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Inspection on 06/12/07 for Ealing House Residential Home

Also see our care home review for Ealing House Residential Home for more information

This inspection was carried out on 6th December 2007.

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.

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

What the care home does well

The owner/manager has a very person centred approach to care and the best interests of those living in the home are at the heart of changes being made. The home is well decorated and homely. Even the containers for aprons and gloves used in each person`s room had been covered with material to match furnishings so that they were less obtrusive. The quality of care plans is excellent with all formal assessments completed. Staff were knowledgeable about individuals in their care.

What has improved since the last inspection?

The Statement of Purpose and service user guide have been updated but the manager is aware that this will need to be done regularly when new beds become available and other changes to the home are made. The manager and her deputy have been providing staff with regular supervision. Records relating to accidents or incidents are now placed on a persons file as required at the last inspection. Building work is underway to provide 3 more bedrooms, a new dining room, kitchen and landscaped gardens. The patio area has already been built.

What the care home could do better:

Risk assessments in relation to the building work must be completed to ensure the people living in the home are safe from harm. Staff receive supervision but the manager acknowledged that this is not always written up, which means evidence cannot be provided. Although the senior night carer now audits the medication administration record (MAR) sheets to ensure that any gaps are explained, this does not meet the required level of recording in line with regulations. The temperatures of fridges and freezers must be within safe levels.

