Inspection on 17/01/06 for Abbey Grange

This inspection was carried out on 17th January 2006.

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

Abbey Grange 14/08/07

Abbey Grange 05/10/06

Abbey Grange 03/08/05

Abbey Grange 10/03/05

Abbey Grange 14/10/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Whincroft 18 Glen View Road Burnley Lancashire BB11 2QN Lead Inspector Mrs Keren Nicholls Unannounced Inspection 17th January 2006 10:20 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Whincroft DS0000061077.V279205.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 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. Whincroft DS0000061077.V279205.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Whincroft Address 18 Glen View Road Burnley Lancashire BB11 2QN 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) 01282 453158 01282 425983 Mrs Linda Jane Harris Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Whincroft DS0000061077.V279205.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The staffing of the establishment shall, until further notice continue to be - The registered provider/manager to work in the home on a full time basis. 8:00 am - 10:00 pm 3 x care assistants (one designated as in charge in the absence of the registered provider/manager) 10:00 pm - 8:00 am 2 x waking watch care assistants (one designated in charge) Cook hours = 54 per week Cleaner hours = 35 per week 3rd August 2005 Date of last inspection Brief Description of the Service: Whincroft is a family run care home, offering 24 hour personal care and accommodation to 24 older people. Whincroft is a no smoking home. The house is a semi-detached property located in a residential area on a fairly busy road on the outskirts of Burnley. There are attractive enclosed gardens, accessible to residents, and on-street parking and a bus stop outside the home. On the upper ground floor there are two lounges, a separate dining room and seating in the entrance hallway. There is a shared lounge and four selfcontained units on the lower ground floor. Various aids are provided to help with mobility and independence, such as hand rails and facilities for disabled people in bathrooms. Bedroom accommodation is on three levels, on the lower and upper ground and first floors. There are 16 single and 4 double rooms. 11 bedrooms have en-suite facilities. Some of the rooms (units) are fitted with kitchenettes. A ‘stair walker’ is available, to help residents to access first floor bedrooms. The home provides recreational activities and outings. Whincroft DS0000061077.V279205.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced visit to Whincroft during the inspection year April 2005 to April 2006. The inspection took place over two days (12:05 hours). During the visit the inspector spoke with 13 of the 23 people who lived at the home and examined written information, including records. Two people were in hospital. She also talked to the manager, the staff on duty and visitors. With the permission of residents, she looked round the home. Eight residents and six visitors/relatives returned comments cards, with their views about the home. What the service does well: What has improved since the last inspection? The ‘Service Users Guide’ had been updated with correct information about the staff and contracts had been improved, so that individuals knew how fees were to be paid. Whincroft DS0000061077.V279205.R01.S.doc Version 5.1 Page 6 Risk to residents had been minimised by staff updating assessments in care plans, with details of management strategies to help prevent falls and to minimise other risks. Fire safety risk assessments had been completed. The premises had been improved. Residents appreciated the decoration and new carpets in some bedrooms and work to make the home safe (such as guarding radiators) had progressed. Staff numbers in the mornings had been increased, so staff had more time to spend with residents and to enable people to have better choices of routines (such as getting up times). Staff training had continued to ensure that staff knew how to care for everyone properly. To safeguard residents’ best interests, the manager had continued to update and improve the policies and procedures and record keeping. 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. Whincroft DS0000061077.V279205.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Whincroft DS0000061077.V279205.R01.S.doc Version 5.1 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 the following standard(s): 4, 5 and 6 The admission process was well managed and ensured that prospective residents had the information they needed to make an informed decision about residence at Whincroft. A well-trained and qualified staff team met residents’ assessed needs. EVIDENCE: The admission process included ensuring that prospective residents had the opportunity to visit the home and stay for a trial basis. One person had visited for an afternoon to help her make a decision about residence and one resident explained she was staying for two weeks before making up her mind. The requirement and recommendation from the last inspection (about updating the service user guide and statement of purpose and improving information in residents’ contracts) had been completed. Up to date and comprehensive information for prospective residents was provided, to help them to judge whether Whincroft is the right place for them to live. Residents and relatives were confident that the home was meeting their needs. “Whenever we visit I always find my mother really clean, content and cheerful Whincroft DS0000061077.V279205.R01.S.doc Version 5.1 Page 9 and I feel sure this reflects on the excellent care she receives from staff members”. All the staff had received training in care and health and safety practices in respect of older people. Initial and on-going needs assessments were documented in care plans and advice was