Inspection on 29/11/05 for Hilltop

This inspection was carried out on 29th November 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 14/07/05

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 29th November 2005 10:00 Hilltop DS0000007271.V270249.R01.S.doc Version 5.0 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 Hilltop DS0000007271.V270249.R01.S.doc Version 5.0 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 Adults 18-65. 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. Hilltop DS0000007271.V270249.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hilltop Address 1 The Drive Walthamstow London E17 3BN 020 8520 5348 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) MCCH Society Limited Ms Sue Farress Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Hilltop DS0000007271.V270249.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th July 2005 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, and 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 DS0000007271.V270249.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 29/11/05 and was unannounced. The inspector had the opportunity of speaking with service users, staff, and the homes manager was present for most of the inspection. Overall, the inspector was satisfied that this is a well run home. Service users spoken to informed the inspector that they are generally satisfied with the level of care and support provided, although they would welcome greater opportunity to access the community. What the service does well: What has improved since the last inspection? 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. Hilltop DS0000007271.V270249.R01.S.doc Version 5.0 Page 6 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 Outcomes Statutory Requirements Identified During the Inspection Hilltop DS0000007271.V270249.R01.S.doc Version 5.0 Page 7 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 the following 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 Statement 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 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 DS0000007271.V270249.R01.S.doc Version 5.0 Page 8 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 DS0000007271.V270249.R01.S.doc Version 5.0 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 the following standard(s): 6,7,8,9 and 10 It is the view of the inspector that service users have a large measure of control over their daily lives, care planning is of a good standard, and service users are involved in the day to day running of the home. However, the home must ensure that risk assessments are comprehensive and up to date. EVIDENCE: All service users have clear and comprehensive care plans in place. Plans are drawn up with the involvement of the service user, and are regularly reviewed. Plans are individualised, and include information on personal care, mobility and social and leisure activities. There were also guidelines in place on managing any challenging behaviours that service users exhibit. Service users have an annual review meeting in conjunction with their placing authority, and daily logs are also maintained. Risk assessments are in place for all service users, for the most part assessments were clear and comprehensive, covering risks associated with falling and accessing the community. One service user will on occasions pick up cigarette ends and eat them whilst in the community. The risk assessment on their file states that when they are in the community, staff will keep hold of this service user at all times, and physically restrain them from bending down to pick up cigarette ends. The manager informed the Hilltop DS0000007271.V270249.R01.S.doc Version 5.0 Page 10 inspector that this was out of date, and that the home has a policy of “no restraint”, yet there was no other risk assessment in place on this issue. It is required that all service users have comprehensive, accurate and up to date risk assessments in place, covering all areas of potential risk to themselves and others. 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. Service users are involved in the day to day routine of the home, for example they have responsibility for laundry, cleaning and food preparation. Regular service user meetings are held, these give service users the opportunity of been involved in the running of the home, for instance over menu planning and choosing holidays. 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 DS0000007271.V270249.R01.S.doc Version 5.0 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 the following standard(s): 11,12,13,14,16 and 17 It is the judgement of the inspector that more needs to be done to enable service users to live valued and fulfilling lives in the community. Service users must be able to attend their chosen place of worship in line with their stated preference, and the home must provide sufficient community based social and leisure activities. EVIDENCE: One service user has a job delivering papers and leaflets in the area. At present no service users are involved in any formal education, nor do any service users have access to day services. The manager informed the inspector that they believed several service users would benefit from and wish to attend day services, and it is a repeat requirement that day services are provided in line with service users assessed needs and stated preference. Care plans for two service users indicate that they go to church every other Sunday when it is “their turn”. The manager explained that staffing levels are insufficient to support both service users to go to attend church every week, and that therefore they take turns and go on alternate weeks. Both service users spoken to informed the inspector that they would like the opportunity of Hilltop DS0000007271.V270249.R01.S.doc Version 5.0 Page 12 visiting church every Sunday, and it is required that the home meets service users needs in relation to their spiritual and religious beliefs. Service users have access to a variety of social and leisure activities, both in house and in the community. In house service users have access to TV, DVD, music, board games, puzzles and the home has a fishpond that service users help maintain. In the community service users go to the pub, cinema and bowling. However, as at the last inspection the inspector has concerns that service users are not provided with sufficient community based social and leisure activities. For example, records indicated that one service user had in the past month only been offered two leisure activities outside of the home, and this issue must be addressed. Service users are offered an annual holiday as part of their basic contract price. Service users are involved in choosing and planning their holidays, and this year there have been holidays to Spain and France. 