Inspection on 31/10/06 for Hazelbrae

This inspection was carried out on 31st October 2006.

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

Hazelbrae 19/09/07

Hazelbrae 19/09/05

Hazelbrae 21/04/05

Hazelbrae 28/09/04

Hazelbrae 14/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Hazelbrae 76 St Saviours Road St Leonards-on-sea East Sussex TN38 0AR Lead Inspector Melanie Freeman Key Unannounced Inspection 31st October 2006 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hazelbrae Address 76 St Saviours Road St Leonards-on-sea East Sussex TN38 0AR 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) 01424 425080 01424 830686 Crowhurst Care Limited Mrs Susan Straughan Care Home 15 Category(ies) of Dementia (15) registration, with number of places Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That only service users with a dementia type illness may be admitted. The maximum number of service users to be accommodated will be fifteen (15). The service users accommodated will be aged sixty-five (65) years of age or over on admission. 19th September 2005 Date of last inspection Brief Description of the Service: Hazelbrae is a detached property situated in a residential area of St-Leonard’son-Sea. Local shops are situated within walking distance. The town centre, shops and railway station are situated approximately one mile away. Residents private accommodation is situated on two floors. A stair lift is provided to assist access to the first floor. The home has a rear garden readily accessible to residents. Hazelbrae is registered to provide residential and social care to (15) older people who have a dementia type illness. The registered provider is Crowhurst Care Ltd. Mrs Susan Straughan is the registered manager. The home provides care and support to residents who are both privately funded and those who are funded by Social Services. The home’s fees as from 01 October 2006 range from a basic fee of £362.00 per person per week depending on the room to be occupied and the care needs of the individual. Additional costs are charged for chiropody (approx £11) hairdressing (£7-£22), newspapers toiletries and a charge of £5 is made for physical motivation an activity available in the home. Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term ‘service user’ to describe those living in care home settings. For the purpose of this report those living at Hazelbrea care home will be referred to as ‘residents’. This was a key inspection that included an unannounced visit to the home and follow up contact with resident’s representatives and visiting health and social care professionals. The unannounced visit included a meeting with the registered manager who facilitated the inspection process and received the inspector’s feedback at the end of the inspection. On the day of the home visit the inspector spent most of her time meeting with residents and their visitors, and observing practice in the home, and she was able to eat a midday meal with the residents in the communal dining room. A tour of the premises was undertaken and a range of documentation was reviewed including the homes statement of purpose and service users guide, care plans, duty rotas, medication records, and recruitment files. The care documentation pertaining to three residents was reviewed in depth along with a number of policies and procedures and records relating to health and safety. In addition service users surveys were given to ten residents or their representatives and five staff surveys were left in the home for staff to return. The information contained in the returned surveys has been incorporated into this report. What the service does well: What has improved since the last inspection? Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 Page 6 There were no requirements made at the last inspection. Some redecoration has been progressed since the last inspection and training has continued to be given a high priority. 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. The summary of this inspection report can be made available in other formats on request. Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from the provision of comprehensive documentation, which enables them to make an informed choice about whether to move into Hazelbrea Care Home. All residents are assessed prior to an admission being agreed to by a competent person. EVIDENCE: The home has a suitable service users guide/statement of purpose. This document is available in the entrance area of the home, and includes a copy of the most recent inspection report. It was noted that the Service users guide did not include resident’s views and how this could be achieved was discussed with the manager. Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 Page 9 A review of the care documentation confirmed that pre-admission assessments are completed by the registered manager prior to an admission being agreed and ensures that the needs of residents admitted to the home can be met by the staff within the homes environment. These documents demonstrated that a multi-disciplinary approach to this assessment is completed. A social care professional reported that the manager contacted them following the assessment to ensure she had all the necessary information and to advise them that the assessment had been completed. Intermediate or rehabilitative care is not provided at Hazelbrea Care Home. Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Resident’s health and care needs are set out in an individual plan of care. Resident’s care needs are met taking into account resident’s dignity with evidence of regular input from health care professionals as necessary. The medicine administration practice in the home was safe although the storage of medicines needs improvement. EVIDENCE: The care documentation pertaining to three residents was reviewed as part of the inspection process and each of these residents were met with during the inspection visit to the home. The care documentation was found to be individualised and to focus on what the resident can do as well as the care needs to be met. Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 Page 11 The plans of care are written by the manager but she advised the inspector that the carers and relatives are involved in the planning of care provided. The home operates a key worker system where by an identified carer takes a specific interest in a small group of residents to ensure that a very individualised approach to care is maintained. One resident knew who her key worker was and spoke positively about her. Observations confirmed that residents were clean and well looked after and that they were treated as individuals by the carers looking after them. Most feedback was positive about the care provided and comments included ‘I and all my family are very happy with the care that my father receives in the home’ the home provides the best care that is possible’ ‘the staff and manager are very professional in their attitude to my care without losing site of the fact that I am a person’. Some feedback from relatives however indicated that more input from staff is needed to ensure residents are appropriately dressed and attended to following visits to the toilet. The records indicated that regular contact is maintained with the community health care professionals as necessary. Discussion with the visiting Community Nurse confirmed appropriate contact is maintained and that staff respond to any care instructions or recommendations made. Another health care professional contacted was complimentary about the specialist care provided. The inspector was impressed that the care documentation reflected how to promote resident’s privacy and dignity and the Community Nurse also said that she felt that resident’s privacy was respected as curtains were always drawn when personal care was being provided. The inspector was however concerned that the Chiropodist was treating residents feet in a communal area with more than one resident in the room at one time. This concern was raised with the Chiropodist and the home manager to address. Risk assessments are used to inform the care provided although it was noted that one resident who has her medication put into her food did not have a corresponding plan of care. The medicine records were found to be full and accurate and practice observed was seen to be safe. The storage of medicines however needs to be improved as the following areas of concern were identified; 1) The lock to the metal cupboard is rather flimsy 2) The cupboard is in a communal area where the temperature is not controlled and may get hot in the summer months, and access is not restricted and could be entered from the garden. 3) Arrangements for the suitable storage of any Controlled Drugs have not been established. Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 Page 12 The inspector was also concerned that she found creams prescribed for individual residents in other resident’s rooms along with un-labelled creams that were found in shared rooms. Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Links with friends and relatives are encouraged and choices made are respected. The arrangements for activities provide choice and activity and on the whole the provision of meals ensure residents have a choice and variety in their diet. EVIDENCE: During the unannounced visit to the home staff were found to be interacting with residents in a positive manner and care staff co-ordinated a quiz in the afternoon that many of the residents enjoyed and joined in with. One resident loves music and this was playing in the lounge for her. Activities are based around family activity although some external entertainment is provided and includes a motivational therapist who promotes physical and mental stimulation and visits the home on a monthly basis. Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 Page 14 Activities are mostly arranged for afternoons although some feedback identified that activities and entertainment are not always given a high priority. Residents are give choices throughout the day and encouraged to make choices about every day matters including what they do and what they wear. On speaking to residents and visitors it was clear that visiting is very positively encouraged with no restrictions being imposed. One visitor expressed a satisfaction that staff made her and all her relatives very welcome and always provided a drink and biscuits. One resident has a cat and enjoys looking after her pet and the company it provides her. Staff respect this relationship and assist in the pet care when needed. The meal eaten with residents was attractive and well enjoyed by residents who were assisted by staff as necessary. The inspector did however suggest the further use of fresh vegetables and fruit would improve the diet. Contact with relatives also suggested that the food could be further improved. The last inspection completed by the Environmental Health Officer reported ‘diligent and capably run food management’. Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures in the home ensure that complaints and any allegation or suspicion of abuse made would be managed appropriately. EVIDENCE: The home has a suitable complaints policy, which is made available to residents and their representatives. The home manager confirmed that there had been no official complaint since the last inspection. Relatives and visiting professionals spoken to confirmed that they were confident that any complaints or concerns that they had would be listened to by the manager and responded to effectively. The Adult Protection procedure was reviewed and confirmed that the procedure was appropriate however some updating was needed and the manager was responsive to this shortfall and confirmed that this would be address this matter. The manager and staff spoken to had a good understanding of promoting the protection of residents. Staff training on this subject has been provided. Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable homely environment that is being improved with general redecoration. Improvements need to ensure all resident safety issues are fully addressed and maintained and include suitable infection control practice. EVIDENCE: Hazelbrea is a converted property that provides a home like environment which residents are able to identify with and were seen to be moving around the freely during the unannounced visit. One relative spoken to was delighted to report that her father felt that Hazelbrea was his ‘home’. Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 Page 17 There was evidence that redecoration and improvements to the environment are being progressed however it was noted that a shared room was being redecorated while occupied, which clearly caused some difficulties for the residents. A planned programme for maintenance and redecoration is not recorded and the need for this was discussed with the manager this may in turn ensure that such matters are attended to in systematic way. Smoking is allowed in the home in certain areas and one of the designated areas is the dining room. Discussion with the manager confirmed that staff use this area to smoke in during their breaks. Clearly this impacts on the residents, as this is a communal space. The manager agreed to review this practice and identify a more suitable area for staff to smoke in. Residents have the use of a lounge conservatory and separate dining room on the ground floor and furnishings here are domestic in style. There is a garden area that accessed via the conservatory this needed some attention to ensure an attractive garden area and safe environment for residents as it provides the disabled access to the home. The home is not designated to provide a service to people with physical disabilities as the stairs and other access arrangements would make it unsuitable for residents with a permanent restricted mobility. Access to the first floor is via stairs or a chair lift, further steps are found upstairs. Individual rooms were found to be personalised, attractive and clean. When checking the call bell system it was identified that this was not working in a number of areas. The home manager was aware of this and confirmed that in these areas the bell system was being replaced as a priority and that in the mean time residents when in these areas are being checked on a half hourly basis to ensure their safety. Two unguarded radiators were also found these were not in use and the home owner advised that these are to be removed and this is why they had not been guarded. Since the inspection the home manager has confirmed in writing that all the call bells are now working and the unguarded radiators have been removed. The home’s laundry is sited away from food preparation areas and suitable hand washing facilities were found throughout the home. The washing machines are domestic in style and do not have a sluice cycle. Staff are hand sluicing some laundry and this is not good infection control practice and must be reviewed. Whilst looking around the home the inspector was concerned to find unnamed pots of cream around the home which could be used for more than one resident posing a high risk of cross infection. Accommodation within the home for staff is limited and the only office facility is situated in the basement very separated from the home. Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are having their needs met by suitably trained staff although the staffing levels need to be constant and reflect the level of activity in the home. Residents are protected by the home’s recruitment policy and practices. EVIDENCE: At the time of this inspection visit there was 15 residents living in the home, and on the day of the unannounced inspection the staffing arrangements were found to be appropriate to meet the care needs of the residents and time was available in the afternoon for some activities. The staffing on this day included two carers the manager a cook and a cleaner. Feedback from resident/relative surveys was very positive about the staff and their availability comments included ‘there is always a member of staff close at hand to assist and help me in a caring manner’ ‘staff are always cheerful when we visit and willing to take time out to talk about how mum has been’. All feedback about the staff was positive and included ‘they are kind and very helpful in all my care needs, its like a family’ ‘I think Sue and the rest of the Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 Page 19 staff do a fantastic job in caring for people at Hazelbrea’ ‘I would always recommend this home the staff are all well trained and very friendly’. Discussion however with some relatives following the inspection identified that the staffing arrangements do not currently ensure thorough supervision and support of residents and regular staff availability for the provision of activities in the afternoon. A staff