Inspection on 12/04/05 for Crescent House

This inspection was carried out on 12th April 2005.

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

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

Other inspections for this house

Crescent House 19/05/08

Crescent House 26/07/07

Crescent House 10/05/06

Crescent House 22/09/05

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 Jane Jewell Unannounced 12 April 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. 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 Version 1.10 Page 3 SERVICE INFORMATION Name of service Crescent House Address 108 The Drive, Hove, East Sussex, BN3 6GP 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) 01273 732291 The London & Brighton Convalescent Home Mrs Jennifer Downes Care Home 17 Category(ies) of Old age (17) registration, with number of places Crescent House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of people to be accommodated is Seventeen (17 ). 2. The people accommodated must be older people aged sixty-five (65) years or over upon admission. 3. The home may accommodate one named service user who has mental health needs. Date of last inspection 22 October 2004 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 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 sinlge occupancy with six having ensuite facilities. There is a shared dinning room, lounge and conservatory. The home has a well-maintained 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. Crescent House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced routine inspection, which took place between 9.50am and 5pm. On the day of the inspection there were sixteen residents living at the home. The inspection involved a tour of the premises. Staff and care records were examined. Six out of the seven staff on duty were consulted. Eight residents, one relative and a social worker were also consulted. A discussion with the deputy manager took place around progress since the last inspection. The focus of the inspection was on the quality of life for people who live at the home. What the service does well: What has improved since the last inspection? Many of the areas of concern noted during previous inspections have been addressed. Action is in place to ensure that those areas not yet fully met are done so in the near future. Investment in the homes environment has meant that the much redecoration has been undertaken resulting in a more pleasant, comfortable and safer environment in which to live. Crescent House Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Crescent House Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Crescent House Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3, and 4 The home provides both prospective and existing residents, with a good level of information about services at the home. This supports prospective residents and their representatives to make informed decisions about the home. Residents are only accommodated if the home is satisfied that they can meet their needs. EVIDENCE: There is a significant amount of information produced about services offered by the home. As well as a comprehensive statement of purpose and service user guide a useful booklet on the most frequently asked questions has recently been developed. These are all displayed around the home including previous Inspection reports. Not all staff were fully familiar with the contents of these documents, in particular the aims and objectives of the home. This has implications for the delivery of care practices and the home achieving its stated purpose. Documents seen for recent admissions showed that resident’s are only accommodated following an assessment of their needs by a member of the management team. Information about their needs is gathered from a variety of sources including the residents, their representative and health care Crescent House Version 1.10 Page 9 professionals. Their needs assessment them forms the basis of their care plan. This helped ensure that staff were aware of the recorded needs of new residents. The management teams judgement has improved in terms of ensuring that the home only provides care for people whose needs it can meet and are within the homes registration categories. The home has supported residents to move on when their needs had been assessed to significantly change and could not be safely met by the home. A number of residents have developed specialised needs since living at the home. In order to ensure that these needs are properly identified and addressed, the home has been previously required to ensure that staff undergo training in the care of people who have Alzheimer’s and dementia. The deputy manager reported that this is due to be undertaken shortly. Crescent House Version 1.10 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8, and 10 Care plans provided a good standard of recorded information about each resident, however the information held was not always being used by staff to guide them in their work with residents. Not all identified risks are being managed properly. The health needs of residents are addressed by good multi disciplinary working taking place on a regular basis. EVIDENCE: Four individual plans of care were inspected. These comprised of many documents including risk and needs assessments, basic information, daily notes and a plan of care. Although these contain a good standard of information on the needs of residents they are often difficult to navigate and to retrieve essential information. To address this the deputy manager is about to implement a daily care plan to ensure that staff are familiar with the daily routines of each resident. The deputy manager takes the lead in writing care plans with staff updating daily notes for each resident. Not all staff accessed care plans regularly to update themselves on the needs of residents. Crescent House Version 1.10 Page 11 No resident consulted was aware of his or her care plan, despite the vast majority of care plans being signed by the individual. Some residents stated that they were not interested in being involved in their care plan where others wanted to know what was written about them. Care plans are reviewed and updated by the deputy manager using the daily notes as the main source of information. To ensure that all changes in needs and preferences are identified residents must be active participants in the planning of their care. One resident stated that they needed staff to take more time when undertaking personal care tasks. This