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. 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, and since the last inspection there is now a key code in place to denote what each colour represents. Hilltop DS0000007271.V270249.R01.S.doc Version 5.0 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 the following standard(s): 18,19,20 and 21 The inspector was satisfied that appropriate arrangements have been made to ensue that service users personal and health care needs are been met. EVIDENCE: Guidelines were in place on providing personal care to service users in care plans. These guidelines indicated that staff encourage service users to do as much of their personal care 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, including any follow up action necessary. These evidenced that service users have access to health care professionals as appropriate, including physiotherapists, psychiatrists, opticians and dentists. All service users have recently been offered a flu vaccination. The home makes use of the Continence Advisory Service, who supply advise and continence products. Used continence products are disposed of appropriately. The home has a comprehensive medication policy in place, and all staff receive training before they are able to administer medication. No service users Hilltop DS0000007271.V270249.R01.S.doc Version 5.0 Page 14 currently self medicate or are on any controlled drugs. Medications are stored in a locked cabinet. The home keeps records of medications entering the home and of those that are returned to the pharmacist. Clear guidelines are in place for the administration of medication prescribed on a PRN basis. Medication Administration Record (MAR) charts are maintained. However, these contained several unexplained gaps in them, and it is required that all medications are administered and recorded appropriately. The home has a policy in place on death and dying. The home has sought and recorded the views of service users (or their relatives where appropriate) on their wishes in the event of their death. The manager informed the inspector that service users would be able to remain in the home with a terminal illness as long as the home was able to meet their medical needs. Hilltop DS0000007271.V270249.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 22 and 23 The inspector was satisfied that the home has taken appropriate steps to help ensure that service users are not at risk from adult protection issues. Staff have received training in this area, and policies and procedures are in line with current legislation. EVIDENCE: The home maintains a complaints log, although the manager informed the inspector that the home had not received any complaints within the past twelve months. There was also a complaints procedure, this included contact details of the CSCI, and since the last inspection is now on displayed within the home. The home has a copy of the Local Authorities adult protection procedures, also its own policy on adult protection. This appeared to be in line with current legislation. All staff have undertaken training in adult protection issues, and staff spoken to demonstrated a good understanding of their roles and responsibilities with regard to adult protection. All service users have their own bank accounts. The home holds money on behalf of service users in a locked safe. Records and receipts are maintained of financial transactions involving service users monies. The inspector checked several financial records at random, and all appeared to be satisfactory. Hilltop DS0000007271.V270249.R01.S.doc Version 5.0 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 the following standard(s): 24,25,26,27,28,29 and 30 It is the inspector’s judgement that service users are provided with adequate communal and private space. However, more attention must be paid to maintenance issues, such as broken furniture and stained carpets. 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. However, the carpet in the hallway and dining area was badly stained, and this must be cleaned or replaced. The home consists of two sitting rooms, a conservatory, kitchen/dinning area and garden, service users are able to move freely around communal areas. The garden has appropriate garden furniture, and a BBQ. However, the front garden was overgrown and very untidy, and it is required that the home maintains the garden to a reasonable standard. Further, in the rear garden there was a discarded dishwasher and armchair, and these must be removed. The home recently had a new kitchen fitted, and service users were involved in choosing it. At the last inspection several Hilltop DS0000007271.V270249.R01.S.doc Version 5.0 Page 17 kitchen cupboard doors and handles were ether missing or broken, and these have subsequently been replaced. 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. Bathrooms were clean, tidy and free from offensive odour on the day of inspection. Since the last inspection all bathrooms are now fitted with a working lock, including an emergency override device. 