Inspection on 22/10/08 for Brownlow House

This inspection was carried out on 22nd October 2008.

CSCI found this care home to be providing an Adequate service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Brownlow House 23/10/06

Brownlow House 18/02/06

Brownlow House 21/06/05

Brownlow House 28/01/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

CARE HOMES FOR OLDER PEOPLE Brownlow House Brownlow House 142 North Road Clayton Manchester M11 4LE Lead Inspector Val Bell Unannounced Inspection 10:00 22 October 2008 nd 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 Brownlow House DS0000062022.V369092.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. Brownlow House DS0000062022.V369092.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brownlow House Address Brownlow House 142 North Road Clayton Manchester M11 4LE 0161 231 7456 0161 231 0032 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) Mr Bradley Scott Jones Mr Russell Scott Jones Mr Bradley Scott Jones Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (28), Physical disability (3) of places Brownlow House DS0000062022.V369092.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home can accommodate up to a maximum of 28 service users requiring personal care only by reason of old age (OP) Three named service users requiring care by reason of physical disability (PD) may be accommodated. Should either of the service users no longer require the services offered by the home then the place shall revert to that of old age (OP). The care staffing levels do not fall below the minimum levels specified in the Residential Forum Guidance for Staffing in Care Homes for Older People. The dependency levels of service users are assessed on a continuous basis and staffing levels adjusted where appropriate to ensure continued compliance with the Residential Forum Guidance for Staffing in Care Homes for Older People. The service should employ, at all times, a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 23rd October 2006 3. 4. 5. Date of last inspection Brief Description of the Service: Brownlow House is a registered care home providing personal care only for up to 31 older people over the age of 65 years. The home is a detached building set within its own grounds, with a garden to the rear of the property and a parking area to the front of the building. The property has access both at the front of the building and the rear by steps and ramps. The home has three floors of accommodation accessed by stairs and a passenger lift. The basement of the property accommodates the laundry and the boiler for the heating system. The accommodation comprises of 3-shared bedrooms each accommodating a maximum of two people and 25 single bedrooms. One of the single rooms has en-suite facilities and all other bedrooms have a hand basin. There is a large lounge to the rear of the property leading onto the dining room. At the front of the property there is a lounge, there is also a small television lounge for use by residents who prefer to watch television rather than being involved in group activities. Fees are £382.88. Extra charges are made for hairdressing. Brownlow House DS0000062022.V369092.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was a key inspection, which included a site visit to the home. The visit was unannounced which means the manager was not informed beforehand that we were coming to inspect. During the visit we spent time talking to people living in the home, the provider, newly appointed manager, cook, activity co-ordinator and other staff on duty. An Annual Quality Assurance Assessment (AQAA), which is a self-assessment document had been completed by the manager and returned to the Commission prior to our visit. Eight staff surveys were also completed, although no surveys were returned from people who use the service. Relevant documents, systems and procedures were assessed and a tour of the home was undertaken. What the service does well: What has improved since the last inspection? Brownlow House DS0000062022.V369092.R01.S.doc Version 5.2 Page 6 A comprehensive system for assessing the needs of people admitted to the home had been developed. This enabled individuals’ and staff to decide if the home would be able to provide the care and support required. It was pleasing to find that five good practice recommendations had been taken on board by improving medication records, recording of activities and complaints, timely repairs and maintenance and training records. What they could do better: We made four requirements and six good practice recommendations. Capacity assessments must be undertaken in line with the requirements of The Mental Capacity Act to determine a person’s ability to make decisions relating to freedom of choice and liberty of movement. Staff must not be employed to work in the home until a POVA First, suitable written references and a CRB have been received. This action is necessary to ensure that recruitment procedures afford protection from harm to people using the service. The management of personal finances and recruitment procedures must be improved. Staff must adhere to safe working practices at all times. In particular, mobility equipment such as wheelchairs must be used in accordance with manufacturers’ instructions to prevent accidental injury to people using the service. Evidence should be made available to demonstrate that the people accommodated in this home are consulted and given choices that meet their dietary preferences. The religious and cultural needs of the people accommodated should be assessed as this may affect the way their care and support is provided. The environmental health officer should be consulted on the recommended and/or required frequency of health and safety training provided to staff. Ensuring that staff are trained in current safe health and safety practice will afford protection to the welfare of people using this service. We also recommend that training in dementia care and safeguarding adults from harm is made available to staff. Brownlow House DS0000062022.V369092.