Inspection on 15/11/05 for Homecrest Residential Home

This inspection was carried out on 15th 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Homecrest Residential Home 12/02/07

Homecrest Residential Home 02/10/06

Homecrest Residential Home 17/02/06

Homecrest Residential Home 14/09/04

Homecrest Residential Home 28/04/04

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Homecrest Residential Home 49/55 Falkland Road Wallasey Wirral CH44 8EW Lead Inspector Les Smith Unannounced Inspection 15th November 2005 09:30 X10029.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Homecrest Residential Home DS0000033293.V267459.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 Older People and 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. Homecrest Residential Home DS0000033293.V267459.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Homecrest Residential Home Address 49/55 Falkland Road Wallasey Wirral CH44 8EW 0151 639 7513 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) Norens LTD Linda Margaret Knapman Care Home 34 Category(ies) of Dementia - over 65 years of age (34) registration, with number of places Homecrest Residential Home DS0000033293.V267459.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Thirty Four (34) adults over the age of 65 (DE/E) with dementia and may from time to time admit persons between the age of 60 and 65 years of age. 14th September 2004 Date of last inspection Brief Description of the Service: Home crest is a detached three storey building in a residential area of Wallasey. There is off-street parking at the front of the building and a patio/garden area at the rear. Homecrest is close to local shops, amenities and public transport facilities. Home crest is registered to provide care for up to 34 people Dementia over the age of 65 and may accommodate younger adults between the age of 60 and 65 from time to time. All communal facilities are on the ground floor and a lift serves all storeys. Homecrest is an accredited holder of the British standards Institute ISO 9001and is also accredited for the ‘Investors in people’ award. Homecrest Residential Home DS0000033293.V267459.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 over a period of 7 hours in the presence of the registered manager. Time was spent in discussion with the manager and examining records and associated documentation. A tour of the home was carried out. The inspector spoke to several residents and visitors to the home 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. Homecrest Residential Home DS0000033293.V267459.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Homecrest Residential Home DS0000033293.V267459.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5,6 The homes Statement of Purpose does not provide enough information for prospective residents to make a fully informed choice about where they want to live. EVIDENCE: The homes Statement of Purpose needs to be updated to include all the details required in schedule 1 of the Care Homes Regulations 2001. The service users guide has been updated but requires further updating to remove the individual inspectors name and insert the phone number for CSCI. Homecrest Residential Home DS0000033293.V267459.R01.S.doc Version 5.0 Page 8 Each service user has a contract detailing the terms and conditions and these were evidenced on the residents files examined. Residents are only admitted to Homecrest following a detailed pre-admission assessment. All pre-admission assessments are carried out by the homes manager and include direct input from the prospective service users’ family / representative. Resident files examined also contained copies of the assessments from social services. Resident care plans are detailed, comprehensive and clearly set out how the individual needs of each resident can be met. The manager encourages and promotes visits or trial periods of stay in the home before the resident moves in on a permanent basis. Homecrest does not provide intermediate care. Homecrest Residential Home DS0000033293.V267459.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service Users, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 There is a comprehensive and consistent care planning process in place that supports the residents by providing staff with the information they need to satisfactorily meet the residents identified and changing needs. Medication management is fully compliant with current good practice requirements and guidelines. EVIDENCE: Homecrest Residential Home DS0000033293.V267459.R01.S.doc Version 5.0 Page 10 A random selection of care plans and related documentation was examined as part of the case tracking process. Care plans included biographical, physical and mental health details and risk assessments. Some risk assessments were only included were it was considered to be appropriate and it will be a recommendation of this report that risk assessments for pressure sores e.g. Waterlow score, Nutrition, Falls risk, mobility and handling are included for all residents. Care plans detailed specific interventions for mental health as well as physical problems and also detailed behavioural triggers and specific interventions. Care plans were reviewed on a regular basis and the case tracking process demonstrated that changing needs were reported and acted upon in a timely way. A separate record within the care plan recorded all visits by health care professionals and records were seen detailing visits by GPs, district nurses, continence specialists etc. There are no residents self-medicating at Homecrest. The MAR sheets were examined and the inspector found all to be completed with no signature gaps. Residents drugs returned to pharmacy are recorded, a date and signature from the pharmacy representative being obtained when returned. The