Inspection on 31/07/07 for Elm Tree House

This inspection was carried out on 31st July 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Elm Tree House 07/09/06

Elm Tree House 25/10/05

Elm Tree House 27/04/05

Elm Tree House 19/10/04

Elm Tree House 13/05/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOME ADULTS 18-65 Elm Tree House 4 Kilkenny Avenue Taunton Somerset TA2 7PJ Lead Inspector Barbara Ludlow Unannounced Inspection 31st July 2007 09:30 Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 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 Elm Tree House DS0000016047.V342322.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 Adults 18-65. 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 Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elm Tree House Address 4 Kilkenny Avenue Taunton Somerset TA2 7PJ 01823 322408 01823 322408 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) Mr Philip Mark Coggins Mrs Elizabeth Anne Coggins Mrs Elizabeth Anne Coggins Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (9) of places Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named resident over 65 years of age Date of last inspection 24/04/07 Brief Description of the Service: Elm Tree House is registered with the Commission for Social Care Inspection to provide care to up to 9 people under the age of 65 who have mental health difficulties. The home itself is a large semi detached Victorian house, which provides accommodation on three floors. There are seven single bedrooms and one double. One single bedroom is on the ground floor and all others can only be accessed by stairs and therefore people living at the home need to be physically able. All communal areas are located on the ground floor. The home is owned by Philip and Elizabeth Coggins, Elizabeth Coggins is the registered manager. Fee range from £385 per week. Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of this inspection visit was to inspect relevant key standards under the Commission’s ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are: - excellent, good, adequate and poor. This inspection was made by B. Ludlow for CSCI over a six hour period. Mrs Coggins the Registered Manager came into the home on her day off to assist with the inspection process. All eight service users in residence were seen as they went about their daily life at the home. Opportunities were taken to speak in private with service users about life at Elm Tree House. Lunch was observed served to individuals at different times, a rather ad hoc occasion. Two service users went out to lunch. Staff were seen and spoken with and a tour of the premises was made and three bedrooms were seen. Records were sampled; these included staff recruitment, maintenance and care planning. Written responses were made to the questionnaires sent out after the inspection visit. All service users responded and two relatives. The analysis is incorporated into the inspection report. What the service does well: This service is well established and has provided a stable home to one resident for many years. Residents asked all said they enjoyed living at the home. The people living at the home are able to spend their time as they wish. Routines had established for some and freedom and choice in every day life was evident. Individualised care is supported, an example was seen where an effort was made to quickly arrange for one person to go out, after they had missed an earlier opportunity to meet up with staff and another service user. Residents reported that the staff are friendly and caring. Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard assessed: 2 Quality in this outcome area is good. People who chose to live at Elm Tree House have their needs assessed prior to admission. People may visit the home to meet the staff and other residents and there is an informative service user guide. This ensures that personal and social health care needs can be met by the service offered at the home and that the person has enough knowledge of the service to make an informed choice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A statement of purpose and a service user guide have been written for the home. A copy of these documents was given to the inspector. These were read after the inspection, it is recommended that more information about the costs of care be added to the very detailed service user guide when it is reviewed each year. Time was spent with the most recent resident admissions into the home and with two people who have been resident at the home for a number of years. A resident more recently admitted to the home said they had made a number of visits to view the home and meet the staff and other residents before Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 9 moving in, it had impressed as they ‘thought it homely’. Their decision to move in was confirmed as being a very positive one and one they were pleased to have made. They described the home as being ‘friendly and designed for the people’ and ‘more like a family than a home’. The care records sampled had details of the pre admission consultation and assessment of need. The home had copies of the Somerset Partnership assessment documentation and risk assessments had been undertaken. Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards assessed: 6,7,9 Quality in this outcome area is good Residents are supported in their decision making, their choices and their independence in daily living. Residents are involved in their care planning and have key workers to support them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each resident has an individual care plan. A sample was inspected and evidence was seen of the assessment of risks. Each person had a detailed health history and family contact details recorded. Mental health care needs and professional contacts involved in their care were clearly recorded. One examined demonstrated a thorough admission and reassessment process. A six monthly assessment was in place from the visiting social worker. Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 11 A feedback form is sent out to the family or supporter of a new resident after four weeks. This is to check their view that the placement is working. One was seen and this acknowledged that the person had settled in and gave positive feedback. Key workers are assigned to the residents. One visiting professional said this works very well for their client whose quiet communication is skilfully interpreted by their key worker. A copy of all documentation from the social workers and other health care professionals is held on resident’s personal files. The home has a policy statement that clearly sets out their position with regards to data protection and confidentiality. Service users are informed they can access their files if they wish. Health care professionals that visit regularly to administer care were satisfied with the care of their clients. Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards inspected: 12,13,15,16,17 Quality in this outcome area is good. The home offers and supports residents to lead the lives they choose. Help and assistance is arranged to enable a variety of outings and daily life experiences. Independence is promoted and encouraged with risk assessments to support the individual. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home fits in well in the area, an end terrace house in a quiet part of town. It has a garden with seating and patio area. There is a comfortable and clean communal lounge, dining and kitchen space. Access around the home is unrestricted in the communal areas and garden. Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 13 Shops, cafes and leisure facilities are available locally and are within walking distance. Residents who have extra one to one time with staff are taken out in staff cars. A nominal contribution was described as being paid to the member of staff for parking or towards petrol costs by the resident. This should be recorded and a cost tally agreed to ensure the system is accountable and clear. The home has a disabled parking sticker to allow one car free parking on such trips. The home accesses travel vouchers from the council for the residents to use. At the inspection residents went out with staff both during the morning and the afternoon. The outings were to shop and one person went bowling. Residents who were able went out independently to the shops or for lunch. Care plan records are made of likes and social interests. One resident said they go swimming and two others attend the local leisure centre. Two residents who were not feeling too well and one other stayed at home during the day and were seen resting in their rooms. Three residents seen in private commented that they are settled and enjoy living at Elm Tree House. Holidays although none arranged for this year have been arranged in previous years. One resident told the inspector that this had been good for them as they would not have had the opportunity to travel if not for the opportunity and support given by Mrs Coggins and the home’s staff. Relationships that have developed between residents are supported. It was noticed that staff are respectful and privacy is upheld with staff knocking and checking with the resident before entering their bedroom. Service users have keys to their rooms and are encouraged to lock them if they go out. A master key is held for emergency access, this is also made clear in the service users guide. Menus are made up on a four week rota and appear to be well balanced. A relative reported they felt the teatime choice could be healthier and gave an example of sausage roll and Danish pastry being offered for tea; it was also felt that more fresh fruit and vegetables could be offered. Meals were served during the inspection at ad hoc times to suit the residents. Lunch on the day of the inspection was not a social occasion within the community of the home but catering was for individuals. Visiting professionals commented they had noticed very early lunches being served. The service users asked commented saying they found the food ‘great’ and ‘good’. A review of mealtimes is recommended to make sure opportunities for social dining occasions are made for the residents within the community of the home. Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 14 The management has reported to CSCI that the residents health and nutritional needs are promoted with the introduction of more / different foods. The greenhouse in the garden seen at inspection is being used to enable service users to grow and pick their own salad vegetables. The management of the home stated in their Annual Quality Assurance Assessment that they hope to promote more of this over the next twelve months. Assistance at lunchtime was unhurried and carefully managed for one service user. Weight loss and diabetes control was monitored for one resident who was very pleased with their weight loss but also said they enjoyed the meals that are offered. The kitchen is domestic in style and is accessible to residents. The kitchen was clean and tidy. Pre-prepared frozen meals are used. Lots of drinks were seen to be offered during the day and no complaints were heard. Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards inspected: 18,19,20 Quality in this outcome area is good Personal support is managed to meet the residents assessed need and to suit their individual need. Medication records were complete and medications were appropriately managed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Personal support is given; residents choose how they appear, by selecting their own clothes and hairstyle. All residents have a designated key worker who would assist the resident in social care activities, and outings either as a one to one or group activity. Personal care may need to be monitored; one relative said their relative should change their clothes more frequently. The inspector noted that residents were appropriately dressed and looked well kempt. One person had untidy toenails and may have needed assistance or prompting to deal with them. Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 16 ‘Healthcare needs are recognised and help is requested’ said one social worker. GP input is requested if needed however residents would attend their GP at his surgery. The inspector heard that residents may be taken to the surgery but the staff would not accompany them during their consultation unless specifically asked to do so. Community Psychiatric Nurse (CPN) visits the home on a regular basis and feels that the clients are well cared for. Contact is made with dentists and other related health care practitioners as required. The medication administration records were examined and with one exception they were fully up to date with clear records of medication given recorded. Creams and the audit control of creams was not inspected, self administrated creams were to be signed for to complete an audit trail and prn administered medications were to be more clearly recorded. The AQAA stated that the home will continue to work to improve and monitor the administration of ‘when required’ (prn) administered medicines. No deficits were apparent at this inspection. The AQAA also stated that the care plans could have more information regarding daily health care needs. Progress will be monitored at the next inspection. Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards inspected: 22,23 Quality in this outcome area is good Staff recruitment was a sufficient process that offers residents protection from potential harm. There is a complaints procedure and residents felt they would be able to raise any concerns with the Manager or with staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: No complaints have been made to Commission for Social Care Inspection or were reported to have been made to the management of the home. The home has a complaints procedure that is also in the service user guide given to residents. Residents asked said they would speak to Mrs Coggins if unhappy about anything. This was also the response from the resident surveys, two said they would go to Mrs Coggins others indicated they knew how to complain and one said they would speak to a senior carer or key worker. Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards inspected|: 24,30 Quality in this outcome area is adequate. The communal areas of the home were clean and tidy. The bedroom accommodation sampled was not clean and there were areas where hygiene standards were compromised. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The entrance hallway was clean but had a musty odour. The communal areas seen during a tour of the premises were clean and looked to be homely and comfortably furnished. There was a television in the main lounge. The bedrooms were sampled with the permission of the residents. Dust was seen on the decorative painted rails, tables, storage bowls and shelves. In one room a table was littered with cigarette ash from an overfilled ashtray, stained and used cups with tea bags. The bed linen in one room did not appear to be Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 19 clean. The inspector was informed that the cleaning had been undertaken that morning. The stains and debris seen did not support very thorough cleaning. The deep cleaning of the bedrooms should be improved. Attention is needed to the infection control where buckets are used by residents for bodily waste (sputum and urine) There must be a policy and procedure for staff to support the cleansing of these items to reduce the risk of cross infection and prevent odour. Communal areas seen were clean and tidy. There is a separate staff toilet, which had hand gel and paper towels but no liquid soap. This should be rectified. The kitchen was kept clean and tidy throughout the day. There is no lift between floors and there are baths at the home. Each bedroom has a shower cubicle with a thermostatically controlled shower. One resident enjoys having a shower where ‘they don’t have to queue to use it’. It was seen as a further aid to independence. One service user said they ‘miss not having a bath’. Where one room is shared there is no privacy screening for the service user who may choose to shower. Screening should be considered to promote the dignity of the service users sharing a room. Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 20 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is adequate Staff records are held in accordance with the national minimum standard. There is staff training and regular staff meetings are held. Staff spoken with were very positive and were reported to be very helpful and supportive of the residents in their care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff records were sampled for new employees since the last inspection. The staff had complete recruitment files. One person had two references that were dated five days after the persons start day, these had been preceded by telephone calls to the referee and had been followed up when not received. Written references should be obtained before the employee commences working at the home. More recently the process of recruiting staff has been managed by the home’s administer to ensure references were on file and Criminal Record Bureau Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 21 checks were made. The administrator has reorganised the office and said of the file management this is ‘much better’. At a previous inspection the manager had recruited a person aged less than 21 years to work night shifts at the home. The inspector at this time was reassured when this person had completed all their training to enable to manage the residents and any situations they may face when sleeping in at the home. This person remains mostly on day shifts at the home. Sleeping nighttime cover is made with senior staff and proprietors who live close by being on call. All staff left ‘in charge’ at night being that they are the most senior person/ only person on duty at the home, should be aged over 21 years. Staff supervision was in hand and good evidence was seen of the process. The administrator who has experience in care work had a plan for the regular supervision of staff. Staff meet every four to five weeks and have opportunities to speak with the management every four to five weeks. Training is improving, the Deputy Manager is studying National Vocational Qualification (NVQ) Level and 50 of the staff team are on NVQ training courses. Staff expertise spoken with knew the residents well. Mrs Coggins had impressed one social worker with her knowledge and practices for managing behaviours that were challenging. Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 22 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards inspected: 37,39,42 Quality in this outcome area is good. Mrs Coggins is an experienced care home owner / manager. The service users spoke highly of life at the care home. There are systems in place to manage the health and safety and maintenance of the premises to a good standard. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service users spoke highly of life at the home. Comments included they ‘liked living at the home’ and liked the staff and opportunities open to them. One person said they felt ‘safe’. Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 23 Mrs Coggins has many years as a care home owner and manager and has expertise in caring for the client group younger adults with mental health conditions. Community professionals commented that the home provides a good service and appreciated the expertise of the homes manager with their clients. The records for maintenance were seen, all bedrooms have showers that are thermostatically controlled, a legionella risk assessment has been undertaken. Shower heads are cleaned periodically with antibacterial spray as a preventative measure. There is a cleaning schedule for the upkeep of the home. Six service users smoke in their rooms. The fire safety maintenance records were seen, the weekly alarm test had been carried out on 23/07/07 and the alarm is serviced quarterly was serviced on 29/06/07. The emergency lighting had been checked. The fire fighting equipment had received an annual service in 08/06. The management of hazardous cleaning chemicals is generally well managed in line with the COSHH guidance. One bottle of toilet cleaner was removed from a communal toilet to safe storage at the inspection, otherwise chemicals were well managed. Staff training included COSHH awareness. Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 24 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 Standard No Score 1 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 2 28 X 29 X 30 1 STAFFING Standard No Score 31 X 32 3 33 2 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 3 X 3 X X 3 X Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 25 NO 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 YA30 Timescale for action 23(2)(d) Deep cleaning or bedrooms must 24/09/07 be made to improve the basic cleanliness of the resident’s accommodation. Infection control measures must 24/09/07 16(2)(k) be improved where buckets are used by the residents. Cleaning must be supported with a protocol for regular cleaning to reduce the risk of cross infection and any odour that may be present. 19(1)(b)(i) Written references should be 24/09/07 Schedule obtained prior to a member of 2 staff commencing work at the home. Regulation Requirement 2. YA30 3. YA34 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 YA1 Good Practice Recommendations The service user guide does not have details of the current costs for care and accommodation. It is recommended that more information about the costs be added to the service DS0000016047.V342322.R01.S.doc Version 5.2 Page 26 Elm Tree House user guide when it is reviewed each year. 2 YA17 A review of mealtimes is recommended to make sure opportunities for social dining occasions are made for the residents within the community of the home. Shower screening for privacy should be considered to promote the dignity of the service users sharing a room. Travel expenses reimbursed to staff by residents should be more formally recognised and recorded. This will protect both staff and residents from the present informal system which could be open to abuse. Staff left alone and therefore in immediate charge of the home must be aged over 21 years. 3 4 YA18 YA27 YA23 5 YA33 Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Elm Tree House DS0000016047.V342322.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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