Inspection on 10/05/06 for Crescent House

This inspection was carried out on 10th May 2006.

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

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

Other inspections for this house

Crescent House 19/05/08

Crescent House 26/07/07

Crescent House 22/09/05

Crescent House 12/04/05

Crescent House 28/10/04

Crescent House 27/04/04

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 Crescent House 108 The Drive Hove East Sussex BN3 6GP Lead Inspector Key Unannounced Inspection 10th May 2006 10:00 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 Crescent House DS0000014193.V292861.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. Crescent House DS0000014193.V292861.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Crescent House Address 108 The Drive Hove East Sussex BN3 6GP 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) 01273 732291 The London & Brighton Convalescent Home Mrs Jennifer Susan Downes Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Crescent House DS0000014193.V292861.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The maximum number of service users to accommodated is 17 That service users are aged over sixty five (65) years on admission. That the home may accommodate one named service user who has mental health needs That the home may accommodate one named service user who has dementia 22nd September 2005 Date of last inspection Brief Description of the Service: The home has been owned for over a hundred years by the London and Brighton convalescent Home, a charity. The home is a detached Edwardian property located half a mile from Hove. Main line train services are within walking distance and the home is near to bus routes into Hove and Brighton. The home is registered to provide care for up to seventeen older people. The home is on three levels, ground, first and second floor, with a chair lift providing access to first floor. Service users accommodation is situated on the ground and first floor with the second floor used as a storage area. All bedrooms are for single occupancy with six having en-suite facilities. There is a shared dinning room, lounge and conservatory. The home has a rear garden with the front garden gravelled to provide off road parking. The homes literature states that its mission is to assist its residents in maintaining a highest quality of life, as well as quality of care. And assures its residents individual care with respect to their privacy, dignity safety and security. The fees have recently increased and are £361 a week regardless of which room is occupied. These fees include all services and facilities apart from hairdressing, chiropody and newspapers any taxis required and dry cleaning of clothes, these extras are itemised separately with appropriate receipts. Crescent House DS0000014193.V292861.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term ‘service user’ to describe those living in care home settings. For the purpose of this report those living at Crescent House Care Home will be referred to as ‘residents’. This key inspection was based around an unannounced visit completed over a full day in May and included a meeting with the registered manager and the head of care who received the inspector’s feedback at the end of the inspection. During the visit to the home the inspector reviewed in depth the care provided to 3 residents and followed this review up with contacting 3 of their representatives. Two visitors were also spoken to along with most of the residents. All staff on duty were spoken to and the inspector had a mid-day meal with the residents. A selection of documentation was reviewed and this included the statement of purpose and service users guide, staff duty rotas, training records, 3 recruitment files, records relating to health and safety and a number of policies and procedures. In addition service users surveys were given to 10 residents or their representatives along with 5 staff surveys. The information contained in the returned surveys has been incorporated into this report. What the service does well: The home provides both prospective and existing residents, with a good level of information about what services are provided and what to expect when living at the home. All feedback received about the home reflected a satisfaction with the care provided and the relaxed friendly atmosphere generated. Staff were found to be attentive to residents responding to their care needs sensitively. They were also noted to have a good rapport with residents and visitors who confirmed that they felt very comfortable visiting Crescent House at any time. Two visitors spoken were also very complimentary of the care saying ‘I am very happy with this home and the care it provides’ and ‘this is a wonderful place’. A visiting health Care professional contacted following the inspection confirmed that the quality of care delivered at the home was good. Crescent House DS0000014193.V292861.R01.S.doc Version 5.1 Page 6 Flexible routines regarding meal times, going to bed, rising and bathing continue to be part of daily practices at the home, ensuring that residents individual preferences are respected. What has improved since the last inspection? 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. Crescent House DS0000014193.V292861.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 Crescent House DS0000014193.V292861.