Inspection on 17/05/06 for 88 - 90 Offham Road

This inspection was carried out on 17th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

88 - 90 Offham Road 06/08/07

88 - 90 Offham Road 07/09/05

88 - 90 Offham Road 17/05/05

88 - 90 Offham Road 20/01/05

88 - 90 Offham Road 01/04/04

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

CARE HOME ADULTS 18-65 88 - 90 Offham Road West Malling Maidstone Kent ME19 6RD Lead Inspector Debbie Sullivan Key Unannounced Inspection 17th May 2006 09:45 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 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 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 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 Adults 18-65. 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. 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 88 - 90 Offham Road Address West Malling Maidstone Kent ME19 6RD 01732 874295 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) MCCH Society Limited Mrs Ann Patricia Francis Care Home 7 Category(ies) of Learning disability (7) registration, with number of places 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Two service users whose date of birth are: 11/05/1934 and 27/03/1926 Service Users to be 50 years and over The home is restricted to provide residential care for one female service user less than 50 years, whose date of birth is 16/07/1964. 7th September 2005 Date of last inspection Brief Description of the Service: 88/90 Offham Road is one of a number of registered care homes managed by MCCH Society Ltd in the south east area. The home is registered to offer 24hour care to a maximum of 7 service users who have learning and physical disabilities and who are aged 50 years and over. The home is accessible for 3 wheelchair users on the ground floor, with a further 4 bedrooms on the first floor, there are 4 bathrooms. Ground floor bathrooms are equipped with specialist equipment to assist people with physical disabilities. The premises are not equipped with a shaft lift; consequently not all areas of the home are accessible to wheelchair users or those with limited mobility. Each service user has their own bedroom. There is open plan communal space on the ground floor comprising of a living and dining area leading into the kitchen. The home has a large mainly lawned, fenced garden. The premises are within a few minutes walk of West Malling town centre, which offers a range of local facilities and services. 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over six and quarter hours and was undertaken in the company of the staff present at the home and the service users. During the morning and afternoon three staff were on duty, the registered manager was not present due to training. Time was spent speaking with staff, speaking with one service user individually with a member of staff who was supporting them to do so, touring the premises, reading documentation, speaking with service users throughput the day in communal areas and in general observation of the daily routines. Throughout the day staff were helpful in providing information and there was a pleasant friendly atmosphere in the home. Information was also received through comment cards and the pre inspection questionnaire. At the time of the inspection there was one vacant bedroom. Comments from relatives and visitors on comment cards included, “We as a family are very happy with the care and attention our (relative) receives, ---always seems happy and ready to return to Offham Road” “We are very pleased with the way they look after our relative” Comments from Health and Social Care Professionals included “Informal complaints from staff re delay of environmental adaptations” “ Staff have usually contacted me when there have been problems” What the service does well: Clear information is available regarding the service on offer and is available in a format accessible to potential service users. 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 6 Health and personal care needs are well met and documented and importance is given to ensuring that changing health needs are recognised, referred to outside agencies and that contact with health professionals is maintained. Staff are knowledgeable regarding the needs of service user, treat them with respect and dignity and as individuals. Staff are well supported and state they enjoy working at the home. The atmosphere in the home is friendly and welcoming. What has improved since the last inspection? What they could do better: Care plans need to include the most recent assessment and risk assessment information. 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 7 Medication procedures need to be improved upon in terms of the recording of verbally changed medication or dosage and counter signing of MAR sheets. The lack of a choice of living area to access as an alternative to the open plan communal living/dining space can cause friction between service users, and does not allow for visitors to be seen in private away from bedrooms or for those needing a quiet space. Repairs are needed to some doorframes and paintwork due to wheelchair damage and to the downstairs bath; the lack of this facility restricts the choice of service users with mobility problems. Additional measures need to be put in place to reduce risk of cross infection. The access to the outdoor fire escape route needs to be made more accessible. 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. 