to move in only if the home knows that it can properly look after them. EVIDENCE: The home has an updated statement of purpose that describes the service provided and it has a service user guide. Each resident is given a copy of this and prospective residents can use both of these documents to decide whether the home could be suitable for what they need. The Inspector looked at the care files of two residents, one who had only recently moved into the home. There was a pre admission assessment form filled out by the manager to find out what care this person needed. This is important because it means that the home does not allow someone to move in if it cannot properly look after him or her. The care file for this person also had a written plan for her daily/nightly care to instruct staff. It included a section on cultural needs. There is also a ‘getting to know you’ questionnaire that the manager says was with this person’s family at the time so they could help to fill it out. When the Inspector spoke to this resident she said that the home was providing what she needed but that she had not been there long. Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 9 The other resident had been at the home for two years. This resident had a lot of health problems. Although there was no pre admission assessment of what she needed made at the time, after she moved in there were written monthly up dates made of how she needed to be looked after on ‘care plan’ sheets. The difference between the quality of written care files of these two residents shows how the home has improved its systems over the past 18 months. The manager told the Inspector that four residents with dementia had moved from the main house to the ‘Lodge’ recently. The Lodge is specifically registered to care for people with dementia and the main house is not. People change and the manager is aware that others may need to move over in the near future. There is only one vacancy there at the moment so this may cause difficulties. The manager said that the owners of the home have been made aware of the increasing difficulty of filling vacant places at the main house because people are being supported in the community to stay in there own homes for as long as possible these days. The manager is aware that any plan to change the main house into a dementia care home also would need to be discussed at an early stage with the Commission for Social Care Inspection. Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 10 The detail in written care plans for individuals has improved. but are still not adequate with regards to social and psychological needs. Staff know how each resident is to be looked after and residents physical needs are well taken care of. EVIDENCE: The Inspector saw the service user plans –‘care plans’ for two residents. This document has been recently re designed by the manager and has improved in the detail that it contains. Staff need detailed and specific information about how to look after a person. The plans still need to say more however about a person’s psychological and social need. The home was told to do this at the inspections in 2004. It must now be done. The service user plan did not have a section for health needs; this information was kept on another document in the file. It would be helpful for staff if all of this information were put on the ‘care plan’. This is recommended. The Inspector could see that service user care plans are reviewed regularly to catch any changes in peoples care needs. The Inspector saw that staff treated residents with kindness and courtesy. The residents that the Inspector spoke to said that staff knock on their bedroom Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 11 doors before they go in and know how to look after them. Relatives were seen visiting residents during the time that the Inspector was at the home. Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 Residents have a comfortable but limited life style. Leisure activities do not take place when the activities co coordinator is not available. During weekends and holiday periods residents who need encouragement and assistance spend days without social and recreational stimulation. EVIDENCE: Residents spoken to said that they could get up and go to bed when they choose to. The inspector saw a resident who can do so without assistance, going out into the safe garden during the visit. The home has a part time activities co coordinator but she was on holiday during the week of this visit and the special leisure room was not being used. Resident’s social and leisure interests were seen written down in the care plans that the Inspector looked at. There was also a record kept of the activities that residents undertake and when. The last entry for one resident was two weeks previously. One resident who needs to stay in her room said that she did not have enough to do. There was a notice on display announcing a ‘reminiscence session’ on 25th May. The television was on in the lounge at the ‘Lodge’ but no residents seemed interested in it. The Inspector did not see any organised one to one or group leisure or social activities taking place during the time that she was at the home. Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 13 The home has a policy of welcoming visitors at any reasonable time and residents spoken to said that their relatives and friends are made welcome and that they could see them in privacy if they wish to. Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 14 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 The home has and uses proper systems for dealing with complaints and with any allegations or suspicions of abuse of residents. Residents are protected by open and accountable procedures. EVIDENCE: The Inspector saw a written complaints procedure that contains the address and telephone number of the Commission for Social Care Inspection. Two residents that the Inspector spoke to said that they felt able to complain to the manager if they were not happy about something. The manager described an incident that had happened recently and the action that she took. This showed the Inspector that the manager is familiar with the correct procedure for dealing with allegations or suspicions of abuse of residents. Records show that eight staff at the home undertook some training in [prevention of] ‘Elder Abuse’ run by the company in August 2004. Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 22,24,25 and 26 The home consists of two separate ‘units’ and the buildings went up in three phases over time. Residents experience a different quality of environment depending on the part of the home that they live in. Getting around the oldest parts of the home is risky for some. EVIDENCE: Some decoration has been undertaken since the last inspection. All except one of the areas identified at last years inspections as needing improvement have been done. The toilet by the kitchen in the main house remains in need of decoration. The manager says that this is on the maintenance plan. One resident spoken to told the Inspector that she is pleased with her bedroom especially as it opens onto the enclosed garden. She went on to say that she feels lucky as some other bedrooms in the house are not so good. There are some shared rooms in the original main house where rooms have high ceilings and vary considerably in size and shape. This part of the home has stairs, steps, landings and half landings and would be difficult for many residents to get around. The extension wing to the main house is easier to negotiate but the Inspector heard a number of residents asking staff which direction along Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 16 this corridor the lounge and dining room were. The layout of the main house is potentially confusing. Previous reports of the home have said that a number of residents in the main house have dementia. Although four people have moved into the ‘Lodge’, the Inspector did notice from talking to people that some had a degree of mental impairment. Residents bedrooms contained sufficient furniture and had personal effects. Residents do not use rooms on the attic floor. The Inspector noticed the following on a tour of the home: There was an odour in the ‘Lodge’, particularly in two bedrooms. This suggests that spillages are not being cleaned up properly. This is not good enough hygiene practice for a modern care home and it must be improved. Carpet in room three in the Lodge was buckling. This could make someone trip over, particularly a resident who is not steady on their feet. It must be put right or replaced. The carpet in room 11 of the Lodge is very badly faded and looks poor. It must be replaced. Floorboards on the ground floor corridor of the main house outside rooms 6 and 7 are very uneven and could cause a fall. They must be put right. A toilet seat in the Lodge, pointed out to the manager at the time, is wobbly and could cause a fall. It must be put right or replaced. The home has an attractive and safe garden where residents, including those with dementia who need to keep on the move can enjoy the outdoors. A beech tree in the garden is taking some natural light from the room at the end of the ground floor corridor in the main house. This must be pruned back. The home now has an additional standing hoist to help to move people safely. The manager said that some staff have been trained in how to use it properly and the Inspector saw that some more training was listed in the office diary for 7th June. Extra sensors have been put on the passenger lift door, as the home was told it must at the last inspection. All of the en suite bathroom doors have now been replaced as required. The home was told last year to make sure that residents were protected from very hot radiators. The bedrooms in the main house have had the radiators covered but the public areas there and also in the sun lounge in the Lodge had not been done. The home must deal with this quickly now. The Inspector saw that water dissolvable laundry bags were being used to collect and carry foul linen as they should be. Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 Residents are safely looked after by competent staff. EVIDENCE: Concerns about a proposed reduction in levels of staffing during the evenings led the Commission for Social Care Inspection to make an announced visit to the home on 23rd March this year at 7.30 pm. The night shift had been lengthened to twelve hours with one waking staff working in each of the houses and one other moving between the two. This could have resulted in early evening staff feeling under pressure to get residents ready for bed before while there was more staff on duty to do it and before the night shift came on. Although the Inspectors found the home calm and residents being looked after, staff were being expected to carry out domestic tasks during the night. This could result in night staff feeling under pressure to get the housework done by morning regardless of how much of their time residents might need in the night. The Inspectors did not find that residents were being ‘rushed’ into bed but did find that the ‘handover’ of information from the day staff was poor. This meant that events in the day such as visitors or birthdays were going unremarked upon by night staff when they were working with residents and therefore a ‘person centred’ approach to residents care difficult to achieve. The home was required to improve this situation within one month. During this June 2005 inspection the manager said that staff were no longer expected to do domestic tasks at night except load the washing machine. The Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 18 staff that the Inspector spoke to confirmed this. The manager also said that the night time staffing arrangements were working and that most staff were satisfied that they could give residents the care and attention that they need. The manager also said that a short ’handover time’ between the two shifts of staff was taking place so that information about individual residents days could be passed on. One member of staff spoken to confirmed this. Duty rosters for the week of the inspection show that three members of staff were on the night shifts, one allocated to each house and the third to move between as needed. Residents spoken to in Waterloo House told the Inspector that they are not put under pressure to retire to their rooms or to bed earlier than they wish to. It is more difficult to get the opinion of people in the ‘Lodge’ because of their level of mental impairment. The Inspector will continue to monitor the evening and night staffing arrangement. There was a vacancy for a laundry assistant in the home. The Inspector looked at the personnel files for three members of staff recruited to the home this year. All contained the documents and evidence that the home is required to obtain about employees to make sure that they are suitable to work with vulnerable people. This is good progress from the last inspection. The training programme shows that the company is making training available at the home on first aid in June and on equality, diversity and rights in July. Records also show that individual staff at the home have undertaken and updated ‘statutory’ training over the last twelve months as well as some staff undertaking training on elder abuse, bereavement, care planning and caring for people with dementia. The Inspector saw an induction training programme for the latest recruit to the staff team that covered the issues set out in the National Minimum Standards. The worker confirmed that she had undertaken the programme. Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 and 38 The home is well managed by the person in charge and residents benefit from staff having good professional leadership and continuity of care. The provider company is slow to put in place some safety measures and this could place some residents at risk of harm. EVIDENCE: The manager of the home is registered with the Commission for Social Care Inspection. She is undertaking her professional qualification. The manager has made sure that that most of the improvements that the home was told to make after inspections last year have been made. The home would benefit if the manager had some administration support and could delegate some routine administration tasks. Staff spoken to say that the manager is a good leader who makes clear what is expected. They feel able to approach her with any concerns about residents or the way that things are being run. Asked if there is any thing happening at the Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 20 home that they think is not right or good for the residents, all staff spoken to said ‘no’. Records show that eight staff went through basic first aid training in August 2004. This means that a qualified first- aider can be present on every shift. Many staff have updated their training on manual handling, food hygiene, fire safety and safe administration of medication. Training on infection control for some staff took place at the end of last year and further is planned for July this year.. Staff that have not undertaken any infection control training in the last two years must do so. The Inspector saw a certificate for servicing of boilers and central heating systems dated in September 2004. There was no evidence to show that the electrical wiring systems in each house have been inspected in the last five years. The home was told to do this at the last inspection. This must be done quickly now. Hot water temperature in bathrooms is regularly tested but there were three particularly high scores and no evidence that any thing had been done to put this right. The manager must make sure that the handyman reports these problems to her so that she knows they have been put right and residents are not at risk from accidental scalding. At the inspection in August 2004 the home was told to make sure that the radiator and water pipe surfaces in both houses were covered so that they could not burn a resident. The manager said that some had still not been done. The home was told to do this without any further delay. The home was also told to make sure that high windows were safe for residents. First floor casement windows in the ‘Lodge’ open wide enough for a slight person to fall or jump through. Residents at the Lodge have mental impairment and could be at risk through accident, confusion or depression. The home must weigh up the risk for each resident that has access to each of these windows and decide whether/which windows need to have resrictors put on them to make them safe. This must be done quickly now. The uneven corridor floorboards and the rucked carpet in one bedroom have already been mentioned above. They must be put right quickly. The manager needs to make sure that staff report these potential danger spots around the home as soon as they develop. Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 x COMPLAINTS AND PROTECTION 2 x x 3 x 3 2 2 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x x x x 2 Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 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. Standard OP7 Regulation 15 Requirement The registered person must ensure that care plans (service user plans) provide sufficient detail about residents care needs including psychological and social care needs. These should be signed and dated by staff. (unmet 31/10/04) The registered person must ensure that residents, particularly those with sensory impairement or dementia have some structured and planned opportunities for stimulation each day. The registered person must ensure that risk assessments are completed fully in conjunction with the ACoP guidelines and actions taken as appropriate for risks identified. (unmet 30/09/05) The registered person must ensure room 11 of the Lodge has floor covering of a better quality. The registered person must ensure that the toilet seat pointed out to the manager during the inspection is fitted safely or replaced. E53 S4260 Waterloo House V230564 020605 stage 4.doc Timescale for action 1st August 2005 2. OP12 12 1st August 2005 3. OP25 13 1st September 2005 4. OP25 23 1st September 2005 25th July 2005 5. OP25 13 Waterloo House Version 1.30 Page 23 6. OP25 23 7. 8. OP26 OP38 13 13 9. OP38 23 10. OP38 13 11. OP38 13 12. OP38 13 13. OP38 13 14. OP38 13 The registered person must ensure that the beech tree is pruned back to allow more natural light into the end ground floor bedroom of the main house The registered person must ensure that the offensive odour in the home is erradicated. The registered person must ensure that care staff that have not undertaken training in infection control in the last two years do so. The registered person must ensure that an up to date five year periodic inspection of the electrical installation certificate is available (unmet 30/09/04) The registered person must ensure that hot water outlets in residents rooms and bathrooms that are recording a temperature of higher than 43 degrees are reported to the manager for action. The registered person must ensure that all radiators and hot water pipes are covered to protect residents from burn unless written risk assessment shows it to be unecessary (unmet 30/09/04) The registered person must ensure that all windows above ground floor level have resticted opening unless a written risk assessments shows it to be unecessary.(part met 30/09/04) The registerd person must ensure that the floor boards on the ground floor corridor in Waterloo House are made safe The registered person must ensure that the carpet in room 7 of the Lodge is made safe. 25th July 2005 1st August 2005 1st January 2006 1st August 2005 15th July 2005 2nd July 2005 15th July 2005 1st August 2005 15th July 2005 Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard OP9 OP8 OP31 OP24 OP27 Good Practice Recommendations Health needs should be recorded on the service user plan document. That the manager carries out regular auditing of accidents in the home in order to identify changes that need to be put into place to avoid them. That the manager is provided with some administation support It shouild be documented where residents do not wish to hold a key to their rooms or risk assessments show it is not safe for them to. Consideration should be given to the need for domestic staff at weekends. Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Imperial Court Holly Walk Leamington Spa Warwickshire CV32 4YB 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. Extracts may not be used or reproduced without the express permission of CSCI Waterloo House E53 S4260 Waterloo House V230564 020605 stage 4.doc Version 1.30 Page 26 - 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!