Inspection on 15/06/06 for Castle Hill House Limited

This inspection was carried out on 15th June 2006.

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

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

Other inspections for this house

Castle Hill House Limited 09/02/09

Castle Hill House Limited 05/03/07

Castle Hill House Limited 09/02/06

Castle Hill House Limited 12/10/05

Castle Hill House Limited 23/03/05

Castle Hill House Limited 07/09/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Castle Hill House Limited Castle Hill House Castle Hill Bodmin Cornwall PL31 2DY Lead Inspector Kerensa Livingstone Key Unannounced Inspection 15th June 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Castle Hill House Limited DS0000054294.V295769.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. Castle Hill House Limited DS0000054294.V295769.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Castle Hill House Limited Address Castle Hill House Castle Hill Bodmin Cornwall PL31 2DY 01208 73802 01208 75836 castlehillhouse@hotmail.com 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) Castle Hill House Limited Mrs Judith Ann Adams Care Home 20 Category(ies) of Dementia - over 65 years of age (4), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (4), Old age, not falling within any other category (20), Physical disability (20), Terminally ill (20) Castle Hill House Limited DS0000054294.V295769.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. Service users to include up to 20 adults of old age (OP) Service users to include up to 20 adults aged over 65 with a terminal illness (TI{E}) Service users to include up to 20 adults aged over 65 with a physical disability (PD{E}) Service users to include up to 4 adults, aged over 65 with dementia (DE{E}) Service users to include up to 4 adults aged over 65 with a mental illness (MD{E}) Total number of service users not to exceed a maximum of 20 Date of last inspection 9th February 2006 Brief Description of the Service: Castle Hill House is a care home registered to provide nursing care for up to twenty Service Users over the age of sixty-five. Four of the beds in the home are registered for service users with a dementia DE (E) and four beds are registered for service users who have a mental disorder MD (E). The home is registered to take Service Users who require terminal care (TI) or have a Physical Disability (PD). The entrance to the front of the home is locked. One of the Registered Providers is the Registered Manager with responsibility for managing the home on a day-to-day basis. The two Providers live in a separate building on the same site and are supported on a day-to-day basis by a Deputy Manager. The home is an older style residence set in it’s own grounds in a quiet residential area on the outskirts of Bodmin. The home is in an elevated position, providing super views over the surrounding countryside. There is a large car park to the side of the home. Bedrooms are situated on the ground and first floor. There is a shaft lift that can take a wheelchair. There is a lounge and dining room on the ground floor. Castle Hill House Limited DS0000054294.V295769.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors undertook this unannounced key inspection, both of which have visited the home on previous occasions. The inspection lasted six hours. The inspectors spoke with the Registered Manager and Deputy Manager, relatives, staff and Service Users. The environment was inspected and documentation relating to all aspects of the service scrutinised. Pre inspection information including questionnaire were submitted with comprehensive information prior to this inspection. It was evident that a considerable amount of work had been undertaken since the last inspection to meet the large number of requirements. What the service does well: What has improved since the last inspection? The Service Users Guide and Statement of Purpose have been reviewed since the last inspection. All prospective Service Users must be provided with the Service Users Guide. Service Users contracts have been reviewed to include a breakdown of the fees and who is responsible for paying them. Since the last inspection a full assessment is undertaken by a person who is trained to do so and this includes the information listed in National Minimum Standard (NMS) 3.3. prior to the Service User being admitted to the home. The care planning and risk assessments have improved significantly. There is evidence of Service User and representative involvement. All staff are being provided with in house training on a range of topics e.g. Protection of Vulnerable Adults, Fire, Moving and Handling following requirements from the last inspection. Castle Hill House Limited DS0000054294.V295769.R01.S.doc Version 5.2 Page 6 Since the last inspection a customer survey has been completed (May 2006), a report produced which is accessible on the reception table of the home and details the action taken. This must be part of wider quality monitoring system and be extended to include staff and other stakeholders in the community. What they could do better: 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. Castle Hill House Limited DS0000054294.V295769.R01.S.doc Version 5.2 Page 7 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 Castle Hill House Limited DS0000054294.V295769.