sought from specialist professionals (such as the district nurses, continence advisor etc.) where there was an identified need. The home was working towards ensuring they could meet the special needs of those who have a dementia or sensory impairment, but further staff training and assessment of changing needs will be necessary. The needs of one person who is blind should be considered in terms of this disability. The home does not offer intermediate (rehabilitation) care. Whincroft DS0000061077.V279205.R01.S.doc Version 5.1 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 the following standard(s): 7, 8, 9 and 10 Improvements to care planning records helped to ensure that most residents’ personal and healthcare needs were met. Support with personal care was generally provided sensitively in a way that promoted service users privacy and dignity. EVIDENCE: Care plans had improved, to show how resident’s social and emotional needs were to be met at the home. These could be improved further with social histories. Care plan reviews were up to date. Residents were better protected by more detailed risk assessment. Staff were observed to give prompt attention and residents said that they were happy, comfortable and several commented that they felt well cared for. However, gaps in meeting the needs of two residents were identified and discussed with the registered manager. Ways in which to improve the quality of life for one person was discussed including; the compilation of a social history; ensuring this person has a full up to date assessment of personal and healthcare need; identification and treatment of problems and a plan for present and future care which takes into account her social history, mental stimulation, social stimulation and physical activity. Whincroft DS0000061077.V279205.R01.S.doc Version 5.1 Page 11 The source of continence problems for one person should be identified and eradicated. Risk to residents was minimised by the home carrying out the requirement from the last inspection regarding improving medicine policies and procedures. The recommendations from the last inspection (for example about variable dose medicines and reviews) were carried forward and information was sent to the home to help staff with compliance. The practice of keeping prescription creams and external preparations on dressing tables should be reviewed and creams should not be shared. Several people commented that their privacy was respected. Help with personal care was given in private, and staff were discreet. Screening was provided in shared rooms and residents could use the telephone in private. Staff had been given instruction about knocking on doors and waiting for a reply (unless the care plan instructed otherwise), but the inspector experienced that this was not always followed. Out of respect for residents (and to improve food hygiene arrangements – see Standard 38), staff should not handle food such as biscuits and should provide side plates for bread at meal times. Whincroft DS0000061077.V279205.R01.S.doc Version 5.1 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 the following standard(s): 12, 13 and 15 Flexible routines enabled lifestyle choices. Social activities could improve to provide daily variety and interest. Staff encouraged and enabled residents’ contact with family and the local community. Meals were of good nutritious quality, offered choice and were enjoyed by residents. EVIDENCE: Visiting times were flexible, so residents could continue relationships with relatives and friends. Residents and their relatives said that visitors were always made very welcome. Several people said they went out with family and friends and one person said he liked to go out shopping. Residents liked the singsongs and entertainers and had enjoyed the many activities over the Christmas period. However, several people commented that either the home did not, or only sometimes provide suitable activities, which would make daily life more interesting, stimulating and enjoyable. Everyone spoken to said they liked the meals. The menus offered choice and variety. Staff had reflected on how their conduct affected residents and had ensured that meal times were peaceful occasions. The meal observed was served in pleasant dining surroundings with appropriate crockery and cutlery. Residents had choice of where to eat, some choosing to take meals in their bedrooms or the lounge. Whincroft DS0000061077.V279205.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Complaints were handled properly, giving residents confidence that their concerns were listened to, taken seriously and acted upon. The vulnerable adults procedure and staff training in protection issues needs improve, to ensure that people living in the home are fully protected from harm. EVIDENCE: Everyone had a copy of the service users guide, which contained a summary of the complaints procedure. The procedure had been amended to let complainants know they can contact the Commission at any stage, should they so wish. Residents said they knew how and to whom to complain if they had a problem. Two people said that they were confident that any concerns were acted upon straight away. Since the last inspection one concern had been raised with the home and dealt with and recorded according to procedure. Residents said that they had no complaints or concerns at the moment. Staff spoken with understood the indicators of abuse and how to minimise risk. Several residents commented that they felt safe at the home. The home’s protection procedure did not clearly describe the action to be taken in the event of suspicion, or evidence of abuse. Staff were unclear about local reporting procedures, their responsibilities under the General Social Care Council’s and the home’s codes of practice (including whistle blowing), and the relationship between recruitment, the Protection of Vulnerable Adults (POVA) register and potential referrals. Whincroft DS0000061077.V279205.