Inspection on 11/05/07 for Grange House

This inspection was carried out on 11th May 2007.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Grange House 17/08/06

Grange House 17/01/06

Grange House 12/07/05

Grange House 06/12/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Grange House 9 Grange Road Hayes Middlesex UB3 2RP Lead Inspector Robert Bond Key Unannounced Inspection 11th May 2007 10:00 Grange House DS0000048879.V335285.R01.S.doc Version 5.2 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 Grange House DS0000048879.V335285.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 Adults 18-65. 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. Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grange House Address 9 Grange Road Hayes Middlesex UB3 2RP 0208 813 5264 0208 813 5264 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) www.milburycare.com Milbury Care Services Limited Nigel Selvin Lloyd Brown Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th August 2006 Brief Description of the Service: Grange House is operated by Milbury who are a nationwide limited company who provide residential care to people with learning disabilities. Grange House is registered to provide care to five residents, and the home’s speciality is to provide for people with autism. Grange House is a detached property on a quiet residential street in Hayes. The home is a short drive from the local amenities of Hayes town centre and its public transport links. The property has five single en-suite bedrooms, one of which is on the ground floor. The communal rooms are spacious and include a through lounge, kitchen/diner, conservatory, and a large secure garden with a large activities room at the end. The home has its own vehicle to enable staff to take residents on outings. The fees charged range from £1,737 to £1916 per week. Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection considered the home’s performance against the key National Minimum Standards (NMS) for care homes for younger adults. The Inspector obtained in advance a pre-inspection questionnaire completed by the Registered Manager, and also received back two questionnaires completed by relatives of residents. One respondent wrote, ‘Good care. Provides healthy and friendly environment for our son. He is happy at Grange House’. The term ‘residents’ is used to describe those living at the home, in place of the term ‘service user’ that was previously used. On the day of his visit, the Inspector toured the premises, interviewed the Registered Manager, met two residents and three members of staff, and examined a range of records and files. The Inspector spent approximately five hours at the care home. The home is fully occupied, by the same five residents who have been there since the home opened. Cultural and diversity issues are addressed within the home by for example holding monthly cultural meetings at which ethnic food is served. Cultural needs are not however routinely considered as part of individual care planning. There are a number of staff vacancies, including the post of Deputy Manager. The Inspector assessed the anticipated outcomes for 27 of the NMS, and found that 2 were exceeded, 18 were fully met, whereas 7 were only partially met. This led to the Inspector making 8 requirements (one restated from the previous CSCI inspection), and 3 recommendations. What the service does well: The home continues to provide a good standard of care. Detailed individualised person centred care plans are in place. The range of activities available is substantial. The full range of required policies and procedures is in place. The home operates for the benefit of its residents. Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 6 The home is an attractive and homely place to live, being well designed, decorated, furnished and equipped. Both of the relatives of residents who completed satisfaction survey questionnaires were very positive in their feedback answers. What has improved since the last inspection? What they could do better: The statement of terms and conditions issued to each resident must contain details of the charge made for use of the home’s vehicle. Attention should be paid to make sure that social, cultural and religious needs of residents are assessed and recorded in a way that is likely to lead to the needs being included as goals in the residents’ care plans. Individual care plans must consider how to meet all assessed care needs of residents, including their cultural, religious and social needs. An advocate must be sought to represent the interests of the resident who has no relatives willing to undertake this function. Advice should be sought form a nutritionist or dietician so that healthy diets may be more fully promoted. Ways must be found to increase the percentage of the support staff employed who have obtained an NVQ level 2 or 3 in care. Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 7 A deputy manager is urgently needed, and more permanent support staff must be recruited. The support staff must receive formal supervision more frequently. It is strongly recommended that a new computer should be purchased for the benefit of staff and residents, and so that electronic links with the outside world can be reinstated. A new fridge thermometer is required. Staff must be trained in what is the safe operating temperature range for the fridge concerned, and trained in what action to take if the fridge thermometer suggests that the equipment is operating outside of that range. 