Inspection on 12/12/05 for 39 Harvard Road

This inspection was carried out on 12th December 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

39 Harvard Road 04/07/06

39 Harvard Road 28/07/05

39 Harvard Road 11/01/05

39 Harvard Road 13/09/04

Similar services:

Ridgemount

Wingham Court

Old Hastings House

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

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

CARE HOMES FOR OLDER PEOPLE 39 Harvard Road Ringmer Nr Lewes East Sussex BN8 5HH Lead Inspector Judy Gossedge Unannounced Inspection 12th December 2005 10:00 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 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 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. 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 39 Harvard Road Address Ringmer Nr Lewes East Sussex BN8 5HH 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) 01273 812125 01273 814468 East Sussex County Council Vacant Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The maximum number of service users to be accommodated is thirtysix (36) One (1) service user to be accomodated in the self-contained flat in the home. Service users must be older people aged sixty-five (65) years or over on admission. Four places are available to service users between the age of fifty-five (55) and sixty-four (64) 28th July 2005 Date of last inspection Brief Description of the Service: 39 Harvard Road is run by East Sussex County Council (ESCC) and is a purpose built property on two floors, set in its own grounds in Ringmer, with the village centre nearby. Service user accommodation comprises of thirty-six single bedrooms, one of which can be used as a double bedroom and there is a self contained flat. Divided in to three units within the home each with dining and lounge facilities, on two floors with level access facilitated in the home with the provision of a passenger lift. There is a conservatory and garden for service users to access. Two units are for service users receiving respite care or short term care for periods of up to six months. One unit is for service users on the Living at Home Programme, a rehabilitation scheme run by ESCC to work with service users to return home within an agreed timescale of up to six weeks. 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken by the Lead Inspector for the home and a CSCI Pharmacist Inspector and took place over seven and a quarter hours on 12 December 2005. This is the second statutory inspection for the year and should be read in conjunction with the first inspection carried out on 28 July 2005 to give an overview of all the standards to be assessed within this period. A tour of the home took place including communal areas and a selection of service users bedrooms. Rotas and care records were also inspected. Twentyseven service users were resident and six service users were spoken with individually, three in the lounges and three in their bedrooms. Service users were also spoken with generally in the communal areas. Comment cards were left in the home following the last inspection and two were returned from service users during the interim period. Four of these service users were case tracked as part of the inspection process. One relative also commented on the care provided. The Acting Manager, two duty officers, the cook, a member of the housekeeping team, an occupational therapist and a number care workers working on the morning and afternoon shift were spoken with. The CSCI has previously sent separate correspondence to the Responsible Individual for ESCC to raise concerns at the recruitment processes and lack of evidence of recruitment documentation in place on site for all its registered services. ESCC has stated that all the required documentation will be in place by 1 January 2006. ESCC Older Peoples Services has gone through a re-structuring exercise and a new Manager started to work at 39 Harvard Road in September 2005, moving from another ESCC registered service. The CSCI are awaiting an application for a Registered Manager for the home. The Acting Manager stated she is in the process of reviewing systems and procedures in the home and it was not possible to evidence on the day all the required information. What the service does well: A detailed Service Users Guide is available to be viewed in the service users bedrooms. The care service users receive was seen to be delivered in a way to ensure their dignity and respect. Relative and service user feedback was that they were pleased with the overall care provided in the home. 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 Page 6 There is good support from healthcare professionals on the Living at Home Scheme. The meals in the home offer both choice and variety and special dietary needs can be catered for. The home continues to hold the Clean Catering Award by Lewes District Council. What has improved since the last inspection? What they could do better: Care plans and supporting risk assessments continue to be inadequate and do not detail all the areas of care to be provided. Recruitment procedures and staff information needs to be held at 39 Harvard Road to evidence that this is in place to meet requirements to ensure the safety and welfare of service users. Some issues relating to health and safety were identified, and an update of health and safety training provided has been requested to ensure the health safety and welfare of service users. There are some opportunities for service users to join in leisure activities but these should continue to be developed to ensure that service users social care needs are met. Not all hot water outlets accessed by service users have fail-safe devices fitted locally to protect service users. Please contact the provider for advice of actions taken in response to this 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 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 