Inspection on 09/11/06 for Houndswood House

This inspection was carried out on 9th November 2006.

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

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

Other inspections for this house

Houndswood House 02/12/08

Houndswood House 03/06/08

Houndswood House 13/02/08

Houndswood House 11/04/07

Houndswood House 18/04/06

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 09 November 2006 10:15 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.V310534.R01.S.doc Version 5.2 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.V310534.R01.S.doc Version 5.2 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 Virginia Cheytan Care Home 65 Category(ies) of Dementia - over 65 years of age (23), Old age, registration, with number not falling within any other category (45), of places Physical disability over 65 years of age (4) Houndswood House DS0000019459.V310534.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 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 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. This home may accommodate 23 named individuals with dementia who require personal care. If a named individual is no longer resident at the home for any reason the CSCI must be informed and the number will be reduced appropriately. 27th June 2006 5. 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 and an assisted bath is available on the ground floor. A lift serves each end of the home and a 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.V310534.R01.S.doc Version 5.2 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 charges in the region of £700 per week although fees will vary according to individual requirements. Houndswood House DS0000019459.V310534.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit was conducted by two Regulation Inspectors from the Commission for Social Care Inspection who were joined by a Health and Safety Inspector who conducted a focused inspection on Moving and Handling Practice. It took place between 10.15 am and 7.15pm. Some improvements have been made, specifically to the environment but outstanding requirements remain. The inspection consisted of discussions with service users, staff and relatives. The inspectors observed care delivery and toured the building. The home has made some efforts to improve. It was odour free and some communal areas are more relaxed due to a change in seating arrangement. Refurbishment work has commenced and two bathrooms have been created from an adjacent bathroom and toilet: one with an assisted bath (that has yet to be commissioned) and a shower room. The access to this area could be improved as the doorway is awkward to navigate. The majority of service users appeared well kempt and their personal care had been attended to. Where standards have not been inspected on this occasion they have been covered in previous inspections earlier in the year. What the service does well: What has improved since the last inspection? The refurbishment programme has commenced and this was evident in various areas of the home but is concentrated within the main house. New carpets had been fitted in bedrooms and communal areas. Some bedrooms have new furniture and are awaiting redecoration. There was no odour and this is a positive move as this has been an ongoing issue previously. Some service users have responded positively to the repositioned chairs in one of the lounges. Houndswood House DS0000019459.V310534.R01.S.doc Version 5.2 Page 7 The statement of purpose and service users’ guide have been updated to reflect the changes within the home. Results from a quality assurance survey have been collated and will be published in the near future. A newsletter has been published to advise of forthcoming attractions and publish pictures and accounts of recent events. 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. Houndswood House DS0000019459.V310534.R01.S.doc Version 5.2 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.V310534.R01.S.doc Version 5.2 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 adequate despite an up to date Statement of Purpose being in place; this judgement has been made using available evidence including a visit to this service. EVIDENCE: Each service user had an assessment in place that was either conducted by the home staff or a care professional. Assessed needs were identified as stated in the introduction they were not always monitored as part of the care plan: examples are pressure care and fluid intake. The regularity of weight recording has increased and this is an improvement from the previous inspection. A requirement made at the previous inspection has been met to update the Statement of Purpose and Service Users’ Guide to reflect that the capacity of the home is currently reduced. Houndswood House DS0000019459.V310534.R01.S.doc Version 5.2 Page 10 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 could better inform how service users are to be cared for. Observing dignity service users’ dignity. Quality in this outcome area is poor; this judgement has been made using available evidence including a visit to this service. EVIDENCE: There continues to be improvement in care plans but this has now been ongoing for several months. The lead