CARE HOMES FOR OLDER PEOPLE Ealing House Residential Home 86 Repps Road Martham Great Yarmouth Norfolk NR29 4QZ Lead Inspector Alison Hilton Unannounced Inspection 6th December 2007 08:50 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 Ealing House Residential Home DS0000033998.V356265.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. Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ealing House Residential Home Address 86 Repps Road Martham Great Yarmouth Norfolk NR29 4QZ 01493 740227 01493 740227 ealinghouse@mac.com 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) Mrs Sally Watson Mrs Sally Watson Care Home 14 Category(ies) of Dementia - over 65 years of age (14), Old age, registration, with number not falling within any other category (14) of places Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd November 2006 Brief Description of the Service: Ealing House is a care home providing personal care and accommodation for 14 older people some of whom have dementia. It is owned and managed by Mrs Sally Watson. Ealing House is located in the centre of the village of Martham close to shops, pub and local amenities. It is a short car ride to the coastal town of Great Yarmouth. The home consists of a detached two-storey house, with a variety of communal space. The building is situated within its own grounds, with an enclosed garden at the rear. There are currently major alterations taking place inside and outside the building, which will enhance the lives of those living in the home. There will also be a small increase in numbers of beds available from 14 to 17. The inspection reports are available in the hallway at the home. Information regarding the cost of a bed in the home is available on request. Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We (Commission for Social Care Inspection) carried out an inspection of Ealing House using the Commissions methodology. This report makes judgements about the service based on the evidence we have gathered. The manager completed an Annual Quality Assurance Assessment (AQAA), which was received prior to this inspection. Our evidence also includes an inspection of the home which Alison Hilton, Inspector, made on Thursday 6th December 2007. The manager was present throughout the inspection. A number of records were seen, together with staff personnel files and files of people living in the home. We spoke to staff and people living in the home during the visit. There were 12 people in the home and one person in hospital who returned during the inspection. Surveys were sent to those living in the home, their relatives and staff. People living in the home returned 8 out of 13 surveys. All surveys were completed with the support of family members. Some comments were made such as “They (staff) spend time and listen to me”; “ the doctor or nurse comes to see me if I need them”; “staff are caring and friendly”. Most stated that it was family members who visited and chose the home, and it would be to them they would complain. Relatives returned 10 out of 13 surveys. Comments received from relatives included “ friendly environment. Residents are treated as individuals”; “excellent care and attention to all needs”; “ my mother is very happy”; “ the support and care my relative gets far exceeds what I expected”. One family member commented that they would like more residents without dementia to be living in the home. Staff returned 6 out of 17 surveys. Staff comments included “ the standard of care is very good”; “I think we should do more trips out and more 1-1 time” (this was echoed by two other carers). Several staff commented on the usefulness of handovers. All said they get appropriate training. Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Risk assessments in relation to the building work must be completed to ensure the people living in the home are safe from harm. Staff receive supervision but the manager acknowledged that this is not always written up, which means evidence cannot be provided. Although the senior night carer now audits the medication administration record (MAR) sheets to ensure that any gaps are explained, this does not meet the required level of recording in line with regulations. The temperatures of fridges and freezers must be within safe levels. Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 7 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. Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 8 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 Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 9 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): 1,2,3,5,6 Quality in this outcome area is good. The provider follows an assessment procedure and visits people who may wish to live in the home before they are admitted to ensure their needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Ealing House does not provide intermediate care therefore Standard 6 is not applicable. Information provided in the Annual Quality Assurance Assessment (AQAA) showed that prospective residents are assessed by two experienced members of staff. On arrival at the home further assessments are made in areas such as falls, pressure risk and malnutrition using the Malnutrition Universal Screening Tool (MUST). These were seen on files seen during the inspection. Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 10 All new people coming to live at the home have a Contract of Residence on arrival and these were seen in a separate file in the home. Seven out of eight of the returned surveys for those living in the home said they had received a contract, one was unsure as another relative dealt with the paperwork. Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. The administration of medication is not adequately recorded which means those living in the home are at risk. The care plans are excellent and provide all the information needed so that those living in the home can have their needs met in a positive and individualised way. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There were comprehensive care plans for those people living in the home whose files were inspected. The quality of the care plans is excellent with a large amount of personal detail so that carers know what care needs to be provided and how it should be done. There are extra details such as whether the person likes to wear make up, which shows the staff treat each person as an individual. The home has started to use information provided by the person and / or their relatives to give a pen picture so that staff can understand different needs and behaviours. Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 12 Details provided in the AQAA and on the files inspected showed that several risk assessments are completed. These include pressure areas and the use of pressure relieving aids; the risk of falls with appropriate action to be taken and an assessment by the continence team and appropriate toileting regimes that are put in place with use of allocated individual named pads. The home has the input of CPNs, district nurses, dentists, chiropodist x 2, speech therapist and GPs. Opticians visit regularly and hearing referrals would be made as required. Details of these visits are recorded and evidence was seen during the inspection on individual files. There are currently no people in the home who self-administer their medication and this has been recorded on files seen. Administration of medication is completed on the Medication Administration Record (MAR) chart. At the last inspection there was a requirement that the MAR chart must be signed every time medication was administered. As a result of the requirement the manager put in place a strategy where the night senior checks all MAR charts, notes any signature omissions and gets staff to detail whether the person had their medication or not. However, if the record is not signed at the time the medication is administered by the person who did it, this is not a suitable arrangement. This also brings into question whether there has been effective training and supervision. The manager needs to look at the homes disciplinary procedure in relation to administration of medication recording. Although the AQAA states that medication is administered by staff who have undergone external approved training, the new care administrator has not yet undertaken such training although she has completed some internal training. The Controlled Drugs register was seen and was up to date. Staff were seen and heard to treat those living in the home with respect and to encourage them to do what they could for themselves. Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. The home offers choices wherever possible, from meals, activities and other preferences. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Details in the AQAA showed the home has a shop to allow residents to choose their toiletries and to ensure they never run out. Each person has his or her items labelled, which was seen during the inspection. One person did move into the home with her dog but he became unpredictable in his behaviour and had to be given to a relative. The home has an aquarium. They used to have cats, but the residents did not like them. Details provided in the AQAA showed that leisure activities are offered to the residents and they choose what they participate in. On the day of inspection some were watching staff decorate the Christmas tree, others were watching the news on TV whilst others were having their hair done. The home was due to a Christmas party the following week and trips to the pantomime were being Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 14 arranged. The home recently arranged a boat trip and most people went on it and there are ‘parties’ for special days like Halloween. An entertainer was due to perform on 12th December. There is reminiscence work carried out through ‘memory joggers’ as well as staff painting nails and spending time 1-1 with those living in the home. There is an over 60s club available in the village which is offerred to residents. The manager said she had tried (unsuccessfully to date) to get the local vicar to visit the home on a regular basis. People spoken to during the inspection said they enjoyed what went on and liked to watch the news. Residents have set mealtimes for lunch and tea, but breakfast is served either in their bedroom or in the dining room as preferred. There had recently been an inspection by Environmental Health who awarded the home 4 stars. The kitchen prevented the home receiving the highest grade, but this is due to be replaced within the next year as part of the improvements being made. There will also be a new dining room, which will allow people to sit together and provide more space for those with physical problems who require aids. The home employs two cooks to work opposite each other and they produce the lunch and tea. There is a four-week menu, which rotates with seasonal adjustments. On the day of inspection lunch was a chicken and ham pasty with potatoes, cauliflower, peas and swede; followed by semolina. The cook was aware of those who needed soft diets and others who were diabetic. The manager said that meals are usually staggered so that staff can assist those who need it and can then be available to prompt others. On the day of inspection this did not happen and several people in the dining room did not receive the help they needed due to circumstances outside the control of staff. Ealing House is participating in an Assistive Technology Project looking at the benefits of using Assistive Technology within the care home setting. People in the home are able to have their visitors in private in either their bedroom or a quiet area in the house. The manager said she was trying to find external advocates for those living in the home and had been in contact with Age Concern but was waiting for them to telephone. Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Quality in this outcome area is good. The home has a complaints procedure ensuring that those living in the home and their relatives know how to make a complaint and who to speak to. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information provided in the AQAA and inspection of the document showed that the home has a complaints procedure, which is on display in the hall on the notice board. All contracts seen had reference made to the complaints procedure. Details provided in the surveys showed people knew how to make a complaint although no-one felt they had needed to. All people living in the home are added to the electoral register and appropriate action taken, be this assisting the individual to complete ballot forms in private or their family member to assist them. There is an Adult Protection Policy in place, which has been approved by the Lead for Norfolk County Council (NCC) in Adult Protection. All staff are trained in Awareness sessions through NCC. Any allegations would be put through the Joint Protocol for Abuse. There have been no complaints received at the home or by the Commission. Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 16 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): 19,20,21,22,23,24,25,26 Quality in this outcome area is good. People living in the home have a well-maintained and homely environment. Their rooms contain items that ensure they have pleasant surroundings. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information provided in the AQAA showed that many areas of the home have already been refurbished. The remainder is scheduled to be completed within the next 12 to 18 months. New laundry facilites have been installed with new washing and drying facilites which are compliant with the sluicing facilities required and water regulations. The home has installed an Inco pad macerator for the hygienic disposal of inco pads, washcloths and wash mitts. Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 17 The rear garden will be landscaped and a car park created by February 2008. Although the home has some shared rooms, a curtain down the middle of the room provides privacy. All rooms have curtains around their sinks. There is a payphone for residents in the hallway, but the home has a phone system so those living there can have phones in their bedroom with personalised bills. As the home is upgraded the doors are being fitted with locks so that residents can hold their own key. The manager said that she intends to have old-fashioned signage produced locally so that people who live in the home can more easily understand where rooms such as the toilets are. There was evidence on the files seen that the home has the necessary equipment to ensure the safety and health of those living there. There were no unpleasant odours in the home. The current building work means that at times the home is draughty and on two occasions the heating had to be turned up because those living in the home were cold. Risk assessments must also be completed in relation to the building work (discussed further in Standard 38). Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 18 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): 27,28,29,30 Quality in this outcome area is good. Recruitment procedures are good and ensure those living in the home are protected. Staff are competent, which ensures people are well cared for and their needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information provided in the AQAA stated that the home has 14 carers and three domiciliary staff. The carer hours in the home are approximately 390 per week, not including the Managers hours. This was confirmed on the weekly rotas. When the new extension is opened the manager said that the staffing skill mix and numbers will be reviewed. All new staff are inducted into the work place and have supernumery status for up to three weeks. This was confirmed by staff during the inspection. Information in the AQAA showed that 43 of carers are trained to NVQ Level 2 or above. Many of the remainder are highly experienced with up to 20 years experience. Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 19 The manager said that Tuesday and Thursday are training days and half the staff do training on one day and the other half on the other day to ensure all staff have the opportunity to complete the necessary courses. The home has a rolling programme of training. The manager said that there are scheduled training session which cover all aspects of the statutory training by using DVDs. There are competency questions and answers attached to each element of the training to ensure staff have reached a good level of understanding. Manual handling training was completed in October 2007. First Aid has not been completed yet, as the manager could not source a trainer. The programme for 2008 is January Dementia; February Health and Safety, COSHH and Infection Control; March Diabetes and MUST; April Adult Abuse and May medication administration. The manager and deputy have undertaken the Dementia Care Mapping course (Oct 07). Staff spoken to during the inspection said they received the appropriate training they needed to do their job. However there was evidence that even where staff are completing training their competency must be questioned (see Standard 9). This was in relation to the Medication Administration Record (MAR) charts, which are not being completed properly. In the surveys staff commented on the usefulness of handovers to pass on information and know what happened on the previous shift. Those living in the home had a high regard for the staff. Some comments made were that “Staff are amicable”; “They (staff) spend time and listen to me”; “staff are caring and friendly”. Relatives’ comments in the surveys included “friendly environment. Residents are treated as individuals”; “excellent care and attention to all needs”; “my mother is very happy” and “the support and care my relative gets far exceeds what I expected”. Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 38 Quality in this outcome area is adequate. The manager runs the home well and for the benefit of those people living there so that their interests can be safeguarded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Details in the AQAA showed that the manager had been running the home since 2001. Prior to that she was a Senior Nurse in the Health Service, where she gained the Certificate in Management. The manager is a NVQ Assessor, and keeps up to date professsionally by reading Journals and attending relevant training sessions. She said that she is also a qualified Manual Handling Trainer. Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 21 The manager said that she and her deputy have started to complete formal supervision, but this is not always written. The manager was reminded that supervision must be recorded to evidence that it is taking place and should include aspects of practice, philosophy of care in the home and career development. The fridge and freezer temperatures were both above the required level. The fridge should have been a maximum of 5 degrees and was 10 (had been up to 11). The freezer should have been a maximum of 18 degrees and was 21 and had been up to 23 degrees. Food kept in the fridge had not been covered or dated (apples and cream) and cheese had not been dated when opened. The home must complete a risk assessment in relation to the work being carried out on the premises to ensure that all those living there are kept safe and well. The manager did explain all the things in place to ensure the safety of those living there but there must be a formal record so that staff have something to refer to in necessary. The finances of three people living at the home were seen and found to be correct. Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 2 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 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 2 X 1 Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 (2) Requirement The home must have suitable procedures for the recording of medication to ensure the safety of those living in the home. This requirement has not been met in the previous timescale of 23/11/07. Staff must receive training and be competent to administer and record medication to ensure the health and safety of those living in the home. The fridge and freezer temperatures must be kept at the appropriate temperatures to ensure people living in the home are not at risk. Food kept in the fridge must be covered and dated once opened to ensure the health of those people living in the home. The home must complete a risk assessment in relation to the work being carried out on the premises to ensure that all those living there are kept safe and well. Timescale for action 14/12/07 2 OP30 13 (6) 18 (1) 31/12/07 3 OP38 12 (1) 14/12/07 4 OP38 16 (2)(g) 06/12/07 5 OP38 13 (4) 14/12/07 Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP36 Good Practice Recommendations The manager should record supervision to provide evidence it has taken place. Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Ealing House Residential Home DS0000033998.V356265.R01.S.doc Version 5.2 Page 26 - 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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