Inspection on 20/03/07 for Malvern House

This inspection was carried out on 20th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Malvern House 30/11/09

Malvern House 26/11/07

Malvern House 29/06/07

Malvern House 19/06/06

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Malvern House 271-275 Hale End Road Woodford Green Essex IG8 9NB Lead Inspector Zita McCarry Unannounced Inspection 09:30 20 March 2007 th 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 Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Malvern House Address 271-275 Hale End Road Woodford Green Essex IG8 9NB 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) 020 8531 5081 020 8531 5084 info@malvernresthome.co.uk Malvern House Retirement Homes Ltd Carol Ann Rolph Care Home 34 Category(ies) of Dementia - over 65 years of age (34), Old age, registration, with number not falling within any other category (34) of places Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Total beds to be used flexibly between categories (34). Date of last inspection 19th June 2006 Brief Description of the Service: Malvern House is a privately owned care home offering residential accommodation and support to 34 elderly people, including those with dementia. There are 2 double bedrooms and 30 singles. All have wash hand basins and several have ensuite toilets. There are two lifts and access is suitable for those with limited mobility. There are three bathrooms, with assisted baths. There is a conservatory, patio and attractive garden planted to lawn and flowers. The home is situated on a main road in a residential area of Chingford (in the London Borough of Waltham Forest) with access to local shops and transport links. Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the report of an unannounced inspection undertaken in March 2007. Two inspectors inspected the service. To assess the service the inspectors toured the building, read records relating to the care of service users, management of staff and documents pertaining to the running of the home. The inspectors met with service users, staff and visitors and their views and comments are included within the report. The recently appointed manager assisted the inspectors during the day and the registered provider was present for feedback on the day. The inspectors would like to thank everyone who assisted in the inspection process. Whilst the service continues to fail to meet the National Minimum Standards in many areas of care the inspector positively notes that the home is making progress in addressing these shortfalls. What the service does well: What has improved since the last inspection? The service has introduced new care plans, which provide guidance to staff in how to meet service users needs, although more work is required in this area. Many areas of the home have been redecorated the home is brighter, clean and free from malodours. The organisation within the home has vastly improved. The home has made considerable effort in providing an accessible complaints procedure for service users and relatives, although more work is required in this area. Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 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 Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is adequate. However the service is unable to provide an effective package of care to service users admitted without adequate assessments of need or when differences in assessment are not clarified with the placing authority. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The files of two service users were reviewed to assess the services preadmission processes. On the first file checked the service user was admitted to the home on an emergency basis, there was no social work assessment of need, despite the local authority being responsible for the placement. However there was a letter from the social worker that stated the prospective service user was “fully self-caring” and mobile with a stick. The home undertook an assessment of need and noted that the service user needed “prompting and Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 Page 9 assistance with all aspects of personal care/dressing”. When there is a difference of opinion in respect of a service users needs this must be addressed promptly. There was no evidence that this had happened. On the second file reviewed the social workers assessment of need provided only limited information but a letter from a medical professional described the service user as “severely demented”. In this instance the services own preadmission record was found to be inadequate. There was no reference to the service users, social background, work or life history. The service is unable to plan an adequate service for someone with dementia without such information. The service user had a diagnosed condition with presenting behaviours, however the assessment failed to adequately address this or provide staff with information of guidance on the condition. It was noted that whilst there were shortfalls in the preadmission assessment of these service users there was a marked improvement in the process, this needs to be ontinued. Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is poor. Service users living in Malvern House cannot be consistently assured of prompt appropriate action in the event of a health crisis. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector noted an improvement in the care plans that have been introduced into the service. The three reviewed addressed all areas of need as identified in standard 3 of the NMS. The care plans seen gave staff a good level of detail in directing the care to be provided. It as also noted that the service now has moving and handling assessments in place. Service users and/or their advocate should sign care plans where at all possible. The signature will evidence that the service users and/or advocate agrees to the arrangements the home has made to meet their needs. Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 Page 11 The inspector reviewed the accident records within the home. There had been 83 accidents recorded since the last inspection. The accident record is designed for employee accidents and is not the best tool for recording and monitoring accidents for older people. The quality of recording and detail on the accident records varied considerably. One service user had the same accident twice in one morning. The accidents as described by staff were that the service user went to sit down on a chair but missed the seat and fell backwards unto the floor. This is a very unpleasant accident particularly for older people who have a much higher risk of fracturing a femur or pelvis. Despite this the inspector noted the lack of evidence that any action, assessment, treatment or observation provided other than the service user was “picked up”. The Commission was not notified of these accidents in line with Regulation 37 of the Care Homes regulations. There was no evidence that risk assessments were routinely reviewed in response to accidents within the home. The inspector tracked the records that documented the care of a service user as her health deteriorated, and noted that the home failed to seek prompt medical assistance for the service user when she was in a health crisis. There was substantial evidence that service users medication was managed safely and administered as prescribed. The inspectors randomly selected 8 service users medication records and tracked the medication being received into the service, an audit was undertaken of randomly selected medications and all were found to be in order. The inspector noted various records containing confidential information stored on an open shelf in the service users lounge. The inspectors asked a service user if she held a key to her bedroom she advised that she did not but would like to have one. The explanation presented for not providing the service user with a key to her accommodation was that the service users sister had been consulted and not considered it necessary. There was no explanation as to why the service user should not be consulted directly about a key to her private accommodation. Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. However service users living in the home are not consistently offered a choice in the food provided. Nor does the furniture provided promote their independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has an activity co-ordinator in post who assists in the provision of activities for service users. The home offers a variety of group activities, relatives confirmed in-house entertainment. However the levels of individual support service users receive in meeting their social wellbeing was less evident. The inspector read the assessment of need for a service user, on which referral to the service was based. It noted that attending a place of worship was important to the service user and an activity that the service user wished support in re-establishing following a loss in confidence. Despite detailing the importance of this the home had failed to address it in the assessment or subsequent care plan. The service user was not therefore supported to attend her place of worship as detailed by the placing authority. Interviews with staff Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 Page 13 confirmed that no service user attends church and that occasionally staff will take a service user out on a 1:1 basis. Interviews with two relatives provided evidence of their level of satisfaction with the service. One relative described how the manager responded to her initial complaints and concerns promptly and appropriately. Relatives were satisfied with the service provided in the home. The home has several reclining chairs in the lounge areas. These are useful for service users who wish to rest and elevate their feet. There was evidence that on occasion service users who decline to go to bed at night sleep in these chairs. However once the service users were in these chairs, particularly with their feet elevated they were effectively restrained, as the chairs are much too low for them to rise out of independently. The inspectors observed one service user clearly distressed and uncomfortable in the chair and unable to remove herself from it. There was evidence that one service user recently admitted shared a double bedroom with an existing service user. Neither service user knew each other and the service could evidence no consultation with either service user in relation to this arrangement. The food presented at lunchtime appeared nutritious. However there was evidence that service users were served food that they would not choose to eat. The meals are plated up in the kitchen so service users have no real choice of what is put on their plates. The inspector spoke with the cook who plates up the meals and she was unaware of a service users particular dislike of a vegetable that had been served to her. The service will need to develop a means of ensuring choice at mealtimes. On the topic of choice one service user said ”you eat what they give you if you don’t like it then you don’t eat it”. It was noted that lunch was served to 6 service users on small table in front of them whilst they stayed in their armchairs in the lounge. When asked why they did not join other service users for lunch a service user reported that he falls off the chairs in the dining room, many of which have no arms to support service users transfer safely. However another service user who also did not go to the dining room said it was because she wished to listen to her favourite television program, the inspector was pleased to note this was a good example of staff responding to the individual wishes and preferences. . Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is poor. The service has taken steps to facilitate user complaints. However in the event of a disclosure of abuse the service was unable to demonstrate an appropriate response. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has put considerable effort into making the complaints procedure accessible to service users. It is well advertised in a large easy to read print. The content of the procedure needs reviewing to direct unsatisfied complainants appropriately. The service will also have to develop a procedure to direct staff in handling complaints. The inspector reviewed the complaints within the home and noted there were 5 recorded complaints presented for inspection. On some complaints the detail was insufficient to enable the reader assess the full nature of the complaint. For example there was one letter for a senior member of staff alleging another member of staff was shouting at a service user. There was no detail of the verbal abuse. There was no detail of an investigation but a letter from the provider advising dismissal for similar future misconduct. The registered manager had not taken up post at the time and was unable to furnish the inspector with further information. The Commission will require further information on this incident to assess whether service users were adequately safeguarded. Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 Page 15 The inspector noted two other complaints were about staff not providing assistance promptly, one service user reported to the manager that they had to wait 2 hours to be assisted to their bedroom. The complaint which was responded to within timescales was addressed. The manager confirmed that staff reported the reason for the delay in assisting the service users was because they were so busy. Another complaint detailed a member of staff refusing a service users request for assistance which resulted in the member of staff being disciplined. The inspector noted a complaint that had not been logged in the complaints record where a service user complained his care was rushed because staff were in a hurry. During the course of the inspection an adult protection issue was identified. The inspectors were not satisfied that prompt appropriate action would have been taken without their guidance. The inspectors observed two staff responding inappropriately to the allegations the service user was making. Their actions were sufficiently inappropriate for the inspector to intervene and ask them to desist. The Commission is not satisfied that staff understood their responsibilities and roles in relation to actual or suspicions of abuse. The service will have to deliver adult protection training by a skilled trainer to ensure all staff are aware of their responsibilities and respond appropriately. Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The service has worked hard to improve the environment for service users living in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has made considerable improvements to the environment, new flooring has been laid, and the home appears brighter and much cleaner. The service was free from mal odours. There has been an evident reorganisation of the office, which appears, organised and accessible. The service has begun to put signage around the home to guide service users and must continue to develop this. Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is poor. There is inconsistency in the staffing levels and at times service users living in the home experience unreasonable delays in having their needs met. The services recruitment is not sufficiently robust to demonstrate to service users and relatives that only staff with appropriate skills and experience will be employed to provide their care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager advised the service has arranged its staffing rota to accommodate peak busy periods. However there is a lack of consistency in the staffing levels. It appears that on week days the staffing levels appear higher with 5 or 6 careworkers on duty in the morning dropping as low as 4 careworkers in the mornings at weekends. It was also noted that there were only 2 care workers on duty some evening to support up to 34 service users between 6 and 9pm. It has been previously noted within this report that service users have complained about the lack of prompt assistance particularly in the evenings. On the day of the inspection the inspectors observed a service user in the calling out in distress but there were no staff around to respond to her. The service needs to be mindful to match the allocation of staff to the service users needs and the physical environment. The service has failed to demonstrate that there are sufficient staff on duty at all times to meet the needs of the service users. Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 Page 18 Four staff files were randomly selected to test the services recruitment processes. It was noted that the service has appointed on the basis of POVA first checks. Such checks should be used only when there is a crisis in staffing levels and the Commission is consulted. There was evidence that an application form detailing the applicant’s skills, experience and suitability was not completed. It was of concern the officer appointing the careworker also provided a character reference, and on another file the service had appointed using two references form friends rather than a previous employer which would have provided much more relevant information. Out of the 25 staff in post 9 hold an NVQ 2 award and 1 a NVQ 3 award. Training has been provided in house by unqualified staff. There was observational evidence obtained in the course of the inspection that staff did not move and handle service users safely nor respond appropriately when a disclosure of abuse is made. Staff require training to be delivered by persons who have the skills and qualifications to do so. Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. However the service users need to be protected from the spread of smoke in the event of fire. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager holds an NVQ 4 award and is currently undertaking a Registered Managers Award. There were fire doors on the first floor that did not close into their frames securely; this must be remedied to prevent the spread of smoke in the event of fire. There was evidence of regular fire alarm testing taking place. There was substantial evidence of the home ensuring the servicing and maintenance of equipment. Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 Page 20 There was evidence in the form of records and feedback for relatives that the service is beginning to consult with service users and their advocates. This is positively noted and areas that should contain to develop. Staff supervision has commenced but again this is an area that needs to continue to develop. The service has been receiving Regulation 26 reports, these are not being undertaken by the provider but rather completed by a member of staff employed in the service. The purpose of the visit is to monitor the service and performance of those who are employed within it. Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 1 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 1 3 X X X X X x 3 STAFFING Standard No Score 27 1 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 X X X 2 X 2 Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 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 OP3 Regulation 14 Requirement The registered manager must ensure that the service has an up-to-date comprehensive assessment of need before service users are admitted to the home. Unmet requirement. The registered manager must ensure that the assessment of service users reflect their life history. The registered manager must ensure care plans evidence service user and or advocate agreement to the arrangement recorded on them. Also that care plans reflect the placing authorities plan of care, The registered manager must ensure that each service user had a detailed risk assessment that fully identifies the risks and actions of staff to minimise the risks. Unmet requirement. The registered manager must ensure that all accidents are recorded in sufficient detail. Timescale for action 25/06/07 2 OP3 14 &12(1)a &16(1)m 15 25/06/07 3 OP7 25/06/07 4 OP7 13 25/06/07 5 OP8 12 17 25/06/07 Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 Page 23 6 OP8 13 7 OP8 13 8 OP8 37 9 10 OP8 OP10 13 12 11 OP12 12 12 OP15 12 23 13 OP15 12 14 OP16 24 The registered manager must ensure that service users receive prompt nursing or medical attention when required. The registered manager must introduce a system to demonstrate that accidents and falls in the home are monitored and appropriate management action taken. The registered manager must ensure that the Commission is notified without delay of any occurrences as detailed in regulation 37 of the Care Home Regulations 2001. The registered manager must ensure that all service users are moved and handled in a safely. The registered manager must ensure that service user’s confidentiality and privacy is maintained. The registered manager must ensure a range of individual activities introduced, including activities appropriate for people with dementia. Unmet requirement. The registered manager must ensure service users are given the opportunity and support to eat their meals at a dining table. The registered manager must revise the homes process serving and presentation for food and drink to service users to ensure service users exercise real choice. The registered manager must ensure that all complaints about the care of service users regardless of source are recorded and thoroughly investigated and responded to appropriately. Unmet requirement. DS0000067137.V329811.R02.S.doc 25/06/07 25/06/07 25/06/07 25/06/07 25/06/07 25/06/07 25/06/07 25/06/07 25/06/07 Malvern House Version 5.2 Page 24 15 16 OP38 OP27 23 18 17 OP29 19 18 OP36 18 19 OP33 24 20 OP10 12 21 OP14 12 22 OP14 16 23 OP16 24 24 OP16 24 The registered manager must ensure that the all fire doors close into their frames. The registered person must review and improve upon the current staffing levels within the home to ensure service users needs are adequately met. The registered manager must ensure that no-one is appointed to work in the home unless all the required documentation as detailed in schedule 2 of the CHR 2001. The registered manager must ensure that all staff have supervision at least 6 times a year, the record of which will be recorded. The registered manager must introduce appropriate ways of eliciting feedback form service users on the service provided and ensure their feedback is acted upon. Service users must be offered a key to their private accommodation unless the outcome of a risk assessment dictates otherwise. The registered manager must ensure that service users do not share bedrooms unless they expressly wish to do so and full consultation has been noted. The registered provider must ensure service users have suitable furniture that meet their needs and does not restrain their movements. The registered manager must ensure that all complaints are recorded centrally and held for inspection. The registered person must provide full details of the incident alleging of verbal abuse of service users to the Commission. DS0000067137.V329811.R02.S.doc 25/06/07 25/06/07 25/06/07 25/06/07 25/06/07 25/06/07 25/06/07 25/06/07 25/06/07 25/06/07 Malvern House Version 5.2 Page 25 25 OP30 18 Including contact details of complainant. The registered manager must ensure staff are adequately trained in adult protection and moving and handling. 25/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Malvern House DS0000067137.V329811.R02.S.doc Version 5.2 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. 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