Inspection on 12/02/08 for Hilbre Court

This inspection was carried out on 12th February 2008.

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

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

Hilbre Court 20/06/07

Hilbre Court 20/02/07

Hilbre Court 21/06/06

Hilbre Court 01/03/06

Hilbre Court 07/11/05

Hilbre Court 01/02/05

Hilbre Court 28/06/04

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

CARE HOMES FOR OLDER PEOPLE Hilbre Court 2 Barton Road Hoylake Wirral CH47 1HH Lead Inspector Peter Cresswell Key Unannounced Inspection 09:30 12 and 13th February 2008 th 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 Hilbre Court DS0000018895.V359903.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. Hilbre Court DS0000018895.V359903.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hilbre Court Address 2 Barton Road Hoylake Wirral CH47 1HH 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) 0151 632 2220 Mrs Delrose Haynes-McManus Miss Tracey Dawson Care Home 14 Category(ies) of Dementia - over 65 years of age (14) registration, with number of places Hilbre Court DS0000018895.V359903.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The number of persons for whom residential accommodation (with both board and care) is provided at any one time is fourteen (14). Only elderly persons with mental disorder may be accommodated. Date of last inspection 20th June 2007 Brief Description of the Service: Hilbre Court is a large detached property with a pleasant, secluded garden at the rear. The seafront is a short walk from the home with public transport and shops in Hoylake town centre a little further away but still within walking distance. The home provides care and personal support for fourteen older persons with dementia. There are eight single rooms and three that can be shared, all of them with an en-suite toilet facility. There is a passenger lift to the first floor. On the ground floor there are two lounges and a separate dining room. A three bedroom extension has been built and at the time of the site visit a decision on an application to register the home to care for additional people was still under consideration by the Commission for Social Care Inspection. Some additional internal improvements were made at the same time, in particular the addition of a ground floor shower room. Fees for Hilbre Court range from £380 to £450 a week. Hilbre Court DS0000018895.V359903.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 1 star. This means the people who use this service experience adequate quality outcomes. This inspection included two unannounced site visits. First of all, a CSCI pharmacist inspector visited for two and a half hours, followed a day later by a Regulatory Inspector and a Regulation Manager. The pharmacist inspector examined all aspects of the home’s medication procedures. On the second day we looked at all parts of the home, spoke to the Registered Manager, the owner (the registered person), several residents, staff and a relative who was visiting the home. We examined documents, including care plans, reviews, daily reports, fire safety documentation, recruitment information, training records and medication. What the service does well: What has improved since the last inspection? A new computer based care planning system has been introduced and is currently in development. Care plans were more clearly recorded and reviewed. Recruitment records had been improved and the appropriate checks are now being carried out on staff. The building work has been generally completed and the environment was much more attractive than on the occasion of the last visit. A part time activities organiser (he also works at the owner’s other nearby home) has been employed and has begun to arrange some activities based on the expressed interest of the people who live in the home. The manager is no longer doing the cooking, enabling her to concentrate on her management duties. Hilbre Court DS0000018895.V359903.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hilbre Court DS0000018895.V359903.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 Hilbre Court DS0000018895.V359903.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4. Quality in this outcome area is adequate. Residents are assessed before they are admitted, so that the service can meet their needs, though the recording could be improved. The Statement of Purpose and service user guide give prospective residents and their relatives information about the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A revised Statement of Purpose and Service User Guide have been produced and should now be kept under review to ensure that they remain up to date. The copy of the Statement of Purpose that was given to us has anticipated the registration of the additional three places and should not be used until registration has been completed. Pre admission assessments are completed for new residents but in many cases they are not signed or dated. The new computerised care management records system does not include a pre admission assessment but the owner told us that it might be possible to design one to fit in with the new system. For publicly funded residents there were assessments from the appropriate authorities. Hilbre Court does not provide intermediate care so Standard 6 does not apply. Hilbre Court DS0000018895.V359903.