Inspection on 18/05/05 for Elm House

This inspection was carried out on 18th May 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

Elm House 29/03/10

Elm House 22/04/09

Elm House 17/04/07

Elm House 23/08/06

Elm House 25/10/05

Elm House 12/10/04

Elm House 13/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Elm House 43 Cambridge Road Southport Merseyside PR9 9PR Lead Inspector Claire Lee Unannounced 18 and 20th May 2005 th 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 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. Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Elm House Address 43 Cambridge Road Southport Merseyside PR9 9PR 01704 228688 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) Mr Peter John Berry Mrs Paula Claire Ikin Old Age 30 Category(ies) of Old Age 30 registration, with number of places Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Old age, not falling within any other category (30) Date of last inspection 12/10/2004 Brief Description of the Service: Elm House is a privately owned care home that provides thirty single places for older people. Twenty three beds are for nursing care and seven for personal/residential care. Elm House is situated close to Southport town centre, local amenities and Hesketh Park. The home has has four floors with a passenger lift to all areas. The home has a lounge with a conservatory to the front of the building and this is used as dining room. There is a ramp at the front entrance and staff use a portable ramp to access the steps to the main front door. The home has car parking space and a well maintained garden at the rear. Baths are suitably adapted to assist those who are less able and a walk in shower has recently been installed on the top floor. The home has a call system with an alarm facility for residents. Elm House is privately ownded by Mr Berry and is managed by Mrs Ikin. Mr Berry has sought planning permission for an extension to the rear of the building for six single ensuite bedrooms and more recreational space. The overall number of beds at the home will remain unchanged as alterations are planned to the existing single rooms. This work has yet to commence however general maintenance and decoration plan of the home is ongoing. Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was an unannounced visit as part of the regulatory requirement for care homes to be inspected at least twice a year. The inspection took twelve hours over two days. A tour of the building was conducted. A selection of care, staff and nursing home records were also viewed. The manager, owner, three staff members, six of the twenty-eight residents and one relative were spoken with and their views obtained of the home. Satisfaction cards were also given to residents and relatives to complete at their leisure. Comments received have been favourable regarding the overall service and facilities. Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 6 What the service does well: What has improved since the last inspection? Following the last inspection the hall, landings and some bedrooms have been redecorated. New carpets have also been laid. A walk in shower has been installed on the top floor and residents and staff said this facility was working very well. Activities and social interest are now being recorded in resident care files and staff are arranging more varied pursuits to suit individual needs and wishes. Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 7 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. Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 3 Little progress has been made with issuing contracts to residents and/or their representative to ensure they are fully informed of the fee rate and the terms and conditions of the home. The manager assesses all care needs prior to and during the early stages of admission to the home. This ensures resident care needs can be met. EVIDENCE: Not all resident files viewed had details of contacts issued. Some contracts were incomplete and had not been signed or dated by the resident and/or their representative. A resident interviewed was unsure of whether they had been given a contract and who was responsible for issuing this document. The manager visits prospective residents before they are admitted to the home in order to assess their care needs. The assessment includes information regarding general health, mobility, nutrition and social care. Individual records are kept for each resident and this information forms the basis for the plan of care. Assessments completed by social workers, hospital and community staff were also on file. Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 10 A resident who had recently been admitted stated that although she found the initial move difficult she was settling in well and staff had made her welcome. Staff interviewed were able to describe in detail the care needs for this person. Funding for residents who now require nursing care instead of residential/personal care was discussed. The home acts for residents in this instance and social services are contacted to enable a social review to take place. The resident and family are kept full involved and a care file recorded this change in funding and care provision. Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8, 9 and10 Not all care files recorded sufficient detail regarding the health care needs of the residents. Care plans did not reflect changes in general condition and these shortfalls have a potential to place residents at risk. Personal care was provided sensitively, to maintain the privacy and dignity of residents. EVIDENCE: The residents had an individual plan of care however not all care needs were identified or had been reviewed to ensure information was accurate and up to date. This included information regarding mobility, nutrition and wound care and was a requirement following the last inspection. With regards to falls, one resident’s care file and written entry in the home’s accident book did not record any observations of pulse, blood pressure or neurological signs following the incident. The resident’s risk assessment and care plan had also not been reviewed to reflect the increase risk of falls and the need for careful monitoring by staff. The home cares for residents with different medical conditions and those who require terminal care. Residents have access to specially trained staff from the Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 12 hospice and community and this input was seen in a care file. Residents who had medical conditions, for example, diabetes were being monitored by the home and also receiving regular visits from the community diabetic service. A resident said, “staff make sure my diabetes is well controlled.” Residents were weighed however it is good practice for a new resident to be weighed on admission. This enables staff to monitor any loss or weight gain and would be particularly useful when caring for residents who take a diabetic diet or have specific nutritional requirements. Residents and their representatives are included in the assessment process but some of the residents met with had little knowledge or understanding of the care plan. One resident said they would like to discuss their care in more detail and one resident said they were happy for the manager to take the lead. Two care files viewed had been signed by a family member on behalf of the resident. Staff interviewed discussed how the privacy and dignity of the residents is respected and a resident said, “the staff are attentive and knock on my bedroom door before coming in.” This was observed during the inspection. A male member of staff asks female residents if they are happy for him to assist with washing and dressing. Medicine sheets were signed and dated by staff however wound care dressings must also be signed for when applied by staff. A self-medication form had been completed for a resident who wished to use this form of administration. Generally record keeping of medicines received in to the building was of a good standard and staff had literature on medicines prescribed. They also attend regular medicine awareness training. The home’s pharmacist provides help and advice and carries out a check of the medicines charts. Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 and 15 There was a pleasant and friendly atmosphere in the home and the daily life and routine was flexible to suit individual needs. Lunch was a social event and staff were chatting with residents in the lounge. An activities programme is in place. EVIDENCE: The home had a four-week menu that was on display. The menu offered a good choice of hot and cold meals three times a day with light refreshments at other times. Staff were observed informing residents of the choice available at lunchtime and also offering an alternative meal. They assist with the serving of meals from a hot trolley. The majority of residents interviewed were happy with the food and said that it was served hot and ‘on time’. One resident asked for more choice at teatime. Residents take their meals in the lounge or in their bedrooms if they prefer. The home does not have a separate dining room however the provision of this room is included in the extension plans. Meals are served at set times though arrangements are flexible to suit individual needs, for example, hospital appointments. The kitchen was well stocked with fresh produce. An Environmental Health Inspection was conducted last month and requirements were issued with regard to the purchase of a food probe, implementation of a cleaning rota and other general maintenance work in the kitchen. This work is being undertaken. Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 14 A list of activities offered by the home is on display. A member of the care staff has the role of activities organiser and he discussed the various board games, musical entertainment and occupational therapy sessions that arranged each Friday. Staff spend time with residents who wish to remain in their bedrooms and the occupational therapist provides one to one therapy. A resident said, “I prefer to stay in my room and enjoy my TV, the staff do come in and see me.” The home has a minibus and one resident said she was looking forward to trips out once the warmer weather was here. A resident was attending a church and also discussed arrangements for attending a stroke club. Relatives were seen popping in at various times of the day and one resident had bedding plants for the garden which she was going to plant out in the afternoon. The home has a chiropody and hairdressing service. Care files now include residents’ preferred social interests and these were arranged with individual wishes in mind. Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The home has a complaint procedure and complaints received had been handled promptly and efficiently. Residents were confident that their concerns would be listened to and acted upon. EVIDENCE: Residents interviewed were aware of the complaint procedure. A resident stated, “I can always approach Paula (manager) or Mr Berry if I have a concern, they will help me sort the problem.” Residents interviewed were happy with arrangements in the home and did not wish to raise any concerns or complaints. Staff interviewed were familiar with the complaint procedure and knew what to do should a complaint arise. The inspector visited the home following the last inspection regarding a complaint. This has been resolved to a satisfactory standard by all parties involved. No other complaints have been received. Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25 and 26 General management of the home ensures appropriate and homely surroundings and since the last inspection there has been considerable work to improve the general décor of the building. Work must however continue to improve the overall standard of the bedrooms and bathrooms as this has the potential for comprising the comfort of the residents. EVIDENCE: The majority of bedrooms on the top floor, the hall, landing areas and lounge/conservatory have been redecorated to a good standard. Bedrooms viewed were attractively decorated and residents had personalised them with ornaments, photographs and pictures. A resident said she was very pleased with the new colour scheme in her room. A walk in shower has been fitted on the top floor bathroom with a sink suitable for the hairdresser to use. Progress has been made regarding the overall décor of the building however the Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 17 following areas still require attention. The timescales set at the last inspection in October 2004 have been extended. • • Bedrooms on the first, ground and lower ground floor must be decorated and new furniture purchased to replace old and worn pieces. The radiators in Room 7, 19 and the ground floor corridor must be covered, guarded or have a low temperature surface to reduce the risk of injury to the resident. The home requires further laundry space as the existing laundry is very small and provides limited segregation of dirty and clean linen. At present ironing is carried out in the staff room. Plans to alter this must be included in the home’s general maintenance plan. The bathroom on the first floor requires new fittings and fixtures as existing ones are old and rusty, this includes provision of a new bath chair hoist. The bathroom on the lower ground floor is not currently in use to due to restricted access for residents who require a hoist. Plans to alter this must be included in the home’s general maintenance plan. • • • The drawing up of a maintenance plan for the ongoing decoration and refurbishment of the home is recommended. The home should consider the purchase of an electric hoist as at present only manual hoists are available. This would make the transfer of residents more comfortable and assist staff with the manoeuvre. Discussion with staff confirmed this. A specialist mattress and a height adjustable bed must be provided for a resident with complex nursing needs who also requires regular pressure relief. This too would assist the staff with the care provision. Hot water temperatures are regulated to the baths and walk in shower. This ensures hot water is delivered at a safe temperature. Hot water signs are placed above the sinks. The home was clean and hygienic and bedroom carpets were being cleaned. Housekeeping and maintenance cover is arranged most days. Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 and 30 Sufficient numbers of staff were deployed to meet the needs of the residents. Some staff had not received the necessary training, to ensure competency in this role. Recruitment procedures were robust to safeguard and protect the people living in the home. EVIDENCE: A qualified member of staff is on duty twenty fours hours a day. Inspection of the duty rota and direct observation confirmed that sufficient staff were on duty. Staff interviewed stated that the manager ensures the correct number of staff work each day and that “Paula (manager) does her best to cover sickness and holidays.” Two full time care positions have recently been filled and new staff will commence their work once the manager has undertaken a full recruitment check. A new member of staff discussed the induction he was receiving and stated that senior carers and the manager were supervising him. The manager works along side staff to provide support and to monitor the standard of care in the home. A member of staff said, “the manager is very much hands on and is always there to help.” The home has a deputy manager and Mr Berry who is also a qualified nurse, takes charge of the home when needed. Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 19 Staff meetings are held and minutes taken. The home operates an ‘employee of the month scheme’ which the residents can participate in. Residents interviewed spoke favourably with regard to the caring approach of the staff and that generally when calling for assistance staff were quick to respond. Some residents made comments regarding the care staff serving meals, as at this time they are not able to give personal care. This they thought put a lot of pressure on the staff. The concern was discussed with the manager in relation to the allocation of work for the lunch and tea time periods. Staff were seen working as an effective team and a member of the care staff said, “the home is just great to work in, we all get on well and can approach Paula (manager) at any time.” Staff training is ongoing and staff are currently undertaking a distance-learning course in infection control. Manual handling instruction is given annually by the manager and for new staff during their induction. Some staff have certificates in first aid and it is recommended that this continue. Not all staff have up to date certificates for basic food hygiene. This is required for all staff that serve food. Staff training files were in place however it is recommended that these be brought up to date to include the most recent training. The personnel files of three staff employed indicated that the home had undertaken all the necessary recruitment checks to ensure protection of the residents. Protection of Vulnerable Adults [POVA] checks and Criminal Records Bureau checks at enhanced level were available. Written references had been sought and this included information from the most recent employer. Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33 and 38 Mrs Ikin’s management approach is positive, enthusiastic and provides clear direction to staff. A current safety certificate is needed of the emergency lighting to ensure the health, safety and welfare of the residents. EVIDENCE: Mrs Ikin and Mr Berry work hard with the staff to promote a friendly and ‘homely’ atmosphere. This was observed during the time spent talking with staff and residents. Staff interviewed stated that they had a good working relationship with the manager and valued her ‘open’ approach. Mrs Ikin has completed general and risk management courses. Discussion with residents confirmed that they were generally pleased with the overall management of the home and also the decorative changes that are Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 21 taking place. A resident said, “Paula (manager) is very kind and leads a good team of staff.” Staff have received regular fire prevention training and this is being arranged for the night staff this month. The testing of fire prevention equipment is carried out however a requirement is made for the testing of the emergency lighting by the home’s qualified engineer. The home has a fire risk assessment of the building. Some fire doors were wedged open and these must be shut. If a resident wishes to have a fire door open then it is recommended that the home contact the fire safety department for advice and also consider the installation of automatic self closure devices. Safety certificates were on file and in date for the gas, electric, lift and testing of portable electrical equipment. Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 2 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 2 2 2 2 2 2 2 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 x x x x x 2 Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 23 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. Standard 2 Regulation 5 Requirement Timescale for action 18.8.05 2. 7 15 3. 7 15 4. 8 12/15 Residents must be issued with a standard form of contract for the provision of services and facilities including amount and method of payment of fees. (Timescale of 12.12.04 not met) Resident care plans must record 18.6.05 in sufficient detail clear guidance to staff the actions needed to meet their health care needs. Resident care documentation must be kept under review (Timescale of 12.12.04 not met) The plan of care is to be drawn 18.8.05 up with the resident , agreed and signed by the resident and/or representative (if any) Resident care documentation 18.6.05 must must identify appropriate action needeed by staff to identify risk of falls Prescribed wound care dressings must be signed for on the medicine sheets following their application The registered provider must provide new new fittings and fixtures for the first floor bathroom as existing ones are old and rusty, this includes 18.6.05 5. 9 13 6. 21 23 18.5.06 Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 24 provision of a new bath chair hoist 7. 21 13/23 The registerd provider must provide the home with further laundry space as the existing laundry is very small and provides limited segregation of dirty and clean linen. Plans to alter this must be included in the home’s general maintenance plan The bathroom on the lower ground floor is not currently in use to due to restricted access for residents who require a hoist and plans to alter this must be included in the home’s general maintenance plan The registered provider must provide a specialist mattress and height adjustable bed for a resident with complex nursing needs The registered provider/owner must deorate the bedrooms on the first, ground and lower ground floor and new furniture purchased to replace old and worn pieces The registered provider is to ensure the radiators in Room 7, Room 18 and on the ground floor corridor are guarded/covered or have low temperature surfacaes (Timescale of 12.4.05 not met) The registerd provider must provide basic food hygiene training for staff The registered provider must ensure the emergency lighting is tested by the homes qualified engineer The registered provider must ensure all fire doors are kept shut 18.5.06 8. 21 23 18.5.06 9. 22 16/23 18.5.06 10. 24 16/23 18.5.06 11. 25 13/23 18.11.05 12. 13. 30 38 18 23 18.8.05 18.6.06 14. 38 23 18.6.05 Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 25 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 8 19 22 30 38 Good Practice Recommendations Resients are to be weighed to monitor loss or weight gain The drawing up of a maintenance plan for the ongoing decodration and refurbishment of the home The purchase of an electric hoist Staff training files to be updated to include most recent training. First aid training should continue Advice should be sought from the fire safety department regarding the homes fire doors. Consideration should be given to the purchase of automatic self closure devices for the fire doors Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection Burlington House South Wing, 2nd Floor Crosby Road North, Waterloo Liverpool L22 0LG 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 Elm House F53 F03 S17232 Elm House V224777 100505 Stage 4.doc Version 1.30 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!