CARE HOMES FOR OLDER PEOPLE
Cornerways Cornerways 14-16 Manor Road Paignton Devon TQ3 2HS Lead Inspector
Michelle Finniear Announced Inspection 9th November 2005 09:10 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 Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 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. Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Cornerways Address Cornerways 14-16 Manor Road Paignton Devon TQ3 2HS 01803 551207 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) Peninsula Care Homes Ltd Vacancy Care Home 50 Category(ies) of Dementia - over 65 years of age (50), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (50), Old age, not falling within any other category (50), Physical disability over 65 years of age (50) Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 21/6/05 Brief Description of the Service: Cornerways provides a comfortable environment for service users. The home is located close to the sea front in Paignton, and is level both to the sea, and local facilities and services. The home provides care for up to 50 older people who may or may not also have some degree of physical disability, dementia or mental disorder. Cornerways has accommodation over three floors with a newly fitted shaft lift to access the upper floors. The home has three ‘shared’ rooms with the remainder being for single occupancy. Rooms vary in size and shape with some being very large, and the majority have ensuite facilities. There are several lounges and a large dining room where service users can choose to have individual tables if they wish. Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over 7 ½ hours in November 2005. The visit was announced, which meant that the owner and service users were given prior warning of the date and timing of the inspection. To complete the inspection a tour was made of most of the home; fourteen service users were interviewed and time was spent with other service users with greater frailty; two members of staff were spoken to; time was spent with the homes management and various records were inspected, such as care plans, the fire log book, and medication records. Discussion was also held on staff training and recruitment. Prior to the inspection five relatives and five service users completed comment cards about the home, and the home-owner completed a pre-inspection questionnaire. One relative wrote a letter to CSCI concerning the service. What the service does well:
The home provides comfortable accommodation, which is currently going through a programme of redecoration and renovation. Most rooms have ensuite facilities, and there is a choice of communal space for service user use in three lounges. An excellent menu is prepared with evidence of several choices for dessert, ensuring service users enjoy a varied and nutritious diet. The home has newly developed thorough care plans, which reflected well the service users needs and the actual care given by staff. Plans include risk assessments and other user specific assessments, such as falls risk assessments, to ensure service users abilities and choices are maximised whilst their safety is maintained. Care plans are important in ensuring care is consistently given in accordance with service user needs and wishes. Comments from service users, visiting professionals and relatives were complimentary, and included “I cannot praise Cornerways too highly”. “Jill, Heather and all the staff are so caring, and they treat all the residents with kindness and great dignity at all times” and “”It’s like a home from home” Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 Page 6 One relative/visitor expressed concern over the length of time the home had been without a shaft lift during the fitting of the new lift. There had been an extensive delay, due to issues with planning and not related to the homes ownership or management. This issue has now been resolved, and there is a new lift fitted. In the absence of the main lift service users had to use the chairlift to access upper floors. What has improved since the last inspection? What they could do better:
Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 Page 7 The registered person must carry out risk assessments in relation to workplace activities at the home. This will ensure that service users and staff are not subjected to un-necessary or foreseeable risks. Full Supervision systems must be implemented for all care staff, including the manager. Supervision is a system of staff development and performance management, which ensures that staff are working consistently and receive the training and support they need to do their job. The registered person must provide hot surface protection to all areas where the service users have access. An immediate risk assessment must be undertaken and the order of provision prioritised. This is to ensure service users are protected from any risk of injury from coming into contact with a hot radiator. The registered person must expand upon the current questionnaires to provide a full system for reviewing and improving the quality of care at the home. This is important as the home needs to take account of what service users and others think and feel about living at the home and of what they can do to improve their services. The home manager is recommended to increase the amount of information gathered on service users life histories prior to admission to the home. This is to ensure the home has full information about a service users earlier life, personality, likes and dislikes etc to assist them in supporting a service user who is no longer perhaps able to communicate their needs or wishes verbally. The home manager should revise the homes policy on adult protection to be sure it complies with all areas of the local policy. The home manager should ensure that the homes policy on restraint includes all areas including the ‘baffle’ device on the front door. This is to ensure that service users are protected and that any areas of restriction are open and as little restrictive as possible.i The home manager is advised to review the programme of activities with the specific needs of service users with memory loss in mind. This is to ensure that service users with memory loss take part in activities that reflect their wishes, and stimulate their interests. The registered person should ensure that the homes washing machine is capable of achieving a sluicing cycle. This is to ensure the homes machines are capable of achieving full infection control, especially where there may be problems with the management of continence. The homes manager should consider the provision of tabards for staff who move from caring tasks to serving food. This is to ensure that service users are kept free from any risks of cross infection from uniforms.
Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 Page 8 The toilet on the ground floor had a serious odour problem which needs to be reviewed and the bin replaced. This is to ensure service users live in an attractive environment. The home manager should consider whether service users may be involved further in the development of the homes newsletter. 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. Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 Page 9 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 Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 Page 10 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): These standards were not inspected EVIDENCE: These standards were not inspected on this occasion, but were seen on the last inspection of the home which took place over two days in June 2005. For information on the homes compliance with these standards please refer to the report of the inspection of 21st June 2005. Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9. Cornerways has a clear and consistent system for the planning of health and care required , ensuring staff have the information to satisfactorily deliver care to service users in the way in which they have indicated they wish it to be delivered. EVIDENCE: Since the last inspection the home has altered the system used for the planning of care and recording of service user need. The records sampled for six service users were comprehensive and had recently been reviewed. Care plans are important in ensuring that service user needs are identified and addressed in a consistent fashion, and in accordance with service user wishes. Evidence was seen from the file of the most recently admitted service user of a pre-admission assessment process. This service user file contains an information sheet, information on medical care, information about the client, risk assessments, a needs assessment, property list, nutrition and falls risk assessment and a full care plan to meet the needs identified. This file had last been updated on the 24th of October 2005, and the home is endeavouring to ensure that plans are updated on at least a monthly basis.
Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 Page 12 Evidence could be seen of consultation having been undertaken with service users and relatives concerning care delivery, and some care plans seen had been signed by users or relatives. Discussion was held with the manager on increasing the social history element within service user files, particularly for service users who have some degree of memory loss. This is to ensure the home has full information about a service users earlier life, personality, likes and dislikes etc to assist them in supporting a service user who is no longer perhaps able to communicate their needs or wishes verbally. Since the last inspection the home has altered the way in which medication is both stored and administered at the home. The new system is much better at safeguarding service users from any potential risk of the wrong medication being given. For service users who wish to self-administered their medication the home requests confirmation from their general practitioner that they are safe to do so. The home now uses a monitored dosage blister pack system, which means that medication is pre-packaged by the pharmacist in a series of blister packs. These make it easier to verify whether medication has been administered on a particular day and therefore provide a clearer audit trail. Records were completed appropriately, and the home has additional secure storage for controlled medication. Evidence was seen of service users having access to support services such as district nurses, dietician and speech therapy, physiotherapy, occupational therapy and general practitioners. Service users in discussion confirmed this and that in addition, Chiropody, optical and dental services were also available to them in the home, or at local premises. This demonstrates that service users have their health care needs assessed and specialist support services are provided or accessed when needed. Service users who require specialist moving and handling equipment or pressure area relieving equipment have this is provided either by the home or by the district nursing service following a detailed assessment. Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 14, Service users at Cornerways are encouraged to make choices and retain autonomy in their lives, and to follow activities of their choice. EVIDENCE: Discussion with the homes management and with individual service users indicated that they have the ability to exercise choice in relation to many activities of daily living, for example whether to participate in leisure and social activities provided, choices at mealtimes as to what to eat and where, choices in personal and social relationships and support to follow chosen religious observance. This might include for example being taken to a local church or the home arranging for an in-house communion service. The homes care plans record service users interests, and the home provides a programme of activities, including some trips out, videos, games, quizzes, crafts, ‘Chairobics’ and keep fit. Discussion was held with the manager on expanding this program, with particular reference to the needs of service users with memory loss. The home has consulted with service users concerning activities, and a number of service users have requested additional outings, however when a date arrives service users often cancel at the last minute. A recent trip was held to a local hotel for afternoon tea, and additional trips are planned in the week following the inspection to take service users Christmas shopping in small groups. These have been well supported.
Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 Page 14 Service users are able to have visitors at any time at the home and also to choose whether they wish to see people not. Service users rooms and lockable if the service user wishes. Service users can receive visitors in private in their rooms, or there is a variety of communal space available. Support to attend medical appointments is provided. Service users are encouraged to maintain their own financial affairs for as long as they wish to do so. The home holds a small float for some service users for day to day expenditure, which was examined during this inspection and found to tally correctly with the individual running account maintained. A record of service users furniture or significant items is maintained by the home, and the level of insurance cover provided is specified in the homes statement of terms and conditions. The meal being served on the day of the inspection was Roast turkey breast, chipolata and bacon roll, red wine gravy, roast potatoes, fine beans, roast parsnips, bread sauce, cranberry sauce and creamed potatoes. Dessert was a choice of rhubarb crumble, rice pudding, mandarins flan, raspberry and mixed fruit trifle, strawberry mousse, or fruit salad. Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 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 the following standard(s): 18 Cornerways has a thorough and robust approach to the protection of vulnerable adults . EVIDENCE: Cornerways has a policy and procedure for the protection of service users from abuse. This policy was seen during the inspection, and requires some attention to meet all the areas of the local policy guidance -- The Alerters Guide. This guide is based on national guidance and ensures that all agencies involved in the protection of vulnerable adults, including the police, social services and care home providers all operate in a consistent and cohesive fashion. Since the last inspection a service user raised concerns about a member of staff. The home acted immediately to protect the service user, and the member of staff was subsequently dismissed for other issues. Throughout the process the home acted in a way which protected both this and any other service user at the home, and acted in an open and professional manner. Support and reassurance was offered to the service user throughout. This demonstrates the home acts robustly to protect service users in their care. The home has a policy on restraint, and this should be revised in the light of the baffle device which has been fitted to the front door. A policy on restraint is important as it clearly sets out for staff and service users where and how any issues of restriction of service user choice may be instituted. This might for example include when and why the front door may be secured, and for what period for the protection of service users.
Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 Page 16 Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 Page 17 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26 The environment within Cornerways is good, offering service users an attractive and homely place to live. Plans are in hand to address areas of work identified with regard to décor/refurbishment. EVIDENCE: At the time of the previous inspection Cornerways was undergoing major building works to the rear of the building to provide a larger shaft lift to access all floors. This has now been completed, and a new layout has been provided to the entrance hallway which provides better storage and clear access to the lift area. This area has also been redecorated which is a significant improvement. Additional redecoration plans include the lounge and corridors, which have in some cases suffered damage from equipment. Service users commented that all areas of the home were kept very clean, and the majority of the home was free from significant odour. Some areas of odour were noted in a few bedrooms, but discussion indicated staff have
Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 Page 18 strategies for addressing this wherever possible, which includes cleaning of carpets and replacement of furnishings. One toilet on the ground floor had a significant odour problem, and needed a replacement bin. Lounges and the conservatory were being well used during the course of the inspection. There is limited car parking at the home, but parking is available on streets nearby, particularly during the winter months. The home has a laundry and clean clothes storage to the rear of the building. Service users commented favourably upon the laundry service and ironing. Bedding for the home is provided by contract. Service users bedrooms were individual and showed evidence of personal belongings and furnishings. Some rooms had access to a shared balcony and all rooms varied in size, shape and outlook. The majority were ensuite with at least a toilet, but many also had baths or showers. The manager has plans to upgrade and refurbish all rooms as they become vacant or they are able to do so without disrupting the service user concerned. Three service user rooms on the second floor have Velux windows, which have received attention since the previous inspection with regards to window opening restriction, which presented a risk at that time to service users. Discussion was held concerning the use of tabards, aprons and gloves when providing care, and removing these whilst serving food, which is the homes practice. The home has a comprehensive infection control policy, which includes the use of disinfectant wipes, and hand sanitisers. The home is to verify whether their washing machine is capable of achieving a full sluicing cycle. The home has no sluice. Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 Page 19 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): These standards were not inspected on this occasion. EVIDENCE: These standards were not fully inspected on this occasion, but were seen on the last inspection of the home which took place over two days in June 2005. For full information on the homes compliance with these standards please refer to the report of the inspection of 21st June 2005. Staffing levels seen were satisfactory for the number and current dependency level of the service users. Service users also commented on the approachability, friendliness and kindness of the staff. One relative commented that “The staff always have a smile on their faces and nothing is too much trouble”, and that their relative had improved since being at Cornerways: “….she is now walking with assistance and seems so much more alert. That is because Jill and all the staff spend time with the residents, talk to them and have a laugh!.” Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 36, 38. The Health and safety of service users and staff is promoted at Cornerways; staff are well supervised and service users have a developing say in the way that the home is run. EVIDENCE: The home has a developing Quality assurance and quality monitoring system. At the time of the inspection the home had issued a questionnaire to service users, was developing a newsletter and had held a service user meeting. This will need to be expanded to provide a full system that will ensure service users and their supporters will have a real say in the way in which the home is run. Discussion was held on ways to achieve this. Discussion was also held on the homes recruitment and selection policies and supervision arrangements. Staff at the home receive supervision, but systems need to develop further to ensure staff receive full supervision at a frequency
Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 Page 21 of at least six times a year. Supervision is a system of staff development and performance management, which ensures that staff are working consistently and receive the training and support they need to do their job. At the last inspection it was acknowledged that additional training was required in several areas of health and safety working practices, including first aid, food hygiene, infection control, and moving and handling. The home has now either undertaken this training or has timetabled plans to achieve it for all staff in the near future. Fire safety training has been undertaken. Risk assessments have been undertaken for service user based activity and for environmental hazards, but have not yet been undertaken for workplace activity. This is important in ensuring that service users and staff are protected from any foreseeable and preventable risks whilst carrying out care tasks. Discussion was held on the provision of tabards for staff when serving food. Data sheets were available for cleaning products selected at random. These are important as they ensure that safety information on all chemicals and cleaning materials in use is available within the home in case of accidental misuse. Chemicals such as cleaning materials are kept locked away. The home has automatic temperature regulation to baths and hot surface protection has been provided to some but not all service user accessible areas. Hot surface protection is required to ensure that service users are protected from the risks of burns from coming into contact with hot surfaces such as radiators. It is understood that the remaining radiators are due to be protected. Current Gas safety certificates were seen, and the home had a complete electrical test carried out last in 2002. The lift was serviced in October 2005, as were the hoists and bath hoists. Testing for Legionella was carried out in February 2005. These areas demonstrate the home has regular contracted safety tests. Portable appliance testing is due to be carried out. This is to ensure the electrical safety of portable electrical appliances such as table lamps and televisions. Discussions were held on the lock fitted to one service users door, which the service user felt was not suitable to meet their needs. Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 2 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 2 x x 3 x 2 Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 Page 23 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 OP38 Regulation 13 Timescale for action The registered person must carry 28/02/06 out risk assessments in relation to workplace activities at the home. Previous requirement date 22/9/05 Full Supervision systems must 28/02/06 be implemented for all care staff, including the manager. The registered person must 28/01/06 provide hot surface protection to all areas where the service users have access. An immediate risk assessment must be undertaken and the order of provision prioritised. The registered person must 28/02/06 expand upon the current questionnaires to provide a full system for reviewing and improving the quality of care at the home. Requirement 2 3 OP36 OP38 18 13 4 OP33 24 Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 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 2 Refer to Standard OP7 OP18 Good Practice Recommendations The home manager is recommended to increase the amount of information gathered on service users life histories prior to admission to the home. The home manager should revise the homes policy on adult protection to be sure it complies with all areas of the local policy. The home manager should ensure that the homes policy on restraint includes all areas including the ‘baffle’ device on the front door. The home manager is advised to review the programme of activities with the specific needs of service users with memory loss in mind. The registered person should ensure that the homes washing machine is capable of achieving a sluicing cycle. The homes manager should consider the provision of tabards for staff who move from caring tasks to serving food. The toilet on the ground floor had a serious odour problem which should be reviewed and the bin replaced. The home manager should consider whether service users may be involved further in the development of the homes newsletter. 3 4 OP16 OP26 5 6 OP26 OP12 Cornerways DS0000049076.V265582.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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