inspector spent time during feedback identifying where further developments were needed in care plans. The Health and Safety Inspector correlated Regulation inspector findings that the there was insufficient detail in moving and handling guidelines. One service user had previously experienced serious pressure wounds and there was no turning chart or fluid chart in place to reflect the care plan. A turning chart appeared to be created during the inspection by a member of staff as the ink and handwriting was the same over consecutive days. One care plan identified that nutrition was to be promoted to encourage a weight gain but there was no record of the service user’s likes and dislikes to encourage this. Two service users were observed to have bruising but there was no record of staff having recorded this or any accident that may have contributed. Houndswood House DS0000019459.V310534.R01.S.doc Version 5.2 Page 11 Where good care has been delivered and is effective (e.g. pressure sore prevention) there is no record as to why this is successful. Further detail is required to evidence how service users with dementia have their needs met. Medication was checked and a requirement has been made, as recording did not accurately reflect the amount of medication available. Several handwritten instructions were not signed and some were illegible. One signature was overwritten to signify refusal, which appears to illustrate that the sheet was signed prior to administration, which is poor practice. A number of stock items had not been carried forward so no amount was reflected on the Medication Administration Record sheet. The inspector showed the manager where these issues were whilst checking medication records and storage. Some staff were observed to be caring and kind but some poor interaction was noted during the inspection. Staff in the main house were constantly busy ring to complete tasks such as medication, offer drinks and supervise meals whilst trying to ensure service users who wanted to walk without mobility aids were safe. Lunch was observed in both parts of the home and service users were not served table by table but individually. This resulted in the loss of a social opportunity, as service users could not dine together as some had finished their meal before others started. Gravy was poured over meals without service users being asked if they wanted it. One staff member watched television whilst waiting for assistance from a colleague and did not reassure a service user in pain. Service users were not consulted on where they wished to sit and were agitated by other service users who shouted. One service user had asked to go out into the garden – three hours later this had not occurred. They then had to wait twenty minutes for a member of staff to be identified to accompany them outside (after they had been transferred to their wheelchair). The identified member of staff changed three times before the service user went into the garden. During this time a member of staff went on their break with the service user still waiting to go out. Staff who worked with service users with dementia could not identify how they cared differently for those with specialised needs or what provision was available. Staff who are working with those who require dementia care have only had one day’s training in dementia awareness and this is inadequate. Children’s television was on loudly and remained so until an inspector intervened. Letters to inform families of the refurbishment were displayed on several walls throughout the home - a more appropriate way of displaying information was discussed with the manager. Some mouth care is still poor and this was evident in service users who were spending time in bed. Signs to inform relatives of the refurbishment adorn communal walls. Turning sheets and instructions displayed in bedrooms would be better placed in a folder or discreet place. This issue was raised at the previous inspection. It is disappointing that service users’ dignity was Houndswood House DS0000019459.V310534.R01.S.doc Version 5.2 Page 12 compromised despite now being raised several times. The appointment of a deputy manager and senior nurses has still not occurred (although an interim appointment was made but vacancies still exist). Houndswood House DS0000019459.V310534.R01.S.doc Version 5.2 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. Quality in this outcome area is adequate; this judgement has been made using available evidence including a visit to this service. EVIDENCE: Some service users have recently been on day trips to Southend and Brighton and photographs featured in the home’s newsletter. One activity organiser was off (the home usually has two) on the day of inspection. The other organiser was busy co-ordinating activities on both sides of the home. There are no ongoing provisions for service users with dementia – staff could not identify how they worked differently with service users with dementia. The television was on loudly and service users with mobility needs were unable to move away to a quieter area. A group of service users have joined a community group and attend weekly. Relatives and friends can visit the home at flexible hours. Inspectors spoke to some visitors who commented upon the improvements made regarding