Inspection on 08/08/05 for Priory (The)

This inspection was carried out on 8th August 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Priory (The) 26/11/08

Priory (The) 20/11/07

Priory (The) 26/10/06

Priory (The) 07/11/05

Priory (The) 02/03/05

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE The Priory 112 Priory Road Noak Hill Romford RM3 9AL Lead Inspector Edi OFarrell Unannounced Inspection 8 August 2005 11:15 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. The Priory G55 S0000027872 The Priory V241969 080805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Priory Address 112 Priory Road, Noak Hill, Romford, Essex RM3 9AL 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) 01708 376535 Aermid Health Care Limited CRH Care Home 30 Category(ies) of OP Old Age 30 registration, with number of places The Priory G55 S0000027872 The Priory V241969 080805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2 March 2005 Brief Description of the Service: The Priory is a 30 place care home for older people, situated in a residential part of Hornchurch. It is on a bus route to Romford, where there is a railway station. The home is owned by a private company, Aermid Health Care Ltd, who run other similar homes. The house was originally a purpose built childrens home, to which an extention, and loft conversion have been added. There are 20 single, and five double rooms, with the majority having either ensuite toilets, or one toilet shared by two rooms. The rooms are of varying sizes and shapes, but all are big enough for service users to have small personal posessions in place. The bedrooms are on all three floors, which are accessed by a lift and stairs. The dining room, lounge, and conservatory are on the ground floor, and the latter leads onto a patio and well tended garden. Personal care is provided on a twenty-four hour basis, and health needs are met by visiting professionals. The Priory G55 S0000027872 The Priory V241969 080805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This, unannounced, inspection took place on a weekday from late morning to mid afternoon. The home was toured, including some of the bedrooms. Some service users were asked for their views on the home, and care records were checked. Some staff were asked about aspects of care and working in the home, and they were observed carrying out their duties. Records, such as staff training, accident and incident reports, and daily logs were also checked. The findings of the inspection were discussed with the acting manager, and the quality assurance manager, who previously managed the home, and is providing additional cover whilst the Registered Manager’s post is vacant. Service users, staff, and management are thanked for their hospitality and input to the inspection. What the service does well: What has improved since the last inspection? Some new furniture has been purchased for the dining room, lounge, conservatory, and some bedrooms, and some areas have been redecorated. This improvement programme is continuing, and service users wishes and preferences have been taken account of. All this means that the environment is continually being improved for the people who live in the home. The Priory G55 S0000027872 The Priory V241969 080805 Stage 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Priory G55 S0000027872 The Priory V241969 080805 Stage 4.doc Version 1.40 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 The Priory G55 S0000027872 The Priory V241969 080805 Stage 4.doc Version 1.40 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, 2, 3, 4 & 5 Prospective service users, and their representatives, have the information they need to make a choice about moving into the home; this includes visits to the home. They know what services they will receive and what they pay for them, as they have a written contract. Service users’ needs are fully assessed prior to them moving in, and they know that these will be met. The home does not provide intermediate care. EVIDENCE: Five care plans were examined, including two for recent admissions, and one for respite care. The Statement of Purpose, and the Service User Guide were examined, along with the contracts/statement of conditions. The preadmission process was discussed with the acting manager, and with two service users. All the documents were up-to-date, and written in plain English, so that they provide very useful information to prospective service users. They, along with other documents, such as the full complaint procedure, are used at different stages of the referral and admission process i.e. initial referral; visit to the home; and as a welcome pack on admission. In addition the documents, including the last inspection report, are on display by the visitors’ signing-in book. The Priory G55 S0000027872 The Priory V241969 080805 Stage 4.doc Version 1.40 Page 9 The acting manager uses a standardised pre-admission format to decide whether the home can meet need. This assessment sometimes takes place where the prospective service user is living at that time, or sometimes when the service user visits the home. Where social services are involved a copy of the community care assessment is obtained. The information gathered from the two assessments is then used to draw up an initial care plan. Where social services are not involved, because the service user will be funding their own place, the initial care plan is based on information provided by the service user, and their relatives. Where specialist health professionals have been involved, for example, where the person is in hospital, information is also gained from those workers. The Priory G55 S0000027872 The Priory V241969 080805 Stage 4.doc Version 1.40 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, 8, 9 &10 Service users’ health, personal, and social care needs are very clearly set out in care plans, which are used as working documents, so that needs are fully met. Service users are protected by the home’s policies, procedures, and practice for dealing with medication. They are