Inspection on 08/11/05 for Alandale

This inspection was carried out on 8th November 2005.

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

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

Other inspections for this house

Alandale 10/04/07

Alandale 24/05/05

Alandale 11/01/05

Alandale 03/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Alandale Alandale 9 The Drove Whitfield Dover Kent CT16 3JB Lead Inspector Michele Etherton Announced Inspection 8th November 2005 10:00 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 Alandale DS0000023343.V254494.R01.S.doc Version 5.0 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. Alandale DS0000023343.V254494.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Alandale Address Alandale 9 The Drove Whitfield Dover Kent CT16 3JB 01304 824904 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) ALANDALERESIDENTIALHOME@NTLWORLD.COM Mr Paul Maple Mr Paul Charles Maple Mr Paul Maple Care Home 29 Category(ies) of Learning disability (1), Old age, not falling registration, with number within any other category (28) of places Alandale DS0000023343.V254494.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residential care for people with a learning disability is restricted to 1 person whose d.o.b is 20.10.1940. 24th May 2005 Date of last inspection Brief Description of the Service: Alandale, is a large extended detached property. Currently Registered to provide accommodation for twenty-nine Older people, the Home offers a pleasant and spacious environment to live in. Located in a semi-rural setting on the outskirts of the village of Whitfield, the Home is within 5minutes walk of the local pub and 10 minutes walk to the shops in the village, limited parking is provided outside the Home, although street parking is available on the main road. Access to rail transport, is some distance away, a bus service is available in the village. There are 25 single rooms, and 2 double rooms situated over two floors, access to all areas of the Home is provided by the use of a stair lift. Each bedroom has a private wash-hand basin and call bell, a cordless telephone is available to service users to make and receive calls in private. The owner/manager takes an active role in the day-today running of the Home, and employs a ‘care’ manager. In addition to care staff, the home employs ancillary staff, to provide cooking, cleaning, and maintenance duties. The Home has a range of communal areas available to its residents including a smokers’ lounge, dining area, and a choice of several large and small lounge areas, the Home also benefits from the addition of a conservatory. The Home has an enclosed well-maintained garden laid to lawn with a raised pond located to the rear of the Home Alandale DS0000023343.V254494.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection. The inspection was undertaken between 9.40 a.m. and 5.20 p.m. During which the remaining key standards were inspected and progress made by the home towards achieving outstanding requirements and recommendations assessed. The previous inspection had highlighted two requirements for action to be taken in respect of the content of staff files and improvements to staff training and health & safety measures, a number of recommendations for improved practice were also issued on that occasion. The inspector was satisfied from the findings of this inspection that the outstanding requirements and the majority of the recommendations were addressed satisfactorily. During this visit the inspector toured the premises, and spoke privately with four care staff who spoke positively about the support provided to them individually and as a team from the present owner manager and the deputy manager. The inspector also spoke at length with the deputy manager and the providers. Whilst the majority of service users were seen and acknowledged during this visit ten service users were spoken with in more depth, three in the company of their relatives. The inspector spent time in the communal areas speaking with service users and their relatives, other users were seen separately some in their bedrooms some in the communal areas. The communal areas were lively, with a buzz of conversation, service users were chatty and appeared settled in the home. The inspector viewed a reduced range of documentation that included three care plans, staff personnel and training files, a staff rota, medication administration sheets, complaints information, accident records, the fire book, and finance records relating to service users. Comment cards were received from 8 relatives, 2 service users, and 7 health professionals, and their feedback has contributed to the compilation of this report. One complaint that had been referred to the adult protection team has been satisfactorily resolved, the home were not required to take any additional actions as a result of the investigation and this is now closed. This inspection produced one new requirement relating to infection control procedures, and additional recommendations for improvements to practice have been made. What the service does well: Alandale DS0000023343.V254494.R01.S.doc Version 5.0 Page 6 Feedback from service users and relatives indicates that the home offers a comfortable, clean and homely environment. The accommodation is seen as being of a high standard and well maintained. Staff’ are seen as friendly, and understand the needs of the service users, this is supported by health professionals who spoke positively about the home and the support provided by staff. 