Inspection on 19/05/08 for Crescent House

This inspection was carried out on 19th May 2008.

CSCI found this care home to be providing an Adequate service.

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 26/07/07

Crescent House 10/05/06

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 Gwyneth Bryant Unannounced Inspection 19th May 2008 09:15 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.V363376.R01.S.doc Version 5.2 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.V363376.R01.S.doc Version 5.2 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 01273 732393 markandtree@hotmail.com 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.V363376.R01.S.doc Version 5.2 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 26th July 2007 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 dining 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 £381 per week as at 19 May 2008. 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.V363376.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was an unannounced inspection and took place in just under six hours. The purpose of the inspection was to check compliance with the requirements made at the last inspection and inspect key standards. There were seventeen people in residence on the day of which four were spoken with. The Head of Care, one visitor and two staff were also spoken with. A tour of the premises was carried out and a range of documentation was viewed including care plans, personnel and medication records. Prior to the site visit the Registered Providers were asked to provide information on the service. This was provided and the information included in this report as necessary. People spoken with on the day mentioned the care and kindness of staff and that they felt well cared for. Prior to the site visit we asked the Registered Providers to complete an Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. The Head of Care said that it was returned in time but not received in the CSCI office, however a copy was provided on the day of the site visit. Information from the AQAA is included in this report as necessary. What the service does well: What has improved since the last inspection? Crescent House DS0000014193.V363376.R01.S.doc Version 5.2 Page 6 There have been improvements to the environment in respect of fitting handrails either side of the front door steps, improving the car park and refurbishment of bedrooms and communal areas. 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. The summary of this inspection report can be made available in other formats on request. Crescent House DS0000014193.V363376.R01.S.doc Version 5.2 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.V363376.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 4 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Improvements need to be made to the admission assessment to demonstrate the needs of people moving into the home can be met. EVIDENCE: The pre-admission sheets for the last three people to be admitted were viewed and while they identified needs, they did not include information as to how the home will meet those needs. There was particular concern for one person admitted a week prior to the site visit whose pre-admission assessment was basic and a care plan had yet to be developed. These shortfalls do not give sufficient direction to staff in meeting the needs of people newly admitted to the home. Intermediate care is not provided. Crescent House DS0000014193.V363376.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. All aspects of service users health, welfare and care must be identified and planned for, in order to clearly direct staff in the delivery of appropriate care. Improvements in the administration in medication need to be made to ensure people living in the home are not at risk. EVIDENCE: Four care plans were viewed and in the main were found to include most aspects of care needs. However, information in the plans were often a single sentence and it is important to ensure full details of how needs are to be met are recorded as a point of reference for staff. In addition one care plan folder merely contained the care plan template and none of it had been completed. It is important that all care needs are identified, planned for and that staff are clearly directed in meeting care needs, particularly as a number of new staff have been recently recruited. Daily notes were variable with some being very detailed and enabling the reader to determine how an individual spent their day, other notes tended to be blander with comments such as ‘slept well’ or ‘had a good day’. Crescent House DS0000014193.V363376.R01.S.doc Version 5.2 Page 10 It is important to ensure daily notes contain sufficient details to facilitate the monthly care plan reviews and provide a clear record of how people spend their day. Although environmental risk assessments had been carried out for those at risk of falls, they were inadequate as they did not clearly identify the hazards nor include sufficient detail for the management of these risks, this was the case even for those people identified as being at high risk. Risk assessments must be expanded to provide staff with clear direction on the management of the risk. This is particularly important for those people who have already sustained injuries as a result of a fall. One care plan showed that a confused individual had used the commode in another person’s room but there was no information as to what action staff need to take to prevent a further incidence. It is necessary to be attentive to these matters as such incidents impinge on privacy and poses a risk of cross infection. One person was identified as being at risk of urinary tract infections but there were no records to show