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Inspection on 24/08/06 for Field House Care Home

Also see our care home review for Field House Care Home for more information

This inspection was carried out on 24th August 2006.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

A kind and caring ethos was prevalent throughout the home. Service users spoken with spoke highly of the staff and care received and expressed no concerns. Activities on offer are service user focussed and led and offer and enable service users to find a lifestyle that satisfies their needs. Service users spoken with spoke highly of the activities coordinator and one stated that he was inspirational. The relative spoken with stated that care was at an extremely high standard and staff were always smiling and were kind and respectful. The menu on offer is wholesome and appealing and service users are enabled to have input into this and the choices on offer. The premises are well maintained and provide a comfortable and homely environment. There are various seating areas, which offer privacy should it, be desired and relatives are welcomed into the home at all times. Observationsmade during the inspection showed that service users were treated with respect and help was given in a discrete manner.

What has improved since the last inspection?

Consent has been gained where bedrails are in use ensuring service users rights are upheld. Staff were able to discuss the issues of entrapment and the positioning of bedrails. Quality assurance questionnaires have been introduced and further development is taking place ensuring that the home is run in the best interests of service users. Staff files observed contained evidence of Criminal Record Bureau checks verifying they had taken place, thus ensuring service users are protected. Further staff have enrolled on the National Vocational Training working towards ensuring service users are in safe hands at all times.

CARE HOMES FOR OLDER PEOPLE Field House Care Home 11 Main Road Radcliffe On Trent Nottingham NG12 2FD Lead Inspector Karmon Hawley Unannounced Inspection 24th August 2006 10:00 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 Field House Care Home DS0000026436.V307199.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Field House Care Home DS0000026436.V307199.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Field House Care Home Address 11 Main Road Radcliffe On Trent Nottingham NG12 2FD 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) 0115 9335811 0115 Mr R C Pring Mrs P A Pring Mary Patricia Walker Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50), Terminally ill (4) of places Field House Care Home DS0000026436.V307199.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. within the total number of beds a maximum of 4 beds may be used for the category TI 27/02/06 Date of last inspection Brief Description of the Service: Field House Care Home provides social and nursing care for older people. The home is located approximately five minutes walk from Radcliffe on Trent town centre. Accommodation is arranged on two floors with forty-four (44) single bedrooms and three (3) double bedrooms. There is a passenger lift and the home is accessible to wheelchair users throughout. There are six bathrooms with specialist lifting equipment in place and sufficient well-sited toilets to meet service user need. In addition there are safe enclosed gardens. The current weekly fees are as follows and are discussed prior to admission: £485 for a room without ensuite and £510 for a room with ensuite facilities. Hairdressing and chiropody are at an additional charge. Field House Care Home DS0000026436.V307199.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the site visit an analysis of the performance of the home over the previous year took place in line with the key national minimum standards. The evidence gained was assessed and thus the site visit planned in accordance with further evidence required to demonstrate compliance with the national minimum standards. The unannounced site visit took place in four and a half hours and was performed by one inspector. The main method of gaining evidence during the site visit was case tracking, this is a method of sampling the records of four randomly selected service users to ascertain if the needs of service users are appropriately assessed and identified needs are being catered for by the home to maintain optimum health and wellbeing of the service user. Six service users were spoken with and one relative, so as to give the inspector an insight into the conditions and standards within the home. Those spoken with were happy with the staff, care received and the standards within the home. The manager and deputy manager assisted in the inspection process and three members of staff were spoken with. Staff were able to demonstrate an understanding of service users needs and the core values and principles in relation to their job role. What the service does well: A kind and caring ethos was prevalent throughout the home. Service users spoken with spoke highly of the staff and care received and expressed no concerns. Activities on offer are service user focussed and led and offer and enable service users to find a lifestyle that satisfies their needs. Service users spoken with spoke highly of the activities coordinator and one stated that he was inspirational. The relative spoken with stated that care was at an extremely high standard and staff were always smiling and were kind and respectful. The menu on offer is wholesome and appealing and service users are enabled to have input into this and the choices on offer. The premises are well maintained and provide a comfortable and homely environment. There are various seating areas, which offer privacy should it, be desired and relatives are welcomed into the home at all times. Observations Field House Care Home DS0000026436.V307199.R01.S.doc Version 5.2 Page 6 made during the inspection showed that service users were treated with respect and help was given in a discrete manner. What has improved since the last inspection? What they could do better: To ensure service users are fully protected it is required that appropriate risk assessments with regards to the use of bedrail and the risk of entrapment are in place. To demonstrate that staff are fully trained and competent to do their further documentary evidence is required in respect of staff undertaking mandatory training. It is recommended that the room temperatures in the clinical rooms are recorded so that this may be adequately controlled thus ensuring medicines are stored at the correct temperature. Please contact the provider for advice of actions taken in response to this Field House Care Home DS0000026436.V307199.R01.S.doc Version 5.2 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Field House Care Home DS0000026436.V307199.