Inspection on 20/07/05 for Hillgreen Care (Ruskin Road)

This inspection was carried out on 20th July 2005.

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

Hillgreen Care (Ruskin Road) 22/05/06

Hillgreen Care (Ruskin Road) 09/03/06

Hillgreen Care (Ruskin Road) 22/11/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Hillgreen Care (Ruskin Road) 13 Ruskin Road Tottenham London N17 8ND Lead Inspector Jackie Izzard Announced 20 July 2005 @ 9.30 am 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hillgreen Care Address 13 Ruskin Road, Tottenham, London N17 8ND Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 7226 8969 020 7226 3939 Mr Roger Goddard for Hillgreen Care Ltd Dennis Obemeata-Yamah PC - Care Home 6 beds Category(ies) of LD - Learning Disability registration, with number of places Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users living above the first floor should not require assistance in the event of an emergency. Date of last inspection 22 November 2004 Brief Description of the Service: This home is one of two operated by Hillgreen Care. 13 Ruskin Road is a six bedroom house on a residential street in Tottenham. The home is registered to care for six adults, between the ages of eighteen and sixty five years, who have a learning disability. The people living in the home have challenging behaviour and/or autistic spectrum disorders. The house is well-equipped with six single bedrooms each with en-suite toilet and sink. One bedroom has its own bathroom. Two bathrooms are provided for the other five residents. There is a spacious lounge and separate dining room. The dining room is used for music, activities and smoking. There is a garden. The home is within a short walk of Tottenham High Road and within easy access of buses, Seven Sisters Underground stations and Bruce Grove, White Hart Lane and Northumberland Park rail stations. Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection. Hillgreen Care had six weeks notice that the inspector was coming. The inspector stayed in the home for six and a half hours. She looked around the building, checked the home’s records, talked to the manager, the director of Hillgreen Care, two staff, three relatives and four residents. One resident was in hospital at the time of this inspection and one was missing from the home. The inspector received written feedback about the home from two other relatives, a psychiatrist and three social workers. All their feedback was positive. What the service does well: What has improved since the last inspection? Risk assessments have improved. These are records which say that certain activities carry a risk to people’s health and safety (eg smoking) and tell staff what to do to ensure that the risks are not too high (eg how to make sure a smoker doesn’t start a fire and how to help a smoker if they want to stop smoking). As staff have got to know people better, they have found more activities for them to do so that they can go out and do things they are interested in. Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 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. Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 4 People can read the information provided by the home and make visits so that they are able to make an informed choice about moving in. They may also feel assured that the home will assess their needs fully. EVIDENCE: The home has a statement of purpose and service user guide which have been assessed as satisfactory at the previous inspection of the home. From inspection of three residents’ files, the inspector saw that their needs had been assessed prior to their placement at this home and also after they moved in. The assessments were comprehensive. All six admissions were planned. Two residents told the inspector they had visited the home before deciding to move in. Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 9 Residents’ needs are assessed and an individual care plan drawn up by the staff team. The plans are of a good standard and residents are encouraged to lead more independent lives than they did before moving to this home. EVIDENCE: The inspector looked at three residents’ care plans. These were comprehensive. Each resident also has a weekly individual activity programme tailored to their needs. The inspector saw that staff enable residents to decide if they want to take part in a planned activity or not. One resident found it difficult to make decisions about his/her day to day life and the manager was able to explain how staff support this resident to make his/her own decisions and choices. The three residents’ files inspected each contained risk assessments relevant to that individual. Risk assessments on smoking have been devised since the last inspection. A requirement is made that the manager undertakes a risk assessment for one named resident who has engaged in a high risk behaviour. Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 10 Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 17 Residents lead a good quality of life at this home. Their families are welcomed and each resident has an individual programme of leisure and educational activities. EVIDENCE: The home employs an Activity Organiser who supports residents with activities. Records in the home show evidence that residents are encouraged to develop personally and learn new skills. Everybody is encouraged to learn how to cook with staff support. Other examples where a resident is encouraged to develop are in the areas of anger management, decision making and personal care. Residents are supported to attend adult education if they wish. Each person has an individual weekly activity programme. Three residents confirmed to the inspector that they did follow their programme. They are encouraged to go out and use community amenities regularly. A few examples of activities currently taking place were; swimming, visiting library, yoga class, cooking and cinema. Three residents told the inspector they liked the home, were looked after well and were happy. The fourth resident said s/he sometimes liked staff and sometimes liked his/her activity programme. Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 12 Two residents spend regular time with relatives and visitors are welcomed in the home. During this inspection, one resident was visited by three relatives. The inspector was able to meet the relatives, who praised the home and said staff were “well-mannered and welcome you”. The menu was satisfactory and three residents said they liked the food cooked for them. The home plans to organise holidays for residents next year. Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 Residents are well cared for and their physical and emotional health needs met. They are protected by good practice in administering and recording medication. EVIDENCE: The inspector asked two residents who receive support with bathing if they were happy with the way staff help them. Both said yes. One said s/he was looked after very well. The physical appearance of the four residents was good. The inspector looked in three files for evidence of regular dental and optician appointments and registration with a GP. It was evident that these appointments had taken place. One person was missing from the home and it was difficult for staff to meet his needs. Staff knew where the person was and the manager explained that staff regularly visit this person and try to persuade him to return. The local Community Team for people with learning disabilities support staff in meeting people’s emotional needs. Medication storage and records were seen to be satisfactory. None of the residents looked after their own medication. This is however the first year the home has been operating so some residents may be encouraged to become self-medicating in future years. A relative praised the home for trying to support a resident to give up smoking. Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23 The complaints procedure needs to be amended and distributed to residents and their relatives so that they know how to complain if they needed to. Residents are not currently protected from the risk of abuse as the home does not have an adult protection procedure to guide staff. EVIDENCE: There was one complaint made in the last year when a resident made a complaint about a staff member, leading to an Adult Protection enquiry. The complaints procedure does not meet the required standard as it does not include how to complain, who to, or the stages and timescales of investigating complaints. A requirement is made to ensure the general complaints procedure and residents’ complaints procedure are amended. Two relatives gave written feedback to the inspector that they did not know the home’s complaints procedure. The home did not have its own adult protection procedure. A requirement was made at the previous inspection of the home that the adult protection procedure be amended to include that a staff member will routinely be suspended if a serious allegation is made about him/her until an investigation is completed, and that the management of the home would not investigate any allegation of abuse without the prior agreement of the social work team. These requirements were made following an allegation made by a resident against a staff member at the home. A proper procedure has still not been written and this requirement is restated in this report. The inspector advised the manager and director of Hillgreen Care that the procedure must include the two issues already mentioned and be a step-by-step procedure for staff to follow. A requirement is also made that all staff are provided with training in the protection of vulnerable adults. Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 15 The manager told the inspector that none of the residents are able to look after their own money. Hillgreen Care acts as the corporate appointee. The written policy for managing residents’ finances is satisfactory but is not accurate as the practice is entirely different. Financial records are kept and sent to families, but not the resident, every three months. A requirement is made for Hillgreen Care to produce a policy that reflects their practice in managing people’s money and ensure it complies with the Care Homes Regulations 2001. Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29, 30 The house has been made homely and comfortable. The facilities are adequate to meet residents’ needs and the standard of cleanliness, décor and furnishings is good. A requirement is made to supply towels for handwashing in bathrooms. EVIDENCE: The house is homely, well decorated and furnished and secure. The inspector looked at four bedrooms. These were well furnished and had en-suite facilities. Each bedroom was personalised with the residents’ own belongings and reflected their interests. The two bathrooms provide sufficient privacy and one resident access to their own bathroom. The manager was advised to undertake a risk assessment on bathroom locks as one bathroom had a bolt which makes access in an emergency difficult. There is a small laundry room. Shared spaces were used appropriately. The lounge has a television and the dining room has a music centre. The dining room is also used for activities or general conversation. The dining room is also used as the designated smoking room for the four residents who smoke. Smoking is not allowed at mealtimes. There is a garden with a barbeque area. Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 17 One resident’s needs have changed since having a stroke some months ago. As the home is not equipped for people with a physical disability, this person is shortly due to move to another home. On the day of the inspection, the house was clean and hygienic with the exception that no towels were provided in bathrooms for people to dry their hands. While the manager gave an explanation for this, a requirement is made to provide paper towels so as not to discourage hand washing. Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, 35 Staffing levels meet residents ’needs. Service users are well supported by staff that receive training and regular supervision. Shortfalls in the recruitment process means that service users may be at risk. EVIDENCE: The company’s recruitment policy states that two written references will be obtained, including one from the last employer. However, one staff file had no written references. There were records of two verbal references only; one of which was very poor and the referee had refused to give a written reference. A requirement is made to obtain two written professional references for this employee. One staff member, recently employed, had a CRB undertaken by another organisation. Staff are receiving training and supervision and feel well supported. Requirements are made to ensure Hillgreen Care takes out its own CRB and references on every employee as two omissions were found in the recruitment process of current staff. A requirement is made that Hillgreen Care take out another CRB check on this person and every future employee or