Inspection on 08/06/09 for Higham House

This inspection was carried out on 8th June 2009.

CQC found this care home to be providing an Adequate service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Higham House 27/08/08

Higham House 06/06/08

Higham House 15/01/08

Higham House 04/07/06

Higham House 20/10/05

Higham House 16/06/05

Higham House 10/05/05

Higham House 09/09/04

Higham House 15/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 25/11/2009.

Key inspection report CARE HOMES FOR OLDER PEOPLE Higham House 87 Higham Road Rushden Northants NN10 6DG Lead Inspector Catherine Perrins Unannounced Inspection 8th June 2009 09:30 DS0000045316.V375998.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Higham House DS0000045316.V375998.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Higham House DS0000045316.V375998.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Higham House Address 87 Higham Road Rushden Northants NN10 6DG 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) 01933 314253 F/P 01933 314253 Mr Tissa Nihal Atapattu Mrs Nelum Vijayanthi Atapattu Pam Band (Acting Manager) Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (30) of places Higham House DS0000045316.V375998.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Higham House care home is registered to provide personal care with nursing to male and female service users who fall within the following categories:- Old age, not falling within any other category (OP) 30, Dementia, over 65 years of age (DE(E)) 30. The maximum number of persons to be accommodated at Higham House nursing home is 30. 27th August 2008 2. Date of last inspection Brief Description of the Service: Higham House is situated on the main road through Rushden. It is within easy access of the local towns of Rushden and Higham Ferrers. A local bus service is easily accessible. The home is a converted building and provides nursing care for up to 30 frail, elderly residents of both sexes with both physical and dementia related illnesses. There are two communal sitting rooms, a dining room, kitchen and laundry room. The home also has a patio area. All of the bedrooms have either a wash basin or an en suite shower room. The Statement of Purpose, Service users’ Guide & Inspection Report is available on request (these provide information on how the home is organised and what services they provide). At the time of the inspection, fees ranged from £400 to £550.00 per week. Extras include hairdressing, dry cleaning and phone calls made from the foyer. Higham House DS0000045316.V375998.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. This was an unannounced key inspection which means that we focussed on the ‘key’ national standards. The key standards are those considered by the Commission to have the most impact on outcomes for residents. As part of the preparation for this inspection a period of four hours was spent reviewing the information that CQC has about this service. We looked at all the information that we have received, or asked for, since the last key inspection or annual service review. This included: Surveys returned to us by people using the service and from other people with an interest in the service. Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service, these are called ‘notifications’ and are a legal requirement. The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. Relevant information from other organisations. The inspection visit lasted six hours during the morning and afternoon of a weekday. An ‘expert by experience’ assisted with the inspection. Experts by experience are people who have experience of using social care services. The expert by experience spoke to people who live at the home and their relatives and spoke to staff. He also made observations based on his experience. Comments made by the expert by experience have been included throughout this report. During the inspection two people were ‘case tracked’. This involves looking in detail at all aspects of their care and experiences at the Higham House, including looking as their individual plans of care and other records, talking to them and talking to their care staff. Higham House DS0000045316.V375998.R01.S.doc Version 5.2 Page 6 Because people with dementia are not always able to tell us about their experiences we also used observations of peoples state of well being and how they interacted with staff members and others. A sample of staff files were also viewed as part of the inspection. The acting manager was present for the inspection. What the service does well: The admissions process is well managed. Our expert by experience noted, “The three visitors I spoke with said they were very happy with the care their loved ones received. They thought the staff were wonderful and had no complaints at all. One commented that she would certainly recommend this home to others.” Care plans contained some detail about peoples preferences such as what time they liked to get up and go to bed. Staff were seen assisting people in sensitive manner. Our expert by experience commented that, “One particular staff member was very patient helping to feed a resident; not rushed, just at the right pace.” People with pressure area needs receive the appropriate care. A relative told us that “the home is like a family – the best.” Said she was always made to feel welcome and offered drinks and a meal.” What has improved since the last inspection? The manager explained that there had been a number of improvements since the last inspection such as redecoration in the older parts of the home, new carpets and bedroom furniture in some of the bedrooms and a double sink in the kitchen. A visiting general practitioner commented that, “the home used to be dowdy and depressing but is now much brighter.” He went on to say that there had been “good improvements over last couple of years which seemed to have improved staff morale.” The home has had a ramp made so that people can access the patio area. Staff have attended a number of training courses. Higham House DS0000045316.V375998.R01.S.doc Version 5.2 Page 7 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Higham House DS0000045316.V375998.