that they were given additional fluids as recommended by their GP. Discussion with the Head of Care found that staff do offer extra fluids, however this needs to be recorded to enable staff to monitor fluid intake. One care plan indicated that an individual needed to be weighed weekly and this was carried out in practice. It would be good practice to ensure that care plans include records of additional snacks that have been offered and whether or not they were consumed. This allows staff to identify preferred foods which can then be offered more frequently. Comments from those spoken with found that staff were very kind and caring and one person said: • • they (staff) do all they can to make us feel at home. I have no complaints whatsoever. Discussion with the Head of Care found that all staff have received up to date training in the safe handling of medication. However, a number of shortfalls were found in the medication administration records. These included signatures being scribbled out and replaced with a code letter, which indicates that medication is signed for prior to administration. There were also some signatures just scribbled out. In addition, correction fluid had been used on medication administration records, weight charts and care plans. It is important to ensure all records relating to care needs are clear, accurate and up to date. There needs to be particular attention to medication charts as it is crucial that it is clear whether or not medication has been given. Crescent House DS0000014193.V363376.R01.S.doc Version 5.2 Page 11 It was good to note that where individuals were prescribed medication ‘as required’ there was a clear record detailing what the medication was for and the prompt for its administration. Crescent House DS0000014193.V363376.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The lifestyle experience by people living in the home mostly match their expectations, choice or preferences. EVIDENCE: Records relating to the daily routines of individuals included preferred times for getting up and going to bed. Preferred leisure activities were also identified, however there was no information as to how the home intended to meet leisure needs. There is a programme of activities and on the day of the site visit some individuals chose to visit a local day centre during the morning. Discussion with the Head of Care found that the home is actively seeking ways to expand the range of leisure activities. Two people spoken with said that they were not keen on the bingo as ‘its not worth it for a bar of chocolate’. Another person said ‘its ages since they did the arts and crafts’ in the home and they particularly liked this activity. All those spoken with said that visitors are made welcome at all reasonable times and were always offered refreshments. People spoken with indicated that they are offered choices in respect of their daily routines and one person said that they were offered a bath in the evening but said they preferred one in the morning and this was provided. Crescent House DS0000014193.V363376.R01.S.doc Version 5.2 Page 13 While staff were seen, in general, to treat people living in Crescent House with care and respect but there were some concerns. There was one incident whereby a carer was weighing people in the sun lounge. This was discussed with the Head of Care who agreed that it should not have happened and she dealt with the matter at the time. In addition a carer was overheard to be discussing someone whilst in the hallway and they could be heard in the office. Again the Head of Care was aware of why such practice is unacceptable and confirmed she would deal with the matter on the day. Meals are varied, nutritious and wholesome and for the most part people living in the home maintain an acceptable weight. The lunchtime meal on the day appeared plentiful and was attractively presented. Comments from those spoken with were variable with two saying they really enjoyed the meals and another saying that they felt the meals were ‘plain English cooking’ and that they would prefer something spicier occasionally. Generally there was agreement that there was a lot of choice for supper menus but the lunchtime choices tended to be omelette or salad as an alternative to the main meal. One person was not sure if they could have a cooked breakfast but thought someone might do them a boiled egg if they asked. These issues were discussed with a senior carer and the Head of Care who agreed to raise the matter at the next residents meeting and in the interim make sure everyone was offered a cooked breakfast at least once a week. Crescent House DS0000014193.V363376.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure with evidence that those living in the home feel that their views are listened to and acted upon. People living in the home are further protected by satisfactory adult protection systems. EVIDENCE: Information in the AQAA indicated that there are detailed policies and procedures on both complaints and Protection of Vulnerable Adults. The complaints log was viewed and it is clear that all complaints are dealt with in accordance with the homes policies and procedures. People spoken with felt they could talk to anyone if they had any concerns about the care given. Staff are expected to be familiar with the homes policies and procedures on adult protection and there is an on-going staff training programme to ensure all staff are trained in the Protection of Vulnerable Adults. Crescent House DS0000014193.V363376.