was discussed with the deputy manger who agreed to ensure that this was addressed and their care plan updated. The standard of daily recording was noted to be good with a clear account of actions and events that had occurred. Personal risk assessments are undertaken on potential risks faced by residents including, pressure sores, fire, behaviour and mobility. As required at the last inspection these must provide details of how identified risks will be managed. This had not been completed. All residents consulted indicated the way in which their health needs were being met and when they have requested medical intervention this is sought promptly. The home works closely with health care professionals including District nurses, dentists, chiropodists. Residents felt they are treated with respect and their right to privacy is upheld. Bedrooms doors are fitted with locks and staff were observed knocking on bedroom doors before entering. Medical treatment was being undertaken in private at the time of the inspection. Several male carers work at the home and residents consulted stated that they did not have any preference in the gender of staff undertaking personal care. Crescent House Version 1.10 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 standard(s) 12,13,14 and 15 Flexible routines are part of daily practice at the home. There is clearly more work needed to ensure that opportunities for occupation and stimulation are improved. Links with families are valued and supported by the home. Recent meals were not always to some resident’s satisfaction. There is a strong emphasis on choice of meals being offered. Not all practices were in line with food safety guidance placing residents at potential risk. EVIDENCE: The majority of residents consulted felt that they were not suitably occupied and complained of often being bored. Three residents stated separately that they used to like playing bingo at the home but this has stopped recently as other residents were unable to understand what was going on. The record of activities recorded films, movement to music and shopping being undertaken. A large number of residents stated that they like to knit and staff helped to obtain the necessary equipment for them. Some residents were found to have made a clear choice to remain in their rooms and this was respected by staff. Lack of staff skills and time to provide residents with opportunities for stimulation was noted in previous inspections and recommendation made for this to be addressed. This had not been undertaken. The home has now been required to develop and implement a plan of activities, based on the likes and dislikes of residents. Crescent House Version 1.10 Page 13 Residents stated that there is flexibility in daily routines regarding meal times, going to bed, rising and bathing. A visitor stated how well staff treat them and are given clear information and are made to feel welcome. Residents spoke of their visitors being able to visit at any time and were offered hot drinks during their stay. Residents were observed being offered a choice of the main midday meal with residents stating that they are always offered a choice of main meal. The meal served looked appetising and plentiful. Variable feedback was received from residents on the standards of food, with some saying how nice the meals were. Three residents commented separately that standards of meals at the weekend had recently deteriorated. Records of meals provided were not always completed at the weekend therefore it was not clear what food is being offered and made available at this time. This was raised with the weekday cook and deputy manager who were not aware of some residents dissatisfaction and agreed to identify and address the issue. Residents stated that in addition to the main meals regular snacks and hot drinks were offered. Two residents stated how important it was for them to have a glass of sherry with their meal. Many other residents were observed to also be provided with an alcoholic beverage of their choice. The majority of residents eat their main meal in an attractively decorated dinning room, while others prefer to eat in their bedrooms. Eight residents had requested a sharp knife to eat meals with. The inspector was concerned to note that small kitchen knives had been provided to them, which the inspector considered was dangerous. The deputy manager was asked to risk assess these knives to establish their suitability for safe use. The kitchen was well equipped but due to worn cupboards and surfaces can present as untidy. Considerable efforts continue to be made to ensure that the kitchen is clean despite the difficulties with the overall presentation of the kitchen due to its age. The cook reported that it is due to be refurbished in the near future. In line with previous requirements entry to the kitchen has been restricted for health and safety reasons. Staff were observed entering the kitchen area and serving food without wearing the appropriate protective clothing. The cook started to immediately address this by ordering different coloured tabards for staff. Crescent House Version 1.10 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 standard(s) 17 and 18 The inspector judged that resident’s rights were upheld. The homes practices are designed to protect residents from abuse. Not all staff were clear on the correct way of reporting any suspicions of abuse. EVIDENCE: Much effort continues to be made to ensure that resident’s rights are protected including ensuring there is regular access to personal monies where it is held by a relative. A list of useful contact numbers including local advocacy services is included in the homes literature. In line with previous requirements the manager has undertaken training in adult protection. The majority of staff have also undergone this training with the remaining four staff due to undertake this shortly. There are clear policies on adult protection including a flow chart, which is displayed, for staff on how to report suspicions. Despite this not all staff consulted showed an understanding of adult protection guidelines. It was reported that due to a series of administrative errors by external bodies one existing staff have not undergone a Criminal Records Bureau (CRB) check. This appears to have been outside of the control of the home. Not withstanding this there is a need to ensure that this is undertaken as a matter of priority in order to safeguard residents. For all other staff CRB checks have been undertaken. Crescent