Inspection on 10/10/06 for High Hilden

This inspection was carried out on 10th October 2006.

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

High Hilden 17/09/08

High Hilden 09/11/05

High Hilden 22/07/05

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE High Hilden Limited High Hilden Close Tonbridge Kent TN10 3DD Lead Inspector Mrs Lynnette Gajjar Key Unannounced Inspection 10th October 2006 09:35 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 High Hilden Limited DS0000064651.V299254.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. High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service High Hilden Limited Address High Hilden Close Tonbridge Kent TN10 3DD 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) 01732 353070 High Hilden Limited Mrs Carol Ann Tincombe Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th November 2005 Brief Description of the Service: High Hilden has been a residential care home for the elderly for 60 years. It is registered with the Charities Commission and its articles of association state that the home’s land and buildings are vested with the Official Custodian of Charities. A board of Trustees consisting of a chairman and seven other members governs the home. The Trustees provide their services on a voluntary and unpaid basis. High Hilden is registered for up to 40 older people, but only offers shared accommodation in specific instances, otherwise all clients are offered single rooms over the ground and first floors. There are office facilities, a meeting room, an activities room, a hairdressing salon, a staff room, storage facilities and a visitor’s suite on the second floor. All floors are accessible by two shaft lifts as well as staircases. The house is surrounded by extensive grounds and has car parking for visitors to the front, and ambulance bay and staff car parking to the side. High Hilden is about one mile from Tonbridge town centre and the main line train station and there is a bus stop at the end of the Close. The home’s current scale of fees is: £316.77 to £480 per week. Fees at High Hilden include chiropody care. Additional charges that are not covered by fees include hairdressing, newspapers, toiletries, clothing and some outings The last inspection report can be located on the hallway table at the main entrance of the home. High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection, for the year running from April 1st 2006 to March 31st 2007. The visit lasted from 09.35am until 17:00pm. At the time of this visit High Hilden is currently running with one vacancy. The ladies and gentleman living here have been referred to as clients throughout this report as this is the term understood within the home. The visit was spent talking directly with clients privately and collectively, care and ancillary staff, administration staff, visiting health professional and the deputy matron. The registered manager was taking annual leave. Some judgements about quality of life and choices were taken from direct conversation with clients and observation followed by discussion with care staff. Additional information was obtained through receipt of the manager’s preinspection questionnaire, a tour of the premises and conducting a case tracking exercise, by reading the files and care plans of the three clients and two care staff and one ancillary staff, as well as some policies and records maintained by the home. Documentation was on the whole in good order and the recommendations from the previous inspection had been implemented. Questionnaires feedback was also received from a further 2 relatives/carers and 1 health professional. Overall the ladies and gentleman living here, relatives and professionals are very satisfied with the service received. Some comments received: “ Every one is so kind, couldn’t ask for more” “Very satisfied” “One of the best homes I visit, communication is very good, and I enjoy coming here.” “ Marvellous” High Hilden has celebrated it 60th Year as a care home this summer with a garden party opened by Sir Henry Cooper and Dame Kelly Holmes. Many clients discussed this, the marquee and wonderful food, string quartet and all their families who came along too What the service does well: High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 6 High Hilden has a calm and pleasant atmosphere and it is run in the best interests of the clients. It is decorated and furnished to a high standard, and is clean, bright and airy. Clients are happy and contented, like living there, feel well cared for and are treated with respect. Those spoken with said they felt safe, expressed confidence in the care staff and manager to listen to them and “feel good” in themselves. Personal health care needs are well supported. Clients are encouraged to maintain regular contact with external agencies and professionals to managed their health care and personal preferences. Health professionals strongly commended the staff on their caring but also the good communication about their patients care. The home continues to benefit from a stable and highly motivated care team with a developmental and experienced manager. What has improved since the last inspection? What they could do better: Care plans can be developed further by holding more written detail of the very personal, overall excellent care observed and described by the ladies and gentleman living here. Care plans and daily records should show the care needed and support given, what the person continues to be able to do for themselves, opportunities for choices, how the person has felt, been involved etc, to reflect the guidelines and assessed plan of care. Risk assessments could