CARE HOMES FOR OLDER PEOPLE
Celia Johnson Court Gregson Close Studio Way Borehamwood WD6 5RG Lead Inspector
Claire Farrier Unannounced 12 July 2005 9:00 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. Celia Johnson Court I52 s19311 celia johnson court v238218 120705 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Celia Johnson Court Residential Home Address Gregson Close Studio Way Borehamwood Hertfordshire WD6 5RG 0208 2073700 0208 3815221 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) Aldwyck Housing Association Limited Mrs F Brown Care Home 37 Category(ies) of OP Old Age - 37 registration, with number of places Celia Johnson Court I52 s19311 celia johnson court v238218 120705 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: There are no additional conditions of registration. Date of last inspection 30 January 2005 Brief Description of the Service: Celia Johnson Court is a care home providing personal care and accommodation for 37 older people. The home is owned by Aldwyck Housing Association, which is a voluntary organisation. It was opened in 1992 and consists of a purpose built two storey building. The home is located in a modern housing estate on the outskirts of Borehamwood, near to the town centre. Public transport is easily accessible, and the home also has its own transport. All the home’s bedrooms are single with en-suite facilities. There is a passenger lift. The home has attractive gardens on three sides that are well maintained and easily accessible. Celia Johnson Court I52 s19311 celia johnson court v238218 120705 stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the first unannounced inspection of the inspection year and took place over one day, starting at 9.00am. Two inspectors visited the home, and the majority of time was spent observing and talking to residents and staff. Some time was also spent looking at records and care plans, and the results of the inspection were discussed with the manager. Eight residents and seven members of staff were spoken to during the inspection. This was generally a positive inspection, and the majority of the standards were met or partially met. New requirements were made concerning maintenance and medication. Requirements have been repeated on the use of window restrictors and door wedges. What the service does well: What has improved since the last inspection?
The requirements from the previous inspection have been addressed. In particular, window restrictors were fitted to all first floor windows and the fire service were asked for advice on the use of wedges to hold bedroom doors open. Care plans are now used more effectively for monitoring concerns, and programmes were seen for monitoring adequate nutrition. Tablecloths and napkins are now provided for lunch in the dining room, following the suggestion of residents in a recent residents meeting.
Celia Johnson Court I52 s19311 celia johnson court v238218 120705 stage 4.doc Version 1.40 Page 6 The activities programme has been enhanced by weekly outings in the homes minibus, to places of interest such as Southend and Aldenham Country Park. 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. Celia Johnson Court I52 s19311 celia johnson court v238218 120705 stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Celia Johnson Court I52 s19311 celia johnson court v238218 120705 stage 4.doc Version 1.40 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 standard(s) 3 and 4 A comprehensive assessment of the needs of the residents was seen to be in place, and appropriate risk assessments are carried out to ensure that the residents live in a safe environment. Sufficient information is available within the home on residents’ needs and access to appropriate services to enable the needs to be met. EVIDENCE: Care records of residents were inspected and there was evidence of pre admission assessment of needs being carried out in each case. The home receives a copy of the pre admission assessment of needs of prospective residents for those who are funded by the Social Services and discharge letters from hospital, where applicable. The staff members were observed to have a good relationship with the residents and to treat them with respect. One resident was upset because she could not find her bag, and the staff and manager assisted her very sensitively. The home has sufficient levels of staff and appropriate training to ensure that they can meet the needs of the residents. Celia Johnson Court I52 s19311 celia johnson court v238218 120705 stage 4.doc Version 1.40 Page 9 All the staff spoken to, including domestic staff, said they have the skills and knowledge to meet the specific care needs of the residents. The residents spoken to said that the staff are very good and very kind, and understand their individual needs. Celia Johnson Court I52 s19311 celia johnson court v238218 120705 stage 4.doc Version 1.40 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 standard(s) 7, 8, 9 and 10 The individual needs of residents are clearly set out in care plans to ensure that all their needs are identified and can be met. Several errors were seen in the administartion and recording of medication, which could cause a risk to the health of the residents. Residents said that staff treat them with respect, and the policies and practice in the home also promote service user privacy and dignity. EVIDENCE: Detailed case tracking was carried out through the files of four residents. They contain clear and easily accessible information on the resident’s health and personal care needs, with comprehensive procedures for meeting the needs. Appropriate goals are identified for each person, related to personal care, health care and activities. The key worker for each resident completes a regular review in the form of a