Inspection on 26/09/06 for Hickling House

This inspection was carried out on 26th September 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

Hickling House 19/08/09

Hickling House 17/03/09

Hickling House 29/07/08

Hickling House 22/05/07

Hickling House 24/02/06

Hickling House 25/10/05

Hickling House 29/11/04

Hickling House 16/06/04

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

CARE HOMES FOR OLDER PEOPLE Hickling House Town Street Hickling Norwich Norfolk NR12 0AY Lead Inspector Ann Catterick Unannounced Inspection 26th September 2006 09:30 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 Hickling House DS0000027434.V314330.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. Hickling House DS0000027434.V314330.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hickling House Address Town Street Hickling Norwich Norfolk NR12 0AY 01692 598372 P/F01692 598372 info@hicklinghouse.fsnet.co.uk info@glendonhouse.fsnet.co.uk Mr Rhoderick Smart Mrs Frances Smart Angela Marlow Care Home 29 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) Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (28) of places Hickling House DS0000027434.V314330.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Up to twenty-eight (28) service users, over 65 years of age with dementia may be accommodated. One (1) adult with dementia may be accommodated The total number not to exceed twenty-nine (29). Date of last inspection 24th February 2006 Brief Description of the Service: Hickling House is a care home providing personal care and accommodation for 29 older people with dementia. Mr Rhoderick Smart and Mrs Frances Smart own the home and the registered manager is Mrs Angela Marlow. The home is situated on the outskirts of the village of Hickling, close to Hickling Broad and less than 5 miles from the Norfolk Coast. Originally a Victorian Inn, the premises has been extended and modernised to provide residential accommodation on two floors. There are 25 single rooms, 24 of which have en suite facilities, and 2 double rooms, both with en suite facilities. A shaft lift and separate stair lift provide access to the upper floor and there are two outside fire escapes. The weekly fees for care and accommodation are between £380 and £500 a week. Day care is provided to a small group of people and they are accommodated during the day in the general communal areas. Hickling House DS0000027434.V314330.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was a key unannounced inspection and took place on the 26th of September 2006. The site visit lasted 8 hours and prior to this a pre inspection questionnaire was received from the manager. Four comment cards were received; two from care professionals, one from a service user and another from a relative. The lack of response was a little disappointing. The manager had been on leave at the time they were received into the home and it is likely that the forms were not promoted as much as they would usually have been. On the day of the site visit the inspectors were able to speak with the manager, staff and service users as well as have a tour of the building and look at care plans, staff files and other documents and policies. Generally this is a well-managed care home that provides a good quality of care. All of those service users spoken to, who were able to comment, were satisfied with the care they received. General observations showed that service users were content and settled within their environment. There are some areas where the home could do better and these are identified within the requirements and recommendations. What the service does well: The home is well managed and has enough staff to meet the needs of service users. There is a relaxed atmosphere and the ambience is good. Feedback from health professionals about the care service users receive was very positive. Care plans were seen to have meaningful reviews on a regular basis. The home provides at least 40 hours staff a week dedicated to activities and occupation within the home. The home provides good-sized personal space and varied communal space. Hickling House DS0000027434.V314330.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Hickling House DS0000027434.V314330.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 Hickling House DS0000027434.V314330.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessed needs of service users are being met. EVIDENCE: Prior to admission the home receives assessments from placing professionals from health and/or social services. Evidence of these was seen on the day of the site visit. The manager would visit a prospective service user prior to admission to ensure that the home could meet their needs. Those service users within the home were having their needs met. This was evidenced by observations, inspection of care plans and discussion with staff and service users. Intermediate care is not offered in this home. Hickling House DS0000027434.V314330.R01.S.doc Version 5.2 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 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users general health and social care needs are being met and their privacy and dignity is promoted and protected. Concerns were identified with regard practice around the care and administration of medication. The Registered Manager plans to address these issues as soon as possible. EVIDENCE: Care plans were read and these included good information regarding health and personal care needs. Nutritional charts were seen on file and several staff have had training in this area. Pressure care charts were in place and clear continence assessments were seen. Some social information and history was available but this could have been more detailed. All of those service users spoken to were satisfied with their care and their personal and health needs were being