Inspection on 17/08/06 for Eastfield House

This inspection was carried out on 17th August 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Eastfield House 13/03/08

Eastfield House 28/02/06

Eastfield House 21/10/05

Eastfield House 08/12/04

Eastfield House 12/08/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Eastfield House Eastfield Lane Whitchurch on Thames Oxfordshire RG8 7EJ Lead Inspector Delia Styles Unannounced Inspection 17th August 2006 10:40 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 Eastfield House DS0000037997.V306519.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. Eastfield House DS0000037997.V306519.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eastfield House Address Eastfield Lane Whitchurch on Thames Oxfordshire RG8 7EJ 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) 01189 842586 01189 842179 eastfieldhouse@majesticare.co.uk Eastfield House Limited Mrs Mary Bayliss Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27), Physical disability (2) of places Eastfield House DS0000037997.V306519.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The total number of persons that may be accommodated at any one time must not exceed 27 The PD category refers to one named resident under the age of 65. Date of last inspection 28th February 2006 Brief Description of the Service: Eastfield House is situated in the village of Whitchurch-on-Thames. The home is registered to provide personal care for 27 male and female service users aged 65 years and over. District nurses visit the home to provide nursing care. Communal space comprising two lounges and a separate dining room is located on the ground floor. Bedroom accommodation is situated on the ground and first floors and there are also five flats for independent living in the grounds of the home. Room sizes and amenities are listed in the home’s Statement of Purpose and Service User Guide. A good range of activities is provided and regular trips to places of interest are arranged. The gardens surrounding the home are well maintained and provide extremely pleasant outdoor amenities. The current fees for this home range from £450 to £700 per week. Eastfield House DS0000037997.V306519.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’ . A key inspection looks at those National Minimum Standards for the service considered most important by the Commission and that should be assessed at least once in every 12 months. The inspector arrived at the home at 10.40am and was there for 5½ hours. The inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that the CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the service and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. A total of nine residents’ comment cards – ‘Have Your Say About Eastfield House’ – were received by the inspector before the inspection. Six of the nine questionnaires were completed with the help of residents, relatives or a staff member. A comment card was received from the GP of the local surgery that provides medical care to the residents. Five health and social care professionals who visit the home also returned questionnaires, as did four residents’ relatives. The inspector looked at how well the service was meeting the standards set by the government and has, in this report, made judgements about the standard of the service. The inspector toured the building, spoke to the deputy manager, house manager, a care leader and several staff members and residents during the day. The company’s operational manager was also visiting the home during the morning of the inspection and discussed some of the quality assurance, training and development aspects for the home. A sample of residents’ care plans and records, staff recruitment and induction records and other records about the maintenance and running of the home were examined. What the service does well: The home is clean, bright and well maintained so that residents have attractive and comfortable rooms, shared dining and sitting rooms, and well-maintained and attractive gardens to enjoy outside. Residents and their families are appreciative of the way in which staff care for them. Some of the survey comments made were: ‘I am very satisfied with the level of care that my [relative] receives at Eastfield House. All the staff are friendly, helpful and very patient’. ‘I am very happy here – the gardens are lovely. Well cared for’. Eastfield House DS0000037997.V306519.R01.S.doc Version 5.2 Page 6 ‘I feel I’m looked after in a good home and couldn’t ask for anything more’. Health and social care professionals’ survey comments also support the residents’ opinions of the home and the staff, for example: ‘Excellent care provided by the home. Good training provided for staff. Happy, relaxed atmosphere. I have always found good practice in this home’, and ‘This is an excellent home, very friendly with caring and helpful staff. Very professional manager with a good understanding of client needs. My clients have been/are very well cared for in pleasant surroundings’. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Eastfield House DS0000037997.V306519.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 Eastfield House DS0000037997.V306519.