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Most parts of the home are maintained providing a homely and comfortable environment for people living in the home; improvements need to be made in respect of on-going maintenance to ensure all areas of the home are pleasing and safe. EVIDENCE: A tour of the premises was carried out and a number of randomly selected bedrooms inspected. Most parts of the home are adequately maintained and it is clear that individuals are able to bring in their own items to personalise their bedrooms. It was of concern that there remains a call bell system in which the bell is fixed to one point in some bedrooms therefore are not accessible unless the individual is actually in their bed. It is vital that help can be summoned in an Crescent House DS0000014193.V363376.R01.S.doc Version 5.2 Page 16 emergency; therefore upgrading the call system needs to be prioritised to ensure people are not at risk. A gradual upgrade and refurbishment and where redecoration has been undertaken this has been completed to a good standard. Despite this refurbishment the home still needs considerable investment to improve the overall facilities. This includes the redecoration of remaining bedrooms and replacement carpets. Information in the AQAA indicated that there is a plan to carry out a large part of this work within the next twelve months. Discussion with one person found that they were able to choose the colour of the carpet in their rooms but not the colours of paint and furnishings although they were not dissatisfied with the decor. There are currently two assisted baths on the ground floor and a standard bath on the first floor. The two people who used to use the first floor bath now have to come downstairs to the use the assisted baths on the ground floor. It is important that there is sufficient bathing facilities to meet peoples’ needs, therefore action needs to be taken to ensure that bathing facilities are made available on the first floor. The hot water delivery temperatures were tested both in communal bathrooms and individual bedrooms and were found to be variable with some as low as 28.60 and others as high as 50.50. Water needs to be delivered at temperatures that are comfortable for people to wash in but not so hot as to place them at risk, with the optimum temperature being 430. The maintenance records were viewed and although these showed the variable temperatures had been identified no action had been taken to remedy the situation and therefore this needs to be addressed to ensure people are not at risk of scalds. Generally the home is clean and tidy and staff were seen to be wearing aprons when required, however dirty laundry was seen on the laundry floor, including soiled underwear. This practice needs to be addressed to reduce the risk of cross infection. It is good practice to keep soiled laundry in bags until they are washed and this could be considered as a means of reducing risk of cross infection. Crescent House DS0000014193.V363376.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are sufficient staff deployed who have the skills to meet the needs of those people living in the home and the recruitment practice sufficiently robust to safeguard those living in the home. EVIDENCE: The staff rota showed that there were sufficient numbers of staff on duty to meet the care needs of people living in the home. People spoken with said that if they needed staff, their calls were answered promptly at all times. Comments included: • • • • ‘they (staff) are very good ‘I cant fault them. They meet my needs very well. If I wasn’t happy here I wouldn’t stay. There is a staff training programme that ensures all staff have both mandatory training such as moving and handling in addition to training in infection control, first aid and food hygiene. Of the twelve care staff six have achieved National Vocational Qualification level 2 in care and a further four are due to begin this training in June 2008. In addition three staff who already have National Vocational Qualification level Crescent House DS0000014193.V363376.R01.S.doc Version 5.2 Page 18 2 are due to begin this course at level 3 later in the year. Therefore the home is on target to exceed the required 50 of care staff with this qualification. Recruitment records for the last three people to be employed were viewed and it was clear that they had provided the required documentation prior to starting work. All had two written references, Protection of Vulnerable Adults and Criminal Records Bureau checks. These recruitment practices ensure that people living in Crescent House are not at risk. The Head of Care explained that she has recently obtained the necessary documents to implement a staff induction programme that meets the Skills for Care guidance and will be using it for all new staff. Throughout the site visit staff were observed to spend most of the day on various tasks rather than spending time with people living in the home. For example, at one time it was noted that the Head of Care was dealing with medication, a senior carer was preparing lunch and another carer was dealing with paperwork. This suggests that the service tends to be task orientated rather than person centred and this culture needs to be reviewed to ensure the home is run in the best interests of people living in the home. Crescent House DS0000014193.V363376.