Inspection on 18/10/05 for Eastbrook House

This inspection was carried out on 18th October 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

Eastbrook House 17/11/09

Eastbrook House 08/12/08

Eastbrook House 02/08/06

Eastbrook House 16/05/05

Eastbrook House 15/02/05

Eastbrook House 04/05/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Eastbrook House 16 Eastbrook Avenue London N9 8DA Lead Inspector Peter Illes Unannounced Inspection 18th October 2005 10:15 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 Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 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. Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Eastbrook House Address 16 Eastbrook Avenue London N9 8DA 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) 020 8805 6632 020 8805 6637 easterbrookhouse@btopenworld.com Mr Roland Jenkins Beacham Mrs Janet Beacham Mr Johnathan Beacham Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43) of places Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th May 2005 Brief Description of the Service: The home is owned by Mr & Mrs Roland Beacham and managed by their sons Jonathan and Richard, the former being the registered manager. Eastbrook House has been run by the Beacham family for the past twenty years. The home is registered to provide care for forty three older people. The number of double rooms had been decreased so that there is now only one double room. At the time of the inspection there were forty service users living in the home. The communal space includes three lounges and a dining room. There is a passenger lift and the garden is to the rear of the property. Eastbrook House is situated in a quiet part of Edmonton at the end of a short residential road. The home is accessible by public transport and within ten minutes walking distance of the local amenities. The home aims to provide a safe and caring environment for service users. Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took approximately six and a quarter hours with one of the home’s managers being present or available throughout. The registered manager was not on duty at the time but briefly visited the home on the day. The home had made a decision to limit the maximum number of service users to forty while it further reviewed the use of its double rooms. There were forty service users accommodated and no vacancies at the time of the inspection. The inspection included: discussion with nine service users, seven of them independently; brief discussion with two relatives and a friend of a service user who were visiting the home at the time of the inspection and independent discussion with eight staff including the two heads of care, the home’s cook, activities coordinator/ care staff and four other care staff. Further information was obtained from a tour of the premises, and a range of documentation kept at the home. What the service does well: What has improved since the last inspection? Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 Page 6 The home has met eleven requirements made at the last inspection leaving three that are restated. The improvements made are in the following areas: assessment of skin vulnerability, notifying CSCI of significant incidents, food storage, adult protection, two maintenance items, staff training, staff supervision, and three identified areas regarding medication. The home had also acted satisfactorily on three recommendations made regarding medication issues. 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. Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 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 Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Service users who move into the home can be confident that their needs will be assessed at that point to ensure that the home can meet their needs. Their needs continue to be reviewed once admitted so that their changing needs can be identified and properly addressed. EVIDENCE: Four new service users had been admitted to the home since the last inspection. The files of three of these and one longer-term service user were inspected. These all contained satisfactory assessment information that related to their needs at the point of admission. The home’s staff had undertaken the assessments and two of the service users files also contained assessment information provided by the referring authorities. The two heads of care were able to describe the service users needs and other care staff were able to demonstrate an appropriate knowledge of the service user’s needs when spoken to throughout the inspection. The home does not provide intermediate care. Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 9 Service users needs are generally well set out in their care plans. However, further attention is still needed to one identified service user’s risk assessment to ensure that detailed guidance is available to staff on how to minimise an identified risk. Service users health needs are monitored and addressed with service users being supported to access a range of healthcare professionals as appropriate. Further attention is needed with regard to contact with the GP in identified circumstances. Annual health checks would also benefit the promotion of service users good health. The home has policies and procedures in place regarding medication to protect service users although the implementation of these need improving with regard to administration of medication. EVIDENCE: The four service user files inspected all contained up to date care plans that had been based on service user’s assessed needs. The two heads of care informed the inspector that they reviewed the care plans of all service users with the respective allocated key workers. There was evidence seen on the care plans to substantiate this. Relevant risk assessments were also seen on the files that were seen to inform the care plans. These included standard risk assessments for all the service users including nutrition, body mass index and Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 Page 10 moving and handling. The inspector was pleased to see that the home had introduced a regular skin vulnerability assessment