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20, 21, 22, 23, 24 and 26 Overall, the home provided a bright, warm, clean, and ‘homely’ environment, although some improvements could be made to enhance the safety and comfort of residents. EVIDENCE: The communal rooms (lounges and dining room) provided spacious, clean bright and comfortable accommodation. The home is non-smoking. Furniture and decoration was domestic in character, with residents’ belongings and furniture giving a ‘homely’ feel. Residents said they liked living their home. The pleasant gardens were accessible. Generally bathrooms and en-suites provided for the needs of residents. However, the bathroom by the front door was not suitably located, and therefore not used. On the first inspection day several toilets and bathrooms did not have towels. For infection control, liquid in preference to bar soap should be used in shared bathrooms. For the safety of residents, the ground floor bathroom should not be used to store ladders and other items (see Standard 38 – safe working practices). Whincroft DS0000061077.V279205.R01.S.doc Version 5.1 Page 15 The home had various aids and adaptations to promote mobility and independence. These included chair raisers, handrails and grab rails, bath hoists and raised toilet seats, sling hoist and stand aid, turntable, slide sheets and pressure relieving equipment. The only means of inside access to the downstairs units and upstairs bedrooms are by stairs. A stair ‘walker’ was provided. One person, a wheelchair user, was unable to use her en-suite shower and commented that she did not like having to go outside and round the home to access the main house for a bath, especially in bad weather. Two people on the first floor were not ambulant. The manager should consider the mobility of people who occupy upstairs rooms. The registered persons said they were planning to install a passenger lift to all floors. Information about bedroom sizes was contained in the service users guide. As a ‘pre-existing’ care home, some rooms were small, but the occupants said they were suited to their needs. Residents said they liked their bedrooms, which they had personalised with their own belongings. Every room had a door lock and was appropriately and nicely furnished and decorated. Each person had either a lockable piece of furniture, or a ‘cash box’ to keep medication (if they self-medicated) or valuables safely and securely. The manager said she was improving locked facilities as new furniture is purchased. One bedroom had a noticeable odour. The cause should be investigated and eradicated. To ensure the safety of residents, the registered persons had provided twentyone radiator guards. There were thirteen left to guard, which had been assessed as lower risk. Whincroft DS0000061077.V279205.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 and 29 A competent, well-qualified staff team provided good care and attention. Robust recruitment procedures and good record keeping helped to ensure the protection of residents. EVIDENCE: Everyone spoken to said they liked the staff. Staff were described as “kind” and “patient” and thought to have “good attitudes”. Staff numbers had been increased in the mornings, to ensure that time was available to meet the fluctuating needs of residents and to provide residents with choice and flexibility in routines. NVQ training was positively promoted: 87 of the care staff had achieved level 2. Five staff had level 3. This exceeded the standard and ensured staff had the basic underpinning knowledge and skills necessary to meet the general needs of older people. All the staff files had been updated and thorough recruitment procedures were followed. Whincroft DS0000061077.V279205.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34, 36 and 38 A qualified manager and management team provided appropriate leadership and staff supervision, and ensured that the home was run in residents’ best interests. The registered persons need to ensure that the quality of care is properly monitored according to legislative requirements. Improvements could be made to health and safety to fully protect residents and staff. EVIDENCE: The registered manager was qualified and experienced. Residents said that they liked the manager. One person said the registered persons were “exceptionally kind- they bend over backwards to give extras”. The manager made herself available to listen to residents and to supervise the care practice of staff. A senior staff team, who were qualified and experienced, supported the manager. The manager updated her knowledge and skills by attending courses and gaining local knowledge of services and facilities. Whincroft DS0000061077.V279205.R01.S.doc Version 5.1 Page 18 Various strategies were used to communicate with residents and other stakeholders and review the quality of care. These included regular meetings with residents and staff, one-to-one discussion, care plan meetings and customer satisfaction questionnaires. The home used their ‘Investors in People’ award to underpin the quality of training. The manager could not evidence how such strategies were used to forward plan and to improve service delivery, so the registered persons need to prepare a report of the review of the quality of care, showing how improvements have been and are to be made (as recommended at the last inspection). A copy of the report should be made available to residents and to the Commission. Insurances were up to date and the registered persons had plans for upgrading the premises to better meet the needs of residents (such as adding a conservatory, extending, altering a bathroom and providing a passenger lift). However, a business and financial plan to evidence plans for future improvements, current accounting and business management, training budgets etc. and to ensure the home was financially viable