Inspection on 08/01/08 for Acorn House

This inspection was carried out on 8th January 2008.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Acorn House 02/12/08

Acorn House 22/01/07

Acorn House 04/05/06

Acorn House 06/10/05

Acorn House 16/06/05

Acorn House 25/11/04

Acorn House 04/05/04

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

CARE HOMES FOR OLDER PEOPLE Acorn House 63 Hayes Lane Croydon Surrey CR8 5JR Lead Inspector Liz O`Reilly Key Unannounced Inspection 8th January 2008 10:30 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 Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 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. Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Acorn House Address 63 Hayes Lane Croydon Surrey CR8 5JR 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) 020 8660 3363 Medicrest Ltd Care Home 31 Category(ies) of Dementia - over 65 years of age (31) registration, with number of places Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd January 2007 Brief Description of the Service: Acorn House is a 31-bed home for older people who are living with dementia. It is linked to Acorn Lodge (a similar care home owned by the same company), and the two share a large rear garden. The home is situated in the pleasant rural area of Kenley, the only drawback being that it is some distance from the nearest public transport links. The home’s stated aims and objectives are to ‘provide a home from home’ a friendly atmosphere where staff are approachable and an open relationship is encouraged between people who use the service, staff and relatives. Fees for this service are from £400 to £416 per week. Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one regulation inspector on 8th January 2008. The inspector had the opportunity to speak with people who use the service, two visitors to the service, staff and the acting manager. Surveys were provided for people who use the service, staff and relatives. Nine surveys from people who use the service, three from relatives or friends and seven staff surveys were returned. We discussed the service with five people who use the service, one relative and three members of staff on the day of the visit. A number of people who use this service were unable to give verbal feedback on what they felt about the care they received. The inspector spent time in communal areas observing activities, the manner in which care was provided and communication between staff and individuals. The acting manager has completed an annual quality assurance assessment of the service for the CSCI. Information from all of the above sources and observations made during the visit to the service have been used to reach the judgements made in this report. This service provides Adequate quality outcomes for people who use the service. What the service does well: People who use this service told us “I like living here, they treat me very well”, “I never thought I would be somewhere like this, but if I can’t be at home I’d rather be here than anywhere else”, “this is a nice place” and “they look after me here”. The service offers a homely and comfortable environment where people can personalise their rooms. People told us, “I have a nice room” and “it’s quite comfortable here”. We observed good relationships between staff and people who use the service. Comments from people who use the service on the staff group were positive. They told us “they are pretty good here”, “they are very patient” and “the ladies who work here are very kind”. Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 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 Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The service understands the importance of having sufficient information when choosing a care home. No one moves into the home until a full needs assessment has been carried out. EVIDENCE: All of the people who use the service who returned surveys said they received enough information about the home to make a decision about moving in. A ‘welcome pack’ is provided for each person which includes information on what they can expect from the service. We found the information laid out in way which made the pack easy to use. We found that before anyone is admitted an assessment of their individual needs is carried out. This assessment is carried out by staff from social services and the home is provided with a copy of the assessment before a decision about the admission is made. Senior staff from the service will also Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 Page 9 visit the person before they move in. This makes sure that staff have information about the needs of the person before they move in and that the manager can make an assessment as to whether the service can meet these needs. Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use this service experience adequate quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Care plans could be more person centred. Information on how the needs and wishes of people who use the service will be met and their personal preferences are not consistently recorded. The health care needs of individuals are monitored and medication is well managed. EVIDENCE: We looked at the care plans for four people who use the service. We found care plans give, in some instances good information on the needs and preferences of individuals. However in one instance the assessments and information had not been fully completed and in a number of instances there was no information on how the needs and wishes of people would be met. Staff had taken time to get information on what people would like to do but had not followed this through with how they would be supporting people to achieve this. In one instance it was noted on the care plan that the individual Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 Page 11 should be provided with an advocate. We could see no information that action had been taken on this. Care plans could be more detailed and person centred. Evidence that care plans have been set up and reviewed in consultation with people who use the service and or their relatives or representatives needs to be in place. Consideration should be given to requesting and working with people who use the service to provide a life history which they would be willing to share