Inspection on 14/07/05 for Hilltop

This inspection was carried out on 14th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hilltop 23/10/07

Hilltop 10/08/06

Hilltop 29/11/05

Hilltop 04/11/04

Hilltop 02/06/04

Hilltop 18/01/04

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 Hilltop 1 The Drive Walthamstow London E17 3BN Lead Inspector Rob Cole Unannounced Inspection 14th July 2005 at 10:00am 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. Hilltop G56 G06 S7271 Hilltop V240018 140705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hilltop Address 1 The Drive, Walthamstow, London, E17 3BN 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 8520 5348 MCCH Society Limited Ms Sue Farress Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Hilltop G56 G06 S7271 Hilltop V240018 140705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 4th November 2004 Brief Description of the Service: Hilltop is a residential home providing support and personal care to five adults with learning difficulties. All current service users moved into the home from the former Leytonstone House Hospital in 1991. The home is situated in a residential area of Walthamstow, in the London Borough of Waltham Forest, and is close to shops and other local amenities, including transport networks. All service users have their own bedrooms, and share a communal lounge, conservatory, kitchen/dinning area, garden and bathroom and toilet facilities. The home is operated by MCCH Society Ltd, and the property is owned by Circle 33 Housing Association. Hilltop G56 G06 S7271 Hilltop V240018 140705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 14/7/05 and was unannounced. The inspector had the opportunity of speaking with service users, staff, and the homes manager was present throughout the inspection. Overall, the inspector was satisfied that this is a well run home. Generally the home is able to meet service users needs, and staff appear to be sufficiently competent and experienced to carry out their duties. There were however some issues that need to be addressed, and these are highlighted within the report. What the service does well: What has improved since the last inspection? What they could do better: Despite improvements, there are still some issues that need to be addressed. Issues of particular concern are around the general maintenance of the home and the level of day services and community based social and leisure activities available to service users. The kitchen cupboards are in a very poor state, and one bedroom carpet urgently needs replacing. Service users have only limited access to day services and social activities within the community, and this must be addressed. Hilltop G56 G06 S7271 Hilltop V240018 140705 Stage 4.doc Version 1.40 Page 6 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. Hilltop G56 G06 S7271 Hilltop V240018 140705 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 Hilltop G56 G06 S7271 Hilltop V240018 140705 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) 1,3,4 and 5 The inspector was satisfied that prospective service users are provided with sufficient information about the home to make an informed choice. This information is provided through documentation and the opportunity of visiting the home. EVIDENCE: The home has both a Statement of Purpose and a Service User Guide in place. Attempts have been made to make both documents more accessible to service users by producing them in pictorial form. The SOP contains details of the staff team and their relevant qualifications, the organisational structure, age range and gender of service users, fire procedures, the philosophy of care and the physical environment of the home. The Service User Guide includes the aims and objectives of the home and the facilities and services provided. The Guide also includes what fees are charged by the home. Each service user has a contract/statement of terms and conditions, which include details of rooms to be occupied, duties and responsibilities of each party, fees charged, what they cover and what is extra. These documents have been signed by the homes manager, and since the last inspection service users have also signed them. Although there have been no recent admissions to the home, there is a policy in place covering admissions. This indicated that prospective service users would be able to visit the home before making any decisions as to move in or not. The policy also stated that the placement would be reviewed after six Hilltop G56 G06 S7271 Hilltop V240018 140705 Stage 4.doc Version 1.40 Page 9 months. From observation and discussion with service users there was evidence that the home is generally able to meet the needs of service users, for example staff demonstrated a good ability to communicate with service users, some of whom had complex communication needs. Hilltop G56 G06 S7271 Hilltop V240018 140705 Stage 4.doc Version 1.40 Page 10 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) 6,7,8,9 and 10 Overall the inspector was satisfied that service users individual needs are been met. Service users have a large measure of control over their daily lives, and are involved in the day to day running of the home. EVIDENCE: All service users have clear and comprehensive individual care plans in place. Plans include weekly timetables, guidelines on personal care, medication, social activities and mobility. There was evidence that plans are reviewed every six months, with the involvement of service users, social workers, keyworkers and the homes manager. Daily logs are also maintained for all service users. Care plans include clear guidelines for the management of any challenging behaviours that service users may exhibit. Risk assessments are in place for all service users, and these are of a higher standard then at previous inspections, for example they now include information on how risks can be reduced and managed, where as previously they only set out what the risks were. However, assessments have not been dated, and there was no indication of when they are next due for review, and it is required that risk assessments are dated and regularly reviewed. Hilltop