Inspection on 29/09/05 for Alton House

This inspection was carried out on 29th September 2005.

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

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

Other inspections for this house

Alton House 09/06/08

Alton House 05/11/07

Alton House 15/05/07

Alton House 23/11/06

Alton House 09/01/06

Alton House 26/01/05

Alton House 15/07/04

Alton House 01/03/04

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

CARE HOMES FOR OLDER PEOPLE Alton House 22 Sunrise Avenue Hornchurch Essex RM12 4YS Lead Inspector Joanna Moore Unannounced Inspection 29 September 2005 09:30 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 Alton House DS0000027828.V256309.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. Alton House DS0000027828.V256309.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Alton House Address 22 Sunrise Avenue Hornchurch Essex RM12 4YS 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) 01708 451547 Mr Frank Barrs Mrs Patricia Lilian Barrs Mrs Patricia Lilian Barrs Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Alton House DS0000027828.V256309.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Alton House be registered to accommodate 19 older people of either sex, with the registration category of Old Age, not falling within any other category. 26th January 2005 Date of last inspection Brief Description of the Service: Alton House is a privately owned care home providing care and support to 16 older people. The home is owned by Mr and Mrs Barrs and is currently managed by Mrs Barrs. The home is situated in a quiet residential area of Hornchurch with access to local shops and transport links. The home is traditionally styled and in keeping with other properties in the area. It offers a warm, welcoming environment. Alton House DS0000027828.V256309.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the annual inspection program. The inspection took place between the hours of 9.30am and 4.30pm. As part of the inspection the inspector spent time chatting with three service users and two visitors. What the service does well: What has improved since the last inspection? The frequency of staff meetings and fire drills has improved since the last inspection but the inspector was disappointed to see that the majority of requirements and recommendations from the previous inspection remain outstanding. Alton House DS0000027828.V256309.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Alton House DS0000027828.V256309.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 Alton House DS0000027828.V256309.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): An effective admission procedure was not always put into practice, which resulted in one service user residing at the home with complete lack of clarity as to their status within the home. EVIDENCE: The statement of Purpose referred to the inspecting agency as the NCSC and therefore required updating to reflect regulatory changes. Two service users files were viewed to monitor the admission process. One service user had received assessments and the home was in possession of the central care management assessment from which they were able in partnerships to draw up an initial care plan. The second service user had however no evidence of any assessment taking place prior to admission and there was total lack of clarity as to what the future plan was. This service user had been admitted on a respite basis, which was at the time of inspection in its 7th week. The home had not been informed how long the service user would be at the home prior to admission and believed that the placement may turn into a long-term placement. No initial placement review had been held to understand whether it as an appropriate setting for the service user or to Alton House DS0000027828.V256309.R01.S.doc Version 5.0 Page 9 clarify future plans. It was not possible formally to evidence that the home was or was not able to meet this service users needs ion the absence of a preadmission assessment. No contract of service was available for either service user. Service users are offered the opportunity to visit the home prior to admission but in most cases visits are carried out on behalf of the service user by their family. Service users are offered a trial stay before their placement is formalised. A relative said that when it came to the time that their mother required residential care that they immediately considered Alton house. Alton house had been recommended to them by a friend and they had previously had experience of the home through visiting the friends’ parent. Alton House DS0000027828.V256309.R01.S.doc Version 5.0 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. Service users needs are in the main outlined in a plan of care and appropriate support is in place to address their needs however the home needs to ensure that all specialist needs are identified and systems put into place to ensure these needs are effectively met. Service users privacy and dignity is maintained. Service users are protected by safe systems of medication administration and recording. EVIDENCE: All residents are registered with their local GP. The chiropodist, district nurse community psychiatric nurse, dentist and optician are involved