tool for all service users, as required at the last inspection, to minimise the risk to fragile skin. At the last inspection it was also required that guidance for staff in minimising the identified risk regarding one service user who smokes must be clearly agreed and recorded on his care plan. Although some further information had been included on the file this was still not sufficient. It is required that the risk assessment includes that the service user must only smoke in the designated area of the home, that staff retain his smoking material at other times including when the service user is in their bedroom and that the service user is restricted to the amount of smoking material they can access during the course of the day. There must also be evidence that the service user has agreed to these restrictions. The requirement is restated. The inspector was informed that all service users were registered with a GP and evidence to substantiate this was seen on the service user files inspected. There was also evidence that service users are supported to access other health care professionals including: optician, dentist, chiropodist and community nurse. Service users spoken to confirmed that this was the case. The home is complying with a requirement made at the last inspection that identified significant events such as a service user being sent to hospital on an unplanned basis are notified to the CSCI. While inspecting service users care plans the inspector noted that one identified service user had been prescribed medication by their GP by telephone to assist staff deal with the service user’s aggressive behaviour. The inspector also noted that approximately two weeks later the medication had been changed by the GP as it was reported that the first medication was not proving effective. Again, the record showed that this change of medication had been prescribed following a telephone conversation between the care staff and the GP. One of the head’s of care confirmed that the GP had not seen the service user during this period. The head of care stated that this happened with other service users from time to time with the GP apparently trusting and acting on the staff’s description of a situation by telephone. A requirement is made that the home must make all practical efforts to support service users to be physically seen by their GP if circumstances relating to their health needs change, particularly if that results in a change to their prescribed medication. A clear record is to be kept in each case if this cannot be complied with including the reason for this. One of the heads of care stated that all service users were given a healthcheck when they first registered with a GP but a number did not have annual health checks as a matter of course. A recommendation is made that the home requests the relevant GP’s to provide an annual health check for all service users. Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 Page 11 There was evidence that the home had complied with three requirements regarding medication made by the CSCI pharmacy inspector at the last inspection. These related to checking medication entering the home, signing for administering medication to individual service users and regarding documentation when medication is given to service users who are going to stay away from the home for planned leave. Recommendations relating to a summary of the medication policy, medication profiles and homely remedies were also seen to have been acted on. The medication and medication administration records (MAR) charts were inspected for three service users at random and were seen to be satisfactory. During the course of the inspection the inspector found a medication pill on the floor of one of the service user’s lounges. This was identified as a prescribed medication pill by a member of care staff and that it should not have been on the floor. One of the heads of care told the inspector that all care staff who administered medication were reminded regularly that they must directly supervise service users take their medication and report and record if a service user is having difficulty with this. A requirement is made that staff administering medication must observe service users taking their medication and report any difficulties regarding this. Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 & 15 The home continues to provide a range of appropriate activities to meet service users needs and wishes and that contribute to service users social opportunities. Service users are also supported to maintain and develop relationships with relatives and others to the extent that they wish. The home serves varied and healthy meals that service users enjoy although further attention is needed to food storage. EVIDENCE: The home continues to offer a range of activities both inside and outside the home. The home has a part time activities coordinator who remains enthusiastic about her job and confirmed that she keeps the activity programme offered to service users under review. Service users and relatives spoken to confirmed that the home provided music and movement, art and craft, bingo and regular outings by minibus to various places of interest. Photographs were seen displayed in the entrance to the home from a number of outings throughout the summer including a trip to Clacton. The home also has a programme of entertainers who visit the home during the year. Relatives and friends spoken to confirmed that they were made welcome at the home when they visited and had the opportunity to speak to service users in Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 Page 13 privacy if they wished to. One relative spoken to stated that they thought the care at the home was good and felt they could comfortably approach staff if they wished to discuss issues with them. Evidence was also seen from the visitor’s book that the home receives significant numbers of visitors each week. Service users spoken to were complimentary about the meals served at the home. The lunchtime meal served during the inspection looked appetising and well presented and one service user told the inspector that it was always as good as that. The cook was spoken to and confirmed that she was now responsible for all food stored in the kitchen as required at the last inspection. The home had adequate supplies of food that were seen to be stored appropriately and corresponded to the home’s menu, which was also seen. The cook confirmed that the home could provide appropriate meals to cater for special diets such low fat and gluten free. It was noted that one of the fridges in the kitchen had a range of staff’s packed meals stored that some staff had bought into the home for their meal break. This food was not the responsibility of the home and was not separated from food being stored for service user’s meals that is the responsibility of the home. A requirement is made that any staff food bought into the home is stored appropriately and separately from service user’s food. Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Service users and their relatives can be confident that concerns raised will be effectively dealt with by the home. The home has adult protection policies and procedures in place to assist protect service users from abuse. EVIDENCE: The home has a satisfactory complaints procedure that was seen displayed in the entrance to the home. The manager on duty stated that no new complaints had been recorded at the home since the last inspection and the complaints book was seen to confirm this. Service users and relatives spoken to indicated that they had no concerns about the home but that if they did they felt confident that the managers would listen to and act on their concerns. The home had introduced a distance learning protection of vulnerable adults training programme to the home following a requirement made at the last inspection. The written course material was seen along with evidence that relevant material on adult protection had been placed in the staff room for staff’s information. The inspector was informed that three staff had successfully undertaken the distance learning course and a rolling programme was under way for other staff to do so. Staff spoken to confirmed this and were aware of the adult protection material that had been placed in the staff room. The home also had a copy of the latest local authority adult protection policy and procedure for the local authority the home was situated in. Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 24 & 26 Service users live in a home that overall is safe and well maintained. They benefit from sufficient numbers of toilets and bathrooms although identified maintenance regarding some of these is still needed. Service users bedrooms suit their needs with the facilities in some being upgraded to further meet service users needs. The home was clean and tidy throughout creating a pleasant environment for those living there and visiting. EVIDENCE: The manager on duty accompanied the inspector on a tour of the three floors of building, a number of bedrooms were inspected at random as part of the tour. The inspector was pleased to see that the home was in the process of implementing a programme of replacing identified worn vanity units in service user bedrooms as required at the last inspection. Service users spoken to indicated that they liked their bedrooms and could have their own possessions in them if they so wished. The inspector was also pleased that an identified Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 Page 16 maintenance issue in a first floor shower room had also been satisfactorily dealt with. A requirement had been made at the last inspection that the home ensured that the central ventilation system to the bathrooms and toilets without windows on the ground and first floors was working effectively. The manager on duty showed the inspector work that had been undertaken to the central extractor fan to the system so that this could operate effectively and tested the system to demonstrate this. The system was still not in use however because when operating the fan, situated in the roof above the second floor made an unacceptable noise that vibrated through the service user bedrooms on that floor. The manager stated that parts had been ordered by an identified company that should reduce the noise to an acceptable level that would allow the ventilation system to be in use at all times. It was not clear at this inspection how long this would take and the requirement is restated with a renegotiated timescale. The home was clean throughout during the inspection and despite the ongoing difficulty with the ventilation in the ground and first floor toilets and bathrooms the home was free from offensive odours. The home had a satisfactory system for dealing with soiled waste and staff spoken to were aware of the home’s procedures regarding infection control. Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 An effective staff team, in sufficient numbers, address service users needs. The home is committed to providing relevant qualification training for staff to ensure that service users are in safe hands. The home still needs to improve its recruitment procedure to maximise protection for service users. Service users also benefit from a staff group that have access to a range of training opportunities to keep their skills updated. EVIDENCE: A satisfactory and up to date staffing rota was seen. The rota indicated the following numbers of staff on duty in the home: Seven care staff working on the early shift, six staff working in the afternoon up until 6 pm, four staff working from 6 pm until 9 pm, three staff working between 9 pm and 10 pm and two waking night staff. One staff member told the inspector that the work can be very demanding at busy times of the day. The manager acknowledged this and indicated that the management team monitored staffing levels on an ongoing basis. Domestic staff and a cook are employed in addition to the above. Staff on duty during the inspection matched those recorded on the rota. The manager on duty indicated that the home continued with a rolling programme of training staff to national vocational qualification (NVQ) level two in care. This was so that the home continues to employ a minimum of fifty percent of care staff with this qualification. Evidence from staff files sampled and discussion with care staff supported this. Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 Page 18 A requirement was made at the last inspection that all staff employed at the home have satisfactory enhanced criminal records bureau (CRB) and protection of vulnerable adult (POVA) clearances and that four identified staff members were supervised at all times until these had been obtained. Evidence was seen that this requirement regarding the four identified staff had been complied with. Three new care staff had been employed since the last inspection and their staff files were inspected. One of these staff files contained the necessary documentation to evidence a satisfactory recruitment procedure including two references, proof of identity and satisfactory enhanced CRB and POVA clearances. The inspector was disappointed to find that one of the other staff had only one reference on file and neither of the other two had satisfactory enhanced CRB or POVA clearances. The registered manager visited the home during the inspection and he telephoned the CRB office to query one of theses clearances, stating that the home had applied for this in July 2005. The registered manager stated that the CRB office had told him that CRB were still waiting for a response from the police. He went on to say that, in his experience, there was now a significant delay in obtaining all clearances from the CRB office. The above requirement is restated and amended that the two identified staff must be supervised at all times until the satisfactory clearances are received. At the last inspection a requirement was made that the distance learning training for care staff in first aid and moving and handling was to be supplemented with direct face-to-face input from a trainer. The inspector was informed that one of the home’s management group had subsequently undertaken and passed a training course in July 2005 to enable them to provide practical moving and handling training for staff. Evidence to verify this was not available at the inspection and a requirement is made that this evidence is forwarded to the CSCI. The inspector was also informed that future first aid training would now be purchased for staff from a neighbouring local authority and this would be taught in the conventional way. A staff member spoken to confirmed that they had been booked on this first aid training by the home. There was evidence of a satisfactory overall training programme for staff. Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 36 Service users and other stakeholders benefit from the home being run by a competent manager. Staff are appropriately supervised and this assists them with both their own professional development and in meeting service users needs. EVIDENCE: The registered manager has over three years experience in his post and has passed his registered managers award. Service users and relatives indicated to the inspector that they hold him, and the rest of the management team, in high regard. Several stated that if they had a concern they would have no hesitation of raising it with the registered manager and were confident that they would be listened to and their concern acted upon. At the last inspection a requirement was made that all staff had individual supervision at least every two months. At that inspection it was identified that the two heads of care and the home’s cook were not receiving formal Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 Page 20 supervision as outlined in the national minimum standards although did feel themselves well supported. The inspector was pleased to see evidence that recorded individual supervision sessions had started and that the staff this related to felt the supervision was useful. Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 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 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 2 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X 3 X X Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 13(4)(b) Requirement Timescale for action 30/11/05 2 OP8 12(1) The registered persons must ensure that guidance for staff in minimising the identified risk regarding one identified service user who smokes must be clearly agreed and recorded on his care plan as indicated in the body of this report. (timescale of 30/6/05 not met) 30/11/05 The registered persons must ensure that all practical efforts are made to support service users to be physically seen by their GP if circumstances relating to their health needs change, particularly if that results in a change to their prescribed medication. A clear record is to be kept in each case if this cannot be complied with including the reason for this. The registered persons must ensure that all staff that administer medication observe service users taking their medication and report any difficulties regarding this. 30/11/05 3 OP9 13(2) Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 Page 23 4 OP15 16(2)(g) & 13(4). 5 OP21 23(2)(p) 6 OP29 19(5), Sch.2(7) 7 OP30 18(1)(c) The registered persons must ensure that staff’s own food is stored appropriately and separately from service user’s food. The registered persons must ensure that the central ventilation system to the homes bathrooms and toilets is working effectively. (timescale of 30/6/05 not met) The registered persons must ensure that all staff employed have satisfactory enhanced CRB/ POVA checks and that the two staff now identified without these are closely supervised at all times by staff with such clearance in the interim. (timescale of 30/6/05 not met). The registered person must send to the CSCI evidence that an identified senior member of staff is now qualified to provide practical moving and handling training to care staff in the home. 30/11/05 31/12/05 30/11/05 30/11/05 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 OP8 Good Practice Recommendations The registered persons should request the relevant GP’s to provide an annual health check for all service users. Eastbrook House DS0000010643.V252161.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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. 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