Inspection on 10/10/06 for Froome Bank

This inspection was carried out on 10th October 2006.

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

Froome Bank 31/10/08

Froome Bank 10/08/07

Froome Bank 29/12/05

Froome Bank 21/07/05

Froome Bank 04/03/05

Froome Bank 06/09/04

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

CARE HOMES FOR OLDER PEOPLE Froome Bank Tower Hill Bromyard Herefordshire HR7 4QN Lead Inspector Denise Reynolds Unannounced Inspection 10:00 10 October 2006 th 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 Froome Bank DS0000060777.V301833.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. Froome Bank DS0000060777.V301833.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Froome Bank Address Tower Hill Bromyard Herefordshire HR7 4QN 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) 01885 483469 01885 489421 Shaw healthcare Ltd Ms Helen Margaret Ammonds Care Home 18 Category(ies) of Dementia (9), Old age, not falling within any registration, with number other category (9) of places Froome Bank DS0000060777.V301833.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29/12/2005 Brief Description of the Service: Froome Bank was purpose built as part of the Bromyard Community Hospital complex but is self-contained with its own front door. It is within walking distance of Bromyard town centre although the route is not flat. The building is situated so that the garden looks out over lovely countryside views and each unit has its own courtyard garden. The service provider for Froome Bank is Shaw healthcare Ltd who took over control of the Home from Herefordshire Council on 2nd June 2004. During 2005 they completed a major refurbishment project. The refurbished accommodation is laid out in two self-contained nine place units each providing a defined service. One of the units, known as the Pink unit provides 9 places for older people with general age related care needs. The other, known as the Blue unit provides 9 places for people who have care needs due to having a dementia illness. Froome Bank DS0000060777.V301833.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over two days; the second day was arranged because not all areas of the inspection had been covered on the first day due to the issues that arose. During the two days spent at the Home the inspector spoke individually with two people who live in Pink unit and were able to converse about life at the Home. Time was also spent talking to some of the people living in Blue unit as far as this was possible and sitting in the sitting room to see how part of their day was spent and how much contact they had with staff. A community nurse and the relatives of a service user were also spoken to. When planning the inspection we sent service user and relative comment cards to the Home to be given to people. None came back to us before the visit. The manager found four completed service user comment cards amongst paperwork in the office on the first morning. Relative comment cards and paid reply envelopes were on the table in the entrance hall. Comment cards sent direct to the local GP practice by us provided useful information. One member of staff was spoken to individually and others more briefly as they went about their work. During 2005 we sent some questionnaires to the Home for staff and seven of these were sent back to us in the lead up to this inspection. In an attempt to receive more views about the Home from a range of people some CSCI cards were left at the Home during the inspection and as a result of this a few staff contacted us. Relatives of two residents were spoken to during the inspection and another was contacted by telephone afterwards. A range of records, including care records were looked at and there was a tour of the building and grounds. What the service does well: Residents like the staff and feel safe at the Home. Visitors are made very welcome. The quality of décor and furnishings makes the Home a pleasant and comfortable place overall. Local doctors commented positively about the service in the survey “ Friendly …staff appear to be extremely competent and committed to their clients … environment is excellent .. staff are good at assessing patients medical needs and seek advice appropriately ..” and a district nurse spoken to briefly said staff at the Home are helpful when they visit. Froome Bank DS0000060777.V301833.R01.S.doc Version 5.2 Page 6 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. Froome Bank DS0000060777.V301833.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 Froome Bank DS0000060777.V301833.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users needs identified during the assessment process need to be reflected in more detail in care plans to make sure that staff have all the information they need about each person’s individual needs and preferences. EVIDENCE: The Home gathers detailed information about prospective service users from assessments done by social care staff and by doing its own assessments. Copies of assessments were seen in the care records sampled. Not all the information gathered is reflected in the care plans, this could result in some aspects of a persons care not getting enough attention because of staff not knowing about it. This was particularly the case in respect of people’s social and leisure preferences. Froome Bank DS0000060777.V301833.