Inspection on 09/06/05 for Ambleside Avenue, 15

This inspection was carried out on 9th June 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

Ambleside Avenue, 15 23/10/07

Ambleside Avenue, 15 04/05/06

Ambleside Avenue, 15 21/10/05

Ambleside Avenue, 15 15/12/04

Ambleside Avenue, 15 07/06/04

Ambleside Avenue, 15 26/02/04

Similar services:

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Norbury Crescent (30)

Edenvale

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Chatsworth Care - Dawson House

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Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 15 Ambleside Avenue 15 Ambleside Avenue Streatham London SW16 1QE Lead Inspector Rehema` Russell Unannounced 9th June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ambleside Avenue, 15 Address 15 Ambleside Avenue, Streatham London SW16 1QE Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8769 9723 020 8769 9723 ambleside@southsidepartnership.org.uk Southside Partnership Mark Wallis CRH Care Home 6 Category(ies) of PC Care home only registration, with number of places 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th December 2004 Brief Description of the Service: 15 Ambleside Avenue is a detached purpose built house that has been designed to provide support and accommodation for six service users who have learning/physical disabilities. It is managed by Southside Partnership, a voluntary organisation. The property is wheelchair accessible. Internally the corridors and entrances to rooms are wide and allow manoeuvrability for wheelchair users. There are six single occupancy bedrooms, all above minimum space standards. The ground floor has two bedrooms, a lounge, a large kitchen/diner, a bathroom with toilet, and a separate toilet. The first floor has four bedrooms, a bathroom with toilet, a separate toilet, the office, the laundry room and storage rooms. There is a lift, a garden to the front and side, and a ramp to the front door. The home is within easy walking distance of a large shopping area with full community facilities and bus and rail public transport. 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over a period of 6 hours on Friday 27th May 2005. The inspection included: a tour of the building; observations of residents; communication with one resident; speaking with support workers; speaking with the manager; and, looking at documentation. There had been a large change of personnel at the home since the previous inspection. The long-standing registered manager has moved to another establishment and there is a new manager who has been at the home for a few months only. Two residents had died during the Christmas period, two longstanding support workers have left the service with a third one retiring soon after this inspection. This had been particularly unsettling for one resident but the home had handled this with sensitivity and was using only bank and agency staff who had worked at the home over long periods and so were familiar with the care needs of the residents. What the service does well: What has improved since the last inspection? The majority of the previous requirements had been implemented and the three remaining requirements were in the process of being implemented. The home had managed the changeover of personnel well and also the adverse effect this had had on one of the residents. 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 and 3 There is a range of information ensuring that prospective residents and interested parties have the information to make an informed choice about the home. Prospective resident’s individual aspirations and needs are thoroughly assessed to ensure that action can be taken by staff to provide for these needs and aspirations. EVIDENCE: The home has three booklets – Statement of Purpose, Service Users Guide and Resident’s Handbook – which are all comprehensive, and which provide all the required information residents need to decide whether they wish to live at the home. The manager intends to update the relevant pages in the Statement of Purpose and Resident’s Handbook in regard to the recent staff changes that have taken place at the home and in the parent organisation. Three of the current four residents have been at the home for many years. The assessment procedure for the most recently admitted resident was seen. Even though this had been an emergency placement, for a known time limited period of three months, a thorough and detailed assessment had been completed. As the prospective resident is non-verbal and has very limited communication skills, staff from the home spent a day with the resident, the manager and the keyworker in the previous placement gathering the relevant information and getting to know the resident. Very detailed and clear guidelines for working with the resident and meeting their needs had been drawn up, and each section of the Client Assessment was broken down into 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 9 “strengths” and “problems/needs identified”. The care plan had been drawn up from this information, as is good practice. Information from a range of records, as well as verbal information from keyworkers and the manager, evidenced that the home accesses the full range of health and social care specialists. To ensure that the home meets residents’ needs and aspirations, an independent advocate is also accessed. 