journal, approximately every two months. The comments seen in the journals included “Fine, happy, family visit” and “Nice lady, made friends with (another resident)”. This could be a more relevant and useful tool for monitoring the care plan, by relating the comments directly to the care plan goals and their outcomes. Celia Johnson Court I52 s19311 celia johnson court v238218 120705 stage 4.doc Version 1.40 Page 11 Evidence was seen that the residents are involved in decisions about their care. Annual reviews are carried out, and the review record includes a space for the resident’s comments and family comments. Changes were seen to be made in the care plans related to the comments and wishes of the residents and their families. In one example a daughter had commented that she would like her mother to wear pop socks rather than socks, and the care plan then noted that pop socks are to be worn at all times. Records of appropriate health checks were seen. Risks of falls and nutritional issues are monitored and all the residents are weighed regularly. The home has good support from the local GP services and community nurses, and evidence was seen of appropriate referrals for wheelchair services and mental health services when needed. One resident who has Parkinson’s disease commented that the staff understands the condition and her changing daily needs. All the residents said that the staff treat them with respect and provide a good quality of care. All the staff, including domestic staff and kitchen staff, were observed to use each resident’s preferred name. The home has appropriate procedures for administration of medication, and all the staff who administer medication have had certificated training on the safe handling of medication. However several areas of poor practice were observed in the administration of medication: 1. The medication trolley is stored securely under the main staircase of the home but extra stocks of medication are kept on top of a filing cabinet in the care officers’ room. The care officers’ room is locked when not in use, but all medication should be stored securely as required by the Royal Pharmaceutical Society. The controlled drugs cabinet is in the bathroom in the manager’s office suite, and the medication fridge is in the manager’s office. Work is in progress to move all medication to the current care officers’ room and designate that as the medical room. However the disparate storage currently in place may be the cause of some of the concerns noted below. 2. Most of the residents’ medication is supplied in Nomad boxes, with each dose of medication in a separate compartment. However a lot of medications are currently supplied in the original packaging, which increases the risk of error. It was reported that the pharmacist is obtaining new Nomad boxes to ensure that all medications are supplied by this method in future. 3. A spot check of medication showed some errors. One resident’s digoxin had a stock of one fewer than was recorded on the MAR (medicines administration record) chart. Another resident’s arimidex contained more than were recorded on the MAR chart. There is no system of effective audit to ensure that any errors are noted and explained. Celia Johnson Court I52 s19311 celia johnson court v238218 120705 stage 4.doc Version 1.40 Page 12 4. Chloramphenicol eye drops were seen for two residents, in a plastic box in the care officers’ room. The labels clearly states that the eyedrops need to be stored in a fridge. 5. Two residents look after their own medication. Neither had signed that they had received their medication the previous week. 6. The recording of variable doses of medication, for example for paracetamol and co-dydramol when 1 or 2 may be given according to need, is erratic. On some occasions the number of tablets given is recorded, but more often this is not recorded. It is therefore no possible to carry out an accurate audit of the medication. 7. Controlled medication is stored appropriately, but the recording could be improved. The pharmacist does not currently sign the controlled drugs (CD) register when he takes returns of medication. There were some gaps in recording in the CD register, with a resulting discrepancy between the stock held and what was recorded. Celia Johnson Court I52 s19311 celia johnson court v238218 120705 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, 14 and 15 The residents are happy with the activities and daily life in the home and maintaining contact with families and friends is promoted by staff in accordance with the residents’ wishes. Wholesome and varied meals are provided within the home presenting a well-balanced nutritious diet for the residents. Residents maintain their independence by making choices about the food and how they spend their days. EVIDENCE: The first floor lounge is used as an activity room, and also contains facilities for the visiting hairdresser to use. There is a daily programme of activities, including bingo, quiz and music. There are also reminiscence groups, and individual outings for residents for shopping or to the pub. One resident, who is hoping to be able to return to her own home, goes out on her own, to the shops and to the local church. The home has its own minibus, and weekly outings are arranged for a small group of residents. On the day of the inspection, residents went on a day out to Aldenham Country Park. Several residents spoke enthusiastically of these outings. An extra member of staff is on duty to accompany the residents who go out, and the home’s maintenance man is the driver. One lady spoken to at breakfast time said that she doesn’t like the activities and doesn’t want to go out. However later she was seen waiting with others to go on the outing, and said that she would probably enjoy it.