G56 G06 S7271 Hilltop V240018 140705 Stage 4.doc Version 1.40 Page 11 There was evidence that service users are able to make decisions over their daily lives. Service users spoken to informed the inspector that they are able to get up and go to bed as they wish, choose what they wear, when they have their meals etc. Restrictions on choice are clearly recorded on care plans, for example there are guidelines in place on managing the amount of tea one service user has. These have been drawn up with the involvement of the service user and their psychiatrist. Staff were observed to consult with service users on the day of inspection on an informal basis, for instance over meals and activities. More formal arrangements also exist to involve the service users in the running of the home, including weekly service user meetings. These are minuted, and records indicated that they include discussions on menus, activities and the overall support they receive. The home uses service users questionnaires to gain feedback, and those seen by the inspector were generally positive. Three bedrooms have been decorated since the last inspection, and the manager informed the inspector that service users were involved in choosing the new décor. At present, service users are not involved in the recruitment of staff to the home. The inspector was informed that it is planned that service users from the home will be involved in future staff recruitment, and this is recommended. The home has a confidentiality policy in place, which makes clear that on occasions a confidence may have to be broken in the health, safety and welfare interests of service users and others. Confidential records are stored in a locked filing cabinet, which staff and service users can access as appropriate. Staff spoken to demonstrated a good understanding of issues around confidentiality. Hilltop G56 G06 S7271 Hilltop V240018 140705 Stage 4.doc Version 1.40 Page 12 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) 11,12,13,14,15,16 and 17 It is the view of the inspector that more cold be done in the home to promote service users community participation. Service users have been denied access to day services, and insufficient community based social and leisure activities are provided. EVIDENCE: Service users have the opportunity to develop social and emotional skills through their involvement in the community, and through the day services they attend. In the home staff support service users to develop independent living skills, for example with making drinks and snacks, and doing their own laundry. Service users regularly attend a local church. One service user is involved in employment, delivering papers. No service users are currently involved in any formal educational opportunities, although all service users have in house skills programmes in place to help develop independent living skills. Two service users attend local day services, were they are involved in art programmes, and have access to social activities, such as attending dog racing. The manager informed the inspector that another two service users had recently been involved with day services, and had vary much and valued this Hilltop G56 G06 S7271 Hilltop V240018 140705 Stage 4.doc Version 1.40 Page 13 opportunity. However, this had been withdrawn earlier this year due to financial reasons, and it is required that all service users are offered day services as appropriate. Service users access local shops and parks in the community, and use local transport networks including busses and trains. Service users are provided with a variety of social and leisure activities both in house and in the community. In house service users have access to TV, DVD, music, BBQ’s and the home has a fishpond that service users help maintain. In the community service users visit local cafes, restaurants and pubs along with bowling trips. Parties are arranged to celebrate birthdays, for instance the home recently hired out a hall and disco to celebrate one service users birthday. All service users are offered an annual holiday as part of the basic contract price. The manager informed the inspector that there were plans to take service users to Spain and France later this year. Despite the wide range of activities available, the inspector was not satisfied that they are provided in sufficient numbers, for example records evidenced that in the month of June 2005 one service user had only been out of the home on one occasion. It is required that service users are provided with appropriate community based social and leisure activities in line with their assessed needs and stated preference. Service users were observed to move around the house and garden freely as they wished, and staff were observed to knock on bedroom doors and await an answer before entering. Staff interacted with service users in a friendly and respectful manner, and not exclusively with other members of the staff team. On occasions service users made it clear that they did not wish to be disturbed by staff, and staff were seen to respect this. There was evidence that service users were involved in the daily routine of the home, for example care plans stated that they are involved in doing their laundry, and on the day of inspection service users were observed to be helping with the cleaning of the home. Menus are planned by service users during their weekly meetings, and records are maintained of menus. These indicated that service users are offered a varied, balanced and nutritious diet. Service users are involved in food preparation, including buying the food. Fresh fruit was available on the day of inspection. The kitchen was clean and tidy, and food was stored appropriately. Fridge and freezer temperatures were checked and recorded. The home has a set of colour coded chopping boards, but there was no key to denote what each colour represented, and this must be addressed. Hilltop G56 G06 S7271 Hilltop V240018 140705 Stage 4.doc Version 1.40 Page 14 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 and 20 The inspector was satisfied that appropriate arrangements have been made to ensue that service users personal and health