Inspection on 11/08/05 for Grove House

This inspection was carried out on 11th August 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

Grove House 08/09/08

Grove House 20/08/07

Grove House 20/06/06

Grove House 06/12/05

Grove House 21/10/04

Grove House 27/04/04

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

CARE HOMES FOR OLDER PEOPLE Grove House 7 South Hill Grove Harrow Middlesex HA1 3PR Lead Inspector Judith Brindle Unannounced 11 August 2005 10.45am 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. Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Grove House Address 7 South Hill Grove Harrow Middlesex HA1 3PR 020 8864 5216 020 8864 5216 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) Mrs Dympna Kritikos & Mr N Kritikos Mrs Dympna Kritikos Care Home 4 Category(ies) of OP 4 registration, with number of places Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons who can manage the stairs without physical assistance may reside on the first floor. 2. You may only service users in the bedrooms located on the second storey When they have been subject to an assessment by a competent person representing the service user and nominated by the placing agency. In the case of a service user who is self funding, the assessment must be undertaken by a competent person who is independent of the home - Occupational Therapist, CPN or Care Manager. This assessment must clearly state that the service user is able to ascend and descend the stairs to the ground floor without the assistance of staff. A copy of this assessment must be retained in the home and be available for inspection. Any such assessments held at the home, must be subject to regular external review in accordance with the changing needs, abilities or condition of the service user. Date of last inspection 21/10/2004 Brief Description of the Service: Grove House is a care home that provides personal care and accommodation for up to 4 older people. Mr and Mrs Kritikos own the home. The registered manager is Mrs Kritikos. Grove House is a family owned and run care home. Mr and Mrs Kritikos live on the premises with their family. The home is located in Harrow on a quiet residential road, within a few minutes walk, or short drive from local shops, and other amenities. There are local public transport facilities in the vicinity, which include a public bus and train service. Sudbury Town underground train station is within a few minutes walk from the care home. The home was opened in 1995, and consists of a semi-detached house, with parking for approximately four cars at the front drive area of the house. There is one single bedroom on the first floor, and one on the ground floor. There is a shared bedroom on the ground floor. The home has an enclosed well-maintained garden with a seting area, that is accessible to service users. Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place throughout 3.5 hours during the day on the 11th August 2005. The registered manager was on duty. There were no service user vacancies at the time of the inspection. A tour of the premises took place. Care records, and staff personnel records were among a variety of records inspected. All the residents, the staff on duty, spoke to the inspector during the inspection. Twenty National Minimum Standards for older persons including key National Minimum Standards for older persons were inspected during the unannounced inspection. Inspection requirements from the previous inspection were met. What the service does well: What has improved since the last inspection? What they could do better: There could be further development in some records including ‘daily’ progress notes. The activities participated in need to be clearly recorded. Some care plan/assessment information and documentation needs to be in place. Recruitment procedures need to be followed and further developed. Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 Page 6 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. Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 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 Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 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) 3 , Standard 6 is not applicable. Arrangements are in place for residents to have their needs assessed prior to moving into the care home and during the trial period to ensure that the service can meet prospective resident’s needs. There needs to be further development in some assessment information and documentation. EVIDENCE: The home has an admission procedure, and needs assessment procedure. There is assessment of individual residents’ needs prior to their admission to the care home, and during the ‘settling in’ period. In two care plans inspected this documentation had been reviewed. The care plan of a recently admitted resident did not include comprehensive information, and documentation in regards to assessment of the resident’s needs. There was an assessment review form that included some information in regards to the resident’s needs but this needs further development. The comprehensive assessment format form in this care plan had not been completed. Documentation confirmed that residents are involved in this assessment process. Service user questionnaires completed during the assessment Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 Page 9 process included information on resident’s preferences and needs. Records confirmed that staff action is taken to meet recorded assessed needs. Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 and 10 Arrangements are in place to ensure that resident’s health and personal care needs are met, and that their privacy and dignity is respected. There needs to be some development in recorded staff guidance, and risk assessment to meet some identified care needs. Medication is stored and administered safely. There needs to be further development in regards EVIDENCE: Three residents had a care plan, which is generated from a comprehensive assessment. The care plan documentation and information, was accessible for reference by staff. Two of the care plans inspected had a plan of care for daily living and recorded longer-term goals. These goals recorded evidence of assessment. Assessment includes risk assessment of falls, pressure sores and dependency levels. The home has a pressure sore policy. The registered manager informed the inspector that no residents have a pressure sore. A service user recently admitted to the care home did not have a care plan documentation in place. This needs to be developed to set out detailed action which needs to be taken by staff to ensure that all aspects of the health, personal and social care needs are met. This was discussed with the registered person/manager. Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 Page 11 There was recorded staff guidance in regard to service users bathing procedures, personal care. There needs to be further development of risk assessments, which include risk in regard to the steps that lead from the garden seating area to the garden area, and also a risk assessment in regard to the new pet (small dog) being a trip hazard. There needs to be a ‘managing the stairs’ risk assessment in place in regard to the service user who has a room upstairs. There must be evidence that the service user can safely manage the stairs. This is a condition of registration. Records, service users, and staff confirmed that residents access dental facilities, chiropody services, and optician services. All the residents are registered with a GP. Residents’ weight is monitored, and visits by the GP and community nurse, and care manager were recorded. The care home has an accessible medication policy. Medication is stored in a locked facility. It is dispensed by the pharmacist into ‘medication blister’ packs. Medication administration records were available for inspection. Records confirmed that the pharmacist visits the care home regularly. The registered person spoke with the pharmacist during the inspection. The home has privacy and dignity policy. Staff were observed to have an understanding, and respect for resident’s privacy and dignity. A resident spoke of staff being respectful of personal privacy. There needs to be development in regard to the ‘daily’ progress records of residents. These need to conform to data protection legislation, and to the issue of privacy and confidentiality. Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 and 15 There has been progress in the provision of varied leisure and social activities for residents since the last inspection. Residents participate in a variety of daily activities. Recording of this needs development. Residents are supported in the management of their finances. Residents are supported in maintaining contact with relatives/significant others. Meals provided are varied and wholesome. EVIDENCE: Since the previous inspection the registered person has developed an activity programme. A copy of this documentation was included in the individual service user plans. Activities included walks, and exercise sessions. A resident spoke of going for walks with staff. There needs to be recorded guidance/risk assessment agreed by the resident, staff and care manager in regards to the need for a resident to be accompanied by staff on walks. This was discussed with the registered manager, and is recommended that this is an issue for the residents forthcoming review meeting, and also that the resident has the opportunity to go out for at least daily walks. The registered person reported that residents participate in varied activities, including community based activities and barbeques. She should ensure that these activities are recorded. This was discussed with the registered manager. Records inspected did not provide evidence of the variety and number of activities taking place. Residents were observed to be watching television, and Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 Page 13 reading the newspaper during the unannounced inspection. Resident’s leisure preferences are recorded in their care plans. A resident was having her hair done by a hairdresser during the inspection. The home has a visitor’s policy. Visiting times are stated in the policy, but the inspector was informed that this is flexible and visits could occur at any reasonable times. The care home has a visitors recording book. A resident kindly spoke to the inspector of the contact that she had maintained with relatives, which included telephone calls and visits. Records informed the inspector that relatives/significant others were kept informed of issues in regard to the progress of their friend/relative living in the care home. There was recorded evidence of relatives being positive about the service provided. Information in regard to resident’s family contact details were recorded in their care plan. Resident’s are supported by relatives/significant others in the management of their finances. Records are maintained of purchases made by or on behalf of residents. Residents’ rooms showed evidence of residents having brought some personal possessions with them on admission to the care home. Records were kept securely. The menu was available for inspection. The lunch recorded on the menu for the day of the inspection was not what was prepared. The registered person explained the reason for this and confirmed that there was flexibility in regards to the menu depending on choice. Any changes to the menu should be clearly recorded. There were some records in regard to food eaten by the residents. It should be recorded on the menu that service users are offered choice. Records of food eaten by residents need to be further developed to ensure that it is clearly recorded as to what residents have actually eaten, and therefore identify choice, any changes to the menu, and changes in resident’s appetite. The registered person and records confirmed that there had been a recent visit to the care home by a food and safety person who provided food safety documentation and information. Drinks and snacks were offered to residents during the inspection. Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Arrangements are in place for handling complaints objectively. Residents are aware of how to complain, and were confident that concerns would be listened too. Systems are in place in regard to the responding to any suspicion or allegation of abuse. EVIDENCE: The home has a complaints policy. There have been no recorded complaints since the last inspection. Residents spoke of having confidence to communicate ‘concerns’ to staff if they needed too. The home has an adult protection policy, and a whistle blowing policy. Records confirmed that the registered persons have received protection of vulnerable adults training, and that staff had received some adult protection training during Foundation Induction training. The registered manager informed the inspector that she intended to complete some ‘in house’ adult protection training for staff. There was accessible information and documentation and guidance in regards to the issue of elder abuse The care home also has a counter bullying policy, service users’ rights policy and anti-harassment policy. Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 Page 15 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) 19,24 and 26 The location and layout of the care home is suitable for its stated purpose. It is accessible with a ‘family’ environment and atmosphere. Resident’s bedrooms are personalised. The residents are provided with clean comfortable and safe surroundings. EVIDENCE: The home is located within a few minutes’ drive or walk from a variety of shops, and facilities. The inspection included a tour of the premises. The home has a family environment and atmosphere. The provider’s family live in the care home. A resident spoke of this being very positive and reported that she felt that she was part of the family. The environment has homely features, which include houseplants, a fish tank and displayed pictures. The premises is well maintained. There is a large covered decking area in the garden area, which has several quality chairs. Two residents spoke of using that facility. The garden is enclosed, and attractive with a variety of plants. Resident’s bedrooms were inspected. These contained evidence of personal belongings. Residents kindly informed the inspector that they were happy with Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 Page 16 their rooms, (see Standard 8 in regard to a risk assessment needed for one resident in regard to use of the stairs). The home has an infection control policy, and a storage and disposal of hazardous substances policy. The care home is clean and free from offensive odours. Laundering facilities are located away from food storage and food preparation areas. Staff complete the cleaning duties. Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 Page 17 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, 29,30 Arrangements are in place to ensure that the number and skill mix of staff on duty enable needs of service users to be met. The recruitment procedures need some development to ensure that there are appropriate safeguards to offer protection to people living within the home. Staff receive appropriate training, there needs to be development in induction training/recording for new staff. EVIDENCE: The two registered persons, and a care staff member were on duty during the unannounced inspection. The staff rota was available for inspection. The two registered persons (which includes the manager) work full time hours and they employ two care staff that work part time. Additional staff which includes the proprietors, daughter works some part time hours, when required. The registered manager reported that she regularly reviews staffing needs. Resident’s night care needs are assessed, and sleep patterns recorded. A recorded routine ‘daily shift planner’ was available for inspection. The home has a recruitment policy. The staff files of two care members were inspected. The documentation of one staff file confirmed that the home has undertaken the necessary recruitment checks to ensure protection of service users. The second staff file did not contain a completed application form, and the Criminal Records Bureau check record though recent had been completed during previous employment. The non portability of CRB checks was discussed with the registered manager. The registered person must ensure that a satisfactory Criminal Records Bureau check is completed, and that evidence of a completed application form for the new staff member is supplied to the Commission of Social Care Inspection. Records, and the registered person Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 Page 18 informed the inspector that verbal references had been obtained. There needs to be two written references relating to persons working at the care home. Residents spoke positively of the care and support that they received from staff. A staff training plan was available for inspection. Records, and the registered person confirmed that staff have received appropriate training. This includes recent health and safety training, safe working practices, risk assessment training, manual handling training, basic food and hygiene training, and fire prevention training, and protection of vulnerable adults training. The registered person has a variety of training videos with questionnaires for staff to complete in regard to the training. Records informed the inspector that a care staff member had completed a TOPSS foundation induction standards programme of completing. There needs to be recorded evidence that the new staff member has completed or is in the process of completing an induction programme. Records confirmed that a care staff member had recently received staff supervision. Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 Page 19 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) 31,33,35,36 and 38 There is leadership, direction and guidance for staff to ensure that residents receive consistent quality care. Resident’s financial interests are safeguarded. Staff receive supervision. The health and safety of residents is an issue identified by the service and promoted. EVIDENCE: The registered manager has managed and run the home since it first opened in 1995. Her husband is the other registered provider. The registered manager informed the inspector that she had completed an NVQ level 4 course in management. Records confirmed that the registered manager undertakes periodic training to update her knowledge, skills and competence, whilst managing the home. Records, and staff confirmed that the manager is fully involved in the responsibilities of the care home, works most days, and that is accessible for Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 Page 20 guidance and direction when needed. Residents who kindly spoke to the inspector were aware of whom the manager was, and were positive about her. The registered manager’s job description was available for inspection. Records confirmed that there ha been further development and review of policies and procedures. Several policies had been recorded as having been read by staff. The home has a financial affairs and valuables policy, and ‘service users monies policy’. The registered manager informed the inspector that the service users’ relatives manage the service users finances. The registered manager informed the inspector that she purchases items for service users, then she sends the receipt to the relative (who handles the service users’ monies), and he/she then reimburse the registered manager the cost of the item. Appropriate individual residents expenditure records are maintained. Required fire safety checks are carried out. Records and staff confirmed that staff receive fire instruction, and that fire drills took place regularly. A staff member who kindly spoke with the inspector had knowledge of appropriate fire procedures. Fire extinguishers were observed to be free standing. They need to appropriately secured, to minimise risk to health and safety. Recorded evidence of required electrical and gas system checks were up to date and available for inspection. The home has an accident policy/procedure. A certificate of employers liability insurance was displayed and up to date. Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 Page 21 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 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 x x x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x 3 3 x 2 Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 Page 22 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 3 Regulation Reg 12,13, 14 Requirement The registered person needs to ensure that residents have a comprehensive recorded assessment of their needs, completed by a competent person. All residents must have care plan documentation in place, which sets out detailed action which needs to be taken by staff to ensure that all aspects of the health, personal and social care needs are met. There needs to be further development of risk assessments, which include risk a)in regard to the steps that lead from the garden seating area to the garden area, b) also a risk assessment in regard to the new pet (small dog) being a trip hazard. There must be evidence that the resident who has a bedroom upstairs can safely manage the stairs. Daily progress records need to conform to data protection legislation and to the issue of privacy and confidentiality. There needs to be recorded Timescale for action 16/9/05 2. 7 Reg 12,13,15 16/9/05 3. 8 Reg 13(4) 1/10/05 4. 8 Reg 13(4) Condition of reg Reg 12(4)17 Reg 16/9/05 5. 10 1/10/05 6. 12,14 1/10/05 Page 23 Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 12,13(4), 14 7. 15 Reg 17(2) schedule 4(13) Reg 19 schedule 2(8) 8. 29 9. 10. 29 30 Reg 19 schedule 2 (5) Reg 18(1) 11. 38 Reg 13(4) guidance/risk assessment agreed by the resident , staff and care manager in regards to the need for a resident to be accompanied by staff on walks. Records of food eaten by residents need to be further developed to ensure that it is clearly recorded as to what residents have actually eaten There needs to be a satisfactory Criminal Records Bureau check completed in this employment for a care staff member. Evidence of this needs to be supplied to the CSCI. The registered person needs to suppy the Commission for Social Care Inspection with evidence that a new staff member has completed an application form. There needs to be two written references relating to persons working at the care home. There needs to be recorded evidence that the new staff member has completed or is in the process of completing an induction programme. Fire extinguishers need to be appropriately secured, so as to minimise risk to health and safety. 1/10/05 1/10/05 1/10/05 16/10/05 1/10/05 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. Refer to Standard Good Practice Recommendations It is recommended that the issue of a resident needing staff support during waoutside the care home, is discussed during the residents forthcoming review meeting. The resident should have the opportunity to go out for G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 Page 24 Grove House 2. 3. 4. walks at least daily. The registered person should ensure that all residents activities are recorded. Any changes to the menu should be clearly recorded. It should be recorded on the menu that service users are offered choice. Grove House G62-G11 S17573 Grove House v212176 050705 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection 4th Floor Aspect Gate 166 College Road Harrow HA1 1BH 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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