Celia Johnson Court I52 s19311 celia johnson court v238218 120705 stage 4.doc Version 1.40 Page 14 Her care plan recorded that she should be informed of activities and encouraged to sit in the lounge rather than on her own. The activities record in her file showed that she does take part in activities, and reports that she enjoys them. Relatives and friends are encouraged to visit without undue restrictions, and family members are invited to the resident’s reviews. Emphasis is given to autonomy and choice for the residents. Residents meetings occur within the home and minutes are typed up and are placed on notice boards throughout the home. Residents’ views and opinions are expressed freely within the home and efforts are clearly made to ensure that they maintain vital links, personal autonomy and choices. If further support and/or advice is required in order to ensure freedom of choice for the residents the home is able to link with specialist advocacy services. The residents were enjoying a leisurely breakfast when the inspection began, most of them in the dining room, with the option of breakfast in their room. Groups of friends sit together in the dining room, and the atmosphere is relaxed and sociable, with discussion between residents and with the staff. After breakfast the tables were laid for lunch, with cloths and napkins, which changed the atmosphere and made the meal time an occasion to look forward to. The tablecloths and napkins have been provided as a result of a discussion at the last residents meeting. All the residents spoken to said that the food is good and that they enjoy their meals. There is a good choice of meals, including the option of a cooked breakfast, and alternatives are provided for those on a diabetic diet. One resident who is diabetic said that there are no diabetic puddings on offer, just jellies. On investigation, it was found that diabetic puddings are prepared, but as they have don’t appear to be any different from the puddings offered to other residents, the diabetic residents may not be sure of what they are. Celia Johnson Court I52 s19311 celia johnson court v238218 120705 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) 16 and 18 A comprehensive complaints procedure is in place, and residents and their relatives are confident that any complaints will be properly investigated. All staff have appropriate training on prevention of abuse, and robust polices and procedures are in place to ensure that the residents are protected. EVIDENCE: A satisfactory complaints procedure is in place. Residents and their relatives are encouraged to make their concerns and complaints known. One complaint has been recorded since the last inspection, which was resolved to the satisfaction of the family member concerned. Training in the prevention of abuse is included in the induction programme. The staff spoken to were aware of the home’s procedures and of the whistle blowing policy, and all the staff, including domestic staff, confirmed that they have attended training in prevention of abuse. Celia Johnson Court I52 s19311 celia johnson court v238218 120705 stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 The home is clean and generally well maintained. Individual and communal facilities are appropriate for the residents’ needs. This ensures that the residents are able to maximise their independence and live in a safe and comfortable environment. Celia Johnson Court I52 s19311 celia johnson court v238218 120705 stage 4.doc Version 1.40 Page 17 EVIDENCE: Celia Johnson Court is a purpose built two storey building, located in a modern housing estate on the outskirts of Borehamwood. The home has attractive gardens on three sides that are well maintained and easily accessible. One resident was seen enjoying the sunshine in the garden, and she said that she likes to sit in the sun whenever she can. A path around the building provides access to all parts of the garden for residents with poor mobility. The home is generally well maintained, and a handyman is employed to ensure that repairs are dealt with effectively. However some parts of the home are starting to show their age. The corridor carpets look stained and worn in several places. An area of the first floor corridor needs painting, where it appears that a sign had been removed from the wall. The wall mirror in one bedroom is cracked. The small lounges on each corridor are furnished with comfortable domestic style settees and chairs, but the seating in the activity room, which is the room most used by the residents, has vinyl high seat armchairs. Many of these are looking shabby and discoloured, and they have a functional rather than homely appearance. The staff spoken to confirmed that they have training in infection control, and they all sign the home’s infection control guidelines. Liquid soap and paper towels are provided by all washbasins. However there is no soap or hand towels in the laundry. The laundry assistant said that she washes her hands in the sluice room, on the other side of the corridor. Liquid soap and latex gloves were available there, but there are no paper towels. The home has good procedures for dealing with laundry, and the laundry assistant works from Monday to Friday and takes pride in providing a good service for the residents. There was a slight but noticeable smell of urine in two bedrooms. The home has put in procedures to address this, including solid flooring and regular cleaning and shampooing. The residual smells may be due to the age of the carpets in the corridors, and further efforts should be made to address this. Celia Johnson Court I52 s19311 celia johnson court v238218 120705 stage 4.doc Version 1.40 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 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 Staff numbers in the home are sufficient to ensure that all the residents’ needs are met, and staff receive appropriate training. Good recruitment procedures and staff training make sure that, as far as possible, the residents are supported and protected in the home. EVIDENCE: The home has a good level of staffing, with five care assistants and duty officer on each shift during the day and two waking night staff. A thorough recruitment procedure is in place, including obtaining CRB (Criminal Record Bureau) and POVA (protection of vulnerable adults) disclosures before new staff start to work in the home. All the staff spoken to said that they take part in regular training. The domestic staff are included in all training offered, including training on prevention of abuse and dementia care. Twelve care assistants are currently studying for NVQ qualifications in provision of care. All the members of the care staff and domestic staff spoken to during the inspection were enthusiastic about their work in the home, and one said that there is an open and happy atmosphere there. The residents feel confidence in their abilities and several said that the staff are very good and very kind. Celia Johnson Court I52 s19311 celia johnson court v238218 120705 stage 4.doc Version 1.40 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 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) 33, 35 and 38 The home actively seeks the views of the residents and other involved people in order to ensure that a good quality of care is provided. The residents of the home are generally safeguarded by the practice of appropriate health and safety procedures. EVIDENCE: A sound quality assurance system is in place that meets the needs of the service. Annual questionnaires are sent to all the residents and their families, and feedback is given to them on the outcomes. There are regular residents meetings in the home. The minutes of the last meeting, held in early July, showed that there were discussions about outings, the provision of tablecloths for the dining room, and the care provided. Residents were asked to make suggestions for any improvements they would like to see in the home, to give to Aldwyck’s Chief Executive when he makes a visit to the home. The home also receives unannounced monthly monitoring visits from the proprietor, Aldwyck Housing Association, and the reports of the visits are sent to the Commission for Social Care Inspection.
