Inspection on 08/11/06 for Forget-me-not Residential Home

This inspection was carried out on 8th November 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.

Other inspections for this house

Forget-me-not Residential Home 10/11/08

Forget-me-not Residential Home 15/12/05

Forget-me-not Residential Home 28/06/05

Forget-me-not Residential Home 11/01/05

Forget-me-not Residential Home 08/06/04

Forget-me-not Residential Home 18/03/04

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

CARE HOMES FOR OLDER PEOPLE Forget-me-not Residential Home 151 Burnham Lane Slough Berkshire SL1 6LA Lead Inspector Jill Chapman Unannounced Inspection 8th November 2006 10:20 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 DS0000011316.V318524.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. DS0000011316.V318524.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Forget-me-not Residential Home Address 151 Burnham Lane Slough Berkshire SL1 6LA 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) 01628 668902 01628 668902 Mr Roger William Pell Mrs Tania Pell Ms Shirley Elizabeth Fairley Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places DS0000011316.V318524.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th December 2005 Brief Description of the Service: Forget-me-not Residential Home is a care home providing personal care and accommodation for 16 service users aged 65 years and over. Mr and Mrs R. W. Pell privately own the home, which was opened in 1995. The two storey home is situated in a quiet road just off a main thoroughfare on the outskirts of Slough. All the homes bedrooms are single, and 7 have en-suite facilities. There is a passenger lift. The home has a large, easily accessible garden. The current fees for the home range from £440-£490 per week. DS0000011316.V318524.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was anunannounced ‘Key Inspection’. The inspector arrived at the service at 10.20 am and was in the service for six and a quarter hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. A inspector toured the premises, spoke to the proprietor Mrs Pell, the manager Ms Fairley, staff on duty and some of the service users. Some of the daytime routine and a lunchtime meal was observed. Records relating to care, staff and health and safety were sampled. What the service does well: New service users are only admitted if the home has carried out an assessment to make sure it can meet their needs. The home does not admit service users who need intermediate care. Service users have care plans which show the care they need and how staff should give this. Staff help service users to take their medication and to access healthcare. Staff are trained to know how to protect service users confidentiality and privacy and how to treat them well. The home meet the differing care, health and religious needs of the elderly service users and from evidence seen they would be able to meet any cultural needs. The home provides service users excellent opportunities for activities, mental stimulation and community involvement. Service users can make choices in their routines and meals.They enjoy appetising food and sociable mealtimes. Service users know how to make a complaint and staff deal with their concerns appropriately. Staff are aware of how to protect service users from abuse. DS0000011316.V318524.R01.S.doc Version 5.2 Page 6 Service users benefit from a clean, homely, well-maintained and comfortable home. Service users are supported by a stable staff team who are trained to meet their needs. There are enough staff to meet service users current needs. There is an experienced and competent manager in post and the home is well managed. The home seeks the views of service users and their relatives to help develop the service. Staff receive regular supervision to help them work effectively with service users. Health and safety systems are generally good. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000011316.V318524.R01.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 DS0000011316.V318524.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 7 Quality in this outcome area is good. New service users are only admitted if the home has carried out an assessment to make sure it can meet their needs. The home does not admit service users who need intermediate care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an assessment process which includes a written assessment of need to make sure that they can meet the needs of prospective service users. Completed assessments were seen on three files sampled and two service users said they had been able to visit the home before deciding to come and live there. Copies of post placement reviews were seen on files sampled. In discussion with the manager it was found that the home does not take service users who need intermediate care and so standard 6 does not apply to this home. DS0000011316.V318524.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. Service users have care plans which show the care they need and how staff should give this. The home meet the differing care, health and religious needs of the elderly service users. There are risk assessments to show where individual service users are vulnerable but more written guidance is needed to help staff know how reduce the risks. Staff help service users to take their medication and to access healthcare. Staff are trained to know how to protect service users confidentiality and privacy and how to treat them well. