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Inspection on 16/06/06 for Hillcrest Residential Home

Also see our care home review for Hillcrest Residential Home for more information

This inspection was carried out on 16th 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The manager is very dedicated and caring. Both she and care staff are all approachable and friendly. The recording in the daily statements about residents in the home is good and shows what care had been provided and by whom. Care staff were seen to be respectful and preserve dignity. The home is comfortable and on a smaller scale than some care homes and therefore has more of a domestic feel. Two sets of visitors to the home were very complimentary about the food and one visitor said they would recommend the home as it provides all the care you need. Comment cards received from residents and relatives/visitors expressed a generally positive response to questions asked.

What has improved since the last inspection?

The home has made significant progress upon requirements made in January 2006 and those from November 2005. Care plans were of good quality and up to date. The complaints procedure was available to be seen on the wall and as part of the Statement of Purpose. A process for recording and dealing with complaints was in place. As was an effective quality assurance system to monitor the running of the home, this was based upon views from residents and their families. Practice relating to staff had improved. Recruitment of staff was better along with the training that had been supplied and planned to take place.

What the care home could do better:

An immediate requirement was left with the manager. Hot water temperatures for bathing were measured as so high that there was a possible hazard from scalding. The CSCI will monitor the response from the home to ensure this risk is reduced. The home needs to focus on the developing a better range of pastimes for the resident group, based upon their preferences. Feedback from residents and relatives felt this could be improved. More information on residents` wishes at the end of their lives would ensure that appropriate support is given. In relation to staffing the manager must produce a plan of training and development for each staff member that should be part of formal supervision of which there was no evidence. Recruitment files though improved must have two references in each case. Minor repairs need more prompt attention.

