Inspection on 16/11/05 for Hamilton Court

This inspection was carried out on 16th November 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 24 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hamilton Court 02/05/07

Hamilton Court 07/06/06

Hamilton Court 19/05/05

Hamilton Court 23/03/05

Hamilton Court 16/12/04

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

CARE HOME ADULTS 18-65 Tudor Views 2 Hinstock Road Handsworth Birmingham B20 2EU Lead Inspector Julie Preston Announced Inspection 16th November 2005 10:00 Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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. Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Tudor Views Address 2 Hinstock Road Handsworth Birmingham B20 2EU 0121 5154955 0121 5154680 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Tudor Views Ltd Mr Sukhwinder Singh Care Home 13 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (13) of places Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users must be aged under 65 years. That additional garden space is created for the service users to the side of the home which affords a degree of privacy for service users, within 4 months of registration. That the home provides personal care only for thirteen people for reasons of mental disorder, excluding learning disability or dementia. (13MD) That a minimum of two staff are on duty at all times, one of whom should be designated senior. That the manager completes the Registered Managers Award or equivalent by April 2005. 19th May 2005 3. 4. 5. Date of last inspection Brief Description of the Service: Tudor Views is a large detached house situated opposite a park in the Handsworth Wood area of Birmingham. The home provides care to people with mental health problems and currently has an all male service user group. Shopping, leisure and public transport facilities are within walking distance of the home. Bedrooms are available on all floors and there are two lounges on the ground floor, one of which is a designated smoking area. Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted by two inspectors over the course of one day. The inspectors met with service users that live in the home and talked to them about the care they receive and the opportunities they have to do things for themselves. A tour of the premises was undertaken and records were sampled that relate to service users care, staff recruitment and health and safety practice. A letter of serious concern was sent to the registered provider after this inspection as evidence was seen that led the inspectors to believe that a service user had been admitted outside of the home’s registration category and that a member of staff living on the premises had not requested nor received a satisfactory Criminal Records Bureau check. This report should be read in conjunction with the report made following the visit of 19th May 2005. What the service does well: What has improved since the last inspection? What they could do better: A new service user had been admitted to the home. The inspectors were concerned that the home could not meet the person’s needs. Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 6 Care plans and risk assessments need more work to make sure that service users needs are clearly described to assist staff to meet those needs. There are some concerns about health and safety practice. Staff need training in adult protection and the safe handling of medicines. The inspectors wrote to the registered provider about serious concerns regarding staff recruitment practice. Some equipment in the home needs to be cleaned regularly and some minor redecoration needs to take place. There is no system of quality assurance in place to enable a review of the quality of care provided in the home. 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. Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 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 the following standard(s): 2 There was evidence that a service user had been admitted outside the home’s conditions of registration, which is a breach of the Care Standards Act (2000). EVIDENCE: The inspectors observed the process of assessment that had been used to admit a service user to the home during the week before this inspection. The records seen stated that an assessment had been completed by a social worker that works for Tudor Views Ltd, however this was not available. An assessment by the funding agency, Birmingham Social Services Department identified that the service user did not have a diagnosis of mental illness; therefore the inspectors had reason to believe that a service user had been admitted outside of the home’s conditions of registration, which is an offence under the Care Standards Act (2000). A letter of serious concern was sent to the registered provider following this inspection whereby requirements were made that evidence of the person’s mental health diagnosis be provided to the CSCI. Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 9 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 the following standard(s): 6, 7, 9 Service users plans and risk assessments are in need of review and development to provide clear information about how their assessed needs are to be met within the home. Service users have opportunities to make decisions about their lifestyles. EVIDENCE: Two individual care plans were sampled at this inspection. Both were seen to be in need of development to clearly identify the service users needs and the strategies in place to meet the needs assessed. For example, one plan referred to the person “needing prompts” with personal care tasks. There was no further information to describe what this meant. The same plan was seen to be incomplete with regard to the service user’s needs in the areas of sleep, night care, social skills and personal relationships. The section within the plan that described the service user’s communication needs stated that the person “cannot understand” again, with no further information to identify what this meant. Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 10 A number of incidents were seen to be recorded on a service user’s file that detailed information about the person demonstrating challenging behaviour, poor motivation and self-neglect. There was no evidence of a system of monitoring in place to respond to these incidents effectively. The completion of individual care plans is necessary to ensure that service users needs are assessed and that there are strategies in place to meet those needs. Risk assessments were sampled within two service users files. Some risks had been assessed and there were strategies recorded to manage them, however a number of areas were noted to require further development to ensure that appropriate controls were identified to reduce known risks. For example, a health and safety risk assessment described the service user as at “low risk” and referred the reader to further information within the file. This record was not available. Another assessment had limited information recorded about the person’s mental health care needs and the indicators that would enable staff to determine a decline in the person’s mental health. Service users told the inspectors that they have opportunities to make decisions about their lifestyles such as choosing college courses and managing their own money. One service user said that staff were always available to help him if he needed them but would let him “do my own thing” where he was able to. A member of staff commented that although structured activities are scheduled for service users, no one is forced to take part in anything they are not happy with. The member of staff gave an example of supporting a service user to take a shower and said that if this were refused she would go back later and offer support again. Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 12, 13, 15, 17 Service users have opportunities to take part in activities, which they enjoy and keep in touch with their friends and relatives. There is a risk to service users health due to the practice of bringing hot food into the home without a robust system of food hazard analysis. EVIDENCE: Discussion with service users and examination of their daily records demonstrated that there are opportunities for accessing community-based activities on a regular basis. Service users described going out to buy DVDs and videos, shopping on the Soho Road and in the city centre, pub and café visits and attendance at college. During the inspection service users were seen to make use of the telephone and the inspectors were told that service users open their own mail, with help from staff if required. Individual plans sampled showed that information had been included about the contact arrangements for service users to see their families and friends. Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 12 A service user stated that he could make telephone calls in private if he wanted to speak to his relatives. The inspectors had the opportunity to take a meal with service users. The food provided was well presented and the service users said they had enjoyed it. All service users present at this inspection made positive comments about the food they eat. One service user said he cooked for himself on a regular basis and liked to do this. It was noted that food is transported from another care home to Tudor Views in metal containers. There were no records of the temperature of the food upon arrival or consumption, which is unsatisfactory and could contribute to the risk of food poisoning. The food hazard analysis must be developed to ensure safe food handling practice takes place and arrangements must be made for food to be cooked on the premises. Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 18, 20 Service users plans require development to clearly state how their personal care needs are to be met. The system of receiving medicines into the home and administration to service users is in need of development to ensure that robust practice takes place. EVIDENCE: The care plans sampled showed that further work is needed to clearly identify service users personal care needs. Plans were seen to state that individuals required “assistance” or “support” with personal care, but did not describe the type or frequency of support needed. In one bedroom, the inspectors could not see that the service user had been provided with a toothbrush, although the manager confirmed that the person had one. Medication administration records were sampled and a number of anomalies were found- Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 14 * A PRN (as required) medicine was noted to have been administered to the service user three times a day for a three week period and the total amount received into the home did not match the record of the number of tablets administered, * Two tablets were missing from a total of twenty tablets recorded as received into the home. The medication record showed that one had been dispensed; however the number remaining did not balance with the number recorded as received, * The number of aspirin tablets seen in stock for a service user did not match the amount entered onto the medication administration record. In other records sampled, it was noted that the balance of medicines in stock matched the administration records. A system of auditing medicines received and administered is required to ensure that there is robust practice in this area and that any errors are identified and resolved. The inspectors were unable to determine that staff have received accredited training in the safe handling of medicines. Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 15 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 the following standard(s): Neither of these standards was assessed at this inspection. EVIDENCE: Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 16 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 the following standard(s): 24, 30 There are some repairs, cleansing and refurbishment needed to provide a more comfortable environment for service users. The practice of carrying soiled linen to the laundry room through areas where food is eaten creates risks to service users health and well being. EVIDENCE: A tour of the premises was conducted and the following issues were identified as in need of further action: * An exposed light bulb at head height in the entrance to the top floor WC is in need of covering, * The bathroom near to bedroom 7 did not have a supply of liquid soap or paper towels for hand washing purposes, * The extractor fans in both ground floor WCs were in need of cleaning, * Damp patches were noted on the walls in bedroom 3 and the carpet in this bedroom was in need of replacement, Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 17 * The cupboards in bedroom 4 were being used to store items that did not belong to the service user that occupied the room, * The bedding in bedrooms 1 and 4 was dirty and stained. This was rectified during the inspection. Some areas of the home were seen to have improved since the last inspection. Broken radiators had been removed and the hallway and stair carpets had been cleaned. The inspectors noted that due to the location of the laundry room, it is necessary to carry soiled linen through the dining area and lounge. A risk assessment of this practice is required to ensure that appropriate infection control measures are in place. Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 18 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 The home cannot demonstrate that staff have the skills, knowledge and experience to meet the needs of all service users. Poor recruitment and selection practice does not protect service users living at the home. New staff do not receive an induction to their work within the home and training in adult protection is outstanding from the previous inspection. EVIDENCE: This report has identified that the inspectors had reason to believe that a service user with a learning disability and no mental health diagnosis had been admitted to the home. There was no evidence to determine that staff have the skills, knowledge and experience to work effectively with people with a learning disability. It was further identified that the person has a hearing impairment and uses sign language to communicate. Again, there was no evidence to show that staff have signing skills, although it was reported that a British Sign Language (BSL) user had been to the home to meet with the service user. It was of serious concern to note that a member of staff, who had no appropriate Criminal Records Bureau (CRB) check, was living in a bedroom in the top floor of the home. Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 19 This seriously compromises the safety and well being of service users within the home as it is not possible to establish whether the member of staff has criminal convictions that may deem the person unfit to be working in a registered care home. A letter of serious concern was sent to the registered provider following this inspection and requirements made that action be taken to address the matter. Within the same person’s records, there was no evidence of proof of identity and in another record sampled the home had not followed up gaps in the person’s employment history. One record did not identify when the member of staff had commenced his employment at then home. Training records were sampled and showed that for two members of staff appointed this year no induction had been provided following their employment at the home. Induction packs were seen within their individual files, however they had not been completed. Staff have not received training in adult protection, which is an outstanding requirement from the previous inspection. Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 20 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 The home does not have a registered manager however assurances were received that the new manager would be making application to the CSCI for registration. The new manager is enthusiastic about developing the services provided within the home and service users made positive comments about him. There is no system of quality assurance to monitor and review the service provided to people that live in the home. Some development of health and safety practice is needed for the protection of service users. EVIDENCE: The home does not have a registered manager and the new manager had not submitted an application for registration to the CSCI at the time of this inspection. This is now required. Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 21 The inspectors found the new manager to be enthusiastic about developing the service for the benefit of the people that live at Tudor Views. One service user stated that he felt the running of the home had improved since the appointment of the new manager. Another said that the manager was very good and couldn’t fault him. A number of requirements from the previous inspection are outstanding. However, the inspectors recognised that the new manager, who had been appointed within the last few weeks, had had little time to take action to address those requirements. The home does not have a system of quality assurance that seeks to monitor and review the service provided and include the views of service users. This is required. Fire safety records were observed and demonstrated that the fire alarm system is tested and serviced on a regular basis. Control of Substances Hazardous to Health (COSHH) products were seen to be securely stored within the home. It was noted that water temperature regulator valves had not been fitted onto all hot water outlets within the home and there was no evidence that the hot water supply had been tested on a regular basis to monitor the temperature. The home’s risk assessment for the premises stated that window restrictors were fitted however, the inspectors observed unrestricted windows in bedrooms 5, 7 and 8 on the first floor. Immediate requirements were made that this be addressed by 25/11/05. The smell of cigarette smoke was detected in a number of bedrooms and cigarette burns observed on some carpets. Immediate requirements were made that the home makes arrangements to protect the well being of service users that smoke in their bedrooms. Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 22 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 1 X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 2 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 1 X 1 2 X CONDUCT AND MANAGEMENT OF THE HOME 1 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tudor Views Score 2 X 2 X Standard No 37 38 39 40 41 42 43 Score 2 X 2 X X 2 X DS0000054608.V257242.R01.S.doc Version 5.0 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA32YA2 Regulation 14(1-2) Requirement The home must advise the CSCI, in writing of the assessment of the service user with a learning disability admitted to the home and provide evidence of the person’s mental health diagnosis. Each service user must have a written plan of care that sets out how their needs in respect of health and welfare are to be met. Individual plans must be subject to regular review. Monitoring systems must be developed and implemented for service users who demonstrate challenging behaviour and/or are at risk of self neglect to ensure that their needs are met as part of the individual planning process. Risk assessments must be completed to identify the controls in place to manage assessed risks for all service users. The food hazard analysis must be developed to include risks DS0000054608.V257242.R01.S.doc Timescale for action 09/12/05 2 YA6 15(1-2) 20/01/06 3 YA6 15(1-2) 20/01/06 4 YA9 13(4)(b,c) 20/01/06 5 YA17 13(4)(c) 21/11/05 Tudor Views Version 5.0 Page 24 6 YA17 16(2)(i) 7 YA18 15(1-2) 8 YA20 13(2) 9 YA20 13(2) 18(1)(c)(i) 10 YA24 23(2)(d)(m) 13(4)(a) 11 12 YA30 YA30 13(3) 13(3) associated with food being transported to the home. The assessment must detail the control measures in place to ensure it is safe. The CSCI must be advised, in writing of the arrangements to prepare and cook food on the premises. Personal care plans must be developed to clearly instruct staff how to meet service users assessed needs and to explain the meaning of “support” and “assistance”. The medication administration system must be developed to provide an accurate record of auditing medicines received into the home and dispensed to service users. The home must ensure that all staff have accredited training in the safe handling of medicines, where this is part of their role. The home must ensure that action is taken to address the following matters, - cover the light bulb in the top floor WC - replace the carpet in bedroom 3 and redecorate areas in this room where damp patches have stained the walls - remove the items in bedroom 4 that do not belong to the service user Liquid soap and paper towels must be provided in all communal bathrooms. A risk assessment must be completed with regard to the practice of carrying soiled linen through the dining room and practice must reflect the outcome of the assessment. DS0000054608.V257242.R01.S.doc 20/01/06 20/01/06 20/01/06 06/02/06 20/01/06 20/01/06 20/01/06 Tudor Views Version 5.0 Page 25 13 14 YA30 YA32 15 YA34 16 YA34 17 18 19 YA35 YA35 YA37 20 YA39 21 YA42 22 YA42 23 YA42 Extractor fans in the bathrooms must be cleaned. 18(1)(a) Staff must receive training in 18(1)(c)(i) communication with service users with a hearing impairment in order to meet their needs. 7,9,19, 17(2) Staff recruitment records must Sch2,4 be maintained in accordance with the Care Homes Regulations (2001). 7,9,19, 17(2) The registered provider must Sch2,4 advise the CSCI of the satisfactory CRB check for the member of staff living on the premises and provide evidence of this person’s induction and the date employment commenced. 18(1)(a)(c)(i) Staff must receive training in adult protection. 18(1)(a)(c)(i) Staff induction records must be completed and made available for inspection. 8(1-2) The registered provider must ensure that an application is made to the CSCI for the registration of the new manager. 24(1-3) The home must develop and implement a quality assurance system to review the quality of care provided in the home. 13(4)(a-c) Hot water delivery 23(2)(j) temperatures must be tested routinely to ensure that water is provided at a temperature on or close to 43 degrees Celsius. 13(4)(a-c) Windows on the first floor and above must be restricted in line with the home’s risk assessment outcomes. 13(4)(a-c) Arrangements must be in 23(4)(a) place to ensure the safety of service users that smoke in their bedrooms. DS0000054608.V257242.R01.S.doc 23(2)(d) 20/01/06 20/01/06 20/01/06 09/12/05 06/02/06 20/01/06 20/01/06 20/01/06 25/11/05 25/11/05 25/11/05 Tudor Views Version 5.0 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Tudor Views DS0000054608.V257242.R01.S.doc Version 5.0 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!