Inspection on 30/08/07 for Britannia Care Home

This inspection was carried out on 30th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Britannia Care Home 03/07/08

Britannia Care Home 23/01/07

Britannia Care Home 16/05/06

Britannia Care Home 10/01/06

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

CARE HOMES FOR OLDER PEOPLE Britannia Care Home 4 Thorn Street Girlington Road Bradford BD8 9NU Lead Inspector Mary Bentley Unannounced Inspection 30 August 2007 09:45 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 Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 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. Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Britannia Care Home Address 4 Thorn Street Girlington Road Bradford BD8 9NU 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) 01274 770405 Girlington Nursing Home Ltd Ms Shaheen Kauser Care Home 25 Category(ies) of Dementia (25), Old age, not falling within any registration, with number other category (25), Physical disability (25) of places Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, Dementia - Code DE and Physical disability - Code PD The maximum number of service users who can be accommodated is: 25 23rd January 2007 2. Date of last inspection Brief Description of the Service: The home offers personal care to people from a wide range of cultural backgrounds, predominantly, but not exclusively, people of Asian origin. It is situated in the Girlington area of Bradford, which is approximately 1 mile from the city centre. There is a very good range of amenities available locally including shops, public houses, churches, and mosques. The home is well served by public transport. The home has 3 floors; the communal rooms are on the ground floor and consist of two lounges and dining room/lounge. One lounge is a designated smoking area for people living in the home. There are 17 single and 9 doubles rooms; none of the rooms have en-suite facilities. There are four communal bathrooms located on the first and second floors, and communal toilets are located throughout the home. There is a passenger lift to all floors and a ramp for disabled access at the front of the home. There is a small parking area at the back and street parking is available. In August 2007 the owner told us the fees ranged from £284.48 to £394.37 per week. Hairdressing and the cost of outings are not included in the fees. Information about the service (The Statement of Purpose) is displayed in the home. Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We did this unannounced inspection in one day between the hours of 9.45am and 4.30pm. Since the last inspection the home has changed its registration and no longer provides nursing care. The reason for this visit was to look at how the home is managing the change and meeting the needs of the people living there. We also checked what progress the home is making in dealing with the requirements made at our last visit. During the visit we spoke to some people living in the home, staff and management. We looked at various records relating to care, staff, and maintenance and looked at some parts of the building. Before we visited we sent comment cards to 10 people involved with the home, including people living in the home, their relatives and care professionals who visit. Comment cards give people the opportunity to tell us what they think about the service. The information we get is shared with the home but we do not say who has provided it. Three comment cards were returned. In preparation for the visit we asked the home to complete a self-assessment form and we looked at any information we have received about the service since our last visit. We considered this information as well as the information from the comment cards when preparing this report. What the service does well: The home is friendly and relaxed. Daily routines are flexible and because there are not many people in the home staff have plenty of time to spend with people. People said they are well cared for and relatives said they are kept well informed by the home. One person said “I have been here for many years and I like it here.” People said the manager and staff listen to them and they feel they have no need to complain. There is good interaction between staff and people living in the home. Many of the people living in the home are from an Asian background. There are also a number of staff from Asian backgrounds and many speak a second language Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 Page 6 such as Punjabi or Urdu. This means that staff have a good understanding of people’s cultural needs and it makes it easier for people to talk to staff. The home provides a choice of Asian and English food and people said they enjoyed the food. The home has been awarded 5 stars (the highest rating) by Environmental Health for its standards of food safety and hygiene. What has improved since the last inspection? What they could do better: The home must make sure that information about the service is available in a range of formats so that people using the service, and those thinking about using the service, have clear and accurate information about what is being offered. The home must continue to improve the care records so that they can show that people, or those close to them, are involved in planning how care needs will be met. More work is needed on the environment, in particular the bathing facilities to make sure that the home is properly equipped to meet people’s needs. The use of CCTV inside the home must be kept under review and specific information about this must be included in the Statement of Purpose. Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 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 Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 & 3. Standard 6 does not apply to this service. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People’s needs are assessed before they move in. More needs to be done to make sure that people thinking about choosing the home are given clear and accurate information in a format that they can easily understand. EVIDENCE: The records showed that people’s needs are assessed before they are offered a place. When assessing people’s needs the home takes account of assessments done by other social and health care professionals, copies of these assessments were available in the care records. Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 Page 10 The amount of information recorded in the home’s pre-admission assessments varied. It was not always clear who had been involved and whether people had been given the opportunity to visit before deciding about moving in. The home has a Statement of Purpose and Service Users guide. Some parts of the Statement of Purpose need to be changed to make sure people are given clear and accurate information about the range of services offered by the home. The owner has plans to make these available in alternative formats but this has not yet been done. As one of the home’s stated objectives is to provide a multi-cultural service it is essential that these documents are available in alternative formats. The home does not provide intermediate care. Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People’s needs are met in a way that respects their privacy and dignity. Improvements are needed to the care records to make sure that people’s needs are met consistently and to make sure that people are involved in care planning. More care needs to be taken with the way medicines are recorded to make sure that people are getting their medicines in the way that they are prescribed. EVIDENCE: The home is in the process of changing the format it uses for care records to make sure that the records are easier for people living in the home and staff to use. Training is being arranged for care staff on care planning, as this is an Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 Page 12 area they did not have much involvement with when the home was operating as a nursing home. We looked in detail at the records of two people living in the home and looked at some specific issues in other care records. There was not much evidence that people had been involved in drawing up the care plans. However, people told us that they are consulted about how their needs will be met and kept informed. One relative said “I am involved with everything so I know my mother’s needs are more than fully met.” The care plans set out how people’s personal, health, and social care needs will be met. The care plans also have information about people’s cultural and religious needs, for example the language they speak. One care plan about a person’s mental health gives clear information for staff on the signs to look for to alert them to any deterioration and tells them what action to take. Another person’s care plan did not have information for staff on how to manage behaviour, although it was clear from our observations that the person was at times restless and agitated and requiring a lot of support from staff. One person was identified as being nutritionally at risk at the time of admission. This is being dealt with, there is a detailed care plan, and the person is gaining weight. Another person was identified as being at risk of developing pressure sores; the care plan contains clear information on what is to be done to reduce this risk. The daily notes written by staff are mostly about how people’s personal care needs are being met and give very little insight into how people are spending their time or how they are feeling. The care records show that people have access to a range of NHS services and that the home seeks advice from other health care professionals where necessary. The home is working closely with the diabetic nurse specialist and district nurses to make sure that the needs of people with diabetes continue to be met, and that staff are appropriately trained in this area. No one living in the home manages his or her own medicines. At present there are some nursing staff working in the roles of senior care assistants and they are responsible for dealing with medicines. Care staff have been Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 Page 13 enrolled on training on the safe management of medicines to help prepare them for taking on this responsibility. The medication records showed that medicines are not always signed for, this makes it difficult to tell if people are getting their medicines as prescribed. We saw that some people were not following the date order on the medicine packs and this was leading to confusion about when people had their medicines. The owner told us he was already dealing with this. The medicine trolley was in the dining room for most of the morning and was not anchored to the wall, for safety reasons it should be secured to the wall or kept in the treatment room when not in use. Our observations of working practices showed that staff are kind, respectful and attentive to people’s needs. Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are treated as individuals. They are given the support they need to follow personal interests and be as independent as they can be. EVIDENCE: One regular visitor to the home said, “There are all religions and races in the home and I have not seen any difference in the care given to all”. Daily routines are flexible and people have the choice of spending their time in the communal rooms with other people or in their own rooms. Information about people’s cultural and religious needs is recorded. The home has an activities programme offering a variety of activities inside and outside the home. Each person has an individual record showing what he or she has taken part in. The record also shows whether people have enjoyed a particular activity or not. Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 Page 15 People can have visitors at any time that is convenient to them. The daily menu is displayed in the dining room and people are offered a choice of English and Asian food. Halal meals are provided for people who want them. One person said they enjoying being able to have a variety of English and Asian food. Another person we asked about the food said, “they give me what I ask for, and I help by telling them what I like”. We observed the lunchtime meal, people were given time to enjoy their food and were helped discreetly where necessary. Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is committed to promoting an open culture that allows people to express their views and concerns in a safe and understanding environment. EVIDENCE: The home has not had any complaints since January 2007 and none have been referred to us. Two people told us they never had any reason to complain because they could talk to the manager and staff. Information about how to make a complaint is displayed in the home in a standardised format. Because of the small number of people living in the home at present it is easy to make sure that people are given all the information they need. However, as numbers increase the home will have to make sure that information, such as the complaint’s procedure, is made available in alternative formats. One health care professional who visits said the home always responds positively to suggestions for improving the service. Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 Page 17 Information about the protection of vulnerable adults is available in the home. Staff have received training on protection and safeguarding and are aware of how to report any concerns they might have. Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24 & 26 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and comfortable but more needs to be done to make sure it is properly equipped to meet people’s needs. EVIDENCE: The parts of the home we looked at were clean and tidy. People said it is usually clean and fresh. There is an ongoing programme of redecoration and refurbishment; some new bedroom furniture has been provided. Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 Page 19 CCTV is used inside the home to monitor the main entrance and the entrances to the lift on all floors and the entrances from the stairs to the landings on all floors. We discussed this as the last visit and expressed our concerns about the implications for people’s privacy. Since then the home has consulted with people using the service and has agreed policies and procedures about the use of the cameras, the storage of the tapes and access to the tapes. However, there is no information in the Statement of Purpose about the use of CCTV and therefore new people moving into the home may not be aware of it when deciding if the home is the right one for them. The home has four communal bathrooms. One has been converted to a shower room. When we visited in January a second bathroom was being converted to a shower, this work has not yet been completed. The remaining 2 bathrooms are also in need of refurbishment, the owner confirmed that funding had been made available and this work would be going ahead in the near future. There were no sink plugs in the washbasins in 2 of the bathrooms; this would make it difficult for people to use this sink for washing. The bathrooms are sparsely decorated, for example there are no curtains or blinds on the windows, (the glass is opaque). This does not help to create a relaxing environment where people can enjoy a bath/shower. In most of the bedrooms people had some of their personal belongings around them. People living in the home said they could stay in their bedrooms if they preferred not to use the communal rooms. There is very little outside space for people to use, the main area at the back of the home is tarmac and has a fairly steep slope. The home has a designated smoking room on the ground floor; throughout the day the door was open. This meant that people living and working in the home did not always have a smoke free environment. Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff available to make sure people are safe and they get the care they need. There are suitable systems in place to make sure that all the required checks are completed before new staff start work in the home. Staff are supported and given the training they need to help them care for people properly. EVIDENCE: On the day we visited there were 6 people living in the home. There were 2 care staff on duty as well as a cook and laundry/domestic assistant. The owner was also in the home. Duty rotas are available for all grades of staff. The rotas show there are a minimum of 2 staff on duty at all times which is enough to meet the needs of the number of people currently living in the home. We are waiting for the home to give us information on how staffing levels will be increased as the number of people living in the home increases. Many of the people living in the home are from Asian backgrounds and some do not speak any English. The ethnic mix of the staff group is well matched to Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 Page 21 the needs of people living in the home. People benefit from being cared for by staff that are able to speak their language and understand their culture. One health care professional that visits the home said they felt the staff are eager to improve and are motivated to follow their professional advice. Since changing the categories of registration earlier this year the home no longer provides nursing care although some nurses continue to work in the home in the role of senior care assistants. The information provided in the Statement of Purpose about staffing needs to be amended to avoid any confusion about the role of nurses working in the home. This was discussed during the visit. 