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. Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Most of the aspirations and needs of existing residents have been satisfactorily assessed, and are kept under review. The individual statements of terms and conditions do not include all of the required detail. EVIDENCE: As no new residents have moved into the care home since before the previous CSCI inspection, no analysis of original assessments was made on this occasion. However it was noted that the missing original assessment on a current resident has now been obtained and placed on her care file. Careful attention must be paid to make sure that social, cultural and religious needs are assessed and recorded in a way that is likely to lead to them being included as goals within the care plan. Recommendation 1. The Inspector case-tracked one resident and noted that good risk assessments had been undertaken, and were being kept under review. The Inspector examined a sample terms and conditions statement that had been issued to a resident. He found that the document was easy to read and clearly presented most of the necessary details. However, no mention was made in the contract of the additional charge to the resident, family member or appointee for use of the home’s vehicle by the resident. The Inspector noted Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 10 from the home’s records of money deducted from the resident’s funds that the charge is currently in the region of £60 per month. In order to promote transparency, the charge must appear in the terms and conditions statement. Requirement 1. Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Most but not all of residents’ care needs are assessed and recorded in their care plans. Residents are assisted to make decisions about their lives but the use of an advocate is indicated in one instance. Appropriate risk assessments are undertaken to promote an independent lifestyle for residents. EVIDENCE: The Inspector case-tracked the care records of one resident chosen at random. He found that records were clearly maintained and filed. Good use has been made of photographs. Personal details were recorded at the front of the file, but the resident’s ethnicity was not noted there. As the resident is a member of an ethnic minority, his/her cultural needs should have been considered and are in practice, the Registered Manager reported, but the care plan does not mention this aspect. Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 12 The resident’s religion is recorded, and again appropriate action is taken by the home to assist in meeting his/her religious needs, but again the care plan did not refer to this aspect. Although good as a personal care needs document, the care plan did not consider the resident’s social needs, although in practice appropriate activities and stimulation are provided. See Requirement 2. Care plans now include space for the resident or their representative to sign their agreement to the plan. However neither of the care plans seen by the Inspector were actually signed. The Registered Manager said this issue would be addressed during the next review cycle. It was clear to the Inspector from the level of detail contained in the plans, and the use of a Person Centred Planning format, that residents are appropriately consulted and their wishes taken into account. The key worker system is in operation. The placement of the resident case-tracked had been reviewed by the placing authority, London Borough of Harrow, on 29th June 2006. The social worker’s report encouraged the home to make arrangements for an advocate, and this had been made a recommendation by the Inspector at the previous inspection. As no action has been taken, a requirement is now made. Good risk assessments that promote service users’ independence were seen to have been undertaken, kept on file, and regularly reviewed. Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The extent to which residents are able to engage in outside activities within the wider community is good. Family links are well maintained. Residents’ rights and responsibilities are sufficiently recognised. Provision of a healthy diet for residents could be promoted further. EVIDENCE: The Registered Manager reported that four out of five residents attend either a day centre or college. The Inspector noted that two residents were doing just that on the day of the Inspection. An examination of individual activity programmes triangulated the evidence. A seven day a week activity programme has been devised. It was dated January 2007 and the Registered Manager reported that it would soon be updated for the summer season. The Inspector examined a daily diary system that records amongst other things what each resident eats on a day to day basis. The Registered Manager added that these documents are going to be Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 14 more made more individual and person centred in future, which is commended. The home has a vehicle that staff can drive to take residents out to activities. Holidays are also organised. The Inspector saw evidence of a passport being obtained for one resident so that she/he could go abroad on a holiday. The Registered Manager reported that residents are encouraged to assist in the running of the care home. The Inspector observed a resident helping with the washing up. The Inspector observed a midday meal being prepared. He also noted that improved records of food actually consumed throughout the day by residents are now kept. A recommendation is again made that the views of a dietician or nutritionist are obtained. This approach may be a helpful means of supporting the Registered Manager’s campaign to promote healthy eating by the residents. The Registered Manager reported that a pictorial menu is now available to assist residents in choosing their preferred food for the menu. This approach is commended. Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive good personal support in ways that they prefer and require. Residents’ health needs are well met. Residents are well protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: The Inspector case-tracked the care records of one resident. He found that personal support needs and goals were well documented in detail and in a way that demonstrated that resident’s preferences had been taken into account. The support plans were seen to be more detailed than at the previous inspection. Following a recommendation in the previous CSCI inspection report, health action plans are now in place for every resident. The Inspector also noted on the case-tracked file, a medication review, dental report, chiropodist’s report, and a monthly weight chart. Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 16 The Inspector checked the home’s medication storage arrangements, the records of medication administration to residents, and the record of medication returned to the pharmacist. No errors or omissions were noted. Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A good complaints procedure is in place and is followed. A good POVA procedure is in place. EVIDENCE: The Inspector noted from the pre-inspection questionnaire submitted that the home had received one formal complaint. The Inspector asked to see the home’s record of the complaint, which concerned unexplained bruising observed on a resident’s body by a relative. The complaint, its investigation and its outcome had been appropriately recorded and investigated by the Registered Manager. The outcome recorded, following an examination by a GP, was that the injury had occurred accidentally whilst the resident was being restrained using the ‘child control’ technique approved by Milbury. The Registered Manager had reported the matter to the resident’s care manager, and the Registered Manager considers that the care manager would have reported the matter to the London Borough of Hillingdon’s Safeguarding Adults Manager if he/she had considered that to be necessary. The home does have a satisfactory POVA procedure in place, the Registered Manager has received training in the procedure he reports, and new staff members who have not yet be trained in POVA have been booked onto future training. The Inspector receives Regulation 37 reports when restraint has been used, and the Inspector checked that ‘critical incident reports’ are being sent by the home to Milbury, and that RIDDOR reports are also sent whenever a resident or a member of staff is injured. Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 18 Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a homely, comfortable and reasonably safe environment that is well decorated, furnished and equipped. Residents live in a home that is clean, hygienic, and very tidy. EVIDENCE: The Inspector toured all the communal areas of the home. The premises are well designed, and were found to be clean, very tidy, well decorated, well furnished and well equipped. The level of provision of equipment in the activity room (at the bottom of the garden), which was also seen to be exceptionally tidy, is commended. The only fault found in the home was a broken fridge thermometer, which is dealt with in more detail under Health and Safety. Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Sufficient staff are deployed in the home but there are insufficient permanent support staff in post. An insufficient proportion of the support staff have an NVQ in care award. Training records are good. Without a deputy manager in post, the support staff are not receiving formal supervision sufficiently frequently. EVIDENCE: The Inspector examined a sample of staff rotas held in the home, and noted that sufficient staff were rostered to be on duty. The Inspector observed that sufficient staff were on duty during his inspection visit. Agency staff are not used, but considerable use is currently being made of bank staff as the home currently has 155 vacant support hours per week, and the Deputy Manager post has not been filled. The Registered Manager reported that the Deputy’s post had been advertised but not filled. A requirement is made at this inspection as the situation has not substantially improved since the previous inspection. Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 21 The Inspector checked the recruitment file of an employee who had commenced her employment since the previous CSCI inspection. He found that all appropriate checks had been undertaken, and a satisfactory induction had been provided. The Registered Manager reported that the home will use the new Common Induction Standards when further appointments are made. The Inspector examined the home’s individual and collective training records and training plan and found them to be more up to date that at the previous inspection. The Registered Manager reported that of the 13 support staff in post, 3 are currently undertaking an NVQ in care, but only 2 members of staff have the award at present. This equates to 15 of the staff being NVQ qualified, whereas the nationally agreed target is 50 . Hence a requirement is made. The Inspector checked the staff supervision records and found that some staff members were not receiving their formal supervision as frequently as the NMS stipulate. Hence the requirement made in the previous CSCI inspection report is restated as the timescale has not been met. When asked by the Inspector, the Registered Manager responded that if he had a deputy in post to share the supervision responsibilities with, all support staff would be supervised in line with the NMS. Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit substantially from a well run home, but a deputy manager is required. Residents and relatives views are sufficiently taken into account. Record keeping is likely to suffer as the home’s computer is broken. The health, safety and welfare of residents and staff is promoted except where the apparent operating temperature of the fridge is concerned. EVIDENCE: The home now has a Registered Manager in place, who is committed to improving standards within the home to the benefit of residents. He is undertaking the Registered Managers Award. The Registered Manager remains responsible for a two person supported living scheme known as Ross Cottage in addition to the management of Grange House. There is still no Deputy Manager in post. Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 23 The Registered Manager reported that quality assurance is undertaken at the Annual Review Day when family members are asked for their comments about the service. The outcomes of the review day are then used to create a business plan for the year ahead. The Inspector noted that the home does not have a working computer at present, and hence the home cannot be contacted by email and the staff cannot access the internet or Milbury’s website. It is therefore strongly recommended that Milbury provide a new computer to the home. The Inspector checked the home’s record of hot water temperatures, and fridge and freezer temperatures. These were satisfactory except that the fridge was consistently being recorded as operating at a minus temperature. The Inspector checked the fridge and found that the contents were not frozen and therefore concluded that the fridge thermometer must be faulty and must be replaced. As the fault had continued undetected for over a month, staff must also be trained to know the correct operating temperature of the fridge, and trained in what procedure to follow if the thermometer suggests the fridge is operating at the wrong temperature. Cleaning chemicals were safely locked away. Grange House DS0000048879.V335285.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 Adults 18-65 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 x 2 3 3 x 4 x 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 x 26 x 27 x 28 x 29 x 30 4 STAFFING Standard No Score 31 x 32 2 33 2 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x 2 2 3 Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 25 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA5 Regulation 5 Requirement The statement of terms and conditions issued to each resident must contain details of the charge made for use of the home’s vehicle. Individual care plans must consider how to meet all assessed care needs including cultural, religious and social needs. An advocate must be sought for the resident who has no parents able to represent her interests. Every effort must be made to increase the percentage of NVQ qualified staff employed in the care home to 50 . The registered person shall ensure that sufficient permanent support staff, and sufficient management staff are employed in order to meet the health and welfare needs of the residents. The registered person must ensure that all staff are appropriately supervised. Restated from the previous inspection report DS0000048879.V335285.R01.S.doc Timescale for action 01/07/07 2. YA6 15(1) 01/09/07 3. YA7 15(2)© 01/08/07 4. YA32 18(1)(c) 01/05/09 5. YA33 18(1)(a) 01/09/07 6. YA36 18(2) 01/09/07 Grange House Version 5.2 Page 26 7 8. YA42 YA42 23(2)(c) 18(c)(i) as the timescale of 01/11/06 was not met. A new fridge thermometer is required. Staff must be trained in what is the safe operating temperature range for the fridge concerned, and trained in what action to take if the fridge thermometer suggests that the equipment is operating outside of that range. 01/06/07 01/06/07 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 YA2 Good Practice Recommendations Attention should be paid to make sure that social, cultural and religious needs are assessed and recorded in a way that is likely to lead to them being included as goals in the resident’s care plan. Advice should be sought form a nutritionist or dietician so that healthy diets may be more fully promoted. A new computer should be purchased for the benefit of staff and residents, and so that electronic links with the outside world can be reinstated. 2. 3. YA17 YA41 Grange House DS0000048879.V335285.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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. 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