CARE HOMES FOR OLDER PEOPLE
Greenacres Pighue Lane Wavertree Liverpool Merseyside L13 1DG Lead Inspector
Inger Moynihan Unannounced Inspection 1 December 2005 09:00 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 Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 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. Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Greenacres Address Pighue Lane Wavertree Liverpool Merseyside L13 1DG 0151 259 7899 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) Mr Ilam Chaudhry Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42) of places Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 15th December 2004 Brief Description of the Service: Greenacres is a residential care home providing 24-hour personal care and accommodation for 42 older people. There is currently no registered manager at this home. Mrs Lynn Williams is currently acting as manager of the home and her application to become registered is currently being processed by the CSCI. The home is located in the Wavertree district of Liverpool and is within easy access to bus routes, churches, shops and local amenities. The home is a purpose built single storey building, which was opened in 1996. There is car parking to the front and side of the home and a central courtyard provides a safe garden area for service users to sit. Bedroom accommodation comprises of 40 single bedrooms and one double bedroom all with en-suite facilities. Communal space within the home consists of two lounge areas, a dining room and a small smoking area. Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over six hours and was the statutory unannounced inspection for 2005/2006. A tour of the premises took place and staff and service users records were inspected. Six staff and five service users were spoken to during this inspection. What the service does well:
Efficient systems are in place to ensure service users good health. Service users stated they are treated with respect and their right to privacy is upheld. The service users spoken to during inspection discussed their particular healthcare requirements with the inspector and confirmed they felt well cared for and had easy access to relevant health care professionals when necessary. The relatives of one service user commented the staff are very quick to pick up on any issues relating to my dads health and always keep me up to date on everything that is happening. I think my dad receives a good standard of care at Greenacres. This was further supported by a service user who stated the staff are very quick to respond to when I am not well and always call my GP if I need to see him. A range of social activities are provided to ensure service users interest and mental stimulation. Some of the service users stated they did not wish to become involved in these activities and were happy the staff respected their decision. One service user commented I enjoy the social activities because it gives me a chance to chat with the other service users. The daily routines within the home are flexible and service users can come and go as they choose. A number of service users confirmed they had their own routines and were free to go about the day as they wished. All of the service users commented on how much they enjoyed the food with one service user stating I always enjoy the meals and I always have enough to eat and drink. Service users confirmed they could have their meals in their own room and were always offered a choice. A complaint procedure is in place to ensure service users views are taken into account and acted upon appropriately. One service user commented the staff are very kind and caring and I have no complaints to make about the way I am looked after. Another service user stated the girls are excellent and nothing is ever any trouble to them. The standard of decoration throughout the home is good and provides a comfortable and pleasant environment for the service users to live. Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 6 The acting manager offers clear leadership to staff to ensure they are supported in their role. The staff spoke well of the acting manager and confirmed there were sufficient staff on duty to care for the service users. This is a positive aspect of the home and prevents poor working practices developing. Efficient systems are in place to ensure the home is run for service users best interest. The health, safety and welfare of the service users is well promoted. What has improved since the last inspection? What they could do better:
Service users’ care needs are assessed before they move into the home to ensure the acting manager and staff team can provide the necessary care. However, risk assessments need to be routinely incorporated into this process. A documented plan of the care provided to each service user is in place which gives staff information on how to look after the service users properly. However, this information needs to be updated to ensure it is an accurate reflection of service users care needs. To ensure service users safety, staff must be more vigilant in the way they handle service users medication. A varied and nutritious diet is provided which ensures service users good health. However, one service user spoken to said she was not completely satisfied with the standard of the food provided and wanted more choice to be offered. In the light of this some improvements do need to be made to the alternative meal provided to ensure all service users receive a balanced diet. Staff need to be informed of the different agencies they can access if they wish to make a complaint. Procedures are in place to ensure server users are protected from abuse, although staff do need to be provided with training in this aspect of care provision to ensure they are up to date with current good practice. Some improvements need to be made to the bathrooms and toilets to ensure service users comfort.
Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 7 Training in relation to issues of diversity must be provided. Some improvements need to be made to the systems in place to promote service users health and safety. 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. Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Service users’ care needs are assessed before they move into the home to ensure the acting manager and staff team can provide the necessary care. However, risk assessments are not routinely incorporated into this process which could lead to important aspects of service users care needs being missed. EVIDENCE: An assessment of service users individual care needs is carried out prior to any service user being admitted into the home. This ensures the registered manager and staff team are able to meet the service users specific care needs as required. The assessment process includes meeting the prospective service user and their relatives/representatives and discussion with relevant social/health care professionals. While risk assessments are incorporated into the assessment process, this is not routinely carried out. To ensure important aspects of service users care needs are not missed, the registered person is required to ensure risk assessments are routinely carried out.
Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 10 Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 A documented plan of the care provided to each service user is in place which gives staff information on how to look after the service users properly. This documentation needed to be updated to ensure it was an accurate reflection of service users care needs. Efficient systems are in place to ensure service users good health. To ensure service users safety, staff must be more vigilant in the way they handle service users medication. Service users stated they are treated with respect and their right to privacy is upheld. EVIDENCE: Service users health, personal and social care needs are set out in an individual plan of care. This is in line with good practice and ensures staff know how to care for the service users in accordance with their particular needs. The acting manager agreed this information needed to be updated to ensure it was an accurate reflection of service users care needs.
Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 12 It was agreed with the acting manager that all of the care plans would be streamlined and updated by 28 February 2006. The service users spoken to during the inspection discussed their particular health-care requirements with the inspector and confirmed they felt well cared for and had easy access to relevant health care professionals when necessary. One service user stated I think the staff are all wonderful and very helpful in every way. The acting manager is very efficient and I am very satisfied with the care I receive. All of the service users spoken to during the inspection confirmed the staff treated them with respect and dignity at all times and particularly when carrying out personal care. One service user commented the staff are very discreet when helping me with my personal care which is very important to me, they are nothing other than kind and polite. When service users are unwell or become vulnerable in anyway, they must rely on the staff to care for them properly. It is clear from the service users comments that staff are providing a standard of care which is in line with good practice and meets service users individual needs. The relatives of one service user commented the staff are very quick to pick up on any issues relating to my dads health and always keep me up to date on everything that is happening. I think my dad receives a good standard of care at Greenacres. This was further supported by a service user who stated the staff are very quick to respond to when I am not well and always call my GP if I need to see him. During a tour of the building it was noted that the medication had been left out in the dining room. Some of this medication had been taken out of its box therefore it was not possible to identify who it belong to. This issue was addressed with the acting manager immediately who ensured the medication was then stored safely. The acting manager agreed to address this issue with the member of staff concerned. In the light of this, the registered provider must write to the CSCI and inform the inspector of the action taken to address this matter. Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 13 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, 14 and 15 A range of social activities are provided to ensure service users interest and mental stimulation. The daily routines within the home are flexible and service users can come and go as they choose. A varied and nutritious diet is provided which ensures service users good health. However, some improvements do need to be made to the alternative meal provided to ensure all service users receive a balanced diet. EVIDENCE: A range of social activities are provided which the service users confirmed they are free to participate in if they wish. An activity organiser is employed in the home for four hours per week and plans are being made to provide a range of activities over the Christmas period. The service users confirmed a range of social activities take place during the week which they are free to participate in if they wish. Some of the service users stated they did not wish to become involved in these activities and were happy the staff respected their decision. One service user commented I enjoy the social activities because it gives me a chance to chat with the other service
Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 14 users. A number of service users confirmed they had their own routines with regard to social activities and were free to go about their day as they wished. On the day of the inspection arrangements had been made for about 12 service users to attend any entertainment event. All of the service users spoken to during the inspection confirmed the routines within the home are flexible and they could come and go as they wish. The relatives of one service user confirmed they could visit at any time and were always made welcome by the staff. All of the service users commented on how much they enjoyed the food with one service user stating I always enjoy the meals and I always have enough to eat and drink. Service users confirmed they could have their meals in their own room and were always offered a choice. One service user spoken to said she was not completely satisfied with the standard of the food provided and wanted more choice to be offered. This issue was discussed with the acting manager and it was agreed that a more comprehensive choice of meal would be offered as an alternative rather than a snack. Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 15 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 A complaint procedure is in place to ensure service users views are taken into account and acted upon appropriately. However, staff need to be informed of the different agencies they can access if they wish to make a complaint. Procedures are in place to ensure server users are protected from abuse, although staff do need to be provided with training in this area to ensure they are up to date with current good practice. EVIDENCE: The service users spoken to during the inspection said they were aware they could make a complaint about any aspect of the service they received and who they should contact in the event of them wishing to do so. One service user commented the staff are very kind and caring and I have no complaints to make about the way I am looked after. Another service user stated the girls are excellent and nothing is ever any trouble to them. With regard to the homes complaint procedure, the registered person must ensure all staff are aware of the different agencies staff can contact if they wish to make a complaint about any part of the service provided at Greenacres Care Home. Not all of the staff have completed training on the protection of vulnerable adults from abuse, although they did acknowledge that a training course on this issue had recently taken place. The acting manager had already identified this as a training need for the staff team.
Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 16 All of the service users spoken to during the inspection confirmed they were treated with respect and courtesy at all times and had never experienced anything other than kindness from the staff team. The CSCI has received one complaint about the standards of care provided at Greenacres; the investigation of this complaint is ongoing. Although the acting manager had displayed the telephone number of the organisation Action on Elder Abuse, not all staff were aware of this information. It is recommended that the registered person ensures all staff and service users are aware of the telephone number of this agency so they can report any concerns anonymously. Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 17 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 The standard of decoration throughout the home is good and provides a comfortable and pleasant environment for the service users to live. EVIDENCE: The location and layout of the home is suitable for its purpose and overall is well maintained. There is a programme of routine maintenance and renewal of the fabric and decoration of the premises. Since the last inspection, new carpets have been fitted in some of the corridors although the remaining carpets are badly stained and are in need of replacing as the acting manager stated they are beyond cleaning. On the day of the inspection corridors were being painted and arrangements had been made for a number are of bedrooms to be redecorated. The inspector noticed and the acting manager agreed that the shower rooms and some of the toilets needed to be refurbished. Discussion with the registered provider confirmed this work would be undertaken after the redecoration of the corridors and bedrooms. The registered person must ensure the strip lights in the ensuite facilities are cleaned.
Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 18 Some improvements have been made to the dining room by way of new curtains and redecoration. New tablecloths have also been purchased. These tablecloths were plastic and although practical are not deemed appropriate for adults. The registered person must look to replacing these tablecloths with something more appropriate. The home was clean and tidy and systems were in place to prevent the spread of infection. Appropriate laundry facilities are provided. The domestic and laundry staff confirmed they always had sufficient equipment and materials to carry out their work. It is clear the staff are working hard to ensure a clean and tidy environment is provided for the service users to live. Greenacres is built around an inner courtyard where there is a pleasant garden and seating area. This area had been made safe for service users to wander into. All bedrooms within the home are single occupancy with ensuite facilities. To ensure service users feel comfortable within the home, they are encouraged to personalise their rooms with their own belongings which many have done. Various items of equipment are provided to assist service users with their mobility and bathing. Regular safety checks are made on this equipment. Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 19 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 and 30 There are sufficient trained and competent staff to meet the service users needs and thorough recruitment and selection procedures are in place to ensure service users safety and welfare. Staff require further training to ensure their practice is in line with good practice EVIDENCE: The staff rota indicated staff are evenly deployed to ensure service users’ care needs are met at all times and to ensure their safety and well-being. The staff spoken to confirmed there were sufficient staff on duty to care for the service users. This is a positive aspect of the home and prevents poor working practices developing. The staff spoken to during the inspection confirmed the acting manager encourages them to become involved in all training events. This is a positive aspect of the home and ensures service users are being cared for properly and their needs are being met in accordance with good practice. Through discussions the acting manager outlined how she had carried out an audit of staff training needs and was in the process of making arrangements for further training to be provided. This training includes fire safety, medication procedures and moving and handling etc. Thorough recruitment and selection procedures are in place which include carrying out the necessary Criminal Record Bureau disclosure checks. This
Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 20 ensures suitably qualified and competent staff are employed in the home and that service users’ safety is promoted. The registered manager confirmed that training in relation to issues of diversity had not been provided and agreed to ensure all staff are updated in this aspect of care. This will ensure service users specific care requirements are met in relation to their religion, sexuality or cultural background. The inspector was informed there is a low staff turnover with only one domestic staff vacancy. This is a positive aspect of the home and ensures consistency in the care provided to service users. Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 21 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, 32 and 38 The acting manager offers clear leadership to staff to ensure they are supported in their role. Efficient systems are in place to ensure the home is run for service users best interest. The health, safety and welfare of the service users is well promoted. EVIDENCE: Through discussion, the acting manager demonstrated she was aware of her responsibilities with regard to the management of the home, supervision of staff and the care of service users. This is a positive aspect of a home and ensures service users are cared for in accordance with their particular needs and requirements. The staff spoke highly of the acting manager. They said she was very supportive and had contributed to creating a friendly working
Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 22 environment. The service users also spoke highly of the acting manager stating she was extremely caring and compassionate in her manner. During discussion the acting manager outlined some of the changes she wanted to make in the home. It was acknowledged however, that because she had only been in post since July of this year, these changes would take some time to implement. The staff commented they worked well as a team and enjoyed their work. All of these issues demonstrate a good quality of care continues to be provided at Greenacres. Staff comments included I love my work and enjoy working with the service users, I feel we all work well as a team. Safe working practices have been developed and staff have been provided with the appropriate training to ensure service users safety and welfare. During a tour of the building inspector noticed one of the fire exits had been blocked with a lounge chair and a hoist. Also a sign had not been displayed to indicate oxygen was being stored in one of the service users bedrooms. The acting managers had already identified that further health and safety training was required for some staff. To ensure staff and service users safety in the event of a fire, the registered person is required to ensure alternative arrangements are made for the storage of this equipment and that all fire exits are kept clear at all times. Also that a sign must be clearly displayed on any service users bedroom door to indicate oxygen is being stored. Not doing this could put staff, service users and staff from the Fire Department at risk of harm. The acting manager agreed to address these issues on the day of the inspection. There was a smell of urine in a number of bedrooms. This issue had been addressed in part by removing the carpet and replacing it with lino. While this is a very practical way of dealing with this issue the registered person is also required to review the way in which service users continence is being managed by the staff team and to ensure the correct products are being used. The registered person is advised to keep up-to-date with all of the information provided on the Health and Safety Executive and Medical Devices Agency Web Sites. Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 23 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 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 2 x x x x x x x
x STAFFING Standard No Score 27 3 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 x x x x x 2 Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 24 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 OP2 Regulation 14 Requirement The registered person is required to ensure a risk assessment is routinely carried out when assessing all aspects of service users care needs. The registered person is required to ensure all care plans are reviewed and streamlined. The registered person is required to ensure service users medication is stored safely at all times. The registered person is required to ensure all service users are offered a full choice of menu and that alternative meals are not snacks. The registered person is required to ensure all staff are aware of the various agencies they can contact if they wish to make a complaint. The registered person is required to ensure all staff have completed training on the protection of vulnerable adults from abuse. The registered person is required to ensure the carpets that are
DS0000025108.V267695.R01.S.doc Timescale for action 26/02/06 2. 3. OP7 OP9 15 13 26/02/06 01/12/05 5. OP15 16 01/02/06 6. OP16 22 01/02/06 7. OP18 18 01/03/06 8. OP19 23 01/05/06 Greenacres Version 5.0 Page 25 9. OP19 23 10. OP19 23 11. 12. 13. OP19 OP30 OP38 23 18 16 13. OP38 12 badly stained in the corridor areas are replaced. The registered person is required to ensure the bathrooms and toilets are refurbished. The registered person must write to the inspector to confirm the date this work will be completed. The registered person is required to ensure the plastic tablecloths are replaced with something more appropriate. The registered person is required to ensure the strip lights in the ensuite facilities are cleaned. The registered person is required to ensure staff are provided training on issues of diversity. The registered person is required to address the smell of urine around the building and particularly in service users bedrooms. The registered person is required to ensure all fire exits are kept clear at all times. 01/02/06 01/02/06 01/02/06 01/03/06 01/03/06 01/12/05 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 1. Refer to Standard OP38 OP16 Good Practice Recommendations It is recommended that the registered person keep up to date with the information provided on the Health and Safety Executive and medical devices agency web sites. It is recommended that the telephone number of the organisation Action on Elder Abuse is made available to staff and service users so they report any incidents of abuse anonymously. Greenacres DS0000025108.V267695.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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