in the home and attend as required. The home is supported by the local NRSS nursing team who provide support to the home to prevent unnecessary hospital admissions and GP call outs within office hours. The home ahs a link nurse who visits every two weeks who reviews any medical concerns raised regarding residents and provides advice and training upon request. One service user case tracked is a diet controlled diabetic however there was no information outlining whether their blood sugar levels required monitoring and if so how often and whom would undertake this role. The registered person is required to liaise Alton House DS0000027828.V256309.R01.S.doc Version 5.0 Page 11 with the placing authority and doctor to understand fully whether blood sugar levels require monitoring, how often and who will undertake this task. Care plans which detailed the needs of service users were in place, reviewed regularly. For the new service user whose placement status was unclear an initial care plan had been developed from discussions with home and the initial information received. One-service users medications were checked as part of the case tracking, the others service user was not receiving any medication. A record of medications entering and leaving the home was held. Competency assessments on the administration of medication are undertaken by all staff involved in the administration of medication. Medication was dispensed from monitored dosage medication packs pre-filled by the chemist. Medication administration records recorded medications given as per prescription. The home had been visited by their community pharmacist on 21.6.05 to review their medication storage and administration with no requirements made. Controlled drugs storage was appropriate with controlled drugs being stored in a double locked cupboard and staff double signing when these are administered. Service users, and their relatives said that staff knock on doors before entering and treat them with respect and honour their dignity. Service users also said that staff are kind to residents with dementia. All consultations with medical staff take place in service users rooms and visitors are able to met in private in the resident’s room if the resident wishes it. Alton House DS0000027828.V256309.R01.S.doc Version 5.0 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): 12,13,15. Service users benefited from a varied and regular activity plan within the home however there were no opportunities offered for service users to go outside of the home. Service users were supported in keeping contact with family and friends. Service users benefited from plenty of varied wholesome and nutritious food. EVIDENCE: Daily activity sessions are run in the afternoon in the main lounge. Activities included film shows, music, quizzes, name game, quoits, I spy, cards, dominos, sing alongs, reminiscence. Manicure and hairdresser sessions take place in the small lounge. One visitor said that they came at least once a week and each time there was something going on in the main lounge. One service user commented that they would like to go out for walks. It is recommended that the home put in place arrangements fro the service user to go out with staff support if necessary at least every three days. Alton House DS0000027828.V256309.R01.S.doc Version 5.0 Page 13 The home was from documentation viewed, discussions with relatives, service users and the deputy manager able to evidence that visitors were made welcome at all times. Contact with family was maintained by making visitors welcome and assisting service users to make a phone call. Both visitors spoken to on the day said that staff were friendly to them and a welcoming atmosphere was around. One visitor was asked whether they had been offered a cup of tea and said that they had not. It is recommended that the home offer the service user and their guest a cup of tea. The home was from documentation viewed, discussions with relatives, service users and the cook able to evidence that adequate amounts and variety of wholesome food were provided throughout the day. Diabetic and vegetarian diets can be catered for. One service user said “ its not 5 star hotel standard but its fine and there’s plenty of it”. Alton House DS0000027828.V256309.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 17 Service users and their families feel able to complain to the home and have confidence that their concerns will be listened to and acted upon. The home does not have robust systems in place to protect service users from unsuitable people coming to work in the home or gaining employment elsewhere. EVIDENCE: The complaints book recorded five complaints received and appropriately managed. The complaints policy required updating to reflect the change of regulatory body in 2004 and then inserted into the service user guide. One relative interviewed (whose comments are dotted about through the report) said that the staff are lovely and due to their previous experience of the home and a friends recommendation said that they had made a positive choice for this to be the home for their parent. This relative said that they felt that their mum was safe when they left and was condiment should anything happen that the home would call them immediately and indeed had done so in the past. Whilst not formally aware of the complaints procedure this gentleman was aware that he could make a complaint to the home manager, deputy or to an outside body. The gentleman expressed confidence in the homes ability to deal with any issues of concern raised. Alton House DS0000027828.V256309.R01.S.doc Version 5.0 Page 15 The home has an adult protection policy and is clear of its duties to report issues of concern to the local adult protection co-ordinator. The proprietor/ manager was unaware of the role POVA, the processes of referral to POVA and the need to have a POVA first check carried out prior to recruiting new staff. The owner/ manager is required to familiarise themselves with POVA and associated procedures Alton House DS0000027828.V256309.