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff know about the importance of respect for individuals and the promotion of dignity but there are some improvements needed to make sure these values are always put into practice. The quality of the care plans and some aspects of attention to personal and health care need to be strengthened to make sure that each person gets the care that they need at all times. EVIDENCE: Comments received from the local GP practice showed that they have confidence in the care provided at Froome Bank as shown in the following response “ Friendly …staff appear to be extremely competent and committed to their clients staff are good at assessing patients medical needs and seek advice appropriately ..” Froome Bank DS0000060777.V301833.R01.S.doc Version 5.2 Page 10 Some service users had long and/or dirty fingernails and one person was observed to be wearing dirty glasses. Several people had not had their hair done before being brought from their rooms in the morning. Dry toothbrushes, and soap were seen in some bedrooms and dried out flannels seen in bedrooms after people had been brought from their rooms in the morning; one of these had faeces on it. A cardboard box containing ‘stock’ clothing was found on the floor of a linen cupboard. The use of stock clothing is incompatible with upholding resident’s privacy and dignity so if stock is held for emergency use it should at least be carefully laundered and properly stored. There was evidence in the care records that residents have been consulted about certain aspects of their care plan such as administration of medication and having their photograph taken. The content of the care plans did not make it clear that people are being consulted about their day-to-day care needs although one plan was seen written in the first person which seemed to suggest they had been. Communal message books are used to record detailed information about residents as well as for passing general messages between staff. When asked about the problem caused by residents not being able to have access to what is written (because of other residents’ privacy) the manager said that entries are copied into the individual records. The Home records and monitors service users weights and has risk assessments in place that are relevant to individual people. Some examples were seen where information in care plans was contradictory, out of date or duplicated. In some examples information was not dated. Some risk assessments had not been carried forward into the plan for the persons care and in one case there was no falls assessment for someone who had fallen three times. Some examples were seen in the daily records that showed health problems reported for several days before being acted upon. Evidence could not be found that chiropody had been provided regularly for a person. Some entries were undated. Two staff were seen moving a resident from her wheelchair to an armchair; both had done moving and handling training in June this year. This was not reflected in the way they went about this. They started to move the person without using a handling belt until the Manager intervened. They didn’t take enough time to explain to the resident what they were doing, for example they did not tell her they were going to put the belt around her or why. Equipment including pressure relieving cushions and mattresses, a mobile hoist and handling belts are available. Froome Bank DS0000060777.V301833.R01.S.doc Version 5.2 Page 11 Medication storage is secure and medication was observed being administered and recorded carefully. The medication records looked at for one person did not make it clear whether a treatment had ended or not. All of the residents have locks on their bedroom doors so that if they choose to they can assure themselves that they will not be disturbed or have someone go into their room when they are out. Staff were seen knocking on doors before going in; residents confirmed that the staff are good about this. Froome Bank DS0000060777.V301833.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The mass-produced nature of the food provision is unpopular with residents and limits them having a real say in what they have to eat. The range of activities provided is not regular enough and does not take enough account of what individuals might enjoy doing. There is consultation with service users about some things and this could be developed further to give them more influence over their lives. EVIDENCE: The Home has a friendly and welcoming atmosphere. The visitors’ book showed that there are lots of people coming and going and residents said they can have visitors when they like. A relative spoken to said she feels she can come when she likes. People said they are not always happy with the food they have and thought this mattered a lot because meals are important part of the day. The main meal of the day is provided from the external caterers who supply the hospital. The food is ‘Cook/chill’ which means that it is cooked off site and warmed on arrival at the Home. Residents said that this limits the choice they have about the overall menus although there is a choice offered each day. They also said that the quality and quantity of food are not always as good as they would like. Froome Bank DS0000060777.V301833.R01.S.doc Version 5.2 Page 13 The manager had arranged a meeting with the caterers on the first day of the inspection and invited residents to take part in this. Residents later said they were glad they had been given the chance to say something and hoped some good would come of it. Information provided by the service in the questionnaire filled in before the inspection showed that a range of activities is arranged at the Home but during the inspection residents said that there is not much to do. People enjoy going out for a drive in the minibus which is scheduled as a weekly event but in reality is dependent on the availability of enough staff to provide cover for the trip and to stay in the Home with those not going out. Residents said this means it does not always go ahead. There was not much information in the care plans about people’s individual interests and preferences and how these are included in their daily lives. Examples were seen in some care plans of passing reference to interests and hobbies that could realistically be included as part of a care plan. For example someone enjoys crosswords and playing cards and another person likes football but there is nothing in the care plans to make sure these are provided regularly, if at all. Each care record has a sheet to record activities – one example seen listed the most recent activity for that person three weeks before the inspection as ‘X had a shave this morning’. Another person’s record had only two entries since the start of 2006 both of which said the person had a phone call and in one that they had had their hair done. Another person had no entries in their activities record since May 2006. A resident said people were disappointed not to have had more outdoor events during the lovely summer weather. A volunteer who provided activities had recently left and no one had an overview of activity provision. Although a church service is conducted at the Home regularly the care records do not provide information about whether separate arrangements are made for the different Christian denominations represented among the residents. Froome Bank DS0000060777.V301833.