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Field House Care Home DS0000026436.V307199.R01.S.doc Version 5.2 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 the following standard(s): 3 and 6 The quality rating for this outcome area is good this judgment was made using evidence available including a visit to the service. Service users may be assured that their needs will be assessed and met prior to moving into the home. The home does not offer intermediate care services. EVIDENCE: The manager, deputy manager or a registered nurse visits prospective service users within the community to carry out a preadmission assessment. Service users and relevant others may also visit the home and spend time there prior to making a decision about moving into the home. There was evidence of preadmission assessments taking place within those case files examined; the assessment covered the requirements of the standard. Staff spoken with were able to discuss the preadmission process. Field House Care Home DS0000026436.V307199.R01.S.doc Version 5.2 Page 10 One service user spoken with discussed how their relatives had been fully involved in the admission process. There are no arrangements made for the home to provide an intermediate care service. Field House Care Home DS0000026436.V307199.R01.S.doc Version 5.2 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 the following standard(s): 7,8,9 and 10 The quality rating for this outcome area is good this judgement was made using evidence available including a visit to the service. Service users health, personal and social care needs are set out in a plan of care. Whilst risk assessments are in place, service users may still be placed at a degree of risk due to the lack of risk assessments in regards to entrapment. Service users health care needs are fully met. Service users are protected by the homes policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. EVIDENCE: Four service users case files were observed which demonstrated that service users undergo various assessments such as manual handling, pressure area care, the activities of daily living and nutrition. Information gained from these assessments was used within the plan of care. Field House Care Home DS0000026436.V307199.R01.S.doc Version 5.2 Page 12 Care plans in place were well organised, reflected service users likes, dislikes and preferences and were relevant to identified needs. Daily records were maintained which were in depth and reflected service users needs, there was evidence to demonstrate that all issues were followed up. There were a number of risk assessments in place; however where one service user had bed rails in place a risk assessment for the risk of entrapment was not available. On speaking with a staff member they were aware of the risks of entrapment and they discussed the measures taken to ensure service users were protected. There was evidence within service users plans of care to demonstrate that the multidisciplinary team and specialist service are accessed as required and specialist equipment and aids were available. A general practitioner was visiting the home on the day of the inspection to carry out routine visits to service users. One service user spoken with substantiated that they may see a doctor or the optician at any time. There are dedicated clinic rooms on each floor of the home for the storage of all medicines. The room on entering was very warm, the deputy manager stated that rooms temperatures were not monitored, however if it felt that it was warm then the window was opened. On observation the room was well organised and tidy. Relevant policies and procedures with regards to medication were in place. The medication charts of those service users case tracked were checked against the medication, these corresponded. The manager stated that all staff are instructed on maintaining service users privacy and dignity during induction and throughout employment. On speaking with service users all stated that staff were very kind and respectful and their privacy was maintained at all times. Several service users made very positive comments about their care and said that they always felt respected by staff. Staff spoken with were able to how they maintain service users privacy and dignity appropriately. Field House Care Home DS0000026436.V307199.R01.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 and 15 The quality rating for this outcome area is excellent this judgement was made using evidence available including a visit to the service. Service users are enabled to find the lifestyle experienced in the home matches their expectation and preferences and satisfies their needs. Service users are enabled to maintain contact with relevant others, Service users are helped to exercise choice and control over their lives. Equality and diversity of service users and staff is fully recognised within the ethos of the home. Service users receive a wholesome appealing diet in pleasing surroundings. EVIDENCE: The manager stated that the routine of the home was flexible and service users may choose what time they get up and retire to bed and how they spend the day. Both staff and service users spoken with substantiated this. An activities coordinator is employed along with an assistant who provides varied activities to service users such as quizzes, reminiscence and news of the day. Activities are offered as a group and also on an individual basis. On speaking with the activities coordinator he discussed how activities are service user led and service users had in fact chosen the poems for that days poetry reading. Field House Care Home DS0000026436.V307199.R01.S.doc Version 5.2 Page 14 The activities coordinator stated that the aim of activities organised is to set realistic