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents’ care needs are fully assessed before they come into the home, so that they can be confident that the home will suit them and provide the level of care they need. Standard 6 is not applicable as the home does not provide intermediate care. EVIDENCE: The inspector looked at the pre-admission assessments for two recently admitted residents, and for one resident whose needs have changed substantially since their initial admission. The manager visits prospective residents in their homes or in hospital (if they have needed hospital treatment) to assess whether the home can meet their care needs. The home uses the company’s detailed pre-admission assessment form. There was detailed information about people’s care needs. The comment cards received from residents showed that they felt they had had enough information about the home before admission to make an informed decision that it was likely to meet their expectations and care needs. Eastfield House DS0000037997.V306519.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The planning and delivery of care is good, so that residents’ individual health and personal care needs are met. The medication system is safe and satisfactory but some aspects of the medication records could be improved. EVIDENCE: A sample of three residents’ care plans was looked at. These are of a good standard and show that regular review and updating of residents’ care needs and records is made. Residents sign a self-medication form to indicate that they accept the responsibility for managing their own medication if they wish to, and have been assessed by the doctor as able to self-medicate. Eastfield House DS0000037997.V306519.R01.S.doc Version 5.2 Page 10 The medication administration records (MAR) were seen by the inspector and were complete in terms of the date and time medicines are given to residents. However, as at the last inspection, the inspector noted that some handwritten alterations had been made by staff that were not countersigned by the doctor or a second staff member. For example, one resident’s eye drops were to be given more frequently, on the instructions of staff at a clinic s/he had recently attended. The instruction on the MAR sheet had been made, but had not been dated or signed by the staff member. Another resident’s regular medication dosage had been increased on the instruction of the doctor. Alteration to the MAR sheet had been made, but was unsigned and potentially could have been confusing for the staff administering the tablets, although the correct dosage had been set out by the pharmacist in the sealed blister pack of medication. Instructions for another resident to receive ear drops did not specify the type of drops or the duration of this treatment. Again this was not signed by the staff member or countersigned by a second member of staff. All handwritten entries should be dated and signed at the time they are made and, to avoid the risk of mistakes, checks should be made by a second person who then should countersign the first person’s entries. The deputy manager said that the home had recently changed to a different pharmacist who supplies residents’ medicines in individual named blister pack (Nomad) cards for each resident, with their prescribed dose of medication for the various times of day. The deputy said that this system is lighter and easy to use, and takes up less storage space. It is also now easier to have new resident’s prescriptions made up and supplied in the blister packs. The staff responsible for administering medication to residents have attended relevant training. Observation of interactions between staff and residents showed that residents feel comfortable and relaxed in the home and able to influence their care and ‘do their own thing’ as far as possible. From the evidence seen by the inspector and comments received, the inspector considers that the home would be able to provide a service to meet the needs of individuals of various religious, racial or cultural backgrounds. The comment cards received from a GP and health and social care professionals are very positive about the standard of care given to residents in this home Eastfield House DS0000037997.V306519.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good range of activities within the home and community so that residents have the opportunity to join in social and recreational events that interest them. The residents enjoy meals and mealtimes, and menus offer choice and variety. EVIDENCE: From conversations with the activities organiser, residents and other staff, it is clear that the social and recreational aspects of residents’ care are given high priority. There is a varied programme of activities and entertainments that appear to suit the needs of most residents. There were examples of residents’ handicraft work on display – decorated bird nesting boxes, plant pots, knitted items and decorative bowls of varnished dried pasta, seeds and pulses – some of which were for sale. The home was busy preparing for a fete to be held at the weekend following this inspection and residents and staff were all involved. Efforts are made to meet the interests and pastimes of some of the male residents by having a regular afternoon of card games, dominoes and drinks specifically for them. Eastfield House DS0000037997.V306519.R01.S.doc Version 5.2 Page 12 One resident has a greenhouse in the garden and had a good crop of tomatoes. The home has a piano and has recently invited volunteer pianists to come and play for the residents. Two lay readers from the local Anglican Church lead a time of Christian worship in the home each week. Residents, who wish to and are able, attend the local