enabled to retain responsibility for their own medication where appropriate. Service users feel that they are treated with respect and their right to privacy is upheld. EVIDENCE: Service users were asked for their views, records were checked, and staff were observed, both directly and indirectly, carrying out their duties. The home used a very straightforward assessment and care planning system, which together with an efficient filing system provides a clear and comprehensive plan of care for each service user. The care plans and daily logs are filed together, so that care staff always have immediate access should they need to refresh themselves about how to meet the care needs. The care The Priory G55 S0000027872 The Priory V241969 080805 Stage 4.doc Version 1.40 Page 11 plans follow through from the assessed needs identified at the pre-admission stage. They are reviewed on a monthly basis, and changed where necessary. Examples of this were; changes following hospital stays, falls, and short illnesses. Risk assessments are in place for such things as self-medication, and moving around the home and grounds, and these are also regularly reviewed. Service users’ preferences are well documented. A good example are the night care plans, which include preferences for times of going to bed and getting up, type of bedding, and where the service user likes to take morning tea and breakfast. A score of 4, commendable, has been given for Standard 7, because as well as being comprehensive and up-to-date, the care plans are very clearly working documents. In addition the monthly reviews are meaningful and lead to changes in care plans where needed. The home has avoided over-complicating the system, whilst still ensuring that needs are identified and met. Health needs are identified and met by visiting professionals, such as the GP, district nurses, and the chiropody service. The relationship between the home and these services is very good, resulting in prompt responses when needed, including during the weekend. A specialist commission pharmacist inspection was carried out in February 2005, which was prior to the last inspection. As the findings were not known at that time, they were checked during this visit. Overall that inspection had found no major shortfalls in the policies, procedures, and practice but had made some Requirements and Recommendations, which had been acted on by the acting manager. There are currently two service users who take responsibility for their own medication. Appropriate risk assessments are in place; the service user, the GP, and the acting manager sign the consent form; and there is a six monthly review. Service users spoke highly of staff, and how the home is run with a minimum of rules. Staff were observed to knock on bedroom doors, and to be both knowledgeable and respectful of individual service users’ routines. Examples are preferences of where, and at what pace, to eat each meal; amount of time spent in their own room or communal areas; comfortable private space to meet visitors for one service user who has one of the smaller rooms; mode of address; and types of social activities enjoyed. The written records demonstrate a commitment to upholding privacy and dignity, as they are written in a very person centred way, using positive language where possible. This encourages staff to see each service user’s strengths, as opposed to weaknesses. The Priory G55 S0000027872 The Priory V241969 080805 Stage 4.doc Version 1.40 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, 14 & 15 Service users are encouraged and supported in leading a life that matches their expectations and preferences. Contact with families, friends, and the local community is actively encouraged. Service users are encouraged and supported, within a risk management framework, to exercise choice and control over their lives. Service users receive a wholesome, appealing and balanced diet, in pleasant surroundings. Their preferences in terms of types of food, and where to take meals are recorded and respected. EVIDENCE: Service users were asked about their lifestyles, social and recreational activity records were examined, as were the records of the three monthly residents’ meeting. At the last inspection a score of 4, commendable, was given for Standard 12, in recognition of high quality provision. This score has been maintained at this inspection, and a further 4 has been given for Standard 14, as the two sets of Standards relate to each other. The home has an extremely relaxed atmosphere, even at key periods, such as meal times. During the visit service users were observed to following their own pursuits such as reading, listening to the radio, sitting in the garden, The Priory G55 S0000027872 The Priory V241969 080805 Stage 4.doc Version 1.40 Page 13 watering the flowers, watching TV in their rooms, and doing a quiz with a member of staff. Preferences for social, religious, and recreational needs are well documented, and staff demonstrated knowledge of these. The threemonthly residents’ meeting is used to both consult service users on decisions that have already been made, and to seek their views on how the service can be improved. The home produces a three-monthly newsletter, to which staff and service users contribute, and the content is discussed at the meeting. Service users are encouraged to be critical, for example, where some new furniture had been promised but had not yet arrived. They are also asked for their views on past activities, such as outside entertainers, and a yearly visit by a local community group. This information is then used to organise future events. Service users look forward to annual events, some of which have been their suggestions, such as an Easter bonnet competition. They are also looking forward to a forthcoming outing to Southend, and the annual fete, which is being opened by the deputy Mayor of Havering. Food preferences are documented in the care plans, and are respected, for example, lunch on the day of the visit was sausages, which some service users do not