Inspection on 02/07/07 for Franklin House

This inspection was carried out on 2nd July 2007.

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.

Other inspections for this house

Franklin House 13/06/06

Franklin House 07/03/06

Franklin House 13/07/05

Franklin House 08/02/05

Franklin House 20/07/04

Franklin House 22/01/04

Similar services:

SignHealth

Mere Hall View

Beechfield Lodge

Christopher Grange (Rhona House)

Sense

Auden House

Deafway

Sign, 100 Bowfell Road

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

CARE HOMES FOR OLDER PEOPLE Franklin House 4 Franklin Street Oldham OL1 2DP Lead Inspector Sandra Buckley Unannounced Inspection 2nd July 2007 09:30 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 Franklin House DS0000005507.V337197.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. Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Franklin House Address 4 Franklin Street Oldham OL1 2DP 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) 0161 678 7870 0161 785 0779 Mr Harold Hilton Mrs Margaret Smith Mrs Marie Louise Powers Care Home 38 Category(ies) of Dementia - over 65 years of age (14), Old age, registration, with number not falling within any other category (23), of places Sensory Impairment over 65 years of age (1) Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 23 OP up to 14 DE(E) and up to 1 SI (E) Date of last inspection 13th June 2006 Brief Description of the Service: Franklin House is a detached, purpose built property, registered to accommodate 38 people. The home is privately owned and is situated in fairly close proximity to Oldham town centre. Accommodation for service users is situated on the ground floor. All bedrooms are single, 28 of which have en-suite toilet facilities. The home is built on a quadrangle with a central courtyard. Lift access is provided to the lower ground floor, which houses the laundry and provides access to a garden area. Car parking space is available at the front of the building. Fees charged by the home are £328. Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit was made to the home on 2nd July 2007. The manager of the home did not know beforehand that we were coming to inspect. This inspection looked at all the key standards and included a review of all available information received by the Commission for Social Care (CSCI) about the service provided at the home since the last inspection. During the site visit information was taken from various sources, including observing care practices and talking to people in the home. The manager, relatives and some members of the staff team were interviewed. A tour of the home was undertaken and a sample of care, employment and health and safety records were seen. Comments from questionnaires returned from people who live in the home and their relatives are also included in this report. All but one of the requirements made at the last inspection had been completed. However, there still remain a number of service developments to be addressed. The CSCI requires the home to complete an annual quality assurance assessment (AQAA) to tell us what they are doing well, and what they need to do better. We use this document on our inspection and check that what they have told us is accurate. We did not agree with some of what they told us about assessment, daily life, personal care and protection. What the service does well: There was evidence that the home is in the process of reviewing its practices and quality assurance system. One visiting professional said “I have seen positive improvements in pressure sore care and prevention with staff aiding people’s recovery.” A relative said “staff always take time to discuss with me my relative’s needs”. Comments received from people in the home included “I am happy and contented here” and “Staff are very nice to me.” Another said, “I have never eaten so much food” and “I cannot fault the manager I would talk to her if I had any problems.” Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 6 Staff and relatives said that they found the manager approachable and supportive. What has improved since the last inspection? What they could do better: The home needs to ensure that a professional assessment of people’s needs is obtained prior to their admission to ensure they can meet the person’s needs. Aspects of personal care afforded to people in the home were lacking. More attention needs to be given to maintaining hygiene standards, for example, hair, nails and general presentation of people ensuring their personal selfimage and dignity is promoted. A review of staffing levels and routines in the home need to take place to ensure accountability of staff both in personal care and domestic routines. Management systems should be implemented to ensure there is a monitoring process of care delivery. Filing systems were messy, with two systems running at the same time, which may result in inconsistencies in care delivery. Complaints made to the home should be recorded in full, together with outcomes of the investigation. This will demonstrate that the manager listens to people and acts on what they say. Employment, recruiting and vetting procedures were also unsafe, in that, Criminal Record Bureau checks had not been consistently obtained. This may result in unsuitable staff being employed at the home. Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 7 Parts of the environment, odour control and fabrics needed upgrading. It is acknowledged this has already started, however the implementation of a refurbishment plan with timescales for action would provide evidence of how this is to evolve. 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. Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 Quality in this outcome area is adequate. The lack of specific assessments that relate directly to the home’s provision of service may pose a risk to people wishing to enter the home. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: There was evidence that the home consults the assessment information when completing care plans, to see if they can meet the prospective individual’s needs. Unfortunately, of the four people’s assessments that were examined, three did not relate specifically to the facilities and services of Franklin House. Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 10 For those people who are self-funding, the home undertakes an assessment of need. The home’s annual quality assurance assessment (AQAA) did not reflect the need for a professional assessment to be sought before admission. Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 & 10 Quality in this outcome area is adequate. Care practices did not promote people’s dignity and privacy. Medication needs to be stored as prescribed to ensure its efficiency in maintaining people’s health care needs. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The home had made improvements in care planning since the last inspection. These now provide full details to staff on how to meet the physical needs of people in the home. Unfortunately, the lack of assessments relating specifically to the home may lead to people’s health care needs not being met. Files were messy and not easy to follow, with much information requiring archiving to provide a more streamlined approach. Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 12 Health professionals visits were recorded, for example, GP’s and podiatry. The inspector spoke to a district nurse who visits eight people in the home, five of which are for monitoring purposes only. They said, “I have seen positive improvements in pressure sore care with staff diligence aiding the recovery of people in the home”, also “care staff always have access to protective clothing and wear them appropriately”. People’s weight was recorded in care planning to ensure weight loss is identified. Comments from relative questionnaires said, ‘Staff always take time to discuss with me my relatives needs’ and ‘medical attention is always sought if needed.’ Another one said, ‘the majority of staff have a good relationship with people in the home and I feel care about their health and well-being.’ Observations throughout the day found that several people were high dependency and a number of people in the home appeared unkempt, with hair and nails needing attention. A gentleman required a shave and some clothes would have benefited from ironing. During interviews with staff, it was apparent that there was no system of accountability and task allocation, which resulted in a lack of direction for staff and people’s dignity in the home being compromised. One relative questionnaire said, ‘overall, I am quite satisfied with the care provided, one observation seems to be a high level of staff turnover.’ The manager agreed with this, saying recently this had been the case due to genuine reasons. This gives all the more importance to systems of accountability in the home being introduced to ensure new staff receive guidance. One person said, ‘staff always cover me up when I get out of the bath and respect my privacy.’ People were also complimentary about the staff saying, ‘staff are wonderful’ and ‘staff are very nice to me.’ The recording of medication was appropriate, however one person was allergic to penicillin, which was recorded in their care plan but had not been transferred onto the medication record sheet. Medication was also stored in the fridge that should not have been and may result in a change in its properties. Senior staff have received training in the administration of medication. There was evidence in care planning that specialist mattresses, aids and adaptations had been provided when needed. Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 13 Examination of daily reports found these would benefit from additional information to that which the care staff had provided. Daily notes are recorded electronically, with only senior staff having access. Care staff in the home do not have access and this should be reviewed as part of the accountability process. The manager said, care staff could access the records, they only need to ask. The inspector found this process time consuming which staff also commented on during interviews. Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 14 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): Standards 12, 13, 14 & 15 Quality in this outcome area is adequate. Social activities and stimulation need to ensure the diverse needs of people are met. Routines are task focussed and do not always promote people’s choice and dignity. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The manager stated that the home had employed a part-time activity coordinator. One relative questionnaire said, ‘there are activities but my father does not wish to join in.’ More than one person in the home said, ‘I like to go to bed late and we can get up when we want.’ One person said, ‘I am happy and contented here, I could not be in a better place.’ Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 15 A number of people in the home were high dependency. Observations throughout the day found care staff interactions were task orientated. In the large lounge/dining room, both the TV and radio were on at the same time, which made it difficult to enjoy either. A diary of activities was maintained with the names of participants being recorded. A small number of people had participated in the activities. A wider range of activities needs to be provided to cater for other people in the home. The manager said that outside entertainment is provided which all enjoy. One person stated that friends call and take them to church. The manager said at present the home was unable to provide any religious services due to staff shortages at the local churches and those who wish to attend rely on staff availability or relatives. One person’s questionnaire said, “meals are sometimes repetitive” another person said, “food varies”. A relative commented that their father had never eaten so well and was putting on weight, they also said they regularly see staff making sandwiches for supper. The inspector dined with people in the home. Staff asked people if they’d had enough to eat and seconds were offered. Fresh fruit was offered as an alternative to a sweet. Standards in the dining room did not respect people as individuals. Cups were placed on tables without saucers. Tea was served from a large teapot. Several people would have benefited by individual teapots so they could help themselves, rather than having to ask staff. The presentation of food and second helpings need to be served individually, rather than from a pan in the dining room. Two people in the home were left at dining tables for two hours before being moved to more comfortable seating. Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18 Quality in this outcome area is adequate. Procedures for safeguarding people who use the service were in place. Complaints from individuals are not fully recorded which my result in their needs not being met. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Questionnaires from people in the home and their relatives said they knew how to make a complaint. A record of complaints was maintained. A complaint was recorded in March 2007 relating to clothes going missing and other people entering their room. No outcome of this complaint was recorded. On 16th April 2007 a complaint raised concerns over confidentiality issues. The manager had taken appropriate action, resulting in disciplinary procedures. Questionnaires also gave examples of complaints raised and outcomes. These included ‘damage to clothes in laundry, I spoke to staff because other people were wearing damaged clothes and they acted on my concerns right away.’ Also, ‘I complained about the lack of fresh fruit which is now always available.’ Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 17 One person said, ‘I can’t fault the manager, I will talk to her if I have any problems.’ Examination of daily notes found that one person had complained of their relative’s room being in a poor condition and that pillows smelt. This had not been recorded in the complaints book nor what action had been taken. Training records identified that staff had training in the protection of vulnerable adults. Several staff had completed NVQ training, which also includes abuse awareness. Staff at interview were aware of how abuse may present and said that refresher courses were available by video training. Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 18 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): Standards 19 & 26 Quality in this outcome area is adequate. A number of the fixtures and fittings need replacing and some redecoration is required in order to improve the quality of life for people in the home. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The manager gave a tour of the home. A number of bedrooms were cluttered with spare mattresses being stored in them. Some rooms also had unpleasant smells. Bedding and towels were of poor quality and beds were stained. Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 19 The inspector acknowledges that refurbishment had started with several rooms having new beds, wardrobes and carpets. The lounge carpet had also been replaced. One relative questionnaire said, ‘occasionally public rooms smell but the bedrooms smell more often, although they are cleaned regularly. One thing I find frustrating as a visitor is that flowers are left dead in vases.’ This was also noted on the day of inspection and highlights a lack of organised routines and accountability. The owner visited at the time of inspection and said that new bedding and towels had been purchased but had not been replaced. Instructions were given on the day of inspection to replace the worn bedding and towels. One person said, ‘I like my room, it is very comfortable,’ and ‘I have just had a new carpet.’ Another said, ‘I was told I could bring in my own possessions but I did not want to.’ The inspector noted that several rooms had been personalised with one person saying, ‘I prefer to stay in my own room and watch TV.’ Outside of the home provides a safe quadrangle for people to walk round. However, at the time of inspection the gardens were unkempt and building work was being undertaken to build a conservatory that would become a smoking room for people who live there. Some areas of the home had been affected by water seepage, which was being attended to at the time of inspection. The home employs a handyman to address routine repairs and maintenance issues. The owner produced evidence of work and purchases. The implementation of a refurbishment plan would help the home to identify future needs, outgoings and clarify timescales for action. Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 20 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): Standards 27, 28, 29 & 30 Quality in this outcome area is adequate. Recruitment and vetting procedures were unsafe, putting people at risk of potential harm. Staff deployment and accountability needs to be monitored to ensure people’s needs are met. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Several people in the home were highly dependent on staff care. As mentioned previously, under standard 10 and 15 of this report, the quality of personal hygiene standards in daily life was, at times, lacking. Interviews with staff and the manager highlighted that specific tasks were not always allocated, leaving this to staff’s level of training and integrity. However, the evidence pointed to lack of accountability and organisation. Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 21 Staffing levels and deployment need to be reviewed and routines put in place to ensure people’s needs are met. There was a gender mix of staff within the team, which the men in the home were pleased about. Interviews with male staff highlighted their awareness for discretion when delivering care to females in the home. They said they always ask permission first, however, they were aware who did not want personal care delivered by male staff and this was respected. One questionnaire stated that there had been a high level of staff turnover, which the manager agreed with and said that this was for genuine reasons in each case. This resulted in a core of new staff having been employed. During interviews with the manager and staff they said it was usual practice for new staff to shadow more experienced staff. Due to the high number of new recruits, the period for shadowing more experienced staff had been cut. Over half the staff had obtained an NVQ qualification and induction was in line with Skills for Care. During interviews with staff they demonstrated knowledge of people’s care needs and discussed other training they had been involved with, for example, moving and handling, dementia care and health and safety. Care staff have insufficient time to access daily notes and have no responsibility to complete these which are left to senior staff to complete electronically. Staff confirmed they have regular handovers to update them on people’s care needs. Additional access to daily notes and responsibility for completion would promote accountability. Examination of three newly recruited staff files found that employment recruitment practices have not improved since last inspection. Employment history was incomplete and, in some instances, had not been fully explored. Criminal Record Bureau checks had not been undertaken prior to their employment. Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 22 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): Standards 31, 33, 35, 37 & 38 Quality in this outcome area is adequate. Management responsibilities are not fully discharged, which means the health, safety and welfare of people in the home may be compromised. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The manager is registered with CSCI and has successfully completed the Registered Manager’s Award. The registered provider is supportive and available on a regular basis. Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 23 The home has made improvements in the quality monitoring systems by seeking people’s and relatives’ views in the home. The quality of care afforded to some people in the home needs to be improved. Routines need to be put in place with nominated staff to undertake tasks and promote accountability. This is also applicable to domestic routines in the home. Staff meetings took place with evidence on the agenda that the manager had also brought these issues to staff’s attention. The minutes stated that the manager and deputy were in discussion on how monitoring systems could be improved. However, this was in January 2007 and there is now an urgency to improve routines. Staff skills are also looked at during the supervision process. Staff training is provided in safe working practices, for example, moving and handling and fire procedures. Equipment in the home had been checked by professionals, e.g., hoists, gas and electric and records were available for inspection. The home manages several people’s finances; records were maintained and receipts for purchases were in place. Other records in the home required reviewing, especially in relation to recruitment procedures and complaints recording. There was also a need to archive old information so this is not misleading. Daily notes required more detail on care delivery, with junior staff having time allocated to access notes on the computer system. Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 24 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 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X 2 2 Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 25 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 OP3 Regulation 14 Requirement Timescale for action 31/07/07 2 OP9 13 3 OP29 19 The home must obtain a detailed professional assessment of need of people wishing to enter the home prior to their admission which will ensure the service is able to meet their assessed needs. All medication in the home must 31/07/07 be stored as directed so that medication remains safe to administer. When new staff are employed, 31/07/07 the home must ensure that references are fully explored and references requested which are not listed on the application form must be recorded and the reason why. Criminal Record Bureau Checks or POVA first checks must be obtained prior to staff commencing employment to ensure that only suitable people are employed. Timescale of 01/08/06 not met. Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 26 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 4 Refer to Standard OP12 OP15 OP16 OP19 Good Practice Recommendations People who use services must be assisted, as far as practical, to attend religious services of their choice. Staff routines in the dining room should be reviewed to insure the individuality of people in the home and provide a more pleasant dining experience. Complaints made by people in the home and their relatives should be fully explored and recorded. A safe well maintained environment should be maintained through the provision of adequate bedding and towels. The outside quadrangle of the building should be improved to provided a safe and congenial sitting area for people in the home, with the risk assessment in this area being continually reviewed. The refurbishment of the home would benefit from appropriate planning with timescales for action. Staffing levels, routines and accountability should be reviewed to ensure odours in the home are eliminated. The numbers and skill mix of staff need to be reviewed to promote accountability when providing personal care for people in the home. Record keeping and filing systems in the home need to be reviewed in order to ensure consistency and lessen duplication of records, as demonstrated in daily reports, with some being recorded on paper in files and others electontronically. The home should ensure that any allergies of people in the home are recorded on their medication sheets. The home must ensure that a review of staff routines takes place, ensuring staff are accountable for care delivery and that people are afforded dignity through personal care, maintaining their hygiene, hair and nails and general presentation. 5 6 7 OP26 OP27 OP37 8 9 OP9 OP10 Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Franklin House DS0000005507.V337197.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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