manager conducts a monthly audit on medications and this was demonstrated to be effective by the standard of medication storage, administration and stock control for all drugs and not just those classed as drugs of potential abuse. Homecrest does not hold ‘Homely remedies’ and only medications prescribed for residents is held. The inspector observed staff speaking and caring for residents with dignity and respect. The visitors’ room on the second floor remains rarely used and plans still exist for converting Homecrest to all single rooms. Should this not occur in the near future then the visitors’ room should be refurbished current décor and furnishings are not conducive to promote use. Shared rooms are provided with screens to allow personal care to be given in a discrete and sensitive way. The home has a policy in place in relation to dying and death. Homecrest Residential Home DS0000033293.V267459.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service Users have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 As far as possible residents have choice and flexibility in how they spend their day in the home, and pursue leisure activities according to their choice and preferences. This allows independence and individuality for each resident. Meals at Homecrest are good, offering choice and variety whilst catering for residents dietary needs or cultural preferences EVIDENCE: Homecrest Residential Home DS0000033293.V267459.R01.S.doc Version 5.0 Page 12 Key workers record residents’ likes and dislikes in the care plans and daily routines are as far as possible arranged to meet individual preferences. The home staff provides a range of activities such as old movies, bingo and continue to hold events such as a summer fair to raise funds to purchase additional leisure materials for the residents. The activities co-ordinator is currently on maternity leave and the inspector was informed that if she does not return a replacement would be recruited. All religious denominations are served by a catholic mass being held in the home every Friday and there are regular interdenominational services. Outside entertainers visit the home every month and staff members are positively encouraged to do one to one activities with residents. The inspector observed examples of one to one activity during the inspection. Family/representatives and other visitors are welcomed at the home at any time. Comments from one visitor at the time of the inspection were very complimentary in relation to the care given at the home and the attitude of staff. A varied and nutritious diet is provided with residents special dietary needs or cultural preferences being catered for. On the day of inspection the inspector observed the mid-day meal being served. Meals were well presented and appeared to be wholesome and nutritious. Staff was observed helping residents in a discrete, unhurried and sensitive way during the mealtime. The menus seen were varied and provided for alternatives for each meal. The kitchen was clean and well organised. Fridge and freezer temperatures were recorded as required. The food stores were examined and found to be clean, well stocked and well maintained. Homecrest Residential Home DS0000033293.V267459.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service Users feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 The home has a complaints and adult protection policy and procedure in place to help ensure the safety and welfare of residents. EVIDENCE: Homecrest has an appropriate complaints procedure. There has been one complaint made directly to the CSCI since the last inspection which was investigated and found to be unsubstantiated. The complaint procedure is prominently displayed in the entrance hall and includes the address and phone number of the CSCI. All residents’ are registered on the electoral roll and a number do participate in any elections. There is a policy on adult protection in place including whistle blowing. Homecrest Residential Home DS0000033293.V267459.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 The overall structure and external decoration of the building is of a good standard. Most residents’ rooms are personalized to varying degrees; however there is a backlog of maintenance, which is not conducive to safe comfortable surroundings and potentially places residents at risk of harm or injury. EVIDENCE: Ramps and handrails facilitate access to both the homes front entrance and the rear garden. Rooms are spacious and airy and decorated to a good standard. An extensive programme of redecoration is in progress with floors being colour Homecrest Residential Home DS0000033293.V267459.R01.S.doc Version 5.0 Page 15 coded to help residents with their orientation. There is however a backlog of maintenance and refurbishment needed to meet the required standard as detailed in requirements 2 and 3. There are two communal lounges that are both used extensively by the residents. Both lounges are decorated to a good standard but the chairs in lounge 1 are in very poor condition. The dining room carpet is very badly stained and should be replaced. The inspector was informed that despite regular deep cleaning it cannot be improved. There are sufficient bathrooms and toilets available and two of the single rooms have ensuite facilities. Toilet 1 and bathroom 5 are both in need of refurbishment as detailed in requirement 2. Handrails are fitted throughout the home in all appropriate areas and a passenger lift serves all floors. Specialist equipment such as wheelchairs and pressure relieving mattresses are provided as necessary. The front of the home is a parked area but is inaccessible to residents. There is a large well-maintained garden to the rear of the home. The concrete pathways have however started to break-up, as have some parts of the flagged area. On the day of inspection the home was clean, pleasant and hygienic with the exception of two bedrooms, which were malodorous. The inspector was informed that despite regular cleaning and some alternative flooring being installed the nature of the residents’ conditions was proving to be a difficult problem to solve. The inspector was assured that efforts are continuing to find a solution. Homecrest Residential Home DS0000033293.V267459.