Inspection on 18/04/06 for Houndswood House

This inspection was carried out on 18th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Houndswood House 02/12/08

Houndswood House 03/06/08

Houndswood House 13/02/08

Houndswood House 11/04/07

Houndswood House 09/11/06

Houndswood House 05/01/06

Houndswood House 22/06/05

Houndswood House 20/10/04

Houndswood House 04/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Houndswood House Harper Lane Radlett Hertfordshire WD7 7HU Lead Inspector Angela Dalton Unannounced Inspection 18th April 2006 10:55 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Houndswood House Address Harper Lane Radlett Hertfordshire WD7 7HU 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) 01923 856 819 01923 853 509 Speciality Care (REIT Homes) Limited Viginia Cheytan Care Home 65 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (65), of places Physical disability over 65 years of age (4), Terminally ill over 65 years of age (3) Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. This home may accommodate 4 older people who require personal care. This home may accommodate 45 older people with need for convalescent and respite care who require nursing care. This home may accommodate 3 older people in need of terminal care who require nursing. This home may accommodate 4 older people with dementia who require personal care. This home may accommodate 4 older people with physical disability who require personal care. Houndswood House may admit service users with elderly needs until a maximum total of 45 service users are resident. The condition will be removed once the Commission for Social Care Inspection is satisfied that the home is able to comply with and maintain regulatory requirements. 5th January 2006 Date of last inspection Brief Description of the Service: Houndswood House is a care home providing nursing and personal care and accommodation for 65 older people including people with Dementia (DE), Physical Disability (PD) and Terminally ill (TI). The home is owned by Craegmoor and registered under Speciality Care (REIT Homes) Limited. The home was opened in 1997 and is situated in a rural area between London Colney and Radlett. It is a period house with modern extensions, set in extensive parkland gardens with pathways and a large patio area, which can be reached via the lounge, dining room or conservatory. The home is divided into two areas, identified by staff as the ‘main house’ and the ‘extension’. The older part of the house has one large ground floor lounge and a small sitting room. The ‘extension’ has communal areas all on the ground floor, which include dining, lounge and conservatory areas. All bedrooms in the new area have ensuite facilities with toilets. Bathrooms have hoists fitted to baths. A lift serves each end of the home and a newer wheelchair lift has been added to enable improved access to one part of the older building. The home is reached via a driveway from Harper Lane. Car parking facilities are provided to the front and rear of the building. Houndswood House is not served by public transport, but is close to Junction 22 of the M25 Motorway. Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 5 The majority of the bedrooms are for single accommodation (47) and there are 9 double sized rooms. 41 single rooms and 4 double rooms have en-suite facilities. The home has extensive gardens that are well maintained and easily accessible. Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted by three Inspectors on 18th April 2006 between 10.55am and 6.15pm. There have been some improvements made since the previous visit but further developments are still required to enable the current risk assessment to be altered. Houndswood House was accommodating service users and staff from its sister home Ravenscroft in Barnet following a fire in 2005. Ravenscroft has since been sold and staff and service users who wished to remain at Houndswood House have done so. This has addressed the feeling of uncertainty that staff and service users were previously experiencing. Houndswood House charges in the region of £700 per week although fees will vary according to individual requirements. What the service does well: What has improved since the last inspection? What they could do better: Staff interaction with service users was observed to be poor. Service users were having things done for them rather than with and on several occasions staff did not speak to service users or ignored them. The care of service user varies according to the member of staff and examples will feature in the body of the report. Staff presence was low throughout the home and there were long periods of time were service users were left unsupervised. Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 7 Relatives were observed to have difficulty finding members of staff and a service user in their bedroom stated the only time they saw anybody was at meal times. Care plans contained contradicting information and weight records were not kept as prescribed in the care plan. Assessment tools were in place to measure weight loss and depression but no corresponding action plan was in place when assessments identified that deterioration had occurred. Food and drink was disposed with at lunchtime but this information was not transferred to care plans or to colleagues to ensure service users eat and drink. Bedrooms remain spartan and some service users had few clothes and those they did have were shabby and worn. One service user invited an Inspector to look in their wardrobe which bore out that they had few clothes. They were wearing a pair of split trousers whilst having this conversation. Although there have been improvements in the environment and record keeping the culture of the home appears to remain unchanged. 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. Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 The home is not fully meeting identified individual needs. Quality in this outcome area is poor. EVIDENCE: Each service user had an assessment in place that was either conducted by the home staff or a care professional. Although assessed needs were identified as stated in the introduction they were not always monitored as part of the care plan. One care plan identified that weight records were to be monitored weekly but details were sporadic. The records that had been taken illustrated that weight loss occurred but no action plan was in place to show how it was being dealt with. The same was true of monitoring service users’ mental health: an assessment tool is being used to measure depression but when the outcome showed depression not all service users had a plan of care in place demonstrating how this need is met. The manager acknowledged that care plans are still being worked upon but improvements were required. The level of care delivered is not meeting the needs identified in the assessment phase. Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 10 A requirement has been made to update the Statement of Purpose and Service Users’ Guide to reflect that the capacity of the home is currently reduced. Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Care plans do not adequately inform how service users are to be cared for. Staff do not implement guidance contained within the care plan. The majority of staff fail to observe service users’ dignity. Quality in this outcome area is poor. EVIDENCE: As previously stated there has been some improvement in care plans and the manager acknowledges that there is further work to do. In addition to the issues mentioned in the previous chapter the care plans contained conflicting information. One service users’ care plan stated that they did not have any religious beliefs and also that they saw the vicar monthly and was a member of the Church of England. Another care plan stated that a service user was fully mobile but also required two carers for toileting. These examples are not isolated but provide evidence that developments are still required. Where full guidelines are in place staff do not appear to be following them. One service user had at least ten cups left in his room which had clearly been accrued over some time and not removed. Despite challenging behaviour against other service users being identified in his care plan the Inspector spent twenty minutes on the first floor before encountering a member of staff. Service users may be at risk if the level of supervision is inadequate. Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 12 Health needs of service users are being compromised by the poor recording of needs (e.g. weights) and not following through on the outcome of assessments. Medication was checked and major improvements have occurred. A requirement has been made to carry forward amounts of ointments and liquid medication. Although some staff are reported to be caring and kind – one relative referred to a nurse as the ‘best of the best’, poor interaction was noted throughout the home. Dignity of service users continues not to be observed and this occurs through every aspect of care delivery. Some mouth care is still poor: a service user whose dentures have been loose since the previous inspection in January is due to have them replaced next week. Some service users needed attention paying to the cleanliness of their teeth. Signs from relatives and staff to provide instructions continue to adorn bedroom walls and would be better placed in a folder or discreet place. Inspectors observed service users being ignored. One service user was woken to be assisted with a drink whilst another service user was ignored who was trying to attract staff attention. A female service user asked to go to the toilet and when they realised they had asked a male carer they said ‘Oh you can’t take me can you?’ The carer replied ‘We’re going to serve you some lunch’ and did not pass on her request to a female colleague. The service user then had to ask again after attracting the attention of a female member of staff. A service user with a visual impairment was seated facing the window and not included in the group (this was attended to once reported). Another service user was having reminiscence cards thrust into her face in an aggressive manner. Whilst discussing personal care a service user reported that they weren’t always properly dried as they couldn’t dry their back. ‘Depends on who bathes me, depends whether I’ll ask. Some don’t speak from start to finish except to say “arms up’’ or whatever. Some are nice though.’ Three Inspectors observed many instances were service users’ dignity was compromised and this must be addressed, as it appears endemic within the culture of the home. The appointment of a deputy manager and senior nurses may assist in this transition. Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Service users can participate in a small selection of activities. Meals are varied and appetising but not delivered in a dignified manner. Nutrition is not monitored. With the exception of meals quality in this outcome area is poor. EVIDENCE: Service users spoke highly of the activities co-ordinators stating they were kind, considerate and patient. Radio 1 was on in the main house and this appears to have been chosen by the staff rather than the residents. The activities co-ordinator played a Glen Miller CD which received a more positive response. Board Games were being played but the activities co-ordinator resources are stretched. Most activities take place within the home and this is probably due to its remote location. The activities co-ordinator was assisting the hairdresser and was not able to fully concentrate upon overseeing activities. The hairdresser would be able to offer a one to one consultation if a staff member was available to assist with service users who wander. A designated room has been made available for the hairdresser as she was previously working in a corridor. It is recommended that a hairdressing basin be fitted as a domestic basin is in use (a specialist basin had been previously delivered but broke whilst being fitted.) A requirement has been made regarding restraint of a service user in order to dye their hair. The care plan reported that two staff members were required as the service user became violent when visiting the hairdresser. Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 14 The manager has explored this but must do so further as she has a duty of care to ensure that service users are not unnecessarily distressed. Meals continue to be of a high standard: lunch was hot and tasty and an easy to read accurate menu was on display. Unfortunately staff did not ensure that lunch was a pleasurable experience. A service user was being fed with a heaped tablespoon. After an inspector intervened the spoon was replaced with a dessertspoon but this was still heaped. Although plate guards were in a drawer they were not attached to plates prior to serving. Again, following an Inspector intervening after observing service users struggle plate guards were fitted but this drew attention to service users requiring assistance. Meals were placed in front of service users without informing them what was being served or any pleasantries exchanged. Portions of meals and large amounts of drink were disposed of and when the carer was asked who they belonged to they were unsure. This illustrates that food and drink is not being adequately monitored. Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 A complaints protocol is in place. Service users are not safeguarded from abuse and quality in this outcome area is poor. EVIDENCE: Moving and handling was observed to be of a higher standard on this occasion although interaction by staff could be improved. There is a format for complaints to be recorded and the procedure is prominently displayed with the home. As discussed earlier a protocol is required if service users are being restrained. Staff must be mindful that occasions where service users’ dignity is not observed may be interpreted as abuse. One service user had a table placed in front of them; they asked for this to be removed and it was briefly but then replaced. Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected 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 Service users are not assured of privacy. The environment does not fulfil its potential. Quality in this outcome area is poor. EVIDENCE: Following the closure of Ravenscroft, Houndswood House has inherited an amount of furniture. This has improved the lounge areas in the main house but the standard furniture must be addressed. In parts of the home, tables had loose legs and furniture was missing veneer. Floor covering is industrial in some bedrooms but this is to be replaced as part of the refurbishment process. Some of the bedrooms remain spartan and impersonal. This must be addressed now that service users will not be returning to Ravenscroft. All bedrooms do not have a lock on the door and as such privacy is not assured. Hoists, wheelchair friendly weighing scales and laundry stands were some of the items in corridors and bathrooms. This impacted upon the accessibility of bathrooms and the space for service users and staff to move freely around the home. The toilets in the main house on the ground floor are still not accessible to wheelchair users and are often used for storage. The corridor which had no heating at the previous inspection has had a fan heater fitted to a bracket. Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 17 A requirement has been made to ensure this is safe. Some bedrooms were too hot and a fan was broken so a comfortabole temperature could not be achieved. The odour within the home has been addressed and this is a vast improvement. Bedroom mattresses were stained and soiled. This must be addressed. Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Staffing levels do no not assure the safety of service users. Adequate personnel documentation was not in place. Quality in this outcome area is poor. EVIDENCE: Staff were not always visible within the home and service users were often left unsupervised. Staffing levels should be reviewed. Internal rotation has recently ceased and staff either work in the main building or extension. If the shift leader has weak management skills this affects the way in which the team works and has an obvious bearing on the way in which care is delivered. This has been referred to in earlier parts of the report. Recruitment records were checked and care staff had all necessary documentation in place. A new member of domestic staff did not have a comprehensive work history or school or college addresses. A requirement has been made. Training has been provided but staff appear to have difficulty applying theory to practise as illustrated previously. Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,38 The home is not run in the best interests of the service users. The health and safety of service users and staff is not assured. EVIDENCE: The Inspectors discussed the culture of the home with the manager and stressed that this needed to change in order for the home to progress. Stronger leadership is required in order for staff to recognise that current practice is unacceptable. The home appears to be run for the convenience of staff rather than the comfort of service users. The manager must evidence to the Commission that the fan heater fitted in the bedroom corridor ensures the health and safety of service users and staff; it must not pose a risk to fire safety and be electronically sound. The dining room floor was being mopped at 11am which posed a risk to both service users and staff. This practice is to cease and to recommence earlier in the morning. Door wedges must not be used and they are still in use in service users bedrooms and offices. Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 20 An Inspector broke the break panel on the fire door release system, as instructions were unclear as to how the emergency fire door was activated. A member of staff who had worked in the home for two months was unsure of how to release the door. Financial records were inspected but it was unclear how service users would be notified regarding the amount of personal allowance they had available if the company looked after accounts. This will be inspected again and the manager is required to ensure that service users have an awareness of how to access money. One service user’s care plan states that he did not like to spend money but should be encouraged to buy new clothes. There was no accompanying action plan to explain how this was achieved and clothes had not been purchased. Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 1 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 2 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 1 3 1 3 3 1 1 3 STAFFING Standard No Score 27 1 28 3 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 1 2 2 3 X 1 Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 6 Requirement Timescale for action 31/05/06 2. 3. OP4 OP7 12(1)(a) (b) 12 &15(2)(b) 4. OP8 12(1)(b) The Statement of Purpose and Service Users’ Guide must reflect that the occupancy numbers have been reduced by the Commission for Social Care Inspection. An update copy must be sent to CSCI. Service users’ assessed needs 30/04/06 must be met. 15/05/06 Care plans must be consistent and staff must be aware of guidance. Service users needs must be identified (e.g. pressure care, sensory, nutrition, challenging behaviour) and details recorded of how they will be met, monitored and managed. This requirement was made at previous inspections. AN ENFORCEMENT NOTICE MAY BE SERVED. Health needs must be fully met 15/05/06 e.g. oral hygiene and dental care. This requirement was made at previous inspections. A Service User had waited three months for replacement dentures. AN ENFORCEMENT NOTICE MAY BE SERVED. DS0000019459.V288793.R01.S.doc Version 5.1 Houndswood House Page 23 5. OP9 13(2) 6. OP10 12(4)(a) 7. OP15 16(2)(i) 8. OP18 13(6)(7) (8) 9. OP19 23 10. OP21 23(2)(n) Accurate records must reflect correct amounts of medication. Amounts of liquid medication and creams must be carried forward. The dignity of service users must be observed. This requirement was made at previous inspections. Staff must improve their interaction with service users and demonstrate kindness and consideration. AN ENFORCEMENT NOTICE MAY BE SERVED. Nutritional needs must be met; Service users must be treated with dignity at mealtimes and individual needs are to be met. Food intake is to be monitored as meals and drinks are currently disposed of indiscriminately. Where concern is identified appropriate action is to be taken. Service users are not to be restrained unless agreed by a multidisciplinary team with a written agreement in place. The manager must be aware of her duty of care. An up to date refurbishment plan is to be submitted in light of changes to senior personnel to illustrate the company’s commitment to refurbishment of Houndswood. The toilets in the main house on the ground floor are not accessible to wheelchair users. This is not acceptable with the current needs of service users. This requirement was made at previous inspections. A plan of action must be submitted to the Commission for Social Care Inspection. 15/05/06 30/04/06 15/05/06 15/05/06 31/05/06 31/05/06 Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 24 11. 12. OP24 OP25 12(4)(a) 23(2)(p) 13. OP27 18(1)(a) (b) 14. OP29 17(2)&19 (1) 15. 16. OP32OP31 OP33 9 24 17. 18. OP35OP34 OP38 13(6) 13(3)(4) 23(4) Locks must be fitted to bedroom doors to ensure service users’ privacy. Service users rooms must be of a comfortable temperature. Some are currently too hot and cannot be controlled. Fans do not work in all rooms. Staff must meet the needs of the service users and demonstrate that their dignity and safety is assured. Service users are regularly left unsupervised. This requirement was made at previous inspections. A copy of the worked rota must be supplied to the Commission at the end of each month. Adequate staffing levels must be evidenced to avoid enforcement action being implemented. Recruitment documentation must reflect that an adequate work and schooling history had been researched. Domestic staff must undergo rigorous recruitment checks. The manager must meet the outstanding requirements to demonstrate fitness. A copy of the quality assurance audit must be submitted to CSCI to illustrate how the home is run for the benefit of service users. Service users must have access to their finances and account breakdown. Health and Safety must be observed within the home: Internal fire doors and bedrooms doors continue to be wedged open, a safe fire protocol is not in place and staff were unaware of safe evacuation procedures and how to operate emergency fire exits, parts of the home are too hot, a floor was being mopped at 11am, a fan heater DS0000019459.V288793.R01.S.doc 31/05/06 30/04/06 30/04/06 30/04/06 31/05/06 31/05/06 15/05/06 31/05/06 Houndswood House Version 5.1 Page 25 has been fitted to a corridor wall. The Commission must be notified as to how the above issues have been addressed. AN ENFORCEMENT NOTICE MAY BE SERVED AS HEALTH AND SAFETY ISSUES HAVE BEEN RAISED AT PREVIOUS INSPECTIONS. 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. 3. 4. Refer to Standard OP12 OP13 OP29 OP30 Good Practice Recommendations Staff should be available to support the activities coordinators and hairdresser to enable service users to fully benefit from their input. Community participation is to be encouraged as many activities are confined to within the home. Where copies of recruitment documents are kept on file a record should be made to reflect that the originals have been seen. Staff should evidence that they have received training by demonstrating good care practice. Houndswood House DS0000019459.V288793.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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. 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