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is adequate. Care plans set out how the home meets residents’ needs. Residents’ interests are protected by the efficient storage and administration of medication, though some minor changes are needed. The privacy and dignity of all residents in shared rooms is not adequately protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has introduced a computerised care management recording system since the last inspection. The system provides for detailed care plans and daily recording. It flags up when reviews are necessary. Daily reports are entered by care staff at the PC terminal and cannot be altered retrospectively. Daily reports were quite detailed but were still not always closely linked to the needs set out in the care plan. This is an issue which needs to be addressed in training and supervision. We looked at a number of the new care plans and those that were completed contained appropriate details. There are some teething problems connected with the computer’s speed which the owner told us were being addressed. Reviews are carried out monthly by key workers and were being recorded. More extensive reviews are carried out every six months and these involve the resident, where possible and relatives. Hilbre Court DS0000018895.V359903.R01.S.doc Version 5.2 Page 10 This inspection included a visit from a CSCI Pharmacist Inspector who spent two and a half hours examining the home’s medication systems. The medicine trolley was tethered to the wall in the corridor using a large padlock and extremely heavy chain. The trolley is situated near the new office and public areas and is quite near the front door. We feel that this does not present a big risk as the front door is locked and the trolley is mostly observed by staff in the office and going about their business. As the home is quite small there is not a large quantity of medicines stored in it. There is a metal drug cupboard in the office. It is still used for storage of drugs that are more closely monitored. Only the Temazepam needs to be stored in a controlled drug cupboard (new legislation). The owner, Mrs Haynes-McManus, ordered a controlled drug cupboard during the site visit. We inspected twelve residents’ medication records. Of these eight had no serious problems. Two residents, recently admitted, did not have photographs for identification but these were printed and put in place during the visit. In all there were only five unexplained gaps in the records of giving medicines and four medicines that had been prescribed giving staff the discretion to give according to the residents’ needs where the actual dose given was not recorded to be sure they were not given too many. Records of medicines returned as waste were on the whole fine and there was only one instance of a medicine not recorded when received. This is a big improvement in record keeping. Medicines were managed where possible in the Manrex blister system. These were also well managed. Other medicines in the trolley were not managed so well. There were some eye drops labelled to be stored in a fridge in the trolley. Other eye drops were not marked with a date of opening but were within 28 days of the date of dispensing. Some tablets and cream in the trolley were not currently prescribed for a resident. We were informed that the registered manager had been on a long period of sickness. We did not gain the impression that the nurse/carers who gave residents their medicines were encouraged to take ownership of checking the trolley or having overall control of the medicines in the manager’s absence. We were shown a computerised system of care planning including a medicine profile. We expressed concern that if these records were included, meticulous care would be needed to keep the paper and electronic records up to date. There is now a collection of medicine information supplied by the pharmacy for reference. We would be interested to see how these are used for the benefit of the residents. Overall quality in medicines is now adequate as no residents were identified as having their medicines administered incorrectly and the record keeping had improved a lot. Hilbre Court DS0000018895.V359903.R01.S.doc Version 5.2 Page 11 At the last four inspections we have raised the need to make screens available in all shared rooms to ensure that personal care could be provided in private. There is a screen in only one such room. In response the owner told us that residents remove screens if they are put in. It is possible there has been some misunderstanding here; the Commission is seeking lightweight screens that can be used to provide some dignity when personal care is being provided, but can be stored unobtrusively when not in use. It is certain only not acceptable for intimate personal care to be provided in the sight of other residents. Hilbre Court DS0000018895.V359903.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. Friends and relatives are made welcome in the home, ensuring that residents can remain in touch with friends and family if they want to. A programme of activities to stimulate residents has begun to be put in place. A varied, well-cooked menu is provided, ensuring that residents receive a balanced, nutritious diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An activities co-ordinator has recently been employed to work in both of the owner’s homes and spends around 16 hours a week in Hilbre Court. He has already begun to prepare activities based on the past and present interests of the residents and when we spoke to him showed a good understanding of the needs of people with dementia. He may find useful support from the National Association for Providers of Activities for Older People whose website is Some residents were encouraged to go out on www.napa-activities.co.uk. walks whilst we were in the home. television reception in one of the rooms was very poor and did not provide much enjoyment for the people watching it. Hilbre Court DS0000018895.V359903.R01.S.doc Version 5.2 Page 13 A five week menu was displayed and contained a varied and nutritious menu. We observed lunchtime and the meal was as described on the menu, including a variety of vegetables. It was pleasantly served, with a choice of sweets. Lunch was unhurried and staff helped residents discreetly if they needed help. Relatives and friends are always welcome in the home and we talked to one of the relatives who visited whilst we were there. Hilbre Court DS0000018895.V359903.