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 Higham House DS0000045316.V375998.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given information about the home and their needs are assessed before they move in to make sure that the home is right for them. EVIDENCE: The home has a combined statement of purpose and service user guide which gives people good information about the home and the services it offers. The statement of purpose / service user guide were not available in any other formats such as large print to make them easier for older people to read. Records show that people’s needs are assessed before they move to Higham House to make sure that the home is right for them. One of the people that we Higham House DS0000045316.V375998.R01.S.doc Version 5.2 Page 10 ‘case tracked’ was admitted as an emergency so his needs were not fully assessed before he moved in but they were assessed shortly afterwards. The manager explained that people are able to visit the home before they move in to help them decide if it is the right move for them. If they are not able to visit, their relatives or friends can do so on their behalf. Higham House DS0000045316.V375998.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff do not consistently have the right information to fully meet people’s full range of needs. EVIDENCE: Our expert by experience noted, “The three visitors I spoke with said they were very happy with the care their loved ones received. They thought the staff were wonderful and had no complaints at all. One commented that she would certainly recommend this home to others.” Each person who lives at the home has an individual plan of care. This contains their care plans and other information that staff need to care for people in the right way. Higham House DS0000045316.V375998.R01.S.doc Version 5.2 Page 12 Care plans seen covered areas such as communication, eating and drinking, personal care, mobility, culture and religion, health and continence. They contained some detail about peoples preferences such as what time they liked to get up and go to bed. There was some evidence of people being helped to make choices such as what clothes they wanted to wear. Individual plans of care seen did not consistently contain all the information that staff need to care for people in the right way. For example the care plan for one person stated that they needed mouth care “as required” but it did not specify what was required or when. Another care plan stated that someone should be using an item of specialist equipment, the manager explained they do not really need to use it anymore but their care plan had not been updated to show this. Our expert by experience noted that one person “was distressed informing all that no one loved her. Staff did come up to her to attempt to reassure her or divert her thoughts away from this distress.” Records show that people had been assessed to find out if they are at risk of developing pressure sores. Where it was identified that there was a risk measures were put in place to reduce the risk such as provision of specialist equipment and helping people to change position regularly. The administration of medication is generally well managed with all entries on the medication record being signed to show that people are receiving their medication as prescribed. Some cream prescribed for one person was entered on the medication record as being administered “as required” with no further detail to tell staff how, why or where the cream should be applied. A bottle of out of date prescribed skin treatment was found in the cupboard underneath some bodies sink in their bedroom. The manager disposed of the bottle and confirmed that all bedroom cupboards would be checked to ensure that they did not contain anything that could be potentially harmful unless a risk assessment had been carried out to show that any risks to people were minimal. The manager also stated that it was the home’s policy to date all creams and lotions when they are opened to ensure that they are used within the time specified by the manufacturer. Higham House DS0000045316.V375998.