Inspection on 26/06/06 for Brook Street (101)

This inspection was carried out on 26th 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Brook Street (101) 20/10/05

Brook Street (101) 05/05/05

Brook Street (101) 11/11/04

Brook Street (101) 08/07/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Brook Street (101) 101 Brook Street Northumberland Heath Erith Kent DA8 1JJ Lead Inspector Pauline Lambe Key Unannounced Inspection 26th June 2006 09:30 Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 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 Brook Street (101) DS0000038200.V289667.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 Adults 18-65. 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. Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Brook Street (101) Address 101 Brook Street Northumberland Heath Erith Kent DA8 1JJ 01322 332840 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) brook@mcch.org.uk MCCH Society Limited Mr Kenneth Hazell Care Home 6 Category(ies) of Learning disability (6), Old age, not falling registration, with number within any other category (6), Physical disability of places (6), Sensory impairment (6) Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th October 2005 Brief Description of the Service: Brook Street is a purpose built detached two-storey property. It offers shortterm respite care to 6 adults with learning disabilities, referring to its service users as guests. The property has six single bedrooms (four with en-suite facilities), four bathrooms and two WCs. Two of the bedrooms are on the ground floor. There is a lift between floors and hoists in the bathrooms. There are two lounges, a dining room, kitchen, utility room with laundry facilities and an office. There is a small area for off street parking at the front of the property, with an enclosed garden to the rear. Brook Street is owned by Bexley Council and operated by MCCH Society Ltd. The home is situated in a residential area and has ready access to public transport, shops, a park and other local amenities. Bexley Council pays the fees for resident care. Residents pay a nominal fee per night and pay for any personal expenditure while they are in the home. Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit for this unannounced inspection was completed on 26th June 2006 over 7 hours. The manager and staff assisted with the inspection. Three residents were in home, The inspection included a review of information held on the service file and the completed pre-inspection questionnaire from the manager, a tour of the premises, inspection of records, talking to residents, staff and the manager and reviewing compliance with previous requirements. Four of the five requirements made at the last inspection had been met. Following the site visit contact was made with relatives and other interested parties to get their views of the service. Feedback from relatives and others was positive about the service. Relatives and professionals said that residents received a high standard of care when staying in the home. What the service does well: What has improved since the last inspection? What they could do better: The registered person must confirm in writing to prospective residents that based on assessment the home is suited to meeting their needs. Residents must be provided with a contract for service. Care plans must be reviewed when subsequent respite care is provided for residents to ensure their care plan is up to date and reflects their current needs. Staff must have access to proper hand washing facilities. Reports must be sent to the Commission monthly as required by regulation 26. Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 Page 6 The registered person must have a quality assurance system in place to review and improve the service. 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. Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5. Quality in this outcome area was adequate. This judgement has been made using available evidence including a visit to the service. Residents were welcome to visit the home prior to admission and had a full needs assessment completed. Residents did not receive written confirmation that the home could meet their assessed needs and did not have contracts for service. EVIDENCE: The home had an updated statement of purpose and a copy of this was sent to the Commission following the inspection. Copies of the statement of purpose, service user guide and last inspection report were left in the front hall and available to residents and others. Residents had a full assessment completed by a care manager at the time of referral to the service. New residents visited the home and spent time there getting to know staff prior to admission. Following the visit a member of staff visited the resident in their own home and prepared their care plan with them and their relative or carer. There was no evidence seen to show that residents received written confirmation that the home could meet their assessed needs. No contacts for service were seen in resident files. The Commission was addressing this matter with the registered person as a general issue in relation Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 Page 9 to all MCCH registered services in the area. The requirement to provide residents with contracts for service has been restated in this report. Requirements 1 and 2. Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Records and observation showed that staff supported residents to make decisions about their lives. Care plans were prepared to show how needs were to be met and residents seen were satisfied with the meals provided. EVIDENCE: Three resident care records were viewed. These included care plans, risk assessments, assessments of need and reflected personal preferences. Care plans seen were not all dated and signed so it was not easy to see when these were prepared. There was evidence on some of the care plans viewed to show these had been reviewed. However once a resident has been assessed and admitted for a respite period there was no evidence to show that prior to subsequent respite admissions the resident’s needs were reviewed to identify and reflect any changes to their care needs. A review of individual care plans must be made part of any subsequent admissions of the resident for respite care. During the inspection staff were observed staff consulting with residents on every day issues. Three residents were in the home and said staff supported Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 Page 11 them to make decisions as to how they spent their day. For example one resident did not want to attend the day centre and staff respected their decision. Another resident wanted to go out and again this decision was discussed with and supported by staff. The residents in the home at the time of this inspection were sufficiently independent to be allowed to take risks. The manager ensured appropriate risk assessments were completed for all residents with their involvement or their relatives. For example risk assessment were seen in relation to residents smoking, behaviour management and obsessive behaviours. Relatives who provided feedback on the service said that staff treated residents with respect. Requirement 3. Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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, 15, 16 and 17. Quality in this outcome area was excellent. This judgement has been made using available evidence including a visit to the service. From records seen and observation staff supported residents to benefit from their stay in the home while keeping up with regular commitments and having access to appropriate activities. EVIDENCE: Residents were supported to take part in appropriate activities based on ability and choice. The tree residents present during the inspection said the loved staying at the home, they had the opportunity to go on outings and enjoyed meeting other residents. One resident referred to time spent in the home as ‘like a holiday’. Patrons from the local pub had worked staff to raise money for the home to purchase a mini bus. The manager said that plans were progressing towards this purchase and those involved with fund raising kept informed of progress. In view of the type of service provided in this home staff worked closely with relatives to build good working relationships with them for the benefit of the residents. Residents were supported to maintain contact with their families Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 Page 13 while staying in the home. Relative contacted gave positive feedback about the service and made comments such as ‘ I have nothing but praise for them’ and ‘my relative loves gong there. Staff were observed communicating sensitively with the residents to ascertain their wishes and feelings. A number of the current residents had keys to their bedrooms and staff asked permission to go into their bedrooms. One resident said ‘I love staying at Brook Street, I can do what I like and get out shopping’. The menus seen indicted that residents were offered a healthy and varied diet. Some of the current residents said they helped in the kitchen and could help themselves to drinks and snacks. The kitchen was clean and tidy with adequate supplies of dry, fresh and frozen foods. Foods were stored properly and records kept of fridge, freezer and food temperatures. Residents seen said they enjoyed their meals and were given foods they liked. At the last environmental health visit the home was awarded with a ‘clean food’ certificate. Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Residents were satisfied with the way their care was provided. Records seen showed residents had their needs met and medicines were safely managed. EVIDENCE: Residents seen said they received care the way they liked and that staff listened to and respected their decisions. Staff supported residents to remain as independent as possible while in the home and this was reflected in the care plans seen. Residents in the home at the time of this inspection were quite independent and able to voice their choices and preferences. One resident who had been in the home often said ‘It is very nice here, I would not want to go anywhere else’. Care plans seen showed how individual needs were to be met. Residents had a choice to stay registered with their own GP while they resided in the home if the GP was in agreement. If this was not possible then residents were registered temporarily with a local GP. As this is a respite service routine health care needs such as dental, optical or chiropody care were accessed for residents except in an emergency. If a resident had a healthcare appointment to keep during their stay in the home staff supported them to keep the appointment. A care manager from Bexley said that in her opinion the home Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 Page 15 provide an excellent standard of care for residents. She added that the staff could meet the needs of highly dependent residents as well as those who were more independent and said that the manager was caring, competent and managed the service very well. Relatives and other professionals contacted were satisfied that when staying in the home residents had their health care needs appropriately met. An organisation medicine policy and procedure was provided and a policy prepared in relation to management of medicines in this home. Residents brought their medication with them to the home. These were recorded appropriately and administration charts kept. Medicines were stored securely in the office and a medicine fridge was provided. Staff must records the temperature of the medicine fridge daily. When writing medicine information on the administration charts staff must ensure the information is the same as that on the pharmacy label. The practice in the home was that two members of staff signed the administration records. Records seen were well kept and up to date. Medicines for three residents were checked and found to be correct. Requirement 4. Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Adequate procedures were in place to manage complaints and ensure protection for residents. EVIDENCE: A complaints policy was provided and suited to the needs of the residents. Residents seen said they would talk to the manager or senior carer if they had a concern. No complaints had been made to the home manager or the Commission since the last inspection. It was evident that staff received a high number of compliments from residents, relatives and other interested parties and Bexley Council had written to thank staff for their care and support given to a resident during a particularly difficult period on their life. Relative contacted knew about the home’s complaints procedure. One relative said they did make one complaint and that this had been resolved to their satisfaction. An adult protection policy was provided and included in the combined statement of purpose and service user guide. Staff seen displayed a good understanding of adult protection and how they would manage suspicion or allegations of abuse. Since the last inspection staff had access to training on this subject. Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27 and 30. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Only the key standards were assessed. The home was suited to meeting the needs of the residents but would benefit from some redecoration. The flooring in one bathroom and the laundry room needed to be repaired or replaced. EVIDENCE: The accommodation provided was suited to meeting the needs of the residents. The environment was comfortable and homely and furniture and fittings seen were satisfactory. No risks to the safety of residents and others were noted. The downstairs hallway and lounge would benefit from repainting and this would enhance the environment. The manager said that a five-year maintenance and redecoration programme was in place and reviewed annually. In view of the high turnover of residents it is very important that attention is given to maintaining the environment. The rear garden was neat and tidy and seating was provided for residents to use. Bathrooms, toilets and en-suites seen were clean and tidy. The bathing facilities provided were suited to meeting the needs of the residents. The flooring in the ground floor assisted bathroom and laundry room was split and must be repaired or replaced, as they are no longer impermeable. Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 Page 18 The home was clean, tidy and well ventilated. Staff had access to protective clothing and liquid soap for hand washing. No paper towels holders were provided and there were no paper towels available for staff to use at this inspection. The manager confirmed that these were normally available and a new stock was due to be delivered. Requirements 5 and 6. Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Appropriate staffing levels were maintained. Staff had access to relevant training and supervision. Recruitment was completed as required by regulation. EVIDENCE: The staff team comprises of a full time manager and senior support worker, support workers and one domestic staff. The manager said that recruitment is currently in process to employ one full and one part time support worker. In the meantime shifts are covered using regular bank staff. Over 50 of care staff have achieved NVQ level 2 or above. The manager said that staffing levels were flexible and were set based on the number and dependency of residents in the home at a given time. One waking night staff was provided. Staff seen during the inspection indicated that they worked well as a team to meet the needs of the residents. Residents were complimentary about staff and made comments such as ‘they are very nice’, ‘the staff here are lovely’ and ‘the staff are very good’. Relatives contacted said staff made them feel welcome and kept them informed of issues in relation to their resident. The original employee files were not kept in the home. Two employee files were viewed and both contained or had evidence to show that the information required by regulation had been obtained for the employees. An induction programme was provided for new staff. Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 Page 20 Residents were admitted to the home based on assessment of need. At the time of the assessment for a new resident, if it was identified that staff need any special training to meet the resident’s needs then this is provided prior to admission. For example plans were in place to admit a resident who required intermittent oxygen and the manager had arranged training for staff on this topic. Records seen showed that since the last inspection staff had access to training such as supervision, epilepsy care, diabetic care, personal safety, care planning and adult protection. Since the last inspection the manager had introduced supervision for staff. Staff seen confirmed they received supervision and said they found this beneficial both for their role and personal development. Most of the staff training was undertaken in-house. Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 and 42. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. The home was well managed however regulation 26 was not fully complied with and there was no quality assurance system in place. Records seen showed attention was given to providing a safe environment for residents and others. Staff must not use correction fluid on care and other records. EVIDENCE: The manager has been in post for some years, was registered with the Commission and has the skills and qualifications needed to manage the service. Relatives and professionals contacted said ‘I have every confidence in the manager’, ‘The home is well managed’ and ‘the manager is excellent’. Monthly staff meetings were held and often included the residents, which showed an openness and inclusion of the residents in the running of the service. Some regulation 26 reports were sent to the Commission. There was no quality assurance system in place. The Commission was addressing this matter with the registered person as a general issue in relation to all MCCH Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 Page 22 registered services in the area. Some in house auditing took place with weekly returns such as accidents, incidents, staffing and complaint information sent to head office. Records seen were generally up to date and well maintained. However a number of entry errors on records seen had been amended using correction fluid. Accident records were well maintained and regulation 37 notifications sent to the Commission as needed. Some accidents to residents had been recorded on incident forms. Care must be taken to ensure accidents are correctly recorded. Health and safety records viewed included fire safety, fire safety, service of moving & handling equipment, electrical service, and lift service. Records seen were all up to date. All windows checked above the ground floor had restricted openings and hot water checked was within safe limits. Hot water temperatures were checked monthly and records showed these were kept within safe limits. Ensuring hot water temperatures are safe was very important as some residents were assessed as having the ability to bathe themselves unsupervised. Fire drills were held at times to include night staff. Requirements 7, and 8. Brook Street (101) DS0000038200.V289667.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 Adults 18-65 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 3 2 3 3 1 4 3 5 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 2 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 2 X 3 X 2 X 2 3 X Brook Street (101) DS0000038200.V289667.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 YA3 Regulation 14 Requirement The registered person must confirm in writing to residents that based on assessment the home can meet their needs. The registered person must supply each service user with a written contract/statement of terms and conditions between the home and the service user. (Timescale of 30/04/06 was not met). The registered person must ensure that resident’s care needs are reviewed as part of subsequent admissions to the home. Staff must sign and date care plans. The registered person must ensure medicines are stored correctly. The temperature of the medicine fridge must be recorded daily. Information entered on the medicine administration charts must match that on the pharmacy label. The registered person must ensure the premises are well maintained and decorated. DS0000038200.V289667.R01.S.doc Timescale for action 04/08/06 2. YA5 5 04/08/06 3. YA6 15 04/08/06 4. YA20 13 17/07/06 5. YA24 23 04/08/06 Brook Street (101) Version 5.1 Page 25 6. YA30 13 7. YA39 24 8. YA41 17 The flooring in the downstairs bathroom and laundry room must be repaired or replaced. The damaged flooring in the downstairs bathroom and laundry must be repaired or replaced. The registered person must 04/08/06 ensure staff have access to proper hand washing facilities where waste is handled and to practice infection control. Liquid soap and paper towels must be provided for staff use. The registered person must 04/08/06 ensure a quality assurance is in place to review and improve the service. Reports prepared based on quality assurance surveys must be sent to the Commission together with any remedial action plans. The registered person must 04/08/06 ensure that corrections made to record entries are made correctly and without the use of correction fluid. 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 Brook Street (101) DS0000038200.V289667.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Brook Street (101) DS0000038200.V289667.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!