80 of care staff have achieved an NVQ (National Vocational Qualification) at level 2 or above and there is an ongoing NVQ training programme. No new staff have been employed since the last inspection, the owner confirmed that he is aware of all the checks that have to be competed before new staff are allowed to start work in the home. The change of registration means that care staff working in the home will be taking on more responsibilities. Training is being arranged to help them with this. Most of the staff have attended training on the management of diabetes and all staff have signed up for training on the safe management of medicines. Training on care planning is to be arranged. Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management team is committing to improving the service and welcomes suggestions and ideas from people involved with the home. EVIDENCE: The registered manager is a nurse and she has enrolled on a course for the Registered Managers’ Award. The owner is also actively involved in the dayto-day running of the home and is there most days. Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 Page 23 Over the past few months a lot of changes have taken place in the home, the main one being the change from nursing home to care home. The management team have spent a lot of time with people using the service explaining how the changes would affect them and supporting people who had to move to alternative accommodation. Some people were reluctant to leave the home because they felt very well cared for and supported. Because of the small number of people living in the home at the moment a lot of consultation is done informally on an individual basis and is not recorded. The home consulted formally with people earlier this year on the subjects of the CCTV cameras and on food. The results showed that people are satisfied with the service. The home has introduced a feedback form for visitors. It is available in reception. Three visiting health care professionals filled in feedback forms in August 2007. All three made positive comments about the staff, the hospitality they received, and the way the home meets people’s individual needs. The home manages money on behalf of one person living there. There are suitable arrangements in place to make sure this person has access to their money when they want it. The home no longer gets involved in managing money for people. Usually people manage their own money or are helped by a relative or friend. One person has an advocate appointed by the local authority because they do not have anyone who can help with this. In the self-assessment form the home told us that all the required checks on equipment and installations were up to date, the documents we looked at confirmed this. The training records showed that most of the staff had fire training in April and May 2006. The advice given by West Yorkshire Fire & Rescue Service is that to comply with the recent changes to the law and to reduce the of injury staff training should be carried out by a competent person at least once and preferably twice in every 12 month period. Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 Page 24 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 2 X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 2 X 2 3 X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 Page 25 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 OP1 Regulation 4 Requirement The Statement of Purpose must be kept up to date. It must include information on the use of CCTV inside the home and must make it clear that nursing care is no longer provided. This is to make sure that people have up to date and accurate information about the range of services being offered. In order to meet its stated objective of providing a multi cultural service the home must make information available in alternative formats appropriate to the needs of people using the service. Previous timescale of 30/04/07 not met. The care plans must continue to be developed to make sure that they set out in detail how people’s assessed needs in relation to personal, health, and social care will be met and so that there is evidence that people or their representatives DS0000061941.V349475.R01.S.doc Timescale for action 30/11/07 2 OP7 15 30/11/07 Britannia Care Home Version 5.2 Page 26 are involved in care planning. This is to make sure that people’s needs are met consistently in a way that takes account of their preferences. Previous timescale of 30/04/07 not met. The medicines trolley must be secured to the wall in the dining room or kept in the treatment room when not in use in order to make sure that medicines are stored safely. Previous timescale of 30/04/07 not met. The home must prepare a plan setting out how it is going to make sure that there are always enough staff to meet people’s needs. Specifically the plan must state: a) How staffing levels will be increased to take account of increasing occupancy and changes in the dependency of people living in the home and b) How staffing levels will take account of the needs of the people receiving day care. A copy of this plan must be sent to the CSCI. Previous timescale of 30/04/07 not met. 5. OP38 23(4) Staff must be given fire safety training by a competent person, at least once, and preferably twice, in each 12-month period. This is to make sure that people working in the home know what DS0000061941.V349475.R01.S.doc 3 OP9 13(2) 30/11/07 4 OP27 18 30/11/07 31/10/07 Britannia Care Home Version 5.2 Page 27 to do in the event of a fire and to reduce the risk of injury to people living and working in the home. Previous timescale of 30/04/07 not met. 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 OP16 Good Practice Recommendations Information about the complaint’s procedure should be made available in alternative formats appropriate to the needs of people using the service. Training should be provided on the Mental Capacity Act. 2 OP18 Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Britannia Care Home DS0000061941.V349475.R01.S.doc Version 5.2 Page 29 - 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!