Inspection on 16/06/06 for Field House Rest Home

This inspection was carried out on 16th June 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Field House Rest Home 06/08/08

Field House Rest Home 30/07/07

Field House Rest Home 17/01/07

Field House Rest Home 12/09/05

Field House Rest Home 28/06/05

Field House Rest Home 17/05/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Field House Rest Home Off Western Road Hagley Clent, Near Stourbridge West Midlands DY9 0HL Lead Inspector Jane Morgan Unannounced Inspection 16th June 2006 9.40 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 Rest Home DS0000018505.V300387.R03.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 Rest Home DS0000018505.V300387.R03.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Field House Rest Home Address Off Western Road Hagley Clent, Near Stourbridge West Midlands DY9 0HL 01562 885211 * 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 Ernest Michael Lane Mrs Jermaine Kathleen Emily Lane Care Home 54 Category(ies) of Dementia - over 65 years of age (54), Old age, registration, with number not falling within any other category (54), of places Physical disability over 65 years of age (54) Field House Rest Home DS0000018505.V300387.R03.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may also accommodate two named persons aged between 62 - 65 years. 12th September 2005 Date of last inspection Brief Description of the Service: Field House is a care home providing personal care and accommodation for up to fifty-four older people who may have physical disabilities and/or illnesses of the dementia type. It is owned by Mr and Mrs Lane. There is no registered manager at present. There has been an acting manager for twelve months. Field House is a Georgian style building standing in ten acres of ground. The setting is rural with village facilities nearby. The home was first registered in 1983 and consists of the original building added to with extensions. The home is divided into three areas known as the main house, the coach house and the cottage. These are connected by a covered corridor. Field House Rest Home DS0000018505.V300387.R03.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The last inspection took place in September 2005. This raised serious concerns about the condition of the home’s environment and aspects of the management of the home. Follow-up visits were undertaken in January and April 2006. During this inspection two inspectors spent a day at the home. Residents and members of staff were spoken to, records were inspected and a partial tour of the premises conducted. Twenty-three relatives returned questionnaires. There were forty residents on the day of the visit to the home. What the service does well: What has improved since the last inspection? What they could do better: Information for residents needs to be improved. Pre-admission assessments, risk assessments for residents, and service user plans are not completed in sufficient detail and immediate requirements for their improvement were left. A number of relatives were unsure about how to complain and there was evidence that a complaint from a relative had not been recorded. A multiagency approach to the investigation of allegations of abuse is not fully established. Staff files contained insufficient evidence of thorough staff recruitment. Aspects of the home’s health and safety need to be improved. Residents did not have access to their spending money in the absence of the acting manager. Field House Rest Home DS0000018505.V300387.R03.S.doc Version 5.2 Page 6 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. Field House Rest Home DS0000018505.V300387.R03.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 Field House Rest Home DS0000018505.V300387.R03.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,(standard 6 does not apply). The quality of the outcomes in this area is poor. This judgement has been made using available evidence, including visits to this service. Information for residents needs improvement. Greater clarity in the terms and conditions of admission is required. Pre-admission assessments are inadequate. EVIDENCE: The statement of purpose is not up-to-date and needs some additional information to meet the requirements of the legislation fully. The home has a standard contract. This states that upon payment of the weekly charge food, heat, light and laundry and all necessary personal care will be provided. Feedback from a relative included a copy of an invoice from the home listing heating and lighting as extras, rather than as included in the fees. The relative stated that they have not been issued with a contract. Another relative expressed concern that a top-up fee charged for a large room with a private bathroom should continue to be charged for a smaller room with a shared bathroom. The relative considered that there was lack of clarity about fees being charged. Field House Rest Home DS0000018505.V300387.R03.S.doc Version 5.2 Page 9 Files for three recently admitted residents were inspected. The first contained a pre-admission assessment but this contained insufficient detail and was undated. The second resident had transferred from another care home. This home had provided good information. This indicted a resident with complex needs. There was no evidence that a pre-admission assessment had been completed by the home. Field House Rest Home DS0000018505.V300387.R03.