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7,8 and 9 Care plans and person centred plans are thorough and reflect residents’ individual needs and goals. Staff assist residents to make decisions about their lives inside and outside the home. Risk assessments confirmed that relevant precautions are taken to facilitate this independence and choice. EVIDENCE: Two care plans were seen. Both were detailed and covered all relevant aspects of residents’ lives. Detailed daily programme and evaluation sheets are kept and the new Manager is currently checking how progress/changes noted in these is fed back into care plans. The manager plans to devise a procedure to link the PCP goals/aspirations to care plans and evaluate how these PCP goals are being met. The manager also plans to separate keyworker meetings from supervision and to have the meetings undertaken by the deputy manager. Staff gave numerous examples of how residents’ choice is facilitated. Very simple phrases are used for those residents who have limited cognitive and verbal ability, but mostly staff ascertain residents’ choices and preferences in regard to clothes, food and activities through their behaviour or body language. One support worker carries out a monthly consultation with each resident by meeting with them and recording detailed notes of their reactions and body language to simple questions/pictures regarding life at the home, relationships with staff and health issues. All three permanent residents also 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 11 have an independent advocate from an appropriate organisation who has undertaken a lot of work with them and has been very helpful, particularly around issues of health. Risk assessments were seen and were found to be detailed and thorough, and as very good practice explained the reasons for each action/precaution to be taken. As further good practice risk assessments are written at team meetings so that the whole team can contribute their experiences and suggestions. 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13 and 15 Residents have opportunities to maintain social, emotional, communication and independent living skills. Residents are enabled to take part in age, peer and culturally appropriate activities, to access the local community and to have appropriate personal and family relationships. EVIDENCE: Verbal evidence and observation indicated that staff support and encourage residents to be as independent and to exercise practical life skills as much as they are able within the limits of their cognitive and physical disabilities. On the day of inspection one resident was being accompanied to the bank, others were observed to be given the time and support they needed to feed themselves and to move around the home as independently as possible. There was verbal, documentary and observational evidence that relevant specialists had been consulted and used to obtain a range of equipment and aids to promote residents’ comfort and independence. There was evidence that visits from appropriate religious representatives are arranged and the Manager had recently held a training day for all staff on how to meet residents’ spiritual needs. 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 13 Previous residents and one current resident has been supported to attend a specialist day centre where skills training and activities take place – the current resident regarded this as “work” and has recently voluntarily “retired” himself from attending the day centre on the grounds that he feels he is too old to continue to go to work. The Manager is currently researching elderly persons day centres and local activities that may now be more suitable for the home’s residents who have now all reached the age of 60 or above. Meanwhile, residents continue to be supported to attend leisure activities that are suitable to their individual interests and take place in the local community, such as the cinema, restaurants, cafes, parks and bingo. Staff also support residents to maintain family and social relationships wherever possible. Only one resident has family that makes contact, although very rarely, but this resident is supported to visit a friend he knows in another Southside Partnership home, and staff have arranged for all residents to have an advocate from an appropriate organisation so that they each have access to an independent interested party. For the resident who is temporarily at the home and has family in France, one member of the staff team is French-speaking and so was able to communicate with her in a second language, which help to extend her limited English vocabulary. 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 and 21 Residents benefit from the provision of flexible personal care which ensures that their physical and emotional health needs are met. Issues of ageing, illness and death are handled with respect and sensitivity. Administration of medication is generally in good order but ‘as required’ medication recording needs monitoring to ensure records are accurate. EVIDENCE: Discussions with staff and observation of practices demonstrated that personal support and communication is carried out sensitively and in a way that ensures privacy and dignity and respect. For example, one keyworker described how he always explains to residents exactly what was happening in regard to personal care and how residents’ reactions and behaviours are interpreted to indicate their preferences and choices. Residents were observed to be well groomed and dressed and to be spoken with in a friendly and respectful manner. Documentation and verbal evidence from staff also demonstrated that residents are supported to access the full range of health care professionals and facilities, and that appropriate consultation and support had been sought from specialist teams. This was particularly relevant for one resident whose behaviour changed markedly some months ago. A specialist social care team was contacted and effected a big improvement in the resident’s outlook and behaviour but recently there has been a different form of deterioration and so the home is arranging for an assessment from a suitable mental health professional. 