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 and 5 The quality in this outcome area is good. Prospective service users have access to comprehensive and clear information about the home and are able to visit before making a decision to move in. Service users are supplied with a contract for the home. EVIDENCE: The home has reviewed its’ statement of purpose and service user’s guide, both are now presented in a user friendly pictorial format and contain comprehensive information about the home. The care plans inspected each contained a written contract in respect of the terms and conditions at the home. Since the last inspection in September 2005,one new admission has taken place. The member of staff in charge said that prior to admission the service user had been able to visit and spend time at the home before moving in early this year and was going through a settling in period. The service user had transferred from another MCCH home, a reassessment of need prior to the move could not be found on the care plan, although it contained good information regarding ongoing care needs and background. 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 and 10. The quality in this outcome area is adequate. Care plans contain comprehensive information and are thorough regarding healthcare needs. Service users are supported to take risks and be independent; risk assessments are not always included on care plans. Service users are able to contribute to the daily running of the home. EVIDENCE: The care plans of four of the six service users were read in detail, a large amount of helpful and informative information is available to staff and contained in care plans, medical and daily files. Records show that service users are supported with a number of medical appointments and in their contacts with health and other professionals such as epilepsy nurses, G.P’s, Speech and Language Therapists and chiropodists. The staff are pro active in making contact with other professionals if health issues are causing concern. 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 11 A member of staff gave an example of a service user with unstable epilepsy where reassessment was being sought from specialist services. Due to the particular and diverse medical needs of the service user group and the advancing years of some residents, staff need to observe and monitor the health of most residents closely. Care plans did not all contain up to date risk assessments, these are held separately in the staff office, it is recommended copies be held on care plans so they are easily located. There was evidence that reviews take place and the service is beginning to undertake monthly reviews of those over 65. Care plans also included background and family information and details of interests, personal care preferences and daily activities. Throughout the inspection it was clear that service users are given opportunities to make decisions about their daily lives and contribute towards the daily running if the home. Choices are given and respected, for example, one service user makes their own meals and goes out independently, others were consulted regarding personal care needs and meal choices and regular service user meetings are held. Since the last inspection there has been more consistency of staffing so staff are more aware of individual preferences. Information was seen to be recorded appropriately on all the documentation read, although MAR sheets should be kept more confidentially and not in the communal area. 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16 and 17 The quality in this outcome area is adequate. Service users are supported and encouraged to participate in activities of their choice. Service users are supported to maintain relationships. The layout of the premises does not allow for some preferred activities to take place or for private space to see visitors. Service users receive a healthy diet and are offered choice of meals. EVIDENCE: Service users are able to exercise personal choice regarding the activities they take part in within the home and in the community. On the day of the inspection one service user went out horse riding, another went into the town independently and those remaining on the home spent time in the communal area or their rooms. Details of social events and clubs were displayed on the house notice board and a service user said they attended a drama group, the Gateway club and went bowling. 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 13 One service user has recently retired from attending day activities in the community who staff said were much happier as a result. Opportunities are offered for those that need more support to go out with staff and this has improved alongside less use of agency and bank staff. Service users are supported on an individual basis to shop and access their finances. In the open plan living and dining area there can be conflict if a service user prefers to have music on rather than watch TV, this communal space curtails the opportunities for individual activities to take place away from the bedroom areas and in peace. Service users are supported to maintain links with families and friends and there was evidence of contact and visits on care plans and in the house diary. There is no separate space available for visits to take place in private, and visitors need to be received in the living area or bedrooms. Lunchtime was observed, service users enjoyed the meal in a relaxed atmosphere that was not rushed. The main meal is eaten in the evening, service users are invited to make menu suggestions at house meetings and can choose an option if they do not like the main meal. One service user is diabetic so diet is monitored, as is the nutritional intake of a service user who prefers to prepare their own food. 