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 6 The information provided for Service Users to enable them to make a choice about where to live has been reviewed. Pre admission information is gathered and contracts include the required information. These are positive changes since the last inspection. EVIDENCE: The Statement of Purpose is a comprehensive document detailing the aims of the home. The Service Users Guide and Statement of Purpose have been reviewed since the last inspection. Both documents are available in the reception of the home, with copies of the reports dating back to 2003. All prospective Service Users must be provided with the Service Users Guide. Service Users contracts include terms and conditions of living at Castle Hill House. Service Users contracts have been reviewed to include a breakdown of the fees and who is responsible for paying them. Contracts were observed to be completed for the newest Service Users who had come to live at Castle Hill House. Castle Hill House Limited DS0000054294.V295769.R01.S.doc Version 5.2 Page 9 At the previous inspection the Inspectors were concerned about the pre admission information that was gathered by the home. However this has been remedied, a person who is trained to do so undertakes a full assessment and this includes the information listed in National Minimum Standard (NMS) 3.3. prior to the Service User being admitted to the home. Intermediate care is not provided. Two carers have undertaken Rehabilitation training. There is no designated facilities or equipment. Castle Hill House Limited DS0000054294.V295769.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Service Users health and social care needs are being met. The Service User’s plan of care directs care including all aspects of physical care, psychological, spiritual and social needs. There is evidence of Service User and / or their representative involvement. Medicines were administered safely. EVIDENCE: Each service user has a care plan which includes all aspects of care. There is evidence of Service User and / or family involvement. These are reviewed monthly. At previous inspections the Inspector and Registered Providers have discussed the importance of including social, spiritual and psychological aspects of an individual’s needs, this has been commenced. All Service Users have a keyworker. A daily record is kept, this recording should be improved to ensure that clear information is communicated. All Service Users are registered with a General Practitioner. The home report good working relationships with the local Primary health care team. Assessment tools are used within the home, for example a nutritional assessment tool, the Waterlow assessment, and a Barthel Scale of functional Castle Hill House Limited DS0000054294.V295769.R01.S.doc Version 5.2 Page 11 ability these are produced by the Deputy Manager. These documents are incorporated into the care planning process. Specialist equipment is sought on an individual basis. All Service Users have a risk assessment. Individual Service Users healthcare needs are met and there is evidence of medical review. The chiropodist was due to visit the home on the following day and the General Practitioner visited on the day of the inspection. Medication administration records (MAR) are completed accurately and medicines are stored appropriately. The MAR sheets are transcribed onto another sheet, it is recommended that this is checked and signed by a second nurse. The Administration of Medicines is undertaken by a qualified nurse at all times, medicines were observed to be handled and administered safely during a medicines round. There is a Controlled Drugs cupboard and register to ensure the safe storage of Controlled Drugs. There is a designated fridge for medicines, this must be kept locked or in a locked room. The clinical room where it is stored was observed to be unlocked, this room should be locked at all times. The fridge temperature is checked and recorded. The pharmacist visited the home on the 18th of May, the inspector was informed that the pharmacist was satisfied with the storage facilities. Staff were observed to respect the Service Users privacy and dignity needs during the inspections. Staff knocked on doors prior to opening them. Several Service Users commented on the kindness of the staff. One double room has no curtains or screening around the washbasin, as noted at previous inspections. This would prevent Service Users having the option of sitting at the wash hand basin. Castle Hill House Limited DS0000054294.V295769.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Service Users are able to maintain contact with families and friends. A wholesome balanced diet is offered to the Service Users. More evidence is required to demonstrate that Service Users are able to exercise choice over their lives and that the activities available in the home meet their individual needs. EVIDENCE: Most of the service users are frail and limited in their ability to participate in many activities. The home does organise activities with the service users, these should be circulated to the Service Users and posted on the notice board. There were no activities available on the day of the inspection and Service Users were non-committal about the activities in the home. Social interests and activities information must be gathered as part of the assessment and form the basis for planned activities in the home. Visitors are able to visit freely and were seen to do so during the inspection. Service Users have furnished their rooms with personal belongings and furniture. The Registered Provider informed the inspectors that the home was reluctant to handle Service Users monies and encouraged the families to support the individual with this, as required. Castle Hill House Limited DS0000054294.V295769.R01.S.doc Version 5.2 Page 13 Service users with whom the inspector spoke said the food was good. Those who are able, eat in the dining room where tables were laid up. Assistance is provided by the staff as required. The wish to remain in one’s room for meals was also respected. A choice is offered for all meals, the menu operates on an eight-week rotation. Service Users are asked whether they would like the menu choice or an alternative, choices are recorded in the diary. The menu on the day of the inspection was written on a board in the hall, it was as follows orange juice/mushroom soup, gammon or vegetable tuna pie, blancmange, cheese and biscuits. The main meal is served at lunchtime and a high tea served with soup, sandwiches, scrambled egg and cake etc. Fresh fruit and vegetables are included in the menu planning. The head cook has completed the Intermediate Food Hygiene and Principles of Food Hygiene and safety, the cook on duty in the kitchen on the day of the inspection has completed the Basic Food Hygiene training and is due to do the Principles of Food hygiene and safety. Castle Hill House Limited DS0000054294.V295769.