Inspection on 18/04/05 for Greig House

This inspection was carried out on 18th April 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Greig House 20/11/06

Greig House 07/11/05

Similar services:

Agar Grove & St Augustine`s Alcohol Treatment & Rehab

Herbert Street

Haven (The)

Charis

Hartley House

Brook Drive, 124

Rugby House Project

City Roads Crisis Intervention

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

CARE HOME ADULTS 18-65 Greig House 20 Garford Street London E14 8JG Lead Inspector Anne Chamberlain Announced Inspection 18th April 2005 10:00am 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Greig House Address 20 Garford Street, London, E14 8JG 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) 0207 987 5658 0207 987 8942 Salvation Army Ms Rita Woolridge Care Home with Nursing 18 Category(ies) of Drug Dependence past/present - 18 registration, with number Alcohol Dependence past/present - 18 of places Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection This is the Services first inspection Brief Description of the Service: Grieg House is an 18 bed residential detoxification centre, operating a two or three week voluntary admission detoxification from drugs and alcohol, for men and women aged 18 – 65. In addition to the registered care manager, centre manager, and deputy centre manager, the home employs a mixture of nursing and care staff as well as administrative and maintenance staff. They retain the services of a masseuse and an art therapist. A psychiatrist visits daily and general practitioner twice a week. A keyworking system is in place The treatment programme is holistic and in addition to medicated withdrawal complementary therapies are available, including acupuncture, massage, aromatherapy, and art therapy. Grieg House comprises an older properly and a new build. In addition to the bedroom accommodation and bathroom facilities there are spacious communal areas, and a number of office and meeting rooms. Greig house has one disability adapted bedroom and access to all ground floor areas is adapted. Grieg House is situated just off East India Dock Road close to transport links and with a number of community resources close by. The home is run by the Salvation Army and has been open for four years. Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector interviewed the Care Manager and also spoke to the line manager for the project, the project administrator and a nurse. She viewed part of the premises including a vacant female room and a vacant male room. The inspector ate lunch in the dining room alongside service users. The inspector viewed a sample of service user files and personnel files for nurses and care workers, in addition to policy and procedural documents and other records. This is the home’s first inspection undertaken by the Commission for Social Care Inspection (CSCI). The inspection resulted in 8 legal requirements and 2 good practice recommendations. The inspector would like to take this opportunity to thank the manager and staff at Greig House for their co-operation with the inspection. What the service does well: What has improved since the last inspection? This is the first inspection undertaken by the CSCI. Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 6 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. Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 The home undertakes comprehensive assessment on referral and before admission is offered. Service users social needs are discussed during their admission and plans are made for their lifestyle post discharge. The plan is reviewed by keyworkers and this is recorded in the service users notes. EVIDENCE: Greig House has an admission criteria. However this is broad. Service users are initially assessed by community drug and alcohol teams. Their assessment information is studied by the team of professionals at Greig House who decide whether admission can be offered. On admission service users are seen by the consultant psychiatrist. Nursing and social care plans are drawn up. Service users psychological and social needs will be discussed with the keyworkers during their admission. Relapse prevention work is undertaken. Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 9 Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7 and 9. Service users are encouraged and supported to take decisions about their lives. They understand that they are following a set programme, but that within that programme their individual medical and social needs are recorded and addressed. Notwithstanding the fact that participation is voluntary and service users are independent adults, risks are assessed and reduced where possible. EVIDENCE: The inspector viewed a sample of service user files and was able to evidence the following through documentation. Service users sign a contract on admission which embodies the main elements of the programme. They agree to administration of medication and to analysis of blood and urine samples and to attend (after the third day) the support groups which are held daily. If they are not sober when they sign this contract then it is resigned when they are. Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 11 Service users are encouraged to consider their own needs and to take decisions and make realistic plans regarding their lives. They are offered therapeutic input with one to one sessions with keyworkers and access to counselling with the care manager. The manager stated that medical needs are always prioritised over social needs. Service users have the opportunity to leave the unit for two hour periods in the afternoon after the seventh day of their admission. Risk assessments are drawn up on the second day of admission and steps are taken to reduce risks. The unit has strict rules about adherence to the programme and service users who fail to comply are warned and then discharged. For example if a service user self-harmed they would be asked to give up any implement they have used and would be given a warning. A repetition would result in discharge. Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15,16 and 17. The project provides appropriate relaxation and recreational opportunities which are part of the therapeutic approach to withdrawal. The boundaries set around access to the community and visits from family and friends are intended to support the individual, and are based on the practice experience of the professionals. The provider seeks to respect the privacy and dignity of service users. These considerations have to be balanced against the responsibility to ensure that the programme is properly followed. Service users have access to wholesome appetizing meals in pleasant surroundings. EVIDENCE: Indoor relaxation and recreational opportunities are provided at Greig House. There are two lounges. One lounge has a pool table, table tennis table, TV, music and IT equipment. The other lounge has TV and comfortable seating. Service users mix freely although exclusive relationships are not allowed. Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 13 Service users are at liberty to use community facilities within the rules of the programme which allows them limited periods outside of the unit. The manager stated that service users are encouraged during their treatment to focus on their own psychological and emotional needs. For this reason visits visits from family and friends are limited to three times a week from the third day after admission. Special arrangements are made for children. Service users rights are respected. Their mail is passed to them unopened unless staff are suspicious about it’s contents, in which case the service user would be asked to open the mail with a staff member present. Service users can lock their doors from the inside but do not have keys to lock their rooms from the outside. Room searches are an agreed part of the programme. Service users do not have keys to the front door. Their allowed time outside of the unit is between 3 and 5p.m. A receptionist is on duty until 8p.m. Catering is contracted out. There is a set menu within which service users are offered vegetarian alternatives. The inspector viewed the menu which looked varied and appetising. The dining room which has windows on to the garden is very pleasant, and the service users who were eating there appeared to be relaxed and enjoying each others company. Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20. The home offers support to service users in a sensitive and responsive way. The care is holistic and the physical and emotional needs of indivudals are met. The home has disability adaptation and can offer a service to people with impaired mobility. Intensive medical care is provided and this is reflected in the high proportion of qualified nurses among the care staff. The handling and administration, recording and disposal of medication is carried out safely although one requirement and two recommendations have been made by the inspector. EVIDENCE: The manager advised that most service users need very little support with personal care. Their main support needs are psychological as they are often anxious, agitated and in physical discomfort. Some service users have additional health and medical needs. Epilepsy and diabetes are not uncommon complications of addiction. The manager advised that diabetics are often skilled at managing their own insulin levels and if they are able to do this nursing staff will not interfere. The nurses are however skilled and experienced in managing any health complications service users may present and they have ready access to the psychiatrist and general practitioner for advice. Service users can have private consultations with the psychiatrist or general practitioner. Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 15 Service users are encouraged whilst at the project to attend to their own health needs. Opiate users frequently have neglected dental needs and they use the nearby London Hospital dental surgery. The home has an adapted bedroom and wheelchair accessible ground floor facilites and is therefore able to offer a service to individuals with impaired mobility. The manager explained that users of alcohol are vulnerable to seizures during withdrawal at which time they need medication urgently. The psychiatrist has a practice of writing a prescription for the individual in advance of this happening in case it should be needed. The manager has checked with the Nursing and Midwifery Council that this practice is allowed. It is enshrined in the medication policy. The home uses herbal remedies and this is stated in the medication policy which the psychiatrist has approved and signed. The inspector viewed the arrangements for the administration of medication. There is no self administration of medication and service users sign an agreement to the medication administration arrangements when they are admitted. There are two medication cupboards and the keys are kept on the designated nurse at all times. Medication is dispensed by a nurse observed by another nurse or care worker. All users withdrawing from alcohol are prescribed vitamins to be taken thrice daily. They sometimes refuse these or do not attend the nurses room at the appointed time. The practice has been