Inspection on 12/12/05 for Linwood House Care Home

This inspection was carried out on 12th December 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Linwood House Care Home 01/10/08

Linwood House Care Home 06/07/06

Linwood House Care Home 13/09/05

Linwood House Care Home 02/02/05

Linwood House Care Home 27/07/04

Linwood House Care Home 18/03/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Linwood House Care Home 1 Mount Hooton Road Radford Nottingham NG7 4AY Lead Inspector Jayne Hilton Unannounced Inspection 12th December 2005 10:30 Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 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 Linwood House Care Home DS0000002297.V253795.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Linwood House Care Home Address 1 Mount Hooton Road Radford Nottingham NG7 4AY 0115 978 6736 0115 9786736 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) Prime Life Limited Miss Claire Anne Turner Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Serice users shall be within category LD The registered manager shall complete the registered managers award by December 2005 and NVQ4 in care within the following 12 month period by december 13th September 2005 Date of last inspection Brief Description of the Service: Linwood House is a detached older property adjacent to the Forest Recreation Ground and on the tram route to Nottingham City Centre. Accommodation is provided on three floors. There is a private garden and ample space for car parking. Linwood House is registered to provide personal care for up to thirteen adults with learning disabilities. Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on 12th December 2005 by regulation inspector Jayne Hilton at 10 50am. The inspection concluded at 1.20pm. The focus of the inspection was on the requirements and recommendations set at the previous inspection and the standards not covered at the last visit. The methodology used was the examination of staff records, complaints records, fire safety records, and other health and safety records, policies and procedures, staff rotas, and a part tour of the building was facilitated. The manager and a staff member were spoken with and four service users throughout the course of the inspection. The outcomes for service users, is assessed as very positive. What the service does well: Prospective service users have the information they need to make an informed choice about where to live and are supported to be as independent as possible and to make decisions and participate in the daily life of the home. Information about service users is kept confidential. Service users receive personal support in the way they prefer and require and their health care needs are well met. Medicines management is well organised and service users know how to complain and are generally protected from abuse. Service users live in a homely, comfortable and safe environment. Toilet and bathrooms are adequate but would benefit from some personalisation. Service users have adequate shared space and the home is clean and free from offensive odours. Service users benefit from clarity of staff roles and they are supported by an effective, competent and well trained staff team, Service users benefit from a well run home with good quality assurance and monitoring systems in place. Service users rights and best interests are safeguarded by the homes policies and procedures and the record keeping practices in the home is good. The acting manager is now registered with conditions in relation to completion of the Registered Managers Award. The health safety and welfare of service users are overall promoted and protected. Service users benefit from a competent and accountable management of the service. Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 6 Service users at home on the day of the inspection appeared relaxed and happy with their daily routines and lifestyles. All were appropriately clothed for the seasonal weather and in their individual personal styles. What has improved since the last inspection? What they could do better: No requirements are set but several good practice recommendations are made from this visit to further improve the service, some of which are carried forward from the previous inspection. Some revision of Policies and day-to-day practices in relation to financial record keeping are recommended to ensure they are fully robust. The Environmental Health officer needs to be consulted about the laundry facilities in the cellar and the boiler. There is a lapse in the service users survey and this needs to be reinstated. It is recommended that staffing hours are continually assessed to ensure that they are adequate, particularly as support staff are expected to undertake cleaning, catering, and laundry tasks within their support hours. It is recommended that the manager delegate a staff member to be responsible for ensuring a system for replenishment of first aid supplies. The manager should further develop service based risk assessments for all safe working practice topics as specified in the Five Step plan for risk assessments. A security review of the premises should be included. Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 7 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. Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 Prospective service users have the information they need to make an informed choice about where to live and have their needs assessed prior to moving into the home. EVIDENCE: A statement of purpose and service user guide is in place, which meets the standard and regulation fully. Service users have access to both and a copy of the inspection report is displayed on the notice board. The homes statement of purpose refers to emergency admissions but is not specific regarding respite facilities and this should be included. The manager reported that this amendment has not yet been completed. Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8.10 Service users are supported to be as independent as possible and to make decisions and participate in the daily life of the home. Information about service users is kept confidential. EVIDENCE: Service users have opportunities to participate in the running of the home, some help with daily housework tasks such as washing the pots and taking responsibility for cleaning their rooms. Service users are involved in recruitment practices and any new organisational policies are presented for their views in residents meetings, which take place regularly. The quality assurance processes support this aspect also. It is recommended that service users views be documented regarding their involvement in the recruitment process. Service users at home on the day of the inspection appeared relaxed and happy with their daily routines and lifestyles. All were appropriately clothed for the seasonal weather and in their individual personal styles. Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 11 There is a policy for confidentiality and the manager reported that this is promoted at induction and throughout supervision with staff. It was reported by the manager that a copy of the homes confidentiality statement regarding sharing information has been given to the day centre. Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were assessed at the previous inspection and found to be met. Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19.20 Service users receive personal support in the way they prefer and require and their health care needs are well met. Medicines management is well organised, EVIDENCE: The nutritional needs of service users are assessed and weight recorded, an intake chart has been set up for one service user who s losing weight and it is recommended the weight record chart be amended to include action taken for observed weight loss or gain. A Medication policy is in place and a flow chart has been produced for Drug errors and this was in place to prompt staff of action to be taken should there be a drug error, the inspector recommends that this policy and others be developed in line with the guidance booklet from the Royal Pharmaceutical Society. A staff signature sheet has been implemented for those staff authorised to administer medication. It is recommended that a medication profile is included in the care plans, which provides a running and instant record of medication review, changes and adverse reactions. Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 14 Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22.23 Service users know how to complain. Policies and procedures are in place to protect service users from abuse, however some revision of these and day-today practices in relation to financial record keeping are recommended to ensure they are fully robust. EVIDENCE: There is a comments, complaints and concerns policy displayed in the home and service users confirmed that they knew how to make a complaint should they wish to. There are no recorded complaints since the previous inspection. There are policies in place for adult protection and staff, have undergone training in adult protection. A recent referral had been made regarding a service user assaulting another service user and the home appear to have implemented appropriate measures to prevent re-occurrence. The manager agreed to follow up this issue with social services and report back to the inspector of the outcome. There is a policy for handling service users finances and which informs staff that service users only must benefit from their personal monies. Checking systems and regular audits are in place. The inspector advised the manager to further reinforce to staff about legislation in relation to use of bonus card schemes etc, so they were fully aware of this. The system for accounting for service users personal allowances was not as robust as it could be and a sample check found that receipts were not in place for all purchases/transactions. Receipts are kept loose with the cash amount and it is recommended that these are numbered and either stapled to the back of the relevant account sheet or numbered and kept in an envelope at the back of the Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 16 account sheet. The corresponding receipt number should be highlighted on the record sheet. Each purchase should be itemised and any cash kept by service users should be highlighted and accounted for separately. Any valuables kept on behalf of service users in the safe are documented in the individuals care plan. It is recommended that a small receipt book is used which acts as a duplicate record for this purpose also. The manager as a fundraising idea for the benefit of service users has set up a ‘tuck shop’. There was no guidance in place to protect service users and staff in its use and this is strongly recommended. Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24.27.29.30 Service users live in a homely, comfortable and safe environment and service users rooms suit their needs and lifestyles and promote their independence. Toilet and bathrooms are adequate but would benefit from some personalisation. Service users have adequate shared space and the home is clean and free from offensive odours. The Environmental Health officer needs to be consulted about the laundry facilities in the cellar and the boiler. EVIDENCE: The home is domestic in character and appears comfortable and adequately furnished. The décor was satisfactory. Some areas have been redecorated since the previous inspection and new furniture purchased. The home is close to local amenities and is accessible for all service users residing at the home. The furnishings are domestic in type and most radiators were observed to be of the low surface temperature type. There is a shared handyman who attends the home on a weekly basis and a property audit is carried out annually. There are no CCTV cameras. Toilet and bathrooms were adequate but would benefit from some personalisation and refurbishment. Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 18 A smoking lounge and kitchenette is provided. The main kitchen was fitted with a range of modern units. Bath Hoists and grab rails are sited in the home but there are no service users with poor mobility currently. One service user requires a wheelchair for long distances but can manage in the home. No lift is available to upper floors. The home was observed to be clean and smelled fresh apart from the remnants of smoke from the smoke lounge. The laundry facilities are based in the cellar. The washer does not have a sluice facility installed. As there are some continence issues identified the provider should consider purchasing a washer with a sluice facility. The sink in the laundry is used for both hand washing and drainage and it is recommended that the Environmental Health Officer be consulted regarding this and the damp and condensation observed in the area. The boiler casing is looking worse for wear and the inspector recommends that the EHO be asked for advice as to its safety. Gloves and aprons were observed, and a policy is in place for infection control. Some garden furniture was noted to be stored under the fire escape, which should be removed. Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31.36 Service users benefit from clarity of staff roles and they are supported by an effective, competent and well-trained staff team. Service users are protected by the home’s recruitment policies. EVIDENCE: All staff have an induction and job description and receive a welcome pack with copies of policies and procedures. A copy of the General social Care Councils Code of Conduct is issued to staff on employment. There are no volunteers used at the home currently but the manager is clear that any volunteers would need to undergo the necessary recruitment processes as employed staff. The manager reported that she supervises staff every two months wherever possible and records of this were inspected at this inspection. Not all staff had six sessions a year and this is recommended. The training provision for staff appears adequate and staff are reported to be working to achieve NVQ2. Mandatory training is provided for staff on an annual basis including food hygiene, which includes an element of infection control. Staff, have also received training in diabetes care. LDAF [Learning Disability Accreditation Framework] The staffing hours for the home are based 210 hours per week with additional support provided on a one to one basis for one service user. The manger uses a proportion