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Staff are receiving training relating to Adult Protection, however the procedures must be in adherence with local Social Services procedures. There is an established procedure for the handling of complaints. EVIDENCE: The home has a complaints procedure, which details the action required, this includes stages and timescales. A record of all complaints, including the investigation undertaken and action taken is kept. Service Users informed the inspector that they felt able to talk to the care staff if they had any problems. One relative informed the inspector that they did not feel that the home’s management listened to their concerns or acted upon them. The Commission for Social Care Inspection has investigated two complaints in the last six months. The first one resulted in the last inspection dated the 9th of February 2006. A significant number of requirements for improvement were made as a result of these complaints and a subsequent visit to the home was made. A procedure detailing the action to be taken in the event that an incident of abuse being alleged has been produced, contact details for the Social Services must be included in this and it should not state that a full investigation will be undertaken by the home prior to deciding whether to refer onto Social Services as the lead agency. All staff are being provided with in house training to ensure that they are aware of the action to be taken. Four staff including the Registered Manager have attended the Social Services facilitated training. Castle Hill House Limited DS0000054294.V295769.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The building generally meets the needs of the Service Users. Some of the Service Users accommodation needs redecorating and all toilet/bathroom facilities require upgrading. Individual Service Users rooms are personalised and suit their needs. The communal areas are comfortable and homely. EVIDENCE: Several curtains and carpets were noted to be in need of replacement in Service Users rooms. At the last inspection an audit of bed linen was recommended as sheets were not to be threadbare in a couple of Service Users rooms, it was observed to be the same at this inspection. The Registered Provider reported that an audit had been done and would be repeated. The bathrooms are dated and in need of refurbishment. Some redecoration had taken place since the last inspection. A programme of routine maintenance and renewal of fabric and decoration of the premises will be inspected at the next inspection. There is a passenger lift. Storage is acknowledged to be an issue at the home with bathrooms being used to store equipment and another bathroom was noted to be used for storage. There must be adequate storage within the care home. Castle Hill House Limited DS0000054294.V295769.R01.S.doc Version 5.2 Page 16 Bedrooms are generally small, there are fourteen single rooms and three double rooms. Service Users rooms are furnished individually and provided with the required furnishings. Adjustable beds are provided for Service Users receiving nursing care. The lack of screening in one double room would not allow a Service User to use the wash hand basin for washing in private. Radiators are safely guarded with low surface temperatures throughout the home and the Providers have informed the Inspector that water temperatures are controlled to reduce any risk to the service users. Lighting in Service Users rooms is domestic in nature. Rooms are naturally ventilated and have plenty of natural light. Service Users commented that their rooms were warm and comfortable. The laundry facilities are compact with one industrial washing and drying machines, all laundry is done internally. Policies and procedures are in place for the safe storage of chemicals and Infection Control related issues. Disposable gloves and aprons are available to staff. The home was found to be generally clean on the day of the unannounced inspection. There were several areas in the home that were odorous. There are two staff that undertake the laundry and cleaning. Staff were observed to be professionally attired in a uniform. There is a sluicing facility on the first floor of the home. Castle Hill House Limited DS0000054294.V295769.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Since the last inspection there has been a significant improvement in the recruitment and training procedures in the home. In-house training is being provided. Staff must be provided with the knowledge and skills that they require to enable them to care competently for the Service Users. EVIDENCE: There is a qualified nurse on duty at all times in the home. The housekeeping and catering staff is included on the rota. There are three care staff on each morning and two each afternoon, in addition to a qualified nurse. The care staff were observed to undertake the laundry as part of their roles. A gardener comes in to maintain the garden. There is a recorded staff rota which show the staff are on duty at any given time. At the previous inspection it came to light that the Registered Manager was not managing the home on a daily basis. This has been remedied and must be maintained. The Registered Manager is required to detail the hours worked on the rota on a daily basis. Five care staff have completed their National Vocational Qualification Level 2 or 3. Four carers have qualified as nurses in another country and two carers are yet to do their training. Staff records are in place to evidence that two written references are being taken prior to employment of new staff. All new staff complete an application form and sign a health declaration. In the files examined, all staff have had Criminal Records Bureau checks undertaken by the Providers. The home has Castle Hill House Limited DS0000054294.V295769.R01.S.doc