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, 3 and 6 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Prospective residents and their representatives are provided with information in a form that is appropriate to them to allow them to make an informed choice. The admission procedures ensure residents are fully assessed prior to an admission being agreed, and have been assured that their needs can be met by the home. EVIDENCE: The home displays a significant amount of information about the services offered at the home. As well as a comprehensive statement of purpose and service user guide there is a useful booklet on the most frequently asked questions about the home. These are all displayed around the home including previous inspection reports. Crescent House DS0000014193.V292861.R01.S.doc Version 5.1 Page 9 Although the certificate of registration was displayed, the part that contained the conditions was not, this shortfall was rectified during the inspectors visit. Records examined in respect of the most recent admission to the home confirmed that residents are only admitted to the home following a full needs assessments being completed and that this now includes a mental health review. These assessments are completed by a member of the management team and involve a visit to the prospective residents, either at hospital or current address, to gather information about their needs. Where appropriate, information about a prospective residents needs is also gained from other sources including resident’s representatives and health and social care professionals. The level of information obtained about prospective residents enables the home to make an informed decision on whether the home can meet a prospective residents needs. All this information is then transferred into the care documentation where it provides the basis of the residents care plan. Discussion with a recently admitted resident confirmed she had chosen this home and that the admission process was straight forward and well organised. Intermediate or rehabilitative care is not provided at Crescent House Care Home. Crescent House DS0000014193.V292861.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Although care documentation is thorough the plans of care are not providing clear guidance to staff on how to meet all the care needs. Resident’s care needs are well met taking into account resident’s dignity with evidence of regular input from health care professionals as necessary. Procedures and practice in the home allow for the safe administration of medicines. EVIDENCE: The care documentation pertaining to 3 residents was reviewed as part of the inspection process. Comprehensive information is gathered about each resident and compiled into several documents. These include risk and needs assessments, basic information, daily notes and a plan of care. Due to the amount of information obtained the head of care provides concise care plans that are used by the care staff. A review of these indicated that they do not fully reflect all the care of residents, for example one residents sometimes Crescent House DS0000014193.V292861.R01.S.doc Version 5.1 Page 11 challenging behaviour was not recorded along with guidance for staff on how to respond. The care documentation is predominantly developed and reviewed by the head of care with the daily notes completed by care staff. Records however indicate that regular re-evaluation of the care and care plans are completed in conjunction with the resident and identified carers. Carers spoken to had a good understanding of residents care needs and all residents spoken to felt satisfied with the care that they received at Crescent House. Two visitors spoken were also very complimentary of the care saying ‘I am very happy with this home and the care it provides’ and ‘this is a wonderful place’. A visiting health Care professional contacted following the inspection confirmed that the quality of care delivered at the home was good. The medicine administration practice observed was seen to be safe and the records demonstrated that systems have been established to ensure staff are appropriately trained and records are accurate and provide a history of what was given by who and why. Notification received from the home following the inspection in respect of a medication error was reviewed by the Commissions pharmacist and was found to be comprehensive with the home taking all the appropriate actions to ensure resident’s safety. During the inspection Staff were seen to be respectful and considerate to all residents and visitors. Each of the residents were addressed by their preferred term and dressed in clothes that they had chosen to wear. A visiting social care professional spoke positively about the way the home addressed respect issues in the home although the inspector believed that matters relating to dignity should be further developed in the care documentation. Crescent House DS0000014193.V292861.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The arrangements for activities now provide further choice and activity and on the whole the provision of meals ensure residents have a well balanced diet that they enjoy. Residents are able to make a range of choices about their lives as well as maintaining links with friends and relatives. EVIDENCE: During the inspection residents spoken to said that they enjoyed the activities provided and were seen to be moving around the home as they wished participating in entertainment and nail painting, as they wanted to. Both staff and visitors said that they felt the activities and entertainment provided was appropriate, however feedback from resident’s surveys indicated that satisfaction with activities and the food provided is not always high. Discussion with the homes management confirmed that activity outside the home is not provided and agreed to promote trips and outings. Crescent House DS0000014193.V292861.R01.S.doc Version 5.1 Page 13 Visitors commented upon how welcomed they are made to feel during their stay, this included being offered beverages or meals and staff being friendly and approachable. Visiting is not restricted and is encouraged. Residents said that they could get up and go to bed when they wanted and spend their day how and where they wanted. The meal eaten by the inspector was found to be well presented and to have a very good taste with an emphasis on home cooking and fresh ingredients. Most residents chose to have their meal in the attractive dining room and it was noted that all residents had a choice of meal and were offered alternatives if they were seen not to be eating well. An Environmental Health inspection completed this year identified that the kitchen was well managed and made no recommendations for improvement. Crescent House DS0000014193.V292861.