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 & 26 Service users benefit from a home which is pleasant and well maintained. The décor and furnishings are appropriate to the needs of the service users. EVIDENCE: It is a generally well maintained and furnished home in a quiet rural area of Hornchurch. The shops are some distance away in central Hornchurch. Furniture provided was suitable for the client group. Each service user had their own bedroom most with either ensuite shower or bathrooms. All bedrooms viewed were decorated to a suitable standard and were furnished according to the users wishes. The home was clean and odour free. For proper infection control it is recommended that the cloth hand towel in the staff toilet be replaced by paper towel. The home was warm and well ventilated. At the previous three inspections the provision of a second assisted bathroom for the home has been recommended. At the three previous inspections it has also been recommended that an occupational therapy assessment of the home be carried out in order to ensure that appropriate adaptations are provided. The staff loo was not flushing properly. Alton House DS0000027828.V256309.R01.S.doc Version 5.0 Page 17 Alton House DS0000027828.V256309.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): Services users are supported by a regular and stable team of friendly and kind staff who are able to meet their needs. Most staff but not all have received training to guide competent practice. Service users are in the main protected by robust recruitment procedures however some staff have been taken on prior to receipt of all the required information which may place service users at risk. EVIDENCE: Staff were deployed in line with previously agreed staffing levels as follows: 7-9 am 2 Care staff and deputy manager 9am-3pm: 3 care staff and deputy/ manager 3pm- 7pm: 2 care staff 7pm- 11pm: 2 care staff 11pm-7am: 2 waking night staff. The staff duty rota did not accurately reflect the actual staff on premises on the day of inspection due to staff sickness and rota changes. It is required that an accurate record of the time people worked in the home is held. The staff rota must clearly designate staff roles and where these change e.g. cook does a care shift this must clearly be recorded as care hours. Service user ‘a’ said “ its a very nice place the staff are mostly lovely and sweet the others ok, there’s no bad ones. They make sure I get my beers every day. They are very kind” Alton House DS0000027828.V256309.R01.S.doc Version 5.0 Page 19 Service user ‘b’ said the staff are all lovely girls, they come in and chat with me when I am in my room. when they have time,. It’s a nice place and although I miss my home I am well looked after and I feel safe” Both visitors said that the staff were very friendly and made them feel welcome when they come. One visitor commented “all the staff have a good sense of humour and I never see a sour face.” The deputy manager provided the inspector with a list of staff employed and the training they had undertaken. A variety of staff training has been provided including health and safety, dementia awareness, fire training, nutrition, adult protection, diabetes, medication, food hygiene, first aid, moving and handling, continence promotion. The training record provided however indicates that not all staff have attended basic mandatory courses which are relevant to their role for example 6/14 have attended health and safety, 9/13, first aid, 9/13 manual handling, 8/13 dementia awareness, 10/14 fire training, 11/13 adult protection. The registered person is required to ensure that all staff attend these basic training sessions. The training record provided does not specify dates that training took place and this limits the usefulness of the training monitoring as will not identify when time limited courses such as first aid have expired and will therefore fail to prompt people to update training. It is recommended that dates be added to the training monitoring record. The deputy manager is according to the training information provided undertaking the registered managers award and is an approved NVQ assessor. Four care staff are undertaking NVQ in care. In order to meet the national minimum standards more staff must undertake this training. Three staff files were selected at random to case track. Recruitment practices were in the main safe however there was no evidence of a CRB check or POVA first check having been carried out for two of these