Inspection on 30/08/05 for Elliot Lodge

This inspection was carried out on 30th August 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

Elliot Lodge 11/10/07

Elliot Lodge 11/02/07

Elliot Lodge 07/06/06

Elliot Lodge 27/01/06

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

Ravenhurst

Polesworth Group 64 Long Street

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

CARE HOME ADULTS 18-65 Elliot Lodge Monyhull Hall Road Kings Norton Birmingham B30 3QB Lead Inspector Alison Ridge Unannounced 30 August 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Elliot Lodge Address Monyhull Hall Road Kings Norton Birmingham B30 3QB 0121 444 0187 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) South Birmingham Primary Care Trust Janet Milutinovic Care Home 6 Category(ies) of Learning Disability - Physical Disability - Sensory registration, with number Impairment (6) of places Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. A qualified nurse must be working in the home at all times and must not have responsibility for any of the other Newholmes bungalows. 2. Six people with a learning disability under 65 years in receipt of nursing care. 3. The seven requirements made in relation to the maintenance and decoration of the home at the unnannounced inspection in December 2004 are met by 30 June 2005. Date of last inspection December 2004 Brief Description of the Service: Elliott Lodge is a purpose built care home, on the site of the former Monyhull Hospital. The home is owned by Family Care Housing, and the care and staffing is provided and managed by South Birmingham PCT (NHS) Trust. The accomodation comprises of a communal lounge, dining room, kitchen, shower room, assisted bathroom, wc, laundry, and six single bedrooms. A qualified nurse is on duty across the twenty four hour period. They are supported by a minimum of three care staff during the day, and one care staff at night. The home is conveniently located for Kings Heath and Kings Norton. There are good public transport links. The home has a people carrier towards which the service users contribute financially. Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken between 0745 and 1415 of one day. One inspector conducted the visit. During the visit time was spent talking with people that live in the home, and observing the care and support they receive. Information was also collected by inspecting the premises, reading records about care, staffing and health and safety. What the service does well: What has improved since the last inspection? Staff had received training in fire safety and the use of PEG tubes. The collection and storage of clinical waste had improved. Qualified staff no longer have to support or cover other care homes in the area. They are able to concentrate fully on the people that live in the home. Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 Page 6 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. Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) x None of these standards were inspected. EVIDENCE: The home has no residential vacancies, and no new service users had been admitted since the last inspection. These standards were not assessed. Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,9 Service users needs and risks are not all well planned or delivered. Service users are not consulted regarding their lifestyle or preferences. EVIDENCE: The individual plan of three service users were assessed. The plans contained information about clinical needs and risks. Service users wishes regarding their life goals or aspirations had not been recorded. Blank copies of the Good Life plan on which this will be undertaken were available in the home. One plan had not been fully reviewed and updated since the service user moved into the home. The record made numerous references to his previous home. Staff had reviewed all risk assessments regularly. Clinical risks such as tissue viability had been assessed. Manual handling risk assessments were available. These must be kept under review. Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,17 Service users are not supported to undertake a variety of interesting activities on a regular basis. Service users are not consistently offered a varied, or nutritious diet. Service users are supported to maintain contact with their friends and family. EVIDENCE: It was reported that service users have undertaken a supported learning course, run by a local college. Certificates for work undertaken were on display in some service users bedrooms. The records of activities offered each day were assessed for two of the service users. The inspector found the level, range and frequency of activities to be unacceptably poor. Observation during the inspection did not witness any planned activities, or engagement with the service users except for at meal times, and when offering a drink. Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 Page 11 Opportunities to access the community were very limited, and staff reported the number of staff on duty hampered this. In August the two service users sampled had been out of the home on a total six occasions. Records of activities undertaken in the home were TV, music, bed rest and sensory lights. One service user had been enabled to watch staff cook a meal once, one day a party was held. The inspector made requirements at the time of inspection that this provision be reviewed, and work to increase the activities available to people undertaken. It is recommended that the amount of bed rest be reviewed, and ways of spreading this across the day, to facilitate quality time for service user and staff be explored. It is positive that four of the service users have been on holiday this year, and that another holiday is planned for April 2006. The inspector met with one service users relatives. They reported being made to feel welcome in the home. Care notes also identified that visits and contact with family and friends is maintained and encouraged. The planned menu of food was interesting and varied. The inspector found this varied significantly from the records of food actually eaten. An immediate requirement was made that work to increase the nutritional content of the diet by incorporating a greater number of fruit and vegetables be undertaken. The variety of the diet must also be reviewed. The same or very similar dishes were noted with frequency-such as Faggotts served three times within eleven days. The inspector made an immediate requirement that three service users be reviewed regards their eating and drinking needs. The inspector tracked one service user who is fed by tube. Evidence that the dietician and specialist nurse had been involved was available. The staff support at meal times must be reviewed. During the inspection two care staff, supported four service users to eat. The inspector prompted staff to re-heat the meals of the people that were supported to eat second. The qualified staff was busy over the mealtime with medication and answering the phone. The ratio of staff to service users, and practice over the mealtime did not ensure service users needs were well met. The needs of service users in this area are significant, and the inspector considers it necessary that qualified staff input be provided over the mealtime. Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 Service users are supported to undertake personal care to a high standard. Routine health appointments are offered. Individual health needs must be better planned and delivered to ensure service users needs are consistently met. Medication management is good. EVIDENCE: The service users were all supported with personal care during the morning of inspection. This was undertaken to high standard. The inspector observed one staff offer a choice of bath or shower to one person, which was positive. Care records did not contain any clear guidance on the service users personal care needs, how these were to be met, and their preferences. It has been required this be developed. The plan of care at night is comprehensive and individual. The plans must be dated, signed, and kept under review. The record of health care appointments showed that routine checks with the dentist, optician and GP for example are undertaken regularly. One service user tracked had been prescribed glasses. She had not been supported to wear them at the time of inspection, and no plan regards this was available in her notes. Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 Page 13 Tracking of more specific health care needs, including orthotic appliances and undertaking exercise regimes as prescribed by the physiotherapy team did not evidence that needs were being well met in this area. Epilepsy care plans did not give specific information or guidance. Staff were instructed to follow “SBPCT policy and procedure” It was not clear where this was located, although a copy of an “NBC policy” was available. This was not up to date. Protocols for the administration of rescue medication required completion to detail when the medication is to be used. Regulation 37 notices informed the inspector that some instances of difficult to manage behaviour had occurred with one service user. The staff had made an appropriate referral, and had been recording the incidents. A management plan was in place. It was not evident that the incident reporting was being evaluated to inform and direct future care practice. It was not clear that the staff were using the information collected to the best effect, as the reports generally showed the service user had become distressed by a known trigger It has been required that this area be further explored, and addressed. Staff had made detailed records of body functions. Weight monitoring had not been undertaken with the frequency identified in the care plan. Medication management was generally good. Records of receipt and administration had been made. It was positive that a review of protocols for As Required medicines had been undertaken with the GP. Protocols must be developed for all as required medicines. The management of creams requires improvement. The inspector observed creams that had not been dated, and creams open beyond 28 days in service users rooms. One as required medicine that would be used during specific times of the month requires clear guidance on which days to use it. The inspector observed one service user be administered an indigestion remedy part way through his lunchtime meal. Such practice is not conducive to the effectiveness of the medicine, or to enjoyment of the lunchtime meal. Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) x These standards were not inspected. EVIDENCE: These standards were not inspected. Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29,30 The environment at Elliott Lodge requires attention to the furnishing, décor and flooring to ensure the comfort and safety of service users. EVIDENCE: The presentation of the home was to a poor standard. The décor, some carpets and lounge furniture was excessively worn, stained, and the lounge furniture was odouress. The service manager confirmed that quotes for the work have been obtained, and authority to undertake the work has been requested. All service users have a single bedroom. These were very personalised. Three of the rooms showed excessive wear to the carpets and décor, but all required some attention to bring them to an acceptable standard. The home has an assisted bath, and shower table. These rooms were clean, but required attention to the décor. It was reported, and correspondence was available that the provision of a shower chair and comfortable seating is outstanding for one of the service users. Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 Page 16 The home has a large lounge. It is recommended the layout of this be reviewed to provide a more homely environment. It is recommended that a telephone be provided in the main living area of the home. The cleanliness of the kitchen, and surfaces around the home was acceptable. Floors in all areas of the home required vacuuming, in addition to the deep clean or replacement. Hygienic hand drying facilities must be provided at all communal sinks. Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,34,35,36 The number of permanent staff is not adequate to continuously meet service users needs. Staff require ongoing training to ensure they have the skills to undertake their role effectively. Evidence that service users are protected by robust recruitment practices were not available. EVIDENCE: The staff on duty worked positively with service users. One of the three staff was an established member of staff. Two bank staff were on duty. It was reported that they had worked in the home previously, and known the service users for some time. Two service users were on holiday at the time of inspection, this had a further impact on the staff available to cover the home. Rota for week commencing August 22nd 2005, identified nine bank or agency staff had been used. Only two of these appeared on other weeks of rota. The inspector could not evidence that consistency of staffing had been well managed. The inspector was pleased to observe a detailed handover at the start of the shift, and for a permanent staff member to give a good handover to the bank nurse. Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 Page 18 The number of staff on duty was of concern. During the morning the inspector recorded three twenty-minute periods where service users were left unsupported or supervised. Three of the service users have no means of calling for assistance. The inspector was concerned by risks presented by other service users, one person’s notes stated, “…if unobserved x will attempt to pinch or scratch other service users.” The door to the home was unlocked, and the inspector observed two visitors walk into the home. An immediate requirement that the ratio of staff to service users be reviewed and action taken accordingly was made at the time of inspection. The manager must ensure that a risk assessment regarding the use of D grade nurses is undertaken, in the event of it being necessary to use them. The staff records contained no evidence of recruitment checks. It has been required these be obtained and held in the home. Staff files contained some evidence of training. A previous requirement was that training in the areas of manual handling, fire, food hygiene, adult protection and PEG feeds be undertaken. It was evident training in the areas of PEG and fire had been provided. The supervision records of three staff were assessed. The records showed supervision is undertaken to a good standard, and the content of the supervision balanced. The frequency with which these are undertaken must increase to meet the bimonthly target. Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 41,42 Service users best interests were safeguarded by logical and detailed record keeping. EVIDENCE: A current certificate of registration and employers liability insurance was on display. Service user finances are checked and handed over at each shift change. Money and financial records tallied. It is recommended that the receipts and correspondence record sheet be stored together for audit purposes. The majority of records of health and safety could not be located. It was evident that fire tests are generally undertaken weekly, although at the time of inspection this was outstanding. (19/8 last test) Records of hot water testing evidenced that this is undertaken routinely, and temperatures are within a safe range. Fridge/freezer temperatures are tested and recorded daily. Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 Page 20 The fly screen in the kitchen was open, and the fly screen on the kitchen door was observed to have torn. It is required these items be maintained in a fit for use condition, and used as required. Risk assessments for the premises and staff could not be located. These must be available, or developed. The food risk assessment required further development to ensure all aspects of food purchase, transport, storage, and preparation is assessed. Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 2 3 3 1 2 Standard No 11 12 13 14 15 16 17 1 1 1 1 3 x 1 Standard No 31 32 33 34 35 36 Score x 2 1 1 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Elliot Lodge Score 2 1 2 x Standard No 37 38 39 40 41 42 43 Score x x x x 2 1 x E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard 6 6 9 Regulation 12(2) Requirement Timescale for action 1/12/05 31/10/05 31/10/05 4. 5. 11 12,13,14 6. 7. 8. 17 17 17, 19 9. 18 Service users must be offered opportunity to undertake person centered planning. 12(1)(a) The service users plan must be and 15 kept up to date. 13(4)(a-c) The manual handling risk and 13(5) assessments must be reviewed periodically and as needs change. 16(2)(mService users must be offered n) opportunities to undertake personal development. 16(2)(mService users must be offered a n) range of interesting leisure opportunities in the community and at home. 16(2)(i) A varied and nutritious diet must be availbale and offered to service users. 13(1)(b) Three identified service users must be reffered to the Speech and Language Therapist. 12(1)(aWhere dysphasia guidelines state b) that service users should be 13(1)(b) weighed weekly, this must be undertaken and a record maintained. 12(1)(a) Service users personal care needs must be planned, showing their preferences have been taken into account. E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc 9/9/05 9/9/05 9/9/05 Refferal to be made by 5/9/05 30/9/05 31/10/05 Elliot Lodge Version 1.40 Page 23 10. 11. 12. 13. 14. 15. 19 19 20 20 24 28, 26 12(1)(ab) 12(1)(ab) 13(2) 13(2) 23(2)(d) 23(2)(d) 16. 29 23(2)(n) All required health care must be provided. Behaviour records must be reviewed and used to inform and direct practice. PRN protocols must be available for all As Required medicines. Creams must be dated when opened and used or discarded within 28 days. Lounge furniture must be replaced. The carpets must be replaced in three service users bedrooms. The identified service users. bedrooms must be redecorated. The lounge must be re-decorated The flooring in the dining room must be replaced. The carpet in the hallway must be replaced. Aids and adaptations as required by service users must be provided. Hand towels must be provided at all communal sinks. 30/9/05 30/9/05 30/9/05 30/9/05 31/10/05 Unmet from the previous inspection. 31/10/05 30/9/05 17. 30 13(3) 18. 30 13(3) The sharps box must be discarded. 19. 33 18(1)(a)( b) 20. 33 18(1)(ab) 19 Schedule 21. 34 Adequate numbers of competent staff must be on duty at all times. Further efforts to ensure consistency of staff must be made. The manager must risk assess the competency and experience of staff, and undertake the action identified. Recruitment records(As detailed in schedules 2 and 4) must be Unmet from the previous inspection. 5/9/05 Unmet from the previous inspection. 12/9/05 5/9/05 30/9/05 Unmet from the Page 24 Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 2 and 4 22. 35 23. 24. 25. 36 42 42 26. 42 previous inspection. 16/9/05 18(c )i Evidence that staff have received 1/12/05 training in manual handling, food hygiene, adult protection, must be available in the home. 18(2) All staff must be supervised at 31/10/05 least six times a year. (Pro rata for part time staff) 13(3) and The fly screen must be utilised. 30/9/05 23(5) The fly screen on the door must be repaired or replaced. 13(4)(b-c) Risk assessments for the 31/10/05 and 23(5) premises and staff must be developed. The food risk assessment must be further developed. 23(4)(c The fire alarm must be tested Unmet )(iv) weekly, and a record of such from the maintained in the home. previous inspection. 31/8/05 available in the home. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard 12 24 24 30 41 Good Practice Recommendations It is recommended that the rest time be reviewed, and spread across the day. It is recommended that a phone be provided in the living area of the home. It is recommended that the layout of the lounge be made more homely. It is recommended that regular cleaning of service users wheelchairs be scheduled and undertaken. It is recommended that reciepts and financial records be stored together. Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Birmingham & Solihull Local Office 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham, B2 4UZ 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 Elliot Lodge E54 S62618 ElliottLodge V246859 300805 - Stage 4.doc Version 1.40 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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