House Version 1.10 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 standard(s) 19,20,21,22,23,24,25 and 26 Recent investment has started to improve the appearance of the home, with much work still needed to ensure that standards are consistent throughout the home. Resident’s bedrooms and communal space is comfortable and homely. The system for residents to call for assistance needs to be reviewed in order to safeguard residents. Poor practices were noted in the management of infection control, which placed staff and residents at risk. EVIDENCE: Since the last inspection the home have continued with their redecoration programme with further bedrooms, toilet and first floor corridor having been redecorated to a good standard. Works that remain outstanding includes: four bedrooms, stairwell, one bathroom, two toilets, kitchen, exterior of the building, painting of radiator guards. Discussion occurred on the need to address this as a matter of priority in order to improve environmental standards and meet outstanding requirements. Crescent House Version 1.10 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 homely and heated to a comfortable level. In line with previous requirements additional chairs have been obtained at varying heights to support the ease of use by residents. There is adequate number of toilets located around the home including six bedrooms which have ensuite facilities and one also has a shower. There are two assisted bathrooms on the ground floor. There is a standard bath on the first floor which is currently not used as it is too low for residents. Plans were discussed with the manager during 2004 with regard to the upgrade of the first floor toilets and bathroom. However it was not clear whether this has been actively pursued therefore the home is now required to improve these facilities including providing hand washing facilities within the toilets and ensuring that adequate bathing facilities are available on the first floor. Residents consulted noted that there was always hot running water available when they required it. Eleven bedrooms are below the recommended 10sq meters, however residents consulted felt that they had sufficient space. All bedrooms were visited and were noted to have been personalised and provided with domestic style furniture and fittings, together with bedding, carpeting, curtains to a good standard. There is a variety of aids and adaptations around the building to support residents independence. This includes grab rails, raised toilet seats, assisted baths and chair lift. Each bedroom is fitted with a call point, those tested were in working order. In line with previous requirements additional call points have been fitted to some bedrooms to ensure that they can be easily reached. However concern continues to be expressed by the inspector on the suitability of the call system as another example was noted whereby a resident was unable to reach the call point in their bedroom and therefore could not call for assistance. Residents felt that their clothes were suitable laundered and all residents clothing was noted to have been laundered to a good standard. There were two cleaners on duty at the time of inspection. Residents stated that they felt that the home and their bedrooms were cleaned to a good standard and with the exception of commode frames this was also observed by the inspector. Crescent House Version 1.10 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 28 There is a core group of staff who have worked at the home for many years and who make a positive contribution to the quality of life of residents. Staffing levels during the afternoon are insufficient to ensure that resident’s needs can be fully met. The arrangements for covering staff absence was poor which resulted in lower staffing level. EVIDENCE: All but one residents consulted said that staff at the home were kind and caring but that they were very busy. The inspector observed many sensitive interactions between staff and residents, which was undertaken in a friendly and relaxed manner. There is a core group of staff who have worked at the home for a number of years and have considerable experience in working with older people. The staffing level noted at inspection was for two carers and a manager to be on duty until 2pm. In addition there was a cook and domestic staff. After 2pm there were two staff on duty until 8pm. The inspector has previously noted that the afternoon staffing levels were inadequate to meet the needs of residents. This had been addressed prior to the last inspection but had not been sustained. The deputy manager was immediately required to address this. No staff have been recruited since the last inspection. Crescent House Version 1.10 Page 18 Staff cover for leave and sickness had been provided by the use of some agency staff and existing staff undertaking additional duties, however not all shifts had been covered. This resulted in the lower staffing levels noted at inspection. This was discussed with the deputy manager who felt that there was a need to recruit “bank workers” to ensure that all future shifts are able to be covered. The home has sufficient staff on NVQ training courses to assist the eventual meeting of the Government target of at least 50 of carers reaching the basic standard. Crescent House Version 1.10 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 35 36,37 and 38 Currently there is a lack of leadership, guidance and direction to staff to ensure residents receive consistent quality care. This results in some practices that do not promote and safeguard the health, safety and welfare of the people using the service. Resident’s financial interests are safeguarded. A good standard of administration continues to be maintained. EVIDENCE: The registered manager is currently on leave. It was not clear who was managing and accountable for the home in the manager’s absence and with residents and staff stating various arrangements being in place. In addition there was no evidence that the registered provider had been visiting the home or undertaking the required monthly-recorded visits. The provider has been contacted separately to the inspection in order to clarify the current management arrangements. Crescent House Version 1.10 Page 20 All members of the management team are rostered to work until 2pm. Instances of poor care practices reported, by the home, under adult protection guidelines since the last inspection were alleged to have occurred during the afternoon. The