met. Care plans signed by the service user were seen. Care plans were reviewed on a regular basis and the reviews were detailed and not just Hickling House DS0000027434.V314330.R01.S.doc Version 5.2 Page 10 stating ‘no change’. Feedback from local health professionals was very positive saying that the care provided was of a very high standard. Over forty hours during the week are dedicated to activities persons and these staff offer opportunity for activities on most days. The home now has a policy and procedure for the administration and care of medication. Most staff who administer medication have had appropriate training. On the day of inspection the member of staff who was administrating medication had been recently promoted. She was seen to administer medication in a competent way. This member of staff had received no formal training although informal training had been given in house. The Registered Manager will ensure that her new senior member of staff receives formal medication training as soon as possible and will not administer medication again until she has had the training. A requirement has been made in this area. A brief audit of medication was completed and there were some errors where the medication administration record (MAR) did not tally with the number of tablets remaining. There was also evidence of secondary dispensing i.e. several service users first names were written on small pieces of paper and these were all in a plastic medical pot. There was no thermometer in the medication fridge. A requirement has been made in this area. Staff were seen to work with service users in a way that protected their privacy and promoted their dignity. A bathroom door did not have a lock and this could compromise privacy and dignity. A recommendation has been made in this area. Screening is supplied in the two shared rooms and most rooms have a toilet en suite. Service users are able to see relatives and professionals in private. Hickling House DS0000027434.V314330.R01.S.doc Version 5.2 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 good. This judgement has been made using available evidence including a visit to this service. The home offers activities and occupation to service users. Service users are encouraged to make choices about the day-to-day aspects of their lives. Visitors are always made welcome and the food provided is of good quality and is eaten in pleasant surroundings. EVIDENCE: The home provides at least forty hours of additional staff each week to provide activity and occupation for service users. This includes quizzes, dancing, cooking, reminiscence, flower arranging and gardening. There are adequate staff on duty at any one time. Care staff should be encouraged to sit and talk with service users whenever possible. Care plans could include more information with regard interests and hobbies and activities to encourage conversation linked to individual hobbies and interests. The home has access to a mini bus and service users do have the opportunity for outings with many service users having recently been on a boat trip on the broads. Raised flowerbeds have been built near the doors of the conservatory and the home had purchased a computer with plans to connect the computer to the intranet. Hickling House DS0000027434.V314330.R01.S.doc Version 5.2 Page 12 Visitors are welcomed into the home and service users can see them in private. There are a variety of communal areas and most service users have a single room. On one care plan information about advocacy and community links was seen. Bedrooms are all of a good size and give opportunity for personal items and some furniture to be brought into the home if this is the service users preference. The dining area is bright and pleasant, offering a comfortable area for service users to have their meals. Some service users choose to have their meals in their rooms. The menu is varied and there are choices for all meals. On the day of inspection the choices were smoked haddock or pizza. Some service users did not want either of the choices and were offered ham with vegetables as a third choice. There is always a cook on duty for breakfast and dinner and tea is prepared by the kitchen staff and completed by the afternoon care staff. On the day of inspection neither cook was on duty and an acting cook was cooking. She was competent in this role and was able to discuss issues around nutrition. The home uses a local butcher and greengrocer and the general quality of food provided appeared good. The kitchen staff all have a food hygiene certificate. Much has been written around diet, nutrition and dementia and it would be useful if kitchen staff had some of the books and leaflets written about this area. A recommendation has been made in this area. All service users spoken to were positive about the food provided and the food on the day of inspection looked appetising. The lunchtime meal was taken in pleasant surroundings and eaten in an unhurried way. Hickling House DS0000027434.V314330.R01.S.doc Version 5.2 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 good. This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure and information with regard adult protection. Service users are protected from abuse by policies and procedures. EVIDENCE: The home has a complaints procedure and information about this is made available to service users and their families. The home had received no complaints since the last inspection. The home has a copy of the local adult protection documents but no guidelines that relate specifically to Hickling House. A recommendation has been made in this area. There is always a senior member of staff on call. Some staff have had training with regard the safeguarding of vulnerable adults and some staff are booked to complete this training in October. Staff spoken to were aware of the