was not available for inspection. Good systems of staff supervision helped to ensure that residents received appropriate care and attention in accordance with the home’s aims and objectives. Generally, health and safety arrangements were good, with staff having attended moving and handling, first aid and basic food hygiene training and with fire safety training being completed during induction. Safety checks on fire extinguishers were up to date and fire risk assessments had been carried out. A fire drill, (which if practicable, includes service users) was due. Fire procedures and staff training should include the advice to be given to visitors and how to move non-ambulant persons and those who may require assistance in an emergency. To minimise the risk of infection, liquid soap should be used in preference to bar soap in communal bathrooms. Towels should always be provided in communal bathrooms, so that users may dry their hands properly. Staff should not handle foodstuffs, such as biscuits and side plates should be provided when setting tables, to prevent bread being put on tables. Whincroft DS0000061077.V279205.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 X 3 2 2 3 3 2 2 STAFFING Standard No Score 27 X 28 4 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 2 X 3 X 2 Whincroft DS0000061077.V279205.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15(1) 12(a) 13(1)(b) Requirement Timescale for action 28/02/06 2 OP18 13(6) 3 4 OP18 OP33 13(6) 24(1)(2) Care plans must identify all aspects of health; personal; psychological and social care needs for each person and detail the action to be taken to ensure that all these needs are met (see Recommendations Nos. 2 and 7). The protection of vulnerable 28/02/06 adults procedures must include clear details of the action to be taken on suspicion or allegations of abuse. Staff must be made aware of this procedure. (Previous timescale of 9/9/05 not met). Staff must be trained in all 30/04/06 aspects of protection issues. The registered persons must look 31/03/06 at how their Quality Assurance system reviews and improves the quality care at Whincroft. They must supply a copy of the home’s quality of care review and improvement report to the Commission and make the report available to service users. (Previous timescales of 10/6/05 and 31/10/05 not met) DS0000061077.V279205.R01.S.doc Version 5.1 Whincroft Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP8 OP8 Good Practice Recommendations The continence problems for one service user should be identified and appropriate action and advice taken (8.6). The special needs of one service user for psychological health (8.7), physical activity (8.8) and for specialist assessment of health to determine present and future plans for care (8.11) should be undertaken. The registered person should obtain the National Health Service Framework for older people, to provide information to service users about their entitlements to best practice (8.13). This recommendation carried forward from the last inspection: Criteria for the administration of when required and variable dose medication should be clearly defined and recorded for all service users prescribed such items. Controlled Drugs should be stored in a Controlled Drug cabinet compliant with the Misuse of Drugs (Safe Custody) Regulations 1973. There should be a formal system of verifying a service users medication on admission. There should be a formal system for the prompting of medication reviews in line with the recommendations in the National Service Framework for Older People. All external preparations and creams should be kept securely and creams should not be shared (9.4) Staff should follow instruction regarding knocking on bedroom doors and awaiting a reply before entering, unless care plans indicate a different approach (10.1) The home should provide opportunities for regular recreational and leisure activities, with particular consideration to people with special needs, such as those with a cognitive or sensory impairment or who are in their bedrooms for prolonged periods (12.3) This recommendation carried forward from the last inspection: The suitability and location of the ground floor bathroom to the front of the home should be included DS0000061077.V279205.R01.S.doc Version 5.1 Page 22 3 OP8 4 OP9 5 6 7 OP9 OP10 OP12 8 OP21 Whincroft 9 OP22 10 OP25 11 12 13 OP26 OP34 OP38 14 15 OP38 OP38 within the registered providers long-term development plans. The registered persons should assess the abilities of residents using the upstairs bedrooms to access communal rooms (independently if possible). The planned provision of a passenger lift should be included in the business and development plan (22.1 and 22.2). This recommendation carried forward from the last inspection: The providers should continue the work to ensure that all radiators are fitted with appropriate covers (25.5). Attention should be given to the strong odour in bedroom No.2 (26.1) The registered persons should make an annually reviewed business and financial plan available for inspection (34.5) Bathrooms should be kept free of hazards and clutter (such as ladders) (38.1) and should always have towels. Liquid dispenser soap should be used in preference to bar soap in communal bathrooms (38.2). Staff should not handle food unnecessarily (such as when serving biscuits) and side plates should be provided, to prevent bread being put on the table at mealtimes (38.2) A fire drill, which if practicable includes everyone at the home, should be carried out in the near future. Staff instruction and training should include the advice to be given to visitors and how to move non-ambulant persons and those who may require assistance in an emergency (38.2). Whincroft DS0000061077.V279205.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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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