Inspection on 04/08/05 for Avenue House

This inspection was carried out on 4th August 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

Avenue House 01/03/07

Avenue House 23/10/06

Avenue House 25/01/06

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Avenue House 26 Clifton Road Tettenhall Wolverhampton WV6 9AP Lead Inspector Bhag Jassal Announced 4 August 2005 9.00 th 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 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. Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Avenue House Address 26 Clifton Road, Tettenhall, Wolverhampton, WV6 9AP 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) 01902 823649 01902 823649 West Midlands Residential Care Homes Limited Jacqueline Stanford Older People 21 Category(ies) of Old Age (21) registration, with number of places Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1) The home is registered as a care home for older people subject to the provider meeting the conditions of registration in appendix 1 dated 17.06.05. Date of last inspection 07.12.04 Brief Description of the Service: The home is a large detached Grade 2 listed building approximately 142 years old. The home stands in two and a half acres of lawns and woodland. The home is within a short distance of Tettenhall Village where the amenities include a post office, shops and a public house. The home has been completely refurbished, adapted and recently extended for its present use as a residential care home for 21 older people. There are two double bedrooms and 17 single bedrooms, four of which have en-suite facilities, two lounges, a dining room, laundry, kitchen, staff room and Registered Manager’s office and a staff training room. There is a large car park and garden. Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and started at 9.00 am and lasted 7 hours and 15 minutes. 19 places were occupied and 2 beds remain vacant. The inspection included discussions with service users, staff, and relatives/friends. The daily routines were observed and service users and staff records, policies and procedures were examined in detail. The inspection of premises both inside and outside and facilities were also undertaken. The ownership of the care home has changed in June 2005, and the new Registered Providers are the West Midlands Residential Care Homes Ltd. At the point of registration in June 2005, there were several requirements, which needed to be addressed by the new Registered Provider and these were imposed as conditions of registration to be implemented by the end of August 2005. At the time of this inspection, an action plan was being implemented to comply with the above conditions of registration. What the service does well: Avenue House is registered for 21 older people. The home makes every effort to meet the assessed needs following a care plan. The home has a good key worker system and staff supervision system in place. The home communicates well with the families/friends and representatives of the service users. The visitors’ book indicated a lot of activities. The service users spoken with said that they are happy and content with living in a homely and caring place. Service users were in the two lounges engaging in their daily activities and they commented that they were content, comfortable, and satisfied with the care provided. The friendly rapport was observed between service users and staff. Meals are varied, well balanced and presented to meet each individual’s choices, preferences and requirements. The home provides good standard of accommodation, which is being maintained safe, secure and to a good standard. Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: The home must continue to improve further the quality of daily care recording. All those members of staff who as yet not received training in safe working practice topics must do so as a matter of priority, which would enable them to improve further their care practices and professionalism. The Registered Provider must take appropriate action to provide adequate domestic and catering staff to complement the care staff at all times as a matter of priority. The home must follow at all timed its own staff recruitment policies and procedures. There are a small number of issues relating to the environment, which must be addressed in order to have a safe and comfortable environment for service users, staff and relatives/friends. The home must take swift action to progress the home’s Annual Quality Assurance development plan. Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 7 The Inspector would like to acknowledge the improvements that are being made by the new Registered Provider and the Manager at Avenue House since the change in the new ownership of this care home. 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. Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 8 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 Standards Statutory Requirements Identified During the Inspection Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 9 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 standard(s) 3, 5 and 6 The home has a good admission procedure providing effective needs assessment and suitability evaluation for both privately funded service users and those placed by the Local Authorities. EVIDENCE: A sample of four service users’ care plans and files were examined in detail at the inspection. All contained evidence that the service users receive the benefit of a comprehensive assessment prior to admission. The Registered Manager stated that she also carryout assessments and these details are documented on care plans, and are drawn up by the senior staff with the assistance from the service users and their families /friends and where appropriate other professionals. There was evidence to show that all the service users have been provided with contracts. The home has a good admission procedure, which is made available to all prospective service users and their relatives/representatives. The home does not offer an intermediate care service. Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 10 Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 11 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 standard(s) 7, 8, 9 and 10 The staff within the home are aware and sensitive to the needs of each and all service users and meet their needs in a professional manner. There is a clear and consistent care planning system in place, which provides the information the staff requires to meet the service users’ health and personal care needs. EVIDENCE: It was evidenced that the service users undergo a comprehensive assessment of their needs prior to admission to the home. A care plan is produced, which is based on the assessment of needs. The home operates a key worker system, which helps to ensure that the recommendations arising from the care plans and reviews are implemented. Four service users’ care plans were selected at random and were examined in detail. The care plans are being kept up to date and reviewed on a monthly basis. The daily care recording formats were also examined and it was noted that the quality and details of recording has improved since the last inspection. It was evidenced also that the home ensures that nutritional screening is undertaken, including weight gain and loss records are maintained and appropriate action is taken if required. Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 12 Case tracking demonstrated an effective review process together with the home’s ability to meet the changing needs as they occur. The service users’ health is closely monitored and appropriate medical care services are sought. It was observed on the day of inspection that no personal care interventions were taken I communal areas. In addition, consultations with health and social care professionals are carried out within the service users’ bedrooms. The Inspector spoke at length with 12 service users and all of them commented positively about care they received and they also felt that they have been provided with everything that they need. Several service users stated that “the home is clean and tidy and carers are very good”. The remaining five service users said “the carers are very friendly and they are always there to help and we can not ask for more”. The Registered Manger stated that three senior carers have received training in safe handling of medication and several other carers have also completed this mode of training. The remaining members of care staff are being enrolled to receive this training shortly. Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 13 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 standard(s) 12, 13 and 15 Avenue House provides a good quality of care and promotes individual lifestyles for service users in residence. Service users maintain contacts where they wish with the families, friends and local community. Meals at Avenue House are of good homely type offering both choices and variety and catering for special needs. EVIDENCE: It was evidenced that the home provides an activities programme in accordance with the service users’ choices, preferences and capacities in relation to – social and leisure activities and cultural interests. The records of activities enjoyed by the service users are appropriately maintained. All the service users spoken to stated that they are in touch regularly with their family members and friends, and spoke about their visitors’ involvement and interest in their daily care matters. The Visitors’ book showed a considerable activity. The relatives of two service users stated that they visit at various times of the day as they wish. All the relatives and friends who spoke to the Inspector said they are given a warm and friendly welcome by the staff whenever they visit the home. It was also evidenced that the service users keep contacts with the local community facilities – e.g. church services, shops, park and pubs. Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 14 It was evidenced that the home provided a varied, wholesome, and nutritious diet. The meals provided during lunchtime on the day of inspection were well received by the service users. The four-weekly menu was examined in detail, and appeared to be satisfactory. The Registered Manager stated that the menu is changed on a regular basis and in consultation with the service users. Several service users told the Inspector “the food was very nice and well cooked”. Other service users also stated that the food was very good offering a good variety. The cook is well trained in food safety and hygiene matters and the kitchen is well equipped and kept clean and tidy. Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and18 Concerns and complaints are dealt with promptly and professionally. The service users are protected from abuse by the home’s policies and procedures. The Arrangements for the protection of service users from abuse are satisfactory. EVIDENCE: The home has a good Complaints Procedure, which is referred to for information in the Service Users’ Guide. There is a satisfactory system of recording complaints and compliments. It was noted that there has been no complaints directed towards the CSCI during the last twelve months. The service users spoken to by the Inspector, stated that their views are always listened to by the Manager and the owner. It was evidenced that the home has a good policy and procedure in place with regard to the protection of service users from abuse. The Registered Manager stated that the staff has been made aware of adult abuse and protection issues through induction and in-house video training and through supervision arrangements. However, the Registered Provider should consider providing professional training on adult abuse and protection issues. Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 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 standard(s) 19, 21, 22, 24, 25 and 26 The general standard of the environment and facilities is good providing service users with a homely place to live. The good standard of cleanliness reflects the ongoing cleaning schedule, which maintains this standard throughout the home. EVIDENCE: The home offers a comfortable and well-maintained environment to all service users. The home has ample communal space – two lounges and a dining room. The home has a rolling programme of redecoration to maintain good standard. The garden and patio areas are also well - maintained. The exterior of building and the canopy are still to be repainted. The outstanding requirements/recommendations contained in the respective inspection reports of the Fire Safety Officer dated 8 April 2005 and the Environmental Health Officer dated 25 May 2005 must be addressed as a matter of priority. There are adequate toilets, bathrooms/showers and washing facilities and maintained in working order. Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 17 There was evidence to show that an assessment of the premises and facilities has been made by a suitably qualified Occupational Therapist and a satisfactory report was provided for inspection. It was noted that the home has also provided suitable aids and adaptations in the home, including the installation of a loop system to meet the particular needs of all the service users. There is a reasonable standard of furniture and fittings provided in the service users’ bedrooms. It was also noted that the bedrooms have been personalised by the service users. However, the excessive noise heard in bedroom 9 from the washing machine/dryer in the laundry next door and/or central heating system must be totally eliminated by providing sound - proof insulation so that the service user have noise free and comfortable bedroom at all times. The required level (i.e. close to 43 Degrees C) of hot water temperature must be maintained in ALL hot water outlets throughout the premises. It was noted that there was no cold water supply to the sink in the bathroom/WC in the staff training room/Registered Manager and Provider’s office. The hot water in this facility is so hot that it could scold any user and thus this issue need to be addressed as a matter of priority. During the inspection, the home was found to be clean, tidy and free from any unpleasant odours. The home has good policies and procedures regarding infection control. The Registered Manager stated that the staff needs to undertake training in infection control, hygiene and cross - infection issues. Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 The home is not adequately staffed at all times, which can have impact on the quality of care provided, and the ability of the home to meet the needs of the service users. The home continues to support staff to complete training. The home has satisfactory staff recruitment policies and procedures. EVIDENCE: The information provided by the Registered Manager and the available staff rotas showed that the home is now adequately staffed by carers to care for 19 currently accommodated service users with varying degrees of dependency levels and needs. However, the Registered Manager stated that the cover for two days for domestic assistant and laundry assistant, and cook cover in the evenings are still to be provided. The Registered Provider must take urgent action to ensure there is adequate domestic, laundry cover for the two days during the week, and the cook cover in the evenings to be provided throughout the week. The carers must be left to do the caring duties at all times. If the carers are covering the above duties then additional carers must be provided to cover their caring duties. The staffing levels in the home is already a condition of registration and thus the Registered Provider and the Registered Manager must take appropriate action to comply with this requirement as a matter of priority. The Registered Manager stated that nine members of staff have completed their NVQ Level 2 training and there are further five members of staff currently Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 19 undertaking this mode of training. The remaining members of staff will be enrolled to follow this training. It was also evidenced that majority of staff has completed their safe working practice topics training and those who as yet NOT received this training must do so as a matter of priority. Discussions with the Registered Manager and examination of the most recently recruited staff files demonstrated that thorough recruitment procedures had not been followed in line with the home’s own recruitment policy. Two written references had not been obtained on the recently recruited new staff before they were appointed. The Registered Manager stated that enhanced CRB and POVA checks are now being undertaken before all new staff actually commences their duty. The Registered Provider and the Registered Manager are aware that any member of staff with criminal records would not be employed in accordance with the Department of Health Guidance issued in July 2004. The home is now introducing the TOPSS Induction and Foundation training for all new members of staff. It was noted that the home’s training programme is now being implemented. The Registered Provider should consider providing specialist staff training in Dementia care, adult protection from all forms of abuse, and disability awareness. Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35, 36 and 38 The home is managed by an experienced Registered Manager, who lead a staff team with a great deal of confidence. The staff is clear of their roles and responsibilities. Good systems of communication are in place to seek views/comments from service users and their relative/friends. The service users’ monies are handled appropriately by the Registered Manager. The staff are regularly supervised to enable them to carryout their work professionally. Health, safety and welfare of service users and staff are promoted by safe working systems put in place by the Registered Provider and the Registered Manager. EVIDENCE: Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 21 The Registered Manager-Jackie Stanford has completed her NVQ Level 4 in care and management qualification. She is suitably trained and experienced person to manage the home. Since the last inspection Mrs Stanford has made a number of further improvements in care planning, recording formats, staff training and supervision, regular meetings with staff and service users. The home is still at the earlier stages of developing and implementing its annual Quality Assurance development plan and quality monitoring systems. The Registered Manager has formulated questionnaires to seek feedback/comments on the services and facilities provided by the home from service users and their relatives/friends. The information received through these questionnaires will be analysed and a report also will be prepared with an action as considered appropriate. The Registered Manager stated that similar route would be followed to obtain feedback from other stakeholders (i.e. professionals who visits the home). The home needs to move swiftly to ensure the full implementation of this Standard as a matter of priority. The home assists several service users with their monies. A sample of four service users’ money was checked and found to be satisfactory. The records of all financial transactions are appropriately maintained. It was also evidenced that all members of staff are now being supervised at the required intervals. The records of supervision were examined in detail during the inspection. Accidents and fire prevention records were examined in some detail, which were appropriately maintained. The Registered Manager stated that remaining few issues identified by the Fire Safety Officer on 8 April 2005 and the Environmental Health Officer on 25 May 2005 respectively are still to be addressed. The Registered Provider must ensure that the electrical equipment is tested at the required intervals and appropriate certificate is made available in the home and for inspection. The Registered Provider must ensure that all those members of staff who as yet NOT received training in safe working practice topics must do so as a matter of priority, (See NMS 30 above). Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 22 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 1 x 3 3 x 2 2 3 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 1 x 3 3 x 1 Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 23 YES 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 OP 19 Regulation 23 Requirement The Registered Provider must ensure that the exterior of the building and the Canopy are repainted; and that the outstanding requirements/recommendations contained in the respective inspection reports of the Fire Safety Officer dated 8 April 2005 and the Environmental Health Officer dated 25 May 2005 must be addressed as a matter of priority. The Registered Provider must ensure that the excessive noise heard in bedroom 9 on the ground floor from the washing machine/dryer in the laundry next door and/or central heating system must be eliminated by providing suitable sound proofing insulation so that the service user has a noise free and comfortable bedroom at all times. The Registered Provider must ensure that the hot water supply to all hot water outlets in the home must be maintained at the required temperature level i.e. close to 43 Degrees C at all Timescale for action 15/12/05 2. OP 24 16 & 23 15/12/05 3. OP 25 13 15/12/05 Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 24 4. OP 27 18 5. OP 29 7, 9, & 19 6. OP 30 12, 13 & 18 7. OP 33 24 8. OP 38 4, 12, 13, & 23 times;and that cold water supply is made available to the sink in the bathroom/WC in the staff training room and Managers Office, and the hot water tap in this facility must also be fitted with a suitable thermostatically controlled mixer valve. The Registered Provider must ensure that adequate domestic and laundry cover is provided for thoughout the week; and adequate evening cook cover must also be provided for throughout the week, and the carers must be left to do their caring duties. If the carers are asked to provide cover for the above duties then carers replacement must be provided. The Registered Provider must ensure that at all times two written references are obtained on all new members of staff before they are appointed. The Registered Provider must ensure that all those members of staff who as yet have not received training in safe working practice topics must do so as a matter of priority. The Registered Provider must ensure that the homes annual Quality Assurance development plan is fully implemented as a matter of priority. The Registered Provider must ensure outstanding issues identified by the respective inspections carried out by the Fire Safety Officer on 8 April 2005 and the Enviromental Health Officer on 25 May 2005 must be addressed as a matter of priority; and that the electrical equipment are tested at the required intervals and appropriate certificates are made 15/12/05 15/12/05 15/12/05 31/12/05 15/12/05 Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 25 available in the home and for inspection by the CSCI; and that all those members of staff who as yet NOT received training in safe working practice topics must do so as a matter of priority. 9. 10. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard OP 9 OP 18 OP 28 Good Practice Recommendations The Registered Provider should continue to support those members of staff who as yet not completed their training in safe handling of medication. The Registered Provider should consider providing staff specialist training in Dementia care, Disability Awareness, and adult protection from abuse. The Registered Provider should continue to support those members of staff who as yet not completed their NVQ Level 2 training. Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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 Avenue House E56 000020880 Avenue House v235351 AI 040805 Stage 4.doc Version 1.40 Page 27 - 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!