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Inspection on 22/08/05 for Bearwood Nursing Home

Also see our care home review for Bearwood Nursing Home for more information

This inspection was carried out on 22nd August 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is very well presented to prospective clients both in general appearance and in the excellent sources of information provided. Relatives commented, "information about the home is good ". A service user also said the information was useful when first coming to the home. Other comments are, "staff are very welcoming", and "they let me get involved". The assessment of needs process is very thorough and fully involving of the service user and responsive to individual wishes. Staff are respectful of the privacy needs of service users and maintain their dignity in their interactions with and during the delivery of care Meals are well received and the variety and provision of culturally responsive meals is good with Caribbean and Asian meals alongside traditional British. The home provides an extensive programme of training for its care staff and provides them with support and guidance through a well-organised system of supervision.

What has improved since the last inspection?

The home has reviewed and reissued sources of information to service users and involve them in all aspects of assessment of needs and care planning including the reviews. The separate provision for the elderly with dementia has improved the care provision for both groups including the elderly frail. The home has reviewed and revised its complaints policy and procedures to make them more accessible and responsive to the needs of concerned individuals. The home has corrected deficiencies previously noted in the recruitment process ensuring all necessary checks are made prior to starting new staff. The quality assurance processes have been formalised and now includes a process of seeking service users views on aspects of service.

What the care home could do better:

The care planning process should be further developed to take account of potential problems arising from known conditions that may have complications that arise unexpectedly but that can be monitored for and guidance given should a circumstance occur. The large patio area could be made more appealing for use by decorating and furnishing appropriately. The variety of bathing opportunities should be maximised by providing an improved servicing arrangement to keep allprovisions in use. The management of hot water could be improved by further monitoring and recording of findings and actions taken. The home requires to be more responsive to resolving issues of odour in individual rooms when this occurs whether transient or more long standing in its nature.

