Inspection on 09/08/05 for Warwick Park House

This inspection was carried out on 9th August 2005.

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

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

Other inspections for this house

Warwick Park House 12/01/09

Warwick Park House 09/01/08

Warwick Park House 05/07/07

Warwick Park House 16/08/06

Warwick Park House 09/05/06

Warwick Park House 26/04/05

Warwick Park House 23/02/05

Warwick Park House 15/09/04

Warwick Park House 04/03/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Warwick Park House 17 Butt Park Road Honicknowle Plymouth PL5 3NW Lead Inspector Fiona Cartlidge Announced 9 August 2005 th 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. Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Warwick Park House Address 17 Butt Park Road, Honicknowle, Plymouth, Devon, PL5 3NW 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) 01752 772433 Warwick Park Limited Mrs Roberta Carole Davina Quarterman Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (10), Physical disability over 65 years of age of places (50), Terminally ill (4) Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. To include 4 Service Users under 60 years old for Service User categories 2. The Home is registered as a Care Home with Nursing for a maximum of 50 Service Users in the categories of PD(E)50, OP 10, TI 4 Date of last inspection 23rd February 2005 Brief Description of the Service: Warwick park Nursing home is privately owned and is registered to provide care for a maximum number of 50 people of either gender with physical frailty, disability or illness. The home is located in the honicknowle area of plymouth and is close to shops and near to a bus route. The home was opened in 1993. It is arranged on 2 floors with the communal lounges and dining room on the ground floor. There is level access to all parts of the home via a passenger lift and ramps. Level access is provided to a large secluded garden with a variety of seating areas. There are 32 single bed rooms and 9 double rooms, most benefit from en suite WCs. The manager is a 1st Level Registered Nurse who leads a team of nurses,care staff and domestic/catering staff. A registered nurse is on duty at all times. Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 8 and a half hours and was announced, a specialist nurse from the health protection agency accompanied the inspector. The Commission received written information before the inspection from the registered manager and feedback from 4 residents and 4 relatives/visitors to the home. A tour of the home took place and personal records of 5 residents and 5 staff were inspected. The inspector spoke to 20 of the residents, 5 visitors as well as the registered manager. What the service does well: What has improved since the last inspection? An amendment has been made to the statement of purpose to include information about the range of needs of the residents living in the home. This should allow prospective residents to make a more informed choice about their admission to this home. The recording of residents social history is documented and communicated to staff this should ensure that people are encouraged to maintain (where possible) past hobbies and interests and be encouraged to join with like minded people in the home. Complaint recording has also been improved, which shows a commitment to analysing actions and an approach that should continually improve the service. 5 fire doors have been fitted with ‘safe’ hold open devices. Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 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. Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4. The information in the statement of purpose indicates a broader range of care than this home has been registered for. The admissions process is not consistent; Registered nurses employed by the home do not always use an assessment tool, which potentially puts those already living in and the persons being admitted to the home at risk. EVIDENCE: The homes statement of purpose/service user guide has been updated and includes this statement ‘ Warwick park intends to meet the needs of all its clients in consultation with the client, their relatives, care managers and our nursing care staff. However it must be noted that we are a dual registered home and as such there is a mixture of client needs in a nursing home and residential environment. We are predominately a nursing home catering for elderly nursing clients some needing dementia care, terminal care or help with physical disability and some residential clients may be more appropriately placed in a residential care home environment’. Despite a requirement being made (regulation 4(3)(a) care homes regulations) following the last Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 Page 9 inspection in April for the registered person to ensure the home operates within its conditions of registration; an application to vary the conditions to include the care of elderly persons who suffer with dementia has not been made, and therefore the home has continued to operate outside of its conditions of registration. This was discussed with the manager at this inspection and an agreement to request the application form from the commission the following day was made. The statement of purpose/service user guide is presented well, written in plain English and contains information about the registered persons, staff, services, facilities and aims and objectives of the home. The document includes a copy of the terms and conditions of residency (contract) and signed copies of these were also found in the personal records seen at the time of the inspection. The personal records held on behalf of 5 residents were examined, there was evidence that pre-admission information about their personal, health and social care needs had been obtained from external health and social care professionals, this information was sometimes gained very shortly before the admission took place. There was no recorded evidence that the individuals had been visited in their current settings by registered nurses employed in the home, although the manager confirmed that 2 of the residents (whose records were examined) had been visited, but an assessment form had not been completed at the time of the visits. There is no written assurance given to residents about their assessed needs being met. A care plan provided by the placing authority of one individual indicated that the person would need to have a nutritional assessment and weekly assessment of their skin integrity following their admission to the home; this plan had not been followed. Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10 Limited progress has been made to ensure all residents have a full needs assessment and that the care plans formulated following their assessment are regularly reviewed/updated. These shortfalls have a potential to impact on the correct action being taken when care is provided. EVIDENCE: The documentation of 5 people living in the home included personal care plans; these had been formulated following an assessment of their activities of daily living however in the case of two, the assessments were not complete, they did not include information about expressing sexuality or dying. The care plans had not been reviewed on a monthly basis. Daily records of condition and care are stored in the resident’s rooms, the care plans and assessments are stored in the office. Assessments had been performed of their mobility and skin integrity and one person had a nutritional assessment. The weights of all 5 people had been recorded on admission and regularly (monthly) after. The record of professional visits indicated that a General practitioner had not seen one of these people at all since their admission in June, although 3 telephone discussions about the person’s health care had been made between the nursing staff and GP and was documented. Records of Other external professional visits included Macmillan Nurses and on the day of the inspection Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 Page 11 a consultant psychiatrist and a district nurse were seen attending the home to visit residents. One resident was referred for specialist medical assessment in a community hospital. All of the people living in the home that were spoken to said that the staff team treated them with kindness and respect. All 4 residents who gave written feedback about the home to the commission indicated that they feel well cared for and are treated well by the staff and their privacy is respected. Staff were observed to knock on doors and gain permission before entering peoples private accommodation. Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 The number and choice of social activities meets the needs of people living in the home. The food is varied and is enjoyed by most of the people living in the home. EVIDENCE: Those people spoken to were satisfied with the recreational activities organised by the home, group activities take place approximately 3 times a week. Slide shows and musical entertainment are offered on a monthly basis. One resident told the inspector about how much they had enjoyed a recent trip to Buckfast abbey – particularly the delicious picnic supplied by staff from the home. The individual records seen by the inspector included a social history providing detail about the peoples past experiences of life, hobbies and interests. The inspector was told by visitors and people living in the home that they were satisfied with the open visiting arrangements and are able to visit in private in their own accommodation as well as socially in the lounges. People living in the home told the inspector they are able to choose how and where they spend their time. With the exception of one person all of those spoken to said the standard of food in the home was good, of the 4 residents who provided written feedback – 2 said they liked the food, 1 sometimes likes the food and the fourth does not Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 Page 13 like the food. Written comments included ‘it would be nice to have more appropriate food in hot weather’,’ the food could be improved – less beans on toast more fish and light food’. Visitors also spoke favourably of the beverages and meals served to them when visiting. One resident said that the break between tea and breakfast was too long and was unaware that an evening snack should be offered and the interval between this and breakfast should be no more than 12 hours (standard 15.3). Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17, 18 People feel safe living in this home and know who to speak to if needed. Some residents may be at risk of having their liberty and choice restricted through lack of consultation with multi-disciplinary teams and advocates. EVIDENCE: The inspector examined the homes complaints procedure, which is displayed on the notice board in the entrance hall as well as in the statement of purpose/service users guide. The inspector looked at a hard backed book introduced since the last inspection, containing a record of complaints and can confirm that a more pro-active and formal approach is being undertaken. The concern is documented and dated and a record of findings included. Written feedback was received by the commission from 4 visitors/relatives; three indicated that they were aware of the homes complaints procedure and 2 indicated that they had actually had to make a complaint. The written feedback received from people living in the home indicated that they knew who to speak to if they were unhappy with their care and all indicated they feel safe living in the home. The homes policies and procedures manual contained information about how to recognise and report allegations or incidence of abuse. The staff training records of 5 members of staff indicated that only one had received training on recognising abuse in vulnerable adults and this had taken place in April 2004. Whilst examining the personal records of 5 residents the inspector found a record of consent to use a lap belt to prevent the individual falling from their chair; this form of restraint was discussed with the Manager who was advised that any restraint must be agreed by a multi – disciplinary team and all Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 Page 15 rational should be documented and reviewed if restraint is agreed - release from that restraint must be regular and must be included in the plan of care as agreed by the multi – professional team. Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 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 standard(s) 19,20,21,22,23,24,25,26 The environment is homely and is adapted to suit the needs of those with physical frailty/disability. Some equipment and areas of the home were dirty, providing a potential risk of infection/cross contamination to persons living in the home. EVIDENCE: The home is pleasantly decorated, a tour of the home revealed evidence that people are able to bring personal items (within space confines) to their own rooms. Maintenance records were inspected the fire equipment and emergency lighting system is regularly checked by staff in the home and serviced annually by a recognised professional. The homes 5 - year electrical certificate is current until October 2007. The dining space in the home is limited. There are 2 lounges available both looking over the safe, accessible, pleasant gardens. Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 Page 17 Most bedrooms have en suite WC’s and other WC’s and assisted bathrooms suited to the needs of people with disability are situated throughout the home. A number of soap bars were found in communal/assisted bathrooms/WC’s, which could if used between people provide a medium for bacterial growth and cross contamination. Liquid soap dispensers were available beside sinks but it was noted that the bottom of these near the dispensing mechanism had a build up of damp deposits, bins were not readily available beside the wash hand basins and one bin used for clinical waste had a swing bin lid instead of pedal controlled lid. The inspector found that the water supplied via mixer taps takes along time to run warm and a resident confirmed that the staff had to go elsewhere to bring hot water. Some nursing equipment such as bath chairs, wheel chairs and commodes were dirty and required a deep clean. The laundry is situated in the grounds of the home, dust and debris had built up on the exposed pipes and no disposable hand towels were available. A supply of vinyl gloves were seen in the home, these are not recommended for use by care staff for protection against infection, the accompanying nurse specialist recommended the use of latex gloves. The homes policies and procedures in relation to control of infection were examined and require review and updating in line with current ‘ best practise’ guidance. Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 The staff are kind and courteous but insufficient numbers detract from the level of care required for people living in the home. Staff do not receive regular training and updates, this provides a risk to people living in the home because the staff team may not have up to date skills and knowledge to meet the range of needs. EVIDENCE: All of those people spoken to both people living in and people visiting the home commented on the kindness of the staff and how hard they work, they also said there is not always enough staff. Written feedback was received by the commission from 4 visitors/relatives 2 indicated that in their opinion there are always enough staff in the home the others commented - ‘the staff are very caring but there are too few of them’, ‘The lounge is left for periods of time without any care staff in attendance, I have had to find a care person to help with a resident in trouble a few times’. The inspector viewed the training and personnel records of 5 members of staff. None of the recruitment records contained evidence of the persons identity, one file contained a Criminal Records Bureau check from another employer and no check had been performed by the home, one file contained 2 written references, but one of these from the previous employer requiring further explanation had not been explored further. One file contained no recruitment Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 Page 19 information or required checks at all, 2 personnel files contained only 1 written reference. 3 of the 5 members of staff had received training in moving and handling, 1 in recognising abuse in vulnerable adults, 1 in fire safety training the plans provided information about the title of the training and the date it was undertaken but no duration. One member of staff had been employed as a junior carer for 2 years and is still under the age of 18years. This was discussed and the inspector was informed the carer had been involved in the provision of personal care along side a more experienced carer. Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 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 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) 33,37,38 Service users are placed at potential risk when fire doors are wedged open. A requirement has been made to prevent this dangerous practise. EVIDENCE: A written comment received by the commission from a visitor/relative stated that Warwick Park is a ’very professional well run caring environment’. Records confirmed that regular meetings are held between the manager and the staff and residents/representatives meetings are held providing an opportunity for them to comment on the services and facilities. A comments/suggestions box is available and this is advertised in the statement of purpose/service users guide. A number of personal records held on behalf of residents were examined during this inspection, the assessments of activities of daily living of two people had not been completed in its entirety and care plans had not been reviewed on a monthly basis as recommended. The standard of personnel Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 Page 21 records for the recruitment of staff were poor and do not ensure the safety of those living in the home. One resident had experienced an accident within the home resulting in a fracture and hospitalisation this had not been recorded as an incident in the accident book or reported to the authorities as required under RIDDOR and the Care Standards Act 2000. People living in the home told the inspector that because the fire doors to their rooms are heavy, when they want them left open they are wedged with bits of furniture/wheelchairs or linen baskets; at the time of this inspection the office door was held open with a wooden wedge – made for its purpose. The manager confirmed that since the last inspection 5 doors had been fitted with safe hold open devices. Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 2 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 2 3 3 3 2 3 2 STAFFING Standard No Score 27 2 28 x 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 2 2 x x 3 x x x 1 2 Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 Page 23 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 4 Regulation 14 Requirement Timescale for action 01/09/05 2. 15 16(i) 3. 17 13(7) 4. 18 13(6) The registered person must confirm in writing to the person having regard to the assessment that the care home is suitable for meeting the individuals needs in respect of their health and welfare. A snack meal must be offered in 01/09/05 the evening and the interval between this and breakfast the following morning should be no more than 12 hours. 01/09/05 The registered person shall ensure that no service user is subject to physical restraint unless restraint of the kind employed is the only practicable means of securing the welfare of that or any other service user and there are exceptional circumstances. Where restraint is used this should be done so after multi discipplinary consultatuion and regularly reviewed by all concerned in the process. The registered person must 01/10/05 ensure that all staff receive training and regular updates to prevent service users being harmed or suffering abuse or being placed at risk of harm or Version 1.30 Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Page 24 abuse. 5. 24 13(4) When service users make a decision that they would like their bedroom doors open and where these doors are designated fire doors , a safe hold open device must be used following consultation with the fire and rescue department. The registered person must ensure soapbars are not shared. Cleaning schedules should be in place to ensure a buildup of dust and debris does not occur on exposed pipes in the laundry. All equipment including bath chairs and wheel chairs and soap dispensers must be regularly cleaned to prevent the risk of cross infection. Latex gloves should be available to staff and hand washing facilities for staff must include liquid soap dispensers and bins for disposable handtowels/gloves. The registered person must ensure that at all times there are suitabley qualified, competent and experienced staff in the care home in such numbers as are appropriate to meet all of the health and social care needs of all persons living in the home. The registered person must not employ a person to work at the care home unless the person is fit to work at the care home; and he has obtained in respect of that person the information and documents specified in paragraphs 1 to 7 of schedule 2 and is satisfied on reasonable grounds as to the authenticity of the references referred to in paragraph 5 of schedule 2 in respect of that person. The registered person must, 01/10/05 6. 7. 26 26 13(3) 13(3) 01/09/05 01/09/05 8. 27 18 (1)(a) forthwith 9. 29 19 01/09/05 10. 30 18(1)(c ) 01/09/05 Page 25 Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 11. 38 13(4) 12. 37 & 38 37(1)(2) 13. 4 4(3)(a) having regard for size of the care home, the statement of purpose and the number and needs of service users ensure that persons employed by the registered person to work at the care home receive - training appropriate to the work they are to perform and suitable assistance, including toime off, for the purpose of obtaining further qualifications appropriate to such work. Fire doors must not be held open 01/09/05 by furniture or any other items. Where people want their doors open this should be done with than safe hold open devices which have been agreed by the fire and rescue department Any event which adversely 01/09/05 effects the well-being or safety of any service user must be reported to the commission as required by this regulation. The registered person must 01/09/05 ensure that the home operates within its conditions of registration. The registered person must apply to vary these conditions to enable the service users who have dementia to remain in the home and a statement as to how there needs will be met must be included in the application to vary as well as the homes ststement of purpose. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 3 Good Practice Recommendations Residents plans of care for daily living and longer term D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 Page 26 Warwick Park House 2. 3. 4. 7 20 26 outcomes should be based on the care management assessment and care plan as well as the homes own needs assessment. Residents plans of care should be reviewed at least once a month and updated to reflect changing needs and current objectives. Consideration should be given to increasing the size of the dining room so that all persons living in the home are able to use the room if desired. Bins used for clinical waste should be pedal operated to prevent contamination to hands. Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 Page 27 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Warwick Park House D52-D04 S3616 Warwick Park House V233577 090805 Stage 4.doc Version 1.30 Page 28 - 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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