like, so chicken had also been cooked, another service user prefers sandwiches at many meals, and this is accommodated. The place and pace that people wish to eat is also respected, with meals being able to be taken in bedrooms, or the dining room. Lunch is a key social event during the day, which most service users choose to take in the dining room. This is an unhurried affair, with one service user still eating at 1.45, and another being served a late lunch at 1.30. The menus are varied, and cooked from fresh as much as possible, with fresh fruit and vegetables being delivered twice weekly. As one service user put it, ‘ this isn’t my home, I had to leave that, but they try as hard as possible to make it my home’. Staff and management are to be congratulated on their efforts. The Priory G55 S0000027872 The Priory V241969 080805 Stage 4.doc Version 1.40 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, 17 & 18 Service users, and their representatives, can be confident that complaints are taken seriously and acted upon. Their legal rights are protected, and care staff are aware how to protect them from abuse. Some staff still need to receive training in the adult protection. EVIDENCE: In response to a Requirement set at the previous inspection the complaints procedure has been amended so that it clearly states that complainants have the right to contact the Commission at any stage. The record of complaints was examined, and although there are few, those that had been received had been responded to promptly and appropriately. Service users who wish to be are registered to vote and are assisted in doing so. A requirement was set at the previous inspection that the training in adult protection be extended to all staff, including cooks, domestics, and maintenance staff. The training records showed that since then some staff have attended the course provided by Havering Adult Protection service. This has included some of the ancillary staff but not all. In addition the home has recently recruited new staff, who will also need to do this training. The course provided by Havering is run on a regular basis, but the Adult Protection Coordinator allocates the, limited, numbers of places on each course. Alternative resources, such as videos and training packs were discussed with the acting manager. This is Requirement 1, which could be achieved by a combination of in-house discussion, and attendance at training courses. The afternoon shift leader had a clear understanding of her responsibilities, and correct procedure. The Priory G55 S0000027872 The Priory V241969 080805 Stage 4.doc Version 1.40 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, 20, 21, 22, 23, 24, 25 & 26. Service users live in a safe, well-maintained environment, with comfortable indoor and outdoor communal space, which is clean and hygienic. Individual bedrooms meet current service users’ needs, but the continued use of double rooms should be reviewed for future admissions, in order that sharing is a choice, rather then a necessity. EVIDENCE: The home was toured, including some bedrooms, bathrooms, and toilets, as well as the kitchen and laundry. Some service users were asked about their bedrooms, and use of the communal space, and they were observed moving about the home during the visit. Needs identified in some care plans were compared to the available facilities. The home is well furnished with domestic type furniture, fittings and equipment. A very homely feel has been created by the use of ornaments, pictures, and the type of furniture. There is an on-going programme of The Priory G55 S0000027872 The Priory V241969 080805 Stage 4.doc Version 1.40 Page 16 redecoration and repair, and the handyman is to be complemented on his standard of work and swift attention to repairs. The outside of the house is well maintained, as are the grounds, which are well stocked with plants and containers. There is a conservatory leading off the lounge, and one end of this is used as a smoking area. The carpet needs to be replaced as dropped ash and cigarettes have damaged it. This is Requirement 2. Appropriate floor coverings were discussed with the acting manager. Since the last inspection some new furniture has been purchased for the dining room, lounge, and some of the bedrooms. The bedrooms are of varying shapes and sizes, and some are still used as double rooms. As the home was registered prior to the implementation of the Care Standards Act 2000 the Commission cannot require the provider to change this, because the new Standards and Regulations do not apply. In addition it was clear in some care plans that service users, or their relatives, have chosen a shared room, though it is unclear in some cases if this is because people do not like sleeping alone, or if it is based on cost. One service user described some of the problems they had had in the past with roommates, who had sleep disturbances. The provider is recommended to review the future use of double rooms. This is Recommendation 1. All the bedrooms seen had personal possessions, including small items of furniture. All parts of the home were very clean, tidy, and free from odour. Most of the service users prefer to use a particular bathroom, where there is a choice of walk in shower or bath. This preference is included in their care plans. Specialist equipment, such as a hoist, and walking aids are provided, where required. The Priory G55 S0000027872 The Priory V241969 080805 Stage 4.doc Version 1.40 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, 28 & 30 The numbers and skill mix of staff meet service users’ needs, and they are in safe hands. Staff are trained and competent to do their jobs. EVIDENCE: Some service users were asked for their views, staff were observed interacting with service users, and two staff members were asked about their work and training. Staff training records were examined, and discussed with the acting manager. Documents, such as care plans, daily logs and accident and incident reports were examined. The home has a balanced staff team in