insufficient staffing levels noted in the afternoon also gave cause for concern that staff are not being provided with appropriate supervision and guidance after 2pm. The home has been required to ensure that all persons working at the home are appropriately supervised. In line with previous requirements the home has instigated tighter controls over the management and storage of residents personal monies. The deputy manager takes responsible for the administration and record keeping at the home. All records requested by the inspector were made available and with the exception of risk assessments, records were generally well organised and supportive to the effective and efficient running of the home. Residents felt confident to ask to see information held about them but had never requested to see it. Some personal information about residents was not stored securely. There is a wide range of procedures & policies designed to inform and guide staff in their work with residents. All residents consulted stated that they were not interested in accessing the homes policies and procedures and did not wish to be involved in their development and review. Not all of the homes practice safeguarded residents from risks. Those that did not included a bath delivering hot water above 43oc and fire doors not closing properly. In addition the system for cleaning and emptying commodes was not in line with infection control practices. Disposable protective equipment was stored in a locked cupboard and therefore staff could not access this easily for each personal care tasks. Liquid soap and disposable hand towels were not available in all communal toilets. There is currently no suitable sink for hand washing within the laundry room and the home is required to provide such facilities. The use of a freestanding radiator was being used to increase the heating to a resident’s preference. This had been positioned in a corridor and presented a trip and scolding hazard. The deputy manager was required to risk assess its use in order to protect residents. Good practices were noted on the management of falls, which included a clear account of accidents, review of the accident and risk assessment following a fall. Crescent House Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 3 2 2 3 2 3 1 STAFFING Standard No Score 27 1 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x 3 2 2 x x x 3 1 2 1 Crescent House Version 1.10 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation 15(2)(c) Requirement That unless it is unpractical to do so residents are consulted regarding the development and review of their care plan and are notified of any revision to the plan. That personal risk assessments record the actions to be taken to manage identified risks. (Outstanding from inspection of 27/04/04) That a programme of activities be developed and implemented based on the likes and dislikes of residents and which is made available to service users. That a record of food provided for all residents be maintained. That the use of sharp knives as cutlery be risk assessed and a record made of the assessment, and which is reviewed regularly. That designated protective clothing be made available for staff when entering the kitchen and serving food. The Registered person shall make arrangements by staff training or by other measures to prevent service users being harmed or from suffering abuse Version 1.10 Timescale for action 30-6-05 2. 7 13(4)(c) Immediate 3. 12 16(2)(m) 30-6-05 4. 5. 15 15 17(2) Sch 4(13) 13(4)(c) Immediate Immediate 6. 15 13(3) Immediate 7. 18 13(6) Immediate Crescent House Page 23 8. 9. 18 19 19(1)(b) Sch2 (7)(b) 13(4)(a) 10. 11. 19 19 23(4)(a) 23(2)(b) 12. 13. 14. 21 21 22 13(3) 23(2)(j) 23(2)(n) 15. 26 13(3) 16. 26 13(3) 17. 18. 26 27 13(3) 18(1)(a) 19. 30 18(1)(c)(i ) or being placed at risk of harm or abuse. (Outstanding from inspection of 28/10/04) That Criminal Record Bureau checks are undertaken for all employees. That hot water in the home is delivered to hot water outlets accessible to residents at around 43°c . That all fire doors are able to be closed properly. That works identified in the plan of redecoration and refurbishments are completed. (Oustanding from inspection 29/10/03) That suitable hand washing facilities are available in the first floor toilets. That adequate bathing facilities are available on the first floor. That a call system with an accessible alarm facility is provided and accessible to service users in their bedrooms. (Oustanding from inspection 28/10/04)) That infection control policies are reviewed and updated to include guidance on the shortfalls in practices noted at inspection. That adequate quantities of protective clothing be made readily available to staff when undertaking personal care duties and disposing of human waste. That suitable hand washing facilities are available within the laundry. That at all times adequate staffing levels are maintained to ensure the health and welfare of service users. That staff undergo training in the care of older people including Alzheimer’s and dementia. Version 1.10 Immediate Immediate Immediate 30-6-05 30-8-05 30-8-05 Immediate 30-6-05 Immediate 30-6-05 Immediate 30-6-05 Crescent House Page 24 20. 34 26 21. 22. 23. 36 37 38 18(2) 17(1)(b) 13(4)(c) (Oustanding from inspection of 28/10/04) Records of visits by the Responsible individual are undertaken and a copy forwarded to the commission for social care inspection. That persons working at the home are appropriately supervised. That individual records and home records are stored securely. That a risk assessment be undertaken on the use of portable radiators, which is recorded and reviewed frequently. Immediate Immediate Immediate Immediate 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 1 12 Good Practice Recommendations That staff are familiar with the contents of the statement of purpose and service user guide. That staff have the skills and time to provide service users with opportunities for stimulation through leisure and recreational activities. (Outstanding from inspection of the 28/10/04). That the kitchen be refurbished. (Outstanding from inspection of the 29/10/03). That liquid soap and disposal hand towels be made available in communal toilets and bathrooms for hand washing. 3. 4. 15 26 Crescent House Version 1.10 Page 25 Commission for Social Care Inspection 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 Version 1.10 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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