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Improvements need to be made to provide clear leadership and direction and to ensure all aspects of peoples health; safety and welfare are protected and promoted. EVIDENCE: It was disappointing both the Registered Manager and her deputy were on planned leave on the day of the site visit. While the day of the site visit should be treated as a normal working day, the issue of ensuring that there is at least one of them on duty at all times has been raised during previous site visits. The Head of Care was knowledgeable about all aspects of the service and facilitated well throughout the site visit, however she is clear that she does not have the required managerial responsibility. It was also of concern to note Crescent House DS0000014193.V363376.R01.S.doc Version 5.2 Page 20 that the Registered Manager and senior care staff take turns in the role of cook and this arrangement impinges on their time for managerial and care duties respectively. It is important to ensure that clear lines of managerial responsibility is maintained at all times as people spoken with were not clear about who was the manager. Discussion with the Head of Care found that the Registered Manager is on target to complete the National Vocational Qualification at level 4 by September 2008. This qualification will increase her knowledge and skills of current care practices. A number of bedrooms had the door locks put on bolt position which renders the door closers ineffective in the event of fire as the doors cannot close. This was discussed with the Head of Care who dealt with the matter immediately and added a note for night carers to ensure it did not happen again. Two doors were seen to be propped open, including the kitchen door which, again renders the closing devices ineffective. It is important to ensure that following maintenance work, door closers remain functional without the need for doors to be propped open. Again there was a discussion around the need for staff to consult with the committee before work on the environment can be carried out and this needs to be addressed to ensure that a safe and pleasant environment is provided for people living in the home. It is equally important for the manager and staff to be up to date with the latest care guidance and legislation. Discussion with the Head of Care found that currently staff use home computers to access this type of information and the provision of a computer with internet access within Crescent House would be a better arrangement. There is a range of quality monitoring systems in place including surveys, staff and resident meetings each of which enable people to be consulted on how the home is run. The Registered Providers need to ensure they make unannounced monthly visits as part of the monitoring process and make the subsequent reports available for inspection. The Head of Care holds some monies on behalf of some people living in the home and all transactions are recorded and receipts obtained as necessary to ensure no one is at risk of financial abuse. Information in the AQAA indicated that all safety checks are carried out regularly and that all policies and procedures are reviewed annually. There were records to show that a fire risk assessment has been carried out and that staff have been trained in fire safety. These measures are in addition to regular fire drills which ensure both people living in the home and staff are clear on what action to take in the event of fire. Crescent House DS0000014193.V363376.R01.S.doc Version 5.2 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 X X 3 2 X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 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 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 2 Crescent House DS0000014193.V363376.R01.S.doc Version 5.2 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 OP4 Regulation 14 (1) (d) Requirement That the pre-admission document be expanded to include information as to how the home will meet assessed needs. That all service users have a completed care plan. Risk assessments undertaken for those at risk falls must include the management of the risk and be regularly reviewed. Food and fluid intake records must be maintained for all service users that require them as under Regulation 17 (1) (a). That all medication administration records are clear accurate and up to date. That the home is conducted to ensure the dignity of service users is protected and promoted at all times. That water delivery temperatures are at a level that does not put service users at risk. That call bells are accessible to service users. That bathing facilities are DS0000014193.V363376.R01.S.doc Timescale for action 19/07/08 2 3 OP7 OP7 15 (1) 13 (4) (b) (c) Sch3 (o) 13(4)(b) (c) 13 (2) 12 (4) (a) 19/06/08 19/07/08 4 OP7 19/06/08 5 6 OP9 OP10 19/06/08 19/06/08 7 OP19 13 (4) (b) (c) 16 (2) (c) 23 (2) (j) 19/06/08 8 9 OP19 OP19 19/08/08 19/09/08 Page 23 Crescent House Version 5.2 10 OP19 11 OP31 12 13 OP31 OP33 14 OP38 provided on the first floor that meet the needs of service users. 23(2)(b) That all parts of the home are & kept in a good state of repair 23(2)(d) and are reasonable decorated to ensure that residents live in a safe and comfortable environment. (timescale of 30/08/07 not met). 10(1) That the registered provider and the registered manager shall having regard to the size of the home, the statement of purpose, and the number and needs of service users carry on or manage the care home with sufficient care, competence and skill. (timescale of 30/08/07 not met). 17 (1) 92) That the use of correction fluid (3) on documents ceases. 26 (1) (3) That the Registered Provider (4) (5) make monthly visits to the home and make the subsequent reports available to the CSCI. 23(4)(aThat fire doors are not wedged e) open. 19/09/08 19/08/08 19/06/08 19/07/08 19/06/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP12 Good Practice Recommendations That service users have the opportunity of going out of the home on outings or trips of their choice in order to enhance their lives. That the staff induction training be implemented for all new staff. 2 OP30 Crescent House DS0000014193.V363376.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V363376.R01.S.doc Version 5.2 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. 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