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. Brownlow House DS0000062022.V369092.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 Brownlow House DS0000062022.V369092.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): 3 and 6 Quality in this outcome area is good. People making enquiries about using this service have an assessment to enable the individual and staff team to decide if their needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at the care records for two people admitted to the home in the previous nine months. Improvements had been made to ensure that in-house assessments of need had been undertaken. Information relating to individual’s religion, nationality, culture or preferred forms of address, however, had not been recorded. It is important that cultural and religious information be recorded as it may affect the way in which care and support is provided in areas such as diet and religious observance. This home did not offer an intermediate care service. Brownlow House DS0000062022.V369092.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. People using this service are treated with dignity and respect and have access to the full range of community healthcare services. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The two care plans that we looked at had been developed from information recorded in their assessments of need. Improvements had been made by developing more detailed care plans that provided clear guidance to care staff on what tasks they must undertake to meet each person’s assessed needs. Risks identified during the assessment process had been carefully considered and plans had been put in place to minimize the risk of accidental injury. Records provided evidence that where health concerns had arisen the person had been quickly referred to the relevant healthcare professional for advice or further investigation. Brownlow House DS0000062022.V369092.R01.S.doc Version 5.2 Page 11 We observed that one person using this service had a facial injury. The acting manager explained that the injury had been the result of a fall. This person’s care records detailed several falls since her recent admission. Professional advice had been sought on making a referral to the falls clinic, although the acting manager had been incorrectly advised that the service was not accessible to people living in care homes. We were given an assurance that a referral would be made as soon as possible. We also observed that this person was seated in her wheelchair at the dining table during lunch. The wheelchair had not been fitted with footplates. Footplates must be fitted to wheelchairs in use at all times to prevent injury from falls or accidental entrapment of feet and legs. We checked medication records belonging to these two people. It was pleasing to see that photographs had been attached to record sheets for identification purposes, as recommended at the last inspection. Medication was stored securely and records of administration appeared to be accurate and up to date. During our visit we observed interactions between care staff and people living in the home. Staff had developed good relationships with the people they supported and conversed respectfully. Personal care was provided in private and staff were observed to knock on bedroom and bathroom doors before entering. One person told us that she got on well with staff and that she was always treated with dignity and respect. Brownlow House DS0000062022.V369092.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. People using this service do not always receive the right kind of support that enables them to make choices and decisions and to exercise their right to freedom of movement. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We asked the activity co-ordinator about the type and frequency of activities that were provided. These took place for two hours each day from Monday to Friday and included bingo, arts and crafts and a weekly exercise class. On the day of our visit people were enjoying a singsong in the morning and dominoes after lunch. It was pleasing to find that the co-ordinator had made improvements by writing down individual’s opinions and whether they had enjoyed the particular activity. She was keen to develop the programme further, particularly by providing more activities that would be interesting and stimulating to people living with dementia. We recommend that the activity co-ordinator be provided with the resources, by further training or other Brownlow House DS0000062022.V369092.R01.S.doc Version 5.2 Page 13 means, to develop her skills and knowledge in current good practice in dementia care. The people we spoke to during our visit told us that visitors were made welcome in the home and that restrictions were not placed on visiting times. A person recently admitted to the home told us that he was not in control of his personal spending money and had not been informed of how much money was being held on his behalf. Records provided us with evidence that staff were managing his personal finances on his behalf. However, this person’s capacity to manage his own finances had not been assessed and there was no written record of him being consulted about this. His daily records told us that he had asked for some money for personal shopping one evening, prior to our visit. It was recorded that his request had been refused on the grounds that it was not safe for him to go out at that time. This decision had been taken without a risk assessment of the situation and was in denial of his rights to freedom, choice and decision-making. We discussed this with the provider and made a requirement for an assessment to be undertaken, in line with the requirements of The Mental Capacity Act. The assessment must determine this person’s capacity to make decisions relating to his freedom of choice and liberty of movement and the person concerned must agree to any restrictions made. Where agreement cannot be reached a referral must be made for an Independent Mental Capacity Assessment (IMCA). We also recommend that his care manager be consulted in relation to this capacity assessment. During our visit we had a lunchtime meal with people living in the home. The meal was well cooked and tasty and the people we spoke to told us that they enjoyed the food provided. However, we were not offered a choice of main course and one person said, ‘I wasn’t offered a choice’. The chef said that a second choice was always offered, although this was not consistently being written down. Evidence of this should be available to demonstrate that the people accommodated in this home are consulted and given choices that meet their dietary preferences. Brownlow House DS0000062022.V369092.