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 6. Although detailed information about 39 Harvard Road is available to be viewed prior to any admission to the home, because of the type of service provided service users have limited choice of placement. Service users are protected by the completion of a written contract/terms and conditions. There are pre-admission procedures in place, which need to be followed to ensure that service users are always appropriately placed at 39 Harvard Road. EVIDENCE: A Statement of Purpose is in place. A copy of the Service Users Guide is kept with other supporting information for reference in each service users bedroom. Both documents have been updated. There are forums for service users and their representatives to give their views on the service received. A copy of the last inspection report is available to view in the home, but it should be ensured that service users are aware of where this is kept in the home. ESCC has a written contract to be used between the home and the service user, and five signed contracts were viewed. The bedroom to be occupied was 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 Page 10 not recorded on any of the contracts and should be. Where a service user has moved bedrooms there should be a record of the agreement made. All service users are assessed by staff from one of ESCC’s Social Services Department’s Assessment Teams and have an assessment completed. A copy of this or of the latest review of this assessment is then sent to the home. The sample documentation viewed confirmed this information is available to reference. One service user resident at the time on the unit providing a rehabilitation service did not meet the registration category for the unit, did not have a care plan in place and was awaiting a more appropriate placement to be found. The Inspector received a number of concerns from other service users resident on the unit relating to this service users care needs. Additional staffing had been put in place to help meet the additional care needs of this service user. This was discussed with the Acting Manager who was able to confirm during the inspection that a new placement had been found for that day. One unit in the home accommodates service users on the Living at Home Programme, a rehabilitation scheme run by ESCC. Occupational therapy and physiotherapy staff were spoken with or observed working on the unit during the inspection with service users to return home. Service users spoke of activities they had participated in and a range of equipment had been provided to assist their mobility. 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 9. Staff are not provided with the detailed information they need to ensure that service users’ health, personal and social care needs are met, therefore putting service users at risk. The home has good systems in place in relation to medication, however additional practice points need to be addressed to ensure complete, meaningful records are available. Medicines training has been addressed. EVIDENCE: A sample of five individual care plans were viewed which varied in detail, and did not always fully describe service users’ care needs or have supporting risk assessments in place. Where service users had been resident for short or long-term care their individual plans did not appear to have been reviewed to ensure that their care needs were still being met. A review of medication handling was undertaken by a CSCI Pharmacist Inspector. Many of the MAR chart viewed recorded the administration of medication with a ‘tick’. This record is not meaningful and the person recording the ‘tick’ must take responsibility. The Inspector was informed the 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 Page 12 ‘tick’ is recorded because the staff cannot guarantee that the medicine in the dosage system is what the label says. This does not meet with current accepted practice across the country. Many service users self medicate and the risk assessment relating to self-medication is not adequate. It is not dated, named or detail individual service users needs. In fact it is a tool to aid the assessment process. There is a problem currently regarding the disposal of medicines, which should be relatively easy to sort out. Concerns were noted in relation to the administration of controlled drugs. In one instance a supply of Temazepam was not entered in the controlled drugs register. Double signatures were not seen to record the administration of Temazepam. A Buprenorphine patch was prescribed and administered as ‘half to be attached to the skin’. The Inspector understood that the use of patches is such that they cannot be tampered with and this must be queried with the doctor. Additional recording omissions also noted were, where one or two is prescribed the actual amount administered is not recorded, when annotations are added to the MAR chart this is not initialled and the dose of two medicines was omitted on a hand written MED 1 form to detail all the medication prescribed. 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 12, 14 and 15. There are some opportunities for service users to participate in activities during their stay, but these need to continue to be developed to enable service users social care needs to be fulfilled. The meals in the home offer both choice and variety and special dietary needs can be catered for. EVIDENCE: There are some opportunities for service users to participate in activities in the home and the recording to evidence this has improved. On the day some service users were in the downstairs lounge singing carols. The care and support provided was seen to enable service users were possible to exercise choice whilst at 39 Harvard Road. 