terms of roles and responsibilities. The established staff have obtained NVQ2 and 3, and new staff are expected to register for this once they have completed induction. In addition there is a training need analysis carried out each year, which is then translated into a costed training plan. For this financial year this takes account of recent staff turnover. Training is for both basic skills, such as first aid and food hygiene, and specifics, such as strokes and arthritis. The home runs a ‘Carer’s Award’ twice a year, where service users and relatives nominate and vote for the carer who they think has ‘gone the extra mile’. This is an admirable way to reward effort, but must be difficult in this home where so many staff show a high level of commitment. The home was awarded a score of 4, commendable, at the last inspection for the level of commitment to staff training and development. This score has The Priory G55 S0000027872 The Priory V241969 080805 Stage 4.doc Version 1.40 Page 18 been maintained in recognition of the training opportunities that the organisation provides, and the enthusiasm of staff in taking these opportunities up. The Priory G55 S0000027872 The Priory V241969 080805 Stage 4.doc Version 1.40 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, 32, 33, 36, 37 & 38 There is currently no Registered Manager, but the acting manager, and quality assurance manager continue to provide effective leadership. The home is run in the best interests of the service users, and the home’s record keeping, policies and procedures safeguard them. Staff are not receiving one-to-one supervision at least six times a year, but this has not affected the quality of service provided by the home. The health, safety, and welfare of service users and staff are promoted and protected, apart from in one instance, where the acting manager puts herself at risk. EVIDENCE: The Priory G55 S0000027872 The Priory V241969 080805 Stage 4.doc Version 1.40 Page 20 The registered manager post is currently vacant, but the deputy manager, and the organisation’s quality manager, who was previously the registered manager of this home, are covering the duties. Evidence from previous sections of this report, and comments from service users and staff, demonstrates that they are providing effective leadership. The home has continued to provide a high quality service despite this vacancy. A manager was appointed mid 2004, but left after a few months in post. The quality assurance manager reported that efforts have been made to recruit to the post, without success. The home must have a Registered Manager. This is Requirement 3. All the evidence in earlier sections of this report supports the judgement that the home is run in the best interests of the service users. Quality assurance and quality monitoring tools are in place, including; regular residents’ meetings, monthly visits and reports on behalf of the provider on the quality of the service, and information on significant events being passed to the Commission. A Requirement was set at the previous inspection that all staff, including the manager and deputy manager, receive formal supervision at least six times a year. This has not yet been achieved, though individual appraisals were carried out on staff earlier this year, and some individual sessions have been held. The practicalities of meeting this Standard were discussed with the acting manager, and quality assurance manager during the inspection. If the Standard cannot be met then the home needs to be able to demonstrate to the Commission that alternative arrangements, such as staff meetings, and discussion meet the Regulation. This is Requirement 4. A range of documents was examined relating to health and safety, including lift and hoist maintenance, gas, electricity and water checks, and training. All were up to date and in order. Recent inspection reports from the local authority Health & Safety and Environmental Health services were also examined. All requirements and recommendations have been acted upon. This Standard would have been fully met had it not been for the practice of toilet rolls and archives being stored in a part of the loft, which is behind water pipes. This constitutes a hazard to anyone attempting to retrieve these objects, which is the acting manager. This also constitutes a hazard to service users as the cupboard is in a toilet to which they have access. This is Requirement 5 The Priory G55 S0000027872 The Priory V241969 080805 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 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 2 2 3 3 x x 2 3 2 The Priory G55 S0000027872 The Priory V241969 080805 Stage 4.doc Version 1.40 Page 22 NO 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 18 Regulation 13 (6) Requirement The responsible persons must be able to demonstrate that all staff employed at the home can recognise potential abuse, and know what their responsibilities are in relation to adult protection procedures. The carpet in the conservatory must be replaced with a suitable floor covering. The registered provider must appoint a manager and put them forward to be registered by the Commission. All staff, including managers, must be appropriately supervised. Records must be maintained which detail the nature of discussion and topics covered. The loft space, which contains the water pipes must not be used for storage. Timescale for action 31/10/05 2. 3. 19 31 23 8 31/10/05 31/10/04 4. 36 18 (2) 31/10/04 5. 38 13 (4) c 30/09/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. The Priory G55 S0000027872 The Priory V241969 080805 Stage 4.doc Version 1.40 Page 23 No. 1. Refer to Standard OP23 & 24 Good Practice Recommendations The use of double rooms should be reviewed on a regular basis, and as far as possible service users should only share where they have chosen to do so. The Priory G55 S0000027872 The Priory V241969 080805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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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