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People’s lifestyle could be improved by the development of a more structured programme of meaningful activities. EVIDENCE: People’s individual plans of care did contain some information about their interests and hobbies. The manager informed us that she was in the process of compiling life histories for each of the people at the home. This is important as it means that activities can be offered that reflect the interests of the individuals who live at the home. Activities sheets were seen which contained a record of the activities that people had taken part in such as watching television, listening to music, bible Higham House DS0000045316.V375998.R01.S.doc Version 5.2 Page 14 reading and hand massage. There was an entry for each person approximately every two days. The manager explained that a specialist company comes into the home once a fortnight to do activities with people and the hairdresser also visits once every two weeks. Our expert by experience noted, “I observed nothing in the way of meaningful or structured activities” He also commented that of the three visiting relatives he spoke to “None said they could recall any activities taking place at the home.” Lunch was observed during the inspection. Staff were seen assisting people in sensitive manner, talking to them and explaining what the food was. Our expert by experience commented that, “One particular staff member was very patient helping to feed a resident; not rushed, just at the right pace. There was contentment on this resident’s face.” A relative told us that “the home is like a family – the best.” Said she was always made to feel welcome and offered drinks and a meal.” The cook was aware of people’s preferences commenting that one person likes to have bacon for breakfast. Menus seen were varied and contained fresh fruit and vegetables. The cook explained that people are asked to choose their meals the previous day. Higham House DS0000045316.V375998.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to raise any concerns that they have through the homes safeguarding and complaints procedures. EVIDENCE: The home has a complaints procedure which outlines what people should do if they wish to raise a concern about the home and the response that they can expect. The manager said that the home has not received any complaints since the last inspection. Three referrals have been made about the home to the Local Authority under the locally agreed safeguarding adults procedure. All three incidents were investigated and unsubstantiated. Staff spoken to knew how to raise any concerns that they may have. Higham House DS0000045316.V375998.R01.S.doc Version 5.2 Page 16 A number of people were observed sitting in reclining chairs. These chairs can be very difficult to get out of when reclined so assessments are needed to ensure that people are not having their ability to move around freely restricted. The manager told us that these assessments have not yet been completed. Higham House DS0000045316.V375998.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Despite recent improvements further development is needed for the property to fully meet the needs of the people who live there. EVIDENCE: Higham House is a large detached house which has been extended to the rear. Our expert by experience noted, “My first impression of the home was that it was clean, but did have not particularly homely feel about it.” Higham House DS0000045316.V375998.R01.S.doc Version 5.2 Page 18 The manager explained that there had been a number of improvements since the last inspection such as redecoration in the older parts of the home, new carpets and bedroom furniture in some of the bedrooms and a double sink in the kitchen. A visiting general practitioner commented that, “the home used to be dowdy and depressing but is now much brighter.” He went on to say that there had been “good improvements over last couple of years which seemed to have improved staff morale.” Communal areas consist of two lounge areas and a separate dining room. Pictures, ornaments and vases of flowers gave the lounges a more homely feel. Our expert by experience commented that, “The dining room was very bare (I would say, the sparsest dining room I have seen since becoming an expert by experience).” Patio doors lead from the dining room to a patio area. These are however, not level access and the home have to use a portable ramp which they have had made to enable people to access the patio. The patio area adjoins a property owned by the registered provider which is rented out to staff of the care home. There is no fence dividing the two properties and the area by the boundary is hazardous in places with uneven step and different levels. Our expert by experience commented that the patio area had “nothing in the way of pots or flowers to make the outside a pleasant sitting-out experience.” The home has five double rooms which are currently not being used. The registered manager explained that they planned to turn these into single en suite rooms. The rooms in the newer extension have en suite shower rooms however the shower cubicles are not level access. This and their size would make it difficult for anyone with limited mobility or who needed assistance in the shower to use them. A strong smell was noticed in the newer extension. The manager said that she thought it was caused by the new carpet. None of the rooms in this area are currently in use. The bedrooms in the older part of the property all have a wash basin in. Some bedrooms had pictures on the doors to help people recognise which is their bedroom. One of the ground floor bedrooms seen was very dark with little natural light due to the close proximity of the neighbour’s hedge to the window. The manager agreed offer the person in this room the option of another bedroom is this room could not be made lighter. Higham House DS0000045316.V375998.R01.S.doc Version 5.2 Page 19 The manager explained that the bath in the bathroom on the first floor of the older part of the property was not used as the bath could not be accessed by people with limited mobility. The manager said that the toilet was used, however on the day of inspection a hoist was being stored in the bathroom making access to the toilet very difficult. The linen cupboard was noted as not