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. Alandale DS0000023343.V254494.R01.S.doc Version 5.0 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 Alandale DS0000023343.V254494.R01.S.doc Version 5.0 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): 1,3, Prospective service users are provided with updated information about the home and the services provided. Service users benefit from assessment of their needs by home staff prior to admission to the home, to ensure their needs can be met. EVIDENCE: The Home has addressed an outstanding recommendation to improve the detail within the Statement of Purpose and service user guide in respect of environment standards met by the home. Two new service users admitted to the home within the past month were spoken with during inspection. Both confirmed they had received information about the home and that an assessment of their needs had been undertaken, prior to their admission. The Home has addressed and outstanding recommendation in respect of assessment. Alandale DS0000023343.V254494.R01.S.doc Version 5.0 Page 9 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): 7,9,10 Care plans are in place for each service user, these would benefit from improved detail. The home is still to fully address recommendations to improve their administration of medication. Service users are satisfied that they are supported appropriately by staff. EVIDENCE: The home has made progress in ensuring that service users and their representatives are being consulted about and agreeing to the content of care plans, but need to ensure this is applied routinely and that all current service users care plans are consulted upon, and this remains an outstanding recommendation. Three care plans were viewed at inspection these accurately reflected current needs, however, the inspector recommended that care plans should indicate clearly for those service users with serious medical conditions, what support and ongoing treatment is in place, including regular outpatient appointments. Whilst discussion with staff during the inspection indicated a common understanding of what a standard personal hygiene routine should consist of for each service user, staff recognised that not all staff members followed the Alandale DS0000023343.V254494.R01.S.doc Version 5.0 Page 10 same routine and also terminology used to record personal hygiene often omitted activities such as shaving, teeth and nail cleansing etc. The inspector has recommended a standardisation of terminology used in daily logs and a common standard established within the home for personal hygiene routines. A previous recommendation in respect of behaviour management guidelines (see standard 18) is still to be addressed, and risk assessments must be expanded to take account of behaviour guidelines. The medication standard was not inspected on this visit. Progress made by the home, however, in addressing previous recommendations for improvements to their administration of medication was reviewed. The home has taken action by contacting GP’s to try and reduce the number of ‘as directed by doctor’ medication dosage instructions issued, and this is ongoing. Photographs are still to be added to the MAR sheets that correspond to service user photographs on MDS cards. Discontinued medications are now being clearly marked as such on MAR sheets. Service users spoke positively about the attitudes of staff and the support they receive from them. Direct feedback from relatives during the inspection and responses received from relatives inspection comment cards, was also very positive and indicated a very high level of satisfaction overall for the service provided. Discussions with four care staff during the inspection indicated a good understanding of the needs and rights of users. Alandale DS0000023343.V254494.R01.S.doc Version 5.0 Page 11 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): 13,14 Service users benefit from a flexible visiting policy to support and maintain their contact with relatives, friends and representatives. The home encourages service users to manage their own affairs and to retain independence. EVIDENCE: The home operates a flexible visiting policy and relatives were noted entering and leaving the home throughout the day. The communal areas were full and the inspector noted a buzz of conversation amongst relatives and their visitors, many of whom choose to remain in the communal areas with their relative. The inspector spoke with three relatives during the inspection, they confirmed the frequency of their visits, and stated they were always made to feel welcome in the home, one relative stated that she enjoyed the homely environment, and felt this to be an important feature and added to the atmosphere of the home. Service users are encouraged to retain as much independence as they are able to in undertaking their own personal care. Those spoken with indicated that they made their own choices as to whether to participate or not in activities provided or in spending time alone or with other users. Two service users currently manage their own financial affairs, relatives or representatives manage the affairs of those who lack capacity to do so themselves. Service Alandale DS0000023343.V254494.R01.S.doc Version 5.0 Page 12 users are encouraged to bring in possessions, and records of these are maintained by the home. Alandale DS0000023343.V254494.R01.S.doc Version 5.0 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): 16,18 Service users’ benefit from a robust approach to the management of complaints. The needs of some service users may be compromised if the implementation of behaviour management guidelines are not formalised and consistently applied. EVIDENCE: No additional complaints have been received since the last inspection. Two previous complaints one of which was referred to the adult protection team have been closed. The inspector was satisfied that the home operates a robust approach to the management and investigation of complaints. Service users and relatives spoken with during the inspection found the providers and the deputy manager approachable and were confident they could raise concerns with them. The home has amended its ‘whistle-blowing’ policy, staff spoken with during inspection indicated that they found the providers approachable and felt listened to, they would have no difficulty in raising concerns if needed. A previous recommendation for the home to develop and implement behaviour management guidelines for some service users remains outstanding, this was discussed in more detail at this inspection and the home management team have agreed to develop and implement guidelines specifically in regard to one service user and these must be agreed by all interested