to leave a space blank on the medication sheet. The manager must ensure that the sheet is consistently completed, for example with ‘R’ for refused. This is a requirement. The inspector noted an omission of a date at the top of a medication administration sheet. The manager must ensure that all sheets are correctly dated. This is a requirement. Controlled drugs are appropriately kept in a locked section within the main drugs cabinet. This inspector checked the controlled drugs book and balances of medication which were correct. The home keeps a record of medications returned to the pharmacy and the inspector viewed this, signed off by the pharmacist. The home does not keep records of incoming drugs. This is because service users bring significant quantities of drugs into the unit. Prescription medications which are to continue as part of the service user’s regime are used. The rest is returned to Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 16 the service user on discharge although many service users fail to take their medications away with them. These are returned to the pharmacy. The temperature of the drugs refrigerator had been recorded regularly and was within the correct range. It would be good practice to keep a copy of the medications policy and a copy of specimen signatures or initials of staff at the front of the medication sheets. This is a recommendation. Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23. The home has an adequate complaints procedure and is prepared to facilitate this for service users. There is a requirement to amend the information relating to the CSCI. Service users are protected from abuse by the three policies designed to safeguard them, which the home has in place. . EVIDENCE: The home has produced a complaints policy a shortened version of which is reproduced in the service user guide along with the procedure. The policy is also posted in the lounge. The manager must ensure that the correct contact details for the CSCI are included in complaints information. This is a requirement. For users whose first language is not English interpretation can be secured and there are also a number of asian languages spoken within the staff group. The inspector viewed the complaints log. There was a low level of complaints. The manager advised that informal complaints are more frequent and are usually dealt with and resolved verbally although service users are always offered the opportunity to make a formal complaint. The home has an adult protection policy, code of (staff) conduct and whistleblowing policy, all of which were viewed by the inspector. There are two policy folders, one for Grieg House specifically and one for Salvation Army policies. The whistleblowing policy was not included in either but was in the Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 18 staff handbook. The manager must ensure that the whistleblowing policy is included in one of the main policy files. This is a requirement. Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30. The home offers a comfortable and safe environment. It is clean and hygienic. Some requirements have been made regarding maintenace. EVIDENCE: The home provides short term accommodation and the inspector has borne this in mind, in inspecting the premises, particulary in terms of homeliness. A large portion of the premises were seen. It would not be appropriate for service users to personalise their rooms and the communal spaces are rather too large to be described as homely although they are welcoming and comfortable. Safety standards are high and in addition to physical safety the staff strive to provide an environment which feels psychologically safe for service users. The inspector noted some peeling paint and wall discolouration in an en-suite bathroom and this room should be redecorated. This is a requirement. The inspector also noted a missing lamp shade in a bedroom and a missing bulb and lampshade in the small lounge. These must be replaced. Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 20 This is a requirement. The home appeared clean, tidy and hygienic. The garden was well kept and welcoming with seating provided. At the time of the inspection some service users were sitting outside enjoying the spring sunshine. Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34, 35 and 36. The home has a robust, safe recruitment policy and the manager is committed to ensuring that it is followed. The staff are properly inducted and offered regular and appropriate training based on their roles and responsibilities. To date staff supervision has not been undertaken regularly and a requirement has been made regarding this. EVIDENCE: The inspector viewed a sample of care workers and nurse’s files. These evidenced a robust recruitment policy. However a second written reference was missing in two cases. The manager has affirmed that future practice will be tighter around this aspect. There was evidence of induction training and of staff signing the code of practice. There is one member of staff who has joined the organisation since July 2004 and who does not have a Greig House Criminal Records Bureau (CRB) enhanced disclosure. The application has been made and the staff member does not work alone with service users. The organisation has a system in place for ensuring that CRB checks are renewed three yearly. All staff undertake induction training and the inspector was able to evidence this and further training through staff training profiles. The manager explained Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 22 that the home has adopted DANOS standards for staff training and development. This means that each job description will have a corresponding set of training needs. Staff will assess their own needs and in discussion with the manager agree plans for development through training. The manager acknowledged that staff supervision has not been regular. The home are recruiting a Care Team Leader who will undertake supervising responsibilities for the nurses and project workers. This will ensure that staff supervision is undertaken at least bi-monthly in future. The manager must ensure that staff have regular recorded supervision not less than six times per year. This is a requirement. Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42 The management group consider the views expressed by service users and feedback from stakeholders. The wider organisation monitors the project which is on a sound financial footing. Long terms plans are made. Safety is given a high prominence and considerable effort is expended to ensure that everything possible is done to keep service users safe. EVIDENCE: Residents meetings take place weekly and provide an opportunity for service users to express their views about the service. The minutes are signed off by the deputy centre manager. The minutes are fed into the managers meeting for consideration. The minutes of the meeting could be printed off and posted on the notice board in the lounge for service users to read. This is a recommendation. Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 24 The inspector viewed the Client Evaluation Survey form and the Quality Assurance Yearly Plan for 2005. The manager advised that informal feedback is collected verbally from stakeholders, for example community social services and medical staff. Person in charge visits are undertaken by a salvation army officer with the title Director of Social Services. The inspector was able to speak to this officer who confirmed that the visits take place on a monthly basis and issues like property maintenance and staffing are discussed. The inspector viewed a record of a visit. The officer is responsible for line managing this and several other projects and provides a link for the manager to the wider organisation. The inspector was advised that the organisation operates a rolling programme of quality assurance with service user surveys being undertaken. The inspector was given examples of the management plan for this year which are being put into operation, like the new appointment of a care team manager and the increase in beds for females. The inspector was advised that the Salvation Army does not operate on a financial five year plan because they have sufficient funding to run the project for the foreseeable future. The inspector was able to view budget information. This was a couple of months out of date but the inspector was satisfied that the manager has sufficient funds and financial information to run the project effectively. The inspector was advised that the catering and cleaning at the home have been contracted out. The inspector viewed logs for food safety monitoring including records for food storage refrigerators. These were in order. The manager advised that there are three other refrigerators, one in the service user’s lounge and two in staff rooms and that recordings of temperatures are not been taken for those. These refrigerators must have temperature recordings made. This is a requirement. In discussion with the deputy centre manager and on inspection of documentary evidence the inspector was satisfied that fire and other safety levels in the home are high, with regular maintenance of safety equipment and utilities. Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Greig House Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 2 x G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 26 N/A 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 20 Regulation 17 (1) (a) Requirement The manager must ensure that the medication sheets are consistently completed with no entries left blank. The manager must ensure that all medication sheets are correctly dated. The manager must ensure that the correct contact details for the CSCI are included in the complaints information. The manager must ensure that the whistleblowing policy must be included in one of the main policy files. The manager must ensure that the bedrooms and en-suite bathrooms are in good decorative order. The manager must ensure that lampshades and bulbs are replaced where necessary. The manager must ensure that staff have regular recorded supervision not less than six times per year. The manager must ensure that temperature recordings are made for all the refrigerators on the premises. Timescale for action 01 June 2005 01 June 2005 01 July 2005 01 July 2005 01 August 2005 01 June 2005 01 June 2005 01 June 2005 2. 3. 20 22 17 (1) (a) 22 4. 23 13 (6) 5. 24 23 6. 7. 24 36 23 12 8. 42 12 Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 27 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. Refer to Standard 20 39 Good Practice Recommendations A copy of the medications policy and a copy of specimen signatures or initials of staff to be kept at the front of the medication sheets. The minutes of residents meetings to be posted on the noticeboard in the lounge. Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 28 Commission for Social Care Inspection 4th Floor, Gredley House 1-11 Broadway, Stratford London E15 4BQ 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 Greig House G57 G06 S61559 Greig House V211626 180405 Stage 4.doc Version 1.30 Page 29 - 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. 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