staff prior to starting work in the home. A CRB check had been applied for but not yet received for one staff at the time of the inspection. The homeowner showed the inspector guidelines agreed by the Commission which state that an employee may start work prior to the receipt of a CRB check however this document also clearly states the conditions under which this can occur which include a POVA first check to be carried out and the staff to be supervised formally on a weekly basis. These things had not occurred. The home is required to evidence that a valid CRB check / POVA first check is in place for all staff prior to commencing employment. The registered person must ensure that a current photograph is in place on all staff files Alton House DS0000027828.V256309.R01.S.doc Version 5.0 Page 20 Two staff files evidenced an induction process the third file did not. The registered person is required to ensure all staff receive a comprehensive induction. Alton House DS0000027828.V256309.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,35,36,37 & 38 The home fails to adequately support staff by regular formal supervision. The building whilst well maintained and having established its safety thorough statutory checks as essentially safe presents a significant number of hazards to both service users and staff which need addressing. EVIDENCE: The manager and owner Mrs Patricia Barrs has been managing the home for many years. Mrs Barrs has no management training. It is recommended that Mrs Barrs in order to meet the National Minimum standards undertake training in management. Mrs Barrs advised the inspector that it is her intention to retire as manager within the next six months and that she will be putting Alton House DS0000027828.V256309.R01.S.doc Version 5.0 Page 22 forward the deputy to registered to manager the home. The deputy holds the city and guilds advanced management in care and is studying for the NVQ level 4 registered managers award. The deputy has worked at the home in a senior position for many years and is well known to service users, staff and families. One-service users finances were viewed as part of the inspection the second service user case tracked managed their own finances independently. A petty cash fund was held for the service user and records were held of all expenditure and receipts to support the expenditure were held. The actual cash held tallied with the records. Staff meetings were held regularly in line with the national minimum standards. The regularity of individual one to one supervision sessions varied from staff to staff. One staff recruited in March 2005 had received only one supervision session since starting work at the home. A second staff had three supervisions sessions in the past seven months, the third staff had four in the previous twelve months. It is strongly recommended that staff receive individual supervisions sessions at least six times per year. Newly employed staff in line with best practice should receive supervisions more regularly and where employed subject to a CRB check should receive weekly supervision. All three staff files evidenced an appraisal carried out within the previous twelve months. Statutory records were viewed including fire records, menus, care records, staff recruitment records, medication records, accident and complaints records. The register of admissions to the home failed to detail the most recent admission. Staff recruitment records as detailed in standard 29 must include all information detailed in the regulations. The accident record failed on each occasion to give sufficient detail e.g. used only a first name or an initial followed by the surname and failed to always state the follow up action or outcome e.g. taken to hospital fractured femur diagnosed. The registered person is required to ensure clear and accurate recording of accidents. Systems and records were in place to evidence regular checking and maintenance of fire prevention systems. The records of fire drill indicate that these were held in December, March and June with the next one planned for the week following the inspection. Fire equipment was last service on 22.8.05. Valid Gas (16.3.05) and electrical safety certificates (26.2.03) were in place. No fire risk assessment was available, the registered person is required to have a fire risk assessment in place. The garden area presented a umber of risks to service users including an unfenced an open pond, pathway/ level around the pond drops vertically and significantly without a proper step, broken bricks and debris have been left around. The registered person is required to carry out a full and proper risk assessment identifying all the risks Alton House DS0000027828.V256309.R01.S.doc Version 5.0 Page 23 and then to address them to protect residents from harm. The passenger lift is serviced quarterly. Portable appliances were last checked in October 2004. The Environmental Health officer visited on 15.9.05 and reported that the kitchen surfaces require renewal. Chemicals were in the main stored in a locked area however it was noted that the cleaning materials were stored in an unlocked first floor cupboard. The registered person is required to ensure all hazardous chemicals are stored in a locked area. The visibility tape situated