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Inspection on 31/05/05 for Crawshaw Hall Nursing Home

Also see our care home review for Crawshaw Hall Nursing Home for more information

This inspection was carried out on 31st May 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The manager carried out a detailed assessment of the care needs of prospective residents prior to admission. Discussions with members of staff confirmed that promoting privacy and dignity for all residents was an important part of their care. Residents comments included, "they look after me" and "staff are very good". One visitor said, "The staff are very thoughtful, couldn`t fault the care". Another visitor said that she would recommend the home. During the inspection a resident asked for a cup of tea and was brought one immediately. Meals were varied and offered choice. One resident said that the food was good and four residents said that they had enjoyed their lunch. The daily routine was flexible allowing residents to choose when to get up and go to bed. There was a low staff turnover and absence levels were low ensuring continuity of care for the residents.

What has improved since the last inspection?

Care planning has improved since the last inspection and included appropriate risk assessments. Care plans and risk assessments were reviewed monthly and effectively promoted the health and welfare of residents. Resident`s and their relatives were actively encouraged to become involved in planning and reviewing care. This ensured that care was delivered in a manner, which met the needs and preferences of each resident. To promote the safety of residents guards have been fitted to several radiators. To improve the environment three bedrooms have been redecorated and laminate floors have been fitted in two of them.

What the care home could do better:

To further improve the admission procedure prospective residents must be informed in writing if their needs can be met at the home. To accurately identify the risk of a resident developing a pressure sore the risk assessment must clearly state how the overall risk has been determined. When a risk has been identified e.g. of falls, information about the measures in place to reduce that risk must be written in the care plan. This will ensure that the care needs of all residents are met. The registered provider must consult the fire service about fitting appropriate locks to the doors at the top and bottom of a staircase, which residents do not normally use. This would ensure the safety of residents. However, it may be necessary for this staircase to be accessible in the event of a fire. To promote the heath and safety of residents all members of staff must receive training in fire safety and moving and handling. The system for monitoring and improving the quality of care and services provided at the home must be further developed. This includes obtaining the views of residents and relatives and compiling an annual development plan.