volunteer. The manager had misunderstood the guidance and was advised that CRBs are not portable from one organisation to another. The inspector spoke to two staff. Both said that the staff work well as a team and that the management were supportive. Staff have received training in giving medication, food hygiene, breakaway techniques, sexuality, learning disability and autism. Two don’t have first aid Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 19 training but will do so as part of their NVQ2 training in care. Staffing levels are; one waking night staff (with somebody on-call) 3 staff in the day and 2 in the evening. This does not include the manager, who works five days a week. Staff meetings are held weekly. The inspector looked at three staff files and saw all had relevant training and a four-week induction plus records of supervision. The inspector agreed to look at the staff training programme at the following inspection. A requirement is made in a previous section of this report to provide adult protection training to all staff. Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 41, 42 While the health and safety of residents is promoted by good practice in this area, a requirement is made to assess the risk of not having window restrictors in bedrooms as some of these restrictors had been removed. EVIDENCE: The required monthly unannounced visits to the home and reports by Hillgreen Care need to be kept up to date. The manager submits monthly reports on the home to Hillgreen Care. The Director of Hillgreen Care has not sent reports of his statutory monthly inspections of the home to the CSCI or the manager since February 2005. A requirement is made that he does this every month. A sample of health and safety matters were inspected. The inspector saw window restrictors had been dismantled in three bedrooms. A requirement is made to undertake risk assessments on these or repair them. Cleaning materials are stored appropriately in a COSHH (Control of Substances Hazardous to Health) cupboard. There is a designated smoking area for residents. Staff are not allowed to smoke on duty. There is a fire risk Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 21 assessment and fire appliances were tested in May 2005. Fire training is included in staff induction training. The inspector saw evidence of this and of the gas appliances being serviced in July 2005. The inspector saw that fridge and medication cabinet temperatures were properly monitored as required. Hot water outlets were checked fortnightly on a rotating basis to make sure the water is not too hot. The manager was advised to check baths and showers this regularly but that sinks could be tested less often, depending on the outcome of a risk assessment. Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x 3 x Standard No 22 23 ENVIRONMENT Score 2 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 2 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 2 3 x 3 Standard No 31 32 33 34 35 36 Score x x 3 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hillgreen Care (Ruskin Road) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x 2 2 x G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 23 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 9 Regulation 13(4)(c) Requirement The registered persons must update the risk assessment for one named resident to address the risk of fire raising. The registered persons must update the general complaints procedure and residents complaints procedure so that the procedure fully complies with both Regulation 22 and standard 22. The registered persons must devise an adult protection procedure for the home. The procedure must include that if an allegation is made against a staff member, they may be suspended pending investigation, and that Hillgreen Care will not investigate any allegations of abuse without the prior agreement of the social work team. This requirement is restated (previous timescale not met). The registered persons must ensure all staff receive training in the protection of vulnerable adults from abuse. The registered persons must inform the CSCI of the date/s that this Timescale for action 31 August 2005 31 October 2005 2. 22 22 3. 23 13(6) 31 August 2005 4. 23 13(6) 31 August 2005 Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 24 training is booked to take place. 5. 7, 23 20 The registered persons must produce a written policy and procedure on managing residents finances which reflects actual practice of the home and ensure the policy fully complies with Regulation 20 of the Care Homes Regulations 2001 and standards 7 and 23 of the service specific National Minimum Standards. The registered persons must provide hand drying facilities in all toilets and bathrooms. The registered persons must ensure they have two written references for a specific named staff member, including one from the previous employer as per Hillgreen Cares written policy. The registered persons must ensure that a new CRB disclosure is applied for in respect of a named staff member and that no further staff or volunteers have any access to residents until Hillgreen Care has taken out a new CRB disclosure for that person and has received a satisfactory outcome. The registered persons must undertake an unannounced visit to the home at least once monthly and send a written report on the conduct of the home to CSCI every month. The registered persons must undertake a risk assessment regarding the dismantled window restrictors in bedrooms. If any risk is identified for any resident regarding falling from a window, the restrictors must be repaired/replaced as a matter of priority. 30 September 2005 6. 7. 24 34 13(3), 16(2)(j) 19, Schedule2 20 July 2005 31 August 2005 8. 34 19, Schedule 2 31 August and from then on 9. 41 26 31 August 2005 and from then on 31 August 2005 10. 42 13(4)(a) 11. Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 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 27 Good Practice Recommendations The registered persons should undertake a risk assessment on the type of bathroom lock provided and replace with a type that staff can open from outside in an emergency if there is any risk identified. Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate London, N14 6HA 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 Hillgreen Care (Ruskin Road) G59 S60578 Hillgreen Care Ruskin Rd V221132 20.07.05 Stage 4.doc Version 1.40 Page 27 - 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. 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