Inspection on 14/10/08 for Arboretum Nursing Home

This inspection was carried out on 14th October 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Arboretum Nursing Home 25/10/06

Arboretum Nursing Home 24/10/05

Arboretum Nursing Home 12/04/05

Arboretum Nursing Home 15/11/04

Arboretum Nursing Home 15/06/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Arboretum Nursing Home Forest Lane Walsall West Midlands WS2 7AF     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Amanda Hennessy     Date: 2 7 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Arboretum Nursing Home Forest Lane Walsall West Midlands WS2 7AF 01922725276 01922644082 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr John Luke,Mrs Mary-Ann Luke Name of registered manager (if applicable) Ms Lesley Sheila Tipper Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Arboretum Nursing Home is a 41 bed home, first registered in July 1990, it is situated in a residential area close to local amenities and public transport. Set in well-tended grounds it shares the site with a day centre. The building has been extended and refurbished, providing care on two floors it is serviced with a passenger lift. The facilities include both single and shared rooms some with en-suite, a number of lounge and dining areas allow service users to have a change of environment and company. The home provides all support services in-house including catering, housekeeping and laundry. The home provides care for older people from age 40 and palliative care in the same age range. As no information about fees has been included within this report the reader is advised to contact the service direct for this information. Care Homes for Older People Page 4 of 28 care home 41 Over 65 41 0 0 41 Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This unannounced inspection was carried out mainly in one day, the 14th October 2008. Another short visit was undertaken on the 27th October 2008 to see staff criminal records checks which which were not available at the time of the visit on the 14th October 2008. Both visits were made by one Inspector, Mrs Amanda Hennessy. Time spent visiting the service was eight and a half hours. As it was unannounced neither the service nor the provider knew we were going. The home’s manager was present throughout the inspection on the 14th October 2008. Information for the Care Homes for Older People Page 6 of 28 report was gathered from a number of sources: questionnaire- Annual Quality Assurance Assessment (AQAA) was completed by the homes manager and sent to us; We looked at the premises, records and documents. We had discussions with the manager and care staff and people who live at the home to gain their views on what it is like to live in and receive care at the home. We looked at how the service has responded to any concerns, how it protects people from abuse and how staff are recruited and trained. We also looked at the number of staff available to care for people at the home. Four people who live in the home were case tracked this process involves establishing people’s experiences of living in the care home by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes of the care that they receive. Tracking peoples’ care helps us understand the experience of people who use the service. What the care home does well: What has improved since the last inspection? What they could do better: The home must ensure that all required checks are undertaken before new staff start to work at the home. The failure to undertake a protection of vulnerable adults check before staff start work puts people living at the home at risk from people who are unsuitable to work with vulnerable people. It is disappointing that the delayed completion of the extension of the home has resulted in other improvements to the existing home being delayed. The current Care Homes for Older People Page 8 of 28 shortfalls in the environment detracts away from the excellent care that the home provides. There is a need for additional dining rooms space and furniture to enable all people to have their meals in the dining room if they wish to. Aids and adaptation in bathroom need to be reviewed so that there are there are more than two showers suitable for people living at the home. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home assesses and meets the needs of people who come to live at the home, including specialist needs such as palliative care. Evidence: New people have their needs assessed before they come to live at the home giving assuarnce that peoples needs are assessed. The home also ensures that a Social Worker assessment is available to them before a decision is made that the home will be suitable to meet their needs. The home accommodates people requiring terminal and palliative care. The home has achieved the prestigious award of Gold Standards framework Beacon status . This shows that the home has become a recognised centre of excellence for palliative care. The home manager is the lead person for palliative care but there is a programme for all staff to have training in caring for people requiring palliative care. It is positive that Care Homes for Older People Page 11 of 28 Evidence: staff report good links with other agencies such as Macmillan Nurses and Doctors. A health professional working for an outside agency told us that: The home provides very good palliative care. