Inspection on 10/05/05 for Greenlands

This inspection was carried out on 10th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Greenlands 19/09/07

Greenlands 05/12/06

Greenlands 25/04/06

Greenlands 07/11/05

Greenlands 24/01/05

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

CARE HOMES FOR OLDER PEOPLE GREENLANDS 46 Green Lane Bolton Lancs BL3 2EF Lead Inspector Lucy Burgess Announced 10 May 2005 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. GREENLANDS F56 F06 S61961 Greenlands V212625 100505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Greenlands Address 46 Green Lane, Bolton, Lancs, BL3 2EF 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) 01204 531691 Mrs Asma Khan and Mrs Shagufta Hussain Mrs Shagufta Hussain CRH Care Home Only 28 Category(ies) of OP Old Age - 28 registration, with number of places GREENLANDS F56 F06 S61961 Greenlands V212625 100505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. Date of last inspection 24th January 2005 Brief Description of the Service: Greenlands Residential Care Home was bought by the new owners Mrs Hussain and Mrs Khan, who took over the management of the home on 17th December 2004. Greenlands is a private residential care home registered to provide care for up to 28 older people. The property is detached and set in its own well maintained grounds. It is situated close to local amenities and accessible for local transport. The Home comprises of four single bedrooms and twelve double rooms. They are individually decorated and furnished and include a wash hand basin and a nurse call. There are no en-suite facilities.The Home offers the choice of two lounges and a separate dining room. The standard of cleanliness is good. There has been an ongoing programme of maintenance and re decoration to ensure a good standard is maintained. GREENLANDS F56 F06 S61961 Greenlands V212625 100505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and took place over two days for a period of 14 hours. The inspector took the opportunity to look round the home, view records and policies as well as talk with a number of residents, staff and visiting district nurse. Discussion and feedback was also held with the Owners/Manager and Deputy Manager. The home is registered to provide accommodation for 28 people. As the inspection was announced a completed pre-inspection questionnaire was received along with feedback surveys from 9 service users, 7 relatives, a GP, district nurse, social worker and community psychiatric nurse. What the service does well: What has improved since the last inspection? A few areas within the home have been looked at and improvements made. This has included a new call bell system, fire alarm panel and lifting GREENLANDS F56 F06 S61961 Greenlands V212625 100505 Stage 4.doc Version 1.30 Page 6 equipment. Improvements have also been made to the heating system, bathrooms and plumbing. The Owners are also planning more work including an extension to the laundry with specialist equipment and new carpeting to the hall, stairs and landings. The home was comfortable, well maintained, clean and odour free. The planned improvements will further enhance the home providing a safe comfortable home for the residents to live. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. GREENLANDS F56 F06 S61961 Greenlands V212625 100505 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 GREENLANDS F56 F06 S61961 Greenlands V212625 100505 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) None EVIDENCE: This area will be addressed at the unannounced inspection. GREENLANDS F56 F06 S61961 Greenlands V212625 100505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 to 11 Care plans and risk assessments are in place for each resident. Information does not give clear or consistent information of the nutritional needs of service users so that staff can satisfactorily meet the needs of service users. Accurate weight and personal care records also need improving to show that adequate care is being provided ensuring the well-being of residents. Personal care and support for service users and families in the event of illness or death is offered in such a way as to promote service users’ privacy and dignity. Some training has taken place, helping staff to improve their knowledge about appropriate care and support. EVIDENCE: Care plans are in place for each of the residents. Records include residents’ routines, care needs and risk assessments for moving and handling. It was unclear how the scoring had been made on the handling assessment. This should be detailed showing how the level of risk has been identified. Care plans and assessments had been reviewed each month. Information seen needed to be updated. One moving and handling assess stated that the resident needs one carer when doing certain tasks however the second assessment states that the resident is self caring. Another plan asks that staff GREENLANDS F56 F06 S61961 Greenlands V212625 100505 Stage 4.doc Version 1.30 Page 10 monitor the residents diet, however no information had been recorded. Several residents need to be supervised when smoking, this should be included on a risk assessment and agreed with the resident that cigarettes can be held by staff. Detailed information about residents’ needs and risk should be clearly detailed on file to ensure that their safety and well-being is maintained. Separate records are made of residents weight and personal care given. This information was untidy and not clear to the reader. Residents should be weighed each month and where residents have been losing weight this should be more often. Plans should include a nutritional assessment and show that residents’ needs are being monitored and additional support provided where necessary ensuring that any deterioration in health is quickly dealt with. Plan also need to include what support the