the environment and the more pleasant odour. Meals continue to be of a high standard: lunch was hot and tasty and an easy to read accurate menu was on display with three options available. The previous standard explores issues regarding dignity at mealtimes. Drinks were available to all service users and staff regularly encouraged service users to drink to prevent dehydration. Houndswood House DS0000019459.V310534.R01.S.doc Version 5.2 Page 14 Choice has been inspected earlier relating to the issue of dignity. Houndswood House DS0000019459.V310534.R01.S.doc Version 5.2 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 Improvements have been identified regarding moving and handling practice. Service users are not assured of protection from abuse. Quality in this outcome area is poor; this judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a comprehensive complaints system is in place and there have been no changes since the previous inspection. Moving and handling had improved since the previous inspection. The Health and Safety Inspector observed some procedures and has made recommendations regarding documentation. The bruising noted by an Inspector had not been referred to Social Services under the local Adult Protection procedure. The home is failing to demonstrate how vulnerable adults are safeguarded. As stated earlier in the report care plans do not demonstrated how bruising is monitored and managed. There have been several occasions where the manager has been prompted to report issues to Social Services to ensure that the local Adult Protection policy is being followed. This is action that the registered manager should automatically take without intervention from the Commission. Houndswood House DS0000019459.V310534.R01.S.doc Version 5.2 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): 19,24,25,26 Environmental improvements have been made but further development is required to enable the home to better fulfil its potential. Quality in this outcome area is adequate; this judgement has been made using available evidence including a visit to this service. EVIDENCE: The fabric of the environment has improved. The toilets and bathroom in the main house have been refurbished. An assisted bath is in place and is awaiting commissioning from the manufacturers and an additional shower has been fitted. The manager plans to ensure that the areas are decorated to ensure that they do not remain clinical. The doorframe has not been altered to accommodate the increase in use and, although staff and service users can use it as a thoroughfare, space is restricted. The fire door has to be held open to enable wheelchairs and hoists to be wheeled through – a door closer system would make access easier. On the day of inspection the hallway leading to the refurbished bathrooms housed a heated food trolley and two tray racks which impeded access. Large areas of the home have benefited from new carpet which has solved the issue of odour associated with urine. New bedding and Houndswood House DS0000019459.V310534.R01.S.doc Version 5.2 Page 17 curtains are on order and redecoration has been completed in several bedrooms and communal areas. Some bedrooms have new furniture and a vanity unit was being replaced during the inspection. The lounge in the main house has been rearranged to position chairs in small groups rather than one large square. Service users seem far more comfortable with the improved layout. Some bedrooms remain spartan and impersonal but the manager assured the inspectors that this would be addressed as the refurbishment programme continues. Not all bedrooms can be locked to ensure privacy – rooms were of a comfortable temperature during this inspection and this has been an issue previously. In the main house a fire door had a gap underneath and a window was wedged shut with toilet roll but with gaps still evident. The level of cleanliness has improved and the home now employs permanent domestic staff where it previously relied upon agency employees. Houndswood House DS0000019459.V310534.R01.S.doc Version 5.2 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): 27,29,30 Staff numbers do not meet service users’ needs. More extensive training would assist staff to better meet service users’ needs. The recruitment process does not reflect scrupulous reference checks. Quality in this outcome area is adequate; this judgement has been made using available evidence including a visit to this service. EVIDENCE: As discussed earlier staff were constantly busy and were unable to spend quality one to one time with service users. Although there are fewer service users in the home the staffing levels have been reduced accordingly. This impacts upon the individual attention that service users receive. This was especially evident in the main house where staff where trying to support a number of service users with complex needs. Service users had no option but to wait for staff to attend to them when they had time: staff where ensuring service users had a cup of tea whilst trying to attend to one service user who was trying to move the tea trolley whilst another was trying to stand unaided and was at risk of falling. This was occurring whilst a service user was waiting to go outside and a member of staff had gone onto a break. Most