Inspection on 20/04/05 for Bradbury House

This inspection was carried out on 20th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Bradbury House 20/05/09

Bradbury House 18/04/07

Bradbury House 25/10/05

Bradbury House 02/11/04

Bradbury House 29/04/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Bradbury House New Street Braintree Essex CM7 1ES Lead Inspector Kathryn Moss Unannounced 20th April 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Bradbury House I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Bradbury House Address New Street, Braintree, CM7 1ES 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) 01376 348181 01376 327225 admin@caringhomes.org Greenacres Homes Ltd Mrs Nicola Leaney Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (OP) 21 Both of places Bradbury House I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 21 persons) Date of last inspection 2nd November 2004 Brief Description of the Service: Bradbury House is situated in the centre of Braintree, with easy access to town centre shops and amenities. The home is registered to provide care to 21 Older People (i.e. over the age of 65), and is not registered to admit people with dementia. The home provides 24 hour personal care and support, and has appropriate equipment to meet the needs of people who have limited mobility (e.g. through floor passenger lift, mobile hoist, grab rails, assisted bathroom, etc.). The home is an older style property, decorated and furnished in a homely manner. Service users are accomodated in fifteen single rooms and three double rooms; all three double rooms have ensuite toilets, as do ten of the single rooms. Communal areas consist of an open plan lounge area, a separate dining room and an outside patio area with seating. The home is owned by Greenacres Homes Ltd., and the registered manager is Nicola Leaney. Bradbury House I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on the 20/4/05, lasting 7 hours. The inspection process included: discussions with the manager, three staff, five service users and three relatives; premises observations on one bedroom, a bathroom, communal areas and the laundry; and inspection of a sample of policies and records (including any records of notifications or complaints sent to the CSCI since the last inspection). Twenty standards were covered, and two requirements and six recommendations have been made. What the service does well: What has improved since the last inspection? What they could do better: Residents would greatly benefit from an additional assisted bathing facility, preferably on the ground floor, as facilities are currently quite limited. This has been highlighted as a requirement. A second requirement and several recommendations have been made regarding some other premises issues. Bradbury House I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 6 Some recommendations have also been made regarding some recording issues. Additionally, as care plans contain a lot of good information, it would improve these if they could be entered on the computer and printed off, instead of handwritten. This would make them clearer to read, more flexible (e.g. to be able to provide residents with a larger-print version), and easier for the manager and staff to update. 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. Bradbury House I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Bradbury House I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 4 and 5 The service operates a thorough and responsible pre-admission assessment process. Care and attention given to ensuring that the home can meet the individual’s needs resulted in appropriate admissions; promoting visits to the home prior to admission enabled prospective residents to feel confidant about their decision to move in. Individuals’ needs were being well met within the home. EVIDENCE: All prospective residents are assessed by the home prior to admission, and information on the person’s needs is recorded. Evidence of pre-admission assessments were present on all three files inspected. The manager showed a good awareness of the needs that the home is able to meet, and clearly took this into account when considering prospective admissions. Over the last year the manager had developed the admission process to include, where possible, more visits to the home by the prospective resident prior to moving in. She stated that this was aimed at making the admission process a much more positive experience for the person, and to help them to maintain control over the process and to feel that it was their decision. A new Bradbury House I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 9 resident was spoken to and confirmed that they had had opportunity to visit the home before they moved in, felt that meeting the manager and visiting the home had helped them to be confidant that this was the right home for them, and that they had settled in quickly and were happy with the way their needs were now being met. A visitor spoken to also expressed great satisfaction at the way the home had handled the admission and subsequent care of their relative. This is to be commended; it was recommended that the home keep a record of pre-admission visits, as these provide evidence of the assessment and admission process. There was evidence of a good level of staff training being provided (see Standard 30), and staff spoken to demonstrated a good understanding of service users’ needs. All service users and relatives spoken to were very positive about the care provided at Bradbury House, and felt confident that staff had the skills to deliver the support and