having a lock on it. This presents as a potential fire hazard. The fire exit in the new extension was locked but the key was not easily accessible. The manager made arrangements to resolve these issues during the inspection. Higham House DS0000045316.V375998.R01.S.doc Version 5.2 Page 20 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27,29,30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by a dedicated and caring staff team. EVIDENCE: Our expert by experience noted, “I observed the staff being very caring and very patient with all residents. I have no doubts about the quality of direct care.” He also commented that when he asked the relatives that he spoke to what they liked about the home all replied “The staff.” The recruitment of staff is well managed with all of the necessary pre recruitment checks being carried out to ensure that staff are suitable to work with older people. Staff told us that they had an induction when they first started working at the home which included working alongside an experienced colleague to make sure Higham House DS0000045316.V375998.R01.S.doc Version 5.2 Page 21 that they had all of the information that they need to do their job in the right way. Staff explained that they attend training courses such as food hygiene, safeguarding of adults, dementia care, infection control, fire safety and moving and handling. Staff told us that they had a test at the end of the training to ensure that they had learnt all of the information that they needed to know. Certificates from the training courses that staff attend are displayed on the wall in the hallway of the home. Staff spoken to had a good knowledge of how to safeguard adults and their responsibilities under the locally agreed procedures. Higham House DS0000045316.V375998.R01.S.doc Version 5.2 Page 22 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 33,35,38 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The acting manager is aware of the improvements needed and is seeking to develop the home in the best interests of the people who live there. EVIDENCE: The home does not currently have a registered manager. The acting manager is a registered nurse and holds a registered manager award. Higham House DS0000045316.V375998.R01.S.doc Version 5.2 Page 23 The manager told us that she was aware of the work still needed on the environment and showed us a maintenance plan which had been devised to prioritise the work needed to the environment. The manager explained that she attempts to carry out an audit on the care plan every month. The last care plan audit completed was December 2008. Records show that the necessary safety checks such as fire checks, checks on the water system and portable appliance testing have all been carried out recently. Hoists and lifting equipment has been serviced as per manufacturer’s recommendations. The manager told us that the home carries out a satisfaction survey twice a year. The results were viewed and were generally positive. One relative commented “staff were super, manager very helpful and supportive.” another said “We would recommend Higham House to anyone looking for a home for their loved ones.” Where issues had been raised in the surveys the manager had recorded a note on the survey to show how the issue had been addressed. Higham House DS0000045316.V375998.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X n/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 X X X X X X 3 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 X X 3 X 3 X X 3 Higham House DS0000045316.V375998.R01.S.doc Version 5.2 Page 25 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. Standard OP7 Regulation 15 Requirement Individual plans of care must contain sufficient detail to enable staff to meet people’s full range of needs and be reviewed at least monthly to ensure that all information is up to date. The storage of any potentially hazardous substances must be risk assessed to ensure that any risks to individuals are reduced to an acceptable level. The laundry cupboard must be kept locked when not in use to ensure the health and safety of everyone in the home. Fire exits must be easily accessed to ensure the health and safety of everyone in the home. Hoists and other equipment must be stored in a suitable place when not in use so as to not restrict people’s access to facilities. The statement of purpose must specify any bedrooms that have little natural light to ensure that people have the correct information about the home. DS0000045316.V375998.R01.S.doc Timescale for action 31/08/09 2. OP38 13 31/07/09 3. OP38 23 12/06/09 4. OP38 23 12/06/09 5. OP38 23 12/06/09 6 OP1 4 31/07/09 Higham House Version 5.2 Page 26 7. OP19 23 8. OP18 17 The outside area must be free from hazards to ensure the health and safety of People who want to use it. Where people use reclining chairs an assessment must be carried out to ensure that this is in their best interests and does not restrict their liberty. 31/07/09 31/08/09 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 OP1 OP12 Good Practice Recommendations The service user guide should be available to people in an accessible format. People would benefit from a more structured programme of activities linked to their hobbies and interests. Higham House DS0000045316.V375998.R01.S.doc Version 5.2 Page 27 Care Quality Commission Eastern Region Care Quality Commission Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Higham House DS0000045316.V375998.R01.S.doc Version 5.2 Page 28 - 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!