rota was available for inspection and confirmed that the evening catering duties are completed by the care staff and that the manager does not always provide the extra carer on the afternoon shift. Indeed much of her time in the home will be taken up with management duties and should not be included in the carer’s numbers routinely. Discussions with the manager identified that she works in the home a high number of hours and is constantly on call to the home. The owners assume responsibility for administration and maintenance. The recruitment practice in respect of 3 staff members were reviewed and found to be full and robust, and the records checked included an application form, two references and the necessary POVA and CRB check had also been obtained. Staff training is well organised and the manager uses a matrix to organise and record the training provided and attended. Contact with staff confirmed that staff training is well promoted with staff able to attend all the necessary training. The manager has confirmed that most care staff have achieved a National Vocational qualification in care level 2. Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was found to be managed in an open and friendly manner. The systems to monitor and demonstrate the quality of care provided need to be fully established. Although resident’s financial interests have been safeguarded systems for this need to be improved. The health, safety and welfare of residents and staff are generally promoted and protected although further attention is needed regarding general safety checks and risk assessment. Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 Page 21 EVIDENCE: The home’s manager has substantial relevant experience and has completed relevant care and management qualifications. During the inspection the manager was found to have an excellent relationship and rapport with staff and residents. She was seen to lead by setting good standards of care by example and demonstrated that she has a good understanding of person centred care and the specialist care needs of residents with a dementia type illness. All feedback received about the homes manager was very positive complementing her support her availability and approach to residents. The Quality Assurance systems need to be further developed and formalised to include an audit of any questionnaires used and the generation of a report to inform the CSCI and any other interested parties. The home does hold money for seven residents and the system for the safe keeping of this was checked with manager. The money for three residents was checked and the money was found to be correct, however the storage arrangement did not comply with the homes procedure and it was also noted that receipts when money is received from relatives are not given and this was discussed with the manager. Certificates relating to Health and Safety in the home were reviewed and on the whole were found to be full and extensive although the certificate demonstrating the safety of the gas boiler and the thorough examination of the chair lift was not available for inspection. Environmental and fire risk assessments are completed although the environmental risk assessments need to be further developed to fully assess all areas and identify any possible risks for example any unguarded radiators and call bells that are not working. Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 X X 3 X X 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 X X 2 Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 OP9 Regulation 13(2) Requirement That the storage of medicines in the home is reviewed and improved to ensure appropriate safe storage of all medicines including individual creams. That a programme of routine maintenance and renewal of the fabric and redecoration is produced and implemented. That the garden is improved to provide an attractive outside space and to ensure a safe disabled side entrance to the home. That the infection control practice in the home is reviewed and improved in respect of the sluicing of dirty laundry and the use of topical creams. That appropriate numbers of staff are deployed in the home to enable staff to meet the needs of residents at all times. That an effective quality assurance system is established and reported on. That the systems for dealing with resident’s monies is reviewed and improved to DS0000021129.V317037.R01.S.doc Timescale for action 01/01/07 2. OP19 23(2) 13(4) 23(2) 13(4) 01/01/07 3. OP19 01/01/07 4. OP26 13(3) 01/02/07 5. OP27 18 01/12/06 6. 7. OP33 OP35 24 16(2) 01/03/07 01/02/07 Hazelbrae Version 5.2 Page 24 8. OP38 23(2) 13(4) 9. OP38 13(4) include the use of receipts and a procedure that reflects the practice in the home. That a safety check is completed on the gas boiler on an annual basis and a thorough examination of the chair lift is completed on a six monthly basis. That the environmental risk assessments are expanded to cover all areas of risk inside and outside the home. 01/12/06 01/02/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard OP1 OP10 OP9 OP15 Good Practice Recommendations That the service users guide includes the views of residents/representatives living in the home. That when any treatments are completed that these are always completed in a private area respecting each individuals right for privacy. That staff do not smoke in resident areas in the home. That the meals are reviewed to ensure a varied and nutritional diet is provided at all times. Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Hazelbrae DS0000021129.V317037.R01.S.doc Version 5.2 Page 26 - 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!