CARE HOMES FOR OLDER PEOPLE Bearwood Nursing Home 86 Bearwood Road Smethwick West Midlands B66 4HNR Lead Inspector Richard Eaves Announced 22 August 2005 nd 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. Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Bearwood Nursing Home Address 86 Bearwood Road, Smethwick, West Midlands, B66 4HN 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) 0121 558 8509 Bearwood Nursing Home Ltd Mrs Edith Ndoro Care Home 74 Category(ies) of Old age, not falling within any other category registration, with number (74) of places Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 28th September 2004 Brief Description of the Service: Bearwood Nursing Home is a large converted building, which has been registered since 1988. The home provides nursing care for up to 74 elderly residents and is privately owned. It is a two-storey building with a large car park to the front of the building and a small patio to the rear. The home was purchased in January 2004 by Mr and Mrs Sandu. A porch entrance leads to a spacious reception area, which is staffed during daytime hours. Seating and a drinks machine are available in this area. A lounge and dining room are provided on both the ground and the first floor for communal use. Accommodation is provided in a combination of single and double rooms some having en-suite facilities. The home is close to local amenities and is on a local bus route. Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the report of a statutory announced inspection undertaken by one inspector over a full day during the summer 2005 and involved a full tour of the bedrooms, communal rooms and service areas. The Standards not inspected on this occasion will be included in the next inspection. The inspector had opportunity to speak with most service users and those able to communicate their views, were positive regarding all aspects of the home and care provision. One of the sample of service users case tracked was able to engage in depth discussion of life at the home and care offered which was very positive and confirmed involvement in the assessment and care planning processes. Other information was gathered by observation, meeting with staff and records, additionally the manager completed a pre-inspection questionnaire and many service users and their relatives returned comment cards. Comment cards were received from 22 service users, 6 relatives/visitors to the home and 2 GP’s. Service user comment card responses all but 1 expressed satisfaction with the care and support that they receive and the one other ticked sometimes but provided no further comment but did indicate that activities were not suited to his needs and made no response to liking the food. Activities were the one area with a negative response, with 4 indicating that activities were not suitable, 3 as sometimes and a further 3 as sometimes. Meals faired better with 2 not liking the food and 2 only sometimes. None of the service user respondents gave additional comments although in speaking with the inspector many voiced how happy they were at the home. Relative responses while small in number were overall very positive about all aspects of the home. One respondent did not know of the complaints procedure and two did not know they could access reports on the home. Two relatives offered comments one stating that their family members receive excellent care and was very happy with how they are looked after. The other comment was a request to have access to mothers records particularly to be informed of weight gain/loss, medication, sleep, appetite and mobility. Also identified was that the outside areas are not used to allow service users to get fresh air. The General Practitioners comments were positive but one expressed reservation that staff decisions in identifying when they can no longer manage a care situation would always respond appropriately. No specific example of this was evidenced during the inspection or from reports on occurrences at the home. Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.doc Version 1.40 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The care planning process should be further developed to take account of potential problems arising from known conditions that may have complications that arise unexpectedly but that can be monitored for and guidance given should a circumstance occur. The large patio area could be made more appealing for use by decorating and furnishing appropriately. The variety of bathing opportunities should be maximised by providing an improved servicing arrangement to keep all Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.doc Version 1.40 Page 7 provisions in use. The management of hot water could be improved by further monitoring and recording of findings and actions taken. The home requires to be more responsive to resolving issues of odour in individual rooms when this occurs whether transient or more long standing in its nature. 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. Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.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 Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.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) 1 - 5 The home provides good sources of information about the home and invites prospective service users to visit and spend time at the home prior to admission to enable them to make an informed decision about entering the home, this is confirmed by contract. Pre-admission assessments are undertaken by the most experienced staff and confirmation is given to the service users that their needs can be met by the home. EVIDENCE: The statement of purpose and service users guide were reviewed and updated since the appointment and registration of the manager in march of this year and provide current and prospective service users with a good sources of information from which to make informed decisions about the suitability of the home and the services they offer. In discussion with a recently arrived service user he said he had a copy in his room and had looked at it. Copies of the service users guide were seen in a number of rooms and the manager confirmed that all rooms had a copy. Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.doc Version 1.40 Page 10 A random sample of case files were inspected at both nursing stations and found to include pre-admission assessment and a further in depth assessment at the time of admission. Also included are individual risk assessments such as falls, pressure sores, nutrition and continence and these were all subject to monthly review. A copy of the letter confirming that assessed needs can be met by the home and the contract are kept on file. The qualifications and experience of the staff confirm that the needs of the categories of service users registered for can be met. The separation of elderly frail service users and service users with dementia on to different lounges on the first floor has proven to be a positive initiative. Discussions with service users and families confirms that the home offers an opportunity to visit before an admission takes place. Most prospective service users are admitted from hospital and unable to take the opportunity to visit, depending on relatives to make the choice. Where a visit occurs this is documented in the persons case file. The home does not provide intermediate care. Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.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 - 10 Health care needs of service uses are fully met and care planning in the home is overall of a good standard. There remains scope to improve if service users are not to be at risk of potential needs not being fully met. Medications are well managed at the home, facilitating the promotion of service users health. Staff show a good understanding of service users needs and have positive relationships with them that is both respectful and protective of their privacy and dignity. EVIDENCE: A sample of case files were selected at random in each area of the home to be inspected and case tracked. The care plans were seen to be drawn from the assessed needs process and were relevant and maintained to a good standard. The care plans reflect actual care requirements and the service users preferences of how it is to be given. In a small number of cases there were notable omissions from the plans, examples include the lack of contingency plan for a diabetic and an epileptic. One other case file for a diabetic had a contingency plan on a secondary care plan but had no reference to its existence on the primary care plan. Care plans and risk assessments are reviewed at least monthly with the involvement of the service user their representative. Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.doc Version 1.40 Page 12 Medication administration is undertaken by nursing staff using the NOMAD monitored dosage system provided by Friar Park Chemist who also undertake the quarterly monitoring visit and issues a report on standards at the home, these were seen to be satisfactory. Discussion with staff and observation of practice confirms that medication administration record (MAR) charts are completed at the time of administrating the medication. The MAR charts examined were completed accurately. Arrangements for all aspects of medication management are robust The sample of care plans inspected include; records of the individuals stated preferences for their daily routine such as rising, retiring and bathing. The staff record the life story for each resident that insight and understanding of the person prior to their admission to the home. Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.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 - 15 The home provides a limited but well-organised and varied social and recreational activity programme that provides interest and pleasure for the residents. An open visiting policy assists service users to maintain contact with their family and friends. Many aspects of care evidences that service users exercise choice and control over their lives. Meals at the home are wholesome and meet the nutritional needs of service users while reflecting choice and taste. EVIDENCE: The home has an activities programme that is displayed on the main notice board and which forms the basis of routine events which is expanded by more ad-hoc and spontaneous events such as exercises, music and movement, entertainers, individual shopping trips. One service user attends a day centre. Hairdressing, aromatherapy, manicure and pedicures are regularly available. The 22 service user comment cards identified that 13 thought the activities were suitable, 6 no reply and 3 not liking. The spiritual needs are met with frequent church visits and services and a number of service users attend the temple close by. Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.doc Version 1.40 Page 14 Visitors spoken with said they felt they are welcome at any time and five of the six relative comment cards respondents stated that staff made them welcome. Care plans identify residents individual likes and dislikes and choices about their individual routines, these are carried out flexibly to provide for choice of the moment. The menus provide for a balanced and nutritious diet and is well received by the residents many able to recall the choices offered at each of the meals and that the three main meals offered a cooked option. The menus have been assessed as nutritionally sound and are put together using a high proportion of fresh produce. Each meal has a choice that meets cultural wishes The 22 service user comment cards identified that 17 liked the meals, 2 no reply, 2 sometimes and 1 not liking. In talking with the service users and in observing the lunchtime meal all were seen and indicated that the meals were most enjoyable. Meals are always included as an agenda item at the monthly service user meetings. The kitchens were clean and all aspects of hazard analysis and critical control points were in place to provide safe food production. Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.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, 17 & 18 The home complaints and protection policies are robust providing a safe environment in which service users feel they can voice concerns and that these will be listened and responded to. Service users rights are protected and staff demonstrate excellent knowledge and understanding of adult protection issues which contributes in providing an environment safe from abuse. EVIDENCE: The home has an appropriate complaints procedure and maintains a detailed record of the complaint investigation and the outcome, six internal complaint were recorded and resolved to the complainants satisfaction. Advocacy services are displayed in the main reception area and the manager identified that the electoral roll is completed each year and confirmed that postal votes had been arranged for the last election. Service user meetings are held monthly and are a good platform for developing ideas whether in respect of planning events or adapting the menus. The home has robust procedures for responding to any suggestion of abuse and training is given to staff in adult protection procedures. Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.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 - 26 The environment of the home is maintained to a good standard, clean and hygienic providing the service users and staff with a comfortable and safe place in which to live and work. The communal areas provide comfortable attractive facility with suitably placed toilet facilities nearby for the residents convenience. Each of the bedrooms are personalised with possessions and are furnished to individual needs, having en-suite or a washing facility with toilets and bathrooms close by providing for the comfort and convenience of the service users. Services such as heating and lighting are provided and monitored to ensure that service users needs for light and warmth are safely met. EVIDENCE: The home is entered from the car park through a secure entrance to a spacious reception which is comfortably furnished and where the registration and insurance certificates and other relevant information are displayed. External Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.doc Version 1.40 Page 17 areas for service user use comprise of patio areas, the main one of which has in parts algae that could present a slipping hazard and requires jet washing. There was little outside seating available. A programme of refurbishment has been undertaken in the lounges, decoration, carpeting and all chairs upholstered, the dining rooms have also been decorated and had new floor covering and several service user bedrooms