care needs are been met. EVIDENCE: Service users informed the inspector that they are able to get up and go to bed when they choose, and guidelines were in place on providing personal care to service users. These guidelines indicated that staff encourage service users to do as much for themselves as possible. Service users choose their own clothes to wear, and all were appropriately dressed on the day of inspection. All service users have a designated keyworker, and keyworkers spoken to showed a good understanding of service users care plans. All service users are registered with a GP. Records are maintained of medical appointments. These indicated that service users have access to specialist health care as appropriate, for example psychiatrists and physiotherapists. Service users have regular access to dental and eye care. The home receives advice and continence products from the Continence Advisory Service, and since the last inspection used continence products are now disposed of appropriately. The home has a comprehensive medication policy in place, and all staff receive training in medications before they are able to administer it. Records are maintained of medications entering the home and those that are returned to the pharmacist. Guidelines are in place for the administration of Hilltop G56 G06 S7271 Hilltop V240018 140705 Stage 4.doc Version 1.40 Page 15 medications prescribed on a PRN basis. MAR charts are maintained, however, these contained several entries of the single letter L. Although MAR charts contained a key to symbols used, the letter L was not on the key, and it is required that all symbols used on MAR charts are clearly identified by the key on the chart itself. Hilltop G56 G06 S7271 Hilltop V240018 140705 Stage 4.doc Version 1.40 Page 16 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 and 23 It is the view of the inspector that satisfactory systems are in place to help ensure that service users safeguard from the risk of abuse, for example appropriate adult protection and complaints procedure, and the provision of staff training. EVIDENCE: The home has a complaints log, although the manager informed the inspector that no complaints have been received in the past year. There is also a complaints procedure. This included timescales for responding to any complaints made and contact details of the CSCI. However, it was not on display within the home, and this is recommended. The home has a copy of the Local Authorities adult protection procedures, and also its own policy, which appeared to be in line with current legislation. All staff have received training in adult protection issues. Staff questioned by the inspector showed a good understanding of their roles and responsibilities in this area. The home holds money on behalf of service users, this is kept in a locked safe and checked by staff during every shift handover. The inspector checked several service users finances, and all appeared to be satisfactory. Receipts and records are maintained of all financial transactions involving service users monies. Hilltop G56 G06 S7271 Hilltop V240018 140705 Stage 4.doc Version 1.40 Page 17 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 and 30 It is the view of the inspector that the home has adequate communal and private space to meet service users needs. However, more attention needs to be paid to the general maintenance, for example the kitchen cupboards are in a poor state and one bedroom carpet urgently needs replacing. EVIDENCE: The home is situated in the Walthamstow area of the London Borough of Waltham Forest, and is suitable to meet its stated purpose. The home is in keeping with other homes in the area, and is close to shops, transport networks and other local amenities. On the day of inspection, the home was clean and tidy, and generally well maintained both internally and externally. The home consists of a sitting room, conservatory, kitchen/dinning area and garden, service users are able to move freely around communal areas. Since the last inspection one service user has moved out of the home, and the room that was their bedroom is now been used as a second sitting room. The garden has appropriate garden furniture, and a BBQ. The home recently had a new kitchen fitted, and service users were involved in choosing it. However, several cupboard doors and handles are missing, and these need to be replaced. This is a repeat requirement from the previous inspection. Further, the front garden Hilltop G56 G06 S7271 Hilltop V240018 140705 Stage 4.doc Version 1.40 Page 18 was overgrown and very untidy, and this is also a repeat requirement that the home maintains the gardens to a reasonable standard. The home has one shower room/toilet, one bathroom and one toilet on its own. Baths and showers have been adapted to make them accessible to service users. Since the last inspection there is now a supply of hot water to all bathrooms and shower rooms. Bathrooms were clean, tidy and free from offensive odour on the day of inspection. However, there was no lock fitted to the upstairs toilet, and this must be addressed. All service users have their own bedrooms, including a hand basin. Rooms meet National Minimum Standards on size requirements. Rooms have been decorated to service users personal tastes, for example with family photographs. At the last inspection there was a strong offensive odour in one service users bedroom. The inspector was informed that this was largely due to the soiled carpet in the room and a requirement was set to replace the carpet. The inspector was disappointed to note that the carpet has not been replaced, and there remains a strong offensive odour in the room. This must be addressed as a matter of priority. The manager informed the inspector that the bed in the room was also soiled, and that this contributed to the odour. This also needs to be replaced. In another bedroom the curtains and a cupboard were damaged, and these must be repaired or replaced. Handrails are in place on the stairs, and there are handrails in all toilets. The bath and shower have been adapted to make them accessible to all service users. The garden has a serious of ramps