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans were sampled and these are up to date and give good information on how staff can meet service users needs and promote independance. Daily records are kept and these show that care plans are carried out. Daily records are written on computer and a hard copy kept on file, the proprietor has introduced this system to make sure care records are easy to read and up to DS0000011316.V318524.R01.S.doc Version 5.2 Page 10 date. The manger said that care plans are reviewed monthly and there was recorded evidence of this. Service users spoken with were clear about what help they needed from staff. Risk assessments identify potential risks for individual service users. It is recommended that these are developed to give more specific information to help staff know what they should do to reduce the risks. The home meet the differing care, health and religious needs of the elderly service users. The service user and staff groups are maily white british. The home encourages them to look at the needs and customs of other groups. A themed week was held recently to look at food, religion and dress of the Asian culture. Service user health care needs are well documented and there are monitoring charts for specific needs. The visits and outcomes of the GP and other health professionals are recorded. Service users said that staff call the GP if they are unwell and one spoke of how staff have supported her with an illness. In discussion with staff it was clear that they liase well with district nurses and other health professionas involved in service users care. Medication is supplied to the home in Nomad packs and these are checked to make sure they are accurate. Staff are trained in during induction to give medication and staffs competency is reviewed if the manager feels more training is needed. The storage and administration of controlled drugs was satisfactory. A previous requirement to make sure staff sign the medication record when medication is given, has been met. A previous recommendation has been met, the pharmacist now visits regularly to check that the homes medication policies and procedures are satisfactory. It is recommended that a stock control system for PRN (given when needed) medication is developed to make sure the proces is working properly. It was seen that staff treat service users with respect and in discussion they were aware of how to maintain their privacy. The staff induction process covers isssues of confidentiality, privacy and dignity. The record keeping policy tells staff how records should be written to maintain confidentiality. Service users were complimentary about how staff treat them. Service users surveys show that staff listen to them and act on what they say. DS0000011316.V318524.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15. Quality in this outcome area is excellent. The home provides service users excellent opportunities for activities, mental stimulation and community involvement. Service users can make choices in their routines and meals.They enjoy appetising food and sociable mealtimes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was good information to show that service users are able to make choices in their daily routines. Service users told how they can have their breakfast at a time of their choice and can choose when to go to bed. The evening staff are on duty till 10pm which means they are available if service users need help later on. The only area where there is limited flexibility is the choice of when they can have a bath, service users have a set bath day each week. Service users spoken with were satisfied with this arrangement. The home provides service users excellent opportunities for activities and mental stimulation. These were evident from discussion with service users and staff, activity timetables, photographs and the service users notice board. The DS0000011316.V318524.R01.S.doc Version 5.2 Page 12 proprietor Mrs Pell plays an active part in developing these opportunities. She also runs a Monday Club at a local venue and service users from the home can attend. Regular activities are held in house and include bingo, reminiscence, visiting entertainers, having their nails and hair done and Sherry and Chat sessions. Themed weeks are held and have included, Asian, Churchill, Halloween and Fireworks weeks. A weekly newsletter is produced in large format to help service users with visual impairment. The home is excellent at involving the home in the local community with visits from a church minister, visits to the Monday Club and the involvement of local schools for work experience or entertainments such as Christmas Carol singing. One service user said she was pleased that she found that friends that she has known for many years from her local community are living in the home. The home helps service users manage their personal spending money and there is a system for the safekeeping of this. This was sampled and found to be accurate. Some have relatives who manage their financial affairs. Service users spoken with said that the meals in the home are good and that they can have a choice from the main menu. It was seen that some service users chose to have a different meal from the full roast lamb meal on offer at lunchtime. Service users commented on how tender the roast lamb was and said that meals were always well cooked. A cook is employed Monday to Friday and an extra staff are deployed to cover weekend lunchtimes. The daily menu is displayed on a notice board in the hall. Service users said that they have an evening drink with biscuits or sandwiches at 8 pm to keep them from being hungry at night. One service users said if she wakes at night staff give her a cup of tea and a biscuit to help her settle. Special diets are catered for and a service user said she chose this home because they could meet her eating routines. Meals are well presented and served hot. Fresh produce is supplied and a butcher rather than the supermarket supplies the meat. The manager said that staff eat lunch with the service users to help them communicate and to make it a more social occasion. DS0000011316.V318524.