Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 21/06/05 for Firbank House Nursing Home

Also see our care home review for Firbank House Nursing Home for more information

This inspection was carried out on 21st June 2005.

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

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

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

Residents generally liked the staff and thought they were looked after well. Comments from residents included "staff treat me very well, they are very nice", "staff are lovely, really marvellous". One resident who liked to spend a lot of time in her own room said the best thing about the home was that the staff, "regularly pop in and out for a chat". One resident said the best thing was the company "some of girls are really nice" and staff, "try to preserve your dignity and treat you with respect". One resident said the best thing was that you were able to rest and staff did everything for you. The home has a pleasant, friendly atmosphere and residents said their visitors were made welcome. Staff know the residents well and detailed assessments are carried out to get a full picture of what each resident needs when they come in to the home.

What has improved since the last inspection?

Some rooms have been redecorated since the last inspection and appeared brighter and cleaner as a result.

What the care home could do better:

Record keeping was generally fair, but more care needs to be taken to make sure that residents` needs are documented clearly so that all staff know what they need to do to look after and monitor the residents properly. Medicines were found in various parts of the home, which were not locked away and suitable safe storage space must be found for them. The provision of recreational activities for residents is very poor, especially for those who are very dependent. More consideration must be given as to how residents spend their day and what social stimulation is provided to them. Staff have received minimal training and there remains a wide number of topics that need to be covered. Many parts of the home still need redecoration and refurbishment and essential equipment such as a dishwasher and hot water geyser need to be provided. Staffing levels are not always sufficient to meet the needs of the residents and the acting deputy manager needs more support from senior managers in the company to ensure that issues found at this inspection are dealt with. The health and safety of staff and residents are at risk because of some of the practices within the home and due to lack of equipment and lack of staff training in some health and safety topics.

