CARE HOMES FOR OLDER PEOPLE
Martins House Jessop Road Stevenage HERTS. SG1 7LL Lead Inspector
Louise Bushell Unannounced 01/08/05 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Martins House Address Jessop Road, Stevenage, HERTS. SG1 7LL Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01438 351056 01438 741528 Chauncy Housing Association limited Mr Joseph Hudson CRH 63 Category(ies) of DE (E) 63 registration, with number OP 63 of places Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 02/11/04 Brief Description of the Service: Martins House is owned and managed by Chauncy Housing Association. Martins House is registered to provide residential support to 63 elderly service users. The home is a purpose built three storey setting in a residential area of Stevenage. There is a parade of shops nearby and the town centre is about a mile away. Accomodation is provided in single rooms, although there are facilities to offer shared facilities if requested. All rooms have en-suite toilet and washing facilities and there are a number of assisted bathrooms throughout the home. On the ground floor there are two sitting rooms, conservatory, activities room and a large open planned dining room. The main kitchen and food storage area is adjacent to the dining room. There are additional small domestic style kitchens on each floor. There is a unit housing eleven frailer service users on the first floor. The floors are linked by two passenger lifts. The home also provides a hair-dressing facility. Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the first inspection of the year and took place early morning to late afternoon. The majority of time was spent talking to service users within the home, actively seeking their individual views and feedback concerning the running of the home, meals, activities, choices, care plans, decoration and any other environmental issues. Time was spent engaging in activities with the service users, having lunch and seeking views of a small group of service users. What the service does well:
A monthly monitoring form has recently been implemented that ensures that all maintenance within the home is highlighted with a clear plan for programme of works to complete. This ensures that general repairs and ongoing maintenance within the home is dealt with swiftly. Those works not completed are then carried forward to the next months schedule. Linked to this maintenance the manager presented an annual improvement plan for the home. A well structured staff team is in place with a positive management structure within the home, this ensuring that at all times of the day at least a senior member of staff is available. Recently the home has filled the vacancy for an activities coordinator has been filled. This person is new to post however has worked within the home in different capacities and therefore has a rapport with a number of the service users already. There is a Friends of St Martins Committee that supports in the fundraising for the home. This is a long-standing group with regular members. The group meets to discuss plans and fund raising ideas. The home has a lovely garden area, which is accessible to all service users. The new awning have now been fitted which provide suitable shelter for the service users. The garden area is well maintained and one service user in particular is involved in the maintenance of the garden. It presents as a homely relaxing environment to sit. A number of courses are currently being provided externally to the in house training. This includes Hearing Aiders, and an activities course for the new coordinator. All bedroom doors are now fitted with automatic fire door releases. Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better:
Following the employment of the new activities coordinator there is now a need to ensure that systems are implemented within the home, to record accurately the activity preferences of each service user and to monitor the activities that they take part in. Advice was provided to the activity coordinator regarding contacting specialist service providing information for older people and activities. The manager should also consider the purchasing of a DVD player and either a larger television or a projection screen enabling a larger number of service user to enjoy films and/or DVD nights. This would also enable further activities within the home such as slide shows. There are some environmental works that are required within the home. These have been identified by the manager as requiring completion. They include refurbishment of the top floor and middle floor bathrooms, cleaning or replacement of the wings hallway carpet, redecoration must continue in the allocated hallways and repairs completed to all ceilings following rewiring works. Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 7 Door wedges were observed being used throughout the home. This practice must cease, if the doors are required to be opened then suitable methods must be used as recommended by the fire authority. Care plans were tracked as part of the inspection process. The details held within the actual care plan were rather sparse and did not give direct details and/or instructions of the care to be provided to the service user. One service user was visually and hearing impaired; however the care plan did not provide this information or a method of best practice to communicate with her. Another example was a service user with diabetes who did not have a diabetes management care plan in place. It is essential that care plans are tailored to individual needs and that they function as a working document, ensuring staff are able to provide accurate care to each person. Records implemented for the purpose of monitoring service user health care must be completed and maintained if accurate monitoring is to occur. Inventories were held on the service users file with a contract of tenancy agreement, there is need to develop the inventories to ensure all items are listed that belong to each service user. Staff