which make all areas of it accessible to service users. On the day of inspection the home was clean and tidy. Protective clothing is available to help prevent the spread of infection. COSHH products were stored appropriately. The home has appropriate washing and laundry facilities, and hand washing facilities were situated nearby the laundry room, and throughout the home. Hilltop G56 G06 S7271 Hilltop V240018 140705 Stage 4.doc Version 1.40 Page 19 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) None The standards in this section were not tested as part f this inspection, but will be tested as part of the next inspection. EVIDENCE: The standards in this section were not tested as part f this inspection, but will be tested as part of the next inspection. Hilltop G56 G06 S7271 Hilltop V240018 140705 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) 37,38,39,40,41 and 42 The inspector was satisfied that the manager is suitably experienced and competent to carry out their roles and responsibilities. Systems are in place to promote quality assurance and help ensure the health and safety of service users and others. EVIDENCE: The homes manager has been working with adults with learning disabilities since 1996, and in a managerial capacity for the past four years. They are currently working towards relevant management and care qualifications. The manager presents as been open, and service users informed the inspector that they found the manager to be approachable. On the day of inspection staff were observed to interact with the manager in a relaxed manner. The home holds staff meetings, staff supervisions, service user meetings and care plan reviews, all of which contribute to the quality assurance within the home. There was evidence that monthly unannounced Regulation 26 visits Hilltop G56 G06 S7271 Hilltop V240018 140705 Stage 4.doc Version 1.40 Page 21 have been taking place, and copies of the reports were available in the home, as were copies of previous CSCI inspection reports. The home uses service user questionnaires to gain feedback, and questionnaires have now also been devised to gain feedback from service users relatives. The home has various policies and procedures in place, in compliance with National Minimum Standards. The inspector checked several of these at random, including confidentiality and adult protection, and all appeared to be satisfactory. The home stores confidential records in a locked cupboard. The inspector was informed that staff and service users can access these as appropriate. The home has various health and safety policies in place, such as fire safety and moving and handling, and health and safety training has been provided, for instance food hygiene and first aid. Fire fighting equipment was situated throughout the home and last serviced in October 2004. Fire alarms are checked weekly, and were serviced by an engineer on the 10/6/05. The Local Fire Authority has visited the home since the last inspection, and found things to be satisfactory. A satisfactory fire risk assessment is in place. Routine health and safety checks are carried out, including testing of hot water and fridge/freezer temperatures. Hilltop G56 G06 S7271 Hilltop V240018 140705 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 x 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 2 2 2 3 3 Standard No 11 12 13 14 15 16 17 3 3 2 2 3 3 2 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hilltop Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 x G56 G06 S7271 Hilltop V240018 140705 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 YA28 Regulation 23 Requirement The registered person must ensure that the missing kitchen cupboard doors and missing kitchen cupboard handles are replaced. (Timescale 31/5/05 not met) The registered person must ensure that the carpet is replaced from the ground floor bedroom by the front door, and that the offensive odour from the same room is eradicated. (Timescale 31/5/05 not met) The registered person must ensure that the gardens are maintained to a reasonable and tidy standard. (Timescale 31/5/05 not met) The registered person must ensure that all serviceusers risk assesments are dated and subject to regular review. The registered person must ensure that all service users have access to appropriate day services in line with their assessed needs and stated preference. The registered person must ensure that all service users have accs to appropriate and G56 G06 S7271 Hilltop V240018 140705 Stage 4.doc Timescale for action 31/10/05 2. YA26 23 31/10/05 3. YA28 23 31/10/05 4. YA9 23 31/10/05 5. YA13 16 31/10/05 6. YA14 16 31/10/05 Hilltop Version 1.40 Page 24 7. YA17 13 8. YA20 13 9. YA26 23 10. YA26 23 11. YA27 12 and 23 suffcient community based social and leisure activities in line wth their assessed needs and stated preference. The registered person must ensure that there is a key available in the home to identify what each coloured chopping board is to be used for. The registered person must ensure that all symbols used on MAR charts are explained on the key contained on the MAR chart. The registered person must ensure that the bed in the ground floor bedroom by the front door is replaced. The registered person must ensure that the broken cupboard and curtains in the first floor bedroom are repaired or replacd. The registered erson must ensure that working locks are fited to all bathroom and toilet doors, with an emergency overide device. 31/10/05 31/10/05 31/10/05 31/10/05 31/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA8 YA22 Good Practice Recommendations It is recommended that service users are offered the opportunity of participating in the recruitment of all staff to the home. It is recommended that the homes complaints procedure is displayed within the home. Hilltop G56 G06 S7271 Hilltop V240018 140705 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Gredley House 1-11 Broadway London E15 4BQ 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 Hilltop G56 G06 S7271 Hilltop V240018 140705 Stage 4.doc Version 1.40 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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