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is adequate. There is a complaints procedure to ensure that residents and other people can complain if they wish to. Staff are not yet trained in the Protection Of Vulnerable Adults, though plans are in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Hilbre Court has an appropriate complaints procedure. There was a copy of the Wirral inter agency procedures on the Protection Of Vulnerable Adults (No Secrets) in the home. Staff had still not received training in this area but the owner told us that arrangements were being made for it to be provided by Wirral Borough Council. Hilbre Court DS0000018895.V359903.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26. Quality in this outcome area is good. The home is clean, comfortable, well maintained and well furnished. Some minor repairs and replacements are needed to ensure residents’ continued comfort. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Hilbre Court has a homely atmosphere. A new extension providing three extra single en suite bedrooms has been built and the owner has applied to CSCI to increase the number of people for whom the home can provide care. The old, very small, manager’s office has now been converted into a wet room, with a specialist shower. The manager said that the residents enjoy using this facility which is a significant improvement. A new office has been created from part of the larger – less used – lounge. The office has windows overlooking the lounge so blinds have been fitted to ensure the residents’ privacy. The building was generally clean and well maintained. The stairs and upstairs corridor have been re-carpeted. Hilbre Court DS0000018895.V359903.R01.S.doc Version 5.2 Page 16 The bedside cabinets, sofa and beds in the shared ground floor bedroom still need to be replaced, and the owner said that this will be done as the changes to the home are completed. One or two other items of bedroom furniture need to be replaced and again the owner said that this is in hand. The ceiling and wall in room 9 is still badly stained. The manager said that this had been caused by a leak in the roof which has been temporarily repaired though more work may be needed on the roof. The damage does need to be made good and redecorated. The larger lounge is less used by the residents, partly because the smaller lounge overlooks the large, attractive back garden and main corridor. Residents who sit there can see out side and also look at the comings and goings in the corridor and front door. Both lounges are well furnished. The sofas in the large lounge are particularly attractive but are very deep and are not easy for frail residents to use – this should be borne in mind when new furniture is bought in the future. Most bedrooms are bright and spacious, though some need some redecoration and brightening up. Some of them are personalised to reflect the tastes of the residents. Two have French windows leading on to the grounds and one of these is generally used by residents who are especially frail. Most of the bedrooms have ensuite facilities. Three bedrooms are available for sharing, though only two were actually shared at the time of the inspection. It is the owner’s policy that in the future people should only share if they have clearly expressed a wish to do so (such as a married couple or partners). Anyone currently sharing should be given the opportunity to move into a single room should the opportunity arise. The home was generally clean and odour-free. The home has an alarm call system but in two rooms the pull cord had been tied up and would have been out of the reach of the resident. The owner noted this herself and untied the cords. Staff should be reminded that such a practice, if done deliberately, is unsafe and unprofessional. Hilbre Court DS0000018895.V359903.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is adequate. Staff are now appropriately checked before they start work, to help ensure that residents are not at risk from unsuitable staff. Staff are beginning to receive regular training to help ensure their competence. Staffing needs to be reviewed to make sure that there are sufficient staff on duty at all times. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The rota for Hilbre Court provides for three care staff (including the manager or senior carer) to be on duty between 8am and 6pm, after 6pm there are only two carers on duty. At night, which starts at 8pm in Hilbre Court, there is one waking member of staff and one sleeping in. The manager said that the night staffing remains under review and has on occasion been increased to two waking staff if necessary. A cleaner was on the rota for 25 hours a week. Care staff are also expected to do some cleaning. A cook was appointed after the last inspection but did not stay long so until a permanent replacement can be recruited ,cooking is being done by care staff or the owner. The manager no longer has to do the cooking. Staffing has therefore improved but there are still some issues to be addressed, especially in the evenings as two staff is not sufficient for this number of residents. The situation should be reviewed further, especially in the light of the possibility of more residents being admitted and we understand that this is the owner’s intention. Hilbre Court DS0000018895.V359903.R01.S.doc Version 5.2 Page 18 New staff receive induction training and staff have attended a seminar on dementia care given by a consultant psychiatrist. The owner is arranging training on the safeguarding of adults but a full training programme needs to be introduced and the owner has confirmed that a full training matrix is to be drawn up, ‘identifying all training undertaken and next session planned’. Three care staff have NVQ3 and it is intended that others start NVQ2 training but