with the staff for the care plan. Staff should also consider the inclusion of the strengths of individuals as well as their needs as part of the care planning. Risk assessments were in place covering a number of areas. Where it has been noted that individuals can become distressed or aggressive staff should include information on the care planning on possible triggers and actions which might help the person to be less anxious. We found the daily records kept by staff tended to focus on the physical aspects of the care provided. When making daily record entries staff should refer to the care plan. All of the people who use the service who completed surveys and who we spoke to felt they received the medical support they needed. We found medication was well managed. The records of medication coming into and going out of the home were in place. The records of medication given by staff were up to date and accurate. At the time of this visit none of the people who use the service were administering all of their own medication. Staff told us that arrangements were in place for regular visits from the chiropodist, optician and dentist. These appointments were recorded on individual files. People who use the service can keep their usual GP as long as they can visit the home. Alternately people can register with a local GP practice who visit the home. District and community psychiatric nurses visit when needed. A district nurse was visiting one person on a regular basis. We observed staff supporting people in a way which respected their privacy and dignity throughout this visit. However we did observe on instance when an individual started talking about a subject of a mildly sexual nature they were asked by a member of staff to stop. Care needs to be taken to make sure that staff understand the right and in some cases the needs of people who use the service to talk about issues that concern them. Consideration should be given to providing training on sexuality. Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use this service experience adequate quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People using the service are given the opportunity to take part in a variety of activities both within the home and in the community. The inclusion of a full social care plan for each person would allow for a more individualised activities programme. People who use the service are generally satisfied with the food provided. EVIDENCE: People who use the service told us they enjoyed the regular trips which had recently included a pantomime in Croydon, a trip to Brighton and a war memorial museum. On the day of this visit a number of people were going to see a play. Staff have produced a timetable of in house activities. These included ballgames, a quiz, skittles and dancing. A Reflexologist visits the home every two weeks. When asked about the activities within the home individuals were less enthusiastic. In surveys, when asked if there were activities which they could Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 Page 13 take part in, five people said ‘usually’, four said, ‘sometimes’ and one person said ‘never’. One person we spoke to told us “ I don’t like joining in games”, another person told us “I would like to do something useful, I’m used to being busy”. One visitor felt that the activities were one area which could be improved. We observed a number of people taking part in a ball game and others enjoying listening to music. However we also observed a number of people sitting with little to occupy them. Consideration should be given to providing more interactive items into lounges to provide more stimulation and choice. Consideration should also be given to providing key staff with training on engaging people with dementia in meaningful daily living activities. Visitors to the service told us that they were made to feel welcome by staff. We were told ‘the staff are always friendly when we arrive and bring us tea or coffee with biscuits’. Another visitor said “staff always make us feel welcome. We observed visitors being provided with a tray of tea and biscuits during out visit. One visitor appreciated the fact that they were encouraged to bring their dog to the home as their friend particularly enjoyed this contact. Feedback through the surveys was mostly positive about the food provided. Five people said they ‘always’ liked the meals and four said the ‘usually’ liked the food. People we spoke to were all positive about the food. Comments included “they are very good cooks here”, “I did enjoy my dinner”, “I really like the pudding”. We observed individuals eating well and staff were supporting people to eat in a sensitive manner. The service produces a menu with alternatives available at each meal time. Staff keep a record of food eaten for each person using the service which makes sure that each person is offered a balanced, varied diet. Further work could be done to make meal times a more social event. Although staff were helping people with their meal in a sensitive manner there was no conversation during the meal. Staff should be provided with more guidance on communication. We noted that no salt or pepper was provided on the dining tables and bibs were put on individuals without any choice being offered. Consideration should be given to providing alternatives to bibs, the provision of condiments on the table, the opportunity for people to serve themselves for at least part of the meal and all staff joining people who use the service in the meal. Discussions with staff showed that they are aware of the rights of individuals to make choices and have control over their lives. This could be more clearly documented and evidenced in care plans. Care must be taken to ensure that the use of stair gates in the home are for the safety of people who use the service and not as a restriction on individual freedom of movement. People who use the service can take part in a Church of England religious service which is held in the home every two weeks. Visits from representatives of other religions can be arranged and we were informed by staff that Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 Page 14 arrangements would be made for individuals to attend local religious services if requested. Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure which is on display and provided to each person who uses the service. Improvements could be made in the recording of complaints or concerns. Staff are provided with training and have a good understanding of safeguarding people who use the service EVIDENCE: Seven people who use the service told us through the surveys that they knew who to speak to if they had any concerns. Two people said they usually knew who to speak to. All of the staff surveyed said they knew what to do if someone had concerns about the service. Staff we spoke to were well informed on what to do should someone complain. We saw the complaints procedure was on display in the entrance of the home. Systems are in place for complaints or concerns to be recorded. However we saw that no entries had been made on the record. Staff should make sure that any concerns are recorded along with actions taken and outcomes. This will show that staff listen to people who use the service or visitors and take action to put things right. We saw that some issues were brought up at meetings Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 Page 16 with people who use the service but could not see any records of actions taken. All concerns raised need to be recorded. Staff are provided with training on safeguarding people who use the service. This ensures that they have an understanding of and can recognise abusive behaviour. It also ensures that staff are aware of their own responsibilities to report any allegation or suspicion of abuse. Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22 & 26 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use the service are provided with a comfortable environment. The home is well maintained, clean and fresh. EVIDENCE: People who use the service told us that the home was usually fresh and clean. On the day of this visit we found the home to be clean and free from odour. Visitors told us that they “never have any concerns about the cleanliness” of the home. Acorn House is not a purpose built or new building but does provide a comfortable and homely environment for people who use the service. Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 Page 18 Individuals we spoke to were happy with their bedroom. We saw that people had brought to the home their own belongings including in some instances items of furniture, photographs and ornaments. These additions give rooms a personalised appearance. Overall the use of different wallpapers and colours give the service a homely appearance. We were informed that plans are in place for the redecoration of bathrooms. The managers’ own assessment of the environment pointed out that improvements could be made to the garden are. This was also highlighted by a visitor to the service as one area which could be improved. An assessment of the building has been carried out to ensure that people who use the service are provided with the right equipment. The manager reported that the recommendations made at this assessment were being implemented. Confirmation that window restrictors have been fitted to all windows needs to be provided to the Commission. We noted that stair gates were being used. Staff must make sure that these are only used as a safety precaution and not as a means of restricting freedom of movement. We noted that one gate, when open, did not give a large amount of space to get through. Risk assessments in relation to the stair gates need to be in place. Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. There are consistently enough staff available to meet the needs of people using the service. Staff are provided with good opportunities for training. More in depth training on supporting people living with dementia would assist in improving outcomes for people who use the service. The staff recruitment process assists in safeguarding people who use the service. EVIDENCE: People who use the service made positive comments about the staff and their approach. These included “these are very nice girls”, “they look after me very well” and “these ladies are very kind”. All of the people who use the service who completed surveys said staff listened to them and acted on what they said. Seven out of nine said there were always staff around when they were needed. Two people said staff were usually around. We observed staff supporting people in a considerate and careful manner. Staff were seen to be discreet in offering assistance. Relatives and friends told us, “we have always found staff to be helpful and friendly” and “Staff were particularly helpful when mother first moved here. They helped to make it much easier”. Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 Page 20 One person who uses the service and one visitor to the home raised occasional problems in communication with some staff who’s first language is not English. One member of staff declined to speak with the inspector stating “I cannot speak English”. In discussion with other staff we found no problems in understanding staff. However action must be taken to ensure that all staff have a sufficient understanding of English to converse with people who use the service and visitors to the home. We are aware that some staff may find talking with an inspector a daunting prospect . The senior management should take time to inform staff of the purpose of inspection and the manner in which we inspect. In future we will expect all staff to be prepared to talk to an inspector if requested. We found staff were offered good opportunities for training. Recent training had included; fire safety, dementia care, health and safety and safeguarding vulnerable adults. In order to meet the needs of people using the service staff must be provided with on going, more in depth training on supporting people living with dementia. We looked at a random sample of four staff files. We found checks had been carried out on individuals before they started work in the home. These including Criminal Records Bureau checks and at least two references. These checks assist in ensuring the safety of people who use the service. In future a full employment history with explanations for any gaps in employment must be sought and recorded for all staff. Where staff have previously worked in a caring role with vulnerable adults or children written confirmation from their previous employer as to why they left must be sought. A recent photograph of each member of staff must also be on file. These additional checks will assist in further safeguarding people. Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People who use this service experience adequate quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The registered managers post is vacant at present but action has been taken to recruit a new manager. People who use the service are consulted about the service they receive through an annual survey and regular meetings. Records are generally up to date but those in relation to water temperatures needs to be improved. Staff are checking food storage temperatures but are not taking action when needed. EVIDENCE: The registered manager for this service left approximately two months before this inspection. An acting manager has been appointed. The acting manager is in the process of completing NVQ level four and has three years experience Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 Page 22 of working in this service. We were informed that recruitment for the permanent manager post had been started. The acting manager is supported by the registered manager from Acorn Lodge which is on the same site. On the day of this visit the manager from Acorn Lodge was in the home providing support and advice to the acting manager. Staff told us they met regularly with the acting manager and felt well supported in their role. People who use the service are consulted on how the service is run through regular meetings. A record of these meetings is kept. We saw that the records showed instances where individuals raised concerns but there was no record of any actions taken. In order to show that actions are taken the records need to show actions and outcomes. Any issues raised at the previous meeting need to be commented on at the next meeting so that individuals are kept informed. Visitors told us they appreciated receiving a quarterly newsletter and attending relatives meetings with the manager and home owner. The organisation also has a quality assurance system in place which ensure that the views of people who use the service and or their representatives are taken into account in the day to day running and planning for the home. We were informed by the acting manager that they were not holding any money for people who use the service. We looked at a sample of health and safety checks carried out by staff. Weekly checks on the fire alarm system were up to date. Checks on the temperature of hot water were carried out on a regular basis. However staff are not checking and recording the temperature of the water before assisting individuals into the bath. In order to safeguard people who use the service from scalds or water which is too cold this must be done. We found staff were checking the temperature of fridge and freezers. However one fridge had been regularly recording a high temperature. Following this visit a new thermometer was installed and the acting manager informed us that the fridge was now showing a safe temperature. In order to ensure the safe storage of food staff must be informed of the safe temperature for fridges and must record that action has been taken should temperatures be over the recommended safe limits. Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X 2 X X x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X N/A X X 2 Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 Page 24 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 OP7 Regulation 15 Requirement In order to make sure that the needs of individuals are met care plans must include:• How assessed needs will be met. • What actions have been taken to meet needs. • Evidence of consultation with people who use the service and or their representatives. • Information on possible triggers for aggressive behaviour. Timescale for action 01/05/08 2. OP16 22 3. OP19 13(4) In order to make sure that any 01/05/08 complaint or concern is acknowledged and addressed a record of any complaint or concern must be kept along with actions taken and outcomes. In order to ensure the health and 01/05/08 safety of people who use the service and ensure that their right to freedom of movement is protected a risk assessment on the use of stair gates must be completed. DS0000048016.V350665.R01.S.doc Version 5.2 Page 25 Acorn House 4. OP29 19 Schedule 2 5. OP30 18(c) 6. OP38 13(4) To ensure that people who use 01/05/08 the service are protected the recruitment procedure must be reviewed to include; • A full employment history with explanations for any gaps in employment. • Staff to sign a statement indicating their physical and mental fitness to carry out their role. To make sure that staff continue 01/05/08 to have the skills and knowledge to meet the needs of people who use the service on going training in dementia care must be provided. In order to ensure the health and 10/04/08 safety of people who use the service staff must be provided with information on the safe storage temperatures for food. A record of actions taken should these temperatures be exceeded must be in place. Staff must take and record the temperature of the water before assisting anyone into a bath or shower. 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. 3. Refer to Standard OP10 OP12 OP12 Good Practice Recommendations Consideration should be given to staff being provided with training on sexuality. Staff should be provided with training on engaging people with dementia in meaningful daily living activities. Consideration should be given to providing more DS0000048016.V350665.R01.S.doc Version 5.2 Page 26 Acorn House 4. OP15 5. OP30 interactive items in the lounge areas for people to engage with. A review of mealtimes should be carried out to include the use of bibs, more opportunities for people to help themselves, access to condiments, staff joining with people who use the service in a meal and generally to assist in making mealtimes more of a social event for all those involved. Consideration should be given to providing English lessons for those staff who are less confident in speaking or writing English. Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Acorn House DS0000048016.V350665.R01.S.doc Version 5.2 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. 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!