Inspection on 22/06/06 for Bridge House

This inspection was carried out on 22nd June 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Bridge House 21/05/08

Bridge House 08/05/07

Bridge House 26/10/05

Bridge House 25/04/05

Bridge House 01/12/04

Bridge House 23/06/04

Bridge House 12/02/04

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

CARE HOMES FOR OLDER PEOPLE Bridge House 1 Forty Hill Enfield Middlesex EN2 9HT Lead Inspector Tom McKervey Key Unannounced Inspection 22nd June 2006 09:30 X10015.doc Version 1.40 Page 1 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 Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 Page 2 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. Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Bridge House Address 1 Forty Hill Enfield Middlesex EN2 9HT Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8363 0045 020 8245 4246 London Borough of Enfield Ms Ruby Chung Care Home 39 Category(ies) of Dementia - over 65 years of age (39) registration, with number of places Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th October 2005 Brief Description of the Service: Bridge House is a large purpose-built care home near Forty Hill in Enfield. The home is owned and managed by Enfield Council. The nearest station is Gordon Hill and the amenities of Enfield town are a short bus ride away. The home is registered to provide care for thirty-nine people who are over the age of 65 and have dementia. There is a car park at the front of the building and a raised area planted with shrubs. The home comprises of three storeys. There are nineteen single bedrooms and eight shared bedrooms located on the upper floors. These are accessed by two passenger lifts. There are two lounges, a large kitchen and a dining room on the ground floor. There is a safe enclosed garden at the back of the home. The entrance to the home is protected by an intercom system and closed circuit television. A coded keypad is used to exit the building. The fees for the service are £602 per week. Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was completed in six and a half hours. Daniel Lim, another inspector from the Commission for Social Care Inspection, assisted the lead inspector in this process. The inspection was carried out as part of the Commission’s inspection programme and to check compliance with the key standards. The manager and deputy were present throughout the inspection. The inspection consisted of a tour of the premises, speaking to a large number of residents, and interviewing staff. Two visiting relatives were also spoken to. All interviews were conducted independently of managers. The inspector also read residents’ case files and staff records in addition to several documents pertaining to the running of the home. What the service does well: What has improved since the last inspection? Risk assessments are carried out on residents regarding susceptibility of pressure ulcers and the action to taken if a resident loses weight is documented. At the last inspection, a requirement was made for a specialist assessment to be carried out of a specific resident’s needs. This was complied with. Residents’ life histories are recorded to inform staff appropriate leisure activities, based on likes and dislikes. Bridge House DS0000033427.V292382.R01.S.doc about Version 5.1 providing Page 6 Staff have been trained in adult protection procedures to safeguard the welfare of residents, and the staff now receive regular formal supervision to support them in their caring role. Staffing levels are regularly monitored by the manager to ensure that sufficient staff are always available to meet residents’ needs. A member of staff now sits at each table at lunchtime, to support residents who require help to eat. Relatives at their last meeting favourably commented this arrangement on, and they said that the interactions between residents and staff had improved as a result of this change. An individual file has been provided for each member of staff’s records. Disposable hand towels have been provided in the kitchen, and cleaning materials are now stored securely. Several requirements from the last inspection about the physical environment of the home and health and safety have been complied with, including: • Replacement of carpets • Installation of a secure entry and exit system to protect residents who may wander. • Toilets have been refurbished. • Gas, electrical, emergency lighting, fire and water installations have been serviced. • Lifts and mechanical hoists have been serviced. • Fire doors are not being wedged open. • A fire risk assessment of the home has been conducted. What they could do better: A requirement made at the last inspection has not yet been met and has been restated in this report, with a new timescale for compliance. In the “Timescale for Action” column, the date in ordinary type relates to the timescale given at the last inspection. The date in bold type relates to the new timescale. Further information about unmet requirements can be found in the relevant standard. Unmet requirements may impact upon the welfare and safety of service users. Failure to comply by the revised timescale may lead to the Commission for Social Care Inspection considering action to secure compliance. Despite several restated requirements, there is still no timescale for replacement of the window frames in the building, which are in a poor state of repair. Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 Page 7 Other requirements have been made in relation to staff using safe moving and handling techniques when supporting residents with mobility problems. All staff in the home should have contracts of their terms and conditions of employment that accurately reflect their roles and responsibilities. There must be better, more accurate recording of the administration of medicines to prevent mistakes being made and residents being harmed. Stimulating activities must be provided for residents that reflect their personal interests on an individual, as well as a group basis. The appearance of the home would be much improved by clearing the weeds and attention to the shrubbery at the front of the 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. Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 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 the following standard(s): 2, 3, 4 & 5. Standard 6 does not apply. The quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. New residents have comprehensive assessments of their needs before being admitted to the home. The home is designed and equipped to meet residents’ needs, and staff are trained to care for people with dementia. Relatives and friends are able to visit residents at any reasonable time. EVIDENCE: The local authority funds the care for the majority of residents in the home, but also admits people who are privately funded. The records of two residents most recently admitted were examined. They contained signed contracts of the terms and conditions of the service and information about what was covered or excluded in the fees. Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 Page 10 There were records of needs assessments being carried out by referring professionals and by senior staff from the home. One resident whose needs had changed recently, was in the process of being transferred to another care home where their needs could be better provided for. At the time of the inspection, this resident and their relatives were visiting another care home to assess whether it would be suitable to meet their needs. The home was purpose-built, and all areas of the home are accessible by people with mobility problems. Lifts are available and bathrooms and toilets have been adapted and equipped for people with physical disability. Staff have attended training in dementia care. A new keypad system had been installed for exiting the building. This protects residents who are liable to wander and put themselves at risk. Recently, the home closed a respite unit and decommissioned a double room. The manager showed the inspector advanced plans to convert this room to a sensory area, which will be a valuable asset to the care of people with dementia. The manager said that when a resident becomes permanent, care managers close the case and no annual care reviews by care managers were not being held. This is not good practice and the Commission will raise this matter with the local authority for Social Care Inspection. There is an open visiting policy, and the visitors book confirmed that friends and relatives visited the home at varying times of the day. Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 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 the following standard(s): 7,8,9 & 10 The quality in this outcome group is adequate. This judgement has been made form evidence gathered both during and before the visit to this service. There are very good care plans and risk assessments in place to guide staff in caring for the residents. However, residents could be put at risk through not recording accurately, the administration of medicines and by using poor techniques when moving and handling residents Residents say they are well cared for and treated with dignity and respect, and their healthcare needs are being met by the staff and healthcare professionals. EVIDENCE: Six care plans that were examined covered all aspects of the residents’ care and there was guidance for staff about actions required to meet the residents’ needs. The plans, which were the responsibility of key workers, were clear and well structured, and there was evidence that the care plans were being reviewed monthly. Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 Page 12 It was pleasing to see a notice for relatives at the entrance to the home, inviting them to look at, and be involved in, care plan reviews. Many relatives had taken advantage of this offer. Care plans are kept in residents’ bedrooms. A risk assessment had been completed for all the residents whose files were sampled, which covered risk of developing pressure ulcers, falls, moving and handling and wandering. The healthcare records showed that a range of professionals were involved in residents’ care, including district nurses, chiropodists and dentists. Residents were also supported to attend out-patient appointments. There were charts in place to monitor residents’ weights. At the last inspection, a requirement was made for a specific resident to be assessed regarding the use of a reclining armchair. There was a record of this being carried out by a psychiatrist and an occupational therapist, who supported the use of the chair. The inspector was concerned to note two incidents when a resident was not being properly supported when transferring from a seating position and another incident when brakes had not been applied when moving a resident from a wheelchair. The inspector informed the manager about this and a requirement is made to address this issue. At the time of the inspection, no resident was self-medicating. Medication was safely stored, but an examination of the administration of medicines records found that there were some errors. Some medication had been given but not signed for, and vice-versa. A requirement is made to address this matter. The controlled drugs stock was checked and found to be in order. The inspectors observed the interaction between staff and residents, which was warm, caring and courteous. The residents were clean and appropriately dressed. Residents, who were spoken to, were very complimentary about the managers and staff and said they were treated with dignity and respect. It was noted that personal care was being given discreetly in bathrooms and toilets with the door closed. Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 14, 15 The quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. While efforts have been made to increase the range of activities for residents, improvement is needed to meet their needs for stimulation on an individual basis. Residents are able to exercise choice about their lives as far as possible, and the standard of catering is good. Friends and relatives are welcome to visit at any reasonable time. EVIDENCE: The manager described a new system for recording programmed activities. These included floor skittles, dominoes, bingo and art sessions, and musical entertainment, some of which is provided by outside entertainers. These activities usually take place for an hour in the afternoon. Occasionally, outings are arranged for groups of residents, and one had recently taken place to Southend. Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 Page 14 At the time of the inspection, the staff were preparing for the annual garden fete to be held at the weekend. Residents’ case files contained biographies that detailed their likes and dislikes, hobbies and interests. However, these interests were not always catered for in the activities. For example, one resident said that they would like a staff member to support them in going out for walks but said that there was not enough staff available. The manager said that this would not be a problem and would discuss this with the resident concerned and their key worker. One other resident who was interviewed, was very satisfied with their lifestyle, which included going out each day for lunch at a local club and watching television in their room. While efforts have been made since the last inspection to extend the range of activities, a requirement is made for each resident to have an individual, as well as a group activity programme, based on their recorded interests. The provision of the sensory room will enhance the activities available to residents. There was evidence in the visitors’ book of regular visits by friends and relatives. Two visitors spoken to during the inspection said that they could visit the home at any time and they were always made welcome by the staff. The majority of the residents in the home have dementia, and were not able to be interviewed, however, their choices regarding likes and dislikes were ascertained from relatives and recorded when they were admitted to the home. Examples were; “Likes a cup of tea last thing at night”, and “Likes to go to bed early”. Two residents were able to describe what choices they made regarding activities, meals and bedtimes. This included choosing to eat in their rooms if they wished. The menus showed that food was nutritious and well-balanced and fresh fruit was available. An inspection of the kitchen stores confirmed that there were ample stocks of food and it was stored safely. Catering staff had been trained in food hygiene. The manager has recently ensured that a member of staff is in attendance at each table to support residents who require help to eat. This arrangement was favourably commented on by relatives at their last meeting, and said that the interactions between residents and staff had improved as a result of this change. Staff were observed supporting some residents to eat in a dignified and unhurried fashion. Special diets were also provided as appropriate. Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 Page 15 Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 Page 16 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 the following standard(s): 16 & 18 The quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents and their representatives can feel confident that complaints will be properly addressed and staff have been trained in adult protection procedures. EVIDENCE: Three complaints were logged in the past year. The manager showed the inspector a detailed investigation into the most recent complaint, which was comprehensive. Complaints had been dealt with in appropriate timescales. There were records showing that staff had attended training in adult protection, and discussions with staff confirmed that they were aware of their responsibility regarding prevention and reporting of suspected abuse. Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 Page 17 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 the following standard(s): 19, 20, 21, 22 & 26 The quality in this outcome group is poor. This judgement has been made from evidence gathered both during and before the visit to this service. The residents live in clean, secure surroundings. Several improvements have been made to internal areas of the home, but the condition of the exterior of the premises is poor, which seriously detracts from the appearance of the home and creates a negative view of the service. EVIDENCE: A tour of the premises was carried out. Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 Page 18 Several improvements have been made following the last inspection. These include the refurbishment of bathrooms and toilets and the replacement of carpets in the ground floor corridor and hallways. There are sufficient toilets and bathrooms for the number of residents in the home, and they are fitted with appropriate adaptations and equipment for example, grab rails, hoists and assisted baths for people with mobility problems. The dining room is not big enough to comfortably seat all residents at once. However, the inspector observed several residents having their meals in the lounges, and some residents also choose to eat in their bedrooms, which relieves the pressure on dining room space. Several bedrooms were visited. The standard of décor was good and there was evidence of personal possessions, for example, furniture, photographs and other mementoes. The inspector saw evidence that a new call-bell system was about to be installed to replace the current one, which was faulty. A requirement from several previous inspections about the poor state of the exterior of the building, particularly the window frames, has not been complied with. It is also of concern to the manager of the home who said she has made several attempts to raise this issue with Enfield Council. A requirement about this matter is restated to obtain a firm timescale for these refurbishment works to be done. In addition to the poor state of the windows, there are weeds growing through the surface of the car park and the shrubbery at the front of the building needs attention. The grass also needed cutting. The home employs a team of cleaners, and at the time of the inspection, the home was very clean and tidy and there were no offensive odours. Care staff are provided with disposable gloves and aprons when supporting residents in their personal care, after which, staff were observed washing their hands. Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 Page 19 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 The quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. There are sufficient numbers of trained and competent staff available to meet residents’ needs. However, new staff do not have contracts, which are necessary to confirm their terms and conditions of employment. Residents’ welfare is safeguarded by proper systems for recruiting staff, but not all staff have a contract of their terms and conditions of service. EVIDENCE: At the time of the inspection there were thirty-six residents living in the home. The inspector examined the staff rota. There are normally seven care staff on duty in the morning, five in the afternoon/evening, and three staff on night duty. This is in addition to the manager, deputy and administrator. There is also a team of catering and cleaning staff. The manager demonstrated the method by which she monitored and adjusted the staffing levels in accordance with the dependency and number of residents, which was a requirement in the last inspection. The inspector was satisfied that this meets the staffing level standard. Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 Page 20 Staff who were interviewed, said that they felt the staff levels were adequate, especially now that there was a new security system in place to prevent residents from wandering outside the home. The staff records showed that proper recruitment procedures were in place, including obtaining references and Criminal Records Bureau clearances. However, three new staff did not have contracts of employment. A requirement is made to address this issue. Interviews with staff and examination of their training records, confirmed their attendance at mandatory health and safety courses, dementia care and adult protection. A substantial number of staff had also attained National Vocational Qualifications. Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 Page 21 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 & 38 The quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The residents live in a well managed home. There is good leadership for the staff whose morale is high, which helps to provide a relaxed atmosphere for the residents. Resident, relatives and staff are able to influence how the home is run, through regular meetings with the manager. Staff receive regular supervision, which supports them in caring for residents. The residents’ welfare and best interests are protected by proper accounting of their personal money, and by ensuring that health and safety systems are implemented and regularly monitored. Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 Page 22 EVIDENCE: The registered manager is very experienced at running the home and she and her deputy have worked at the home for many years. The manager demonstrates a commitment to provide a high quality of service and responds to inspection requirements positively. The staff, and were complimentary about their line managers and said there was good leadership and they were well supported in their roles. Residents, who were spoken to during the inspection, said they were well cared for and felt safe and secure. A survey of residents’ views about the service was carried out in October 2005 and showed a high level of satisfaction about the service provided. There were minutes of staff meetings and residents’ meetings that demonstrated that they had input into the running of the home and were kept informed about developments in the service. The home’s administrator showed the inspector how monies held on behalf of residents for their personal use was accounted for. This included retention of receipts for relatives as appropriate. A sample of individual records and cash balances was found to be satisfactory. There were records of regular formal supervision of staff, which was also confirmed by the staff who were spoken to. Requirements made at the last inspection about health and safety checks of gas, electric and fire installations in the home had been complied with, including a satisfactory test of the water supply. Certificates of compliance with regulations were seen for all these. At the time of the inspection, cleaning and other potentially dangerous substances were stored in locked cupboards. Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 Page 23 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 3 X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X 3 3 3 X 3 Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 OP8 Regulation 13(4)(B) Requirement The registered person must ensure that staff support residents with mobility problems safely when transferring and moving about. The registered person must ensure that the administration of medicines is accurately recorded. The registered persons must ensure that more individual activities for residents are provided in addition to the group programme of activities. The registered persons must inform the Commission for Social Care Inspection about the date by which extensive refurbishment of the windows will be carried out. This was an immediate requirement at the previous inspection; 01/09/06. The registered person must ensure that the exterior of the home is cleared of weeds and the shrubbery is attended to. The registered person must ensure that all staff working at the home have contracts of their DS0000033427.V292382.R01.S.doc Timescale for action 31/07/06 2. 3. OP9 OP12 13(2) 16(2)(n) 31/07/06 31/08/06 4. OP19 23(2,b&d) 13(4)(c) 31/08/06 5. OP19 23(2)(b) 31/08/06 6. OP29OP29 17(2) Sch 4(6)(e) 31/08/07 Bridge House Version 5.1 Page 25 terms and conditions of employment. 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 Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Bridge House DS0000033427.V292382.R01.S.doc Version 5.1 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!