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. Procedures are in place to listen and deal with the concerns of people using the service and to keep them safe from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A record of complaints had been put in place as recommended at the last inspection. The record detailed the nature of the concerns and the action that had been taken to investigate and resolve the complaint. However, the complaints were being recorded in a hardback book that did not comply with the requirements of data protection law. Confidential information must always be recorded in a manner that is accessible to authorised persons, such as people using the service and courts of law, without breaching the rights of others to have their personal information disclosed. To comply with this legislation, confidential information relating to individuals must be recorded on single sheets of paper. Relevant policies, procedures and systems were in place that enabled concerns to be raised in safeguarding people using this service from harm. Brownlow House DS0000062022.V369092.R01.S.doc Version 5.2 Page 15 We asked for written evidence of staff having received training in these procedures and in an awareness of what constituted abuse. The training matrix that the provider sent to us showed that two staff did not attend their planned training, seven staff had not been offered training and the remaining thirteen staff had received training in May 2006. We were also told that some staff had received abuse awareness training as part of their National Vocational Qualification courses. We recommend that annual refresher and update training be provided to staff on abuse awareness and the action they must take to keep people safe if abuse is alleged or suspected. Brownlow House DS0000062022.V369092.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. People using this service are provided with a safe, clean and well-maintained living environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We had a look round the home to assess cleanliness, hygiene and maintenance of the building and facilities provided. A full-time maintenance person was employed to deal with day-to-day issues around the home and a contractor cleaned carpets on a monthly basis. Since the last inspection several bedrooms had been redecorated and some furniture and carpets had been replaced. The communal spaces and bedrooms were clean and hygienic and no offensive odours were present. Regular health and safety audits had been undertaken to ensure that a safe environment was being maintained. Brownlow House DS0000062022.V369092.R01.S.doc Version 5.2 Page 17 We found several fire doors that were not closely fully into their rebates. This places people living and working in the home at risk of smoke inhalation in the event of a fire. The provider immediately telephoned the contractor to ask him to attend and rectify the problem. We were informed that this work had been satisfactorily completed the day after our visit. We recommend that staff employed by the home be reminded of their responsibility to report such health and safety issues in the course of their daily work. Brownlow House DS0000062022.V369092.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. Improvements are needed to the recruitment procedures to ensure protection from harm to people using the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We found the home to be suitably staffed on the day of our visit and rotas provided evidence that sufficient staffing was being maintained. In the eight satisfaction surveys returned to the Commission, most staff thought that enough staff were being deployed to meet the assessed needs of people living in the home. The provider told us that most of the care staff had achieved a National Vocational Qualification at level 2 in care and funding was being sought so that staff could progress to level 3. This will enable staff to further develop their knowledge and skills in the best interests of people using the service. We looked at the personnel files belonging to two newly recruited members of staff to determine if suitable pre-recruitment checks had been undertaken. One of the files contained copies of the required information. The second file Brownlow House DS0000062022.V369092.R01.S.doc Version 5.2 Page 19 contained a copy of the person’s passport, proof of address and induction programme. The Criminal Record Bureau (CRB) certificate was dated two months after the person’s start date and there was no evidence of a Protection of Vulnerable Adults (POVA First) check or any written references having been obtained prior to this person starting work. The provider forwarded some of this information to us following our visit. This included a POVA First check obtained on 28th May 2008 and one written reference. This shortfall in the required recruitment procedures was highlighted in the previous inspection report in October 2006 and it is of serious concern that improvements are not evident some two years later. Staff must not be offered employment before a POVA First and satisfactory written references have been received and new staff must be supervised at all times until a CRB has been