Inspection on 11/07/05 for Carlton House

This inspection was carried out on 11th July 2005.

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

Carlton House 04/07/08

Carlton House 05/07/07

Carlton House 13/07/06

Carlton House 08/12/05

Carlton House 12/01/05

Carlton House 04/06/04

Carlton House 12/01/04

Carlton House 17/11/03

Carlton House 24/06/02

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

CARE HOMES FOR OLDER PEOPLE Carlton House 267 Hainton Avenue Grimsby DN32 0LA Lead Inspector Jane Lyons Unannounced 11 July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Carlton House, Address 267 Hainton Avenue, Grimsby, DN32 0LA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01472 360878 Mrs Katrina Peerbux Mrs Katrina Peerbux CRH 10 DE(E) 10 Category(ies) of OP 10 registration, with number of places Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 12 January 2005 Brief Description of the Service: Carlton House is registered to take 10 service users with residential care needs; these beds are also registered for service users with needs associated with dementia. The home is a detached house situated in a busy rsidential area of the town; it is close to the town centre and on local bus routes. Accomodation is provided on two floors; there is stair lift and chair lift access to the firwst floor. THere are four single rooms and three shared rooms; one bedroom is provided on the ground floor. The home has one lounge, one dining room and an outside courtyard. The home has a pleasant, homely inclusive atmosphere. The home is owned by Mrs Katrina Peerbux. The acting manager is Mrs Roma Redfurn. Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out with the acting manager; the inspection took 8 hours and included a tour of the premises, examination of resident files and records relating to the service. Four of the staff on duty were spoken to during the inspection. There were no visitors to the home during the inspection, however 2 comment cards were forwarded to the inspector; one stated “I feel that they are looked after in every way possible”. Most of the people who live at Carlton House have memory problems and as a result only two service users were spoken to. The inspector observed how staff and service users worked together throughout the day. The views of people spoken to have been included in this report. What the service does well: The home was welcoming and had a relaxed and homely atmosphere. Residents were observed to be very settled and comfortable in their surroundings. The home was clean, tidy and the staff worked hard to make sure the building was odour free. Carlton House is a home where most of the residents have severe memory loss and complex needs. There was a core group of staff who had worked at the home for many years and knew the residents very well; the staff group were enthusiastic and worked hard to meet the residents individual needs. Residents spoken to commented that all the staff were very friendly and kind, they respected their privacy and made their visitors feel welcomed. People spoken to said that the meals were very good, one resident said that he did not eat meat and that a vegetarian meal was always provided, another said that she always enjoyed her meals. All the residents took their meals in the dining room; the meals were served promptly and staff demonstrated a good understanding of the resident’s individual food choices and support needed. Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 6 The home worked well with other agencies such as the community psychiatric nurse and district nurses to ensure the specific care needs were identified and met. What has improved since the last inspection? What they could do better: The management in the home must carry out the work asked of them to action all the requirements made at the previous inspection to ensure the safety and welfare of all the staff and residents. The home did not always make the correct checks on new staff members before they started work. This was really important to ensure the safety of all the residents. The acting manager has not fully put in place a quality assurance system which would provide a better picture of all the checks and questionnaires that are carried out. Regular reviews of aspects of the “homes” performance through a good programme of self review and consultations, which includes the views of residents, staff, relatives and others must be fully completed. There was no current maintenance programme in place and a number of areas internally and externally needed attention with repairs, renewal and redecoration which would ensure the safety of the residents and improve the quality of the environment. Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 7 The owner of the home has a legal duty to visit the home un-announced on a monthly basis and to provide a report of these visits; this would ensure the management of the home is being closely monitored. The home must control the hot water temperatures to a safe level to prevent people from being scalded. Social activities needed to be better organised and recorded to ensure that the residents are offered were appropriate stimulating and involved in meaningful activities. The temperature checks for fridges, freezers and cooked food were not carried out regularly. A complaint was received in April and investigated under the multi agency protection of vulnerable adult procedures; a number of serious allegations regarding staff attitude were upheld, the home took appropriate action and a staff member was subsequently dismissed. 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. Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Staff were informed of the care needs of residents prior to admission; the admission process was thorough with staff ensuring that new residents felt welcome and secure. EVIDENCE: Although there had not been any new admissions since the previous inspection, it was clear from staff discussion and examination of records that the admissions process was thorough. Pre admission assessments were evidenced. Three case files were examined which held full assessment documentation for the residents; the care programmes clearly linked to the assessments. Staff at interview reported that they spent time with the new residents showing them round and introducing them to the other people in the home. One of the service users told the inspector that although he was settled at the home he would at some point like to move back to Skegness where he grew up and where he would be nearer to his niece who lives there. This information Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 10 was passed on to the acting manager who confirmed that she would contact care management on the service users behalf. Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 9 and 10 Service users health needs are met in a consistent manner; this is enabled by the system of care planning. However the home is administering medication to one service user without their knowledge and action needs to be taken to ensure this practice only occurs when family determined by a multidisciplinary team. EVIDENCE: Three care programmes were examined; they had been consistently maintained and were generally very detailed and well organised. The plans had been signed by the service user or family to demonstrate agreement. All problems had been identified from assessment; from case tracking the inspector was able to evidence that the documentation cross referenced well and all problems had been updated to reflect current needs. Service users with problems associated with challenging behaviour had their needs clearly identified in the plans with detailed staff interventions. All programmes were regularly evaluated and a recommendation from the previous inspection to provide a more detailed evaluation record had been implemented with two of the programmes. Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 12 There was appropriate use of risk assessments; assessments for moving/ handling, falls, tissue viability, nutrition and general issues were in place and reviewed regularly. All high-risk areas had associated plans of care in place. The programmes evidenced that service users accessed regular care reviews and that the home sought support from the health care professionals such as Community Psychiatric Nurse’s and District nurses when necessary. One programme evidenced that a service user had been admitted to hospital recently for a behavioural assessment and discharged successfully following a medication review. One service user’s health needs had deteriorated significantly and the staff were working in partnership with the district nurses to provide the care needed in her terminal phase. Staff demonstrated a clear understanding of the service users needs, the care was evidenced to be of a good standard and she looked very settled and comfortable. The systems for the safe handling of medication were examined. Procedures were in place which supported the management of the medication systems; a recommendation made at the previous inspection to review the selfmedication policy to include details of assessment of capability of the service user to self- medicate and staff monitoring procedures had not taken place. Records had been maintained for the receipt, administration and disposal of medication which were satisfactory. The medications were stored in the managers office; the room temperature was not monitored and the room was noted to be very warm during the visit; the management must ensure that the medications are stored safely in line with the manufacturers guidance. From staff interviews it was reported that one of the service users will only accept her medication if it is administered in a spoon of jam; although this practice has been sanctioned by the next of kin, in line with current guidance agreement must also be given by all social and health care professionals involved in the case. Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 and 15 Daily life and social activities were varied and flexible and generally met the expectations and choices of the service users living in the home although the staff could be more proactive and enthusiastic with encouraging service users to participate in more activities. The meals provided in the home were of good quality offering choice and variety. EVIDENCE: During the visit seven of the eight service users spent their time in the lounge area either sleeping or watching T.V. this was only disrupted by a move to the dining room for their lunch. The majority of the service users had a sleep late morning and early afternoon. There was a weekly activity programme in place which included: manicures, exercises, arts/ crafts, bingo, baking, films, music etc however there was little evidence in the records of these sessions taking place and service user participation. One service user spoken to commented that there weren’t many activities taking place but then he didn’t really want to do anything, he preferred to sit in Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 14 the lounge watching the world go by. None of the residents wanted to sit outside in the garden even though it was a warm, sunny day. Staff commented that they could be more proactive and enthusiastic in encouraging service users to participate in activities and that some of their colleagues were better than others in this area. Service users commented that they could rise and retire to bed at times to suit themselves, choose where to have their meals and what clothes they wanted to wear. They also commented that they could spend time in their rooms if they wanted to but usually preferred to sit during the day in the lounge. There was open visiting, there were no visitors to the home during the inspection; the acting manager reported that the majority of relatives/ friends visited the home in the evenings or at the weekends. Meals were served in the dining room and the atmosphere was more lively with a small number of service users talking with each other but in the main conversing with the staff. All the meals were prepared by the care staff who alternate this responsibility; the staff had a good knowledge of the individual service users dietary preferences and needs. Staff assisted service users sensitively and on a one to one basis. The service users in describing the meals said that the meals were very good with good portions. A weekly menu in large print was posted on the notice board in the corridor; the meal served during the inspection was attractively presented and staff gave time between courses for service users to eat at their own pace. Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Over recent months staff failed to realise the conduct of some of the staff was inappropriate and therefore did not report it. Since this time efforts have been made to reinforce appropriate conduct and what action to take. EVIDENCE: The home has policies and procedures to cover adult protection and prevention of abuse, whistle blowing, aggression, physical intervention and restraint in place. There was evidence that the acting manager and most of the staff had accessed training in this area with further sessions scheduled with the Local Authority for later in the year. A complaint was received in April and investigated under the multi agency protection of vulnerable adult procedures; issues relating to a staff member using threatening behaviour and two other staff members using inappropriate language were found to be upheld. As a consequence one staff member has been dismissed and the two other staff had been disciplined. Staff at interview during the inspection reported that they were now very aware of the importance of reporting any instances of poor practise. All staff have been reissued with the homes code of conduct. The acting manager confirmed that the specific training needs in managing challenging behaviour; effective communication skills and treating service users with dignity and respect would be met within the timescales. One of the staff members involved in the complaint needed to have formal supervision so that all the issues could be discussed. For recruitment issues see NMS 29. Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 16 Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 25 and 26. Although the home was clean and tidy, a number of repairs and areas of redecoration were required to ensure service users were provided with safe and comfortable surroundings. The hot water temperature in one bathroom and at two sinks in service users private accommodation were above safe limits and could put service users at risks of scalds. EVIDENCE: Service users spoken to stated that they were happy with their rooms. There was no current maintenance/ redecoration programme available during the visit. A number of areas required attention: • • • In the ground floor bathroom the room required redecoration, the bath side needed repair and the fixed hoist seat required repair/ replacement. The front and rear gardens required tidying; the patio table and chairs required replacement. The fire escape required repainting. J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 18 Carlton House • • • • In room 2, the hand basin was cracked and required replacement and the ceiling required redecorating following a leak from above. In room 4 the light switch required repair, the radiator thermostat required attention and the provision of a privacy lock was required. The banister in the hall required repair. The landing radiator required a low surface temperature cover to be fitted. An immediate requirement notice was served in respect of developing and implementing an appropriate maintenance programme to action all the above works. The hot water temperatures were checked at all outlets accessible to service users and the following deficiencies were identified: Room 4 – 56.2 deg C; Room 3 – 53.9 deg.C and the ground floor bath – 46.2deg.C. Hot water temperatures must be maintained close to and no more than 43degC due to the risk of accidental scalds. An immediate requirement notice was issued in respect of putting up warning signs, carrying out risk assessments and ensuring plumbing services carried out the necessary works. Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 and 30 Service users are cared for by staff in sufficient numbers, however staff recruitment did not offer adequate protection for service users as staff were employed before all the required checks were completed. EVIDENCE: The staffing levels in place were in line with the previous registration authority. Care staff at the home also undertook housekeeping and catering duties; from observation of practise and discussion with staff they were able to meet the needs of the service users. Due to one of the service users deteriorating health needs, the acting manager confirmed that she would be rostering an extra staff member for day shifts and ensuring that two waking staff were on duty at night to ensure that the service user had a staff member with her at all times. There had been some changes within the staff group and from discussions with staff this has improved the morale and working relationships between staff. Staff interviewed confirmed their support with Mrs Redfurn’s application for home manager. . The inspector examined three staff files; one for an existing staff member and two for staff recruited since the previous inspection. One of the files held only Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 20 one reference and for two recently recruited staff members a Criminal Records Bureau check had not been obtained before employment. Two of the files did not contain a recent photograph of the staff member. This does not afford adequate protection for service users and an immediate requirement notice was issued during the inspection. A training programme had been developed in January for the year, which identified mandatory, general and service specific courses. Of the files examined and from staff interviews there was evidence that staff were up to date with the majority of mandatory and general courses; with further sessions scheduled. The induction training programme for the two newly recruited staff had been affected by the management changes; the records needed to demonstrate competency had been assessed in all areas and completion. Outcomes