whistle blowing policy. Hickling House DS0000027434.V314330.R01.S.doc Version 5.2 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): 19,20,25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although there are several positives within this outcome area the safety issues and lack of clear signage for service users have influenced the scoring. EVIDENCE: The home provides comfortable accommodation with bedrooms being of good size with ample communal space and attractive gardens. Evidence was seen of an improvement plan. There has been much written, and consultants are available, to advice on environmental issues for service users with dementia. There was no evidence to suggest that any of the environmental factors relating to dementia had been addressed by the home. All bedroom, bathroom and toilet doors are the same colour with limited signage. Service users looking for a toilet, bathroom or their bedroom are not assisted by their environment. Good clear signage that suits the individual needs of service users should be used. Bedroom doors Hickling House DS0000027434.V314330.R01.S.doc Version 5.2 Page 15 should be of a colour and with signage that individual service users can recognise. Bedroom doors were left open during the day to enable service users to access their rooms if they chose to do so. Rooms were lockable if this was the preference of the service user. This was seen as good practice. Carpeting in many areas is all the same colour and does not make it easy for service users to know where they are and when areas change. There is opportunity for much improvement in this area. Some of the corridors are rather narrow and lighting in these areas was rather dull. In one of the lounges a centre light that had three light bulbs had only one working and this room was rather dark. A recommendation has been made in this area. The ramp that leads from the conservatory into the garden is a good idea but leads on to grass. The manager believed that a path was to be made in the garden. The garden is well cared for with a variety of flowers and shrubs with raised beds near the conservatory to make gardening easier for service users. It is enclosed and of a good size with garden furniture for service users to use. It provides good additional communal space in the warmer weather. The home has the potential to offer a good environment for people with dementia. However, experts in this field are now offering advice and guidance in relation to environmental factors and dementia care and the home has not kept up to date with modern practice. A requirement has been made in this area. The temperature of the hot water was tested in two service users bedrooms and this was very hot 63 degrees Centigrade. A requirement has been made in this area. The home is continuing to cover radiators but some, including bedroom and bathroom radiators are still not covered. A requirement has been made in this area. All areas of the home were clean and well presented being free from any offensive odours. Hickling House DS0000027434.V314330.R01.S.doc Version 5.2 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. Overall the home has a well- balanced staff team with staff having differing levels of knowledge and skill. Staff receive supervision and training although more training relating to dementia care should be sought. EVIDENCE: Four staff files were inspected and two staff were interviewed. Other staff were spoken to on a more informal basis. Staff files included, application forms, references and CRB and/or POVA first checks. Evidence was seen of basic induction training and it has been arranged for the manager to attend training about the new common induction standards advised by Skills for Care and how this will relate to the induction workbook that they use. Those staff spoken to were clear with regard their roles and responsibilities. Especially positive was a new member of staff being aware of what they could not do until they had received the relevant training. The experienced member of staff interviewed was completing her NVQ level three. Both members of staff had received minimum training relating to dementia and both expressed and interest in receiving further training in this area. The manager needs to ensure that there is a rolling programme of training regarding caring for service users with dementia and to encourage staff to read relevant literature. A requirement has been made in this area. There are many links on the Internet and the home should make the most of this information. Hickling House DS0000027434.V314330.R01.S.doc Version 5.2 Page 17 Twenty five per cent of staff have NVQ level 2 or above and other staff are completing NVQ or are waiting to commence NVQ. A recommendation has been made in this area. The care and health needs of service users appeared to be being met and the home was kept clean and tidy by housekeeping staff. The rota was inspected and the home has sufficient numbers of experienced and competent staff to meet the needs of service users. Evidence was seen of formal staff supervision. All comments received from service users and relatives about staff were positive. Hickling House DS0000027434.V314330.R01.S.doc Version 5.2 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): 31,33,35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager manages the home in a competent and professional way. The home has begun to develop a quality assurance system that aims to ensure the home is run in the best interests of the service users. The home takes no responsibility for service users money. There are some environmental issues that do not promote the wellbeing of service users. Hickling House DS0000027434.V314330.R01.S.doc Version 5.2 Page 19 EVIDENCE: The manager is in the process of completing her Registered Managers Award and hopes to complete this in the early