CARE HOMES FOR OLDER PEOPLE Firbank House 24 Smallshaw Lane Ashton-under-Lyne Tameside OL6 8PN Lead Inspector Fiona Bryan Announced 21 June 2005 09.15am st The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Firbank House F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Firbank House Address 24 Smallshaw Lane, Ashton-under-Lyne OL6 8PN Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0161 343 1251 Partnership Caring Ltd Care Home 42 Category(ies) of DE(E) Dementia - over 65 - 20 registration, with number PD(E) Physical disability - over 65 - 22 of places OP Old Age - 42 DE Dementia - 20 PD Physical disability - 22 Firbank House F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than 30 service users to be admitted for nursing care. 2. 3. Two Registered nurses to be on duty between 8 am - 5 pm. One Registered nurse to be on duty between 5 pm - 8 am. The manager to be supernumerary to the above above hours. Date of last inspection 19th January 2005 Brief Description of the Service: Firbank House is situated near to Ashton-under-Lyne town centre. The home consists of two buildings, referred to as the main building and the annex is able to accommodate up to 42 service users and provides both personal and nursing care. The home is owned by Partnership Caring Limited, which is a private company, and is under the day-to-day control of a manager who is also a registered nurse. Twenty-one service users are accommodated in each building with rooms being spread over two floors. There are a total of 36 single rooms and three double rooms, of which the majority have en-suite facilities. Seven communal rooms offer a variety of settings in which service users are able to receive visitors, socialise and participate in activities. The home is close to local shops and bus routes. There is ample parking for those who choose to travel to the home by car. Firbank House F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector undertook this announced inspection, who spent eight hours at the home. Time was spent talking to residents and staff. Four residents were looked at in detail, looking at their experience of the home from their admission to the present day. Staff duty rotas and records of care were examined and a partial tour of the home was carried out. Prior to the inspection comments cards were sent to GP’s who visit residents at the home. One GP had responded at the time of writing this report, who stated that the home was “sometimes good, sometimes not” and who felt that constant staff turnover caused difficulties. Comments cards were left at the home for residents and visitors but none had been returned at the time of writing this report. Since the last inspection the manager and the deputy manager have left the home and efforts are being made to recruit a new manager. In the meantime an acting deputy manager has been appointed from within the home, who has very limited experience of management. In the absence of a manager the home has not moved forward in organising staff training which was an area that was highlighted as being needed at the last two inspections. Staff were concerned that without a manager improvements would not be made and the home’s standards would fall. One complaint has been investigated by the CSCI since the last inspection, which found some shortfalls in documentation and monitoring of a resident’s condition. What the service does well: Residents generally liked the staff and thought they were looked after well. Comments from residents included “staff treat me very well, they are very nice”, “staff are lovely, really marvellous”. One resident who liked to spend a lot of time in her own room said the best thing about the home was that the staff, “regularly pop in and out for a chat”. One resident said the best thing was the company “some of girls are really nice” and staff, “try to preserve your dignity and treat you with respect”. One resident said the best thing was that you were able to rest and staff did everything for you. Firbank House F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Version 1.30 Page 6 The home has a pleasant, friendly atmosphere and residents said their visitors were made welcome. Staff know the residents well and detailed assessments are carried out to get a full picture of what each resident needs when they come in to the home. 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. Firbank House F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Firbank House F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Version 1.30 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 standard(s) 3 and 4 Residents’ needs are assessed before they move into the home. Staff must have further training to ensure that they are always able to meet the needs of the residents. EVIDENCE: Four care files were looked at in detail. Each file provided a care assessment from social services, and staff had also undertaken the home’s own preadmission assessments. Staff said they would read the care file for a new resident and ask them and their relatives about the care that was needed and their preferences regarding their daily routine. Staff were knowledgeable about the residents and were able to describe in detail what help they needed with their daily activities. No dementia care training has been provided to staff to ensure that the care they deliver to residents with meets current guidelines for best practice. Staff have received some training in the care of residents who need enteral feeding, but otherwise no training has been delivered that is specific to the residents’ conditions. Firbank House F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 and 10 More rigour is needed to ensure that care plans identify and fully address all the residents’ needs. The majority of residents’ health care needs are met but staff must ensure that specific monitoring of residents’ conditions is carried out systematically. Poor procedures in respect of the storage of medicines put residents at risk. Staff generally treat residents with respect. EVIDENCE: Four residents’ care files were looked at in detail. Care plans had been developed from the assessment of the resident, and included social needs but one plan needed updating to reflect a resident’s potential psychological needs due to deteriorating physical condition. Many care plans were detailed about residents’ individual preferences but some were vague, for instance stating to “weigh regularly” or apply “appropriate dressings”. Care plans had been reviewed monthly and there was evidence to show that the resident or their representative had been involved in discussion about the care needed. Firbank House F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Version 1.30 Page 10 Residents had been seen by GP’s, practice nurses, chiropodists, Macmillan nurses, opticians and dieticians. One resident who had been for investigations at the hospital was fully aware of her condition and specialist services had been accessed for her. However a complaint investigated since last inspection showed that healthcare needs were not always monitored as well