Inspection on 21/04/06 for Hazlewell

This inspection was carried out on 21st April 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hazlewell 03/03/10

Hazlewell 02/06/09

Hazlewell 18/12/08

Hazlewell 23/06/08

Hazlewell 16/01/08

Hazlewell 16/07/07

Hazlewell 26/08/05

Hazlewell 14/04/05

Hazlewell 01/09/04

Hazlewell 22/04/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Hazlewell 29-31 Hazlewell Road Putney London SW15 6LT Lead Inspector Jon Fry Unannounced Inspection 21st April 2006 11:00 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 Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 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. Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hazlewell Address 29-31 Hazlewell Road Putney London SW15 6LT 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) 020 8788 8753 020 8780 5736 Mr D Patel Mrs Rosemary Carmen Molloy Care Home 29 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (29) of places Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Dementia The home may provide accommodation and care for two named service users with dementia. The category DE(E) must be removed once these named service users are no longer accommodated. 26th August 2005 Date of last inspection Brief Description of the Service: Hazlewell is a twenty-nine bedded care home providing nursing care for older people. The property consists of two semi-detached Victorian houses that have been joined together to make one home. The home is on three storeys and has been extended to the rear with a large conservatory. There is a large rear garden with a patio area available. Hazlewell is situated in a quiet residential street reasonably close to available shops and transport links in Putney. Information about the home is provided to residents in a written guide. The current range of fees are £474.00 to £650.00 per week. Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by a regulation inspector on the 21 and 28 April 2006. The inspection took place over seven hours. The inspector spoke with six residents, one visitor, the manager and one member of staff. A number of records were examined, as well as a tour of the communal areas of the home. Completed survey forms were received from three residents and one health professional. What the service does well: What has improved since the last inspection? What they could do better: The information provided to new and existing residents needs updating. The care plans drawn up for each individual resident following admission could be improved by making them more individualised and ‘person centred’. Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 6 As highlighted within previous reports, the activities on offer at the home could be improved. It is important that residents be given opportunities to attend activities regularly both in and outside of the home environment. Procedures for the administration and recording of medication need to be further improved. This must be done accurately at all times. Suitable working bathing facilities must be made available for resident’s use on the second floor of the home. There are opportunities to improve the systems in place for quality assurance. The home should look at ways of better obtaining residents views and involving them in the life of the home. The registered provider must make formal monthly visits to the home – this issue has been raised in previous inspection reports for the service. 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. Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 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 Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 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 the following standard(s): 1,3 and 5. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The needs of residents are assessed prior to admission to make sure that the home can meet these. The written guide for residents needs updating to provide good information to residents. EVIDENCE: There is an appropriate procedure to make sure that the individual needs of a resident are assessed before they move into the home. These assessments were seen for three residents. Relatives of a prospective resident were being given a guided tour of the home at the time of this inspection. The guide produced for residents and their representatives needs updating. This document currently includes out of date information about making complaints and ‘a typical day’ at the home. The guide must also accurately state the choice on offer to residents at mealtimes. Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8. 9, 10 and 11. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The changing needs of residents are adequately addressed by the home. Care plans are fully completed and reviewed each month. The care plans could be developed to include better information about each resident’s life history and likes and dislikes. The systems to make sure that medication is safely administered to residents require improvement. EVIDENCE: General improvements were noted from the August 2005 inspection in the completion of the individual care plans. Care plans for three residents were looked at and these were being reviewed on a monthly basis. The information was up to date and adequately addressed areas such as mobility and personal hygiene. Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 10 The care plans should now be developed to include better information about areas such as life history and the individual’s likes and dislikes. The home has started to record some ‘lifestyle’ information but this currently includes headings such as ‘soft toy’. It is strongly recommended that this way of working be reviewed and better person centred information be recorded to reflect the individual resident. Entries made in daily care records had improved but a number of these were still observed to state ‘care continued’ or ‘all care given’. Wound assessments had also improved but there is scope to further review these to make sure they fully detail both the plan of care and the actual treatment given. Records of GP visits and monthly weight charts were well kept for the three residents whose care plans were looked at. Individual arrangements following death were also completed for each individual. Written comments were received from one GP who saw residents at the home. They stated that staff were ‘competent and caring’ and that health assessments carried out by the home were ‘generally competent’ with ‘appropriate’ requests for medical assessments made. Medication records were generally well maintained but further improvement is required to fully ensure the safe administration of medicines to residents. Three instances were found where there were mistakes or omissions in completing the administration record. Two instances were seen where creams for residents were not kept locked away as required. Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. In–house activities are provided to residents on an informal basis. There is much scope for these to be developed and improved. Residents generally enjoy the food served at the home. The menus however require review to make sure that individuals are offered a real choice for their meals each day. EVIDENCE: Daily records of activities provided were examined. These included watching TV, music and movement, bingo and a visiting entertainer. Trips out into the community as provided by the home were not included within the record. The manager had however taken one resident out to the bank and for shopping on the first day of inspection. The resident had clearly enjoyed this trip outside of the home. The manager reported that there was no structured programme of activities in place although a weekly schedule was displayed in the lounge of the home. The manager said activities were provided each day and this was done informally to suit the resident’s individual needs. Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 12 Comments from residents included ‘there’s not much in the way of activities’, ‘I mainly watch TV’ and ‘I’m not interested in activities’. The home must review the activities provided to residents and develop a more structured approach based on individual preferences. The provision at the home should include regular opportunities for residents to go on trips and access local community facilities. All the residents spoken to reported that they were able to receive visitors. Two residents were seen to have people visiting at the time of this inspection. One resident reported that they felt staff woke them up too early. A Requirement has been made to make sure that all residents are able to get up and go to bed at times of their own choosing. Comments about the food provided at the home were generally very positive and included ‘excellent’, ‘not bad’ and ‘nice’. Residents spoken to however said that they did not have a choice of meals and usually just had whatever was served to them each day. The menus seen also did not reflect real choice for residents and other records confirmed that only one meal choice was available on some days. Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The complaints procedure as supplied to residents on admission to the home needs updating. Satisfactory policies and procedures are in place to protect residents from abuse. The training provided to new staff must include abuse awareness. EVIDENCE: The home keeps a record of complaints and this was kept up to date with actions taken by the home fully documented. No complaints have been received directly by the CSCI since the last inspection took place. Residents spoken to reported that they did not have any complaints about the service at the time of this inspection. The complaints procedure contained in the guide for residents requires updating as this incorrectly references other authorities that are no longer in existence. Protection of Vulnerable Adults (POVA) procedures are available in the home for care staff to reference. The manager must ensure that the induction training undertaken by new care staff is to the national ‘Skills for Care’ standards that include how to recognise and respond to abuse and neglect. Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24, 25 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home environment has been improved for residents since the last inspection took place in August 2005. Resident’s benefit from improved bathroom facilities on the first floor. The bathroom provision on the second floor still requires improvement. Some items of equipment provided at the home for use by residents and staff require servicing or replacement. EVIDENCE: Improvements made to the environment include new hallway carpeting and an additional shower on the first floor. The decoration of the home has also improved since the last inspection took place. Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 15 The bathing facilities on the second floor must be improved to make sure they can be easily used by residents and care staff. The manager reported that one bath had poor water flow and the other bath provided was noisy and difficult to work. It is recommended that one of these bathrooms be updated to include a shower room. A number of bedrooms present very well and are personalised to the individual resident. Beds for three residents have been replaced as required at the last inspection visit. Further improvements required include replacement of one old style bed that is still in use and minor re-decoration of one ceiling. The sluice was again found not to be working at the time of inspection and requires immediate replacement. The stair lift still requires servicing as has been highlighted at previous inspections. The manager reported that the stair lift was still put into use if the main passenger lift broke down despite the lack of recent servicing. This practice places residents at risk. The lounge of the home was decorated in 2005 and still presents well. A number of chairs were seen to require replacement and the manager stated that funds were available to do this. The windows and blinds in the conservatory area additionally need cleaning. Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels remain adequate to meet the care needs of residents currently accommodated. Further consideration must be given to ensuring that individual social and recreational needs are being fully addressed. All required recruitment checks are undertaken for new care staff by the home to protect residents. All existing staff working in the home must have Criminal Record Bureau (CRB) checks in place. The training for care staff has improved which benefits the individual residents living at the home. EVIDENCE: Comments from residents regarding staff included ‘very kind and helpful’, ‘very polite’ and ‘first rate’. Staffing levels are adequate to meet the care needs of residents accommodated. As stated within this and previous reports for the home, further development work must be undertaken to enhance the social and recreational opportunities available to residents. It is recommended that a dedicated member of staff be employed to provide activities at the service. Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 17 The availability of training for care staff has improved. Recent and ongoing training includes dementia, Food Hygiene, medication and infection control. Six staff members have the NVQ Level two qualification with a further three working towards this award. The manager reported that training records were being updated at the time of this inspection. The Requirement from the last inspection has been re-stated and must now be actioned. The training provided for new care staff must be updated to the new ‘Skills for Care’ common induction standards. These standards will be mandatory by September 2006. Recruitment records looked at for three members of staff were satisfactory. The manager reported that a Criminal Record Bureau (CRB) check still had not been obtained for the homes handyman as required at previous inspections. This is unacceptable and must be obtained as a matter of urgency. Recruitment records for two longer serving members of staff were also unavailable for inspection during this visit. Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Adequate management arrangements are in place at the home. Management practice is to be further improved through NVQ Level Four training. The home needs to look at further ways to regularly consult residents and to make sure their views are listened to. Staff are closely supervised to make sure of their individual good practice. The type of supervision provided however needs to be reviewed. Health and Safety procedures require minor review to fully ensure the safety of residents. Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 19 EVIDENCE: The manager and her deputy are studying for the NVQ Level Four qualification. Improvements were noted in the organisation and updating of information at this inspection. The manager reported that surveys had been supplied to many residents in 2006 but the results of these had not been collated. The home should also look at the possibility of having regular residents meetings that will make sure that resident’s views are listened to and acted upon. Regulation 26 reports by the registered provider are not taking place. Arrangements for individual staff supervision have improved. The manager needs to look at the content of these 1-1 sessions to make sure they are effective in supporting staff to deliver high quality care. Appraisals of staff should also not take place within their supervision sessions. Satisfactory Health and Safety checks take place for hot water temperatures, Fire Safety and hoist equipment. Improvements are required to make sure that fridges are kept at the correct temperature and that regular monthly checks of First Aid boxes take place. Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 2 2 X X 2 2 3 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 3 X 2 Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 OP1 Regulation 5 (1) Requirement The Registered Persons must ensure that the information in the Residents Guide is accurate and up to date. The Registered Persons must ensure that: Individual care plans fully address health, personal and social care needs of residents. Daily care notes must be completed in line with NMC guidelines. (Timescale from previous report not fully met) 3 OP8 12(1) (b) 15 (2) 17 (1) (a) The Registered Persons must ensure that full and detailed assessment documentation is put in place for all wounds / pressure sores as required for individual residents. These must include a detailed plan of care for care staff to follow. 01/08/06 Timescale for action 01/08/06 2 OP7 12 (1) 15 01/08/06 Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 22 4 OP9 13 (2) The Registered Persons must ensure that the administration of all medication is recorded accurately. (Timescale from previous report not fully met) 01/05/06 5 OP9 13 (2) (4) The Registered Persons must 01/05/06 ensure that all items of medication (including creams) be securely stored at all times. (Timescale from previous report not fully met) 6 OP12 16 (2) (m) (n) The Registered Persons must ensure that there is a full programme of activities in place at the home based on the individual preferences of residents. The programme provided must enable residents to engage in local, social and community activities. (Timescale from previous report not fully met) 01/08/06 7 OP14 12 (4) 8 OP15 16 (2) (i) The Registered Persons must ensure that residents are enabled to get up or go to bed at times of their own choosing. The Registered Persons must review the menus provided to ensure they provide real choice to residents. The revised menus must be based on the residents preferences. 01/05/06 01/08/06 9 OP19 23 (2) (b) (c) (d) The Registered Persons must ensure that: the ceiling in room 22 is 01/08/06 Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 23 decorated, the bed in room 10 is replaced, worn or damaged chairs in the lounge and conservatory are replaced, the windows and blinds in the conservatory are kept clean. 10 OP21 23 (2) (j) The Registered Persons must ensure that adequate bathroom facilities are provided for residents on the second floor. These facilities must be in good working order. The Registered Persons must provide written evidence to the CSCI that the stair lift has been serviced. (Timescale from previous report not fully met) 12 13 OP26 OP29 23 (2) (d) 7, 9, 19 The Registered Persons must ensure that the sluice is repaired or replaced. The Registered Persons must ensure that Criminal Records Bureau (CRB) disclosures are obtained for any persons working at the home on a regular basis. Recruitment records must be fully maintained for all members of staff working at the home. This is with particular reference to the domestic staff member / maintenance person. (Timescale from previous report not fully met) 01/07/06 01/06/06 01/09/06 11 OP22 23 (2) (c) 01/07/06 Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 24 14 OP30 18 (1) The Registered Persons must ensure that the individual records of training are fully compiled and kept up to date. (Timescale from previous report not fully met) 01/07/06 15 OP30 18 (1) The Registered Persons must ensure that all new staff receive induction training to national ‘Skills for Care’ specification. Full records must be maintained to evidence this. (Timescale from previous report not fully met) 01/07/06 16 OP33 24 01/08/06 The Registered Persons must ensure that an annual development plan be put in place for the home. This must reflect the views of residents, their representatives and other stakeholders in the service. (Timescale from previous report not fully met) 17 OP33 26 The Registered Provider must make monthly visits to the home and compile a written report as required by this Regulation. The written reports must be supplied to the home and to the CSCI on a monthly basis. The Registered Persons must ensure that: monthly checks of First Aid boxes are carried out with full records kept 01/06/06 18 OP38 13 (4) 01/06/06 Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 25 accurate daily checks of fridge and freezer temperatures are carried out with full records kept. 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 OP7 Good Practice Recommendations It is recommended that the systems for care planning be developed to make sure that good quality person centred information is recorded as required about areas such as life history and the individual’s likes and dislikes. It is strongly recommended that activities be provided by a dedicated member of staff. It is recommended that a walk-in shower be provided for residents on the second floor. The home should look at the possibility of holding regular residents meetings. The content of staff supervisions should be reviewed to ensure they are an effective tool for supporting individual staff to perform their roles. 2 3 4 5 OP12 OP21 OP33 OP36 Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Hazlewell DS0000019097.V294222.R01.S.doc Version 5.1 Page 27 - 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. 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