CARE HOMES FOR OLDER PEOPLE
Hyne Town House Strete Dartmouth Devon TQ6 0RW Lead Inspector
Judy Cooper Announced 28 September 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Hyne Town House Address Strete, Dartmouth, Devon, TQ6 0RW Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01803 770011 01803 770307 Mr Stephen Anthony Mould Mrs Yvonne Margaret Mould Mrs Jean Gloria White Care Home 33 Category(ies) of Dementia - over 65 years of age (33), Old age, registration, with number not falling within any other category (33), of places Physical disability over 65 years of age (33) Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 04/02/05 Brief Description of the Service: Hyne Town house is a period detached building, with a purpose-built wing, situated in the small coastal village of Strete. The home provides accommodation for service users over three floors, with a passenger list to access the upper floors. The majority of the rooms (27) have en-suite facilities and sea views. The home has, until recently, provided accommodation for up to 26 older people, with or without a physical disability or suffering with some form of dementia.The home commenced an extensive refurbishing/extension programme in May 2004, which has resulted in the home being upgraded to a high standard which has included extending the home’s communal space by the creation of a large garden room. A new commercial kitchen has also been installed.Further works to provide additional assisted bathing facilities, easier access to the home’s passenger lift, and a disabled toilet as well as the creation of 9 new single rooms have now been been completed. A new quiet lounge has been created where the previous dining room was and the home has a new staff area and medicine storage room. A new office was also created.The home now comprises of 27 single rooms and 3 double rooms and is registered to accept thirty-three residents within the categories of Dementia - over 65 years of age (33), Old age, not falling within any other category (33), Physical disability over 65 years of age (33). Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over one day. The home did return a pre-inspection questionnaire. Although no written feedback forms were received prior to the inspection, two were returned at the inspection. Opportunity was taken during the inspection, to tour the premises, examine appropriate records and policies, talk with one of the owners and the manager, staff on duty and meet with the majority of residents. Staff on duty were also observed, whilst in the course of undertaking their daily duties. What the service does well:
There is a relaxed, family atmosphere within the home which the owner, manager and staff should be commended on for maintaining. The manager and staff provide very individual care for the residents, some of whom are now unable to fully communicate their needs. The manager and staff are aware of this and try to ensure that care matches the residents’ needs and personal preferences. The staff maintain residents’ dignity and their rights to make personal choices. Due to the category of the resident group cared for at Hyne Town House (i.e. some residents suffer from advanced dementia), it means that staff need to take time and use good observational skills to determine what a resident may be trying to communicate, and this was seen as an integral part of the staffs’ role within the home. The owner and manager undertake regular quality monitoring within the home, looking at ways to both build on, and improve, current practice to ensure that good quality care is provided to residents. Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better:
The registered provider must ensure that residents are protected from the risk of fire within the home by maintaining fire precautions in line with those recommended by the local fire and rescue service. (An immediate requirement was issued at this inspection in relation to some fire doors being wedged open). The manager must review the home’s staffing levels to ensure that residents’ needs and welfare can be met and upheld at all times. The manager must ensure that residents are fully protected by the appointment of suitable staff. To this end, the registered manager must have sight of the returned Criminal Record Bureau enhanced disclosure for all members of staff, before staff are left to work in an unsupervised capacity with residents.
Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 Page 7 To ensure that residents are cared for in a safe environment the registered provider must undertake a risk assessment of the new extension, which is now being used by residents. To protect residents from risks associated with window openings, the registered provider must undertake a risk assessment of all of the homes’ windows and install window restrictors where any risk is identified. Written details of these risk assessments must be included within the other documentation appertaining to minimising risks within the home. The use of a free standing heater, in a resident’s bedroom, must be risk assessed and any identified risk minimised to ensure the resident occupying the room is free from any potential danger associated with the heater. 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. Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 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 standard(s) 3 (6 is not applicable). The admission process is appropriately managed with residents’ needs explored and known prior to admission to the home. EVIDENCE: By looking at the records for one resident, that had been recently admitted to the home, it was noted that a full and detailed admission procedure was undertaken, even when time was of the essence, which had ensured that Hyne Town House was an appropriate home. The manager undertook a preadmission assessment that considered all aspects of the proposed resident’s needs. The manager had used this document to full effect with the prospective resident and their family, care manager etc. The resident themselves was able to confirm that they had been made to feel comfortable and welcomed, both on admission and since, and that all their needs were being met. The home does not provide for intermediate care. Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 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 standard(s) 7,8,9,10. Residents are looked after well in respect of their health and personal care needs. Residents are treated with dignity and respect and their individuality and independence maintained EVIDENCE: Care plans contained all relevant details appertaining to providing for individual residents’ care. The care plans had been regularly reviewed with the resident and/or the resident’s relative/next of kin where possible. They were concise and contained full details of any medical needs of the resident, as well as any visits made by District Nurses, G.P’s or any other health professionals. The manager has ensured that the care planning processes within the home are such that they are relevant and a working, changing document that clearly highlights residents’ needs and any required changes to their care. Of particular note is the fact that a day and night record of needs has been introduced within the care plan itself, which can easily be updated on a regular basis without the whole care plan having to be reviewed. This followed on from the manager’s awareness that is often only small daily or night time changes that need to be put into immediate effect to ensure that the residents remain well cared for and comfortable.
Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 Page 11 It was noted that residents’ medications were being dispensed and administered correctly. (The home received a complaint regarding this issue approximately two months ago. Following an investigation into the complaint it was noted that one resident was being given their night mediation at tea time to take later on, without being observed doing so). This practice is no longer tolerated within the home and the amended medication policy was seen to reflect this. All senior staff that administer medication have received appropriate training. These measures have ensured that residents are protected from any errors in the administration of their medication. Residents’ dignity was seen to be upheld, with all residents being addressed in a respectful and sensitive manner. During the inspection it was noted that one resident was particularly confused and upset, at lunch time, and the staff helping the resident were seen to very caring, compassionate and gentle, which had the effect of calming the resident and allowed the resident to continue with their day in the normal way. This care was provided with due regard for all other residents and helped minimise any concern from the other residents. Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 Page 12 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 standard(s) 12,13,14,15, Residents enjoy a varied life at the home, with visitors encouraged and welcomed and links encouraged and maintained with the local community. The home provides a good variety of nutritious and varied meals. EVIDENCE: Regular activities are made available and these are now publicised in the home’s newsletter with outside entertainment also brought in as desired. The newsletter is sent to all residents as well as their families/carers to ensure that all involved are aware of what is available within the home and are welcomed to join in if they so wish. The home operates an open visiting policy and the visitor’s book clearly showed that the residents had many visitors at varying times throughout the day and residents stated that their visitors were able to visit at a time that suited, and were made welcome within the home. It was noted that during the inspection several visitors came and went quite freely throughout the day. The home has a monthly visiting vicar attend to give Communion and some residents are enabled to attend the local church if desired. The routines within the home are very flexible to ensure that residents can choose how they spend their time.
Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 Page 13 During the inspection it was noted that several had chosen to spend their time in the communal lounges whilst others had chosen to spend time in their own room, either alone or with a fellow resident/friend. A feedback card received at the inspection contained the following comment “Anyone lucky enough to live here is very well cared for. A wonderful place.” The meals provided are varied and nutritionally well planned. A new way of delivering meals has been recently introduced into the home which involves the staff taking a hot trolley to the dining room and allowing the residents to choose what food they may want, rather than it be being plated up in the kitchen. This has been to allow residents the right to exercise further choice and to encourage residents’ appetites with the visual sight and smell of the food. Further consideration needs to be undertaken to ensure that this commendable practice is not overshadowed by some residents being unhappy at having to wait some time for their meals, due to each being served individually by one or two staff members, thereby causing the last residents to be served, rather a lengthy wait. Comments received from residents indicated that they enjoyed their food and that they felt the home’s cook was providing adequately for their diet, one comment was “the home provides very well for my vegetarianism”. Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 Page 14 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 standard(s) 16,18 Arrangements for protecting residents and responding to their concerns are satisfactory. EVIDENCE: The home’s complaint procedure was clear and is displayed in a communal area of the home. The owner/manager has dealt appropriately with any complaint made (either through CSCI or internally). A recent complaint made directly to the CSCI regarding resident care has been fully investigated and is now concluded (see Standard 9 for fuller details). There are appropriate adult protection policies in place, which staff have easy access to. The home continue to use bed rails for one resident in conjunction with the their family giving permission as well as the District Nurse being involved in this decision. The home’s front door is accessed by a keypad system. The number is easily available to anyone, being contained within the visitor’s book, but protects those residents who would be at risk should they leave the home unattended, as such these residents would not have the cognitive ability to input the correct numbers into the key-pad. The owner has stated that the use of this key-pad has been discussed with the fire authority to ensure that the system conforms to their requirements regarding safe evacuation. The owner has now installed a new nurse call pager system, which provides added security for residents as all external exit ground room doors are
Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 Page 15 alarmed. This will, again, help prevent those residents who may be at risk from wandering. The call bell is such that it can only be cancelled at the point of call and the respond time is recorded allowing the manager to monitor call answer times. The owner holds monies for some residents in a designated home’s bank account, as agreed with the resident/their family, and there were detailed records and receipts etc in respect of this, ensuring that those residents that do use this service can be reassured that their monies are being handled appropriately and securely. The owner is also responsible for collecting the pension monies for one resident and then allocating this resident their personal allowance; again there were appropriate records held in respect of this, which ensures the individual resident’s financial protection. Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 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 standard(s) 19,26 Recent improvements/upgrading measures have helped ensure that Hyne Town House provides a very comfortable, clean and warm environment, and which have been finished, and are maintained, to a high standard. The registered providers are compromising residents’ safety, by not fully maintaining all fire prevention measures within the home and by not undertaking a full risk assessment in relation to the new extension and provision of window restrictors in the same area. EVIDENCE: Overall the home presented as very comfortable, clean and welcoming. The tour of the building evidenced that the owner has recently completed a large extension to a very high standard, and further continues to undertake an upgrading programme within the rest of the home, that is aimed at providing a very high standard of accommodation throughout. Bedrooms have been personalised as desired and residents can bring in personal items with them if they wish to. The lounge and dining areas are both spacious and well appointed with both having been upgraded and redecorated. The creation of a large new garden
Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 Page 17 room has further benefited residents in so far as they can enjoy marvellous views and a light spacious area to sit and relax in. The management of the home maintains the day to day home’s fire precautions in line with the requirements of the local fire department, however there is a need to fully record all names of people attending fire drills and to examine the homes’ fire extinguishers on a monthly basis. It was also noted that some bedroom doors were being held open by a fire wedge during the inspection. An immediate requirement notice was issued in respect of this as resident safety was being compromised by the use of such, and the owner did take immediate remedial action before the inspection ended by removing the door wedges. Risk assessments have not been carried out on the new extension and as such any identified risks, such as fully opening windows in the new bedrooms, had not been risk assessed. This could place residents at risk. One bedroom was noted as having a free standing heater, which the owner and manager were unaware of. Continued use of this appliance this may place the resident at risk, as the occupant of the room has very limited sight. Infection control measures were in place and do protect residents from the risk of cross infection. Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30. Staff are not always employed in sufficient numbers to meet the current residents’ needs. Residents are currently not fully protected by the home’s recruitment polices. Increased staff training has allowed the staff the opportunity for further personal development, which has increased their skills and awareness in caring for this resident group. EVIDENCE: The staffing rota was inspected and it was noted that the owner and the manager are trying to recruit an extra member of staff to be available in the mornings. It was however noted, that the manager does not work at the weekend and therefore the staff on duty have to deal with any management tasks as well as provide care as her hours are not compensated for. The current numbers employed are a minimum of four carers in the morning, and in the afternoon with two waking staff on at night. Several residents stated, during the inspection, that they felt staffing levels generally were currently not always such that their needs were being fully met. An example of comments received from residents in relation to this included the fact that some residents felt that they had had to wait for some time for help, staff were often noted as being very busy and had less time to help each resident as they felt some resident’ needs had increased in the home and a few residents took a lot of staff time, thereby limiting the available time spent with others.
Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 Page 19 Residents spoken to did however state that the staff were always “very kind and caring and did all they could”. The staff recruitment programme had not been completed to the required standard. Enhanced C.R.B checks, although applied for, had not been received back, prior to some staff members working with residents in an unsupervised capacity, which could put residents at risk. It was pleasing to note, that the staff mix included a full time male carer, which helps keep a balance of a mixed gender staff group working within the home. Training was well planned and supports the staff in providing for the varied needs of the residents with statutory training and other work related courses being made available including NVQ training in care. Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 Page 20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35,38 The home is managed efficiently and well with residents best interests upheld. Although every day routine health and safety matters are in the main well managed, some environmental safety precautions have not been provided for/completed, which means that residents’ health and safety is being compromised. EVIDENCE: The home is well managed and this was seen to be the case on the day of inspection. Since the last inspection in February this year, the registered manager has improved the overall management of the home by compiling a more “steam lined” recording system. This has resulted in a more effective, user friendly system, which ultimately benefits residents and staff by ensuring staff are fully aware of residents’ changing needs. The manager undertakes quality auditing within the home and residents, their families, other professionals and staff etc are invited to have a say in how they
Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 Page 21 feel the home is being run and to make any suggestions for change known. Feedback questionnaires are sent out and there are regular meetings within the home. This information is collated and any identified shortfalls, good ideas for progress etc are implemented which evidences that the home is looking to the future and to undertaking improvements, which would be of most benefit to residents. One comment received from a District Nurse stated the following “Hyne Town House is a credit to you all and I think it is great that you have bothered to do this (quality questionnaire).” Records that were inspected included the home’s fire logbook and fire risk assessments and room risk assessments. It was noted that the room risk assessments did not cover any of the rooms within the new extension, neither had this area as a whole been risk assessed. This could lead to those residents in this area being at risk, particularly as it was noted that the windows on the first floor of this area had fully extended (non restricted) openings. The home’s hot water supply is regulated where there are full bathing facilities and totally within the new extension. Risk assessments are in place for any other areas i.e. hand washbasins in the older part of the home. Although these measures ensure, less dependent residents are less at risk from the risk of scalding, the manager needs to continually risk assess for any newly identified risks as residents’ needs either change or increase, to ensure that the risk remains minimal. The home is registered to be able to offer care for physically frail and mentally frail residents as well as elderly only residents, and the two former resident groups could be considered to be at a high risk of sustaining a scald/burn from non-regulated hot water. Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 2 Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 19 Regulation 23 Requirement The registered provider must ensure that the homes’ fire precautions are maintained in accordance with the requirements of the local fire and rescue service. The registered provider must undertake risk assessments in relation to the new extension. The registered provider must undertake risk assessments in relation to the provision of window restrictors to windows within the home, and provide as considered required. The registered provider must review staffing levels and ensure that at all times suitably qualified, competent and experienced persons are working at the home in such numbers as are appropriate for the health and welfare of the residents. The registered manager must ensure that an enhanced disclosure from the Criminal Records Bureau is received, and seen, before a staff member is allowed to work with residents, in an unsupervised capacity.
D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Timescale for action 29/09/05 2. 3. 19 19 13 13 29/10/05 29/10/05 4. 27 18 29/10/05 5. 29 18 29/10/05 Hyne Town House Version 1.40 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 19 38 Good Practice Recommendations The registered manager shpuld risk assess the use of a free standing heater in one reidents room, to ensure the resident is not at risk from the use of the same. The registered provider should continue to ensure that all water outlets, including hand basins within the home, are risk assessed and the hot water regulated to 43 degrees Centigrade, as required, to minimise the risk of residents sustaining a scald. Hyne Town House D54-D07 S3725 Hyne Town House V225870 280905 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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