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 and 21 The quality in this outcome area is good. Service users are able to exercise choice regarding personal care preferences and staff are knowledgeable regarding health needs. Medication procedures can be improved upon to further safeguard service users and staff. EVIDENCE: The service users in the home have a range of physical and emotional needs. As far as possible they are offered choice as to how, when and by whom personal care is provided and gender preference is respected and recorded on care plans. During the inspection all personal care was given discreetly and staff were aware of when attention was required. The health of one service user was the cause of some concern and staff did all they could to make the service user at ease and comfortable. Information on care plans was detailed and easily accessible regarding healthcare needs, contacts and appointments. The majority of the service users are over 50 and experiencing age related or changing health needs, these are closely monitored and a variety of specialist health professionals are involved. Where service users have expressed their 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 15 wishes in the event of terminal illness or death these are recorded. Two service users have passed away since the last inspection. Medication is stored securely and during the inspection a member of MCCH’s maintenance team arrived to fit a more secure lock on the cupboard. Staff receive medication training, a recommendation from the last inspection was that two staff sign that medication had been correctly dispensed, this needs to be implemented. MAR sheets contained handwritten, crossed out and changed details where there were new directions following a change of medication or dosage. Where a GP or other health representative changes a medication over the phone the call should be recorded on the MAR sheet and care plan. 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The quality in this outcome area is adequate. The home has a clear complaints procedure that is in a format accessible to service users. Staff have good awareness of Adult Protection issues, new staff should receive this training at the earliest opportunity. EVIDENCE: The home has a clear complaints procedure, which is included in detail on the service users’ guide and was displayed on the notice board in leaflet form. The complaints book contained well-documented details of 7 complaints received since the last inspection, all from service users. Action taken was recorded. Verbal evidence was gained from staff that CRB checks take place prior to employment commencing and there was awareness of Adult Protection issues. The training programme included Adult Protection training dates. One member of staff had not yet undertaken AP training. Since the last inspection there have been two Adult Protection referrals, one remains open. 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29 and 30. The quality in this outcome area is adequate. Service users live in a homely, comfortable and pleasant environment. Individual bedrooms are spacious and personalised. Personal choice is restricted by the availability of only one open plan living area. EVIDENCE: The home offers a clean, well-maintained and comfortable environment. Staff undertake a regular check of the building and raise any requests necessary for repair or improvement, for example the lock being fitted on the medication cupboard. The home is comfortably furnished, individual bedrooms inspected were of a good size and personalised, they reflected individual interests such as music and animals and there were family photos. The layout of the premises make some areas difficult for wheelchair users to access independently and a downstairs bath was out of order restricting choice of bathroom for those with mobility difficulties. 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 18 The main living area being open plan and leading into the kitchen is homely and comfortable, although does not allow for service users to spend time during the day in a quiet or private area away from bedrooms. During the course of the inspection some service users chose to access their rooms for quiet time. One service user explained that sometimes they would just like music on but others prefer the TV. This can lead to conflict. It is recommended that MCCH consider the use of the vacant bedroom or plan for the use of a future vacant downstairs room as a quiet lounge/visitors room. This is becoming more necessary due to the diversity of needs in the house. Some repairs to doorframes and paintwork are required due to wheelchair damage and a gap in the floor covering in one bedroom needs to be attended to, as it could be a cross infection risk. It remains a requirement that due to increased incontinence a washing machine with a sluicing facility be purchased. 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35 and 36. The quality in this outcome area is good. Service users are supported by a staff team that has become more established and therefore can provide better consistency of care Staff are well supported and are confident in their roles. EVIDENCE: Three staff were on duty during the morning and the afternoon, the manager was on a training course and an experienced member of the team was in charge. The last inspection identified concerns regarding the level of staff sickness and use of bank or agency personnel, this is now much improved. The staffing rota and house diary identified that mainly permanent staff are now on duty and when bank staff are used this is kept to a small number who are familiar with the home. A member of bank staff on duty said they liked working at Offham Road as it has a nice atmosphere. Staffing files were not accessible as the manager was not on duty, established staff spoken with said that they had undertaken regular update training on topics such as manual handling, first aid, epilepsy and fire safety. Evidence was seen of some training certificates and a schedule of courses available in 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 20 the summer. One staff member said they had obtained NVQ 3.Awareness of the availability of Adult Protection varied. Verbal information was given that two references and a CRB check are taken up prior to employment, a thorough induction period is given and that the level of support to staff is good with regular documented supervision and team meetings. Service users related well to the staff on duty, were at ease with them and staff were competent and confident in their roles. 