parties and consistently applied by staff. Alandale DS0000023343.V254494.R01.S.doc Version 5.0 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): 19-26 Service users benefit from living in a comfortable, homely environment, that is maintained to a high standard of decoration and cleanliness. The health and safety of service users is promoted through an ongoing programme of guarding radiators, and improvements to cleaning routines for the management of commodes. EVIDENCE: Feedback from service users and relatives was very positive in respect of the homely atmosphere, the quality of the accommodation and the general standard of cleanliness maintained within the home. The home has a development plan, and has an ongoing maintenance programme for upgrading and maintaining the property, the home employs a maintenance person. Bedrooms viewed with service users permissions were pleasantly decorated to a good standard, and individualised with service users possessions, locking facilities are provided in all bedrooms. Service users benefit from access to a range of communal spaces including a dining room, large lounge, and conservatory, these are furnished to a good Alandale DS0000023343.V254494.R01.S.doc Version 5.0 Page 15 standard with the overall appearance being comfortable and domestic in style and character. The home retains a small smoking area for service users. A programme of installing radiator guards is well underway, and until completed remains an outstanding recommendation. Door guards have been fitted to bedroom doors enabling users in the rooms to leave their doors ajar, these are connected to the fire alarm system and will activate in the event of a fire. A pleasant accessible garden is located to the rear of the property accessed via the conservatory, weather permitting. The home is maintained to a high standard of cleanliness and decorative order, service users and their relatives spoke positively of this in discussions with the inspector. The home has introduced satisfactory arrangements for the emptying and cleansing of commodes in the home, but must ensure that cleaning schedules are routinely adhered to so as not to compromise infection control measures. The inspector was concerned that infection control within the home could be compromised by the current practice of staff wearing the same uniforms when undertaking a range of roles e.g. cook/carer, carer/laundry person. It is a requirement that the cook has a separate uniform to that for her care work, and that care staff wear aprons when sorting dirty/clean laundry, so as to avoid risks of cross infection. Alandale DS0000023343.V254494.R01.S.doc Version 5.0 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): 27,29 Service users are supported by a satisfactory number of trained staff, and are protected by improvements to the homes staff recruitment procedure. EVIDENCE: Feedback from service users and relatives through direct interviews and inspection comment cards, indicated overall satisfaction with staffing levels. Service users spoken with indicated that there were always staff around and they had no problems gaining their attention or found their responses to the call bells slow. One relative comment card highlighted some concerns that staff tend to take breaks together. This has been raised previously by the inspector as unacceptable, there was, however, no evidence on this occasion from service users or their relatives that this was still an issue and the home providers believe they have successfully addressed this issue with staff, and will continue to monitor for signs of recurrence of this practice. Feedback from staff spoken with at inspection confirmed their belief that staffing levels were currently adequate for the number and needs of the current user group, some staff indicated that they found their responsibilities in respect of the laundry impacted on their ability to spend quality time with service users, although this view was not shared by other staff and was not raised as a concern by users or relatives. The inspector did raise concerns in respect of infection control regarding these dual roles (see standard 26). Alandale DS0000023343.V254494.R01.S.doc Version 5.0 Page 17 Three staff files were assessed on this occasion, the home has made improvements to the content of staff files and has now met an outstanding requirement to do so. Some suggestions for improvements were made to the way in which the recruitment procedure is undertaken and these were fully discussed at inspection Alandale DS0000023343.V254494.R01.S.doc Version 5.0 Page 18 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): 33,35,36,38 The home is still to fully develop a quality assurance strategy and evidence systems for self-auditing. The financial interests of service users are safeguarded by the implementations of policies and procedures. Staff benefit from participation in planned supervision sessions. The home is developing systems to improve the health and safety of service users EVIDENCE: The home has a current development plan in place and is working through areas of service development. Discussion with staff indicated that full staff meetings are held at least once per year, shift leader meetings are held quarterly; staff confirmed they felt well informed, hearing of developments through the cascading of information from shift leaders or informally from the deputy manager or the providers. Staff felt they had a good relationship with the providers, felt listened too and able to influence service development. Service user questionnaires are issued annually with a newsletter, and the home undertakes analysis of feedback, however, service users are not given Alandale DS0000023343.V254494.R01.S.doc Version 5.0 Page 19 feedback regarding the outcome of this analysis, or how their views influence service development, the home is also still to engage more widely with all stakeholders to gain a view of their view of the service. Although the home are still to evidence strategies for self auditing of the service, these are all recommendations for improvements. The home encourages relatives and representatives to take