of the 210 hours for management duties. The manager should actually work 90 of her time as supernumery to undertake the Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 20 responsibilities of management and as required under the Care Standards Act. That said the team appear to be well supervised and organised. The rota shows that a minimum two care staff are planned to be on duty at all times. An, extra staff member, being on duty from 5 to 8 pm each evening. At night there is one night support worker awake and one sleeping in. It is recommended that staffing hours are continually assessed to ensure that they are adequate, particularly as support staff are expected to undertake cleaning, catering, and laundry tasks within their support hours. A sample of staff personal files was examined and evidence was provided of appropriate recruitment checks. Copies of interview documentation should be included in the individual files. The original CRB documents are not kept in the home, despite the guidance as follows: “Although CRB guidance on some other employment sectors states that Disclosures should be destroyed after six months, the guidance states that CSCI regulated services, Disclosures should be kept for up to twelve months or more to enable CSCI inspectors to see a sample at the next inspection, one of the legal requirements for retaining Disclosures” The Provider is informed that although the arrangements do not meet with the guidance, that CSCI are now adopting a proportionate approach that clarifies what must be available in the care home and what can be retained centrally. Subject to written agreement with CSCI this may now be permitted with clear criteria set for accessing records. The Provider is therefore advised to consult with the Policy and Guidance [for service providers and CSCI staff] Criminal Records Bureau checks dated 2/11/05 and decide whether they wish to make a request for staff records to be held centrally. Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37-43 Service users benefit from a well run home with good quality assurance and monitoring systems in place, however there is a lapse in the service users survey and this needs to be reinstated. Service users rights and best interests are safeguarded by the homes policies and procedures and the record keeping practices in the home is good. The acting manager is now registered with conditions in relation to completion of the Registered Managers Award. The health safety and welfare of service users are overall promoted and protected. Service users benefit from a competent and accountable management of the service. EVIDENCE: The acting manager has recently been registered. She has almost completed the Registered Managers Award. A staff member spoke highly of the manager, stating that she had high standards and a good working relationship with the deputy manager and the rest of the team. It was reported that the manager Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 22 deals with issues in a fair but firm way if needed. Staff are confident of the managers leadership ability and feel that the ethos promoted is good. There was evidence of quality monitoring within the home and the manager is working with the Quality Tree folder, which was seen in the home. Service users surveys have been previously carried out but there was no evidence of feedback regarding the previous survey carried out which was more than eighteen months ago. The provider undertakes Regulation 26 visits as required by regulation. Staff meetings take place on a regular basis and minutes of these were seen. The organisation provides the necessary policies and procedures and staff get an individual copy. Records inspected including fire safety records, these were on the whole satisfactory and included fire evacuation details. Portable appliance tests were all satisfactory and include tests on sockets annually. The manager reported that the organisation is consulting with The Health and Safety Executive and CSCI currently regarding five yearly electric circuit tests. There are two first aid boxes in the home, one was examined and found to be almost depleted of stock. It is recommended that the manager delegate a staff member to be responsible for ensuring a system for replenishment of first aid supplies. Fire risk assessments were evident in service users care plans at the previous inspection and a general fire, environmental and health and safety risk assessment is also in place. This contains basic information and should be further developed to encompass all areas of risk such as Barbecues. As said there was a general Environmental risk assessment in place and Hazard Analysis for kitchen/food use however the manager should further develop service based risk assessments for all safe working practice topics as specified in the Five Step plan for risk assessments. A security review of the premises should be included. Service and maintenance records for equipment were up to date. An annual gas safety certificate was evident also. Window restrictors are fitted throughout. A business and development plan is provided and appropriate insurance cover evident. Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 X 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X 3 X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 X 2 3 3 X 3 3 3 Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 24 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. Standard Regulation Requirement Timescale for action 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. 5. 6. 7. 8. 9. Refer to Standard YA1 YA8 YA10 YA19 YA19 YA20 YA20 YA22 YA23 Good Practice Recommendations Add information regarding respite care provision to the Statement of Purpose and Service Users Guide. Document service users involvement in the recruitment process Provide the day centre with a copy of the confidentaility policy Add an action to be taken coloumn on the weight record Implement an intake chart for the service user who is losing weight Provide a list of sample staff signatures for medicine adminstration Include a medication profile in care plans and document medication reviews, changes and any adverse reactions etc. Endevour to make contact and promote a positive relationship with the neighbour discussed at the inspection Chase the adult protection referal and bring to a conclusion DS0000002297.V253795.R01.S.doc Version 5.1 Page 25 Linwood House Care Home 10. 11. 12. 13. 14. 15. 16. 17. YA24 YA24 YA30 YA30 YA33 YA33 YA39 YA41 Remove the garden furniture from under the fire escape Take apropriate action regarding the bed sited next to a radiator. Consult with the Environmental Health Officer regarding the issues identified in the report and inform the inspector of the outcome Defrost the freezers x3 Review the staffing levels of support staff regularly, in consideration of tasks undertaken in cleaning and catering The manager should work 90 of her time on management duties Reinstate the service users survey and provide feedback for service users Obtain a new style accident book which is designed for data protection. Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Linwood House Care Home DS0000002297.V253795.R01.S.doc Version 5.1 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!