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service has complaints and adult protection procedures in place but needs to improve recording so that information is available to show that concerns have been dealt with robustly. People living at the Home feel safe. EVIDENCE: Staff have received training about safeguarding service users provided by the local multi agency protection of vulnerable adults co coordinator and by Shaw healthcare’s in house training team. There have been some incidents dealt with internally by the manager and her line management that may have been more appropriately dealt with through the multi agency arrangements. This would have provided the manager with the opportunity to explore issues and decide on a course of action with other professionals not directly involved in the management of the service. The records available did not provide enough information to show what action had been taken, why decisions had been made or the responses made to relatives about concerns raised. An example was seen of a situation where relatives were not satisfied with the outcome of their complaint although they were not taking this further. Residents spoken to said they feel safe and know who to speak to if they are concerned about something. Froome Bank DS0000060777.V301833.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The quality of décor and furnishings makes the Home a pleasant and comfortable place overall; this is let down by bathrooms, the laundry and quiet rooms being used for storage. EVIDENCE: Information provided by the service before the inspection and the service providers monthly reports show that required maintenance checks are carried out (in some cases by the PCT who lease the premises to Shaw healthcare) and that the organisation monitors that this is being done. The rooms used by residents are comfortably furnished and attractively decorated. The communal rooms and residents bedrooms seen during the inspection were very clean. The bathrooms need to be tidied up and not be used to store equipment such as wheelchairs so that they are more inviting rooms for people to be able to enjoy having a bath and to feel that their dignity is being respected. Similarly, the quiet room should not be used top Froome Bank DS0000060777.V301833.R01.S.doc Version 5.2 Page 16 store surplus furniture as this stops it being a nice place to spend time and may make people reluctant to use them for entertaining guests. One person said a visitor had asked her if was a bedroom because of the mattress propped against the wall. Concern was expressed from staff, relatives and social care staff about the height of the drop from the garden outside Blue unit and whether the current fencing is adequate to ensure that no one could climb onto it and fall. Froome Bank DS0000060777.V301833.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Whilst staff recruitment, and training is basically sound, improvements are needed to make sure that staff are deployed effectively and work competently so that residents’ needs are met. EVIDENCE: The organisation provides an ongoing schedule of raining for staff that it monitors closely through the use of spreadsheets using a colour coded warning system to identify forthcoming and overdue renewal dates. The area manager had been closely monitoring shortfalls in mandatory training during the year and the manager had been addressing this with input from the organisation’s training personnel. The position had improved and most training in mandatory training was up to date or scheduled in the near future. Progress was being made in providing staff with training in respect of the care of people who have dementia care needs. The poor moving and handling practice referred to earlier in this report casts doubt on the effectiveness of the training in this area. There had been a number of staff changes during the year with high vacancy levels at times. Staff who sent questionnaires indicated that they didn’t think staffing levels were good enough. During the day two support staff are based in the Blue unit and one in the Pink unit. A team leader is rostered on each Froome Bank DS0000060777.V301833.R01.S.doc Version 5.2 Page 18 shift and provides to the pink unit when a second person is needed. There are periods when only one member of staff is in the Blue unit. Concerns were raised with the inspector that because communication can be difficult for people with dementia illnesses, they do not always understand the staff who have unfamiliar accents. The organisation has a well-established recruitment procedure with support provided to the homes by a central human resources team. The recruitment papers in the Home for one person showed a substantial gap in her employment record but there were no details of an explanation being obtained. The manager was not aware of the requirement for this to be done and was unsure whether it would be her responsibility or that of the staff in the human resources team. Froome Bank DS0000060777.V301833.