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Residents benefit from and are supported by robust recruitment policies and an effective, skilled and competent staff team. EVIDENCE: A random selection of staff files including recent starters were examined and found to contain all the required documents including two references, CRB checks and proof of identity. Also present were clear job descriptions, terms and conditions, health questionnaire and evidence of induction training. All staff are given a staff handbook on commencement at Homecrest. One support worker has NVQ 4, one has NVQ 3 and five have NVQ 2. All domestic staff also have NVQ 2. There are two support workers currently studying for NVQ 3 and three for NVQ 2. All senior carers have a valid first aid certificate and there is always a qualified first aider on duty. All staff had completed the required mandatory training in fire safety, manual handling and first aid. Homecrest Residential Home DS0000033293.V267459.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Residents benefit from a well qualified, experienced manager who is competent to ensure that the health, safety and welfare of residents is promoted and safeguarded. Homecrest Residential Home DS0000033293.V267459.R01.S.doc Version 5.0 Page 18 EVIDENCE: The registered manager has substantial experience, holds the relevant qualifications and has been registered by the Commission for Social Care Inspection as a fit person to manage the home. Homecrest was awarded ‘Investor in people’ status in March 2004 and is also accredited by British standards Institute (BSI) holding the ISO 9001 certificate. The BSI conduct six monthly quality assurance inspections and the latest of these had been conducted several weeks prior to this inspection. Resident and family/representative questionnaires are also distributed and processed by the owners’ headquarters. Staff supervision is in place and is carried out by either the manager or deputy manager. Staff appraisal takes place yearly. Monies held for residents were checked against records and found to be correct. Receipts for expenditure are kept and were seen. Monies are held centrally but no interest is generated. If an excessive surplus is accumulated then social services are requested to hold any further payments until notified. Fire alarm and emergency lighting checks are appropriately done and recorded. COSHH assessments had been undertaken and cleaning materials were stored in an appropriate place. On the day of this inspection the home was displaying a valid public liability certificate in a prominent place. All relevant safety certificates for Gas, Electricity, Lift, portable appliance tests and hoists were seen and were found to be valid. Homecrest Residential Home DS0000033293.V267459.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 3 4 3 5 3 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 ENVIRONMENT Standard No Score 19 2 20 3 21 3 22 3 23 3 24 3 25 3 26 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 3 33 3 34 X 35 2 36 3 37 3 38 3 Homecrest Residential Home DS0000033293.V267459.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 4(1)(c) Requirement Timescale for action 31/12/05 2 OP19 23(2)(b) The Registered Person must ensure that the Homes Statement of Purpose is updated and include the services and facilities provided by the home and all the items listed in schedule 1. The registered person is required 31/03/06 to ensure that the home is reasonably maintained both internally and externally: Replace/repair to sealant around wash basins in various rooms; Rm 25 – draw front coming off and bookcase not secured to wall Rm 23 – Malodorous floor covering requires replacement; Toilet 1 – New flooring required; Bathroom 5 – new flooring and bath required; Rm 9 – Bedside cabinet damaged; Rm 12 – Malodorous floor covering needs replacement and floor boards appear to be breaking up; Rm 2 - wardrobe handle missing; Rm 1 - wardrobe handle missing; DS0000033293.V267459.R01.S.doc Version 5.0 Homecrest Residential Home Page 21 Dining room – carpet very badly stained and needs replacement; 3 OP19 The registered person is required 31/12/05 to ensure that equipment provided for residents and staff is maintained in good working order: Grd floor toilet – Grab rail broken and dangerous; Lounge 1 – All chairs need replacement; Soap dispensers’ empty and communal soaps on sinks. 23(2)(o) The registered person must 31/03/06 ensure that the concrete pathways and flagged areas at the rear of the home are renewed and/or made safe 20(1) (a, b) The registered person must 31/12/05 ensure that monies held on behalf of residents is held in an interest bearing account and that interest is apportioned to the individual residents. 23(2)(c) 4 OP19 5 OP35 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 OP7 Good Practice Recommendations It is strongly recommended that risk assessments for Nutrition, Falls, Mobility and pressure sores are routinely included in all care plans. Homecrest Residential Home DS0000033293.V267459.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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. Homecrest Residential Home DS0000033293.V267459.R01.S.doc Version 5.0 Page 23 - 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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