be more person centred and relate to the individual clients needs. Clients and staff would benefit from clearer and more specific guidelines in the administration of PRN medication, such as what exactly the medication is prescribed for and visual triggers and indicators of when medication is to be administered. Clients will be safer with raised toilet seats being fixed to the floor. Staff recruitment, induction and supervision records could be better documented to promote High Hilden standards of care observed. High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 7 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. High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 8 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 High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 9 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): 1,2,3,4,5,6 Quality on this outcome area is good. This judgement has been made using available evidence including a visit to the service. The ladies and gentlemen living at High Hilden and their representatives have access to the information needed in making a decision as to whether the home can best meet their needs. EVIDENCE: High Hilden has a detailed ‘statement of purpose’ and ‘client guide’ for prospective clients. Minor amendments were discussed and were being changed during the visit. These documents would be altered to an alternative format on request, such as larger fonts, Braille, languages, audio. There is a small leaflet available giving photographs showing the home and amenities. High Hilden staff undertakes full pre-admission assessments before offering a visit to the home. This enables staff and clients to get a clearer understanding of the services offered and if the home is able to meet their care needs and expectations. Contracts are in place outlining what the home does and doesn’t provide within its fees. Minor reviewing of wording regarding meal times was High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 10 discussed and again being changed during the visit. Three new clients spoken with today were very happy with the support given when looking to move into the High Hilden and were very complimentary of the kindness shown by staff. The home does not provide intermediate care. High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 11 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 Quality on this outcome area is good. This judgement has been made using available evidence including a visit to the service. Individual health, social care needs and personal choices are well supported through discussion. Those living here are treated with genuine respect and dignity by care staff. Care plans; risk assessments, and daily records could be improved to offer more accurate information of the individual and personal support described by the ladies and gentleman and ensuring consistency by staff. EVIDENCE: Three individual care plans were tracked. Those spoken with described very personal, consistent, safe care and support given by the care staff. How their choices and personal preferences are respected and followed through. However care plans and records tracked did not show this. The current format is generic and tick boxes only showing what needs to be done or has been done to the client. These can be developed further with individual personal information particularly in relation to social interaction and personal preferences and lifestyle choices. Risk assessments format seen are also in a generic format and need to be develop to be more personal to the individual to High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 12 promote individual independence through minimised risk. Records are stored securely. The health and personal care needs of the ladies and gentleman are well supported with regular contact with specialists and external professionals. District nurse visiting today expressed satisfaction with the open and good communication from care staff and working together to address the care required for their patients. Interaction between clients / relatives and staff is good showing genuine respect, friendship and appropriate familiarity with each other. Many joining in various outings arrange by the home. Ladies and Gentlemen discussed getting together formally through clients meetings, what they would like to do, daily routines, activities and issues for the home. Minutes were also evidenced in the foyer. Safe medication practice is encouraged with regular monitoring and auditing by the manager and staff. Clients and staff would benefit from more detailed guidelines of what PRN medication is given for and specific triggers or indicators for administration, particularly for those who may be more confused. Good medication storage and administration was observed during this visit. High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality on this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. The ladies and gentleman living here continue to enjoy a wide range of cultural, social and religious activities and have regular contact with their family and friends. There is a wide choice of wholesome and appealing meals, which are taken in very pleasant surroundings. EVIDENCE: High Hilden has just employed a new activities organiser to arrange events and outings. A programme of events planned was displayed in the home, which is used extensively by clients as they wish. There is an extensive library in the entrance area, which is changed every three months. Clients were sitting in the lounges and conservatory listening to music and reading magazines etc. A passive exercise session was also taking place in the