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home needs to be managed more robustly to provide all residents with a quality service and value for money. Health and safety arrangements in the Home do not ensure that risks to residents are identified and kept to a minimum. EVIDENCE: The manager is an experienced person and has done the registered manager’s award. She has managed the Home through an extended period of change and staff shortages. She is also having input into the management of the home by another manager for one day each week. There was evidence that the management of the service has not been sufficiently robust to consolidate the changes or maintain the quality of the service. This is reflected in the range of issues for improvement identified at this inspection. Some of these issues had not been identified and addressed through the monthly visits and Froome Bank DS0000060777.V301833.R01.S.doc Version 5.2 Page 20 reports by the organisation’s area manager. This suggests that the range and depth of matters looked at during the area manager’s visits should be reviewed. Involvement of a group of residents in the meeting about the food provision shows a willingness to give residents a say in things that matter to them. The organisation has a quality assurance system that uses questionnaires to get the views of residents and their relatives. These were available for the inspector to look at. There was no information about how the results of these surveys are used by the organisation to continually improve the quality of the service. At the last inspection work had begun on establishing regular individual supervision for staff. The manager explained that the ongoing staff shortages since then meant that there had not been much progress with this. The manager confirmed that arrangements for residents’ finances have not changed from the previous inspection when they were examined and found to be satisfactory. Due to the open plan design of the communal areas, residents have access to the kitchenettes at all times. Cleaning materials and dishwasher powder were stored in unlocked kitchen cupboards in both units. This included dishwasher powder decanted into ice cream tubs with no lid and a blue liquid decanted into a bottle with a faded handwritten label which staff thought might be rinse aid. This places residents in both units, but particularly in the dementia unit, at risk of ingesting chemicals. The absence of the original labels and lack of COSHH information increases the risk due to lack of information about the correct way to deal with this for each substance. It was noted that the mobile hoist in the Blue unit had recently had its annual LOLER test. Questionnaires sent back from staff were equally divided about whether repairs and replacements are always done quickly enough. The laundry was being used as storage for equipment and Christmas decorations and there was no evidence of consideration being given to infection control in the way the room is organised for dirty and clean laundry. The space taken up by non-laundry items also presents a health and safety risk in terms of space and fire safety may be compromised. Froome Bank DS0000060777.V301833.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 2 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 2 X 2 X X X 1 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 1 X 2 X 3 X X 1 Froome Bank DS0000060777.V301833.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement Timescale for action 31/12/06 2 OP10 12 3 OP8 13 4 OP12 16 The content of care plans must be sufficiently detailed to provide information as to how the service user’s needs in respect of his health and welfare are to be met. (This relates to the shortcomings in some aspects of the care plans.) Suitable arrangements must be 30/11/06 made to ensure that the care Home is conducted so as to make proper provision for the health and welfare of service users and in a manner which respects the dignity of service users. (This relates to shortfalls in the meeting of personal care needs and the existence of stock clothing.) Arrangements must be made for 30/11/06 service users to receive where necessary, treatment, advice and other services from any health professional. (This relates to apparent lack of chiropody for a person and lack of information about a missed hospital appointment) Service users must be consulted 31/12/06 DS0000060777.V301833.R01.S.doc Version 5.2 Froome Bank Page 23 5 OP19 13 6 OP38 13 7 OP22 23 8 OP36 18 about their social interests and arrangements must be made for them to engage in local, social and community activities. (This relates to the lack of arrangements for activities based on individual preference) (Previous timescale of 01/03/06 not met) All parts of the Home to which service users have access are so far as reasonably practicable free from avoidable risks, and unnecessary risks to the health and safety of service users are identified and so far as possible eliminated. (This relates to the garden fence outside Blue unit) The registered persons must ensure that service users are not put at risk by having access to cleaning products. All cleaning materials must be clearly and accurately labelled and COSHH information must be available where they are used. The registered persons must make suitable provision for the storage of equipment such as mattresses, wheelchairs and cushions. The laundry room must not be used for storage of unrelated items. Arrangements must be made to establish an effective staff supervision system for all grades of staff including the Registered Manager. Previous timescales of 31/10/05 and 01/03/06 not met. 30/11/06 13/10/06 30/11/06 31/12/06 Froome Bank DS0000060777.V301833.R01.S.doc Version 5.2 Page 24 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 OP7 Good Practice Recommendations Consideration should be given to ending the use of communal message books for writing detailed notes about service user’s private information. There should be further work done on ways to improve food provision. Complaints received by the service need to be dealt with more robustly and recorded more thoroughly. The communication needs of service users with cognitive impairment needs to be given greater consideration in relation to deployment of staff in the Blue unit. The registered person should ensure that staff have all understood their moving and handling training and are putting what they have learned into use when assisting residents. 2 3 4 5 OP15 OP16 OP27 OP38 Froome Bank DS0000060777.V301833.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Worcester Office The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Froome Bank DS0000060777.V301833.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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