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. There is satisfactory complaints system in place with residents and their representatives saying that any concerns raised would be listened to and acted upon. There are procedures and practices in place that supports the protection of vulnerable adults. EVIDENCE: There is a clear and accessible complaints procedure for residents, they’re representative and staff to follow should they be unhappy with any aspect of the service. No complaints have been recorded since the last inspection. Resident’s representatives and social care professionals consulted said that they felt confident that any concern or complaint that was raised with the management team would be responded to promptly and effectively. The home has clear procedures in place for staff to follow if abuse is alleged or suspected. Staff have received formal training in adult protection and prevention of abuse and showed some understanding of their roles and responsibilities under adult protection. The management team have recently responded to a concern raised in the home and reported it appropriately to the Adult Protection Team at social services. Crescent House DS0000014193.V292861.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, 20, 21, 23 and 26 Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. On the whole the facilities provide a comfortable environment, which meets the needs of residents, however improvements are needed to ensure residents safety. EVIDENCE: There was evidence of on-going redecoration and furniture replacement in the home including new dining room chairs, flooring replacement and the replacement of two toilets. Despite this refurbishment the home still needs considerable investment to improve the overall facilities. Residents said they were comfortable in their rooms and overall the home provided a comfortable, home-like environment within which the resident can have their care needs met. Crescent House DS0000014193.V292861.R01.S.doc Version 5.1 Page 16 Communal space consists of a dinning room, lounge and conservatory on the ground floor. These are decorated to a good standard with furnishings that are domestic in character. These areas enable residents to have different individual space and the opportunity to move around the home and engage with different activities and people. The conservatory overlooks a rear garden, which is well used in the good weather. There are an adequate number of toilets located around the home including six bedrooms, which have en-suite facilities. Two of the toilets have been upgraded since the last inspection. There are two assisted bathrooms on the ground floor, and one room has an en-suite shower. The standard bath on the first floor has been raised since the last inspection, however this has not enabled residents to use it and the head of care has been given advise that a hoist facility can not be provided in this room. The communal bathing facilities therefore remain limited and the home manager is aware that these need to be improved and discussion took place around the provision of a communal shower on the first floor. Eleven bedrooms are below the recommended 10sq meters. Residents confirmed that they were happy in their rooms, all of which were found to be personalised. Although there is a call system throughout the home, which in some cases is a doorbell type mechanism attached to a wall, it is not accessible to residents in all areas and during the visit it was confirmed that the bells were not working in eight areas. The head of care has identified all areas where the bell is not working and not accessible, and has had an estimate for its up-grade. The current arrangements are not satisfactory and needs to be addressed as a priority. All parts of the home inspected were clean and free from offensive odours. The hand washing facilities in the laundry area and communal toilet areas were discussed with the Health Protection Agency nurse following the inspection. She recommended that the alcohol rub used in these areas is replaced, ideally with the provision of a hand basin, liquid soap and paper towels if this was not feasible detergent wipes would need to be provided. Crescent House DS0000014193.V292861.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 29 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. There is sufficient staff who are suitably trained on duty to ensure that residents receive the level of care they need. Recruitment practice is not thorough and recruitment records are not full. EVIDENCE: At the time of this visit to the home 13 residents were living in the home and the staffing arrangements were found to be appropriate to meet their care needs, allowing time for individual contact and interaction in the afternoons. One waking care staff supported by an on-call manager covers the night. A record is maintained of any nighttime activity and enables the manager to review the staffing cover. Residents, visitors and health/social care professionals spoke highly about the staff saying ‘staff are all kind and friendly’ one regular visitor confirmed that ‘everyone is happy in the home and the staff are so nice’ another relative said the staff ‘are wonderful’ and expressed a satisfaction with the friendly supportive relationship residents and visitors have with the staff in the home. Crescent House DS0000014193.V292861.R01.S.doc Version 5.1 Page 18 The home has a core of stable staff who like working in the home and clearly care very much for the residents in the home. Staff turnover remains low and it was noted that staff, residents and visitors have a close relationship and enjoy each other’s company with staff providing a good level of care. Three recruitment files were selected for review. These included one recently recruited member of staff. The records demonstrated that references are obtained and applications forms are completed although these need to be improved to demonstrate all of the applicant’s previous employment history. The recruitment files, however were not full and in one case did not have a health check or confirmation of an employees right to work in the country. There was no evidence that staff are given terms and conditions of employment or a copy of the General Social Care Code of Conduct. These shortfalls were identified to the registered manager and head of care at the time of the home visit. Staff training continues to benefit from good planning and improved resources. Staff undergo core-training topics such as moving and handling, first aid, food hygiene and fire safety. Additional training in the care of older people including those who have Alzheimer’s and dementia has been provided. Crescent House DS0000014193.V292861.