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. The quality of the outcomes in this area is poor. This judgement has been made using available evidence including visits to this service. Service user plans contain insufficient detail. Clearer evidence of the promotion and maintenance of residents’ health is required. The system for the administration of medication is good. There is evidence that residents’ privacy and dignity are respected in many instances but a lapse was noted. EVIDENCE: The three service user plans inspected contained insufficient detail. One of the residents had been living at the home for five days. The transfer information indicated a history of falls and a risk of pressure areas. The resident was spoken to and was found to be asthmatic. The service user plan covered mobility, and washing and dressing only. It did not contain enough guidance for staff as an initial service user plan in meeting the resident’s needs. Another service user plan inspected was for a resident with diabetes. This aspect of care was inadequately recorded. Feedback from one relative included that she had made an informal complaint because she considered that her mother’s diabetes was not being dealt with properly. The resident’s confusion, broken, itchy skin, and weight loss did not from part of the service user plan. At a previous inspection the acting manager had been advised that a resident’s Field House Rest Home DS0000018505.V300387.R03.S.doc Version 5.2 Page 11 particular condition needed to be covered in the service user plan. This has been added to all service user plans when it is not always relevant, indicating lack of understanding of individualised care. Three family members commented that they were not always kept informed of important matters relating to their relative’s care. Residents have access to health services. Feedback from one relative was that a resident with diabetes was being asked to pay for chiropody when this is provided free by the NHS. He did not understand why he was being asked to pay. Staff stated that a pressure-relieving mattress for one resident had been requested from the district nurse. There was no record of this. Files did not routinely contain nutritional screening. No continence assessments have been completed. Risk assessments were not completed in sufficient detail. Where risks have been identified, they have not been fully translated into a plan of care to reduce the risk. The system for the administration of medication was inspected. Records were completed appropriately. Residents said that they found the staff helpful and kind. They felt that they were looked after and that staff did their best. Residents can receive visitors in private, always wear their own clothes and staff address them by title if preferred. One of the notice boards in the home contains a list of residents’ names indicating when night-time checks are to be made. This includes a note “8pm nappy”. Most of the toilets and bathrooms checked had appropriate locks, a bathroom near the lounge had no lock. Field House Rest Home DS0000018505.V300387.R03.S.doc Version 5.2 Page 12 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): 12-15. The quality of the outcomes in this area is good. This judgement has been made using available evidence including visits to this service. Residents would benefit from more opportunity for activity. They maintain contact with family and friends. Residents are helped to exercise choice within the home’s routines. They are provided with good meals, with choices of food available. EVIDENCE: Social histories had been completed for the residents whose files were inspected. Residents indicated that they have choices within the home’s routines, for example, about where they spend their day and about food. One of the relatives providing comments included that she was pleased when her relative attended keep fit classes or went for lunch at a garden centre. The home holds a keep fit session twice a week and a bingo session once every six weeks. There are trips out sometimes. There are no records of other activities on a regular basis. Residents said that they usually watch television and doze during the day. On the day of the inspection a few residents were sitting outside. Feedback from relatives was that they could visit at any time and are made welcome. Residents’ money is generally managed by relatives, the home holds some spending money for a small number of residents. Residents are able to bring Field House Rest Home DS0000018505.V300387.R03.S.doc Version 5.2 Page 13 personal possessions with them. Some of the rooms are very large enabling residents to bring items of furniture without difficulty. Information is given to residents about access to records. All the residents spoken to were satisfied with the food provided by the home. They said that they have enough to eat and are provided with alternatives if they do not like the meal on the menu. Residents are assisted to eat where necessary and mealtimes are unhurried. Field House Rest Home DS0000018505.V300387.R03.S.doc Version 5.2 Page 14 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 of the outcomes in this area is poor. This judgement has been made using available evidence including visits to this service. Complaints are not fully recorded. A multi-agency approach to allegations of abuse must be established. EVIDENCE: Field House has a satisfactory complaints procedure. However, seven of the twenty-three relatives returning questionnaires stated that they were unaware of the complaints’ procedure. One relative responded that she had made a complaint that had been dealt with to her satisfaction, but this complaint did not appear in the complaints’ record. Another relative commented that she had made a complaint to one of the home’s owners who suggested that she might like a month’s notice for her relative to leave the home. As found at previous inspections the home does not have one adult protection procedure, but two versions. There is a copy of a local authority policy and procedure but the home’s policies and procedures file contains another procedure