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 Page 14 The food provided in the home is freshly cooked and a seasonally varied rotating menu was seen. A rotating menu is in place, and service users are also asked for suggestions as to what they would like to be added to the menu. There are choices at all meals, and staff ask service users on the day to select their choice for each meal. Service users commented on the flexibility of choice if the main meal is not chosen. Special diets are catered for. In addition there is a kitchen within two of the units where either breakfast, or drinks and snacks can be prepared. The lunch on the day was beef chasseur or vegetable burger with potatoes, peas and swede. The Manager and cook both stated that suppers have been improved with snacks available including fresh fruit. Feedback from the service users spoken with was that the food was excellent. Records are kept relating to alternatives provided to individual service users. It was recommended that there is more detailed recording of the selection made by service users at tea-time. The home continues to hold the Clean Catering Award by Lewes District Council. 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 16 and 18. There is a clear and effective complaints procedure in place, which enables service users and their representatives to raise any concerns that they might have. There are detailed policies and procedures in place to protect service users from abuse. EVIDENCE: ESCC has a detailed compliments and complaints policy and procedure in place. Any complaints received are monitored through the line management arrangements in place within the organisation. No complaints have been recorded since the last inspection. The CSCI received one complaint during the last year in relation to 39 Harvard Road. This was satisfactorily investigated by ESCC. Service users confirmed they would feel comfortable raising any concerns with the staff or the Manager. Where one service user stated they had just raised an issue with senior staff in the home about the care provided the Acting Manager confirmed this was in the process of being investigated. There are detailed policies and procedures in place in relation to vulnerable adults. The Acting Manager confirmed an audit of the training in adult protection procedures was in process to ensure that where required staff have received up-to-date guidance. 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 Page 16 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 the following standard(s): 19, 25 and 26. The standard of the environment has started to improve in certain areas in the home, but the quality of the décor, carpeting and furnishings in the bedrooms and communal areas continues to be variable. EVIDENCE: The standard of décor, carpeting and furnishings continues to be variable. The Acting Manager has put a new maintenance programme in place in the home and a number of bedrooms have been repainted since the last inspection. The décor in the hallways and the dining room on Ballard unit was damaged and that the carpet badly stained was reported following the last inspection. Since then the dining room has been redecorated and work was in progress during the inspection to decorate one of the hallways. The Acting Manager also stated that the carpet is to be cleaned in sections. The quality of the furnishings in the bedrooms and communal areas in the home is varied. Five hot water in seven hot water outlets accessed by service users were tested, two were slightly low recording 37.3 and 37.9 with the remainder close 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 Page 17 to the recommended safe temperature of 43° C. This was reported to the Acting Manager who confirmed that fail-safe devices were still being fitted during the inspection which may have an effect on the water temperature in the building. Confirmation has been provided that the Water Supply Regulations 1999 are being met. There were two members of staff undertaking domestic duties in the home. One member of staff was spoken with and spoke of the improved procedures in place in relation to the laundry facility. The home appeared clean and was free from offensive odours. A bottle of cleaning fluid was left in one bathroom which was reported to the Acting Manager and removed on the day. The recording of routine fire checks were seen and were adequate. But again there was some wedging of doors open in the home, and an Immediate Requirement Form was left to resolve this issue. One stairwell was also being used for storage. This was reported to the Acting Manager who resolved this issue on the day. 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30. Staffing levels were adequate to ensure that all the care needs, the health safety and welfare of the service users resident were met. ESCC recruitment policies and procedures need to be followed in order to protect service users. EVIDENCE: A staffing rota was viewed. Staffing on the day was adequate to meet the needs of the service users. But there were only twenty-seven service users resident and staffing levels should be kept under review as the occupancy increases. There is still a reliance on agency and relief staff in the home and the Acting Manager stated that more relief staff were being recruited to be available to work in the home. There has been an increase in bursary and administrative support in the home. It was not possible to evidence the percentage of care staff who hold an NVQ level 2 in care. An update has been requested of the number of staff who hold this qualification and of work being completed to meet training requirements. All recruitment is co-ordinated by the personnel section at ESCC’s head office, which the Inspector has visited and viewed sample documentation across the organisation’s registered services to support the recruitment process in place. Some gaps in the required documentation were found which need to be addressed. The Manager was not able to confirm that all staff now have a satisfactory Criminal Records Bureau (CRB) check in place. In future 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 Page 19 recruitment documentation will need to be available at the home as part of any inspection completed. As no new staff have been recruited since the last inspection it was not possible to evidence if induction training has been provided. But ESCC have detailed induction and foundation training in place which new staff are expected to complete. 