Inspection on 05/07/05 for Heron Court

This inspection was carried out on 5th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Heron Court 10/11/06

Heron Court 22/11/05

Heron Court 15/02/05

Heron Court 18/10/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Heron Court 198 Brentwood Road Herongate Brentwood Essex, CM13 2PN Lead Inspector Vicky Dutton Ann Davey Unannounced Tuesday 5th July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Heron Court Address 198 Brentwood Road Herongate Brentwood Essex CM13 2PN 01277 810236 01277 812560 heroncourt@runwoodhomes.co.uk Runwood Homes PLC Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ms Deborah Doyle CRH Care Home 35 Category(ies) of DE(E) Dementis-over 65 (17) registration, with number OP Old Age (35) of places Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th February 2005 Brief Description of the Service: Heron Court provides care and accommodation for thirty five older service users. Seventeen of these beds are registered for service users who suffer from dementia. The home consists of an original three storey old house, which is a listed building and two single storey units which are a later addition. The main house accommodates service users on two floors and access to all areas is maintained by way of a passenger lift. The second floor is for the use of the staff only. There are a variety of communal spaces, in addition to a dining room. The premises are set back from the road and are contained within an ornamental garden, which has a pond, greenhouse and gazebo. There are pubs and a village store close by. The nearest shopping centre is Brentwood where there is also a train station and bus service. Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of 7.45 hours. As there were two inspectors, this equated to 15.30 hours input. The inspection focused mainly on the progress the home had made since the last inspection, although a number of other standards were also considered. The registered manager of Heron Court is currently covering the manager’s role at another of the registered providers services. Similarly the management role at Heron Court is being covered by a registered manager from elsewhere. At the time of the inspection the acting manager had only been at the home for two to three weeks. The inspectors were also assisted by care team managers (CTM’s) at the home. A partial tour of the home took place. Staff, residents and a visiting professional were spoken with. Records were selected at random and inspected. A notice was displayed in the main entrance area advising all visitors to the home that an inspection was taking place with an open invitation to speak with an inspector. The inspectors gave a full and detailed ‘feedback’ to the acting manager with opportunity for clarification and/or further discussion. What the service does well: What has improved since the last inspection? The home has been through an unsettled period with the established registered manager and other senior staff having agreed to support another home, and temporarily leaving Heron Court. An experienced acting manager has now been appointed to Heron Court and is starting to identify what needs to be done to improve life for the residents living at the home. Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 4, 5. Prospective residents have their needs assessed before moving into the home. Wherever possible they or their families are encouraged to visit the home before moving in. EVIDENCE: Discussion with the acting manager and CTM indicated that all residents have their needs assessed before they move into the home. Care files of recently admitted residents viewed showed that the format used for pre admission assessments was well completed, and identified peoples care needs. This ensures that staff are aware of residents needs when they move into the home. Although not examined in detail staff training records showed that they had undertaken relevant training to meet residents needs. This included training in dementia care. As far as possible prospective residents are encouraged to visit the home before moving in. A recently admitted resident said that her family had visited the home several times before their stay was arranged. Intermediate care is not provided at Heron Court. Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9, 10. In general residents health and care needs are well identified and planed for. However development work is needed to ensure all staff are involved in this process, and that care staff deliver care based on a detailed knowledge of individual residents needs. Medication practices at the home are well managed and ensure that residents are kept safe. EVIDENCE: Several care files were viewed at this inspection. In general they were detailed and addressed all aspects of assessed needs. Regular reviews had taken place and there was evidence of residents/families involvement in the care planning process. Some best practice was noted, for example a short term care plan being put in place for a resident with a urine infection and on antibiotics. Some information was however confusing, identifying (for example), that a resident was mobile with assistance in one place and then stating that a hoist was to be used for transfers in another section. Another identified a two hourly toileting programme, when the daily records identified that a catheter was in place. Care staff are not currently involved in the compilation or maintenance of care records, apart from the daily observation notes. Those care staff spoken with could not demonstrate that they had a detailed knowledge and understanding of individual residents needs. This has the potential to put residents at risk. Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 Page 10 Records showed that resident’s health care needs are well catered for and that they access professional services such as chiropody, optician and local and hospital based health services. Records need to ensure that accurate recording of these processes takes place. One example was seen where it was unclear what process had been followed in relation to a resident’s illness. A district nurse spoken with at this inspection felt that the care offered by the home was good, and that staff were always very helpful. To monitor residents’ wellbeing their weight is regularly monitored and an adequate nutrition record maintained. Medication at the home is well managed through a monitored dosage system. Only minor shortfalls were noted such as protocols not being in place for all medications prescribed ‘as and when required’ (PRN). Throughout the day the homes staff were noted to treat residents with courtesy and respect. Doors were kept shut when personal care was taking place. The homes pay phone is not situated in an ideal place, being in an open corridor. Some aspects of the premises and observed practices do not support a valuing people ethos, these are detailed elsewhere in this report. Residents privacy and dignity was not upheld by a visiting professional. Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 15 Some activities are provided at the home, but these do not provide sufficient stimulation and occupation for all residents. Visiting at the home is open. Food at the home is good and praised by the residents. EVIDENCE: The activity co-ordinator post at the home is currently vacant. Staff at the home try to provide some level of activity, but this is not sufficient to meet residents individual needs. The home is trying to develop this area, and individual assessments in relation to activities and social and cultural needs have been completed. A record of activities undertaken is maintained. On the day of inspection it was ‘pamper day’, one member of staff was observed to be giving a resident a manicure. Residents complained of being bored, and of the televisions in the home being on all the time and too loud. When staff had the opportunity to spend time with residents, little positive interaction was observed. The home encourages visits from friends and relatives. Residents spoke highly of the food offered by the home, especially of the home made cakes, and cooked breakfast. The acting manager said that the home operate a four week menu plan. The chef said that menus are planned a few days ahead, and that what was prepared depended on what stock was available. Questionnaires are currently being completed with residents to Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 Page 12 identify more clearly their preferences and choices. A choice is offered at each main meal. Residents are now able to make this choice on the day, rather than the day before. Lunch on the day of inspection looked appetising and was very well presented. To ensure that residents eat in pleasant surroundings attention to detail is needed. On the day of inspection it was noted that many residents remained in lounge chairs and ate their lunch from over bed style tables. Cloths used for dining tables were creased, place mats chipped and in poor condition, and cutlery mismatched. All residents, including those more able, had plastic beakers to drink from. One member of staff remained standing while they assisted a resident to eat. Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 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 standard(s) 16, 18 The home has an established complaints procedure in place, and residents are aware of how to raise concerns. Staff are not following established processes in relation to complaints. Adult protection procedures are in place to ensure that residents are protected from abuse. EVIDENCE: Residents spoken with confirmed that they knew how to raise concerns and would be happy to do so. The homes complaints folder showed that since November 2004 eleven complaints had been recorded. This shows good practice in that all issues are recorded and could contribute to quality monitoring. However the process followed to resolve these complaints, or if they had been properly investigated or resolved was unclear due to poor recording processes. In general staff spoken with had a good understanding of adult protection issues. Records showed that training had been undertaken in this area. A senior member of staff was less clear of what specific actions might need to be taken when they were in charge of the home. Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 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 standard(s) 19, 20, 21, 22, 24, 25, 26 Many aspects of the premises are unsatisfactory, and do not provide residents with a safe and homely place to live. EVIDENCE: Heron Court was noted to be generally clean, tidy and odour free. The home is situated in a rural area and is set back from the road. As part of this inspection a tour of the premises was undertaken and full feedback given to the acting manager and CTM. Previous inspection reports have raised concerns about the condition and maintenance of the building. This inspection demonstrated that the situation has deteriorated further. There was evidence of damp or water penetration in several areas. This could be potentially harmful to residents. Wall paper is peeling in many areas, and paintwork damaged. In spite of previous assurances that the premises would be fully audited and a programme of refurbishment established, together with timescales, this has not happened. Some staff thought that an audit by the registered provider had taken place, but were unaware of the conclusion of this. Staff at the home commented that due to the condition of the premises they feel embarrassed when showing people round. Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 Page 15 The home has extensive grounds, which includes some outbuildings such as greenhouses and a summerhouse. These were in a run down state. There is a small pond in the grounds. There is also a fenced garden with gazebo suited to service users with dementia. All external areas were somewhat overgrown and would benefit residents more if they were well maintained. Communal space in the two ‘links’ was tight and would not provide sufficient communal space should all nine residents that might live in each ‘link’ choose to use these areas. One ‘link’ lounge/diner only contained three easy chairs, the other four. A number of service users in these areas chose to remain in their rooms. One lounge/diner is still also used as a hairdressers room on one day each week. This is inappropriate, and is an outstanding issue which needs to be resolved. There is still an issue with the staff/visitors room. Although this room was said to be dual purpose, in reality it contained personal information relating to individual residents. This made it unsuitable for use by visitors. The home has three assisted baths, two non-assisted baths and two shower rooms. Many bathrooms and toilet areas at the home are in need of refurbishment. Some showed damp or water damage. The acting manager had already picked up on some of the shortfalls in these areas and had, for example, ordered now toilet roll holders, as these were missing/broken in many instances. Some bathrooms contained items such as disposable gloves and pad bags. As the home is registered to provide a service to residents with dementia this could pose a hazard. To assist residents it should be possible for them to identify hot from cold taps. In many areas this was not possible. Hoists and moving and handling equipment is available to assist residents. As the home is registered to provide dementia care signage must be improved to assist these residents with orientation. The acting manager had already identified this as an area for development and is addressing this. As identified at previous inspections, furnishings and fitments in residents private accommodation are, in many instances, very shabby and worn. In many rooms the furnishings do not match. Some rooms have no lockable storage. In one room an unstable wardrobe presented a hazard. This was pointed out to the acting manager. On the day of inspection the home was warm and well ventilated. Water temperatures tested at random were satisfactory, though some initially ran hot. The laundry was inspected and found to be clean, tidy and well organised. Although the room is fitted with an external bolt, staff indicated that this is not, in practice, used. This could place residents at risk should they enter this area when it is unattended. During a tour of the building, and later observations some health and safety/Infection control issues were identified. Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 Page 16 Open bins contained such items as disposable gloves. A bed in a shared room had been left unmade with a soiled sheet and a soiled toilet roll on the bedside table. Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 30 Established staffing levels are maintained, but these need to be monitored to ensure that residents are kept safe and have their needs met. Staff are recruited safely and receive training to carry out their roles. EVIDENCE: Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 Page 18 Due to local circumstances the registered manager at Heron Court is seconded to another of the registered providers establishments. In addition other senior staff are assisting her. This has left Heron Court vulnerable. The acting manager reported that the home currently has vacancies totalling 130 hours per week. Recruitment is under way. Residents spoken with said that staff at the home were generally nice and caring. Particular staff were especially praised. Although some staff were observed to be excellent and interact in a very positive manner with residents, much of the activity observed was task orientated. Other staff showed little interest in engaging with residents. Staffing levels and deployment/routines need to be monitored, particularly during the lunchtime period. A heated trolley was left unattended in an area where residents who suffer from dementia were accommodated. The agreed staffing levels at Heron Court are: • Five care staff and one senior care during the morning. • Four care staff and one senior care during the afternoon and evening. • Two care staff and one senior care at night. These levels were being adhered to on the day of inspection. The acting manager and CTM on duty felt that dependency levels at the home currently medium. On the day of inspection the home was only accommodating 27 residents. The acting manager felt that staffing levels were sufficient. Ancillary staff are employed at the home. This includes administrative and general hand support. Currently housekeeping/domestic cover is only provided in the morning/early afternoon. However kitchen and laundry cover is provided during the evening to assist in meeting residents needs. The acting manager reported that no new staff had been recruited since the previous inspection. The files of some existing staff were briefly reviewed. These showed that recruitment practices at the home were generally satisfactory and would protect residents. One instance of reference anomalies was discussed with the acting manager. Staff files showed that suitable induction and ongoing training processes are in place, and that some staff are undertaking TOPPS training to enhance their knowledge and care of residents. Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 36, 38 Many issues raised in this report, particularly in relation to the premises have been outstanding for some time. The registered person has a responsibility to manage the home effectively by identifying and addressing these issues. Staff at the home are appropriately supervised. Some health and safety issues have been raised through the report. EVIDENCE: The acting manager at the home is well trained and experienced. Although at the time of inspection she had only been in post for a short period, issues that require addressing had been identified. Although the home has been through an unsettling period, senior staff are striving to maintain morale. A staff meeting was carried out on the day of inspection. Staff files, and staff spoken with confirmed that all staff at the home receive regular supervision. Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 Page 20 Staff records showed that staff receive training in core areas such as moving and handling. Risk assessments have been undertaken for relevant areas. These were noted in some instances to be displayed in resident areas of the building. The effectiveness and homeliness of this was discussed with the acting manager. During the inspection a visiting professional was seen examining residents without being given knowledge of issues pertinent to individual residents such as MRSA. Treatments were being carried out in a corridor area of the building. This was not seen as appropriate. The CTM on duty undertook to address this. Both of these incidents had the potential to compromise infection control, residents safety, and the privacy and dignity of residents. Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 1 2 2 2 x 2 3 2 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 x 3 x x x 3 x 2 Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 Page 22 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. 2. Standard 7 7 Regulation 15 15, 18 Requirement Care plans need review to ensure that the information they contain is accurate and current. Staff should receive appropriate training so that they can be involved in the care planning process and have a greater understanding of residents care needs. Appropriate activity and occupation to be offered to residents based on individualy assessed needs. Complaints should be fully investegated and a record kept of this process and any outcomes. The Registered Person must ensure that the premises are kept in a good state of repair. This refers to the issues raised in the body of the report. Previous requirement of 22/03/05 not met. 6. 19 20 The homes grounds to be maintained to provide maximum benifit for residents. I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Timescale for action 30/08/05 01/10/05 3. 12 16 01/09/05 4. 16 22 01/09/05 5. 19 23 01/10/05 01/10/05 Heron Court Version 1.40 Page 23 7. 20 23 The Registered Person must ensure that there is adequate sitting, recreational and dining space separately from the service users bedrooms. This refers to the limited communal space in the link areas of the home. This also refers to the need for suitable facilities for hairdressing to be provided. Previous requirement of 22/03/05 not met. 01/10/05 8. 20 23 The Registered Person must ensure that suitable facilities are provided for service users to meet visitors in communal and private accommodation which is separate from the service users bedroom. Previous requirement of 22/03/05 not met. 01/10/05 9. 26 12 The registered provider must assess the risk to residents posed by the open laundry area and take appropriate remedial actions. 01/09/05 10. 33 24 The Registered Person must 01/12/05 provide to the Commission a report in respect of any review of the quality of care provided at the home. This standard was not assessed at this inspection and is carried forward. Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 Page 24 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. 5. 6. 7. 8. 9. 10. 11. 12. Refer to Standard 8 9 10 10 15 18 21 22 24 26 26 Good Practice Recommendations Accurate daily records should be maintained that clearly show residents care and results of professional visits. Protocols should be in place for all medication that is prescribed as and when required (PRN). The positioning of the homes pay phone should be considered. The home should ensure that their expectations in relation to preserving residents privacy and dignity are upheld by visitors to the home. The quality of dining equipment such as cutlery and mats should be reviewed. The Registered Provider should ensure that senior staff are confident about the actions to be taken in the event of an alegation of abuse occuring. Water taps should clearly identify hot from cold outlets. Signage should be improved at the home to assist residents who may be confussed. Furnishings provided in residents private accommodation should be of reasonable quality and fit for purpose. The infection control issues identified in this report such as open bins should be addressed. Safe storage should be provided for protective clothing and other items that might present a hazzard to residents. Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Kingwoods House Baxter Avenue Southend-On-Sea Essex, SS2 6BG 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 Heron Court I56-I06 S18041 Heron Court V237017 050705 Stage 4.doc Version 1.40 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. 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