have also been decorated and carpeted. A programme to develop a lounge for service users with dementia is underway on the first floor. A high proportion of bedrooms were inspected and clean and tidy pleasantly furnished and meeting the standards for furnishings locks and safety. Room 2 was noted to have an odour that requires attention and action taken needs to be documented of adjustments made to control hot water supply at 43°c. The home is provided with suitable and sufficient bath and shower facilities, on the day bathroom one was out of service and the ground floor shower room had no extractor. The shower room had an odour that was due to the bin for incontinence pads having no lid, the shower drain was dirty and the floor to wall sealant was disrupted and needed attention. The home is well provided with toilets and bathrooms in sufficient numbers disbursed about the home all adapted to accommodate the disabled. The home has its own laundry fitted with washers that have sluicing and disinfection programmes, on the day two of three machines were waiting repair. A sluicing disinfector is provided on both floors the hand wash facility in the sluice rooms, the laundry and kitchen supply hot water at very high temperature and requires control to promote good hand washing practice. Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.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 - 30 The home benefits from a stable staff group, with good levels of qualification and experience who are a good match to providing consistency of care to the service users. The home has made progress in developing a skilled staff group with an understanding of service users needs and provide all staff with training, which safeguards the health and well being of the service users. Recruitment and selection processes are to a good standard protecting vulnerable people. EVIDENCE: An inspection of the staffing rotas demonstrates that the home maintains satisfactory staffing levels. The allocation being 2 nurses over the 24 hours supported by a senior care and 12 care during the morning, a senior care and 8 care during the afternoon and 7 care at night to care for 64 service users. Currently there are 20 of the 36 carers holding an NVQ at level 2 or higher with a further 11 enrolled. Nurses and carers are well supported in their work by good numbers of ancillary support providing 15 hors of cleaning each day and 10 hours a day in the laundry. Catering is provided by 2 cooks and 3 assistants who between them provide a full service over the week. An inspection of a random sample of staff files show that the home operates a robust recruitment and selection process with all necessary checks including enhanced CRB and POVA and PIN checks for Nursing staff. Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.doc Version 1.40 Page 19 The Home continues to demonstrate a strong commitment to staff training and development and has achieved a ratio of more than 50 of care staff trained at NVQ 2 in advance of the target for the end of 2005. The range of training both mandatory and development is extensive with monitoring to ensure all staff are compliant in attending the mandatory such as Fire and manual handling. Other training recently undertaken includes adult protection, health and safety, TOPPS induction and first aid of which 24 staff are certificated. Care training includes continence care, key worker skills, infection control and basic food hygiene, dementia awareness and challenging behaviour, care of the dying and oral care. Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.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) 33, 36 & 38 The home regularly reviews its performance which includes consultation and seeking the views of service users and their families and evidenced that it is acted upon. Staff receive supervision and direction to ensure that the service users receive consistent quality care. Environment management and staff training in respect of health and safety ensures service users safety and welfare are protected. EVIDENCE: The home regularly undertakes extensive audits of all aspects of service and surveys the views of service users and their relatives. The most recent survey of views has been sent out but responses have been slow to come in. Monthly meetings are held for service users and these are minuted and actions /responses also documented. A quarterly surgery is held for relatives to Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.doc Version 1.40 Page 21 proactively seek their views about the service and notes and actions / responses are also kept. A sample of supervision records were inspected and these show that supervision session topics are relevant and the process is on target to achieve at least 6 sessions a year for all staff. Health and Safety is given appropriate priority with a broad range of monitoring and maintenance in place with all staff receiving training at induction and ongoing at appropriate intervals. During the tour of the building it was observed that all corridors, exit and egress ways were clear. Accident recording appears thorough and is subject to auditing and individual re-assessments. Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 2 3 2 3 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x 3 x x 3 3 3 Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.doc Version 1.40 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 op7 Regulation 15(1) Requirement The registered person must ensure that care plans take account of contingency planning for specific conditions. The registered person will ensure external grounds are safe for use by service users in particular the patio areas kept free from algae which may present a slipping hazard when wet. The registered person must ensure that there is suitable and sufficient patio furnishings for the use of service users. The registered manager must make arrangements for the annual servicing and anti-scald testing of all hot water mixing valves and present the records in a format that shows the history of each valve and actions taken to adjust temperatures. The registered manager must provide safe supply of hot water at staff hanwash points of sluice, kitchen and laundry to promote good hand-washing practice. The registered manager must ensure that baths and showers are maintained serviceable and clean and extractor fans are in Timescale for action 30.9.2005 2. op19 23(2)(o) 30.9.2005 3. op19 23(2)(g) 31.3.2006 4. op25 13(3) 30.9.2005 5. op25 13(4)(a) 30.11.05 6. op21 23(2)(d) 30.9.2005 Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.doc Version 1.40 Page 24 good working order 7. op23 23(2)(d) The registered person must identify the cause and keep individual bedrooms free from odour. 30.9.2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard op7 Good Practice Recommendations The home should ensure that where secondary care plans arise they should have a reference to it in the primary care plan. Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.doc Version 1.40 Page 25 Commission for Social Care Inspection Mucklow Office Park West Point, Mucklow Hill Halesowen B62 8DA 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 Bearwood Nursing Home E55 S52879 Bearwood V237192 220805 Stg4.doc Version 1.40 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. 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!