responsibility for service users monies where they are unable to do so for themselves, currently it does not manage any monies, although it does hold small cash amounts for some service users for security purposes, but is not responsible for managing the expenditure of this. The home maintains a record of individual service users personal possessions. Valuables and small cash amounts handed over to the home for safekeeping are receipted and stored securely, satisfactory records of these items and cash are maintained by the home. Discussion with staff during the inspection confirmed that formal supervision sessions with staff are taking place, in keeping with expected frequencies. Staff spoke positively about having the opportunity for private time with their line manager, and stated that they were able to add items of their own to the agenda for discussion. Records of recent supervisions were reviewed at inspection and some suggestions for improvements to the recording and content of supervision sessions suggested. Although standard 38 was assessed fully at the last inspection, the inspector wished to assess progress made towards addressing an outstanding requirement and recommendation. All care staff have now completed their mandatory core skills training and new staff have commenced induction and some core skills training. The home has developed an induction and foundation training package with a training provider, but must ensure this training is undertaken in a meaningful and thorough manner so as to avoid becoming a cosmetic exercise. In view of the new changes to the induction standards for care staff as from September 2005, the home will need to review its own induction programme to ensure this is compliant, these are recommendations for improved practice. The home has installed door guards on a number of room doors and these are linked to the fire system, the fire risk assessment has been reviewed and forwarded to the fire service. A recent visit by the fire officer confirmed fire arrangements are satisfactory at the home. A fire training programme for staff has been introduced for all staff which will incorporate two fire drills annually, the inspector has suggested an improved method of recording staff who have received drills to ensure the home can reference this quickly. Frequencies of fire equipment testing recorded were overall in keeping with timescales expected, however, the inspector noted some slippage over the last two months; it is recommended that the home ensures fire equipment and alarm testing is routinely undertaken within the expected timescales. The home has Alandale DS0000023343.V254494.R01.S.doc Version 5.0 Page 20 addressed fully an outstanding requirement, and is making progress in the development of environmental risk assessments. The accident book was reviewed and highlighted that 20 accidents to service users have occurred since the last inspection in May 2005, as eight of these related to a service user no longer at the home, the overall accident figure was relatively low, the inspector was satisfied that where concerns exist regarding levels of falls in service users the home takes appropriate action to refer to health professionals for advice. The inspector noted some poor recording in the accident book, this was discussed at inspection and it was recommended that omissions in recording are addressed with the individuals concerned within supervision to ensure they fully understand the process and their responsibilities. Alandale DS0000023343.V254494.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME 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 3 8 x 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 2 2 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 2 x 3 3 x 3 Alandale DS0000023343.V254494.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP26 Regulation 13(3) Requirement The cook must have a separate uniform to that for her care work, all care staff to wear aprons when sorting dirty/clean laundry, so as to avoid risks of cross infection. Timescale for action 12/12/05 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 OP7 Good Practice Recommendations Home to continue to engage with service users and representatives and gain their endorsement of care plans. Care plans to indicate clearly details of treatment routines for those users experiencing serious medical conditions. Home to standardise terminology used in daily logs and a common standard established within the home for personal hygiene routines. Risk assessments to be expanded to take account of behavioural guidelines Home to continue with actions to reduce ‘As directed’ medication dosage instructions from GP’s. Photographs are still to be added to the MAR sheets that correspond to service user photographs on MDS cards. DS0000023343.V254494.R01.S.doc Version 5.0 Page 23 2 OP9 Alandale 3 OP18 Home to develop and implement behaviour management guidelines for some service these must be agreed by all interested parties and consistently applied by staff. Home to continue with programme of guarding radiators Feedback regarding the outcome of this analysis, or how their views influence service development, the home is also still to engage more widely with all stakeholders to gain a view of their view of the service. Although the home are still to evidence strategies for self auditing of the service, these are all recommendations for improvements. Home must ensure Induction training is undertaken in a meaningful and thorough manner, and within expected timescales. It should also be reviewed to establish its compliance with the recent changes to induction standards introduced in September 2005. The home to ensure fire equipment and alarm testing is routinely undertaken within the expected timescales Home to continue with development of environmental risk assessments. Poor recording on accident reports to be addressed with relevant individuals at supervision. 4 5 OP25 OP33 7 OP38 Alandale DS0000023343.V254494.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Alandale DS0000023343.V254494.R01.S.doc Version 5.0 Page 25 - 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!