church services. The home has the use of a minibus (shared with two other homes owned by the same company) and residents have regular opportunities to go shopping and to visit local garden centres and places of interest. The activities co-ordinator organises a small trolley shop stocked with items requested by residents (toiletries, sweets, etc) and bought and sold at cost price to residents. Conversation with residents, and their written responses to questions about meals in the residents’ comment cards, confirmed that the quality and variety of meals is good. The menu sheets were on the mantelpiece in the dining room, and it was not clear which week of the menu cycle was being followed. There were two changes made to the stated menu choices for lunch - toad in the hole had been changed to sausage casserole at the request of residents that morning, and rice pudding had been replaced by pineapple upside-down pudding as there was an unaccountable shortage of milk. The cook said changes to the day’s menu were rare, and she consults with the residents to let them know and ask their preferences for alternatives before preparing the meals. The home manager meets with residents regularly and food and mealtimes are part of the discussions to make sure that residents’ opinions and suggestions are acted on. The standard of the environment in the dining room is also regularly checked as part of the home’s own quality audit. The dining room is attractively decorated and the dining tables (each seat up to four residents) are set with linen tablecloths and napkins, small flower vases, cruets and condiments. Eastfield House DS0000037997.V306519.R01.S.doc Version 5.2 Page 13 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents feel safe and listened to. There are systems in place and staff understand and implement the home’s adult protection procedures. EVIDENCE: Residents’ and relatives’ comment card responses showed that most people know how to make a complaint and who to raise any concerns with (one resident was ‘not sure’ and another said they did not know how to make a complaint). The home’s complaints procedure was on display on the doors of most residents’ rooms, in the reception area, and is included in the Service User guide booklet. No complaints have been received since the last inspection, either by the home or the Commission for Social Care Inspection. The home has taken appropriate action to alert Social Services colleagues in relation to a suspected adult protection risk concerning a resident. Staff have regular training about adult protection issues. The deputy manager and house manager could not locate the Oxfordshire Multi-Agency Codes of Practice for the Protection of Vulnerable Adults at the time of the inspection. The inspector recommends that reference to the local guidelines is made in the home’s policies and procedures, and that all staff have access to the information booklets. Eastfield House DS0000037997.V306519.R01.S.doc Version 5.2 Page 14 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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and the standard of décor and furnishings are good, providing residents with an attractive and comfortable environment. EVIDENCE: The home is clean and fresh smelling throughout except for one room where the carpet smelled strongly of urine despite frequent cleaning. The deputy manager said that there are plans to replace the carpet. Residents’ rooms are well decorated and personalised with their own possessions and ornaments. Residents appreciate the good standard of cleanliness and the décor. Six of the nine survey responses stated that the home is ‘always’ fresh and clean and three said that this is ‘usually’ so. Eastfield House DS0000037997.V306519.R01.S.doc Version 5.2 Page 15 The home uses a commercial laundry service for bed linen and towels. There was an ample stock of good quality clean towels and linen in the store cupboards. Residents’ personal clothing is laundered in-house. The home’s house manager oversees the maintenance and domestic work in the home. A maintenance person undertakes routine maintenance and repairs and a part-time gardener maintains the gardens. The gardens are very attractive and colourful with summer bedding plants. Eastfield House DS0000037997.V306519.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a consistent staffing complement and there is a good system of training in place, so that residents benefit from a reliable and skilled care team. EVIDENCE: A senior carer and two care staff were on duty throughout the day. In addition the deputy manager and house manager were on duty until 4.00pm. The activities co-ordinator and laundry assistant were on duty between 10.00am and 4.00pm and 3.00pm respectively. The maintenance man worked from 9.30am to 3.30pm. The chef manager worked from 8.00am to 5.00pm, and a kitchen assistant from 8.30am to 2.30pm. One domestic worked from 8.00am to 2.00pm. One carer is on duty overnight, with another carer on call within the home. This number of staff meets the requirements of the home’s staffing statement agreed with the CSCI and meets the needs of the current residents. The home benefits from having a low staff turnover so that residents and staff get to know each other well creating a relaxed and positive atmosphere in the home. Five of the current nine care staff have a National Vocational Qualification (NVQ) at Level 2 and two more are currently working towards this award; others