Inspection on 08/05/06 for Clifden House

This inspection was carried out on 8th May 2006.

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

Clifden House 14/05/08

Clifden House 23/05/07

Clifden House 08/11/06

Clifden House 25/11/05

Clifden House 17/06/05

Clifden House 03/12/04

Clifden House 11/06/04

Clifden House 19/05/03

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Clifden House HistoGrange Ltd 82-88 Claremont Road Seaford East Sussex BN25 2QD Lead Inspector Gwyneth Bryant Unannounced Inspection 8th May 2006 08:30 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 Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Clifden House Address HistoGrange Ltd 82-88 Claremont Road Seaford East Sussex BN25 2QD 01323 896460 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) office@clifdenhouse.co.uk Mr Nial Joyce Sheila Collins Care Home 36 Category(ies) of Dementia - over 65 years of age (36) registration, with number of places Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users must not exceed thirty six (36). Service users accommodated must be aged sixty-five (65) years or over on admission. Service users with a diagnosis of an early onset of dementia only to be accommodated. 25th November 2005 Date of last inspection Brief Description of the Service: Clifden House is a large detached house on two floors and provides two passenger lifts to access the first floor accommodation. The home is registered to care for 36 older people with Dementia. It is situated in a residential area of Seaford, with the seafront and town centre within short walking distance. The home is a member of the Alzheimer’s Disease Society. The home provides a light and airy dining room and four lounge areas. There is a large wellmaintained rear garden. The home provides 26 single bedrooms, 24 of which have toilet en-suite facilities and 5 double bedrooms with toilet en-suite facilities. Plans are in place to fit en-suite facilities to the remaining two single rooms. There are four bathrooms with assisted bath seats and six communal toilet facilities. Toilet riser seats, hand and grab rails are fitted as required. The service provides prospective service users and their families with a welcome pack which includes a copy of the Service Users Guide, a contract, terms and conditions, the Statement of Purpose, complaints policy, a copy of the latest inspection report and details of the trial periods offered. Fees charged as from 1 April 2006 range from £365 to £525, which includes toiletries, outings, activities and small items such as tights. Additional charges are made for hairdressing, chiropody and newspapers. Intermediate care is not provided. The email address for the home is office@clifdenhouse.co.uk Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by two inspectors over 9.25 hours. There were thirty-three service users in residence on the day and one who was in hospital. The inspectors spoke to four service users, the cook, two care staff and the registered manager and her deputy. The purpose of the inspection was to check that the requirements of previous inspections had been met and inspect additional standards. The inspectors also spoke to one relative. A tour of the premises was undertaken and a range of documentation viewed including care plans, personnel and medication records. Nine comment cards were received from service users whose relatives assisted in their completion. Comments were in the main positive with all mentioning that they felt the manager and her deputy listened to them and acted to resolve any concerns and that staff were kind and caring. Three mentioned that at certain times of the day staff congregated in the service users smoking room leaving service users unattended. Other social and healthcare staff were not engaged with on this occasion although the inspectors took the opportunity to talk to the two trainers who were providing diversity training to staff on the day of the inspection. What the service does well: What has improved since the last inspection? Care plans and risk assessments are now reviewed monthly and service users or their relatives are given the opportunity to be involved in the compilation and review of the plans. The practice of ‘potting up’ medication has ceased and a suitable drugs trolley purchased. Systems have been created to ensure the CSCI is informed of any allegations of abuse or theft and a suitably qualified person has carried out an assessment of the home and grounds. A new call bell system has been installed and all call bells are accessible to service users. Most staff have been trained in infection control and all staff now receive formal supervision at least six times a year. The requirements Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 Page 6 made by the fire safety officer have been carried out and call bells, fire alarms and emergency lighting are tested regularly. 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. Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 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 Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 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 and 3. Standard 6 is N/A Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Satisfactory pre-admission assessments are carried out prior to service users moving into the home which ensure that their needs can be met and they are provided with detailed information on services provided by the home. EVIDENCE: The Statement of Purpose and Service Users Guide have been recently updated and contain all the information required enabling prospective service users to make an informed choice about where live. Pre-admission documentation was viewed for recent admissions and it is evident that these documents are used effectively to ensure the home is able to meet the needs of prospective residents. At the time of admission information is sought from social and healthcare professionals to ensure all needs are clearly identified and planned for. Intermediate care is not provided. Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 Page 9 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 and 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. All aspects of service users health, social and care must be identified and planned for, in order to clearly direct staff in the delivery of appropriate care. EVIDENCE: Seven care plans were viewed, including three who had been recently admitted and one who was not part of the case tracking process. Basic risk assessments had been carried out but they did not clearly identify the hazards nor include sufficient detail for the management of risks, this is especially true for those who are at risk of falls or tissue breakdown. This was discussed with the registered manager who explained that her deputy has now been trained in risk assessing and templates have been created for this purpose. The home does have a policy of notifying the community nurse for advice and support should it be noted that a service user is at risk. The new system is due to be implemented within the next few weeks. There was evidence to show that relatives are invited to the monthly care plan reviews and the one relative spoken with confirmed this. In addition the manager holds meetings for relatives every 4-6 weeks to give them the opportunity to discuss the service provided and give support to each other. Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 Page 10 One service user told the inspector her hearing aid had broken and she was very upset because she could not hear or join in conversations. This was discussed with the registered manager who said the GP had made a referral and an appointment made but this was not for several months. She agreed to follow this up with the appropriate healthcare professionals as this service users’ quality of life is severely reduced due to being unable to hear. Service users are weighed monthly but while systems have been created to monitor nutritional intake they have yet to be implemented. The registered manager said she intends to implement the nutrition assessments within the next few weeks. It was of concern that one newly admitted service user did not have a care plan although it was evident that her needs were considerable and this needs to be addressed without delay to ensure staff have clear direction in dealing with her needs and in particular her reluctance to wear anything other than a nightdress and underclothes. One care plan showed that the service users’ religious preference was Methodist and the manager explained that she arranged for a local minister to visit. The manager also ensures that the religious needs of other service users are met. The systems for handling medication remain poor, with a number of issues in respect of stock rotation, disposal of medication, medication either not signed for or not administered and second signatures not provided for certain medicines. Where medication has been refused and subsequently destroyed this has not been recorded. Prescribed creams were found in bedrooms that were not for use by the occupant and in a number of cases had passed the expiry date. In addition, eye drops prescribed for a specific service user were found to be out of date. These shortfalls pose a potential risk to service users. Appropriate staff training has been arranged and is due to take place in June 2006. Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 Page 11 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 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The lifestyle experience by service users does not always match their expectations, choice or preferences. Meals are satisfactory but improvements could be made in respect of variety and choice in order that service users are informed of the alternatives available so that they can make an informed decision about what they would like to eat. EVIDENCE: Service users’ care plans include some information on their individual preferences in respect of leisure, however they do not include how they are to be met. Throughout the inspection service users were seen to choose where to spend their day; some stayed in their rooms, some sat in the communal areas while others preferred to wander throughout the building. Despite this element of choice, other aspects such as times for getting up, going to bed and mealtimes were not recorded. The one service user who was able to express a preference said she enjoyed her food and surveys received also said the food was satisfactory. Menus were viewed and seen to be adequate, however a choice of lunchtime meal is not routinely offered and only provided if a service user does not like the planned meal. The cook had a list of service users likes and dislikes. Discussion with Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 Page 12 the manager found that fresh fruit is offered as a snack but no fresh fruit was found on the day and biscuits and cakes were the only food items seen to be offered as snacks. Nutrition was an issue raised as part of a complaint and as a result the registered manager intends to introduce nutritional assessments and meals will then be adapted to facilitate maximum nutrition. One of the inspectors spoke to the cook who only took responsibility for the main lunchtime meals and although she prepared the supper meal she was not aware of any other snacks or drinks offered to service users. At the last staff meeting staff requested that supper sandwiches be more varied as they felt it was ‘always the same’. Meals and nutrition were discussed with the registered manager who confirmed that staff frequently make sandwiches, drinks and cereals for service users throughout the evening and night hours. She also said that although the written breakfast menu was the same each day, service users could have whatever they chose although she agreed this is not recorded. Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 Page 13 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 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a satisfactory complaints system with evidence that service users, via their relatives felt confident their views would be listened to. All staff need to be trained in the protection of adults to ensure that everyone is familiar with procedures so that service users are not at risk of harm or abuse. EVIDENCE: The home has detailed policies and procedures on complaints and comment cards received showed that the registered manager and her deputy listened to any concerned raised and took appropriate action. One complaint has been received by the CSCI since the last inspection in respect of neglect following a fall and inadequate diet. The outcome was that while neither issue was upheld the home was asked to improve their practice when service users lose weight and include more detailed information on meeting service users needs to ensure all staff are clear on the level of assistance needed for eating. The home has detailed policies and procedures on adult protection and the registered manager and her deputy have undertaken a training course, enabling them to cascade this training to all staff. Incident records were viewed and showed that on one occasion staff had physically restrained a Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 Page 14 service user and on another had administered medication in an inappropriate manner. These incidents had not been reported to the manager therefore she did not have the opportunity to fully investigate the nature of the incidents. This needs to be addressed to ensure service users are not at risk and that staff are aware of the limitations of restraint methods. Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 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, 22, 24, 25 and 26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Some parts of the home are well maintained providing a homely and comfortable environment for service users; improvements need to be made in respect of on-going maintenance to ensure all areas of the home are pleasing and safe. EVIDENCE: A tour of the premises was carried out and it was evident that some service users bedrooms had been redecorated and new furniture provided. A new call bell system has been installed and all service users are now able to access a call bell while in bed. There is a written maintenance plan detailing maintenance required and a timescale in which it is due to be finished, this is in addition to the day-to-day work that is carried out as required. There were a number of shortfalls identified such as erratic hot water delivery temperatures which ranged from 190 C to 520 C. The high water temperature put service users at risk and the lower temperatures would be uncomfortable for washing. Minutes from the staff meeting showed that staff had requested Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 Page 16 that ‘something be done’ about the cold water in some rooms. The registered manager said that the maintenance person records water temperatures regularly but these records were unavailable for inspection. A suitably qualified person has made an assessment of the premises and made a number of recommendations. Additional handrails had been fitted and there are plans to addressed all the recommendations in the report within the next few months. Some service users bedrooms did not have all the required furniture, while others had furniture that needed to be replaced or repaired. Some bedrooms were odorous and in need of cleaning, especially the plastic wash bowls and en-suite facilities. All communal bathrooms and toilets need to have liquid dispensed soap, paper towels and toilet paper as required to reduce the risk of infection. Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff training has improved and staff numbers increased, but service users would be better protected by robust recruitment practices. EVIDENCE: Staff rotas were viewed and there are at least six carers on duty each morning and at least four during the afternoon and evening shifts. Four night waking staff are also employed. Domestic and laundry staff are also employed along with a gardener, cooks and kitchen assistants. Overall the number of care hours provided is in line with the guidelines from the Care Forum Staffing Tool. Although sufficient staff are provided two comment cards stated that staff have congregated in the smoking lounge leaving service users unsupervised. This was discussed with the registered manager who agreed to address the issues at the next staff meeting. Currently 15 of staff have achieved NVQ 2 or above and a further nine staff are in the process of gaining this qualification. When they qualify the home will meet the required 50 of staff trained to this level. Both the registered manager and her deputy have gained the Registered Managers Award and a senior carer is also in the process of gaining this award. Staff training since the last inspection has been provided for staff in respect of manual handling, first aid, dementia care, infection control and dealing with Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 Page 18 challenging behaviour, all of which enable staff to effectively and safely deliver care. Although not all staff have done all the training the registered manager provided a written programme to ensure all staff receive the training within suitable timescales. Recruitment practice remains an area for improvement with one employee working without a POVA first check and another whose references were not validated prior to appointment. The employment application form has been expanded to include a full employment history and on the day the registered manager added a section on qualifications. Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 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, 32, 33, 35, 36 and 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Improvements have been made in respect of staff supervision and testing of equipment; service users and staff would benefit from a stronger and more effective approach to the management of the home. EVIDENCE: Staff supervision records were viewed and demonstrated that they were used to identify training needs, although this had not always been acted upon. A number of issues in respect of some staff practices were discussed with the registered manager and while she is clear about her management role she needs to provide more direction to staff and create a system to ensure they follow good practice guidelines on a day-to-day basis. As part of the quality monitoring system the Responsible Individual has produced an annual business/development plan and is introducing a a system Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 Page 20 whereby he intends to monitor compliance with each of the National Minimum Standards during the monthly visits. It is recommended that these visits also include time spent talking with services users about the care they receive and that their views are recorded in the report. These systems will enable the management to objectively evaluate the service and ensure it is run in service users best interests. Service users relatives and or solicitors handle their finances. The home holds a bank account for small amounts of service users monies and full records of all transactions are kept. Documents used for recording items held by the home were viewed and found to be satisfactory. The home is in the process of making an inventory of all service users possessions within the home. A fire safety officer from East Sussex Fire Service undertook an inspection in October and the recommendations made have been met, with the exception of one fire door which needs to be replaced and has yet to be delivered. One of the fire exits was impeded by a fire extinguisher and this needs to be addressed as it puts both staff and service users at risk in the event of fire. Fire and smoke alarms are tested regularly as are emergency lighting and call bell systems to further protect service users. The accident book was viewed and found to be satisfactory and certificates to demonstrate that bath hoists, gas appliances, electrical systems and appliances are safe were available. Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X 2 X 2 2 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 2 X 3 3 X 3 Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 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 OP7 Regulation 13(4bc) 15(1) (2bc) Requirement Risk assessment for those at risk of tissue breakdown or falls need to be more detailed and include the management of the risk. (timescale of 02/02/05 not met). All service users must have a detailed plan of care based on the pre-admission assessment and including information on how care is to be delivered. That care plans include information on how service users leisure preferences are to be met. That action is taken when it is noted that service users have lost or gained weight as required under Regulation 17 (1) (a) Schedule 3 (o). That service users personal auditory equipment is replaced promptly. All staff who administer medication need to receive accredited training as under Schedule 3 (k). (timescale of 17/09/05 and 02/02/06 not met) Timescale for action 08/07/06 2 OP7 15 (1) 08/07/06 3 OP7 16 (2) (mn) 14 (1a) (2ab) 08/07/06 4 OP8 08/07/06 5 6. OP8 OP9 13 (1) (b) 18 (1) (a) 08/06/06 08/07/06 Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 Page 23 7. OP9 13(2) Stock rotation systems for medication need to be created and implemented. Systems for recording medication administered need to be improved. That prescribed creams are used only for the person intended. That service users preferences in respect of getting up, going to bed and mealtimes be recorded and met as required. That meal choice are offered routinely and fresh fruit available each day. That all incidents of restraint are reported to and fully recorded by the manager. That all parts of the home are well maintained and kept in good repair. That the recommendations made by the Occupational Therapist be implemented. That service users bedrooms are furnished in line with the requirements under Regulation 4(3). That hot water delivery temperatures are maintained at or near 430. That all parts of the home are to be kept clean and free from offensive odours. All staff need to provide the required documentation listed in Schedule 2 (as amended) of the Regulations prior to appointment. (timescale of 17/07/05 and 02/12/05 not met) That all staff receive training in dementia care, challenging behaviour and infection control. DS0000021423.V289199.R01.S.doc 08/06/06 8 8. 10. OP9 OP9 OP14 13 (2) 13(2) 12 (2)(3) 08/06/06 08/06/06 08/07/06 11 12 13 14 OP15 OP18 OP19 OP22 16 (2)(i) 13 (6)(7)(8) 23(1ab) (2b) 16(1)(2c) 23(2n) 16 (1) (2c) 13 (4ac) 16 (2jk) 19(4c)(5) 08/06/06 08/06/06 08/07/06 08/07/06 15 OP24 08/07/06 16 17 18. OP25 OP26 OP29 08/07/06 08/07/06 08/07/06 19 OP30 18(1)(ac) (i)(ii) 08/07/06 Clifden House Version 5.1 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP33 Good Practice Recommendations That service users are spoken with during the Providers monthly visits. Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Clifden House DS0000021423.V289199.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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