targets, offer memory stimulation and activity. The assistant activities coordinator also carries out various activities, which include bingo and arts and crafts. Service users are assisted to visit the local village and to enjoy walks around the park; it is ensured that quality time is spent with service users to ensure they may discuss any issues they wish. Service users spoken with spoke very highly of the activities coordinator and one stated that they were inspirational. All service users spoken with were very happy with activities on offer and felt their needs were fully met. Several service users spoke of how they enjoyed the trips outside the home. Following the poetry reading, service users were observed to be discussing the poems and reading further poems at their leisure, on speaking with them they stated that the session had been extremely good. The manager stated that there are no restrictions on visiting and visitors may be received in private should they wish. Visitors may also join their relative for a meal and a quite area is available to ensure this is a meaningful event should it be desired. The main door has a coded keypad lock; relatives have access to the code to ensure no restrictions are imposed. Service users spoken with stated that they may receive visitors at any time and they may be entertained in private. Two service users spoken with stated that staff made their visitors feel welcome and were always friendly and polite. The relative spoken with spoke very highly of the home and the staff, stating that exceptional standards are maintained at all times and staff were always smiling and were exceedingly respectful and patient. They stated that staff were always approachable. Both the manager and staff at the home were able to discuss how equality of both staff and service users is incorporated in to the ethos of the home. Staff discussed the issues of individuality and valuing a person’s autonomy and identity whilst respecting choices and rights. Service users spoken with felt that they were treated as individuals and that staff listened to their needs and were always respectful. On service users spoken with discussed how staff enabled them to maintain their independence as they wished. Service users may access a pay phone if required. Several service users have their own telephone line in their rooms, which were observed during the tour of the home. One service user also has a computer with Internet access. Field House Care Home DS0000026436.V307199.R01.S.doc Version 5.2 Page 15 Service users are enabled to bring in personal possessions should they wish, one service users spoken with substantiated this. The kitchen was clean and tidy on the day of the visit and relevant documentation was observed. All staff working in the kitchen have food hygiene certificates and the main cooks have attained the intermediate food hygiene certificate. The menu observed demonstrated that a wholesome and appealing diet was on offer and there were choices available. The cook discussed alternatives that may be offered to service users and how service users who require specialist diets or who have allergies are catered for. Staff spoken with stated that they felt the menu on offer was at a good standard. All service users spoken with spoke very highly of the food on offer and stated that meals were plentiful and choices were available. Field House Care Home DS0000026436.V307199.R01.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 The quality rating for this outcome area is good this judgement was made using evidence available including a visit to the home. Service users and their relatives may be confident that their complaints will be listened to, taken seriously and acted upon. Service users are protected from abuse. EVIDENCE: Relevant policies and procedures were in place for handling complaints should they be received. The home had not directly received any complaints since the previous inspection. The Commission for Social Care Inspection had received one complaint; the manager and proprietor fully investigated this complaint, which was unsubstantiated. Staff spoken with were able to discuss how they would deal with a complaint should it be received. All service users spoken with stated they were happy with care received and life within the home and they had no complaints. Relevant policies and procedures were in place with regards to adult protection. All staff employed had Criminal Record Bureau checks in place. A number of staff have undertaken the training in adult protection. All staff spoken with were able to discuss the relevant issues of adult protection and how they would deal with it should they encounter it. One service user spoken with stated that they felt safe in the home. Field House Care Home DS0000026436.V307199.R01.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): 19,26 The quality rating for this outcome area is good this judgement was made using evidence available including a visit to the service. Service users live in a safe, well-maintained environment. The home is clean, pleasant and hygienic. EVIDENCE: On the day of inspection the home was clean and tidy. The décor and furnishing were of a good quality and in a homely style. There were sufficient numbers of bathing and toilet facilities with appropriate equipment to meet the service users needs. The laundry rooms were clean, tidy and organised. There was evidence of appropriate hand washing facilities throughout the building. There are various communal areas around the home, which gave service users choices of where to sit. Service users spoken with discussed that they may sit in any area and they may receive visitors in private in the ‘green room’ if they wished. Field House Care Home DS0000026436.V307199.R01.S.doc Version 5.2 Page 18 Service users rooms were personalised and one service user substantiated that they had been enabled to bring in their personal belongings. Two service users spoken with stated that they were very pleased with their rooms and the home was always clean and tidy. A television is provided for every service users’ room. The garden was well maintained and enclosed meaning residents could use it in safety. Field House Care Home DS0000026436.V307199.R01.