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Crawshaw Hall Nursing Home Burnley Road Crawshaw Booth Rossendale, Lancashire BB4 8LZ Lead Inspector Susan Hargreaves Unannounced 31 May 2005 10:00 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 and Care Homes for Adults 18 – 65*. 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. Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Crawshaw Hall Nursing Home Address Burnley Road Crawshaw Booth Rossendale Lancashire BB4 8LZ 01706 228694 01706 215670 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) Mrs Eileen Karoo Mr Jainarain Buluck Care Home with Nursing 23 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia-over 65 years of age (MD)(E) 23 of places Dementia (DE) 6 Mental disorder, excluding learning disability or dementia (MD) 6 Dementia-over 65 years of age (DE)(E) 23 Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 Under Annex 2, a max of 6 service users aged 50 years and above requiring nursing care who fall into the category of MD or DE 2 Staffing will be accordance with the Notice issued dated 7 August 2001 3 The registered provider shall, at all timesm employ a suitably qualified and experienced person who is registered with the National Care Standards Commission as manger of Crawshaw Hall Nursing Home Date of last inspection 14 December 2004 Brief Description of the Service: Crawshaw Hall Nursing Home provides 24 hour care for people who suffer from a mental disorder or dementia. Although the majority of people are over 65 years the home can admit up to 6 people who are under the age of 65 years old. The home is a large detached grade 2 listed building with extensive grounds. There is a secure garden area, which is easily accessible to residents when the weather permits. A parking area for use by visitors and staff is available at the front of the building. The home is situated on the outskirts of the village of Crawshawbooth and near to the local amenities provided in the village. Rawtenstall is approximately 2 miles away. Accommodation is provided in single and twin-bedded rooms. There are no ensuite rooms but bathroom and toilet facilities are easily accessible. communal lounges and dining rooms are located on the ground floor. All th erooms are spacious and airy and there are many unique decorative features in keeping with the age of the building. Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 6 hours. One additional visit has been made since the last unannounced inspection. This visit was to investigate a complaint. Only one part of the complaint was upheld and requirements made in response to this are being monitored. The report of this investigation is available from the CSCI office on request. A tour of the premises took place and staff files and care records were inspected. Members of staff on duty, residents and visitors were spoken to. Discussions also took place with the manager regarding issues raised during the inspection. What the service does well: What has improved since the last inspection? Care planning has improved since the last inspection and included appropriate risk assessments. Care plans and risk assessments were reviewed monthly and effectively promoted the health and welfare of residents. Resident’s and their relatives were actively encouraged to become involved in planning and reviewing care. This ensured that care was delivered in a manner, which met the needs and preferences of each resident. To promote the safety of residents guards have been fitted to several radiators. To improve the environment three bedrooms have been redecorated and laminate floors have been fitted in two of them. Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 6 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. Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Standards Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6-10 and 18–21) (Standards 11–17) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37–43) Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. 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. Prospective service users have an opportunity to “test drive” the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 (Older People) and 2 (Adults 18-65) Admission procedures were thorough. Comprehensive pre-admission assessments were completed for each resident prior to admission. EVIDENCE: Individual records of three resident’s were inspected. Each contained a detailed pre-admission assessment of need. A senior member of staff visited prospective residents in hospital or their own home prior to admission. The manager was informed that all prospective residents must receive confirmation in writing that their care needs can be met at the home. The assessment of need provided useful information for the care plan. Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6-10 and 18 –21 (Adults 18-65) 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. Including their physical and emotional health needs. 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. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. Service users receive personal support in the way they prefer and require. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 7, 9, 18, 19 and 20 (Adults 18-65) are 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 (Older People) 6, 18, 19 and 20 (Adults 18-65) Care plans addressed the personal care needs of each resident. Measures were not in place to reduce identified risks. Care was given in a manner, which promoted the privacy and dignity of all residents. Medication was well managed promoting good health. Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 10 EVIDENCE: The individual care plans of three residents were inspected. These plans identified the personal care needs of each resident and explained how these needs were met. However, it was unclear from the pressure sore risk assessment for two of these residents how the overall risk had been determined. Where a risk, e.g. of developing pressure sores or weight loss, had been identified, a care plan giving information about the action being taken to address the risk was not in place. A written report about the care given to individual residents was completed during each shift. Records of the visits of other healthcare professionals e.g. GP, chiropodist, etc. were included in the care plans. Care plans were reviewed monthly. Residents or their relatives were invited to be involved in these reviews. One visitor said they had seen the care plan and were kept informed of their relative’s condition. Members of staff were observed attending to residents in a kind and friendly manner. A resident said that she liked living at the home. Medication was stored correctly and records were seen to be up to date. The manager was advised to ensure that all handwritten instructions on the medicines administration records were signed and witnessed. Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 11 – 17 (Adults 18-65) are: 12. 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. Including opportunities for personal development. Service users engage in appropriate leisure activities. Service users maintain contact with family/ friends/ representatives and the local community as they wish. And have appropriate personal, family and sexual relationships. 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. 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15, 16 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14, and 15 (Older People) 16 and 17 (Adults 18-65) The daily routine was flexible in order to meet the needs and preferences of residents. A limited range of activities was available. The meals were varied and offered choice. EVIDENCE: Discussion with members of staff and visitors confirmed that the daily routine was flexible. Residents only got up before 8.00am if they were awake or restless. One visitor said that her relative had breakfast in bed once or twice a week before having a bath. Residents were encouraged to pursue their own interests and hobbies. One resident had recently been taken to the hairdressers and another had been taken shopping. The manager explained that they were going to buy some new games and a member of staff would be responsible for organising activities on three afternoons each week. The meal served at lunchtime looked wholesome and appetising. Members of staff were observed feeding residents in a patient and sensitive manner. The meal was unhurried allowing residents time to enjoy their meal. All the Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 12 residents asked, said that the meals were good. The menus were varied and offered choice. Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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. Including neglect and selfharm. The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) 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 (Older people) 22 and 23 (Adults 18-65) Complaints were taken seriously and investigated. Appropriate policies and procedures were in place to ensure the protection of residents at the home. EVIDENCE: A copy of the complaints procedure was displayed in the home. No complaints have been made to the home since the last inspection. The Commission has recently investigated one complaint. Policies and procedures relating to the protection of vulnerable adults were in place. This issue was discussed with three members of staff. They were aware of the procedure and said they would report any concerns immediately Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) 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. Shared spaces complement and supplement service users’ individual rooms. Service users have sufficient and suitable lavatories and washing facilities. Provide sufficient privacy and meet their individual needs. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. And lifestyles. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,25 and 26 (Opder People) 24 and 30 (Adults 18-65) The home was clean and comfortable, which meant that residents had a homely place to live. It was possible for residents to open the door to a staircase on the first floor potentially putting them at risk of injury. EVIDENCE: At the time of the inspection the home was clean, free from offensive odour and well maintained. This provided a safe and comfortable environment for the residents. To further improve the environment three bedrooms had recently been redecorated and laminate floors installed in two of them. Residents had personalised their rooms with photographs, pictures etc. Since the last inspection a lock had been fitted to the door on the ground floor to prevent residents gaining access to a steep flight of steps. However, the key to this lock was kept in a drawer. It was also possible for residents to open the door Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 15 at the top of this staircase. Mrs Karoo said that she would contact the fire service for advice about the safest way of preventing access for residents and maintaining this staircase as an escape route, if necessary, in the event of a fire. To ensure the safety of residents several radiators had been fitted with covers. The manager was advised to complete a risk assessment in order to prioritise the fitting of covers to all other radiators. Laundry facilities were appropriate for the size of the home. The laundry assistant said that she ironed resident’s clothes to help promote their dignity. Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 36 (Adults 18-65) are: 27. 28. 29. 30. • • • Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. 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. Service users benefit from clarity of staff roles and responsibilities. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers standards 27, 29 and 30 (Older People) and Standards 34 and 35 (Adults 18-65) the key standards to be inspected at leat once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 (Older People) 33,34 and 35 (Adults 18-65) Staffing levels were appropriate to meet the assessed needs of the residents. Recruitment procedures were thorough. Training for all members of staff was encouraged. EVIDENCE: Staffing levels were appropriate to meet the assessed needs of the residents. Additional members of staff were on duty to accompany residents to outpatients or on trips out. The files of four members of staff were inspected. These contained evidence that all the required pre-employment checks to ensure protection of the residents had been completed. On appointment members of staff were issued with a contract of employment. It was evident from training records and discussions with the manager that training was encouraged. This included induction training, first aid and NVQ levels 2 and 3. Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 37 – 43 (Adults 18-65) are: 31. 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 a well run home and from competent and accountable management of the service. 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. Service users are confident their views underpin all self-monitoring, review and development by the home. 32. 33. 34. 35. 36. 37. 38. • The Commission considers standards 33, 35 and 38 (Older People) and Standards 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 36 and 38 (Older People) 39 and 42 (Adults 18-65) All care staff received regular supervision. Appropriate procedures were in place to safeguard the health, safety and welfare of residents. Not all members of staff had received training in fire safety and moving and handling. An effective quality monitoring system was not in place. Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 18 EVIDENCE: The home had achieved the nationally accredited Investors in People award. However, a formal system of obtaining the views of residents and relatives about the care and services provided at the home was not in place. Policies and procedures were not reviewed and an annual development plan to help monitor the quality of the service and improve outcomes for residents was not in place. Records of formal supervision for member of staff were seen. This ensured that all members of staff had the necessary skills to meet the assessed needs of the residents. The safety of residents was promoted by regular checks of fire alarms, emergency lighting and fire drills. However, a fire risk assessment had not been completed. Safety notices were displayed in the home. The members of staff on duty at the time of the inspection had not received training in fire safety or moving and handling. Appropriately qualified personnel regularly serviced equipment and appliances. Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 19 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 x 2 x 3 2 4 x 5 x 6 x HEALTH AND PERSONAL CARE ENVIRONMENT Standard No 19 20 21 22 23 24 25 26 STAFFING Score 2 x x x x x 2 3 Score Standard No 7 8 9 10 11 Score 3 2 2 3 x Standard No 27 28 29 30 3 x 3 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No 16 17 18 Score x 3 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 x 32 x 33 2 34 x 35 x 36 3 37 x 38 2 Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 20 NO 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 3 Regulation 14(1)(d) Requirement The registered person has confirmed in writing to the service user that having regard to the assessment the care home is suitable for the purpose of meeting the service users needs in respect of his health and welfare. the registered person shall ensure that - unnecessary risks to the health and safety of service users are so far as possible eliminated. A care plan must be developed explaining the strategies in place to minimise all identified risks The registered person shall ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazareds to their health and safety. The doors at the top and bottom of the staircase, opposite the laundry, must be fitted with appropriate locks. (1) The registered person shall establish and maintain a system for (a) reviewing at appropriate intervals, and (b) improving, the quality of care provided at the Timescale for action 29 July 2005 2. 8 13(4) 29 July 2005 3. 19 13(4)(a) 29 July 2005 4. 33 24(1)(2) (3) 2 Sept 2005 Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 21 5. 33 10(1) 6. 38 23(4)(d) 7. 38 13(5) care home, including the quality of nursing where nursing is provided at the care home. (2) The registered person shall supply to the Commission a report in respect of any review conducted by him for the purpose of paragraph (1), and make a copy of the report available to service users. (3) the sustem referred to in paragraph (1) shall provide consultation with service users and their representatives. (Timescale of 28 May, 26 Nov 2004 and 25 March 2005 not met) The registered provider and the regiatered manager shall, having regard to the size of the care home, the statement of purpose, and the number and needs of service users, carry on or manage the care home (as the case may be) with sufficient care and competence and skill. All policies and procedures must be reviewed and updated regularly. (Timescale of 25 March 2005 not met) The registered person shall after consultation with the fire authority (d) make arrangements for persons working at the home to receive suitable training in fire prevention. (Timescale of 25 March 2005 not met) The registered person shall make suitanle arrangements to provide a safe system for moving and handling of service users. All members of staff must receive training in correct moving and handling techniques. 2 Sept 2005 2 Sept 2005 2 Sept 2005 Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard 8 9 25 33 38 Good Practice Recommendations Pressure sore risk assessments should clearly identify how the overall risk has been determined. All hand written instructions on the medicines administration records should signed and witnessed. A risk assessment should be completed to prioritise the fitting of guards to all radiators. An annual development should be developed. A fire risk assessment should be carried out. Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 1st Floor, Unit 4 Petre Road, Clayton-Le-Moors Accrington Lancashire. BB5 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 Crawshaw Hall Nursing Home F57 F07 S22508 Crawshaw Hall Nursing Home V226028 310505 Stage 4.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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