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35 and 38. The ESCC quality assurance plan needs to be fully implemented in the home, to ensure that service users and their carers/representatives, and other stakeholders are enabled to give their views on the home and the care provided. Satisfactory systems need to be put in place to ensure staff have received the required training to maintain the health, safety and welfare and safety of service users and staff. EVIDENCE: Following a recent restructuring within the organisation a new Manager from another ESCC residential home has recently commenced working at 39 Harvard Road. The Manager has worked for East Sussex County Council for many years as a senior manager. 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 Page 21 ESCC has put a quality assurance plan in place, but this has not been fully implemented in the home. There are some opportunities for service users and carers to put forward their views about the home and the care that they receive through service users meetings, and questionnaires which informs ESCC and staff in the home of the quality of the service being provided. This feedback has not yet been collated and available to view. Where a small ‘float’ of money is held for some service users the financial records to support this activity were adequate. The Acting Manager is in the process of collating individual staff training needs and it was not possible to evidence if staff had received moving and handling, first aid, fire training including fire drills, and basic food hygiene training as required. It was not evidenced if there are adequate numbers of staff in the home trained as a first aider. The relative spoken with raised some concerns of the security in place at the entrance to the home, which was shared with the Acting Manager during the inspection. The organisation has now implemented a system to evidence that the maintenance of equipment and services has been carried out. 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 Page 22 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 3 2 2 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 1 8 x 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X 2 3 STAFFING Standard No Score 27 3 28 X 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 X X 1 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 (1) Requirement That individual service plans in place are subject to further development, to ensure that all areas of care to be provided is detailed, and there are clear instructions for staff to follow in relation to individual service users assessed health and personal care needs, reflect leisure interests and likes and dislikes. These are subject to regular review. That risk assessments are in place where indicated and reflect service users individual care needs. These issues are outstanding since 31.08.05. That there is always a signature to record where medicine has been administered unless selfmedicating. That detailed individual risk assessments are in place for any self-administration of medication whatever the level of administration. That arrangements are in place for the disposal of medicines. DS0000041389.V257846.R01.S.doc Timescale for action 31/01/06 2 OP9 13(2) 31/01/06 3 OP9 13(2) 31/01/06 4 OP9 13(2) 31/01/06 39 Harvard Road Version 5.0 Page 24 5 OP9 13(2) 6. OP12 16 (2) (m) 7. OP19 23 (4a) 8. OP25 14 (4a) 9 OP28 18 (a) 10 OP29 19 (1) (b) (i) 11 OP33 24 (1) (2) (3) 12 13. OP38 OP38 13 (4)(a) 18 (c ) (i) That controlled drugs are entered in the CD register. The administration of controlled drugs is witnessed That leisure and social activities are subject to review and further development. This is an outstanding issue since 30.04.05. That advice is sought on the current practice of wedging doors open and acted upon. This issue is outstanding since 28.08.05. That hot water outlets which are accessible to service users have fail-safe devices fitted locally to provide water close to 43 C. This issue is outstanding since 31.10.03. Written confirmation will be provided to the CSCI that this work has now be completed. That an update is provided of the number of care staff who hold NVQ Level 2 or equivalent and the work in place to enable staff to meet this requirement. That evidence is provided to demonstrate recruitment procedures and to confirm that existing staff have completed a satisfactory Criminal Records Bureau check. That the quality assurance annual plan for the home is in place, the results of service user surveys are made available to service users, and feedback sought from other stakeholders. That there is a review of the security of the building. That the CSCI receives confirmation that staff have received the required updates in moving and handling and basic food hygiene. A system is in place to ensure that staff receive DS0000041389.V257846.R01.S.doc 31/12/06 28/02/06 12/12/05 31/01/06 28/02/06 31/01/06 28/02/06 28/02/06 31/01/06 39 Harvard Road Version 5.0 Page 25 the appropriate update within the required timescale. This issue is outstanding since 31.03.05 and 30.09.05. 13 (4) That confirmation is received that there are adequate numbers of qualified first aiders working in the home. 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 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 39 Harvard Road DS0000041389.V257846.R01.S.doc Version 5.0 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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