Inspection on 21/06/06 for Hilbre House

This inspection was carried out on 21st June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hilbre House 02/06/08

Hilbre House 05/12/07

Hilbre House 29/05/07

Hilbre House 12/12/06

Hilbre House 28/02/06

Hilbre House 09/12/05

Hilbre House 18/02/05

Hilbre House 21/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Hilbre House St Margarets Road Hoylake Wirral CH47 1HX Lead Inspector Leila Mavropoulou Key Unannounced Inspection 21st June 2006 11:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 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 House DS0000018896.V290078.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hilbre House Address St Margarets Road Hoylake Wirral CH47 1HX 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 6781 Mrs Della Haynes-McManus Dr Francis Bernard McManus Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th February 2006 Brief Description of the Service: Hilbre House is a large detached property overlooking the river in the Hoylake area on the Wirral. It provides support and personal care to twenty-seven service users. The accommodation is provided in single bedrooms all with ensuite facility. The home is staffed throughout the day and night. The home has a sitting room, large dining room and conservatory on the ground floor. All parts of the home are easily accessible by a passenger lift. The fee level at the home varies depending on the bedroom accommodated. The home has assisted baths and passenger lift to promote the safety and independence of the service users. Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which lasted five hours. During the inspection, various records were inspected such as: service users records, fire records and staff files. Also, inspection of the building was carried out and four service users, two staff members and the acting manager were spoken to. What the service does well: What has improved since the last inspection? Since the last inspection the following improvements were noted: The service users user plans have been reviewed and are now easy to read and give staff instructions on how care should be delivered to service users. The recording of service users medication records has improved significantly. Staff and service users meetings have been held and it is planned that these would be held on a quarterly basis. The Statement of Purpose has been reviewed and is currently in draft, to ensure that it includes all of the information required. It is easy to read to promote service users understanding of its content. Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 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. Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 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 House DS0000018896.V290078.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5, “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” Prospective service user needs are assessed before admission to the care home to ensure that the service would be able to meet their needs. EVIDENCE: The Statement of Purpose has recently been reviewed to make it easier for service user to read and to provide relevant information to enable service users to make an initial assessment regarding the suitability of the service. All service users are given written terms and conditions of their stay at Hilbre House and notice of any fee increase is given to service users one month in advance of the increase. The fees at the care home differ depending on the bedroom to be occupied £375- £395. The manager from Hilbre House would assess the needs of prospective service users before offering place at the home. This was evidence on the day of the inspection as the acting manager was going out to carry out an assessment of a prospective service user and in the service Statement of Purpose. Completed Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 Page 9 pre-admission assessment forms in service users files examined confirmed that service user needs are assessed before admission to Hilbre House. Where possible service users are supported and encouraged to visit the service before making a decision about the suitability of the home. The staff have the necessary knowledge and skills to meet the physical needs of service users. However, difficulties may arise on occasions due to the lack/poor communication between service users and staff due to language differences as English is not the first language for many staff. Where the registered provider identify that staff language could affect the delivery of care provided to service users, staff are provided with classes to improve their English. Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 Page 10 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): 7,8,9,10,11 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” The staff at Hilbre House regularly review and monitor the health needs of service users and where necessary obtain advice from other specialist health professionals. EVIDENCE: The service user plan format has been revised. All service users have a completed service user plan using the new format. The service user plans and risk assessments are more detailed and easy to understand. The manager must ensure that wherever possible, the service user or their family is involved in the development of the plan. Service users health needs are met by regular visits by the GP, district nurse input, outpatient appointments to various health clinics and six weekly visits by the chiropodist etc. Observation during the inspection showed that service users family are supported and encouraged to participate in the care provided Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 Page 11 as evidence by the family member being present at the optician domiciliary visit. The district nurse provides pressure relief aids after assessment to prevent service users developing pressure areas. Examination of service users files and discussion with the manager confirmed that service users health needs are reviewed regularly by specialist health professionals, either through outpatient visits or visits to the home. Staff from the care home would accompany service users to outpatient visits, where a family member is unable to do so The service users medication records have improved significantly since the last inspection and records