CARE HOMES FOR OLDER PEOPLE Hillcrest Residential Home 14 Northgate Avenue Bury St Edmunds Suffolk IP32 6BB Lead Inspector Claire Hutton Unannounced Inspection 16th June 2006 09:45 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 Hillcrest Residential Home DS0000024417.V294962.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. Hillcrest Residential Home DS0000024417.V294962.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hillcrest Residential Home Address 14 Northgate Avenue Bury St Edmunds Suffolk IP32 6BB 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) 01284 760774 Mr Christopher J and Mrs Magda Hope Mrs Magda Hope Care Home 13 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (13) of places Hillcrest Residential Home DS0000024417.V294962.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1. One named individual to be accommodated with dementia (DE) (E) as detailed in the application for variation dated 16/06/05 8th November 2005 Date of last inspection Brief Description of the Service: Hillcrest Residential Home is a privately run care home based in a Victorian property that has been extended and adapted to provide residential care since 1997. Hillcrest is registered under the provisions of the Care Standards Act 2000 and can accommodate up to 13 older persons, one of whom has a diagnosis of dementia. The home is located in a quiet residential area of Bury St. Edmunds. It is close to a small shop that is accessible to some residents. Hillcrest provides two single bedrooms and one double bedroom on the ground floor along with nine single bedrooms on the first floor. Access to the first floor is by stair lift. There is a step between the lift and the bedrooms, which may prove difficult for service users with mobility difficulties. One of the bedrooms benefits from the provision of en-suite facilities. There are two communal assisted bathrooms and five assisted toilets within the home. Residents have access to a lounge that overlooks the pleasant garden with seating provided. There is also a separate dining room on the ground floor. Smoking is not permitted at the home. Hillcrest Residential Home DS0000024417.V294962.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 key inspection that focused upon the core standards relating to Older People. It took place on a weekday between the hours of 9.45am and 3.45pm. A second inspector accompanied the Lead Inspector. The process included a tour of the building, discussions with residents, staff and the manager who was present all day, observations of staff and service user interaction, and the examination of a number of documents including residents care plans, medication records, the staff rota, recruitment, training records and records relating to health and safety. The report has been written using accumulated evidence gathered before and during the inspection. Five completed comment cards were received back from relatives/visitors and five completed surveys were received back from the current resident group. A previous additional visit was made to the home on 18th January 2006. A number of requirements were made at that time of the home mainly relating to staff matters. What the service does well: What has improved since the last inspection? The home has made significant progress upon requirements made in January 2006 and those from November 2005. Care plans were of good quality and up to date. The complaints procedure was available to be seen on the wall and as part of the Statement of Purpose. A process for recording and dealing with complaints was in place. As was an effective quality assurance system to monitor the running of the home, this was based upon views from residents and their families. Practice relating to staff had improved. Recruitment of staff was better along with the training that had been supplied and planned to take place. Hillcrest Residential Home DS0000024417.V294962.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. Hillcrest Residential Home DS0000024417.V294962.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 Hillcrest Residential Home DS0000024417.V294962.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 and 3. Standard 6 does not apply. Quality in this outcome area is good. Residents can expect all their needs to be properly assessed before they move into the home, with information about the home available. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A revised Statement of purpose and Service Users guide were sent to the CSCI at the end of 2005 and these were found to be suitable and meet the regulations. Mrs Hope confirmed these were still in place and had not been further revised. A copy was available at the home for inspection. Comment cards and surveys returned from residents and relatives/visitors all indicated that a contract with terms and conditions was in place. The manager was able to evidence contracts at the home during the visit. Records relating to four residents were examined. One resident had been admitted direct from a hospital in London. Although the home had not done their own pre-admission assessment, there was a comprehensive report from the hospital social worker. The home had then compiled an assessment of Hillcrest Residential Home DS0000024417.V294962.R01.S.doc Version 5.1 Page 9 needs on the day of admission. This included a dependency assessment, and physical health and falls risk assessment. The three other newly admitted residents had received a pre-admission assessment and these were available for inspection. Hillcrest Residential Home DS0000024417.V294962.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 and 11 Quality in this outcome area is good. Residents can expect that care plans are developed to ensure that needs are met. Timely referrals to health care professionals are made. Residents are protected by the home’s medication procedures. Residents are treated with dignity and respect, although more information on residents’ wishes at the end of their lives would ensure that appropriate support is given. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four care plans of current residents were examined and their care was tracked, including observing them, observing staff working with them, and discussing their care with their key worker if available. The care plan included clear instructions to staff on actions to enable the resident to be cared for appropriately, for example by giving them time to express themselves, ways to improve their fluid intake and to maintain their personal hygiene, and ways to support a resident when moving due to restricted vision. Staff were heard to be using these methods during the visit. Hillcrest Residential Home DS0000024417.V294962.R01.S.doc Version 5.1 Page 11 One resident told the inspector that the staff did try to get them to eat properly. This person admitted that they did not wish to receive certain treatments, and was not always co-operative in following staff suggestions for improving their health. The other three care plans were all on a similar pattern, including one person who was resident admitted for two weeks respite care. None of these included any information concerning the wishes of residents regarding terminal care and arrangements after death. Records of visits by health professionals were recorded. All four had regular visits from the District Nurse for dressings and blood specimens. References to the need for referral to a specialist service in the assessments were all followed up and records made of the outcomes. All plans were reviewed regularly, at least monthly and all reviews were signed and dated. Staff were observed knocking on residents’ doors before entering, and discreetly checking other episodes of personal needs. Medication checks showed that the medication administration record (MAR) charts were all correctly and fully completed, and tallied with the medication administered on the day of inspection. The person receiving respite care selfmedicated their injectable insulin. Staff were alerted to check that this had been taken each time. On the day of inspection, this had revealed that an injection had been missed, as the person admitted. There was evidence available that staff who administered medication were adequately trained. Hillcrest Residential Home DS0000024417.V294962.