that is displayed on a staff notice board within the home. This includes the investigation of injury to residents by the home’s staff and the interviewing of alleged perpetrators and witnesses. This is contrary to the multi-agency approach required by the Department of Health. Staff have not received any adult protection training. The whistle-blowing procedure continues to refer to exhausting internal mechanisms first, contrary to the Public Interest Disclosure Act. Field House Rest Home DS0000018505.V300387.R03.S.doc Version 5.2 Page 15 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 of the outcomes in this area is adequate. This judgement has been made using available evidence including visits to this service. The home’s environment has been improved and is of an acceptable standard. Some aspects of infection control need improvement. EVIDENCE: A meeting was held with the home-owners and acting manager following the September 2005 inspection. The poor condition of the home was discussed and the owners undertook to improve the environment in which residents were living. During the follow-up visits to January and April 2006 and during this inspection, the improvement was obvious. A flat roof has been repaired, sections of guttering renewed, and the main house has been painted outside. There has been re-decoration of areas of the home with some new curtains and bedding purchased. All the areas of the home inspected on this occasion were of an acceptable standard. The grounds are tidy and attractive. The laundries were clean and tidy. There are suitable sluicing facilities. There was offensive odour in two bedrooms. In one the mattress had no protective Field House Rest Home DS0000018505.V300387.R03.S.doc Version 5.2 Page 16 covering. There were bars of soap rather than liquid soap in bathrooms and toilets. In some there were cloth towels or no towels at all. Field House Rest Home DS0000018505.V300387.R03.S.doc Version 5.2 Page 17 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): 27,29. The quality of the outcomes in this area is adequate. This judgement has been made using available evidence including visits to this service. Staffing is at the minimum agreed level. There is insufficient evidence of thorough staff recruitment. EVIDENCE: Staffing levels were at the minimum agreed level. There were forty residents in the home with six members of staff providing care. Five of the twenty-three relatives responding to the survey were of the opinion that at times there are insufficient staff on duty. The inspectors asked to look at the files for the most recently recruited members of staff. They were told that these records were available in the home. Two files were inspected. One contained only an application form. This included a health declaration and a declaration about lack of criminal offences. The employment history was incomplete. The second file contained an application form with an incomplete employment history. There was a criminal records bureau (CRB) check and two references. The reference from the previous employer indicated that disciplinary action had been taken against the applicant. There was no record that this issue had been further investigated. The acting manager had drawn up a staff training matrix as requested. In her absence this could not be found. The acting manager gave this to an inspector on her return from leave. It shows that many of the staff have not received basic training, such as moving and handling, and health and safety. This must Field House Rest Home DS0000018505.V300387.R03.S.doc Version 5.2 Page 18 be addressed with urgency. Staff stated that they have not participated in training on dementia. The feedback from most of the relatives was that staff are pleasant, helpful and kind. Field House Rest Home DS0000018505.V300387.R03.S.doc Version 5.2 Page 19 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): 31,38 The quality of the outcomes in this area is poor. This judgement has been made using available evidence including visits to this service. There is no registered manager. Residents did not have access to their spending money in the absence of the acting manager. Some aspects of health and safety need improvement. EVIDENCE: The home has had an acting manager for over twelve months. An application for registration was made and the assessment of fitness took place. The CSCI indicated that it was minded to refuse the application. It was withdrawn. The owners of the home believe that the acting manager is the best person for the job and a new application for registration is being made. The CSCI has received some positive feedback about the acting manager. In the absence of the acting manager the progress in establishing a quality assurance system was not checked. It will be checked at the next inspection. Field House Rest Home DS0000018505.V300387.R03.S.doc Version 5.2 Page 20 The inspectors asked to look at the handling of residents’ money. The record of transactions was available, but staff had been looking for the tin containing residents’ money before the inspection and been unable to find it. It had been moved from the usual place. The home has a health and safety policy. As noted above, risk assessments for service users need improvement. The kitchen was clean and tidy. A bottle of bleach had been left in a laundry which is easily accessible. Some unrestricted windows were noted, although most are restricted. Water temperatures were within the safe limits. Accidents were being recorded but not in the HSE book. On the morning of the inspection staff did not have access to accident sheets as the office was locked and no member of staff had the key. Two wheelchairs without footplates attached were seen. The lock on one bedroom door would allow a resident to lock themselves in without access by staff in an emergency. Field House Rest Home DS0000018505.V300387.R03.S.doc Version 5.2 Page 21 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 2 2 1 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 1 3 x x x x x x 2 STAFFING Standard No Score 27 3 28 x 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 x x x 1 x x 2 Field House Rest Home DS0000018505.V300387.R03.