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 15 None of the current residents have sufficient cognitive skills to self-medicate and so all medication is administered by staff. The parent organisation ensures that all permanent and bank staff have appropriate medication training. Although the storage, administration and recording of all regularly administered medication was in good order the “as required” medication tablet count could not be reconciled with the amounts recorded as administered. As this has the potential to compromise the safety of residents, an immediate requirement for the situation to be remedied was issued. At the time of writing this report the Commission has been informed by the Manager that the immediate requirement was implemented within 24 hours. 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 There is a clear and effective complaints procedure. EVIDENCE: The complaints policy is available in a format that is suitable to the cognitive abilities of the residents of the home. It is made available to residents in three different booklets, the Statement of Purpose, Service Users Guide and Resident’s Handbook, and all three of these documents are kept in each resident’s bedroom so that they are readily accessible. As previously mentioned there was verbal, documentary (minutes of monthly consultation) and observational evidence that residents’ views are sought and acted upon in regard to their personal and communal lives at the home. In this way, residents are encouraged and supported to make as many choices as possible regarding their lives and have access to a means of redress for any issues they are unhappy with. The complaints record was seen. No complaints had been received since the last inspection. 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29 and 30 Residents live in a homely, comfortable and generally safe environment which suits their needs and lifestyles and provides them with the aids and equipment they require to maximise independence. The home is clean and hygienic throughout but both hygiene and safety could be compromised by the wear and tear on kitchen cupboards and the ease of access to the home from the western side of the garden. Choice is restricted by the lack of access to thermostatic radiator valves due to the new radiator covers. EVIDENCE: The bedrooms and communal room and areas of the home were very attractive and homely, with high quality furniture, fixtures and fittings and with a variety of plants, ornamentation and framed pictures. Staff are to be commended on the efforts they have made to achieve and maintain this. The home is also surrounded on three sides by garden and efforts have been made to make these areas as attractive and accessible as possible. There is a variety of potted plants, a sensory area and a paved area for sitting/eating out/relaxing in a double swing. The Manager said that new garden furniture was in the process of being obtained. Resident’s bedrooms were personalised according to 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 18 the individual’s interests and preferences, and all were well decorated, furnished and fitted. Unfortunately, although radiator covers had been installed as required to prevent danger from hot surfaces, the new radiator covers completely cover over the thermostatic controls. This means that residents no longer have the choice about the temperature of their individual rooms and the Registered Provider must find a way to remedy this. Bathrooms and toilets had suitable aids and adaptations to meet residents’ needs but it is recommended that the hoist in the upstairs bathroom is replaced by a more modern hoist that would better ensure residents’ comfort and dignity. Although the kitchen/diner area was clean and well kept and the dining area had been made attractive and comfortable, there were some areas of the kitchen which did not meet acceptable standards: the cooker hob must be renewed as staff reported that it does not reach suitably hot temperatures, the work surfaces and kitchen cupboards must be replaced as several have chips which may harbour germs, the old cupboard beneath the new cooker must be replaced so that it fits properly, the hole in the ceiling above the cooker must be made good and the lighting must be improved/replaced as by the afternoon of the inspection it was giving very dim light even though it was a bright, sunny day outside. Almost all of these repairs/renewals are the responsibility of the Housing Association which owns the property and the Manager had already arranged for a visit by a maintenance representative which was due to take place shortly. There were three aspects of security that need to be remedied, which is also the responsibility of the Housing Association: (i) The lounge and one of the ground floor bedrooms have French doors which lead out to the sensory garden, however the frames and the locking devices on these doors did not appear to be strong enough to deter intruders, and this must be remedied in order to ensure that residents are safe and secure. (ii) The high part of the fencing along one side of the home which borders a busy main road stops some way short of the garden gate and this, coupled with the size and flimsiness of the gate compromises privacy and security. (iii) The rear of the home is bounded by a low wall bordering a block of flats which themselves have only a low wall to the main road – both walls can easily be breached/stepped over to access an isolated door to the home, thereby compromising its security. These potential security breaches must be remedied to ensure the safety of residents, especially at night. At the last inspection a requirement was made for automatic door closure systems to be fitted within the home to allow fire doors to be kept open safely. The manager had obtained the door closure systems and was in the process of having them fitted. 