Inspection on 24/04/08 for Hillfield Nursing Home

This inspection was carried out on 24th April 2008.

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

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

Other inspections for this house

Hillfield Nursing Home 22/04/09

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Hillfield Nursing Home Grainger Park Road Elswick Newcastle Upon Tyne Tyne & Wear NE4 8RR Lead Inspector Janet Thompson Key Unannounced Inspection 24th April 2008 10:00 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 Hillfield Nursing Home DS0000070986.V361771.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. Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hillfield Nursing Home Address Grainger Park Road Elswick Newcastle Upon Tyne Tyne & Wear NE4 8RR 0191 2261891 0191 2722821 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) www.southerncrosshealthcare.co.uk Southern Cross BC OpCo Ltd Position Vacant Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 50 The maximum number of service users who can be accommodated is: 50 April 2007 2. Date of last inspection Brief Description of the Service: Hillfield Home is registered to provide care for 50 older people. 47 places are for nursing care and three places are available for service users requiring social and personal care only. The home is situated in a residential area to the west of Newcastle upon Tyne. It is close to all local amenities, the town centre and main bus routes. The NHS contracts for 24 continuing care beds at the home and the home manager and the hospital staff carry out the assessments for these places. Hospital staff carry out weekly monitoring and review of the medical care for the service users they have referred to the home. Accommodation is provided over three floors and there are six double bedrooms. None of the rooms have en-suite facilities. There are suitable lounge and dining facilities on each floor and a large conservatory leading on to the garden. Assisted bathing and toilets facilities are available around the home and there is one central passenger lift. The fees for the home are £366 to £539 per week. Further information about the home is available in the service user guide, which contains the statement of purpose and previous inspection reports. This is kept in the reception area of the home. Hillfield Nursing Home DS0000070986.V361771.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 the service experience adequate quality outcomes. This was an unannounced inspection. How the inspection was carried out: Before the visit we looked at: Information we have received since the last inspection visit. How the service dealt with any complaints or concerns since the last visit. Any changes to how the home is run. The manager’s views of how well they care for people. The views of people who use the service, their relatives, staff and other users of the service. Some of this was given to us in the form of questionnaires. At the time of writing this report we had received five completed forms from staff, eight from relatives and six from residents. During the unannounced visit we: Talked with people who use the service and some of the staff. Looked at the information about people who use the service and how well their needs are met. Looked at other records the home is required to keep. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, comfortable and safe. Checked what improvements had been made since the last inspection visit. The manager was at the inspection. Feedback was given to her at the end of the visit. What the service does well: Residents looked well cared for. They said they were well looked after. Staff support residents to maintain contact with their family and friends. Here are some of the comments relatives made: ‘The carers seem efficient and very good to the people in their care’ Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 Page 6 ‘I am always made to feel welcome’ ‘Some carers have exceptional skills, he is different when they are on duty’ ‘Most staff have a nice rapport with him and he is happy in their company’ ‘This is a small friendly home’ ‘They listen to people in their care and where possible make life better for them’ ‘They are compassionate and patient’ Residents did not make many comments in their questionnaires but we spoke to some who said: “I am happy here, the staff are good” “I like the staff, they are my friends” “We are well looked after, you can’t complain really” “I am well fed and looked after” The questionnaires ask residents what the home does well. One responded: ‘the cleaning and the meals/drinks. The staff always speak to us’ The care plans that we read clearly set out the needs of the residents. When we spoke to those residents or discussed their care with staff, the needs matched those written in the plans. The care is regularly reviewed, taking into account peoples changing needs and individual wishes. When asked how they communicate about residents needs staff said: ‘We have a handover sheet. A daily evaluation report for each resident and areas of concern or care are documented in the care plan’ Staff recruitment and training records were clear and concise and contained all relevant information. Staff confirmed that they had checks carried out on them before they were employed. The vetting process helps protect residents. The staff continue to achieve a high percentage in training for NVQ. Over 60 of staff are qualified to level 2 or above. This is above the required 50 target. Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Some of the questionnaires from relatives raised some concerns. They commented that there were not enough social activities. There was evidence that there are, in fact, a lot of social activities. The DT said she would like to take residents out more but does not have access to transport on a regular basis. Relatives were also not clear of the complaints procedure and were concerned that the diet was not good enough. These are some of the relatives’ comments: ‘The food is nutritionally poor, i.e. burger and beans, fish fingers and beans. Food is poor quality and processed. Lunch is normally acceptable.’ ‘I believe I complain through social services, I am not sure’ ‘I think they try hard to celebrate special things, like Easter, but due to staffing not on a regular basis’ ‘They need more outings’ ‘They need more staff at weekends’ When staff were asked what they could do better they responded: Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 Page 8 ‘Have more staff’ ‘Have more time to interact with residents’ ‘Have more time to do social activities’ We felt that relatives might not be aware of all of the social activities, especially those happening on a one to one basis. The manager stated that relatives meetings were not very well attended. We suggested that a newsletter might be a better way of regularly communicating with relatives. The staff levels do meet the minimum requirements for the number of residents actually present in the home. The problem is that the home is spread over three floors with only a small number of residents on each floor. Staff are therefore spread out throughout the building. We ate the food at the home at lunchtime. It was chicken casserole, mashed potato, cauliflower and carrots. The chicken did look processed and was in very dark, salty beef gravy of the reconstituted type. The vegetables were acceptable. The meal was adequate but not good. The menu is about to be changed. The home is introducing a menu based on an independent tool, which ensures that all meals are nutritionally balanced. The health and safety checks were not up to date. Some indicated that water temperatures in resident areas were too high. This puts residents at risk. The fire safety checks were not up to date. This puts residents, staff and other users of the building at risk. The manager has been in post for a year and has not yet applied for registration with CSCI. This is too long a time scale. Part of the application for registration is to assess her ‘fitness’ to manage. This is to protect residents and promote good management of the home. 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. Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 Page 9 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 Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 Page 10 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): 3. Standard 6 does not apply. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are properly assessed, taking account of their needs and wishes, so that they can be assured this is a suitable home and that they receive an individual care service. EVIDENCE: Three pre-admission assessments were seen. They contained enough information to enable staff to assess if they could meet the individual needs before admission. Information from other health professionals and carers was included in the assessment. The assessments noted differing cultural and religious needs. These details were documented before residents were admitted to the home so staff could be sure they could meet the needs of every resident. Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive personal care that is well planned and takes account of their diverse needs. EVIDENCE: Five care plans were examined and three were case tracked. This means that we spoke to the individual residents or observed their care then matched our observations to what was written in the care plan. All three case tracked care plans did reflect the actual care needed by the residents. Care plans took account of peoples diverse and differing needs. People were supported to achieve independence and meet individual goals. Other health professionals contributed to the planning of care. These contributions were clearly recorded. Staff spoken to showed a good understanding of the needs of the residents in their care. They described how they communicated with some residents who did not speak English. Staff had learnt key words such as water, thank you and toilet in the languages that their residents spoke. Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 Page 12 Residents looked clean and well cared for. In questionnaires received most people were happy with the care at the home though some thought it varied depending on the carers on duty. They said: ‘I am well fed and looked after’ ‘We are well looked after’ ‘The broad needs are met, small things such as dentures and shaving are not given adequate attention by some carers while others are excellent’ ‘Some carers have exceptional skills’ When asked about how they give care to people in the home staff said: ‘If I don’t have the knowledge I ask someone who does. I seek advice from health support workers’. (The example was given of meeting the needs of people with different religions requiring end of life care.) ‘Our residents are well looked after’ ‘Our intentions are good, we strive to provide good basic care, I believe our residents are happy’ Medication ordering, administration, storage and disposal were examined. A hospital pharmacist checks the medicines for the continuing care patients every two weeks. All medicines are audited by the nurse every week and by the manager monthly. All medicines were accounted for and all those administered were signed for. Three amounts of controlled drug were checked and were correct. Staff were seen to treat residents politely and respectfully. Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported to lead a healthy and fulfilling personal lifestyle. This takes account of their wishes and diverse abilities. EVIDENCE: An activities co-ordinator, referred to by the organisation as the diversional therapist (DT), is employed at the home for 24 hours per week. She was very enthusiastic about her role and is providing an excellent service to residents. The DT has written life profiles for all residents. This describes each individual’s likes, dislikes and fears, religion and beliefs, leisure, sport, hobbies and preferred relaxation. She records what activities people have participated in and whether they enjoyed it. The DT carries out a lot of one-to-one activities for people who are too ill to join a group or might be otherwise isolated in their rooms. On the day of the inspection she was giving hand massages to those people. Although the social provision is now excellent it was not adequately promoted in the home. Some relatives did not know how much was going on. Relatives, residents and staff were frustrated by lack of opportunity to go out regularly. This is because transport is only available one day per month. Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 Page 14 In their questionnaires relatives said: ‘More outings are needed’ ‘Some staff are good socially, they spend time and help him watch rugby on TV’ ‘they are too short staffed for regular activities’ Staff also said they would like more time to interact with residents and do more social activities. Residents spoken to said they liked the food. Some relatives said in questionnaires that the food was good, others thought that it was nutritionally poor and processed. We ate the food at the home. It was adequate but not good. The chicken casserole was very salty, the gravy was dark brown and the chicken looked processed. The vegetables were adequate. The home is preparing to take on a new nutritional system. This is an independent nutritional tool that devises balanced menus and promotes healthy living. Residents and relatives felt that they were given choices in the home. Residents said they could choose not to join activities, what to eat, how to spend their day and when to go to bed. Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are protected from harm through thorough policies, procedures and staff training. EVIDENCE: Staff follow the home’s policies and procedures relating to the management of complaints and allegations of abuse. Staff are kept up to date with information and training. Refresher training on the protection of vulnerable adults is about to take place. Staff have, in the past, used the whistle blowing procedure when they felt that residents welfare was at risk. Residents are told how to complain through the complaints procedure. This was clearly visible within the home. Residents spoken to said they would complain if they needed to but none of them had any current complaints. In questionnaires most relatives said they knew how to complain but two indicated that they did not know. Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe comfortable home that is generally pleasant and clean. EVIDENCE: The home was generally clean and free from odours. The furniture and general décor provides residents with a comfortable homely environment. Residents spoken to said the home was warm enough and: ‘Oh, it’s always clean’ ‘The cleaning is good, they never stop’ Some of the home is in need of redecoration. This has started on the ground floor and is planned for the rest. The ground floor now looks a very attractive place for residents to live. New dining furniture has been bought and the atmosphere is bright and cheery. Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 Page 17 The shower room on the middle floor has very scuffed walls and flooring. The grouting is brown. It does not look like a pleasant room for residents to bathe in. Some of the bins in the home do not have lids that are operated by foot. This is essential to limit contamination and the spread of infection. Records show that the water in some staff hand washing sinks is as hot as 5052 degrees. This means that good hand washing techniques cannot be followed, as staff cannot wash their hands under running water. Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service are supported and protected through staff numbers, skill and ability. EVIDENCE: The current staffing levels are: Daytime. 8am-8pm. Five care staff and two qualified nurses. Night time. Three care staff and one qualified nurse. The current occupancy of the home is 24 residents. CSCI received various comments in questionnaires indicating that staffing was too low. The staff numbers are sufficient for the amount of residents in the home. The problem arises because this small number of residents is spread over three floors. The staff are also split over three floors. Training records showed and staff confirmed that 60 of staff had achieved NVQ level 2. Essential training such as moving and handling was up to date. Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 Page 19 Staff confirmed that thorough background checks had been carried out before they were employed. Residents were protected through checking of criminal records information for all employees. Interviews are conducted against a person specification list to ensure fair and equal employment. Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People using this service are not fully protected through good and thorough management. EVIDENCE: The home does not yet have a registered manager. The manager has been at the home since April 2007 but has not yet achieved registration with CSCI. The registration process is essential for the protection of those who use the service. This process involves assessment of the manager as ‘fit’ to manage. Staff spoken to were clear about their role and responsibilities. Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 Page 21 The home operates a quality assurance system. Residents, their relatives and professionals are consulted about the service provided. There was evidence that relatives are not always kept up to date with relevant information, for example, the activities on offer, the forthcoming changes to the menu. The manager stated that relatives meetings are not well attended. She stays late one evening per week to see relatives but few make use of this. Some discussion took place as to more proactive ways of communicating with users of the service, this included newsletters and bulletin boards. Servicing and maintenance agreements are in place for facilities and equipment. Risks in the environment and tasks, including safe working practices are assessed and reviewed. Internal health and safety checks were not up to date: The record of weekly hot water checks showed that none had been carried out in February and only two checks were done in March. These records showed that some taps in residents’ rooms were dispensing water as hot as 48 degrees C. The shower on the second floor was measured at 50oC. Some hot water taps were running too cold. On the first floor one room was only 11oC. The water in staff hand washing areas was too hot at 50-52oC. There was no evidence of any remedial action being taken in response to this. The monthly checks of the call bell system had not been done in February. In January it was recorded that 19 were missing or broken. An electrical fault was recorded in the dining room and an electrician requested on 31.01.08. There was no further evidence of any follow up action for this. The monthly checks on window restrictors were not done in February. The weekly checks of fire alarms were carried out except for two periods when they were not checked for 14-15 days. The emergency lights were checked monthly. Faults were recorded for March and April with no evidence of any follow up action. The remaining checks appeared to be carried out but the entries were recorded in weeks, i.e. week one, week two. Without actual dates on these were difficult to audit. The manager was not aware that these checks were not up to date. She stated that the missing dates were when the home was without a handyman. There was no recognised individual responsible for these checks in the absence of the handyman. There were no obvious trip hazards in the home. Fire exits were clear of obstruction and all hazardous fluids locked away. Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 Page 22 Residents personal monies were well accounted for. Records were examined and showed that two signatures were obtained for all transactions. Three amounts of money were counted and were correct. Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X 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 4 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 1 Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 Page 24 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. 2. 3. 4. Standard OP15 OP26 OP31 OP38 Regulation 16(2)(i) 13(3) 9 13(4) Requirement Review the quality and nutritional content of meals. Ensure that staff have facilities to enable them to follow good hand washing practices. A manager registered with CSCI must run the home. Ensure all health and safety checks are up to date. Ensure hot water in all areas is at safe and reasonable temperatures. Confirm how the management of the home ensures the safety of users of the service. Timescale for action 01/06/08 01/07/08 01/06/08 01/06/08 Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 Page 25 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 OP33 Good Practice Recommendations Improve the consultation and communication with users of the service. Hillfield Nursing Home DS0000070986.V361771.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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. 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