from a recent complaint investigation identified further training needs for staff in areas such as promoting service users dignity and respect and communication skills to ensure the welfare of service users was adequately promoted and protected Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33 and 38 Due to the management changes in the home over the last six months there has been inconsistent leadership, guidance and direction for staff to ensure service users receive consistent quality care. This has resulted in some practices that do not promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: There have been a number of management changes in the home over the past eight months with two acting managers having been employed; Mrs Redfurn the current acting manager previously held the deputy managers position and has now submitted her application for registration with the commission. During this time a number of the management systems were not adequately maintained, staff moral dipped and a complaint investigation identified serious issues regarding documentation, staff attitude and standards of communication. Mrs Redfurn has a very good knowledge of the service users and their needs and appears to have the confidence of the staff team and an Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 22 understanding of the work needed to improve and develop the management systems at the home. There was no evidence that any progress had been made towards the implementation of a formal quality assurance programme and given that this requirement had been outstanding since 2002 an immediate requirement notice was issued. Records showed that regular testing of the fire equipment was taking place; staff had last attended a fire drill in 2004 and therefore further drills should be scheduled; the fire officer had visited the home in March 2005 when no issues had been identified. Records to support HACCP control in the kitchen area had not been maintained satisfactorily with gaps in the records for the temperature of food cooked and fridge/ freezer temperatures. The hot water temperatures at three outlets were above safe limits as discussed in an earlier part of the report. There was no evidence that the owner had carried out an unannounced visit each month and provided a report to support the visits. An immediate requirement was issued. Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 1 x x x x x 1 3 STAFFING Standard No Score 27 3 28 x 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 1 x 1 1 x x x x 2 Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 24 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP25 Regulation 13(4) Requirement The registered person must ensure that hot water temperatures at outlets accessible to service users do not exceed 43degC.(Timescale of immedite effect set on 12/01/05 not met) The registed person must establish and maintain an effective quality assurance programme.(Timescale of 31st March 2005 not met) The registered person must ensure that reports are completed to support the formal visits undertaken to the home in respect of Regulation 26. (Timescale of 28th February 2005 not met) The registered person must ensure that all medications are stored within temperatures which do not exceed the manufacturers guidance. The registered person must ensure that agreement is sought from all health and social care professionals to support the practise of covert administeration of medications. The registered person must Timescale for action immediate requiremen t notice issued 2. OP33 24 Immediate requiremen t notice issued. Immediate requiremen t notice issued. 3. OP37 26 4. OP9 13(2) 16th September 2005 1st September 2005 5. OP9 13(2) 6. OP29 and 19 and Immediate Page 25 Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 18 13(6) 7. OP 19 23(2) b 8. 9. OP 38 OP10 and 18 23 (4) e 12 10. OP10 and 18 13(6) and 12(4)and (5) b ensure that CRB checks and pova list checks are carried out and in place at the home prior to employment commencing. The registered person must ensure that a programme for maintenance and renewal is developed and implemented. The registered person must ensure that staff have access to regular fire drills. That the registered person ensures that all staff treat all service users with dignity and respect and ensure the home’s disciplinary procedure is followed if staff have been found to breach a Regulation. That the registered person must ensure that staff do not use threatening language with service users and if found to do so that the home’s disciplinary procedure is followed The registered person must ensure that new staff receive adequate induction training and this complies with NTO standards. requiremen t notice issued. Immediate requirment notice issued. 15th September 2005 Existing timescale of 30th July 11. OP 30 18(1) (a) and (c)(i) Training for all staff by 30th September 2005Existing timescale Existing timescale 20th August 2005 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. 2. 3. Refer to Standard OP7 OP9 OP38 Good Practice Recommendations The registered person should ensure that staff complete the evaluation sections in all the care programmes in more detail. The registered person should review the self- medication policy to provide clearer information on risk assessment and staff monitoring practises. The rgistered person should ensure that the environmental and fire risk assessments are reviewed. J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 26 Carlton House 4. 5. OP38 OP3 The registered person should ensure that staff working in the kitchen maintain the records to support HACCP procedures. The registered person should ensure that the identified service user is supported to explore options to transfer to a home of his choice in an alternative area. Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 27 Commission for Social Care Inspection Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Carlton House J54 2911 Carlton House 241543 11 July 05 Stage 4.doc Version 1.40 Page 28 - 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. 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