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 34 and 35 Staff are competent, trained and qualified and residents are supported and protected. Staff receive structured induction training and have access to a comprehensive training and development programme. EVIDENCE: Staff were observed to be accessible and approachable and to have friendly and supportive relationships with residents, based on a thorough knowledge of their characteristics, needs and behaviours and a commitment to providing them with a high standard of care. A table of the training courses attended by individual staff members since they joined the parent organisation was seen. The home has exceeded the 2005 NVQ Level 2 training target as all but one member of support staff have NVQ Level 3. The parent organisation operates a thorough recruitment procedure based on equal opportunities and ensuring the required protection of service users and induction of new staff is undertaken in 4 stages, which includes Learning Disability Award Frameworkaccredited training. After induction the Registered Provider has a well organised and comprehensive training and development programme, which includes quarterly updates on all mandatory training. Residents and interested parties can therefore be confident that residents are provided with adequate protection and benefit from knowledgeable and well trained staff. 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 41 and 43 The Registered Manager is qualified, competent and experienced and provides open and inclusive management, which ensures the smooth running of the home. Records are well kept, contributing to the effective and efficient running of the home. EVIDENCE: The Manager has extensive experience with the category of client group at the home, both as a support worker, manager and line manager. He is qualified to NVQ Level 4, has undertaken a full range of training suitable for the needs of the resident group, and has recently conducted in-house training for staff in Spiritual Needs, the Role of the Keyworker and Working with Carers. Staff confirmed that the management style at the home was open, positive and inclusive which supports staff to provide a good standard of care. As the residents of the home have now all reached 60 years in age the Manager is currently researching elderly issues/activities and relevant training for staff. 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 21 Currently, the Manager of the home is also undertaking the role of Operations Manager to other learning disability homes of the parent organisation. As this could potentially lead to conflicts of interest, the Registered Provider must write to the CSCI to explain how this arrangement ensures sufficient daily management for Ambleside Avenue and how potential conflicts of interest are being addressed. A range of required records were seen and were found to be well kept and in order, evidencing the efficient internal running of the home. 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 4 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 2 3 3 2 2 Standard No 11 12 13 14 15 16 17 3 3 3 x 3 x x Standard No 31 32 33 34 35 36 Score x 4 x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 15 Ambleside Avenue Score 3 3 2 3 Standard No 37 38 39 40 41 42 43 Score 4 3 x x 3 x 2 G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 23 no 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 26 Regulation 23(2)(p) Requirement The registered person must ensure that radiator covers are adapted so that access to thermostats is facilitated. The registered person must ensure that renewal/repacement of kitchen equipment and cupboards to meet acceptable standards takes place. The registered person must ensure that adequate lighting is supplied to the kitchen/diner. The registered person must ensure that the home is made secure in relation to the two French doors, the garden fencing and gate, and access to the rear of the home. The registered person must write to the CSCI to explain how the current mangement arrangement ensures sufficient daily management for the home and how potential conflicts of interest are being addressed. The registered person must ensure that automatic door closure systems are fitted within the home to allow fire doors to be kept open safely. This is in the process of being Timescale for action 30 September 2005 30 September 2005 30 September 2005 30 September 2005 2. 30 16(2)(g) 3. 4. 30 24 23(2)(p) 13(4) 5. 43 10(1) 31July 2005 6. 29 23(4)(c) 31 August 2005 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 24 implemented (previous timescale of 31/01/05 not met). 7. 8. 9. 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 29 Good Practice Recommendations The hoist in the upstairs bathroom should be updated to improve comfort and dignity. 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 25 Commission for Social Care Inspection Southwark Area Office Ground Floor, 46 Loman Street London SE1 0EH 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 15 Ambleside Avenue G52-G02 S22718 Ambleside Ave V232522 090605stage4.doc Version 1.30 Page 26 - 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. 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