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 and 30 The quality rating for this outcome area is good this judgement was made using evidence available including a visit to the service. The numbers and skill mix of staff meets service users needs. Service users’ are in safe hands at all times. Service users’ are supported and protected by the home’s recruitment policies and practices. Staff are working towards ensuring they are fully trained and competent to do their jobs, however further documentation is required to fully substantiate this. EVIDENCE: The duty rotas were observed which demonstrated that sufficient staff were employed to meet service users needs. The deputy manager stated that skill mix is taken into consideration when planning the duty rota as is the mix of male and female staff. Staff spoken with stated that sufficient staff were employed to meet service users’ needs. Service users spoken with in the main felt that staff were always available should they be needed, whereas one service user stated that they were sometimes short due to staff sickness and staff were very busy at these times. Field House Care Home DS0000026436.V307199.R01.S.doc Version 5.2 Page 20 Five members of staff have attained the National Vocational Qualification (a practical and knowledge based programme which is assessed upon recognised national standards.) level two; two members of staff have attained the National Vocational Qualification level 1 in support services. A number of staff are also working towards this qualification. An induction programme is in use for all new members of staff, this covers both practical and knowledge based areas associated with the home and care required by service users. One member of staff spoken with substantiated that they had undertaken an induction that proved to be very beneficial and enabled them to carry out their job role in a proficient manner. Four staff personal files were observed which contained all required documentation. The administrator discussed the methods employed when recruiting new staff and the checks that are undertaken. Within the staff training room there was evidence to demonstrate that staff are undertaking supervision sessions and receiving support visits form the National Vocational Qualification facilitators. A training facilitator is employed by the home who oversees all staff training. There was evidence to demonstrate that further research is taking place for courses for staff to attend. Staff training records observed demonstrated that staff were undertaking training in mandatory areas, however records did not correspond with courses staff stated they had attended. For instance records for fire training stated that this had been undertaken in November 2004 whereas staff stated that they had recently had a course on this. It is acknowledged that there may be further records available as the training coordinator was not on duty on the day of the visit. Field House Care Home DS0000026436.V307199.R01.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): 31,33,35 and 38 The quality rating for this outcome area is good this judgement was made using evidence available including a visit to the service. 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 her responsibilities fully. The home is run in the best interests of service users. Service users financial interests are safeguarded. The health, safety and welfare of service users and staff are promoted and protected. EVIDENCE: The manager is a registered nurse and is registered with the Commission for Social Care Inspection. She continues to work toward completing the registered managers award. Field House Care Home DS0000026436.V307199.R01.S.doc Version 5.2 Page 22 The office was well organised and records were appropriately stored. Staff spoken with stated that the manager was approachable and supportive at all times and they felt valued within their job roles. Service users spoken with spoke highly of the manager and two service users spoken with stated that they felt the home was well run. The relative spoken with stated that the home was well run and exceptional standards of care were maintained. The manager has sent questionnaires to service users, those returned were observed. The questionnaire covered many issues relating to the home, the service and staff. Outcomes and comments observed were of a positive nature. The manager has also devised questionnaires for both staff and relatives, which are in the process of being completed. The manager is also considering formulating questionnaires for specialist visitors. Service users meetings are held on a regular basis to enable service users to express their needs and feelings. Service users personal finances are not held on the premises, should a cost be incurred relevant others are invoiced for this charge. All relevant maintenance and servicing certificates were observed. There was evidence that the fire alarm systems are checked, although there was no written evidence to demonstrate that emergency lights are tested. The manager stated that these are carried out on a regular basis. Relevant accident records were available within service users files. Water temperatures were recorded weekly. During the tour of the home there were no hazards observed. Field House Care Home DS0000026436.V307199.R01.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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Field House Care Home DS0000026436.V307199.R01.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 OP7 Regulation 13(4,c) Requirement To ensure service users are fully protected it is required that appropriate risk assessments with regards to the use of bedrail and the risk of entrapment are in place. Timescale for action 24/09/06 2 OP30 18(1,c) To demonstrate that staff are 24/11/06 fully trained and competent to do their job further documentary evidence is required in respect of staff undertaking mandatory training. 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 Refer to Standard OP9 OP38 Good Practice Recommendations Monitor the temperature of the clinic room. Ensure appropriate documentation in respect of fire safety is available for inspection. Field House Care Home DS0000026436.V307199.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Field House Care Home DS0000026436.V307199.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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