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 and 15 Quality in this outcome area is adequate. Residents independent enough to develop their own pastimes can expect to be satisfied, but those who wish to have activities supplied may be dissatisfied. Contact with family and friends can be maintained, as is a degree of control over ones life. Catering at the home is of an acceptable standard. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In terms of social activities at the home there had recently been a clothes company visit and some residents had chosen new clothes. A staff member confirmed that once every two months there is a reminiscence session for residents to take part in, once a month a local artist visits and sessions such as art, music or indoor gardening is held for residents. However most of the dayto-day activities on offer were said to be on a one to one such as board games or reading a paper. One resident had an interest in jigsaw puzzles while another was very absorbed in watercolours. In the lounge there is a TV as there is in most bedrooms. From the comments received from residents, relatives/visitors, three residents would like to have more social activities provided for them. Hillcrest Residential Home DS0000024417.V294962.R01.S.doc Version 5.1 Page 13 During the day of inspection four visitors were seen to come to Hillcrest. Two sets of visitors spoken with said that staff were always welcoming. They also felt that the person they were visiting was well cared for. Two visitors spoke of how good they thought the food was, ‘the smell of food is always good’. From the five comment cards received back by the commission four were complimentary about times of visiting, privacy, communication and staffing levels. One comment received was ‘good food, hair washed and set, looking much better, but could be consulted more about care’. In terms of how much choice and control over ones life a resident has at Hillcrest, what was observed is that residents do have choice to lead an individual life, even though decisions may be thought of as unwise. Examples of choice and control include: A resident had made a positive choice to refuse certain treatments. This was documented in their care plan. This person also said that they did not want a locked drawer in their room to keep their money in. The resident said they kept it where they knew they could find it, as they were worried they might forget its location otherwise. Another resident had someone described in their file as an advocate who had Power of Attorney. Staff were seen to be supportive but respect choices made by residents. From the five responses received from residents all five stated that they received care and support they needed either ‘always’ or ‘usually’. When asked the question; Do staff listen and act upon what you say? Again all five responded ‘always’ or ‘usually’. The meal on the day was fish and chips; this was seen to be enjoyed by the majority of the residents. In the kitchen there was a menu planner set out which was generally stuck to. This planned a variety of traditional home cooked food. Recently residents were said to have requested curry, so a change was made. There was a record of food chosen which included an alternative choice on some occasions. Storage, cleanliness and amounts of food were appropriate. From the five responses received back from residents two stated that they only ‘sometimes’ liked the meals at the home. Hillcrest Residential Home DS0000024417.V294962.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 and 18 Quality in this outcome area is good. Residents and others can expect that complaints to be listened to and taken seriously. The home has in place strategies to protect residents from abuse as far as is possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure in place and this is part of the Statement of Purpose and Service Users Guide. Information on how to make a complaint is displayed at the home. A form outlining the complaints procedure and how to complain has been left in every resident’s room along with an addressed envelope. Despite these efforts three sets of relatives/visitors state that they were unaware of how to make a complaint should they need to. The home has not received any complaints since the beginning of the year, when the commission received one complaint. This was investigated and found not to be upheld. The home has a protection of adults procedure in place. At the end of 2005, beginning of 2006 an allegation was made relating to the protection of a resident. This was investigated by the appropriate agencies and found not to be upheld. Since that time the home have been seen to further improve their understanding of such matters. There is a reporting format now in place that is known and available to staff. Staff have under gone training in this area and evidence of certificates was seen. Recruitment files examined for five staff showed that they had all had a CRB (criminal records bureau) before they took up their posts at the home. Hillcrest Residential Home DS0000024417.V294962.R01.S.doc Version 5.1 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 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 and 26 Quality in this outcome area is good. The environment at Hillcrest is comfortable and generally meets the needs of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the whole home was made visiting, (save for one bedroom), communal areas, kitchen, laundry and garden. The entire home was clean, pleasant and hygienic. The home has sufficient toilets conveniently placed around the home. There are two assisted bathrooms and one shower room. There were two matters of minor repair outstanding. There were tiles needing to be repaired in the shower room (the manager had taken reasonable steps to ensure this was no hazard to residents) and a panel in a toilet that was in need of repair as moisture and paint loss had affected the area. Bedrooms were suitable for residents with personal possessions in them. Hillcrest Residential Home DS0000024417.V294962.R01.S.doc Version 5.1 Page 16 The home has a pleasant garden at the rear and the manager was putting plant pots out to the front of the home. A resident and relatives were seen to use the garden as it was a sunny day, however for most of the residents they would be unable to access the garden as there was not level access from the lounge area. The stair lift was seen in operation, a member of staff supported residents’ use of the equipment. A notice of how to use the stair lift safely was posted at each end of travel for additional safety. Risk assessments relating to the use of this equipment was seen. Hillcrest Residential Home DS0000024417.V294962.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. Residents can expect to be supported by appropriate ratios of care staff that are generally well recruited and have reasonable access to training with more training planned. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The current weeks roster and the planned roster were examined. Since the last visit to the home new staff have been recruited. Staffing levels were acceptable with generally three staff in a morning and two in an afternoon. At night there is an awake carer and a person designated on call. In addition there was a cook who works full time, though they were not noted on the roster and should have been. Two senior care staff had evidence of NVQ 2 and 3 completed. A third staff member was completing their NVQ 2. Two staff had evidence of their TOPPS induction that they were completing through Kerrison training centre. Each had certificates for value base in care, skills development and adult protection. The previous day they had attended manual handling training and had a date in September to attend food hygiene training. In addition the manager had plans for two people to attend dementia care training at Otley College and four staff to attend first aid training at Kerrison. Though there is no formal written plans in place to show what training is required and planned (this should be put in place) it was obvious that thought and planning had taken place around training for staff. Hillcrest Residential Home DS0000024417.V294962.R01.S.doc Version 5.1 Page 18 The recruitment records for five care staff were examined. These records have improved and applications, photographic identity, CRB check and references were seen to be in place for all, except for one reference for one person. Hillcrest Residential Home DS0000024417.V294962.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 Quality in this outcome area is poor. The management of the home is improving, and previous shortfalls are being addressed. Evidence of appropriate staff supervision should be developed. Residents cannot be assured of their safety with regard hot water temperatures, as currently there are poor safeguards in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager was helpful to the inspectors and along with staff comment and residents comment concludes that their approach is one of kindness and a genuine wish to care for older people. Staff and residents found the manager approachable and that they listened. One service user said ‘she’s not like a boss, she’s approachable’. Hillcrest Residential Home DS0000024417.V294962.R01.S.doc Version 5.1 Page 20 The manager has the appropriate experience to work with older people having worked in this area for several years. They were RGN qualified, but has not kept up their registration. They had started their NVQ 4 and the registered managers award, but was no longer enrolled and doing the course. Upon discussion the manager agreed to find another training provider and enrol promptly and then notify the commission of the expected timescale for obtaining the relevant qualifications. Since the last inspection there has been thought and development in creating a quality assurance system within the home. An envelope is now left in each bedroom for a new resident. The envelope has a letter of explanation with some forms to receive compliments and concerns/complaints about the home. No complaints had been received but three satisfaction surveys had been completed. When asked about other consultation with residents such as residents meetings, the manager explained these currently do not happen, but that chat is more informal tending to be after lunch. The home does hold a small amount of personal monies for resident and this is kept secure with a system of accounting in place. Only one person has access. There is a policy in place. The manager also spoke of enabling a resident to manage their finances independently, but offering advice on not holding too much cash in a bedroom. The manager stated that staff are appropriately supervised and that formal supervision was taking place, however there was no records to support this statement, therefore it was agreed that the manager would record supervision at the time it takes place. Records and policies relating to servicing of equipment – including all hoists, fire, food hygiene inspection, electrical appliances, clinical waste, infection control policies and clinical waste contracts were examined and found to be satisfactory. Hot water temperatures were taken for the two assisted baths. These were higher that expected at 48.7°c and 47.3°c. There was a serious risk of scalding which was discussed with the manager at the end of the inspection. The hot water temperature from wash hand basins in residents’ bedrooms was also recorded as high as 49.6°c. An immediate requirement was left with the manager stating what action must be taken to reduce the risk and action taken must be notified to the Commission promptly. A book containing the temperature of baths taken was kept in one bathroom this recorded all baths for residents as being below the recommended level for hot water restriction. Hillcrest Residential Home DS0000024417.V294962.R01.S.doc Version 5.1 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 3 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 2 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 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 2 X 1 Hillcrest Residential Home DS0000024417.V294962.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP12 Regulation 16.(2)m Requirement Residents must be consulted and a suitable programme of activities must be provided based on the outcome. Any staff member working at the home must be shown on the roster, including their designation and hours worked. Residents must be protected by the home’s recruitment practice, therefore there must be a second reference taken on the one staff identified. The registered manager must notify the commission about timescales for becoming appropriately qualified. The registered manager must ensure staff at the home are appropriately supervised. The registered manager must ensure so far as is reasonably practicable the health safety and welfare of service users therefore: DS0000024417.V294962.R01.S.doc Timescale for action 24/07/06 2. OP27 17.(2) schedule 4 7,9,19 24/07/06 3. OP29 24/07/06 4. OP31 9 (2) (b) (i) 24/07/06 5. 6 OP36 OP38 18.2 13.4 24/07/06 23/06/06 Hillcrest Residential Home Version 5.1 Page 23 • • • Notices stating ‘caution hot water’ must be posted. An appropriate risk assessment must be completed. Pre-set valves of a type unaffected by changes in water pressure and which have a fail save device must be installed to deliver hot water around 43°c. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP11 Good Practice Recommendations More information on residents’ wishes at the end of their lives should be available and this would ensure that appropriate support is given. All residents should be consulted on the menus and meal times and changes made based upon these outcomes. A plan to make level access from the lounge to the garden should be considered to enable all residents to use the garden area. A training plan for individuals and the home should be in place to ensure regular updates and residents’ needs are continuously met. Development of residents meeting should be considered to further involve residents in the running of the home. Topics such as menus and activities identified in this report could be discussed. 2. 3. 4. 5. OP15 OP20 OP30 OP33 Hillcrest Residential Home DS0000024417.V294962.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Hillcrest Residential Home DS0000024417.V294962.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!