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? YES 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 OP1 Regulation 4 Requirement The statement of purpose must contain all the information listed in schedule 1. (Previous timescale of 30/6/06 not expired). The statement of terms and conditions for residents must be clear about the overall care and services covered by the fee, and additional services to be paid for over and above those included in the fees. Pre-admission assessments must cover all the areas listed in standard 3.3. Immediate requirement. All the needs identified in preadmission assessments must be translated into a care plan. From the date of the inspection. (Previous timescale of 4/4/06 not met) Immediate requirement. Appropriate risk assessments must be undertaken for all DS0000018505.V300387.R03.S.doc Timescale for action 30/09/06 2. OP2 5 schedule 4 (8). 30/09/06 3. OP3 14 16/06/06 4. OP7 15 16/06/06 5. OP7 12 16/06/06 Field House Rest Home Version 5.2 Page 23 6. OP8 12 7. OP10 12(4)(a) residents and further developed into a plan of care to reduce the risks. Immediate requirement. There must be clearer evidence form records of the care provided that residents’ health is being promoted and maintained. From the date of the inspection. All bathrooms and toilets must be fitted with suitable locks. (Previous timescale of 30/6/06 has not expired). Personal information about residents must not be displayed on notice boards. From the date of the inspection. Residents must not be referred to as wearing nappies. From the date of the inspection. More regular activities for residents must be reestablished. All complaints must be recorded. From the date of the inspection. There must be one adult protection policy and procedure drawn up in line with the local authority’s procedures. Policies and procedures referring to internal investigation of allegations of abuse must be removed. (Previous timescales of 31/8/05 and 31/10/05 not met. Timescale of 30/06/06 has not expired.) Immediate requirement. All staff must receive training in adult protection. (Previous timescales of 30/9/05 and 31/12/05 not met. Timescale of 30/06/06 has not expired). The whistle-blowing policy must be altered to comply with the Public Interest Disclosure Act. (Previous timescale of 31/12/05 DS0000018505.V300387.R03.S.doc 16/06/06 30/09/06 8. OP10 12(4)(a) 16/06/06 9. 10. 11. 12. OP10 OP12 OP16 OP18 12(4)(a) 16(2)(n) 22 13(6) 16/06/06 30/09/06 16/06/06 30/06/06 13. OP18 13(6) 30/09/06 14. OP18 13(6) 30/09/06 Field House Rest Home Version 5.2 Page 24 15 16 17 18 OP26 OP26 OP26 OP28 16(2)(j) 16(2)(j) 16(2)(j) 18(1)(c) 19. OP29 19, schedule 2 20 OP30 18 not met. Timescale of 30/06/06 has not expired.) All offensive odours must be eliminated. From the date of the inspection. Mattresses at risk of soiling must be covered. Liquid soap and paper towels must be available in shared toilets and bathrooms. A plan must be put in place and implemented, to ensure that 50 of care staff achieve NVQ level 2 qualifications. Substantial progress on this must be made by the timescale set. (Not checked on this occasion). For the protection of residents, the recruitment process must meet the requirements of the regulations. All the information listed in schedule 2 must be available on every staff file. Immediate requirement. (Previous timescale of 04/04/06 not met). All staff must receive a minimum of three days training per year, including training appropriate for the registration categories, for example, dementia, and have individual training and development profiles. (Previous timescales of 31/8/05 and 31/12/05 not met. Timescale of 30/06/06 has not expired). A quality assurance system must be fully established in accordance with the requirements of regulation 24 and standard 33. (Not checked on this occasion). Residents must have access to their spending money at all DS0000018505.V300387.R03.S.doc 16/06/06 30/09/06 30/09/06 30/09/06 16/06/06 30/09/06 21 OP33 24 30/09/06 22 OP35 12 16/06/06 Page 25 Field House Rest Home Version 5.2 23 OP36 18 times. From the date of the inspection. Care staff must receive formal supervision at least six times a year. (Previous timescales of 31/8/05 and 30/11/05 not met). All staff to have had one recorded supervision session by the date shown. (Not checked on this occasion, timescale has not expired) All substances hazardous to health must be securely stored. From the date of the inspection. All windows with a substantial drop must be restricted. Staff must have access to the means of recording accidents at all times. From the date of the inspection. All wheelchairs must have footplates attached. From the date of the inspection. The inappropriate lock which would prevent staff access in an emergency must be removed from a bedroom door. Immediate requirement. 30/09/06 24 25 26 OP38 OP38 OP38 13(4)(c) 13(4)(c) 13(4)(c) 16/06/06 31/07/06 16/06/06 27 28 OP38 OP38 13(4)(c) 13(4)(c) 16/06/06 16/06/06 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 OP38 Good Practice Recommendations The HSE accident book should be used to record accidents and an audit of accidents should be regularly carried out. Field House Rest Home DS0000018505.V300387.R03.S.doc Version 5.2 Page 26 ------- Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Rest Home DS0000018505.V300387.R03.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!