district nurse and mental health services provide. This should include the reason for the support and what is being provided. Personal care records showed that a large number of residents had been receiving bed baths. Recent work has been carried out on the bathrooms and plumbing however these have now been mended. To make sure that residents’ personal care is fully met, full bathing should be provided on a regular base. Care is offered in private ensuring dignity is respected. New locks have been fitted to bathrooms and toilets to offer further privacy. Residents’ health and medication is regularly reviewed as the GP visits every two weeks, or more frequent if needed, to check that residents are well. The medication was not inspected at this time. The CSCI pharmacist had made a recent visit and a separate report has been made and sent to the home. It was found however that due to staff shortages tablets had been opened ready and left for the evening staff to administer. This is unsafe and should not happen. Medication should only be given out by those staff trained to do so. Cover should be arranged so that sufficient staff are on duty at all times. Accidents are also recorded. One resident had fallen 5 times within one week. This should be looked at and further assessments carried out to see if additional aids could be offered to prevent the number of falls and possible injury. A risk assessment should be completed. Feedback received from the visiting district nurse was good. Stating that staff would contact them if they had any concerns about resident’s health and that any instructions given were always followed up ensuring a consistent approach in care. One relative also expressed that ‘his relative gets on well with staff and they seem to care for her’. Another stated that ‘overall the staff are very friendly and helpful’. A further relative said that ‘the care her mother receives is excellent’. GREENLANDS F56 F06 S61961 Greenlands V212625 100505 Stage 4.doc Version 1.30 Page 11 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 to 15 Activities are provided in and away from the home offering residents opportunities to socialise in and have access to the wider community. Residents are consulted about their preferred routines and information is recorded so staff offer a consistent approach. Links with family, friends and the community are encouraged as this provides more social opportunities and interactions. Food served appeared nutritious and varied. Alternative choices and available and special diets are catered for those who wish. Nutritional needs should be monitored so that residents’ health and well-being is maintained. EVIDENCE: Routines are relaxed. Residents rise and retire to bed when they choose. A choice of activities are offered, these include ‘sit me fit’ exercise, nail care, dominoes and wine and bingo evening. Day trips are to be planned for the summer and the home has access to community transport. Residents also visit the local pub and social club. Feedback received from the service users was mixed. Some would like more choice whilst others preferred a more relaxed quite environment. Activities should be recorded along with who took part. GREENLANDS F56 F06 S61961 Greenlands V212625 100505 Stage 4.doc Version 1.30 Page 12 One resident does not have English as a first language. A basic question and answer sheet has been developed to enable the staff and resident to communicate more freely and assist staff in understanding any requests made. From observations made the resident appeared relaxed and was able to express her needs, which were understood by the staff. The home welcomes visitors to the home at any time. Relationships with family and friends are encouraged. The hairdresser visits weekly and the local clergy also visits residents each month. Resident wishing to take part in the recent election were supported in doing so and postal votes were provided. There are well maintained gardens to the front and rear. Menus are in place. Residents are asked which choice of meal they would like. The cooks makes homemade cakes and deserts. Special diets are also catered for and staff were aware of what a diabetic resident could have to eat. Halal and vegetarian meals are also made available for one resident who follows a halal diet enabling her to follow her cultural and religious preferences. GREENLANDS F56 F06 S61961 Greenlands V212625 100505 Stage 4.doc Version 1.30 Page 13 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 and 18 Satisfactory arrangements are in place in relation to the protection of service users as well as responding to their concerns. Polices are in place outlining the appropriate response for allegations of abuse however training is outstanding in this area to ensure that staff are aware of what action to take so that service users are protected. EVIDENCE: Clear policies and procedures are in place covering these standards. The complaints procedure is contained within the home’s Guide and available to service users and their relatives. Since taking over the home the Owners have not received any complaints. From the feedback surveys relatives expressed that they had received a copy of the Complaints procedure. A copy of the Local Authorities Vulnerable Adults procedure has been accessed. The team have some knowledge in relation to the procedure to follow however staff training in relation to Vulnerable Adults has yet to be undertaken by all staff so that they are fully aware of the action to take ensuring the safety of service users. The home also has further written policies and procedures for adult protection these include dealing with whistle blowing, aggression, service users finances and missing person. GREENLANDS F56 F06 S61961 Greenlands V212625 100505 Stage 4.doc Version 1.30 Page 14 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 to 26 