as they should have been, and one resident who had lost weight had not been weighed regularly although they had been seen by the dietician. An unlocked cupboard in one storeroom in the annexe contained pharmacy items such as phosphate enemas and topical creams. Oxygen cylinders were stored inappropriately and without adequate safety signage in the office and upstairs bathroom. No residents in the annexe were prescribed oxygen. Oxygen must not be administered to residents unless prescribed by their GP. Prescription creams were found in one bathroom. Residents felt they were treated with respect, although one resident complained that staff from overseas sometimes spoke on their mobile phones, when in their room attending them, which they felt was quite discourteous. Where a female resident had an objection to being cared for by a male carer, this was recorded in their care plan. Firbank House F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,14 and 15 Residents’ social, cultural and recreational needs are not always met. Residents are able to make some choices about their lives. Meals suit most residents’ tastes. EVIDENCE: Residents said that the routine within the home was not regimented and that they were able to choose how to spend their day. The atmosphere was relaxed and residents were free to move around the home as they wished, depending on their ability. One resident liked to spend time in her own room knitting and reading. Another resident said she liked to read and watch television and said that sometimes outside entertainers came to sing. However, staff and residents agreed that activities and leisure pursuits for residents were minimal and staff said that they found it difficult to organise social events due to staffing levels and their workload. Residents were observed to be sitting in the lounges for long periods of time with little to stimulate them. Records showed that the advocacy service from the Citizen’s Advice Bureau had been involved in reviews of care to support the residents and their representatives and ensure that their views were made known. Firbank House F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Version 1.30 Page 12 Most residents spoken to said the food was “not bad”, and said that there was some choice although this was limited. Residents said that drinks and biscuits were offered at suppertime, although consideration should be given to providing something more substantial such as cake, toast or crumpets, as the evening meal is served early and many residents have a long gap between that and breakfast the next morning. Firbank House F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Residents are confident that complaints will be dealt with properly. Staff require training to ensure that residents are protected from abuse. EVIDENCE: One resident didn’t know how to make a complaint but had not had reason to complain, and another said she would speak to the nurse in charge and felt any complaints would be dealt with properly. The complaints procedure was displayed in the reception area of the home, but needed updating as it still referred to the previous manager of the home. The majority of staff have received training in adult protection, prevention of abuse or dealing with challenging behaviour. Staff said that they would report any suspected abuse to the nurse in charge or the deputy manager. Firbank House F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,21,23,25 and 26 All areas of the home are not well maintained. Bathroom facilities are sufficient in number but not homely in appearance. Some rooms are not suitable for residents’ needs and some water temperatures are unsafe for residents. Most of the home was clean and tidy. EVIDENCE: Since the last inspection some rooms have been repainted and looked brighter and cleaner. Other rooms still need redecorating and three rooms on the ground floor in the annexe were really dark – residents would not be able to sit in these rooms during the day without the light on. Trees outside these rooms must be cut down to provide more daylight. All rooms were nicely personalised with small items of the residents’ own furniture, photographs, ornaments and mementos. Firbank House F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Version 1.30 Page 15 A torn hallway carpet on the ground floor of the annexe presents as a trip hazard and must be replaced. Lounges and dining rooms in the main building and the annexe were clean and tidy; no malodours were detected. The kitchen was lacking basic equipment such as a dishwasher, hot water geyser, sufficient cutlery and crockery. The bathroom on the first floor in the annexe was cluttered and untidy with commodes, bowls, toilet seats, sponges and wheelchairs. The toilet on the ground floor in the main building had no seat and no waste bin. Notices to staff in bathrooms make these rooms appear unappealing and impersonal. One bathroom contained an oxygen cylinder. The bath water temperature in the first floor bathroom in the main building was 48ºC, which puts residents at risk of scalding. Also water temperatures in the wash hand basins in rooms 19 and 20 were above 60ºC and present a risk of injury to residents and staff. Some wardrobes in residents’ rooms were overfilled with clothes, which meant that clothes were getting creased. Clothes belonging to other residents were found in some wardrobes. Key workers should help residents sort through their wardrobes and put away winter clothes that they will not be wearing, to make more space. Firbank House F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 Staff are not provided in sufficient numbers to ensure that the needs of residents can be met. The home does not have a structured training programme to ensure that staff have the skills and knowledge to do their jobs. EVIDENCE: Examination of staff duty records showed that just prior to the inspection there had been only one nurse and two carers in the annexe to care for eighteen residents; there was also no housekeeping staff and no kitchen assistant so staff had to make breakfast and wash up. Staff are further challenged because of the lack of basic equipment such as dishwashers and hot water geysers; staff were making tea for eighteen residents using two kettles which were leaking. This is also a health and safety hazard as staff are at risk of scalds. In addition to this there is a shortage of cutlery and crockery meaning that staff are having wash utensils to pass them onto other residents, which is time consuming. On the day of the inspection there was only one housekeeper for both buildings. Residents and staff spoken to all said that there were not always enough staff to care for the residents. The acting deputy manager has taken on additional responsibilities, which take up a significant amount of time, but has no supernumerary hours to undertake them, whereas the previous manager was supernumerary full time. Firbank House F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Version 1.30 Page 17 Although some staff had commenced foundation training which will lead to NVQ training, and