conservatory. Clients spoken with said that they enjoyed sitting in the lounges and bedrooms and “looking out at the lovely grounds”. Of which a few were making use of the extensive and attractive gardens (with well spaced out seating) and communal areas in the home and have many favourite areas where they like to sit. Menus are prepared in advance and clients choose what they want from the menu each morning. The menu choices are also displayed on a board in the High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 14 dining room. Most clients prefer to take their meals in the dining room and can sit at attractively laid out tables. One client said they always “it’s lovely but a bit too much for me today” and “lovely food, no complaints at all”. All those spoken with felt there is always a good choice and the food is well cooked and there is “always a lot of it, and being offered seconds”. Client’s families are in regular contact, with an open door visiting policy. A steady flow of visitors was observed through out the day with fondness and familiarity with staff. There is a visitor’s suite on the second floor that has a shower room and separate lounge area with a sofa bed, table and chairs, and kitchenette. Visitors can book into this suite overnight and can purchase breakfast at a modest cost. Clients can also use this suite on a daily basis when they have visitors. The ladies and gentlemen were observed to be stimulated and comfortable in their home. High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality on this outcome area is good. This judgement has been made using available evidence including a visit to the service. Those living here feel confidant to raise concerns or complain to the manager and staff, as they feel they are listened too, and that every action will taken to resolve them. Protection from abuse is promoted through staff training and understanding of the support and actions they may need to take EVIDENCE: The ladies and gentlemen spoken with expressed how they here feel confidant to raise concerns or complain to the manager and staff, as they feel they would be listened too, and that action will taken to resolve them. Many also were quick to say, “that’s if I where to have a complaint but I don’t” “ they can’t do enough for you”. The home’s records indicate they have had two concerns raised. Further issues re dinner times have been raised through the quality assurance questionnaires and responded to by the manager individually. Staff who have been spoken with evidenced a good understanding of how to protect and prevent abuse, including reporting under local procedures. A number of staff has completed training in this area since the last inspection or are due to attend next month. There are no current Adult Protection alerts regarding this home. High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 16 High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 17 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): 19,20,21,22,23,24,25,26 Quality on this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. The ladies and gentlemen live in a safe, clean, comfortable and well maintained home. EVIDENCE: High Hilden is a large estate home situated on the edge of Tonbridge with views of the surrounding countryside. There is a large and airy entrance hall with a grand staircase leading to the first and second floors. With two lifts for clients to access their rooms and other facilities. Including a hairdressing salon on the second floor, activities, visitor room, and manager and administrators office. Since the last visit a ramp has been fitted in place of the steps to one remaining fire exit. All rooms are single, with the exception of two that has been adapted as a living room and double bedroom. The home continues to work towards providing en-suite facilities to rooms that are large enough. There are now High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 18 nine rooms with en suite facilities. Clients’ rooms are comfortably furnished and contain their own furniture and effects. Clients continue to say they have all they need and are very happy with their rooms. There are six bathrooms (one of which is being considered to be adapted to a wet shower room in the near future), and 14 communal toilets, not all are fitted with grab railings. Clients can choose between five comfortably furnished and attractively decorated living rooms. Rooms still retain many of their original features and have beautiful ceilings and large picture windows with views of the gardens. The standard of cleanliness is extremely high and there were no offensive odours. There is car parking to the front of the house for visitors and staff parking to the rear. The gardens are well tended and attractive and clients continue to say they “feel extremely lucky to live there”. High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 19 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): 27,28,29,30 Quality on this outcome area is adequate. This judgement has been made using available evidence including a visit to the service Clients benefit from the support of a confident and motivated staff team. Resulting in good morale and enthusiasm to improve the ladies and gentlemen’s whole quality of life. Further development of the recruitment documentation and induction of staff will ensure a more a robust system. EVIDENCE: The home continues to encourage and support care staff to completed their NVQ 2 and 3 in care. The home currently has fourteen of twenty-five staff holding NVQ 2 or 3 in Care. All staff has undertaken a thorough and comprehensive recruitment checks including all core training. A detailed training