part of next year. Observations and conversations with staff and service users suggested that she is approachable and works in an open and transparent way. As part of the quality assurance system for the home some questionnaires had been sent out to relatives and the comments received were positive. There is no thorough quality assurance system in the home and the manager needs to ensure that a system is created that enables the information received to be documented and published in a way that informs people of the quality of the service and what plans there are to improve the service. If service users choose to have some money in their purse or wallet the can have so. However the homes policy is to pay for anything that the service users want i.e. such as chiropody or hairdressing and then invoice the families. This way of managing money means that the home does not look after any service users money. Evidence of receipts and invoices were seen and these documents were all in order. Staff receive supervision about every two months. Staff receive mandatory health and safety training. Record keeping was generally OK. However the home keeps incident and accident records in an old incident an accident book form and this is not in accordance with the Data Protection Act 1998. The manager has agreed to ensure that records are kept individually to meet with the requirements of the Data Protection Act. The Proprietors do not fulfil his responsibility as described in regulation 26 of the Care Home Regulations 2001. A repeat requirement has been made in this area. The manager was not aware of their responsibility under Regulation 37 of the Care Home Regulations 2001. The manager had been giving notification of deaths but not of illness and other events as stated under the regulation. She is now aware of her responsibilities under this regulation. A door to a boiler room had been left unlocked and was easily accessible to service users. This concern was rectified on the day of inspection. Chemicals were present in bathrooms and these should be stored safely. A requirement has been made in this area. The hot water from two taps in en suite bedrooms was very hot and in one room measured 63 degrees centigrade. Not all radiators are covered. A requirement has been made in this area. Hickling House DS0000027434.V314330.R01.S.doc Version 5.2 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 x 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 x x 1 3 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 2 3 2 1 Hickling House DS0000027434.V314330.R01.S.doc Version 5.2 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 OP9 Regulation 13.2 Requirement The Registered Provider must ensure that arrangements are made to ensure that all aspects of the care and administration of medication are in line with good and safe practice. The Registered Provider must ensure that all staff who administer medication are appropriately trained. The Registered Provider must ensure that the environment meets the needs of service users. The Registered Person must ensure that the hot water outlets accessible to service user are of a temperature near to 43 degrees. On the day of inspection water at two sources was over 60 degrees centigrade. The Registered Person must ensure that all radiators identified as a risk to service users are covered. This relates particularly to those uncovered radiators in bedrooms and bathrooms. The Registered Person must DS0000027434.V314330.R01.S.doc Timescale for action 01/12/06 2. OP9 18.1 a 01/12/06 3. OP19 23.1 a 23.2 a 13.4 a c 01/12/06 4. OP25 01/12/06 5. OP25 13.4 a c 01/12/06 6. OP27 18 1 a 01/12/06 Page 22 Hickling House Version 5.2 7. OP33 26 8. OP38 23 4 9. OP38 13 4 a ensure that staff have the appropriate training to meet the needs of service users. This relates to specific training about caring for service users with dementia. The Registered Provider must 01/12/06 ensure that they visit the home and complete a report as stated in regulation 26 and make his report available to Commission. This is a repeated requirement. The previous timescales were 01/12/05 and 01/04/06. The Registered Provider must 28/09/06 ensure that if service users choose to have their bedroom doors open during the night the manager consults with the fire authority to ensure that this is done in the safest way. This is a repeat requirement. The previous timescale was 01/04/06. An immediate requirement was made. The Registered Provider must 01/10/06 ensure that chemicals are always stored safely and are not left in areas that service users have access to. 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. Refer to Standard OP10 OP15 Good Practice Recommendations It would be good practice to have a lockable facility on all bathroom doors to promote privacy for service users. It would be good practice to make available to kitchen staff books and/or information with regard providing food for people with dementia. DS0000027434.V314330.R01.S.doc Version 5.2 Page 23 Hickling House 3. 4. 5. 6. OP18 OP28 OP25 OP38 It would be helpful for staff if the manager completed basic guidelines for senior staff as to what to do if an allegation of abuse is made. The Registered Provider must ensure that at least 50 of staff have NVQ level 2 or above. It would be good practice to ensure that lighting throughout the home enhances the environment and meets the needs of service users. The manager needs to ensure that staff always return chemicals to the appropriate place when they have finished using them. This relates to chemicals found in the bathrooms. Hickling House DS0000027434.V314330.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Hickling House DS0000027434.V314330.R01.S.doc Version 5.2 Page 25 - 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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