are now working for Level 3. The home meets the recommended percentage (50 ) of care staff with a nationally recognised qualification in care. Eastfield House DS0000037997.V306519.R01.S.doc Version 5.2 Page 17 Staff induction and training records show that the home is committed to providing on-going training and development opportunities for all staff. The inspector looked at three staff files and found that they were well organised. They showed that since the last inspection the home has improved the system for ensuring that all the necessary references and checks have been received prior to appointing new staff to work in the home. There is evidence that staff have regular formal supervision meetings with senior managers to discuss their work and progress in the home. Eastfield House DS0000037997.V306519.R01.S.doc Version 5.2 Page 18 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, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management arrangements in the home are good and meet the needs of the residents. Residents’ views are valued and influence the running of the home. The home has effective quality assurance systems in place. EVIDENCE: The registered manager, Ms Mary Bayliss, was on holiday when this inspection took place. She has extensive experience in her role and has achieved the Registered Managers Award (NVQ Level 4), the required formal qualification for managers of care homes and agencies. Comment cards from professional colleagues are very positive about her abilities, for example, ‘Mary Bayliss takes pride in maintaining a high standard of care’, ‘Very professional manager with a good understanding of client needs’. Eastfield House DS0000037997.V306519.R01.S.doc Version 5.2 Page 19 There are regular residents’ and relatives’ meetings held in the home – a list of dates for forthcoming meetings is displayed in the entrance hall. Conversation with residents, and their comment cards, confirm that people feel that their opinions are listened to and acted upon by the staff and managers. The inspector saw the results of the home’s own quality audit that is a detailed look at all aspects of the home’s facilities, care and environment, and includes action to be taken to address any shortfalls. The home undertakes to look after small amounts of residents’ personal allowances (‘pocket money’) when they are unable or prefer not to do this for themselves. The procedures for keeping a check on the money received and spent by residents are good. The inspector looked at the home’s accident records and fire safety log book and copies of the ‘Regulation 26’ reports for the home - the provider is required (under Regulation 26 of the Care Standards Act) to visit the home unannounced to check on standards and talk to residents and to write a report of these monthly visits. The standard of record keeping is well organised and up to date. The inspector was told that the home’s own fire protection adviser has recently undertaken a risk assessment for all aspects of fire safety for staff and residents, in line with the fire authority’s new regulatory powers in residential care homes that come into force in October 2006. The inspector observed some potential risks to residents when walking around the building, namely, in one apartment a free standing room heater could cause injury or fire if knocked over, and the trailing flex is a potential trip hazard. A doormat in the same room was curled at the edges and could cause someone to trip over. A wall-mounted fire extinguisher near the rear entrance to the home was not securely mounted. These hazards were discussed with the house manager, to be considered as part of the risk assessment process. There is staff accommodation for live-in staff on the top floor of the house. The inspector recommends that, if not already done, the security of staff and residents is reviewed, for example, ensuring that staff are not permitted to invite visitors to their accommodation without prior permission from a senior staff member, and that,in the event of a fire alarm sounding, the whereabouts of live-in staff is known so that their safety can be checked if the building has to be evacuated. Eastfield House DS0000037997.V306519.R01.S.doc Version 5.2 Page 20 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 X 18 3 3 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 3 X 3 X 3 X X 3 Eastfield House DS0000037997.V306519.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 OP9 Good Practice Recommendations Handwritten alterations to MAR sheets made by staff on the verbal instruction of the doctor should be checked, dated and countersigned by the doctor as soon as possible. If the doctor is not available, the staff member who made the entry should date and sign it and have a second person check and countersign the amendment. Ensure that all staff have access to the local Codes of Practice for the Protection of Vulnerable Adults. Ensure that the potential trip and fire hazards, and fire safety/security issues relating to live-in staff identified and discussed during the inspection are assessed and included in the home’s risk assessments and take appropriate action to reduce risks to the safety and security of residents and staff. 2. 3. OP18 OP38 Eastfield House DS0000037997.V306519.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Eastfield House DS0000037997.V306519.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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