staff have attended adult protection training recently. Inspectors identified that dementia training was required as staff had only attended a one day session and this was not adequately meeting the needs of service users. Recruitment records were checked for two new staff who had been employed since the previous inspection. One reference had been written by an employee’s parent and this was not acceptable. Houndswood House DS0000019459.V310534.R01.S.doc Version 5.2 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): 31,32,33,35,38 The management of the home does not ensure that all service users’ needs are met. Service users’ financial interests are not safeguarded. Quality in this outcome area is poor; this judgement has been made using available evidence including a visit to this service. EVIDENCE: The Inspectors again discussed the culture of the home with the manager and stressed that this needed to progress further in order for the home to develop. Stronger leadership is required in order for staff to recognise that current practice is unacceptable. Progress in improvements has been slowrefurbishments have been impeded by senior management halting work for a period of time. A management team is still not in place despite a recruitment drive and the use of three recruitment agencies. Finances were checked and a sum of money could not be accounted for but were identified towards the end of the inspection. The safe is situated in a separate part of the house from the administrator. Receipts did not match with Houndswood House DS0000019459.V310534.R01.S.doc Version 5.2 Page 20 debits for some service users and current procedures are not adequately protecting service users. A quality assurance audit has been conducted to assess service users’ opinions and those of their families and friends. A report will be publicised once results are collated. No health and safety issues were identified on this occasion. Houndswood House DS0000019459.V310534.R01.S.doc Version 5.2 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 3 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 2 X X X X 2 3 3 STAFFING Standard No Score 27 2 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 2 3 X 1 X X 3 Houndswood House DS0000019459.V310534.R01.S.doc Version 5.2 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 OP7 OP8 OP3 Regulation 12 &15(2)(b) Requirement Work continues upon care plans but further information is required to adequately describe how needs are met. Where needs are identified documentation must reflect how they are being met: Examples include turning charts; fluid intake records; mouth care; dementia care; management of choking and bruising. These examples are not exhaustive. Further information is needed of how assessed needs will be met, monitored and managed. The medication system must ensure service user safety. Recording did not accurately reflect the amount of medication available. Handwritten instructions were not signed, some were illegible. One signature was overwritten to signify refusal, which appears to illustrate that the sheet was signed prior to administration. A number of stock items had not been carried forward. Timescale for action 31/12/06 2. OP9 13(2) 16/11/06 Houndswood House DS0000019459.V310534.R01.S.doc Version 5.2 Page 23 3. OP10 OP14 12(4)(a) The dignity and choices of service users must be better observed but this remains a requirement. Examples are cited earlier in the report. A REQUIREMENT HAS BEEN MADE REGARDING DIGNITY AT PREVIOUS INSPECTIONS 30/11/06 4. OP18 13(6) 5. OP19 23 6. OP24 12(4)(a) Vulnerable service users must be 30/11/06 safeguarded from abuse. The correct protocols must be followed when concerns are identified. Hertfordshire Social Service’s Adult Protection policy must be adhered to and CSCI notified accordingly. An up to date refurbishment plan 30/11/06 is to be submitted in light of changes to senior personnel to illustrate the company’s commitment to refurbishment of Houndswood. THIS REQUIREMENT REMAINS UNMET FROM THE PREVIOUS INSPECTION. The gap below the fire door and broken window that does not close must be repaired. Locks must be fitted to bedroom 31/12/06 doors to ensure service users’ privacy. THIS REQUIREMENT REMAINS UNMET FROM THE PREVIOUS INSPECTIONS. Staffing levels must enable staff meet the needs of the service users. Recruitment documentation must reflect that adequate checks have been conducted. Staff must be trained to meet service users’ needs: Adequate dementia care must be provided whilst the home is caring for service users with dementia. The manager must meet the outstanding requirements to DS0000019459.V310534.R01.S.doc 7. 8. 9. OP27 OP29 OP30 18(1)(a)& (b) 19 18,12 30/11/06 16/11/06 31/12/06 10. OP31 OP32 9 31/12/06 Page 24 Houndswood House Version 5.2 11. OP35 13(6) demonstrate fitness. THIS REQUIREMENT REMAINS UNMET FROM THE PREVIOUS INSPECTION. Finances do not reconcile. This must be addressed. 16/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Houndswood House DS0000019459.V310534.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hertfordshire Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Houndswood House DS0000019459.V310534.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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