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. In another bedroom the chair and a cupboard were damaged, 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 DS0000007271.V270249.R01.S.doc Version 5.0 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35 and 36 Whilst the inspector is satisfied that the staff team are sufficiently experienced and motivated to carry out their roles and responsibilities, they have concerns over the staffing levels, in that they are not adequate to meet the assessed needs of service users at all times, and this must be addressed. EVIDENCE: The home provides 24-hour support, including a waking night staff and an emergency on-call procedure. There was a staffing rota on display, this accurately reflected the actual staffing situation on the day of inspection. On a typical day the home will have two staff on the early shift, two staff on the late shift and one night staff. There is sometimes a staff member on administrative duties during the day, and occasionally a flexi shift. On days when the home operates with just two staff on duty, this severely limits service users opportunities of accessing the community. The service users have diverse and often challenging needs, and if one staff member accompanied a service user in the community it would leave only one staff member to support the remaining service users. It is required that the home reviews its staffing levels to determine how it can meet the assessed needs of service users at all times. All staff are provided with a copy of their job description and the General Social Care Council codes of conduct. The home has produced a staff handbook, all staff receive a copy, this gives information about the home and policies and procedures. Through observation and discussion there was evidence that staff Hilltop DS0000007271.V270249.R01.S.doc Version 5.0 Page 19 have a good understanding of their roles and responsibilities, and have built up good relations with individual service users. Regular staff meetings are held, all staff can contribute to the agenda. Meetings include discussions on service user and health and safety issues. The home has policies in place on recruitment and selection and equal opportunities. The inspector spoke with staff members who had been recruited to the home since the last inspection. They informed the inspector that service users from the home had not been involved in their recruitment. It is therefore a repeat recommendation that service users from the home are given the opportunity of been involved in the recruitment of all staff to the home. Staff employment records are held centrally by the organisation, and will be checked as part of the next inspection. All staff receive a structured induction, this includes health and safety and service user issues. Staff work as supernumerary for the first two weeks, giving them the opportunity of shadowing experienced staff members. Records are maintained of staff training, these indicated that staff have recently undertaken training in autism, epilepsy, first aid and Makaton. Of the seven care staff currently employed, six either have or are currently working towards a relevant care qualification. The manager informed the inspector that the sixth member of the staff team would hopefully begin a care qualification at the end of their probationary period. All staff receive supervision from the homes manager. The agenda is set jointly by both parties, and staff receive a copy of the minutes. Supervision covers training, performance and service user issues. However, records indicated that for some staff supervision is infrequent, for example one staff member has had only three formal supervisions in the past twelve months. It is required that all staff receive regular formal supervision, at least six times a year. Hilltop DS0000007271.V270249.R01.S.doc Version 5.0 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None The standards in this section were not tested on this occasion, but will be tested as part of the next inspection. EVIDENCE: The standards in this section were not tested on this occasion, but will be tested as part of the next inspection. Hilltop DS0000007271.V270249.R01.S.doc Version 5.0 Page 21 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 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 2 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 2 3 3 3 3 LIFESTYLES Standard No Score 11 2 12 3 13 2 14 2 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 2 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hilltop Score 3 3 2 3 Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000007271.V270249.R01.S.doc Version 5.0 Page 22 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 YA26 Regulation 23 Requirement 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 31/10/05 not met) The registered person must ensure that all service users have access to appropriate day services in line with their assessed needs and stated preference. (Timescale 31/10/05 not met) The registered person must ensure that all service users have access to appropriate and sufficient community based social and leisure activities in line with their assessed needs and stated preference. (Timescale 31/10/05 not met) The registered person must ensure that comprehensive, accurate and up to date risk assessments are in place for all service users, covering all areas of potential risk to themselves and others. The registered person must DS0000007271.V270249.R01.S.doc Timescale for action 31/03/06 2. YA13 16 31/03/06 3. YA14 16 31/03/06 4. YA9 13 31/03/06 5. Hilltop YA11 16 31/03/06 Page 23 Version 5.0 6. YA20 13 7. YA24 23 8. YA24 23 9. YA26 23 10. YA33 18 11. YA36 18 ensure that service users have the opportunity to attend religious services of their choice. The registered person must ensure that all medications are appropriately administered and recorded. The registered person must ensure that the stained carpet in the hall and dining area is appropriately cleaned or replaced. The registered person must ensure that the home’s garden is well maintained, and that discarded items of furniture are removed from the garden. The registered person must ensure that service users are provided with well maintained and adequate bedroom furniture in line with National Minimum Standards. The registered person must carry out a review of staffing levels to determine how the home can meet the assessed needs of service users at all times. The registered person must ensure that all staff receive regular formal supervision, at least six times a year. 31/03/06 31/03/06 31/03/06 31/03/06 31/03/06 31/03/06 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 YA8 Good Practice Recommendations It is recommended that service users are offered the opportunity of participating in the recruitment of all staff to the home. Hilltop DS0000007271.V270249.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford 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 DS0000007271.V270249.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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