Version 5.2 Page 18 an Equal Opportunities policy and procedure. The Provider is aware that no staff are able to commence employment without the POVA first check having been received. Evidence of interview questions and answers are to be kept on any future interviews. Registration details are checked with the Nursing and Midwifery Council as required. Recruitment difficulties have resulted in the use of recruitment agencies attracting staff from abroad, the Registered Providers must ensure that the communication difficulties observed during the unannounced inspection are addressed. Service Users spoke highly of the care staff. Since the last inspection induction training has been developed and commenced. These improvements must be consolidated. A staff training and development programme has been commenced since the last inspection. Staff are provided with in house training which is externally validated on Protection of Vulnerable Adults, fire, risk assessment, first aid, diet and nutrition, health and safety and infection control training. Moving and handling training has been provided for staff in house, although the inspectors raised concerns with the Registered Provider regarding the moving of one Service User during the inspection. Castle Hill House Limited DS0000054294.V295769.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 The Inspectors were satisfied that there had been an improvement in the leadership and management within the home. EVIDENCE: The Registered Providers have owned the home since 1992 and one of the Registered Persons manages the home on a day-to-day basis as the Registered Manager. The Registered Provider is a Registered General Nurse with a broad range of clinical experience and has a post graduate qualification in Home Care Management. Recent updating has been undertaken. This role is supported by a Deputy Manager. Policies and Procedures are standardised, dated and have recently been updated. Evidence that staff have read and understood them is being gathered. Since the last inspection a customer survey has been completed (May 2006), a report produced which is accessible on the reception table of the Castle Hill House Limited DS0000054294.V295769.R01.S.doc Version 5.2 Page 20 home and details the action taken. This must be part of wider quality monitoring system and be extended to include staff and other stakeholders in the community. The home prefers not handle money for service users. Relatives would be approached if something was needed or an item would be billed, as appropriate. The environmental risk assessments have been reviewed and updated since the last inspection. Environmental risk assessments must be completed for all risks within the home. The Fire Officer visited the home on the 24th of May 2006, found everything to be satisfactory, but advised that the risk assessment needed to be more detailed. All staff are being provided with inhouse training by an in-house trainer. Extinguishers were checked in April 2006. Gas inspection and certification dated 13.2.06. The Inspector has been advised that annual Portable Appliance testing is undertaken on all electrical items. Castle Hill House Limited DS0000054294.V295769.R01.S.doc Version 5.2 Page 21 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 3 3 3 X X N/A 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 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Castle Hill House Limited DS0000054294.V295769.R01.S.doc Version 5.2 Page 22 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 OP18 Regulation 13(6) Requirement The Registered Provider shall make arrangements to prevent Service Users being harmed or suffering abuse or being placed at risk of harm or abuse for example to ensure that procedures and training are in adherence with local procedures. The Registered person shall having regard for the number and needs of the Service Users ensure that all parts of the care home are kept clean and reasonably decorated for example the bathrooms and toilet facilities. The Registered person shall having regard for the number and needs of the Service Users ensure that there is suitable storage for the purposes of the care home. The Registered Person shall keep the home free from offensive odours. The Registered Person is required to keep a duty roster of persons working at the care, and a record of whether the roster DS0000054294.V295769.R01.S.doc Timescale for action 01/08/06 2. OP21 23(2d) 01/11/06 3. OP22 23(2l) 01/11/06 4. 5. OP26 OP27 16(2k) 17(2), Sch.4 01/08/06 01/07/06 Castle Hill House Limited Version 5.2 Page 23 6. OP32 21(2) 7. OP38 13(4) was actually worked. The Registered person shall make arrangements to enable the staff to inform the registered person and the Commission of their views about any matter relating to the conduct of the home. Previous timescales not met. The Registered Person shall ensure that the home is so far as practicable free from hazards to their safety and unnecessary risks to health or safety of Service Users are identified and so far as possible eliminated. 01/08/06 01/08/06 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. 4. Refer to Standard OP9 OP9 OP10 OP12 Good Practice Recommendations For the transcribed medication prescription to be checked and signed by a second nurse. To ensure that the medicines fridge is lockable or in a locked room. For screening to be provided around the sink in the double room, to enable the Service User the option to wash at the wash hand basin. For activities to be based upon Service Users interests, up to date information about the activities that are available in the home to the circulated to all Service Users and posted on the notice board. For an audit into the quality of bed linen to be conducted and replaced as deemed appropriate. 5. OP24 Castle Hill House Limited DS0000054294.V295769.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Castle Hill House Limited DS0000054294.V295769.R01.S.doc Version 5.2 Page 25 - 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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