Adequate accommodation is provided, which meets the needs of older people. Aids and adaptation have also been provided in order to meet the needs of the service users and aid mobility and movement around the home. The standard of the environment was good providing the residents with a clean, comfortable home to live in. Work has been carried out and identified to further enhance the environment, as well as ensuring the safety of service users. The home also employs a number of domestic staff who ensure a safe, clean, comfortable environment is kept for those that live there. EVIDENCE: Greenlands is a large detached property offering pleasant accommodation for the residents. The lounge and dining areas were clean and comfortably furnished. Residents make use of all areas. The home also provides a well maintained garden to the front and side of the home. The home provides 4 single rooms and 12 double rooms. None of the bedrooms have en-suite facilities. Rooms had been personalised with GREENLANDS F56 F06 S61961 Greenlands V212625 100505 Stage 4.doc Version 1.30 Page 15 residents’ belongings. Where residents have requested no locks or keys this has been recorded on their file. Communal toilets and bathrooms were clean. Recent repairs have been made to the bathrooms and locks have been fitted to doors. A walk-in shower is being considered to make bathing easier for those residents who have difficulties with their mobility. The home is equipped with suitable aids and adaptation to assist service users movement around the home. Hand rails, grab rails, hoist, call bells and a passenger lift are available to offer support and aid mobility. Those service users needing support also have the provision of wheelchairs. A separate laundry is provided however planning permission has been applied for to extend the room and for new specialist equipment to be provided. This will provide a more suitable working space to manage the volume of laundry. Further repairs or replacements have also been provided, these include a new call bell system, fire panel and lifting equipment. Repairs have been carried out on the heating and plumbing. Staff felt the work carried out had improved the home. It was found that the fire panel was signalling a fault and the ceiling in the 2nd lounge needed attention. The Manager/Owners were aware of this and were making arrangements to address them. Safety checks are done with regards to fire checks and water temperature however records were not available. These should be carried out regularly to ensure a safe environment for the residents. It is also suggested that the fire officer is consulted about the suitability of the door lock on the front door ensure easy access or exit can be made in the event of a fire. GREENLANDS F56 F06 S61961 Greenlands V212625 100505 Stage 4.doc Version 1.30 Page 16 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 to 30 Insufficient ancilliary and care staff were rostered on duty to meet the personal care needs of service users. Information gathered for newly recruited staff was not completed; clear documentation and Criminal Records Bureau checks are needed prior to staff or volunteers commencing employment, so that service users are protected. Opportunities for training have been provided in relation to NVQ’s. Additional courses have been identified, so that staff can be equipped with the skills to support the needs of service users. EVIDENCE: The home employs 18 carers, 2 non-caring staff, a cook and 2 domestic staff. Several members of the team had been included on the rota as part of the care hours. As they are unable to provided physical care for the service users additional carers should be employed to cover the deficit. It is suggested that the rota clearly identifies care staff, support staff and ancillary staff so that accurate hours can be calculated. A number of staff were spoken with during the inspection, it was found that communication between staff and management was not as effective as it could be. Staff felt that it was unclear what was expected of them and the Manager. Clear roles and responsibilities should be outlined so that staff can carry out their duties as carers properly as well as maintaining the home. GREENLANDS F56 F06 S61961 Greenlands V212625 100505 Stage 4.doc Version 1.30 Page 17 The owners are currently trying to recruit both carers and ancillary staff including a cook. At present the home has 1 cook who works four days a week, the other days are covered by the carers. This is not a suitable arrangement as staff have not the training or experience required. Recruitment files were seen. Information and checks required on new staff prior to starting their employment had not been carried out. All files should have written references, employment details and a criminal record check before working at the home. This is to ensure the safety and protection of vulnerable service users. Training has been provided with regards to NVQ’s with a majority of the team having completed the course or are currently doing the course. Two staff had also completed a course in palliative care, this is to considered for other members of the team. Other training needs have been identified and arrangements need to be made ensuring all staff attend so they are equipped with the necessary skills to support residents in aspects of their daily living. This includes abuse awareness, infection control, food hygiene, moving and handling updates. New staff have been completing the Induction programme, this meets the TOPSS specification, however due to staff shortages there have been difficulties in completing the training within the agreed timescales. GREENLANDS F56 F06 S61961 Greenlands V212625 100505 Stage 4.doc Version 1.30 Page 18 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 and 32 The Registered Manager is a qualified nurse however urgent