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home recognises and meets peoples needs. There are good systems in place for the storage and administration of medicines to ensure that peoples health and wellbeing is promoted. Evidence: The home has a reputation for providing high quality care for people who live there. People living at the home their relatives and other health professionals all were in agreement: They provide good care. Care planning is effective and provides staff with instructions on how care needs should be met and is regularly updated. Care planning is being further developed to more fully identify peoples individual choices and capabilities alongside their needs, this is called person centred care. The home has already developed person centred care planning for people requiring terminal and palliative care. We discussed with the Home Manager how person centred care could be further developed for all people living at the home, with the Manager telling us that she is very keen to do so. Care Homes for Older People Page 13 of 28 Evidence: It is disapointing that the environment of the home detracts away from the excellent care that the home provides. The lack of suitable baths or showers and the current size of the dining room meaning that peoples choice of a regular bath and an opportunity to have all their meals in the dining room cannot be met. Care records identify that people living at the home are regularly seen by other health professionals according to their needs. People told us: they ensure that my teeth and eyes are regularly checked and I see the doctor regularly for my blood. The storage and administration of medicines at the home is undertaken safely and appropriately by qualified nurses. We did advise that two staff members confirm the accuracy of hand written medicine entries and that they sign for the administration of creams rather than tick the entry. Advised changes will give greater assurance that any potential errors will be minimised. It is positive that the Manager does regular checks on medicines. The homes induction and ongoing training and supervision programme include the promotion of peoples privacy and dignity. We observed staff interact with people living at the home. When we asked people living at the home if they felt that staff respect them, they told us: Oh yes the staff are very good. The home has achieved the Gold Standards Framework Beacon status. This is an excellent achievement and means that the home is a recognised centre of excellence for providing terminal and palliative care. All people have a care plan that identifies their wishes for the end of their life and after their death. These advanced directives give assurance that staff and the persons relatives are aware of their wishes and can ensure that they will be met. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the opportunity to make choices about their life at the home, participate in social activities both within and outside the home and maintain relationships with friends and relatives. Evidence: Two activities leaders provide in-house activities and social events on a daily basis. Regular outings are also arranged such as boat trips, shopping trips, visits to the local garden centre and the Arboretum. We asked people living at the home how they spend their time and if they have the chance to go out: Oh yes they take us out, I went to the Big Band at Walsall Town Hall last week- we didnt get back till after eleven o clock it was marvelous. We are going on a boat trip again soon, Ive been on the boat twice already this year. They take me shopping, I like going to Matalan so that I can get the things I need. There is entertainment in the home too, a lady comes to sing to us every month. Care Homes for Older People Page 15 of 28 Evidence: Lesley organises lots of things for us to do. The Home has a day centre on site, which people living at the home can also attend if they want to. The manager has experience in identifying the care needs of people with dementia and did a Dementia Mapping exercise. As a result of dementia mapping she has made improvements to seating arrangements to enable people to socialise more easily, visit the day centre and also keeps people more alert. We found that some people choose to spend their time in their room and it was observed that most rooms were personalised with ornaments, pictures and photographs. People we spoke to said that though they liked to spend time in their room watching their television they did not feel isolated and joined in when activities are provided. Some visitors were received in bedrooms while others remained in the main lounges, there are also a number of quiet areas that visitors can be received privately. The hairdresser comes to the home twice a week. Staff told us that her visits are very popular and that she is kept busy throughout both days. It was also nice to hear that the hairdresser will come at other times if people want their hair doing for a special occasion. Visitors spoken with were very complementary of the home and staff and told us that they are made welcome and kept informed of matters affecting their relative. Peoples personal likes and wishes such as rising and settling time and their ability to make choices such as what clothes to wear is recorded in their care records. When we spoke to people living in the home it was clear that they feel that there wishes are fully taken into account by care staff. The menus provide for a balanced and nutritious diet with account taken of individual likes and dislikes and any special dietary needs. People told us they really enjoyed the meals at the home and that they were offered choice if they do not like the main meal on offer. It was a lovely dinner again today with lovely vegetables. Staff told us that most people have their breakfast downstairs in the dining room but the most people upstairs have their lunch and tea on a tray in front of them in the lounge. The current dining room is small and there is not sufficient seating for people from both upstairs and downstairs to sit at the same time. The Proprietor of the home told us that this will be addressed when the extension is completed as the dining room Care Homes for Older People Page 16 of 28 Evidence: will be much larger. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are listened to and can feel assured that the home will act in their best interests and protect them from harm. Evidence: The complaints procedure is readily accessible and is included both within the service user guide and is also displayed on the main notice board. The home have had six complaints in the last year and of which they have substantiated two. We looked at the homes record of complaints and found that all had been appropriately investigated within the required timescale and required actions implemented following the outcome of the complaint. The majority of people told us that they know how to make a complaint. One person said: Yes I would speak to the Manager. The Home has a robust adult protection policy and actively promotes the policy and that of whistle blowing. Staff receive training including attending the Walsall Social Services training and know how to respond if they suspect or observe any aspect of abuse. The shortfalls in the safe and appropriate recruitment of staff however may put vulnerable people at risk. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The delayed refurbishment of the home, lack of suitable bathing facilities and a failure to provide equipment to minimise the risk of cross infection mean that people may be placed at avoidable risk of cross infection and may not be as comfortable as they could be. Evidence: We found the home to be homely and clean although the marked carpets in one part of the home leading to the new extension detracted from this. The previous inspection (in October 2006) identified a delay in the identified refurbishment a need to address the marked corridor carpets, provide suitable door locks and provide a mechanical sluice disinfector for the effective and safe washing of commode pots. It is disappointing that two years later the improvements to the environment have still not been undertaken due to further delays to the proposed extension. The Proprietor told us that he is hopeful that the extension will be completed at the end of November 2008. The Manager did show us rooms in the other side of the home that have been refurbished since the previous inspection and were found to be homely and comfortable. The home has two separate units one upstairs and one downstairs. Each unit has its own lounge although they share the main dining room. As we have already identified Care Homes for Older People Page 19 of 28 Evidence: there is insufficient space for people living in both units to have their lunch and tea in the dining room at the same time. The Proprietor confirmed that additional dining space and furniture will be available with the new extension. There are forty- one bedrooms in the home of which eight are double rooms and twenty-five are single occupancy. The home has nine bedrooms which have ensuite facilities. The new extension will provide an additional thirteen bedrooms all of which will have ensuite facilities. The bedrooms seen appeared to be comfortable and uncluttered, many were seen to be personalised with pictures, ornaments and some furnishings. A number of bedrooms have been redecorated and re-carpeted. The home has a range of aids and adaptations to assist dependent people. The home has showers that people can be wheeled into on both floors and two further baths on the ground floor and one on the first floor. We found that numerous items were being stored in bathrooms making access to them difficult. Staff told us that they stored things in the bathroom as people did not like them and preferred to have a shower. We found that the baths would not be suitable for dependent people and particularly those who need to be hoisted, which was also demonstrated to the Proprietors. It is a concern that the shower on the ground floor would need to be used by seventeen people and the shower upstairs by stwenty- seven peole. Staff agreed that the number of people using the shower would restrict choice. In addition some bathrooms seen were dimly lit, bare and institutional. The home provides gloves and aprons for staff to minimise the risk of cross infection to people living at the home. We did find that other practices and facilities could be improved to minimise the risk of cross infection. The home does not have a dishwasher which if available would give greater assurance that crockery and cutlery is washed effectively at required temperatures to minimise the risk of cross infection. Staff are hand sluicing and soaking soiled and contaminated laundry which is a significant risk them and other people. The Proprietor was advised to provide special alginate bags so that staff could put infected and contaminated linen directly inside them and then they could be put directly into the washing machine where the bags dissolve minimising any risk. A need to improve arrangements for the laundry were also identified. We were told that this would be addressed with the new extension as a new laundry would be provided. The proprietor has told us that he will provide a sluice disinfector within the new extension. Staff told us that at the present time they chemically disinfect the commode pots but this may not always be effective and the use of chemicals could also be a risk to staff. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has knowledgeable staff who understand and meet people needs. Shortfalls in the safe and appropriate recruitment of staff may put vulnerable people at risk. Evidence: The home is staffed with the appropriate numbers of staff and skill mix to meet peoples needs. It is positive that there are additional staff on duty who provide staff training and assess staff competency. In addition to care staff there additional ancillary staff are employed to meet the domestic, laundry, catering, maintenance and gardening needs of the Home. The homes excellent training opportunities have been recognised by other establishments awarding the the home the Gold Standards Framework Beacon Status which recognises that the home is a place of excellence for the palliative and terminal illness care. The homes has also succesfully regained the Investors in people award. In addition the Manager is also proud that the home has been assessed as a suitable training placement for student nurse training and for nurse adaptation training. The home has more than seventy percent of its care staff with a care qualification with further staff undertaking currently undertaking this training. Other training is provided Care Homes for Older People Page 21 of 28 Evidence: to increase staff knowledge in conditions that affect people living at the home such as dementia care, wound care, continence care and care needs of people requiring palliative care. This gives confidence that staff are knowledgeable and understand people care needs. The homes recruitment and selection procedures puts people at risk from unsuitable people. The home does not ensure that a Protection of Vulnerable Adults check is undertaken before staff start working at the home. The Proprietor told us that he was not aware of the need for the return of the Protection of Adults check before staff start working at the home, although this has been in place since July 2004. This is very disappointing as other procedures around the appointment of new staff, return of references and their training and supervision is good. New carers undertake an extensive induction and foundation programme that meets Skills for Care Standards. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an experienced manager who provides strong and effective leadership however shortfalls in the safe and appropriate recruitment of staff may put vulnerable people at risk. Evidence: The manager is a registered nurse with extensive experience in care home management and holds a certificate in management award and Diploma in Management Studies. Staff said that senior staff are very approachable and work closely with staff. Regular staff meetings also support this with good communication. The Manager told us that the Proprietors are very supportive and care about the home, people who live there and the staff. We have highlighted to both the manager and proprietor that shortfalls in the safe and appropriate recruitment of staff may put vulnerable people at risk. An extensive range of audits are undertaken including surveys of people views of living Care Homes for Older People Page 23 of 28 Evidence: at the home and reviews of clinical activities on a weekly and monthly monitoring such as the incidence of pressure sores and medication management. There are regularly resident and relative meetings. Families mostly manage peoples personal allowances although a small number manage their own affairs. Where money is left for safe keeping full records are maintained of all transactions. The home gives high priority to the induction and ongoing training of its staff and has well-established formal supervisions, which informs the training and development requirements of individual staff. The home has an up to date health and safety policy for safe working practice with a range of risk assessments. Staff receive training and regular updates in health and safety and fire safety. A fire risk assessment is available which is subject to review as changes occur. The homes manager has confirmed that service contracts are up to date. One person did express concerns about the central heating system. We found the home to be warm at the time of the visit but when we asked for the central heating service certificate it was not available. The homes proprietor told us that he would forward it to us. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 29 19 Staff must not work in the home until at minimum a satisfactory protection of vulnerable adults check has been returned and a risk assessment that details the whether it is appropriate for the staff member to start before the return of the criminal records check is completed. This will give assurance that people living at the home are protected from unsuitable people working at the home. 05/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 9 9 Staff should sign rather than tick to confirm that all medicines including creams and lotions have been given. Two staff should sign to confirm the accuracy of handwritten entries of medicines on the medication record. Page 26 of 28 Care Homes for Older People 3 20 There is a review of the dining arrangements to enable people who wish to can have their meals in the dining room. There should be additional adapted bathing/ shower facilities suitable for people who live at the home. There are appropriate storage areas made available particularly for equipment such as wheelchairs. A mechanical sluice disinfector is available for the effective and safe disinfection of commode pots. The practice of hand sluicing washing should stop as this increases the risk of cross infection. The central heating service certificate should be forwarded to the Commission for Social Care Inspection. 4 5 6 7 8 21 22 26 26 38 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!