Inspection on 18/07/05 for Green Haven

This inspection was carried out on 18th July 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

Green Haven 25/06/07

Green Haven 31/08/06

Green Haven 23/01/06

Green Haven 11/02/05

Green Haven 26/08/04

Green Haven 19/01/04

Green Haven 26/06/03

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

CARE HOMES FOR OLDER PEOPLE Green Haven 18 Montpelier Road Ealing London W5 2QP Lead Inspector Sarah Middleton Unannounced 18 July 2005 10.45 AM th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Green Haven Address 18 Montpelier Road, Ealing, London, W5 2QP Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 997 2142 0208 997 4235 Haven Green Housing Association Ltd. Ms Jacqueline Gordon CRH 22 Category(ies) of Physical Disabilty - Over 65 and Old Age registration, with number of places Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: NO Date of last inspection 11/2/05 Brief Description of the Service: Green Haven provides a service for 22 older people. The home is well established and has been in operation since 1961. A voluntary committee manages Green Haven and meets every other month. The committees chairperson is the homes registered Responsible Individual. The home is supported by a group of volunteers known as the Friends of Green Haven. The majority of the service user group are frail elderly. However, the home aims to support service users in maintaining links with the community as far as is practical and in accordance with service users wishes. Green Haven is a large detached property in a quiet residential area of Ealing. The home has parking to the front of the building and a large garden and veranda at the back. It has three floors, with bedrooms on each floor. Those above the ground floor are accessed using the passenger lift. All bedrooms are single, one has en-suite facilities. The home has a large lounge and separate dining room. Smoking is only permitted in a part of the dining room. Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, from 10.45pm – 4.25pm, carried out as part of the regulatory process. The Inspector carried out a full tour of each floor of the home and inspected service user plans, staff files and maintenance records. Four service users and three staff were spoken with as part of the inspection process. The home had met all of the previous requirements, except for two at this inspection. Seven new requirements were set at this inspection. What the service does well: What has improved since the last inspection? What they could do better: The home has not implemented a quality assurance review. This has been an ongoing requirement that must be addressed by the Registered Manager and the committee. This would ensure the home is meeting the needs of the service users and has reflected on the systems that run the home and whether they need adjusting. Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 Page 6 Training on the protection of vulnerable adults is proving difficult to provide for staff. The Registered Manager and Deputy Manager have identified suitable courses, but there have been ongoing problems. This is an important area for members of staff and this must addressed to ensure all staff are fully aware of up to date legislation and policy and procedures to protect vulnerable service users. The home must keep accurate records on medication administration records sheets, to prevent mistakes. In addition, all opened liquid medication must have a date of opening on them, to ensure no out of date medication is kept and administered. All service users, including respite service users, must have risk assessments completed to identify the needs of the service users and to minimise any incidents occurring. The home must be vigilant in maintaining the health and welfare of service users through checking water temperatures are taken where service users have access. Finally, all doors must be fitted with appropriate door releasing equipment, which in the event of a fire, would automatically close. Consultation with the fire authority would advise the home where there were areas needing attention. 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. Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 & 5 Service users receive information about the home and receive terms and conditions so they are fully aware of the services provided in the home. Service users are assessed prior to admission to ensure the home can meet their needs. Prospective service users and their representatives are encouraged to visit the home in order to make an informed choice. EVIDENCE: Service users, their relatives and any representatives are provided with information regarding the home in the form of a Service Users Guide and Statement of Purpose. This is freely available and details all the relevant information service users would need to know. Terms and conditions were viewed and these are given to each individual. A pre-admission assessment is used prior to the admission of a service user. Samples of completed pre-admission assessments were seen and these offered a detailed summary of the service users needs. Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 Page 9 The Registered Manager stated that even if they receive a Local Authority assessment of need, they still complete their own assessment to ensure they can offer a home to a prospective service user. There have been no new admissions since the previous inspection but the Registered Manager has devised a letter to confirm or decline a place for a service user and will use this for future service users. Many of the staff have worked in the home for many years and have the skills to meet the changing needs of the service users. The Registered Manager said that whenever possible prospective service users are encouraged to visit the home and meet other service users and staff. If they could not visit the home, then their relatives or a representative would also be welcomed to visit the home. Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 & 10 The health and personal care needs of service users had been identified and were being met. This would provide a clear guideline for staff to support service users appropriately. Risk assessments must be carried out on all service users living in the home, whether they were respite or long-term service users. This is to ensure the health and welfare of service users is monitored and any identified risks are minimised. There were two shortfalls in the medication systems. All dates of liquid medication must have a date of opening on them and staff must record if a service user has had medication or the reason if they have not. This is to safeguard the service users welfare. Service users were treated with respect and staff were aware of the changing needs of the service users. EVIDENCE: Individual service user plans were available and samples were viewed. Overall these were comprehensive and detailed how the service users’ identified health, personal and social care needs would be met. Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 Page 11 Service user plans were up to date and had been reviewed monthly or if there had been a change in service user needs. Where possible, service users had signed their care plans and been a part of the process of devising the care plan. The records indicated when service users had input from the GP, Chiropodist or other health professionals. Service users spoken with confirmed they see all the health professionals they need to and are happy with the services they receive. The monitoring of health needs is clearly recorded by staff to ensure all needs are being reviewed and met. Samples of the medication administration records were tracked. Gaps in staff signatures were identified for one service user. The senior members of staff administer the medication, which is mainly in doset boxes from the Pharmacist. The home has one service user who has been prescribed a controlled drug; this is in tablet form and is in a doset box. Medications were appropriately and securely stored. Staff receive training on various aspects of medication by the local Pharmacist. There were several bottles of liquid medications with no date of opening on them. Staff were seen to address service users in a courteous manner. Service users spoken with were satisfied with the care given and the attitude of staff. Service users can have private telephones in their bedrooms, as the payphone is in the main hall. Personal care is given in private and all service users bedrooms are single rooms. One service user spoken with confirmed they were happy with the laundry facilities and that their clothes always returned to them. Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14 & 15 Social activities are in place and a member of staff co-ordinates the programme of events each day. Visiting is encouraged for service users to maintain contact with family and friends. Choices are respected within the home and promoted where possible. The meal provision reflected choices and a well balanced diet. There must be dates on any food prepared in the home to ensure the health of vulnerable service users is considered at all times. EVIDENCE: One of the senior members of staff co-ordinate the activities that are run in the home, for example singing, keep fit and art. They consider the activities service users like to participate in and seek to provide a varied programme on a daily basis. Activities for the day are displayed in the main hall, along with what staff are working in the home that particular day. Service users spoken with stated if they could choose whether they took part in activities offered to them. There was a singing session on the afternoon of the inspection. Those wishing to take part did so. Each week Church of England and Catholic services are held for those wishing to attend. The home also organises outings throughout the year through the local community transport. An entertainer also visits the home once a month. Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 Page 13 One service user said they are picked up to attend Age Concern three days a week. Service users can see visitors as and when they choose. The “Friends of Green Haven”, who are volunteers, visit on a regular basis. Choices are offered in each aspect of the care provision and routine of the home. Service users spoken with said they could choose where they spend their time. Those who have personal possessions can bring these into the home and where possible bring items of furniture, if there is sufficient space in their bedrooms. The lunch was seen and the menus reflected choices. There is a four-week rolling menu with two additional choices each day. Individual choices are asked each day and catered for and recorded. Special diets are catered for and any particular likes/dislikes. Lunchtime was observed and was unhurried. Staff were seen to offer choices to service users and to interact in a sensitive manner. Service users spoken with stated they were very happy with the food at the home. Some of the items of food, although had just been prepared, had no date of opening on them. Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 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 standard(s) 16 & 18 The home has a clear complaints procedure and service users were confident their complaints would be listened to and acted upon. Systems were in place for the protection of vulnerable adults. Staff must have training on adult protection issues to ensure all staff are fully aware and have the knowledge and skills to protect vulnerable service users. EVIDENCE: The home has a detailed complaints procedure, which is freely available. Complaints records viewed recorded the action taken by the home to investigate complaints. There have been no complaints since the last inspection and the CSCI had not directly received any complaints since the last inspection. Some service users spoken with knew they could raise any issues with the Registered Manager and they felt happy their concerns would be addressed. The home has a clear procedure for the protection of vulnerable adults (POVA) and this dovetails with the Local Authority documentation. Overall staff were aware of these documents but had not received training on this issue. The Registered Manager has a system for staff that have read policies and procedures to sign to state they have read the documentation. Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 Page 15 The Registered Manager had liaised with the Local Authority for staff to attend the training they were providing. However this course was cancelled. An external company was then identified and training was due over the summer, however this was also cancelled. The Registered Manager is aware this problem needs to be rectified. Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 24, 25 & 26 Overall there is a homely environment for service users. There is a programme for decoration and maintenance of the home. The ground floor bathroom needs to be decorated to provide a pleasant and safe environment for service users using the room. Bedrooms provide privacy and a place for personal possessions to be with service users. The home is clean and is vigilant in infection control procedures. The washbasins in service users bedrooms must have their temperature taken to ensure the welfare of service users is protected. EVIDENCE: A tour of each floor was carried out and a sample of rooms viewed. These were being satisfactorily maintained. A maintenance schedule was seen and this highlighted the work needing to be carried out over the forthcoming year. Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 Page 17 There were no anticipated dates on most of the work and so it was not clear when this would be carried out. The passenger lift is due to be replaced over the summer and a schedule of work was seen to complete this task. Whilst the lift is being replaced, a stair lift will be fitted to the stairs to ensure service users continue to access their bedrooms. Staff will supervise this to ensure service users are safe. There is a large communal lounge on the ground floor and a veranda that is used in the summer months. The home has a large garden and a gardener maintains this. The dining room is sufficient for service users to eat in and is separated from the lounge with large sliding doors. The home has one service user who smokes. The allocated smoking area is in the dining room. The home had a small fire in one of the bathrooms and this is now being redecorated. Due to this incident the ground floor bathroom, which needed decorating and the floor replacing, had not had the work carried out on it. This room will be addressed once the other bathroom has been completed. Once all the work has been carried out there will be assisted baths in all three bathrooms. There are grab rails and other specialist equipment, such as call alarms in each bedroom, throughout the home to meet the needs of the service users. One staff member stated they felt there should be more specialist equipment to move service users more appropriately for the benefit of service users and staff. The Registered Manager was not aware of any problems in moving and handling service users. The bedrooms are single and varied in size. Service users have personalised their bedrooms with items they choose to bring into the home. All rooms have adequate furniture in them to provide a homely environment. The home was clean and bright at the time of the inspection, with satisfactory lighting. Hot water temperatures are checked and recorded. However this is not carried out on washbasins in service user bedrooms. These are fitted with safety valves but they should also be a part of the routine of monitoring water temperatures for the whole home. Emergency lighting is in place and checked on a regular basis. All radiators are covered in the home. Policies and procedures for the control of infection were available. The care staff provides the laundry tasks and the machines are kept in separate rooms with appropriate facilities. Service users said there were no problems with their clothes being washed and returned to them. Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30 There is continuity of care in the home, as the staff team is stable and well established. Staff have the opportunity to study the NVQ courses and have had all the necessary employment checks carried out on them to protect the service users. In-house training is available for all staff, to ensure the service users are cared for by a competent staff team. EVIDENCE: The home has three staff working during the day and a waking night and sleeping in person during the night period. One staff member stated sometimes there was not always enough staff working in the home. The Registered Manager stated this situation occurs rarely and is usually when staff are sick at short notice. Overall most staff felt there was sufficient cover to carry out the tasks that needed completing. There was no evidence at the inspection that there are staffing problems and there are no staff vacancies at present. Staff meetings take place on a regular basis. The home has links with a local College and some staff are studying the NVQ course. There are opportunities throughout the year to enrol for those needing to study this course. The staff employment files viewed contained details of the applicants completed application forms, Criminal Record Bureau checks, terms and conditions of contract and references. The Registered Manager showed a letter from the agency they use, confirming all the workers they provide to the home have had all necessary employment checks. Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 Page 19 A training programme was seen outlining courses staff had attended. This did not outline forthcoming courses. There have been no new staff appointed since the previous inspection. However the two most recent did receive the foundation training. Staff spoken with confirmed they had received an induction when they began employment at the home and felt the training offered to them was relevant to meet the needs of the service users. Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36 & 38 The home is well managed and the Registered Manager has a visible presence in the home. The home has not carried out a review of the care offered in the home. This must be carried out, with consultation with service users, to ensure the home constantly reflects on its practices and works to improve in areas that might be identified in a review. Service records are up to date and safeguard service users welfare. The home must review, with consultation with the fire authority, and consider the health and safety of service users and staff when keeping doors open, without being fitted with door release equipment. EVIDENCE: The Registered Manager has recently completed NVQ level 4 and has been in post for several years. Staff stated the Registered Manager is approachable and offers clear direction in the home. Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 Page 21 Previous inspections made a requirement that the home must carry out a quality assurance review on the home; this would incorporate any views from service users, their families and other professionals. This remains outstanding. The Registered Manager feels it would be appropriate for an objective person to complete this review and has spoken with the committee to establish who would take a lead in this area. Completed questionnaires from service users and family members were viewed from the previous year. These were due to be completed again this year. Overall the staff spoken with confirmed they received regular supervision and that they found it useful and supportive. Supervision notes are kept in a secure place. Appraisals of staff also take place annually. Servicing records were viewed at random. All those viewed were up to date, for example, fire equipment, testing for legionella and the passenger lift. As noted earlier the water from the washbasins in service users bedrooms must have their temperature taken as part of the regular monitoring of all water temperatures. The office doors were propped open during the inspection. There is a fire door, which is kept closed; separating the two offices form the main part of the home. However the doors kept open should be fitted with appropriate equipment, which closes the doors in the event of a fire. Consultation with the fire authority should take place to ensure the home has taken every precaution. Fire drills take place regularly at different times of the day to ensure all staff receive regular practices. Health and safety training has been provided for all staff including domestic staff. Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 3 3 3 x 3 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 3 2 x x 3 x 2 Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 Page 23 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 7 Regulation Requirement Timescale for action 1/8/05 2. 9 3. 4. 9 15 5. 18 6. 7. 8. 19 25 & 38 33 13 (4) (c ) The Registered Person shall ensure that any unnecessary risks are identified, for all service users, and as far as possible eliminated. 13 (2) The Registered Person shall ensure the medication administration records are kept up to date and are recorded accurately. 13 (2) The Registered Person shall ensure that all liquid medication has a date of opening on it. 16 (2) (i) The Registered Person shall ensure that all food prepared, if stored, has a date of opening on it. 13 (6) The Registered Person shall 18 (1) (a) make arrangements, by training staff, or through other measures, on the protection of vulnerable adults. (Previous timescale 30/4/05 not met). 23 (2) (b) The ground floor bathroom must (d) be re-decorated and the flooring replaced. 13 (4) Temperatures are taken of the water in washbasins which are in service users bedrooms. 24 Quality assurance and G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc 1/8/05 1/8/05 1/8/05 31/10/05 30/9/05 1/8/05 1/11/05 Page 24 Green Haven Version 1.30 9. 38 23 (4) (a) (c ) (i) monitoring systems must be devised and implemented. A report of any findings must be made available to the CSCI & service users. (Previous timescale 30/6/05 not met) The Registered Person shall after consultation with the fire authority, take adequate precautions against the risk of fire and make arrangements for doors needed to be kept open to be fitted with appropriate door releasing equipment. 30/9/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard 7 9 19 30 Good Practice Recommendations Those service users unable to sign or be a part of the implementation of their care plan or review, should have this noted on their individual files. It is recommended that the home has a list of all staff able to administer medication. The maintenance schedule should have a list of anticipated dates for all the work that is to be carried out during the year. The training programe should outline forthcoming courses for all members of staff. Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Ground Floor 58 Uxbridge Road Ealing London W5 2ST 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 Green Haven G61-G10 S27707 Green Haven V214850 18.07.05 Stage 4.doc Version 1.30 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!