action is needed with regards to enrolling on the NVQ Management course. The majority of staff have worked at the home for a number of years, effective working relationships and a good method of communication needs to be developed between senior management and the staff team so that consistent staff support is offered ensuring the effective running of the home. Those residents requiring support with finances are assisted, records. This should include a running balance and signatures to evidence that resident’s money is being managed appropriately. EVIDENCE: The Owners/Manager have only been in day to day responsibility for the home since December 2004 and have spent the last few month addressing maintenance work within the home as well as getting to know the residents and staff. Feedback received from the residents found that there had been GREENLANDS F56 F06 S61961 Greenlands V212625 100505 Stage 4.doc Version 1.30 Page 19 little difference in care since the new owners took over, however feedback from staff was mixed. Staff felt were previous routines were in place as well as clear roles and responsibilities this had changed under the new ownership. Staff felt that at times they were not sure what they should be doing as the manager would ask for something to be done but then the deputy may ask for something else. Morale was a little low. It was discussed with Owners/Manager and deputy manager about ways in which this could be improved to ensure the effective running of the home and continuity of care for the service users. Most of the residents’ money is managed by their families or designated representative. Records are made of all transactions. These should include a running balance and signed by the person handling the money and where possible the resident. GREENLANDS F56 F06 S61961 Greenlands V212625 100505 Stage 4.doc Version 1.30 Page 20 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 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 3 3 3 2 2 3 3 STAFFING Standard No Score 27 2 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 2 2 x x x x x x GREENLANDS F56 F06 S61961 Greenlands V212625 100505 Stage 4.doc Version 1.30 Page 21 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 15 Requirement That plans fully reflect the current needs of the service users and are signed to evidence that they have been agreed by the service users or appropriate representative (previous timescale of 31 March 2005) That information is fully recorded within the care plans of support offered from external professionals ie: CPN, district nurse and dietican (previous timescale of 31 April 2005) That moving and handling assessment clearly demonstrate how the scoring has been made That nutritional assessments and monitoring is carried out for each of the service users That accurate records are made of individuals weights and personal care That service users are monitored in relation to falls and action taken to address any/all concerns That adequate arrangements are made for the administration of medication throughout the day That a policy is developed with regards to the management of F56 F06 S61961 Greenlands V212625 100505 Stage 4.doc Timescale for action 31 July 2005 2. 8 15 31 July 2005 3. 4. 5. 6. 8 8 8 8 13 12 12 12 31 July 2005 31 July 2005 31 July 2005 31 July 2005 31 July 2005 31 July 2005 Page 22 7. 8. 9 18 13 13 GREENLANDS Version 1.30 9. 18 18 10. 11. 27 29 17 19 12. 29 19 13. 14. 30 30 18 18 15. 31 9 16. 32 12 17. 35 17 18. 38 13 service users finances including gifts and wills (previous timescale of 31 April 2005) That arrangements are made for all staff to complete training in relation to adult abuse (previous timescale of 31 April 2005) That an accurate rota is maintained, clearly identifying staff full names and roles That staff personnel files include all inforamtion as required under schedule 2 (previous timescale of 31 March 2005) That new staff do not commence employment unless a satisfactory CRB check has been carried out and held on file (previous timescale of 31 March 2005) That all staff receive a minimum of 3 paid days per year (previous timescale of 31 May 2005) That training is provided in infection control, continence care and care of the dying (previous timescale of 31 May 2005) That the Registered Manager commences training in NVQ level 4 Management with immediate effect (previous timescale of 31 April 2005) That communication between management and staff is improved and roles are clearly defined ensuring continuity of care That records in relation to service users finances evidence a running balance and each transaction is signed for That staff complete training in 1st aid (previous timescale of 31 April 2005) 31 August 2005 31 July 2005 31 July 2005 31 July 2005 31 August 2005 31 August 2005 31 August 2005 31 July 2005 31 JUly 2005 31 August 2005 GREENLANDS F56 F06 S61961 Greenlands V212625 100505 Stage 4.doc Version 1.30 Page 23 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. 5. 6. 7. Refer to Standard 12 19 19 30 30 32 Good Practice Recommendations That activities offered are recorded along with attendance That records regarding water temperatures and fire checks are made available for inspection That advice is sought from the fire officer with regards to the suitability of the front door lock That consideration is givent to providing the necessary time needed to complete the induction training That consideration is given to providing specific training in relaiton to the needs of the service users That regular team meetings are held to allow for open effective communication between management and staff and that information is recorded GREENLANDS F56 F06 S61961 Greenlands V212625 100505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton, BL6 6HG 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. 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