care required. Bradbury House I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 Residents health and personal care needs are well met; individual care plans clearly detailed the care and support required. Staff showed a caring approach towards service users, treating them with dignity and respect. EVIDENCE: Three care files were inspected. All contained care plans that covered all key needs (physical and social), provided good detail of the action required of staff to meet residents’ needs, and had been regularly reviewed. There was also evidence (signed consent form) to show that residents/their relatives had been consulted on their care plans. Bullet points and highlighted sections enabled key issues to be easily noted; it was recommended that if care plans could be typed instead of handwritten, they would be clearer to read and easier to amend when needs changed. Service users spoken to felt that staff gave them the level of support and assistance they required, and provided care in an appropriate way. Staff were noted to treat residents respectfully, and to assist them in a discrete and dignified way. Three relatives spoken to were all very positive about the personal and healthcare support provided by the home, with one stating that their relative would not be still alive if it were not for the care provided since their admission to Bradbury House. Bradbury House I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 11 Files also contained a range of additional assessments covering continence, nutrition, mobility and moving and handling, and pressure areas, as well as risk assessments relevant to individual needs. Assessments had been regularly reviewed, and demonstrated that needs in relation to mobility, continence and pressure areas had been assessed; care plans showed appropriate action to meet these needs, including any aids required (e.g. continence pads, pressure relief mattresses and cushions). Staff showed good awareness of the action required to meet these needs, and were able to discuss how continence was maintained, and to describe the progress made in healing pressure areas that one resident had been admitted to the home with. Records showed appropriate referral to health professionals, and one resident’s care plan contained clear instructions about seeking medical support. One resident spoken to stated that they had been able to retain their own GP when they moved to the home, and described how staff had supported them to attend an appointment at the surgery. The manager stated that the home is well supported by local district nursing services. Medication supplies and policies were not reviewed on this visit. Medication administration records (MAR) relating to three service users were viewed, and were well maintained; alterations to medication instructions (e.g. ‘see new MAR’, ‘discontinued’, etc.) were not always being signed and dated by the person making the entry. A carer was observed to follow appropriate procedures when administering and recording one residents medication. Four staff had recently attended medication training. Bradbury House I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, and 15 Daily routines are flexible, and choices are actively promoted. A good and appropriate range of activities and interaction takes place in the home. Visiting arrangements are open and relaxed; staff encourage contact with the local community. The home supplies sufficient quantity and quality of food, and provides a well balanced diet that meets individual needs and choices. EVIDENCE: From discussion with residents and with staff, routines in the home appeared flexible and residents’ individual choices were accommodated. One person said that they felt the best thing about the home for them was “the freedom to come and go as I want”; another recounted that on one occasion they had been out for an evening and returned very late, but that staff had been quite happy to make them a drink and to sit and chat to them. Both a resident and a relative independently described the home as ‘like one big family’. Residents were able to bring their own possessions into the home, and family members were being involved in preparing and planning a room for a new resident to move into. Where able, service users were seen to be encouraged to exercise control and choice over their lives (e.g. through personalising their rooms, maintaining previous contacts outside of the home, etc.). Bradbury House I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 13 Over several inspections it has been noted that there is a consistently high level of interaction between staff and service users at Bradbury House. On this occasion a carer was noted to be interacting very well with a service user who was quite confused. The home has an ‘activities’ programme, and members of staff have specific responsibility for activities in the home. There are regular social events, and one resident commented that staff use “any excuse for a party!” Photos seen showed a very good involvement of service users in these parties, which clearly gave residents a lot of enjoyment. Residents were enthusiastic about a recent evening when staff had arranged a Chinese takeaway and a glass of wine, and they had all sat around chatting. They were also looking forward to an evening out that had been arranged for a residents birthday later in the week. It was noted that on many of these occasions staff attended and assisted in their own time (see standard 32). Visitors were welcome at any time, and the three relatives spoken to all found staff friendly and supportive, and felt that they were encouraged to ‘feel at home’. The home continued to facilitate opportunities to go out into the local community, both for individuals and groups (e.g. for shops, lunch, etc.). All five service users spoken to were positive about the meals provided, and confirmed that a choice of food was available. The cook showed a good knowledge of residents personal preferences and any individual needs, and was flexible and adaptable with respect to the meals provided. The main meal on the day of the inspection was well balanced, looked appetising, and was eaten well by residents; nutrition records showed a good range of meals being provided. At lunchtime staff assisted service users in an appropriate and respectful way, and the dining environment was pleasant. A range of choices were seen being provided at teatime, and service users could choose where to have their meal. Bradbury House I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 The home operates appropriate practices and procedures to protect vulnerable adults, and the manager actively promotes awareness of protection issues. EVIDENCE: Standard 18 was not fully inspected on this occasion, only an issue highlighted at the last inspection regarding the home’s policy on the Protection of Vulnerable Adults (POVA). The registered person had since updated this policy to include details of the procedure to be followed in the event of evidence or suspicion of abuse. This was now much clearer, and included the action to be taken and the Essex multi-agency protocols (including referring incidents to Social Services). The manager stated that all staff had received training in POVA, and that this is regularly discussed at staff meetings. Evidence of recruitment practices showed that the manager was taking up appropriate prerecruitment checks on new staff (see standard 29). The CSCI has not received any complaints about the service over the last year. Service users spoken to had no complaints about the home, and felt safe and confidant living in the home. Bradbury House I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 15 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, 25 and 26 The home is homely, safe and well maintained; heating and lighting were generally satisfactory. The home was clean and hygienic on the day of the inspection; there are systems and facilities in place to prevent the spread of infection, but damaged floor coverings could present an infection control hazard. There are insufficient suitable assisted bathing facilities, and this should be reviewed. EVIDENCE: Only limited areas of the premises were inspected on this occasion, including: communal areas, one bathroom, a bedroom and the laundry. Communal areas of the home viewed were generally in a good state of maintenance and decoration; it was noted that quite a lot of redecoration had taken place over the last year. Some items of bedroom furniture were becoming quite worn, due to their age. In talking to one resident it was noted that their bedroom had been attractively decorated before their admission, and they felt that they had sufficient furniture to meet their needs. Some pipes in a bathroom that had presented a hazard at the last inspection had now been removed; a hole in Bradbury House I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 16 the floor underneath had been repaired on the morning of the inspection, but repair to the floor covering was still needed. There had been no change to assisted bathing facilities since the last inspection, when it had been noted that only one (first floor) bathroom contained an assisted bathing facility (an adjustable bath that can safely and appropriately be accessed with a mobile hoist). As most residents require assistance to get into a bath, on this inspection it remained the case that this one bathroom was being used by most of the residents. Lighting and ventilation were reviewed with respect to issues raised at the last inspection, and it was noted that action had been taken with regard to some of these. It had not yet been possible to resolve concerns about a lack of ventilation in the main lounge area, as some residents became cold when windows were opened. The manager reported that they regularly check hot tap temperatures (and keep records of this), and that since the last inspection a water risk assessment and treatment had been carried out (with respect to Legionella). However, there was no evidence of this available, and no systems had been implemented to check that hot water is stored at a temperature of at least 60°C and distributed at a minimum of 50°C. The manager was given advice regarding monitoring the temperature of an unregulated hot water outlet close to the boiler. On the day of the inspection communal areas were clean, tidy and free from any unpleasant odours. A relative spoken to stated that they visited regularly, and always found the home to be clean and odour-free. Laundry and sluice facilities met the needs of the home, were located away from areas where food was prepared or eaten, and contained hand wash facilities. The washing machine included a sluice wash programme. The laundry would benefit from some refurbishment, and the taped joins around the lino covering a man-hole cover in the floor should be repaired. Infection control policies were not inspected on this occasion, but appropriate practices were seen in place and protective clothing was available. The home’s carpet cleaner was broken, and this should be repaired or replaced as soon as possible. Bradbury House I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 17 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 Appropriate