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38,41 and 42. The quality in this out come area is adequate. Service users benefit from living in a home with an open and friendly atmosphere. The health, safety and welfare of service users, and the confidentiality of their records can be further protected by improvements to fire exit areas being put into place and more secure storage areas being identified for records and personal belongings. EVIDENCE: The ethos of the home was friendly and welcoming, although the manager was not present for discussion regarding the running of the home, the evidence available showed that there have been improvements since the last inspection and following an unstable period in respect of staff sickness and two bereavements it is more settled. 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 22 Policies and procedures are in place for the protection of service users and staff, fire safety procedures had been updated in April 2006. Fire equipment is regularly tested and fridge and freezer temperatures are recorded. One fire exit leading onto the garden and patio area is obstructed by patio furniture, and an area of gravel and brick in the garden is unsafe for wheelchair uses and needs paving over. Items were stored on top of wardrobes in bedrooms and uncovered radiators in bedrooms and communal areas could be a risk to service users with health or mobility problems Some records and documentation including staff files are kept locked in the managers’ office, care plans and other files relating to service users are located in the dining area as were MAR sheets. Storage space is limited but records relating to service users need to be kept more securely and confidentially. 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 2 3 3 4 3 5 N/A INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 2 28 1 29 2 30 2 STAFFING Standard No Score 31 3 32 3 33 3 34 X 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 2 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 2 15 2 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 X 3 X X 2 2 X 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 24 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 YA10 Regulation 17 Requirement “The registered person shall ensure that records are kept securely in the care home.” In that care plans, medical records, daily record folders and MAR sheets must be stored in a secure and confidential place. 2. YA20 13(2) “The registered person shall make arrangements for the recording, safekeeping, recording, handling, safekeeping, safe administration and disposal of medicines received into the care home.” In that when a medication or the dosage is changed over the telephone this must be recorded on MAR sheets and care plans by staff as a change advised by a person trained to do so. Two staff should sign that a medication has been altered. 3. YA24 23(2)(h)(i) “The registered person having regard to the number and needs of the service users provide communal space suitable for the DS0000029266.V293553.R01.S.doc Timescale for action 20/07/06 20/07/06 20/07/06 88 - 90 Offham Road Version 5.1 Page 25 provision of social, cultural and religious activities appropriate to the needs of service users and suitable facilities are provided for service users to meet visitors in communal accommodation which is separate from service users private rooms. In that consideration must be given to accommodating the personal preferences of service users regarding the need for an alternative living space/visitors room, and converting current or future vacant bedrooms for this purpose. This requirement is repeated from the previous inspection. 4. YA27 23(2)(j) “The registered person shall having regard to the number and needs of the service users ensure that there are sufficient numbers of baths and showers fitted with a hot and cold water supply.” In that the downstairs bath be repaired to allow service users with mobility problems in that area of the home choice of bathroom to access. . “ The registered person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home.” In that a washing machine with a sluice facility should be purchased and the gap between the floor covering and wall in the bedroom of a service user be made good. 20/07/06 5. YA30 13(3) 20/07/06 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 26 6. YA42 12(1)(a) The requirement relating to the washing machine is repeated from the last inspection. “The registered person shall ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of service users.” In that measures must be taken to ensure that patio furniture does not obstruct fire exit areas and fire exit routes are safe for wheelchair users. Radiators in areas accessible to service users must be covered or have guaranteed low temperature surfaces. 20/07/06 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 YA2 Good Practice Recommendations 1. 2. YA9 It is strongly recommended that full details of reassessment of need be included on the care plans of newly admitted service users as evidence that needs have been fully reassessed. It s strongly recommended that up to date risk assessments be placed on care plans as well as being located in the staff office. It is recommended that repairs be made damage to paintwork and doorframes caused by general wear and tear caused by wheelchairs. 3. YA24 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 27 4. YA32 It is strongly recommended that newly employed staff undertake Adult Protection training as part of their induction programme. 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 28 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 88 - 90 Offham Road DS0000029266.V293553.R01.S.doc Version 5.1 Page 29 - 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!