Celia Johnson Court I52 s19311 celia johnson court v238218 120705 stage 4.doc Version 1.40 Page 20 The arrangements for management of residents’ money were checked inspected and appeared to be accurate. Money is stored safely and adequate records are maintained in order to protect service users from financial abuse. Appropriate records for the health and safety of the residents and staff are maintained in the home, and staff follow the home’s policies and procedures. All the staff have training in moving and handling, fire safety, food hygiene and infection control as part of their induction. Following the last inspection, window restrictors have been fitted to all first floor windows, to safeguard the residents. During the recent very hot weather several residents and their relatives complained that the windows could not be opened fully, and several of the window restrictors were disconnected. Several restrictors were still disconnected at the time of this inspection. Following the inspection a letter was received from a relative of one of the residents raising concerns about the requirement to limit the opening of windows during the hot weather. However the provision and use of window restrictors remains a requirement for the health and safety of the residents of the home, and management of the control of heat is a separate matter from the possible health and safety risks from open windows and doors. The home should also have procedures in place for managing the effects of a heat wave, which may include the provision of frequent cold drinks, the provision of fans, suitable clothing, and using the cooler areas of the home. Some bedroom doors were again seen to be held open by wedges. The manager has asked the advice of the fire service on the use of door wedges, and following that advice automatic door closers have been ordered for the rooms of residents who like to have their doors open. However these were not in place at the time of this inspection, and the requirement has therefore been repeated. Celia Johnson Court I52 s19311 celia johnson court v238218 120705 stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 2 x x x x x x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 2 Celia Johnson Court I52 s19311 celia johnson court v238218 120705 stage 4.doc Version 1.40 Page 22 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 9 Regulation 13(2) Requirement Poor practice was observed in the administration of medication. Effective measures must be put into place to ensure that all medication is stored, administered and recorded according to the guidelines of Royal Pharmaceutical Society and the relevant legislation. The corridor carpets and vinyl armchairs in the activity room are showing signs of wear. The corridor carpets must be thoroughly cleaned or replaced, and chairs that are stained or discoloured must be repaired or replaced. Offensive smells were noticed in two areas of the home. Effective procedures must be put in place to ensure that the home is free from offensive odours. Appropriate restrictors must be fitted to all first floor windows, and must be operational at all times. (Previous timescale of 31/03/05 not met. Enforcement action may be considered if this requirement is not met within the new timescale.) Timescale for action 30 September 2005 2. 19 23(2)(b) 31 December 2005 3. 26 16(2)(k) 31 December 2005 12 July 2005 4. 38 13(4)(a) & (c) Celia Johnson Court I52 s19311 celia johnson court v238218 120705 stage 4.doc Version 1.40 Page 23 5. 38 23(4)(c)(ii Appropriate automatic door i) closers must be fitted to the doors of bedrooms that are kept open at the wish of the resident, as advised by the fire service. Bedroom doors must not be held open by wedges or other artificial means. (Previous timescale of 31/03/05 not met. Enforcement action may be considered if this requirement is not met within the new timescale.) 30 September 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. Refer to Standard 7 26 Good Practice Recommendations It is recommended that the regular journal reviews should record comments that relate directly to the residents care plan goals and their outcomes. Liquid soap and paper towels should be provided in the laundry. Celia Johnson Court I52 s19311 celia johnson court v238218 120705 stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City AL7 3BQ 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 Celia Johnson Court I52 s19311 celia johnson court v238218 120705 stage 4.doc Version 1.40 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!