records were inspected. The registered manager of the home must ensure that staff are only working in the building with adequate reference checks including a pova first and CRB clearance, for the safety and protection of the service users. A training matrix is held by the home which details all the training that has been attended and completed by all the staff, there is a need to demonstrate the certificates of attendance for staff and for these to be held on file a verification of attendance. The majority of staff had attended a basic first aid course, however for best practice there should be at least one person who has completed the full 5-day First Aid at Work Certificate. Ancillary staff within the home should complete the basic moving and handling training and the adult protection training to ensure service users are fully protected. Staff are being supervised within the home, however there is a need for at least six formal one to one supervisions to occur that are documented per year. The home is currently staffed with two waking night members of staff and a sleep in, following discussions with the manager it is felt that this must increase to three waking night staff in order for service user and staff safety. A detailed fire premises risk assessment must be completed, advice and information was given to the manager. Oxygen is held on site. This is suitably stored however there is a need for the home to ensure that the signs used to display the location of the oxygen are fire retardant and illuminate in such circumstances of fire. Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 8 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. Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 10 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3 & 5. All service users are provided with accurate and adequate information, visits and discussions prior to admission to the home, ensuring that they are empowered and encouraged to make informed choices about where to live. EVIDENCE: A detailed and comprehensive Statement of Purpose is in place, providing sufficient information for all prospective service users, friends and relative and supporters. All service users are provided with the documents prior to admission to the home and following review. The service user or their representative and Registered Manager sign the document on agreement and admission to the home. Care records of service users were inspected and there was evidence of pre admission assessment of needs being carried out in each case. The manager receives a copy of the pre admission assessment of needs of prospective service users for those who are funded by the Social Services and discharge letters from hospital, where applicable. The manager or a senior member of staff would also carry out the home’s own pre admission
Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 11 assessment of needs of any referred service user. Staff members were observed to be interacting well with service users; demonstrating good skills and knowledge to meet the specific care needs of the respective clients’ group. Prospective service users are invited to look around the home. Relatives invariably visit the home prior to admission of their next of kin to the home. The initial admission would be on a trial period for a mutually agreed length of time, which can be extended if need be. This allows the staff ample opportunity to further assess the service user’s needs and to formulate a detailed care plan. Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 12 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 10 Service users care plans did not set out in detail the provision of care required on an individual basis, therefore potential health care needs could remain unmet. Care plans are in need of completing to ensure a consistent level and approach of care is offered to individuals. EVIDENCE: All service users care plans were generated from the pre admission assessment and provides the basis of care to be offered to the individual. All care plans detail specific actions to be taken by the staff to ensure all aspects of the service users health, personal and social care needs are met. All care plans will be reviewed once a month to ensure monitoring and changing needs can be addressed. The plan is drawn up with the involvement of the service user as much as possible, some care plans had been signed by the service user and or representative. Care plans were tracked as part of the inspection process. The details held within the actual care plan were rather sparse and did not give direct details and or instructions of the care to be provided to the service user. One service user was visually and hearing impaired; however the care plan did not provide this information or a method of best practice to communicate with her. Another example was a service user with diabetes who did not have a diabetes management care plan in place. It is essential that care plans are tailored to individual needs and that they function as a working
Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 13 document, ensuring staff are able to provide accurate care to each person. Records implemented for the purpose of monitoring service user health care must be completed and maintained if accurate monitoring is to occur All service users spoken with appeared well cared for clean. Self-care is promoted within the home where ever possible. The ethos of good practice within the home ensures that preventive and restorative care is provided. Specialist medical support and advice is offered within the home to any service users who may require it. All necessary equipment is provided within the home to meet service users needs. Following discussions with service users is was confirmed that the staff are very caring and supportive, encouraging them to make decisions about their lives with appropriate assistance provided. Service users commented that they felt respected at all times. Privacy and dignity was observed being upheld within the home. Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 14 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 The home supports all service users to maintain family, representative and community links as they wish, thus empowering and encouraging service users to maintain, respect, dignity and personal autonomy over choices in their lives. Wholesome, adequate, varied meals are provided within the home presenting a well-balanced nutritious diet for all service users supporting them to maintain a healthy life. EVIDENCE: Following the employment of the new activities coordinator there is now a need for the home to ensure that systems are implemented within the home, to record accurately the activity preferences of each service user and to monitor the activities that they take part in. Advice was provided to the activity coordinator regarding contacting specialist service providing information for older people and activities. The activity coordinator discussed developing a social history of each service user to support in the provision of suitable activities within the home. The manager should also consider the purchasing of a DVD player and either a larger television or a projection screen enabling a larger number of service users to enjoy films and or DVD nights. This would also enable further activities within the home such as slide shows. There is on site a large activities and craft room, which received positive feedback from\the service users. A hair dressing facility is also available. There is need for the replacement of the shower hoses and heads in the hairdressers to
Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 15 prevent spillage of excess water to the floor and a potential health and safety risk. Feedback from service users was positive regarding the activities available. A coffee morning is provided at the weekends and encourages visitors and volunteers to the home. A calendar of events was displayed within the home in the foyer area. Involvement in other local community events is encouraged; emphasis is given to autonomy and choice for the service users. Serivce users views and opinions are expressed freely within the home and efforts are clearly made to ensure that service users maintain vital links, personal autonomy and choices. If further support and or advice is required in order to ensure freedom of choice for the service users the home is able to link with specialist advocacy services in the best interest of the service user. Wholesome meals are provided within the home. Feedback provided by many service users was extremely positive regarding the choice and availability of foods. A four-week rolling menu is in place, which is seasonal. All service users can make, and are empowered and encouraged to make choices over the meals and the foods they eat. Hot and cold drinks are available throughout the home. Lunch was observed within the home and appeared to be unhurried and a calm atmosphere. The kitchen was well organised with recording systems in place. Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 16 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Accurate and robust recruitment checks within the home are not in place leaving the service users at possible risk as they are not protected fully by the homes systems. EVIDENCE: Recruitment staffing file were inspected to ensure the required and accurate documentation was held pertaining to each member of staff, checking their authenticity to work in the UK, suitable references and identification. It was found that one member of staff was working in the home without a completed CRB, Pova first check or two suitable references. The member of staff was requested to cease working at the home until suitable checks had been made and verification received. Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 17 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 22, 24 & 26 The home presents as a safe environment. There are some redecoration and other maintenance works that are required within the home to ensure that the service users are living in a consistently safe, well maintained and homely environment. EVIDENCE: A monthly monitoring form has recently been implemented that ensures that all maintenance within the home is highlighted with a clear plan for programme of works to complete. This ensures that general repairs and ongoing maintenance within the home is dealt with swiftly. Those works not completed are then carried forward to the next months schedule. Linked to this maintenance the manager presented an annual improvement plan for the home. There are some environmental works that are required within the home. These have been identified by the manager as requiring completion. They include refurbishment of the top floor and middle floor bathrooms, cleaning or
Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 18 replacement of the wings hallway carpet, redecoration must continue in the allocated hallways and repairs completed to all ceilings following rewiring works. The premises were clean and well maintained. Spring-cleaning was occurring in a number of the service users bedrooms on the day of inspection. Each room is personalised and individualised. Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 19 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 Sufficient staffing is available during the day to meet service users’ needs. However, the staffing levels at night are inadequate. Staff have access to training. Recruitment procedures are not sufficiently robust to protect service users. EVIDENCE: Staff were observed to be working in such numbers within the home to meet all service users needs. Staffing rota’s reflected that adequately trained staff are working at any time within the building. Service users confirmed that they feel their individual needs are met with staff that are adequately trained. A training matrix is held by the home which details all the training that has been attended and completed by all the staff, there is a need to demonstrate the certificates of attendance for staff and for these to be held on file a verification of attendance. The majority of staff had attended their basic first aid course, however for best practice there should be at least one person who has completed the full 5-day First Aid at Work Certificate. It is also recommended that the ancillary staff within the home complete the basis moving and handling training and the adult protection training. The home currently provides two waking night members of staff and a sleep in, following discussions with the manager it is felt that this must increase to three waking night staff in order to protect both service user and staff safety. Staff records were inspected. The registered manager of the home must ensures that staff are only working in the building with adequate reference checks
Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 20 including a pova first and CRB clearance, for the safety and protection of the service users. Ancillary staff are employed in such numbers ensuring that the building remains well maintained and functions as a clean environment. Following discussions with a number of ancillary staff it is felt that training in the protection of vulnerable adults is required, due to their vital contact with service users. An induction process is in place of all staff that it staggered for the staff member ensuring that key task and training can occur at key stages throughout the process. The training and induction programme is in line with the National Training Organisations guidelines and ensures that staff are meeting the aims of the home and meets the changing needs of the service users. Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 21 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 36, 37 & 38 The home is effectively run with specific managers operating different management areas within the building, ensuring that the home is run in the best interests of the service users. Staff are supervised within the home, however more frequent formal supervision must occur to ensure that home maintains sound management practices in the best interest of the service users and the staff. EVIDENCE: Feedback from service users determined that the management and the ethos of the home is positive. The managers of the home displayed clear direction and leadership which both the staff and the service users were able to understand. Following the last inspection the home was commencing its annual quality review of the service. There is a need to ensure that the results of the review are displaced with a clear action plan in place in order to make and necessary changes from the feedback. Staff spoken to confirmed that they
Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 22 have supervision, however not a minimum of six times per year. There is a need to ensure that all staff receive a minimum of six formal one to one supervision sessions per year and records taken. All records required by regulation were available upon request and were held in accordance with the Data Protection Act 1998. There are an array of risk assessments in place, however there is a need for the home to develop a detailed premises risk assessment. Information and advice was past onto the manager. The home holds oxygen on site. This is suitably stored however there is a need for the home to ensure that the signs used to display the location of the oxygen are fire retardant and illuminate in such circumstances of fire. Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 2 x x 2 x 3 x 3 STAFFING Standard No Score 27 2 28 2 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 1 x 3 2 x x 2 x 2 Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 24 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 7 Regulation 15 Requirement Care Plans must detail all service users assessed and identified need. Care plans must be individual and contain all required information. Weight records must be maintained if a need for monitoring has been assessed. Redecoration and refurbishment plans within the home must continue. Areas as highlighted must be completed. A review on the number of night staff working must be completed with the numbers increasing to three per waking night. Ancillary staff must complete manual handling and Protection of vulnerable Adults training. The registered manager must not employ and allow to work any persons who has not been subject to and in receipt of satisfactory checks. An action plan be completed following the results of the quality monitoring questionaire. This must be made availble to service users with clear actions made. Staff must be appropriately Timescale for action 30/09/05 2. 3. 8 19 & 22 12 (1) 23 (2) (b) 30/09/05 01/11/05 4. 27 18 (1) (a) 30/09/05 5. 6. 27 18 & 29 18 (1) (c) & 13 (6) 19 (1) & (4) 17 (2) 24 (1) (b) & (2) 30/09/05 Immediate action. 7. 33 30/09/05 8. 36 18 (2) 15/10/05
Page 25 Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 9. 28 13 (4) (9) & (c) supervised. The nms state a minimum of 6 formal one to one supervisons per year. A detailed premises fire risk assessment must be completed. Oxygen signs within the home must be fire retardent and illuminate. 15/09/05 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. Refer to Standard 12 12 12 Good Practice Recommendations The home should consider purchasing a DVD player and projection screen. That new hoses and shower heads are fitted to the taps in the hairdressers. Records should be maintained of service users in activities. Records regarding activities participated in should be held to provide a summary of input for accurate reviewing of needs. It is recommended that at least one member of staff obtains the full 5 day at work first aid training. 4. 27 Martins House I52 s19460 Martins House v241868 010805 Stage 5.doc Version 1.40 Page 26 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City HERTS. AL7 3BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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