in the corridor areas required replacement. The freezer contained non-date labelled seafood. The registered person is required to ensure that all food stored in the freezer are labelled with a frozen on date to aid safe food storage. Alton House DS0000027828.V256309.R01.S.doc Version 5.0 Page 24 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 2 1 2 2 2 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 3 2 2 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 2 2 1 Alton House DS0000027828.V256309.R01.S.doc Version 5.0 Page 25 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 OP1 Regulation 5 Requirement The registered person is required to update the statement of purpose and service users guide. Outstanding requirement from previous inspection, previous timescale given 1.03.03 The registered person is required to liaise with the placing authority and doctor to understand fully whether blood sugar levels require monitoring, how often and who will undertake this task. The complaints policy required updating to reflect the change of regulatory body in 2004. When this is completed it must then be placed in the service user guide. Outstanding requirement from previous inspection, previous timescale given 1.03.03 The staff rota must clearly designate staff roles and where these change e.g. cook covers a care shift this must clearly be recorded as care hours. The owner/ manager is required to familiarise themselves with DS0000027828.V256309.R01.S.doc Timescale for action 01/12/05 2 OP8 12 17/10/05 3 OP16 22 01/12/03 4 OP19 17 24/10/05 5 OP19 13 01/11/05 Alton House Version 5.0 Page 26 6 OP27 17 7 OP29 19 8 9 10 11 12 OP29 OP30 OP30 OP37 OP38 19 18 18 17 13 13 14 OP38 OP38 23 13 15 16 OP38 OP38 13 13 POVA and associated procedures It is required that an accurate record of the time people worked in the home is held. Outstanding requirement from previous inspection, previous timescale given 1.03.03 The home is required to evidence that a valid CRB check / POVA first check is in place for all staff prior to commencing employment. Outstanding requirement from previous inspection, previous timescale given 1.03.03 The registered person must ensure that a current photograph is in place on all staff files. The registered person is required to ensure all staff receives a comprehensive induction. The registered person is required to ensure that all staff attend these basic training sessions. The registered person is required to ensure clear and accurate recording of accidents. The registered person is required to ensure that all food stored in the freezer are labelled with a frozen on date to aid safe food storage. Kitchen surfaces require renewal. Hazardous chemicals to be stored in a locked area. Outstanding requirement from previous inspection, previous timescale given 1.03.03 The registered person is required to have a fire risk assessment in place. The registered person is required to carry out a full and proper risk assessment identifying all the risks in the garden and then address them to protect residents from harm. DS0000027828.V256309.R01.S.doc 24/10/05 24/10/05 01/11/05 01/12/05 01/12/05 17/10/05 17/10/05 01/01/06 17/10/05 01/11/05 01/11/05 Alton House Version 5.0 Page 27 17 OP38 13 The visibility tape situated in the corridor areas required replacement. Outstanding requirement from previous inspection, previous timescale given 1.03.03 01/11/05 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 OP12 Good Practice Recommendations It is recommended that the home put in place arrangements fro the service user to go out with staff support if necessary at least every three days. It is recommended that the home offer the service user and their guest a cup of tea. The proprietor should consider how long term plans for a second assisted bath can be achieved. Outstanding recommendation from previous inspection. It is recommended that an occupational therapy assessment of the home be carried out in order to ensure that appropriate adaptations are provided. Outstanding recommendation from previous inspection. It is recommended that dates be added to the training monitoring record. In order to meet the national minimum standards more staff must undertake NVQ training. It is recommended that Mrs Barrs in order to meet the National Minimum standards undertake training in management. Outstanding recommendation from previous inspection. It is strongly recommended that staff receive individual supervisions sessions at least six times per year. Newly employed staff in line with best practice should receive supervisions more regularly. Where employed post Pova first check but subject to a CRB check staff should receive weekly supervision. It is recommended that the proprietor undertake a review of all policies and procedures to ensure they accurately reflect practices within the home. Outstanding DS0000027828.V256309.R01.S.doc Version 5.0 Page 28 2 3 4 OP13 OP21 OP22 5 6 7 OP30 OP30 OP31 8 OP36 9 OP37 Alton House recommendation from previous inspection. Alton House DS0000027828.V256309.R01.S.doc Version 5.0 Page 29 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 Alton House DS0000027828.V256309.R01.S.doc Version 5.0 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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