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. Service users know how to make a complaint and staff deal with their concerns appropriately. that staff . Staff are aware of how to protect service users from abuse but some have not had training in this and others may need up to date training. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The commission has received one complaint from a relative about various care issues and has investigated this in an additional inspection carried out on 21/12/06. This complaint was not upheld. The complaints record was seen and shows that no recent complaints have been received by the home. The complaints procedure is accessible to service users, it is on display on the notice board and in their copy of the Service Users Guide. Service users said they know who to talk to if they have a problem. In discussion with staff and the manager it was found that they would know what to do if they had concerns about the welfare of a service user. The majority of staff have had vulnerable adults training in 2004 and it is recommended that the manager seek advice as to whether this training should be updated in line with current POVA practice. Some staff have not had any training in this, the manager is aware of the need to book this and has DS0000011316.V318524.R01.S.doc Version 5.2 Page 14 information on local courses. The home has a copy of the new Local InterAgency Procedures and the manager said that proprietor Mrs Pell has updated staff on this. There is a Whistle Blowing Policy and the staff said they would use this if they had concerns for service users safety. DS0000011316.V318524.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. Service users benefit from a clean, homely, well-maintained and comfortable home. The communal carpets need repair or replacement to reduce the risk of service users tripping. Advice needs to be sought from the Environmental Health Officer as to the suitability of the floor and wall coverings in the laundry to make sure there are no risks of infection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the home showed that it is clean, well furnished and decorated. The home does not employ a designated cleaner, cleaning tasks are part of the routine for all staff. There is a programme of routine maintenance and renewal DS0000011316.V318524.R01.S.doc Version 5.2 Page 16 of the fabric of the building in place. Since the last inspection the upstairs bathroom, kitchen and two bedrooms have been redecorated. Communal accomodation is very homely and stimulating, photographs and noticeboards reflect the activities, social and community involvement opportunities for service users. There is an attractive garden which is well kept. Service users bedrooms seen were well furnished and personalised with their own belongings. Some bedrooms have en-suite facilities. Service users spoken with were happy with their accomodation and appeared comfortable in their environment. There was a problem with the heating to some bedrooms on the inpsection day and the proprietor was arranging for this to be repaired. Additional heaters were available for those that needed them. It was seen that some of the communal carpets, in hallways and the lounge are uneven, through general wear and the use of walking frames. These need to be made safe or be replaced to reduce the risk of service users tripping. There is a designated laundry and service users clothes are kept in their own linen basket to pevent them being mixed up. Service users said they were pleased with how their clothes are cared for. There is no sluice in the home and at present the home does not routinely deal with incontinence. The washing machine does not have a disinfection/sluice programme and this could be considered when replacement of the machine is due or if the needs of the service user group change. The laundry floor is painted and this is flaking off in places and some of the walls are permeable. It is recommended that advice should be sought from the Environmental Health Officer as to whether this poses a hygiene risk. DS0000011316.V318524.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. Service users are supported by a stable staff team who are trained to meet their needs. There are enough staff to meet service users current needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The physical care needs of the current service user group are low and the home does not take service users who have dementia. There are two care staff on day time shifts and the manager works between 8am and 4pm, Monday to Friday. At night there is one waking night staff. The manager and proprietor are on call and can come in to assist if necessary. There are written guidelines for staff about what to do in an emergency. A cook works Monday to Friday with additional staff on duty to cover weekend lunchtimes. There is a stable staff team and no agency staff have been used by the home. Permenant staff cover vacant shifts. Service users and staff said that the current staffing levels are sufficient to meet the needs of the service users. Service user were very complimentary about staff, they are very helpfull and it was seen that there is a good rapport between staff and service users. DS0000011316.V318524.R01.S.doc Version 5.2 Page 18 A requirement that the registered person must not employ a person to work at the care home until all apapropriate checks have been undertaken has been met.. The manager said that all staff will be subject to a POVA check before starting employment. Records could not evidence this because no new staff have been recruited since the last inspection. The home has a programme of induction and training in place which includes Fire safety, Food Hygiene, Moving and Handling and Emergency Aid. There is a programme of renewal in place for core training. Staff also have been trained in the specific needs of elderly service users, deaf awareness, prevention of falls, diabetes awareness, mental health and dementia awarenes. The proprietor Mrs Pell has undertaken Training for Trainers and carries out some of the training herself. It was seen that Mrs Pell keeps up to date with developments in practice and passes this knowledge on to her manager and staff. The home has achieved 100 of care staff who have NVQ 2. The proprietor Mrs Pell is an NVQ Assessor. DS0000011316.V318524.