were well maintained. Service users are supported to administer their own medication if they wish and are assessed at competent to do so without causing harm to themselves or others. Where service users are administering their own medication this should be reflected in their care plans and systems must be in place to monitor this. A lockable space must be provided in service user bedroom for those that are administering their own medication to promote safety. Bedrooms at Hilbre House are single occupancy, which vary in size. The size of the room is reflected in the service user weekly fee. All bedrooms have a toilet en-suite facility. Some service users have a direct telephone line in their bedroom to promote independence and emotional well being. Other service users have access to the home’s cordless telephone, which promotes their privacy. Observation during the inspection showed that the service users are treated with respect and dignity through the manner in which staff spoke to the service users, by knocking on doors before entering their bedroom and the way assistance is provided with personal care. Observation of service users showed that they were well presented and dressed to reflect their taste and preferences such as the use of make up. The hairdresser visits once a week, which service users spoken to said they enjoyed her visit. Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 “Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service.” Service users social and recreational needs are not met because of dependency level of service user and existing staffing level. EVIDENCE: Observation of service users showed that they exercise a high degree of choice over their daily lives such as: choosing where to have their meals, whether to spend time in their bedroom or in the communal areas, time of getting up and going to bed etc. The revised service users plans reflect service users social needs and interests before moving to Hilbre House. However, the information in the service user plan is not reflected in the day-to-day practice, for all service users. Discussion with the manager said that sometimes service users are taken to the local shops and staff would provide some activities for service users to participate in. However, this is limited to staff free time, as the needs/dependency level of service users appears to be increasing. Service users participation in activities should be recorded to demonstrate that their Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 Page 13 social needs are met. “Talking books” are provided to some service users through a volunteer that visit the service regularly to change books and tapes. Service users are able to choose where to see their visitors and the home has an unrestricted visiting policy. Some service users access community facilities independently. The manager and examination of a sample of service users files confirmed that service users or their representative manage their finances. Service users are able to personalise their bedroom with their own furniture if they wish, as evidenced through a tour of the building. The kitchen has recently been refurbished. The lunchtime meal was well presented even though the cook was not on duty. Service users spoken to spoke highly of the quality of food provided at Hilbre House. Wherever possible fresh produce is used in meal preparation and very little pre cook/frozen food is used. Meals are balanced, varied and well presented. Records are kept of all food provided to service users and fridge and food temperatures are maintained to promote the health and safety of the service users. Currently, none of the service users require assistance at mealtimes. Discussion with the service users and staff confirm that the home would cater for service user that requires a special diet. Currently, two service users have a sugar free diet. The kitchen refurbishment is completed. Service users dietary intake is monitored and service users are weighed regularly to monitor their weight gain/loss. Observation of lunch showed that mealtime is unhurried and staff support service users discreetly to ensure their dietary intake. Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 “Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service.” Service users safety and wellbeing could be improved by the registered provider compliance with its statutory requirement. EVIDENCE: Discussion with service users showed that they know who to make complaints to and felt that they would have the staff support to do so. Discussion with the manager indicated that no formal complaints have been received and any concerns raised by service users or their representatives are dealt with immediately. The manager should keep a record of all concerns raised by service user or their representative and how the issue was resolved. The home’s complaints procedure is displayed in a prominent position. Service users vote either through postal voting or by staff arranging for them to be taken to the polling station. Information on independent advocacy services should be easily accessible to service users and their representatives. To date staff have not received training on managing physical and verbal aggression. The registered person must ensure that staff receive training on identifying and understanding abuse and are aware of the Wirral Adult Protection Procedure to promote service users safety and the home’s procedure on allegations of abuse. The registered person could minimise risk of abuse by ensuring that all staff are appropriately vetted before commencing employment at Hilbre House by obtaining a Criminal Records Bureau Check or a Protection of Vulnerable Adult check. Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 Page 15 Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 Page 16 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 in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” The quality of the accommodation at Hilbre House is good and there is ongoing renewal and maintenance to maintain the quality of the environment. EVIDENCE: The home has an ongoing maintenance and refurbishment programme. The refurbishment of the kitchen has been completed. A maintenance person has been employed to carry out routine maintenance work. The fire officer visited the home recently and the recommendation of the fire officer is being addressed. These are: some of the bedroom door are not closing properly and the closing devices needs adjusting to ensure that they close better to provide adequate fire resistance/protection. The fire officer has recommended that the gap in the ceiling in the electrical room be filled with expandable foam to minimise fire travelling to the first floor. A passenger lift enables service users to access the bedrooms on the first and second floor easily. There is a call system in every bedroom and en-suite, which was tested and found to be working order. Hilbre House promote Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 Page 17 service users safety and independence by providing aids such as: - grab rails, raised toilet seat etc. The home has a large sitting room, conservatory and dining area on the ground floor. Some service users like to sit in the area by the front door, which has comfortable chairs. Service users bedroom reflect their needs and preference e.g. one service user has a double bed, whilst others have brought into Hilbre House some of their furniture to personalise their bedroom. All of the bedrooms are single occupancy. The bedroom furniture in some bedrooms should be replaced through the home’s planned renewal and refurbishment programme. Some of the bedrooms do not have a lockable space for service users to keep their valuables or their medication if they choose to administer their own medication. All bedrooms have an en-suite toilet facility and toilets are located close to the communal areas. The home has assisted baths to promote the safety and independence of the service users. The home is centrally heated. All of the bedrooms are bright and well ventilated. There is emergency lighting throughout the home, which is tested and serviced at regular intervals. Risk assessments for bathrooms have been completed and staff are required to test the temperature of the hot water before a service user get into the bath. Hot water temperature checks must be carried out at regular intervals and record kept to promote the safety of service users. The registered person must ensure that the hot water temperature at outlets used by service users is as close as possible to 43 degrees centigrade. Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 Page 18 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 in this outcome area is poor. This judgement has been made using available evidence including a visit to this service.” The staff recruitment procedure does not promote the safety and well being of service users as Criminal Record Bureau checks and references are not obtained prior staff commencing their employment at Hilbre House. EVIDENCE: At the time of the inspection, there were two care staff and the manager on duty. However, the manager was not on the premises when the inspector arrived in the morning and in the afternoon was not available as she was carrying out a pre-admission assessment, leaving two care staff for a large part of the day to provide the necessary care and supervision to service users. There is a noticeable increase in dependency needs of service users. In addition the layout of the building, which is widespread makes it is difficult to meet the of service users with only two staff. There were other persons on the premises. However, they are employed to work with service users. The staffing level must be reviewed to reflect the dependency level of service users. Also, where there it is known that a member of staff would be required to be off the premises additional care support must be made available to ensure that the staffing level remains appropriate. Generally, the home is well kept and clean. However, two of the bedroom had a malodour. Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 Page 19 The staffing records seen showed that they were incomplete and did not comply with the Care Homes Regulation 2001. Many staff did not have a Criminal Records Bureau (CRB) check or Protection of Vulnerable Adult (POVA) check in the absence of the CRB check to promote the safety of service users. In some instances, CRB were on the staff record, but were not obtained by Hilbre House. Also, two written references were not obtained for all staff. These must be obtained before the employee employment commences at the care home. It is noted that application for some staff CRB have been made. The registered person must ensure that all staff records have the necessary records as required by the Care Home Regulation 2001 by the given timescales, as this has been an outstanding requirement of the past two inspections. Continued failure to comply with the requirements may a result in enforcement action by the Commission. The staff files did not show clearly training provided to staff. The registered person must ensure that an accurate record is kept of all staff training provided. Discussion with the manager indicated that staff appraisals have started and once appraisals are complete, a staff-training plan would be develop. Currently, none of the staff are working towards the NVQ care award. The manager must keep a record of all training provided to staff to evidence that they are provided with three paid training days a year to satisfy the requirement of the National Minimum Standards for Older People. Staff files examined showed inconsistency with induction given to staff. The registered provider must ensure that staff have the necessary knowledge to meet the needs of service users in accordance with the home’s health and safety procedures. The registered person should review its induction procedure to ensure that it meet the National Training Organisation specification. Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,34,35,36,37,38 “Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service.” The management of the home must improve to provide consistency of leadership to staff and ensure that the service meet the changing needs of service users. EVIDENCE: A manager’s application to the Commission has been withdrawn. Currently, the registered provider is the process of appointing another manager. In recent months efforts have been made to implement the home’s quality assurance system through service users meetings and draft letters are in place to send to families and others such as: GP, District Nurses and other health professionals to seek their views on the quality of care provided at Hilbre House. The information would be used to improve the quality of the service. Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 Page 21 A current Public Liability Insurance certificate is displayed and a record is kept of financial transactions for accounting purposes. The home does not handle service users monies. Solicitors or family members manage service users monies on their behalf when they are unable to do so. However, where monies and valuables are given to staff for safekeeping a receipt is given. Currently, staff are not receiving individual supervision. Given the staffing level at Hilbre House supervision of staff day to day practice is difficult as the manager is “hands on”. Thus, the time that they have to work alongside or observe staff practice is minimal. The registered person should consider the administrative and managerial role of the registered manager and ensure that time is dedicated to these functions. The registered person must ensure in the absence of the manager another staff member is responsible for the day-today management of the home. The registered provider continues to have an active role in the day-to-day management of the home. However, report of their monthly visits is not forwarded to the Commission. This is an outstanding requirement from previous inspection reports. Improvement in the record keeping at Hilbre House is being maintained. Observation of service user records showed that they are kept in a secure place. Service users and their family have access to their records in accordance with the service Access to Records policy. The registered provider must ensure that staff training in the following areas is current: - food hygiene, fire awareness, load management and first aid are up to date. The health and safety of service users is promoted through regular checks and servicing of equipment used at the care home. A record is kept of accidents to service users and staff at the care home and where necessary the Commission is informed. Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 Page 22 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 2 3 3 3 X 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 3 18 2 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 3 3 2 2 2 Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 Page 23 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 OP5 Regulation 5 &17 Requirement Any restrictions placed on service users regarding the use of alcohol, drugs and smoking must be included in the Service User Guide. The registered person must ensure that service user plan is discussed and reviewed with the service user or their representative where possible. The registered person must ensure that a record is kept of service users medication received into the care home. The registered person must ensure that suitable recreational and social activities are provided for service users. The registered person must ensure that all staff receives training on understanding abuse. The registered person must ensure that all staff receives training on the management of physical and verbal aggression. Timescale for action 28/08/06 2 OP7 15 30/07/06 3 OP9 13 & 17 28/07/06 4 OP12 16 30/08/06 5 OP18 18 28/08/06 Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 Page 24 6 OP19 23 The registered person must ensure that the recommendation made by the fire officer regarding the bedroom door closures and the gap in the electrical room ceiling is completed within the given timescale. The registered person must ensure that at all times suitably qualified and competent persons are working in the care home in such numbers as appropriate for the health and welfare of service users. The registered person must ensure that all staff have two written references, two pieces of identification on their file a Criminal Record Bureau check, a job description and a terms and conditions of employment. The registered person must ensure that all staff receive the necessary training to carry out their roles and responsibilities and that a record is maintained of all training provided to staff such as: staff induction. 30/07/06 7 OP27 18 15/08/06 8 OP29 17 30/08/06 9 OP30 17 &18 30/08/06 10 OP31 8 11 OP33 26 The registered person must 30/08/06 appoint a manager who is responsible for the day-to-day management of the home. The registered person must visit 30/08/06 the home monthly and compile a report on their findings regarding service user records, recruitment, service users finance etc. and forward a copy of the report to the Commission. The registered person must ensure that staff receives appropriate supervision. DS0000018896.V290078.R01.S.doc 12 OP36 18 30/08/06 Hilbre House Version 5.1 Page 25 13 OP37 17 The registered person must 30/08/06 ensure that the records that records relating to service users, staff and other statutory records are maintained in accordance with the Care Homes Regulations 2001. The registered person must provide training to staff to promote their health and welfare i.e. training in: fire awareness, moving and handling, first aid, and food hygiene. The registered person must ensure that the hot water is checked regularly to ensure that the hot water is close to 43 degrees centigrade and tests for Legionella is carried out. 30/08/06 14 OP38 13 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 OP8 OP12 OP16 OP17 OP24 Good Practice Recommendations The registered person should show in the service user plan input by district nurses etc in the delivery of service user care. The registered person should provide information about local events, which service users could access. The registered person should keep a record of all concerns raised by service users and how they were resolved. The registered person should have details of local advocacy services, which service users and their representatives could access. The registered person should provide a lockable space in each of the service user bedroom to promote their right to privacy. The registered person should ensure that all staff receives DS0000018896.V290078.R01.S.doc Version 5.1 Page 26 6 OP30 Hilbre House at least three paid training days a year. Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Hilbre House DS0000018896.V290078.R01.S.doc Version 5.1 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. 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