matrix is in place. New staff who have worked in car before have not always undertaken a full induction programme to High Hilden. Staff feel supported by the manager and deputy manager. Care staff spoken with and directly observed evidenced clear and good understanding of different individual care needs. Those spoken with commended the training offered including both ancillary and care staff in all topics covered. There are clear roles and responsibilities to enable a smooth and efficient service being delivered, with good communication between staff. Issuing GSCC code of conduct and formalising induction for all staff even if they have worked in care before can improve recruitment documentation and offer better safe guards clients. High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 20 The ladies and gentlemen were seen to react fondly towards individual staff and their help. Comments shared included:” She’s so good”, “Nothings too much for them”, “They’re all lovely aren’t they, all the helpers” “I like having the male staff to help me” “they lovely girls, so helpful, they’re marvellous” Staff were seen to support individuals with dignity but with respectful two-way familiarity. Some staff expressed how they felt then ladies and gentlemen were an extended family. High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 21 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): 31,32,33,35,36,38 Quality on this outcome area is good. This judgement has been made using available evidence including a visit to the service Clients continue to benefit from living in a home that is well managed, safeguards their best interests and promotes and protects their health, safety and welfare. EVIDENCE: The registered manager has worked with this home for 21 years, is a registered level 2 nurse and has completed NVQ 4 registered managers award. Clients and staff expressed a high regard for their management approach to the home. Clients continue to feel the registered manager and deputy manager are approachable and staff said they felt well supported. Regular quality assurance questionnaires are circulated to clients and relatives with prompt responses to issues raised. High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 22 The deputy manager demonstrated through discussion and practice, a very clear understanding of the needs of current clients and current issues. Good financial systems are in place to protect and assist residents with personal monies held by the home. The home does not act as appointee for any clients. Relatives or power of attorneys manages this. Monitoring health and safety in the home is to a good standard. Minor areas were identified and agreed to be addressed as soon as practicable. Equipment is serviced as required to maintain a safe home and facilities. Regular monitoring of accidents occur by the manager and health and safety group. High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 2 High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 24 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 OP29 Regulation 18(1)(c ) (i) Requirement The registered person shall having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that the person employed by the registered person to work at the care home receive structured induction training. To be completed by timescale date. Timescale for action 30/11/06 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 OP1 Good Practice Recommendations It is recommended that consideration be given to rewording in the service user guide and statement of purpose ‘No room service being provided’ particularly in relation to meal-time taking into account individual assessed need and personal choice. High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 25 2 OP2 3 4 5 6 7 OP7 OP8 OP9 OP9 OP26 8 9 10 11 12 13 OP29 OP29 OP33 OP33 OP38 OP38 It is recommended that consideration be given to rewording in the contract in relation to ‘No room service being provided’ particularly in relation to meal-times, taking into account individual assessed need and personal choice. It is strongly recommended that care plan formats be reviewed to include a ‘person centre’ approach covering all aspects of support and social care. It is strongly recommended daily records accurately reflect the care and support given. Showing personal choices and preferences of care are maintained. It is strongly recommended that full PRN protocols be written to ensure consistent administration, recognised triggers and symptoms of ‘when required’. It is recommended the home obtains an up to date BNF and ensure that this is updated at least 6 monthly. It is recommended consideration be given to the use of open sluicing facility in the toilet/washbasin area of the lounge is required and promotes dignity to clients using the toilet areas. It is recommended that all new staff be given access or copies of the General Social Care Council Code of conduct. It is recommended that verbal checks are undertaken and recorded to verify references. It is recommended quality review is expanded to include other professionals and any other stakeholders involved with the home. It is strongly recommended that the manager obtains copies of the latest revised Care Homes Regulations 2006 and policies/procedures are reviewed accordingly. It is strongly recommended that freestanding raise toilet seats with be fixed to the floor. It is recommended serious consideration be given to boxing in hot water pipes in bathrooms and corridors. High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 High Hilden Limited DS0000064651.V299254.R01.S.doc Version 5.2 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!