none actually have that qualification yet. The report of the last two inspections pointed out that some of the overseas staff’s qualifications could possibly be officially recognised as equivalent to NVQ and the Registered Person should consult NARIC (the government agency for the recognition of overseas qualifications) at www.naric.org.uk for advice on this issue. A number of staff are now studying for NVQ and one care assistant is studying for NVQ4. Application has now been made for Criminal Records Bureau (CRB) staff checks for all staff and all have received at least clearance against the Protection Of Vulnerable Adults (POVA) list. The owner has told us that she is now using the National Care Homes Association to apply for the checks and they are providing a much improved service. Most of the home’s staff are from overseas and the owner herself visits the country from which many of them are recruited to arrange recruitment and interviews. The manager has started a programme of one to one supervision but this is not yet recorded. Hilbre Court DS0000018895.V359903.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36, 38. Quality in this outcome area is adequate. Relatives are becoming involved in monitoring standards in the home to help ensure quality standards. Health and welfare is protected but a food safety system needs to be introduced. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager has an NVQ3 and is studying for NVQ4 in management. She has a “hands on” style of leadership and communicates her enthusiasm and commitment to her staff. She has started a programme of regular one to one staff supervision but it is not yet recorded. We spoke to a relative who has very recently helped to form a ‘Relatives Support Group’. The group plans to help in reviewing documentation and training and also to carry out regular checks, which they describe as ‘inspections’, of the home. This has the full support of the owner. It is of course early days for this project but it has the potential to be a powerful quality assurance tool to develop and preserve quality care for the people who live in the home. Hilbre Court DS0000018895.V359903.R01.S.doc Version 5.2 Page 20 The Registered Person visits the home several times a week and is closely involved in its management but does not prepare monthly written reports. Fire safety checks are carried out and the names of staff who have received recent fire safety training was recorded. The Fire Safety Officer inspected the home in November 2007 and made a number of requirements all of which the manager said have been completed. Dry food stores are now kept either in the kitchen or in newly built cupboards. Fresh vegetables are kept in nearby Hilbre House. A few minor items in the kitchen cupboard were beyond their use by date. These were not significant items (cinnamon was one example) but it is essential that all food stocks are checked regularly to ensure that nothing is used that may not be fit for consumption. The last report from the Environmental Health Officer stated that the home needed to introduce a food safety management system, preferably the Food Standards Agency programme Safer Food, Better Business, ‘as a matter of urgency’. The manager has now obtained a copy of the system but it has not yet been fully introduced. This has not been done and it should be introduced as soon as possible. In the meantime the fridge and freezer temperatures are recorded every day. Dirty linen has to be taken through the dining room to get to the laundry. This arrangement is not ideal and, as pointed out in June 2006, there should be a written risk assessment as to when and how this is done. No such risk assessment is in place. The manager and the owner said that staff had been told of the correct procedure, namely that laundry should only be taken through the dining area outside of mealtimes and in a container. Hilbre Court DS0000018895.V359903.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x 3 x 3 Hilbre Court DS0000018895.V359903.R01.S.doc Version 5.2 Page 22 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 Timescale for action 01/04/08 2. OP19 23(2) 3. OP27 18(1)(a) 4. OP30 18(1)(c) The registered person must make arrangements for the recording and safe administration of medicines received in the home and therefore the administration of all medication must be accurately recorded so that all medication can be accounted for. All parts of the home must be 01/04/08 kept in a good state of repair so the damage caused by the leak in the identified bedroom must be made good and the broken bedside light must be repaired. The Registered Person shall 01/04/08 ensure that at all times staff are employed in such numbers as are appropriate for the welfare of residents and must therefore review staffing levels. Persons employed in the care 01/04/08 home must receive training appropriate to the work they are to perform, so a full training programme must be put in place. Hilbre Court DS0000018895.V359903.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard OP22 OP24 OP36 OP38 OP38 Good Practice Recommendations Alarm call pull cords must be kept accessible to residents. Privacy screens should be made available in shared bedrooms. The manager should keep a written record of one to one staff supervision. The Registered Manager should carry out and record a risk assessment on the transport of dirty laundry through the dining room to the laundry. The food safety programme ‘Safer Food Better Business’ should be fully implemented, as required by the Environmental Health Officer. Hilbre Court DS0000018895.V359903.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North West Regional Contact Team Unit 1, 3rd Floor d Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Hilbre Court DS0000018895.V359903.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. 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