other staff had commenced NVQ training, staff require updates in mandatory health and safety topics, and a programme of training needs to be developed that is specific to the needs of the residents and the care that staff are being expected to deliver. Firbank House F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 38 Residents are at risk due to the lack of senior managerial support within the home. The health, safety and welfare of residents and staff are at risk due to poor practices and procedures, lack of equipment and insufficient staff training. EVIDENCE: The previous manager resigned from her position on 29th April 2005 and since this time efforts have been made to recruit another suitable manager. In the meantime an acting deputy manager has been appointed from within the home, who has been working hard to maintain stability and continuity of care for the residents, with a fair degree of success. However there have been few improvements within the home since the last inspection and the acting deputy manager requires a lot of support until the appointment of a new manager, to ensure that requirements and recommendations from this report are complied with and the home moves forward in improving its service to residents. Staff themselves expressed concerns that in the absence of a manager standards would begin to Firbank House F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Version 1.30 Page 19 deteriorate and the registered provider and the area manager must ensure that frequent visits to the home are made so that the acting deputy manager has the support and backing to maintain standards and develop areas within the home. The CSCI has received no reports of visits undertaken under Regulation 26 of the Care Homes Regulations 2001, although it was reported that such visits had just commenced at the home. Staff require training updates in mandatory health and safety topics and fire drills must be arranged. Some of the fire exits were impeded by furniture and equipment. In the main building visitors had not signed in and out on entry and exit of the building so in the event of fire the number of people within the building would not be known. An industrial dishwasher should be provided to ensure that residents’ cutlery and crockery is washed at appropriate temperatures to prevent infection. The hot water geyser must be repaired or replaced as staff were at risk of scalds from using leaking kettles to boil water. The kitchen storeroom on the first floor in the main building was dirty and needed cleaning. Pharmacy items were found in the bathrooms and must be safely stored. One sluice was not locked and contained cleaning products, which should be safely stored. Firbank House F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 2 x 2 x 2 x 2 3 STAFFING Standard No Score 27 1 28 x 29 x 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x 2 x x x x x 1 Firbank House F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Version 1.30 Page 21 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 4,30 Regulation 18 Requirement The registered person must ensure that staff receive training in dementia care and other training specific to the needs of the residents. (Timescale of 31/3/05 not met). The registered person must ensure that care plans fully identify all residents needs and clearly state the action that needs to be taken by staff to address those needs. The registered person must ensure that the health needs of residents are systematically and effectively monitored. The registered person must ensure that all prescribed medicines are stored appropriately. The registered person must ensure that oxygen is not administered to residents unless it has been prescribed by their GP The registered person must ensure that oxygen cylinders are stored in a designated area with appropriate safety signage. The registered person must ensure that a programme of F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Timescale for action 31/12/05 2. 7 15 31/8/05 3. 8 13 31/8/05 4. 9 13 31/7/05 5. 9 13 31/7/05 6. 9,38 13 31/7/05 7. 12 16 31/8/05 Page 22 Firbank House Version 1.30 8. 18, 30 13 9. 19 23 10. 19, 23 23 11. 19 16 12. 19 23 13. 21 23 14. 25 13 15. 27 18 recreational and social activities is developed that meets the needs of the residents. The registered person must ensure that staff receive training in adult protection, prevention of abuse and dealing with challenging behaviour. The registered person must ensure that there is a continued programme of redecoration and refurbishment within the home The registered person must ensure that trees at the side of the annexe are pruned to the extent that the rooms identified during the inspection receive maximum daylight. The registered person must ensure that the ground floor hallway carpet in the annexe is replaced. The registered person must ensure that there are sufficient quantities of crockery and cutlery in the home. The registered person must ensure that bathrooms and toilets are clean and pleasant for residents to use, and are furnished with all necessary equipment and accessories.. The registered person must ensure that bath water temperatures within the home are maintained at 43ºC. Safety notices must be displayed at hand wash basins where water exceeds this temperature and risk assessments must be carried out. The registered person must ensure that at all times suitably qualified, competent and experienced staff are working at the home in such numbers as are appropriate for the health and welfare of residents. F54-04 S25433 Firbank House v223847 210605 Stage 4.doc 30/9/05 31/12/05 31/8/05 31/7/05 31/7/05 31/7/05 31/7/05 31/7/05 Firbank House Version 1.30 Page 23 16. 27 18 17. 32 26 18. 30, 38 18 19. 20. 38 38,19 23 23 21. 22. 23. 24. 38 38 13 COSHH 1988 The registered person must ensure that the acting manager is supernumerary to any care hours provided. The registered person must ensure that visits are undertaken in accordance with this regulation and a report is supplied to the CSCI each month. The registered person must ensure that staff receive updates in mandatory health and safety training. The registered person must ensure that fire drills are carried out at suitable intervals. The registered person must ensure that fire exits are free from obstruction, recommendations from the fire officer are carried out and visitors sign the visitors book on entry and exit of the home. The registered person must ensure that food storage areas are kept clean. The registered person must ensure that cleaning products are stored safely. 15/7/05 15/7/05 31/12/05 31/7/05 31/7/05 15/7/05 15/7/05 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 19,38 Good Practice Recommendations The registered person should ensure that a dishwasher is provided home. Firbank House F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 2nd Floor, Heritage Wharf Porland Place Ashton-under-Lyne OL7 0QD 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 Firbank House F54-04 S25433 Firbank House v223847 210605 Stage 4.doc Version 1.30 Page 25 - 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!