Inspection on 24/11/06 for Fell House

This inspection was carried out on 24th November 2006.

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

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

Other inspections for this house

Fell House 04/01/10

Fell House 21/11/08

Fell House 20/03/06

Fell House 06/12/05

Fell House 06/10/04

Fell House 27/04/04

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOMES FOR OLDER PEOPLE Fell House Albion Terrace Springwell Village Gateshead Tyne & Wear NE9 7RJ Lead Inspector Irene Bowater Key Unannounced Inspection 24th November 2006 09:30a X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fell House Address Albion Terrace Springwell Village Gateshead Tyne & Wear NE9 7RJ 0191 417 4520 0191 417 7977 fellhouse@highfield-care.com www.schealth.co.uk Southern Cross (care homes No2) Limited 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) Mrs Gillian Batey Care Home 52 Category(ies) of Old age, not falling within any other category registration, with number (52), Physical disability (41), Physical disability of places over 65 years of age (41) Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service may from time-to-time admit persons under the age of 65 within the OP category of registration 20th March 2006 Date of last inspection Brief Description of the Service: This purpose built home is in a suburban setting away from the main road. It is in a quiet location with no through traffic. There are shops and other amenities nearby. The home has two floors and is of traditional brick and tile construction. Fell house provides care, including nursing care, to older people over the age of 65 years; some of whom may have physical disability. There is level entry to the ground floor and the upper floor has passenger lift access. There are lounge/dining areas on each floor and a South-facing conservatory. The corridors are wide and the communal areas and bathrooms are of generous proportions. The grounds are well kept, and although the majority of this space is devoted to car parking, service users enjoy the use of a small south-facing terrace in fine weather. The Statement of Purpose and Service User Guide is readily available in the home. The Guide also includes information about how residents’ rights will be respected regardless of age, gender, sexual orientation, race and religion. The information is available in large print and pictorial style. The fee rates vary from £356 to £494.The nursing care contribution is set nationally and is added to the fee rate. Chiropody and hairdressing charges are additional charges. Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over seven and a half hours. The inspector spent time with the Registered Manager, staff and residents. The inspector looked around and talked to residents and staff, and saw the contact between them. Time was also spent checking the cleanliness, maintenance and decoration of the home. A number of documents were looked at including, care plans, training, maintenance, catering, medication, financial, recruitment, health and safety, and complaint records. What the service does well: The staff collects information together about the person before anyone moves into the home to make sure they can meet their needs. Staff involve the residents, their representatives and other professionals in the care planning which makes sure their needs can be met. The staff have formed good relationships with the residents and make sure their rights to privacy and dignity are met. The residents were complimentary about all aspects of the service. Comments included, “The staff are really good, nothing is a bother”, “they do anything I ask”, “I am content and happy,” “they are all very good to me”, The manager sorts everything out,” “we get plenty to eat, the food is good and we can have whatever we want”. Visitors are made welcome and there are good links with the local community. The meals are nutritious and choices are available. Residents said they would be able to use the complaints procedure if they had a concern. They all said that they did ‘not need to complain as the staff always helped them and the manager was always available to talk to. The activities organiser and care staff work hard to provide meaningful activities for individuals and groups of residents. The staff receives the training they need to care for the residents needs. The recruitment policies are followed. Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 6 The home is suitable for the people who live there and there is specialist equipment to meet their needs. The staff receive the training they need to care for the residents needs. Some of the staff have worked at the home for some considerable time and have formed a good team. 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. Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 The quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to the service. Prospective residents are given information about the service provided before admission. This ensures that they can make informed choices. The admission assessments and procedures ensure the residents care needs will be met. EVIDENCE: The home has developed a Statement of Purpose and Service User Guide, which gives information about the home. The Guide includes information about the accommodation, the staff, how to make a complaint and a copy of the recent inspection report. This is readily available in the home and residents confirmed they were given a “brochure” which told them all about the home before they moved in. The Guide also includes information about how residents’ rights will be respected regardless of age, gender, sexual orientation, race and religion. Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 9 The information is in large print and pictorial style. The registered manager confirmed that this is also available in audiovisual style. There is clear information about the terms and conditions and fee rates. The registered manager confirmed that they are being amended to reflect the Company changes. Six care plans care plans were inspected and showed that the manager carries out comprehensive assessments before any resident is admitted to the home. The care managers and the nurse’s assessments were also available. These records form the basis of the care planning process for the resident. Where possible the relatives or resident’s representative is involved in the assessment process. The home writes to all residents to confirm that their needs can be met. Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to the service. The care planning systems provides staff, residents and their representatives with the information they need to meet resident’s needs. The health needs of all residents are being met. There is interagency working. The systems for the administration of medicines are consistent. Personal support promotes residents right to privacy and dignity. EVIDENCE: Six care plans were inspected. All were clearly set out, up to date and signed by the author. Accredited assessments tools for the prevention of pressure sore and wound care, moving and assisting, catheter care, continence promotion, nutrition and mental health status were completed and reviewed and updated monthly. Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 11 All of the care plans are regularly reviewed and updated according to changes in social, personal and health care needs. Residents who have reduced appetite or low weights are regularly weighed and intervention sought from dieticians. Their recommendations are acted upon and the care plans updated as necessary. Up to date information regarding changes in wound care is documented on a regular basis and regular reviews take place with residents’, their relatives and care managers to make sure the home is still meeting their needs. There are appropriate pressure relieving devices available to support the staff and residents in daily activities. Several of the residents have air cell mattresses and cushions to prevent pressure damage. The residents have access to all NHS facilities to ensure their healthcare needs are met. There are regular visits from GP’s and other health professionals including, dentists, opticians and chiropody services. The home has comprehensive medication policies and procedures for staff to use. Records are in place for all medicines received, administered and disposed of. An audit of Controlled Drugs and the Medicine Administration Records (M.A.R.) showed no discrepancies. Handwritten directions on the M.A.R. did not have any signatures. There is a register of staff who are authorised to administer medication. The lock on the medicine storage cupboard was not secure and the extractor fan was not working. A suitable metal medicine cupboard has been fitted since the last inspection. Residents spoken to felt that they are treated with respect and their right to privacy is upheld. Residents spoke about their personal wishes and preferences, which are respected by staff and documented. Examples include locking their bedroom doors, receiving their mail, being addressed by their preferred name and being able to go wherever they wish inside and where possible, outside of the home. There was a good rapport between staff, residents and relatives, which was friendly and professional. The care plans record residents wishes about dying and the arrangements they want after death. The families, Palliative care specialist nurses and consultants are also involved in the process. Staff follow the “Liverpool Care Pathways” for end of life care and have received training in use of syringe drivers and pain control. Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 12 Information about pain control is available and the Medication Administration Records and Controlled Drug records show that staff make sure that appropriate pain relief is given when the residents need it. All of the staff were caring, supportive and sensitive to the needs of both the residents and their families at a very difficult time. Fell House DS0000039416.V313518.R02.S.doc Version 5.2 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 the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to the service. Social activities provide stimulation and interest for residents living in the home. Residents are supported to with opportunities to maintain their previous lifestyles. The residents’ day is flexible and they are encouraged to make choices and take control over how they spend their day. Dietary needs of residents are catered for with a choice of food available. EVIDENCE: The home has an activity person who organises events both inside and outside of the home. The staff also help residents with social and recreational activities. Activities are displayed in a written and picture style in the hallways of the home. There is also a newsletter, which describes the monthly activities, events, and poems and has puzzles to keep everyone busy. Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 14 The activity person keeps records of all events that residents have taken part in. Care plans contain individual social assessments, which staff use to make sure their likes and dislikes are known. There are numerous photographs on display, which show events that have taken place throughout the year. The home are currently preparing for the Christmas festivities. The residents and staff were keen to show how they had made the tree decorations, which were lovely, and how they were hoping to win the themed Christmas tree competition with the company. On the day of the inspection the residents enjoyed a quiz morning, visits from relatives, watching films on television and making Christmas cards. All of the residents said that there was “plenty to do” and “they help to keep me busy”. One resident said they liked to be on their own and did not join in any events and they staff respected these wishes. The residents are encouraged to be in control of their lives as far as possible. They are able to maintain links with the local community and local groups and the school visit the home. Visitors were seen to come and go throughout the inspection. Staff spent time with them and shared information about their relative if necessary. The residents said that they are able to spend their days as they wish. They confirmed that they could get up and go to bed when they want and mealtimes are flexible. Information about advocacy is readily available but all of the residents said that the manager would “always sort anything out”. All of the residents have brought small items with them making their own bedrooms homely and personalised. There are dining rooms on both floors. Both are pleasantly decorated and furnished. The dining tables were appropriately set with cutlery, crockery, napkins and condiments. The inspector joined the residents in the ground floor dining room for the lunchtime meal. Lunch consisted of hot pot and green beans with fruit, custard and cream for dessert. The meal was hot, tasty and of ample portion size. Residents were offered and given second helpings as requested. Hot and cold drinks were served throughout the meal. There was only one choice on the menu but the residents and staff confirmed that that “you can have anything you want, the kitchen will get it for you”. Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 15 All of the residents were complementary about the food saying “there is always plenty to eat”, “I get what I like”, “and the meals are lovely and tasty”. Residents are able to have their meals either in the dining rooms or in their own rooms. Staff were attentive and assisted residents in a sensitive manner. Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to the service. The complaints procedures are clear. Residents and relatives are confident that their views are listened to and acted upon. Arrangements for the Protection of Vulnerable Adults are satisfactory and protect residents from harm. EVIDENCE: The complaints procedure is available to all residents and their visitors. It explains how to make a complaint and who to. The procedure is given to residents as part of their welcome pack when they come to live in the home. Residents said they would be able to use the procedure if necessary but wouldn’t have to as “the staff sort anything out”, “the manager is always about and she makes sure everything is alright.” Other residents said they were “happy living here and didn’t have anything to complain about.” Two anonymous concerns have been raised with the Commission about staffing and food choices. There is no evidence to support these concerns. The home has received no complaints for over a year. There are policies and procedures in place for the Protection Of Vulnerable Adults. As there has been a change in ownership the policies and procedures have been amended. Guidance from the “No Secrets” document and the Local Authority guidance are available for reference in the home. The staff were able to discuss what to do should there be any allegation of abuse. Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,24,26 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to the service. The home is comfortable and clean and meets the needs of the people who live there. However, refurbishment/redecoration is not planned ahead to deal with the natural wear and tear. EVIDENCE: Fell House provides a homely environment and was tidy, warm and well lit. Residents spoken to were very satisfied with their bedrooms and the communal areas. There are lounges and dining rooms on each floor. Comfortable seating is placed at various points in the home where residents can sit quietly or meet with visitors. There is a pleasant south-facing conservatory leading to accessible gardens. The residents said they spent a lot of time outside in the warmer weather. Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 18 Although the home is pleasantly furnished and decorated there is wheelchair damage to the lower walls and doors throughout the home. There are three single bedrooms with an en-suite facility. All toilets and bathrooms are close to the bedrooms and communal areas. A shower facility has been added since the last inspection and some flooring has been replaced. The flooring in the rest of these areas is showing signs of wear being worn and paint marked. The bedrooms are for single occupancy. They were nicely furnished and residents are encouraged to bring small items of furniture, photos and ornaments with them when they come to live in the home. Profiling nursing beds are provided for residents who need them. On the day of inspection the home was tidy, clean and free from any odours. The laundry is separate from the resident areas and was generally organised and clean. The staff were observed to follow infection control procedures at all times. Although all areas were clean, all of the light cords were found to be grimy. These need to be replaced to enable to staff to clean them on a daily basis and minimise the risk of cross infection. Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome is good. This judgement has been made from evidence gathered both during and before the visit to the service. The current staffing levels and staff deployment ensures the residents assessed needs are met. The arrangements for training and recruitment ensure that residents are protected and staff are competent. EVIDENCE: The rota reflected the staff on duty on the day of the inspection. Only one qualified nurse was on duty for the morning, as the other nurse could not report for duty because of personal issues. The home is generally staffed as follows: 2 Qualified nurses 8am to 8pm 6 care staff 8am to 8pm. Overnight there are: 2 Qualified nurses 2 care staff. There are 3 senior care staff. Domestic, laundry, administrative, maintenance, cook, kitchen and activities personnel are also employed. The registered manager is supernumerary. Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 20 The staff continue to work towards gaining NVQ level 2 in care. Currently 28.5 of care staff hold this qualification. Five staff files were inspected. There was evidence of Criminal Record Bureau checks, Protection of Vulnerable Adult checks, two written references, proof of identity, professional identity numbers for registered nurses and completed induction programmes. There is a training and development plan and programme in place. Records showed that all staff have received fire, food hygiene, infection control, moving and assisting and COSSH training. Other training included use of a syringe driver and end of life care, phlebotomy, and safeguarding adults. Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,38 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to the service. The home has an experienced manager who provides clear leadership. The systems for consultation and quality monitoring make sure that the views of residents are sought and acted upon. Residents personal accounts are managed to ensure their best interests are protected. The health, safety and welfare of residents are being protected as far as reasonably possible. EVIDENCE: Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 22 The registered manager is a first level registered nurse who has managed this home for some time. She has to carry out regular training as a professional nurse in order to maintain Nursing and Midwifery Council requirements. The surveys and comments from people on the day of inspection show that the manager is resident focused. Comments from staff include “she is always there to talk to”, and “we get plenty of training and support”. The manager holds monthly meetings with minutes recorded. She also holds weekly surgeries where relatives can come and discuss any issue with her. In practice this is not necessary as it was evident that relatives and residents are confident that they can approach her at any time. Through out the inspection numerous people came for advice, direction, comfort and support. Monthly audits of all care and other services are carried out with action and outcomes recorded. The regional manager visits on a monthly basis and completes a separate report. These reports make sure the quality of the home is continually monitored. The registered manager confirmed that no member of staff is appointee for residents’ money. All residents have an individual balance record that is reconciled every week if any transactions have taken place. Monies are held in one joint non- interest making account. This should be reviewed as some banks are now offering individual account facilities so that residents will then be able to gain interest on their money. The home holds an appropriate float and two signatures; receipts are available for all transactions. Staff have had training in safe working practices with records kept. Fire training is completed every three months for night staff and six months for day staff. Accidents are clearly recorded and the manager completes monthly accident analysis to examine and track any trends. A fire risk assessment is available and up to date. Risk assessments for the safe use of bedrails are available and up to date. In house health and safety checks are carried out weekly. Water temperatures are recorded to ensure temperatures of 44 C is not exceeded. External contract certificates are up to date. Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 2 2 X X 3 X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13,17 Requirement The registered persons must ensure that all handwritten directions on the Medicine Administration Record (M.A.R.) have 2 witness signatures. The lock on the medicine cupboard must be repaired. The extractor must be repaired to ensure the room temperature does not exceed 25 C. The registered persons must ensure that scuffed, damaged paintwork and wall areas are redecorated as part of a planned programme. The registered persons must ensure that the flooring in the upstairs bathing facilities is replaced. The registered persons must ensure that all light cords are replaced to effect daily cleaning. Timescale for action 01/01/07 2. OP20 16,23. 01/04/07 3. OP21 23 01/04/07 4 OP26 13,23 01/01/07 Fell House DS0000039416.V313518.R02.S.doc Version 5.2 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. Refer to Standard OP22 Good Practice Recommendations Suitable provision should be made for hairdressing or other therapeutic techniques. Fell House DS0000039416.V313518.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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