Inspection on 15/05/06 for Malmesbury House

This inspection was carried out on 15th May 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

Malmesbury House 25/08/09

Malmesbury House 29/08/08

Malmesbury House 30/08/07

Malmesbury House 02/11/05

Malmesbury House 18/04/05

Malmesbury House 11/01/05

Malmesbury House 20/04/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Malmesbury House Malmesbury House 18 Beauchamp Road East Molesey Surrey KT8 0PA Lead Inspector Vera Bulbeck Unannounced Inspection 15th May 2006 10:00 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 Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Malmesbury House Address Malmesbury House 18 Beauchamp Road East Molesey Surrey KT8 0PA 020 8783 0444 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) Mrs Mary Gajraj Dr H Gajraj, Dr N Gajraj Mrs Mary Gajraj Care Home 19 Category(ies) of Dementia - over 65 years of age (14), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (2), Old age, not falling within any other category (2), Physical disability over 65 years of age (1), Sensory Impairment over 65 years of age (1) Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Of the fourteen (14) service users in category DE(E) (Dementia - over 65 years of age), one (1) named person may also fall within category SI(E) (Sensory Impairment - over 65 years of age). 2nd November 2005 Date of last inspection Brief Description of the Service: Malmesbury house is a large detached property situated in a residential area close to the local shops of West Molesey. The accommodation is on three levels, ground floor, first floor and second floor. All floors are accessible by a passenger lift. The majority of the bedrooms are of a good size, and are single bedrooms with en-suite facilities. A number of service user’s bedrooms situated on the ground floor have access to the garden. The home is set in spacious and well-maintained grounds, which are readily accessible to the service users. There is a large nicely furnished conservatory used by service users mainly for activities. The conservatory is also used, as a quiet area for service user’s to entertain relatives and friends. There is ample car parking at the front of the premises. Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first site visit to be undertaken by the Commission for Social Care Inspection for the year April 2006 to March 2007. The site visit was over a period of seven hours. For details of how each standard was met please refer to the main body of the report. It was disappointing to note that a number of areas in the home were in need of work to be carried out. The site visit was unannounced, which meant that visitors, staff and residents were not aware of the visit prior to it commencing. The inspector had the opportunity to speak with a number of residents who live at the home. The majority were very complimentary about the home and staff. A full tour of the premises was undertaken. Four care plans were observed. There were three members of staff and the manager and deputy manager on duty with eighteen residents in the home at the time of arrival. All members of staff were spoken with during the visit as well as the Community Nurse; an Assistant community nurse a relative and the visiting Optician. A number of comment cards were left for residents and relatives to complete and requested they be returned to Commission for Social Care Inspection (CSCI). Mrs V Bulbeck, Lead Inspector for the service carried out the site visit. Mrs M Gajraj the Registered Manager of the home was present. The home is registered for nineteen places. There are currently eighteen residents living in the home. The staff was observed to be courteous and the atmosphere within the home was relaxed and friendly. The inspector would like to thank the residents and staff for their co-operation and hospitality during the inspection. The residents living in the home wish to be called residents, therefore service users will be referred to as residents throughout the report. An improvement plan must be submitted to the Commission for Social Care Inspection (CSCI) with dates and timescales regarding the requirements made at the site visit on 15/05/06. Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 7 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 Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 8 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): 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each resident is only admitted to the home following a needs assessment to ensure that the home can meet the resident’s identified needs. The home does not offer intermediate care. EVIDENCE: At the time of the visit it was noted that a resident had recently visited the home for a pre assessment this was undertaken with the residents social worker and management of the home to ensure the home is able to meet the residents needs, prior to admission to the home. The registered manager and deputy manager has arranged to attend equality and diversity training. All staff should receive this training. The home does not offer intermediate care. Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 9 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 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Personal care and healthcare support and assistance is planned and was seen to be provided, where needed, in a respectful and sensitive manner. Policies, procedures and practices are in place, management of the home needs to ensure the safe administration of medication. EVIDENCE: Four residents care plans were sampled and there was evidence that resident’s health, personal and social care needs had been identified and assessed. Care notes need to be in order and to be able to read appropriately, resident’s needs should relate to equality and diversity. It was noted correction fluid was used on a residents’ care plan correction fluid must not be used on legal documents. There is a need to ensure all care plans are up to date and each hold relevant details as stated in the Care Homes for Older People National Minimum Standards and the Care Homes Regulations, Schedule 3. Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 10 A number of risk assessments need to be updated for all residents living in the home. One resident is able to self medicate. Medication records were found to be well documented. However, it was noted that one resident’s medication had been changed on the label by hand, the dosage had been changed and the number of times a day administered had also been changed. Storage facilities were appropriate. Medication is administered from blister packs and two members of staff are involved. The residents spoken to confirmed that staff are respectful and knock on the door before entering. Observation by the inspector was residents and staff have a good rapport, residents are able to discuss with the staff any worries they may have and staff reassure residents, by supporting, explaining, and helping to clarify any problems and to ensure residents have a clear understanding. The inspector was able to speak with two Community Nurses who was in the home on the day of the site visit. The Community Nurses were very complimentary regarding the care the residents receive, and also stated that the other community nurses in the same practice were also happy with the care provided to the residents. Management of the home must ensure that a member of staff is available to be present when requested by the community nurses. The Optician was present in the home on the day of the site visit, he stated he visits on a yearly basis or more often if required. It was noted that a resident’s bedroom is used for the eye examination, as the lighting is right. The optician stated that the other areas he was shown to undertake the examination were not suitable. The inspector was informed the resident has kindly agreed for her bedroom to be used for this purpose and the inspector advised the management they must ensure this information is documented in the care plan and signed by the resident or her family. The Optician stated that residents discuss with him about how happy they are living in the home, he has always received good feedback from the residents. He also informed the inspector “Malmesbury House is one of the best homes he visits”. The inspector had a discussion with a resident who was requesting to bring an electrical armchair into the home, as the chair he had in his bedroom was clearly uncomfortable. The inspector advised the home to ensure the resident was provided with a suitable chair. Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 11 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 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are supported and encouraged to maintain contact with family and friends. Meals are well balanced and varied with individual choices and preferences as well as special dietary needs catered for. EVIDENCE: The Majority of residents have contact with family and friends except two residents. The inspector advised the home to contact Age Concern regarding obtaining an Advocate for the two residents without family contact. The meals served in the home were nutritional in content and well balanced. The staff and residents are involved with the menu planning and the home has a cook who undertakes the cooking duties on a daily basis. One resident confirmed the food is very good, but he often feels hungry after his meal, as the quantity is not sufficient. The inspector would advise the home to ensure there is extra food cooked to enable any resident who would like a second helping, this should be optional to all the residents. There is a planned activity programme one afternoon a week and from time to time extra musical performers are invited to the home. An in house activity Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 12 programme is organised by the staff and during the afternoon, time permitting staff spend time with the residents. The residents seem to spend a lot of their time watching television. Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 13 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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a simple, clear and accessible complaints procedure, which includes timescales for the process. All required policies and procedures are in place to ensure that residents are safeguarded from harm or abuse. EVIDENCE: There have been no recorded complaints in the home since the last inspection. The home has developed its complaints procedure and has incorporated details of the Commission for Social Care Inspection. The inspector was informed all residents have been provided with a copy, which is held in the resident’s bedroom. This was seen during the site visit. A copy of the complaints procedure was seen on the notice board in the hallway of the home. All relatives have been provided with a copy. A relative commented that if she had any problems or complaints she would speak with the manager to discuss what action would be taken. The homes policies and procedures for the protection of vulnerable adults and a whistle blowing policy were in place and the majority of staff except a new member of staff has received the protection of vulnerable adults training. Staff on duty confirmed they had undertaken this training and were aware of the procedures. The home has a copy of Surrey Multi Agency procedures. Residents are encouraged to vote and have been registered for a postal vote. Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 14 Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 15 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 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The location and layout of the home and gardens are suitable for their stated purpose. An ongoing maintenance and redecoration programme provides the residents with clean, pleasant and homely surroundings in which to live. EVIDENCE: The home was found to be clean and tidy, the home has two cleaners on duty on a daily basis. Some of the residents like to be involved with the cleaning in their bedrooms. On entering the home it was noted that CCTV were in the process of being fitted to all communal areas, hallways, landings and entrance to the home. The inspector advised the management of the home this was an infringement of the resident’s privacy and was restricted by the National Minimum Care Standards for Older People to entrance areas only. It was noted that a number of areas around the home are in need of attention. Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 16 In some bedrooms the toilets were badly stained and in other bedrooms the carpets were found to be badly stained, in need of deep cleaning or replacing. Curtains in several bedrooms were hanging off the rails, and another bedroom, which was not in use, the mattress was badly stained and needs replacing. Two chests of drawers were found broken and a handle was missing from a wardrobe door. There was a strong odour in another bedroom. In the bathroom on the top floor in a cupboard under the wash hand basin was a bucket collecting water from the waste pipe, which was leaking. And in another bedroom a toilet was without a seat. The sluice cupboard was found unlocked and inside was a large container of pine disinfectant. Several windows require restrictors on the first and second floor. The laundry floor was very dirty and needs to be cleaned particularly between the machines and behind. It was also noted that chains had been fitted to all the fire doors in the home restricting residents in the event of an emergency to be able to get out of the home. The inspector advised the home to remove these chains, which were carried out on the day of the site visit. The conservatory is light and furnished for the residents to enjoy particularly when entertaining their relatives. However it was noted that there are two coffee tables with glass tops that require safety glass. These were discussed at the previous inspection. The garden is well maintained and secluded and accessible for residents to use. The outside of the home needs painting. Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of the staff meets resident’s needs. The home has a comprehensive staff recruitment and training programme which incorporates all areas needed to ensure, as far as reasonably possible, that residents are in safe hands at all times. EVIDENCE: There is sufficient staff on duty during each shift, these include three care staff, domestic staff and the chef. However, at times there is only two care staff on duty between the hours of 7am and 9am. Management need to review the staffing levels between the hours specified and ensure there are three care staff on duty. A maintenance person visits the home on a regular basis and carries out all the jobs required. Full recruitment procedures are being followed. All staff has been checked against the Criminal Records Bureau (CRB) before working in the home. Staff records were observed and found to be well documented, including contracts and terms and conditions. Training has been ongoing and the majority of staff has attended a number of training courses. However, the training plan needs to be kept up to date. All new staff need to have a comprehensive induction-training programme. All staff has received (POVA) protection of vulnerable adults training, except a new member of staff. Several members of staff have completed NVQ Level 2. Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 18 Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Resident’s, benefit from an open, positive and inclusive management style. The home has a monitoring system in place that is based on seeking the views of the residents. All policies, procedures and practices are in place, but some need updating to ensure, so far as is reasonably practicable, the welfare, health and safety of residents and staff. EVIDENCE: The management of the home need to review their management practices to ensure the home is meeting the required standards. The home to comply with the National Minimum Standards for Older People and the Care Homes Regulations 2001. Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 20 The inspector received positive comments from professionals visiting the home as well as residents and a relative’s comments being very favourable. The management of the home do not mange residents finances, the majority of residents have family who are involved and those without family have a solicitor who has power of attorney. The home had a visit from the Environmental Health Officer on 28/03/06 and was given a Silver Food Hygiene Award. On the day of the site visit it was noted that several storage containers in the kitchen require lids that fit appropriately. In the main storage cupboard it was also noted that porridge oats were in an opened bag. Any dried foods need to be stored in a plastic container with a lid. The inspector observed that food spilled on the floor in the main storage cupboard needed cleaning. A cake was stored in the freezer, which had not been labelled or dated. All food stored in the freezer must be labelled and dated. The inspector also observed that yellow bags, stored in the dustbin outside the home was over flowing with out a lid. There was a large container of pine disinfect found in an unlocked cupboard on the first floor. Which was removed on the day of the site visit. A fire extinguisher needs fixing to the wall. Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 X X 2 Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 22 Yes 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 OP7 Regulation 17 Requirement Care notes to be more informative and to contain up to date risk assessments and to be filed in some order appropriately. (Timescale 01/12/05 not met). The food kept in the freezer must be labelled and dated. (Timescale 03/11/05 not met). The labels on medication must not be changed. Extra food to be offered to residents. Chains on fire doors to be removed. The use of CCTV cameras to be restricted to entrance hall only. Toilet seat missing needs replacing. Badly stained carpets in resident’s bedrooms need cleaning or replacing. A fire extinguisher needs fixing to the wall. Curtains off rails need attention. Restrictors required on all windows on the first and second floor. Two Broken chests of drawers need repair or replacing. DS0000013709.V291574.R01.S.doc Timescale for action 30/06/06 2 3 4 5 6 7 8 9 10 11 12 OP38 OP9 OP15 OP19 OP19 OP19 OP19 OP19 OP19 OP19 OP19 16 13 12 23 23 23 23 13 16 13 16 15/05/06 15/05/06 16/05/06 15/05/06 16/05/06 02/06/06 02/06/06 02/06/06 16/05/06 02/06/06 02/06/06 Malmesbury House Version 5.1 Page 23 13 14 15 16 17 18 19 20 21 22 23 24 OP19 OP19 OP19 OP26 OP26 OP26 OP26 OP27 OP38 OP38 OP38 OP38 16 16 23 13 16 16 13 18 13 13 13 13 25 OP38 13 Handle missing from wardrobe door. To provide an appropriate armchair for a resident. The outside of the house needs painting. Badly stained toilets need deep cleaning on a regular basis. Leaking washbasin in bathroom needs repairing. Badly stained Bed/Mattress needs replacing before the bedroom is occupied. Laundry floor needs cleaning. Staffing levels to be maintained at all times particularly between the hours of 7am – 9am. Yellow bags need to be contained in a bin with a lid. All cleaning materials including disinfectant must be stored a locked cupboard at all times. Storage containers with lids that fit are required in the kitchen. Opened bags of dried food stored in the main storage cupboard need to be stored a sealed container with a lid. The floor in the main storage cupboard needs to be kept clean at all times. 16/05/06 26/05/06 29/09/06 26/05/06 16/05/06 02/06/06 16/05/06 16/05/06 16/05/06 15/05/06 16/05/06 16/05/06 15/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP19 OP30 Good Practice Recommendations A dispenser required in the bathroom for paper towels. (Carried forward from the last previous inspection 02/11/05). To consider all staff to receive Equality and Diversity training. DS0000013709.V291574.R01.S.doc Version 5.1 Page 24 Malmesbury House 3 4 OP38 OP38 All glass top tables to be reviewed. (Carried forward from the previous inspection 02/11/06). To consider a milk dispenser for the kitchen. Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Malmesbury House DS0000013709.V291574.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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