training is provided to give staff the skills to do their job, and staffing levels (number and competence) met the needs of current residents. Recruitment practices promoted the protection of service users. EVIDENCE: The staffing levels on the day of the inspection met the levels agreed with the CSCI; from discussion with staff and residents, staffing levels were well maintained, and were appropriate to the needs of residents. Agency staff are rarely used in the home: some current staff shortages due to sickness were being covered by the manager and care staff working extra shifts; this enabled good continuity of care within the home, and staff should be commended on this. The file of one new staff member was inspected, and showed that all the appropriate checks had been obtained before the person started work. Individual training records and evidence of Induction training were not inspected on this occasion. Records summarising core training were seen, and showed that most staff were up-to-date with all core training subjects. Recent training attended included COSHH, basic first aid, fire safety and moving and handling, and the manager’s training plan for the year included training in bereavement and in continence care. Regarding NVQ training, currently six staff have achieved NVQ level 3, and two NVQ level 2; a further four are in the process of doing NVQ level 2. In a staff team of 18 care staff, this means that 12 staff (66 ) should have NVQ level 2 or above by the end of 2005. Residents and relatives spoken to all felt that staff had the skills and knowledge to provide their care appropriately and competently. Bradbury House I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 18 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) 32 The manager demonstrates clear leadership within the home, and promotes an open, positive and supportive atmosphere. EVIDENCE: Feedback from staff, residents and relatives indicated that standard 32 is being well met within the home. The manager was observed working in the home, and seen to provide clear direction and guidance to staff and to demonstrate a positive and supportive approach when listening to a concern raised by a resident. Staff continued to report that they find the manager approachable and supportive; residents and relatives spoke highly of the internal management of the home, and felt there was good communication. Several relatives particularly commented on a very evident culture of fun and friendliness promoted within the home: they observed that staff were caring and supportive of each other, and felt that this directly influenced the friendly atmosphere in the home, the high level of care and affection demonstrated Bradbury House I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 19 towards residents, and the support given to relatives. Staff regularly came into the home in their own time, especially for social events. Residents clearly appreciated the staff very much, with one saying “I feel like I’ve fallen in clover” and another reporting that “this is my family”! The manager and staff should be commended on this. Bradbury House I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 20 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 3 3 x 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 4 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x 2 x x x 2 2 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 x x 3 x 4 x x x x x x Bradbury House I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 21 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 21 Regulation 23(2)(j) and (n) Requirement The registered person must provide service users with adequate private and communal accommodation, facilities and equipment. This particularly relates to provider ensuring the provision of sufficient and suitable assisted bathing facilities. This is a previous requirement (timescale of 31/3/05 not met) 2. 25 (and 38) 13 The registered provider must ensure that there are adequate systems in place to prevent the risk of Legionella. This is a repeat requirement (timescale of 31/12/04 not met) 31/7/05 Timescale for action 31/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 22 Bradbury House 1. 2. 3. 4. 5. 3 and 5 8 9 19 25 It is recommended that visits to the home prior to their admission are recorded, as these form part of the homes pre-admission assessment process. The registered person should ensure that daily nutrition records are consistently maintained. The registered person should ensure that any changes to medication details or instructions recorded on the MAR are signed and dated by the person making the entry. It is recommended that bedroom furniture be reviewed, and any worn items replaced. To prevent risk of Legionella it is recommended that the registered person ensure that there are systems in place for monitoring that hot water is stored at a temperature of at least 60°, and distributed at a minimum of 50°C. This is a repeat recommendation. It is recommended that repairs to items/areas presenting an infection control hazard are carried out as soon as possible. This particularly relates to floor coverings in areas where body fluids or soiled items may be present (i.e. the first floor bathroom and the laundry), and repairing (or replacing) the carpet cleaning machine. 6. 26 Bradbury House I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Fairfax House Causton Road Colchester CO1 1RJ 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 Bradbury House I56-I05 s17777 Bradbury House v222507 200405 stage 4.doc Version 1.30 Page 24 - 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!