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): Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The homes management is well established but needs to ensure clear leadership and supervision throughout the day along with effective health and safety and quality monitoring systems are fully used. Resident’s financial interests are safeguarded. EVIDENCE: The management structure of the home delegates tasks amongst the management team, made up of the, manager, deputy, head of care and medication co-ordinator. The registered manager is however aware that she has overall accountability for the home. Crescent House DS0000014193.V292861.R01.S.doc Version 5.1 Page 20 The registered manager is currently completing a management course. As recommended at the last inspection the staffing deployment has been reviewed and the registered manager confirmed that the management team now work over the whole day providing on going supervision and support. This level of cover however was not reflected in the duty rotas reviewed and this was raised with the registered manager, she confirmed that up until recently an internal disciplinary investigation necessitated the old staffing schedules to be used. Now that this investigation has been concluded the rotas will be up dated to reflect the correct staffing arrangements. Some quality monitoring has been established and resident questionnaires were completed this year. These have not been audited or reported on and discussion took place around using different forms and systems to gain more meaningful information from a range of sources to ensure practice in the home is monitored and that the views residents and others involved in their care are taken into account. The home has procedures in place for the safe keeping of resident’s monies and a number of individual accounts for personal money are retained and managed by the registered manager. Resident’s representatives spoken to were satisfied with the arrangements and confirmed that money spent is accounted for with receipts being retained. One of the resident’s monies was checked and was found to be in order. It was confirmed that individual bank accounts are to be established for those residents where the money is building up to ensure interest is accrued. Although staff supervision is being completed and recorded by the head of care a clear protocol and guidelines for the completion of staff supervision needs to be established and those completing the supervision need to be appropriately trained. Records relating to Health and safety in the home were reviewed and although these on the whole are full and extensive the following shortfalls were noted. A) B) C) D) That the environmental risk assessments completed are not always accurate The thorough examination certificate for the chair lift was not available The portable appliances in the home had not been checked The homes procedure on the prevention of Legionnaires disease is not being adhered to The head of care completes the home risk assessments and it was suggested that she completes a course on risk assessment and management. Crescent House DS0000014193.V292861.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 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 2 2 X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Crescent House DS0000014193.V292861.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 15(1) Requirement That care plans provide clear guidance for staff on all aspects of the health, personal and social care needs of service users and which make explicit the actions needed to meet these needs. (Made at inspection of 22/09/05) That adequate communal bathing facilities are available on the first floor. (Made at inspection of 30/8/05 with timescales of immediate not met) That a call system with an accessible alarm facility is provided and accessible to all residents in their bedrooms. (First made at inspection of 28/10/04 with timescales of immediate not met) That appropriate hand washing facilities are provided in all areas where infected material is being handled. That the recruitment practice is DS0000014193.V292861.R01.S.doc Timescale for action 01/07/06 2. OP21 23(2)(j) 01/08/06 4. OP22 23(2)(n) 01/08/06 5. OP26 13(3) 01/07/06 6. OP29 19(1) 01/06/06 Page 23 Crescent House Version 5.1 7. OP33 24(1) improved to ensure prospective staff complete a full application form, provide evidence of right to work in this country when appropriate, health checks and are given terms and conditions of employment along with a GCCC. That a system is established and maintained for monitoring the quality of the care provided. (Made at inspection of 22/09/05) 01/08/06 8. OP38 13(4) That robust health and safety 01/07/06 practice is adopted to include thorough accurate environmental risk assessments, thorough examinations of the chair lift and appropriate checking of all electrical equipment. 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 OP12 OP15 OP29 OP36 OP38 Good Practice Recommendations That the improved activity/entertainment programme is developed further with promotion of outings and trips. That the provision of meals is reviewed to ensure residents are consulted and that the meals provided are reflective of their likes and dislikes. That a recruitment checklist is used to ensure all the necessary documents and checks are completed and retained in the home as necessary. That staff completing staff supervision are appropriately trained and a clear protocol for staff supervision is established. That those who are completing risk assessments are given appropriate training on risk assessment and management. Crescent House DS0000014193.V292861.R01.S.doc Version 5.1 Page 24 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 Crescent House DS0000014193.V292861.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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