received. This action is necessary to ensure that recruitment procedures afford protection from harm to people using the service. The provider forwarded the home’s training matrix to us following our visit. This document detailed the dates of training courses attended by staff working in the home. We were told that fire safety and moving and handling training were currently being updated. Much of the mandatory health and safety training, such as infection control had been undertaken prior to and during 2006 and six of the seven food hygiene certificates obtained were over three years old. It is recommended that advice is taken from the environmental health officer and that any recommendations made for refresher training are followed. This will ensure that safe working practices continue to afford protection to the welfare of people using this service. It was pleasing to learn that the provider has included this in the 2009 training plan. Brownlow House DS0000062022.V369092.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is adequate. This home is not always managed in a way that supports the rights of the individual to autonomy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A new manager had recently been appointed, although the current registered manager was still in day-to-day charge of the home. We were told that the new manager would be submitting an application to become registered with the Commission. We were told that this decision had been taken to enable the registered manager to concentrate on the development of the organisation. Brownlow House DS0000062022.V369092.R01.S.doc Version 5.2 Page 21 This service has a quality monitoring system in place and evidence was seen of regular quality audits having taken place. This included satisfaction surveys issued to people using the service and their representatives. We looked at the personal accounts belonging to people who were receiving support to manage their finances. The majority of people living in the home had their personal finances managed by the local authority or their relatives. However, three people were receiving this support from the home. We were concerned to find that their money had been deposited in the company account. This meant there was no way to identify the exact amounts held on their behalf. Records held in the home were poorly managed with no audit trail to determine the accuracy of the figures recorded. One balance showed a £5 shortfall due to a computing error and numerous items of expenditure were unsigned and not cross-referenced to receipts. Furthermore, there was no evidence that these accounts were being audited regularly. Monies held on behalf of people who use the service must be held in an account separate to that of the company account. We examined a number of health and safety records and found these to be accurate and up to date. As detailed under ‘Health and Personal Care’ we observed one person living in the home being transported in a wheelchair that had not been fitted with footplates. This person had been assessed as at risk of falls and we were concerned that she was being placed at further risk by not following good practice guidelines in the safe use of wheelchairs. Brownlow House DS0000062022.V369092.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 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 X 3 X 2 X X 2 Brownlow House DS0000062022.V369092.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 OP14 Regulation 17 (Schedule 3, 3. (q)) Requirement Capacity assessments must be undertaken in line with the requirements of The Mental Capacity Act to determine a person’s ability to make decisions relating to freedom of choice and liberty of movement. Where agreement cannot be reached with the person using the service, referral must be made for an Independent Mental Capacity Assessment (IMCA). Staff must not be employed to work in the home until a POVA First, suitable written references and a CRB have been received. This action is necessary to ensure that recruitment procedures afford protection from harm to people using the service. Timescale for action 22/12/08 2. OP29 19 22/12/08 3. OP35 20 Monies held on behalf of people 22/12/08 using the service must be held in an account separate to the company account. Staff must adhere to safe DS0000062022.V369092.R01.S.doc 4. OP38 13 22/12/08 Version 5.2 Page 24 Brownlow House working practices at all times. In particular, mobility equipment such as wheelchairs must be used in accordance with manufacturers’ instructions to prevent accidental injury to people using the service. 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 OP3 Good Practice Recommendations Cultural and religious information should be assessed and recorded as it may affect the way in which care and support is provided in areas such as diet and religious observance. We recommend that the activity co-ordinator be provided with the resources, by further training or other means, to develop her skills and knowledge in current good practice in dementia care. Evidence should be made available to demonstrate that the people accommodated in this home are consulted and given choices that meet their dietary preferences. Annual refresher and update training should be provided to staff on abuse awareness and the action they must take to keep people safe if abuse is alleged or suspected. We recommend that staff employed by the home be reminded of their responsibility to report health and safety issues in the course of their daily work. Advice should be taken from the environmental health officer and any recommendations for refresher training followed. This will ensure that safe working practices afford protection to the welfare of people using this service. 2. OP12 3. OP15 4. OP18 5. OP19 6. OP30 Brownlow House DS0000062022.V369092.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Brownlow House DS0000062022.V369092.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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