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. Quality in this outcome area is good. There is an experienced and competent manager in post and the home is well managed. The manager could further improve her management skills by gaining the Registered Managers Award. The home seeks the views of service users and their relatives to help develop the service. Staff receive regular supervision to help them work effectively with service users. The standard of record keeping is good. Health and safety systems are generally good but improvements are needed in the storage of cleaning materials and a fire door needs repair to help keep service users safe. This judgement has been made using available evidence including a visit to this service. DS0000011316.V318524.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager has been registered for over 6 years and has National Vocational Qualification level 3. She has not yet started her NVQ Level 4, Registered Managers Award. It is recommended that she undertake this to further improve her management skills. Records show that the manager has undertaken other training to update her practice. There was evidence from records and from discussion with the manager and staff, that staff and care systems are well managed. There are regular staff meetings and handovers at each shift. There is Quality Assurance system in place and an action plan shows that the home has acted on feedback from service users and their relatives. The results of the Questionnaires have been shared with th service users. There are regular service user meetings and a weekly newsletter. In discussion with the manager and proprietor it was evident that the homes policies are regularily reviewed. There is a system in place for looking after service users personal monies. Monies are kept seperately and there are individual records. This was spot checked and found to be accurate. Staff confirmed that receive monthly supervision, the proprietor supervises senior staff and the manager supervises carers. Records relating to staff, service users and health and safety were sampled. these are well kept and up to date. It is positive that the proprietor and manager have helped all staff to use the computer to record daily notes. Health and safety systems in the home are mostly satisfactory. A PreInspection Checklist shows that shows that regular servicing and checks of equipment are carried out. Health and safety records sampled were up to date. It was seen that there is a quick respone to maintenance issues eg heating problems. There is good security which includes a keypad to the front door and CCTV to monitor the outside of the home. There were some areas that need improvement. A kitchen fire door has the latch plate missing and does not close properly and should be repaired. This door was also propped open during the inspection. The registered persons should contact the Local Authority Fire Officer for advice on a whether a suitable hold open device can be fitted. It was found that the cleaning (COSHH) cupboard in hall is left unlocked during the day and this practice should be reviewed to make sure that it does not DS0000011316.V318524.R01.S.doc Version 5.2 Page 21 pose a risk to service users or visitors. An alternative lock is needed as some staff cannot see the combination numbers on this. DS0000011316.V318524.R01.S.doc Version 5.2 Page 22 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 3 3 2 DS0000011316.V318524.R01.S.doc Version 5.2 Page 23 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 OP19 Regulation 13 (4) 1 Requirement The registered persons should arrange for the communal carpets to be made safe or be replaced to reduce the risk of service users tripping. The registered persons should make sure that the COSHH cupbaord is kept locked. The registered persons should make arrangements for the repair of the kitchen fire door. Timescale for action 08/01/07 2 3 OP38 OP38 13 (4) c 23(4) a 08/12/06 08/12/06 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 2 3 Refer to Standard OP7 OP9 OP18 Good Practice Recommendations It is recommended that service users risk asssessments are developed to give more specific information to help staff know what they should do to reduce the risks. It is recommended that a stock control system for PRN (given when needed) medication is developed to make sure the proces is working properly. That the registered persons seek advice as to whether DS0000011316.V318524.R01.S.doc Version 5.2 Page 24 4 OP26 5 6 7 OP26 OP31 OP38 staff need updated training Vulnerable Adult training. The washing machine does not have a disinfection/sluice programme and the registered persons could consider this type of machine when replacement is due or if the needs of the service user group change. That the registered persons seek advice from the Environmental Health Officer as to the suitability of the walls and flooring in the laundry. That the registered manager commences NVQ level 4/Registered Managers Award. The registered persons should contact the Local Authority Fire Officer for advice on a whether a suitable hold open device can be fitted to the kitchen fire door. DS0000011316.V318524.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000011316.V318524.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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