Inspection on 30/10/07 for Mayfield House

This inspection was carried out on 30th October 2007.

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

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

Other inspections for this house

Mayfield House 07/10/08

Mayfield House 23/05/06

Mayfield House 22/02/06

Mayfield House 04/08/05

Mayfield House 06/01/05

Mayfield House 15/06/04

Mayfield House 19/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Mayfield House Mayfield Mews Minshull New Road Crewe Cheshire CW1 3FZ Lead Inspector June Shimmin Unannounced Inspection 30 October 2007 09:30 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 Mayfield House DS0000006654.V342811.R01.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. Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mayfield House Address Mayfield Mews Minshull New Road Crewe Cheshire CW1 3FZ 01270 500414 01270 214946 sheila@mayfieldcarehome.co.uk 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) Littleton Homes Limited Mrs Anne Littleton Mrs Victoria Francis Care Home 51 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (23), Old age, not falling within any other of places category (51) Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1 2 The service is registered for a maximum of 51 service users in the category of OP (Old age, not falling within any other category) Within the overall number of service users to be accommodated a maximum of 23 service users may be accommodated in the category of DE(E) (Dementia over the age of 65 years) 30 January 2007 Date of last inspection Brief Description of the Service: Mayfield House is a two-storey purpose-built home with 51 places for older people. It is on a modern housing estate, approximately a mile-and-a-half of Crewe town centre, with access to bus links and the railway. The property has been extended and now has two separate units, one for people with personal care needs, and the other for people who have dementia. Access to the homes second floor is by a passenger lift and three stairways. There are accessible and well-maintained gardens surrounding the home. The scale of charges range from £353.91 - £516.00 per week. Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was part of the key unannounced inspection of the home and took place over 7 and a half hours. It was carried out on 30 October 2007 by one inspector. An expert by experience also visited the home as part of the key inspection. An expert by experience is a person who, because of their shared experience of using services and/or ways of communicating visits a service with an inspector to help get a picture of what it is like to live in or use the service. Before the site visit the manager was asked to provide information about the home as part of the inspection. The views of relatives, staff members and other people who visit the home such as social workers were also sought. During the visit the inspector spoke to the two managers, several staff members, relatives and a number of people who live in the home. The records for three people who live in the home were looked at to check the care they receive. Policies and procedures and records of medication, care plans, and training records were also seen. What the service does well: Mayfield House provides warm and pleasant surroundings for the people who live there. A social worker commented, “the home has a pleasant and welcoming feel.” Staff are highly regarded by people in the home, relatives and other visitors such as health professionals. A relative wrote, “very considerate” and a doctor, “good overall personal care.” Care staff refer people to health care professionals where necessary to ensure that their health care needs are met. The standard of catering is good and people receive appropriate support at meal times so residents receive a nutritious diet. Complaints are managed well so that people know their concerns will be taken seriously and acted upon. The home has effective measures in place to control any outbreak of infection so that people are protected from infectious illnesses. Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 6 Staff at the home receive encouragement and support to undertake their NVQ so there is an above average proportion of the care staff who hold this qualification. The home is well maintained so that people live in a safe, pleasant and comfortable environment. What has improved since the last inspection? What they could do better: Recruitment practices need to be more thorough so that people know that staff working in the home are suitable to work there. Staff need to take part in fire drills at least twice a year so that they know what to do if there is an emergency. More information needs to be recorded about people’s life histories during the assessment process so that care is person centred. Several actions need to be taken to manage medication more effectively to make sure the people who live in the home receive their medicines safely. Consideration should be given to making sure that people who live at the home are able to enjoy activities in a quiet environment. Staff should attend annual refresher training in moving and handling so that people are safe from possible injury when they are being helped to move. Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An assessment of people’s needs is carried out before they move into the home to make sure their needs can be met. EVIDENCE: One of the joint managers or a senior nurse visit people to carry out an assessment of their needs before they move into the home on a permanent basis. This is to ensure that staff at the home can meet their needs and that the person can decide whether to live in Mayfield House. The assessments of three people who had recently moved into the home were seen. One person came in as an emergency and the assessment was carried out on the day they moved in to make sure that their needs could be met at the home. The manager said that a new form to be used when people moved into the home had been introduced, which would provide more information about the person. There was little information on any of the assessments Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 10 about the social and spiritual needs of people so these needs may not be recognised. The manager said that the home is intending to introduce a life history for family or close friends to complete so that staff at the home would have a complete picture about the needs of the person being cared for. The process has started and an example of a very informative life history of one person was seen. This means that care staff are able to understand the person, their unique life experiences and so be able to provide improved care based on this knowledge. Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 11 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): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health and personal care needs are met in a way that ensures people are treated with respect and their individual rights acknowledged. There are some minor problems with managing medicines that need to be sorted out so that people living at the home receive their medicines safely. EVIDENCE: The care plans of three people who live at the home were looked at. These were generally of a good standard so that care staff would be able to understand what they had to do to meet the needs of people in the home. Some minor problems needed to be resolved. For example, a number of risks had been identified and written on the same form, which meant that care staff might be given insufficient guidance about how to manage those risks. Risk assessments were not always reviewed on a monthly basis so that changes might not be recorded. Some care plans needed to contain more detail, for instance, in relation to the management of diabetes so that each person’s care Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 12 needs would be identified and met. Care plans were usually reviewed monthly but they had not actually been evaluated so that it was difficult to assess whether any further actions had been recorded. For instance one person had lost weight over a period of five months but there was no reference to this on the evaluation of the nutrition care plan. The manager has recently developed a falls risk assessment tool which is to be put into each person’s care plan to make sure they are protected from the risk of falls. No one at Mayfield House has a pressure sore, which is a reliable indicator of good care. However, it was noticed that two pressure-relieving tools were in use, which might confuse staff. There was clear evidence that people requiring support from other health professionals were receiving it. The home has one medication room. However, this is accessible to most staff as care plans are also stored in this room. The medication room should only be accessible by staff who have a direct responsibility for the management of medication. As the medication room door is locked there is also limited access for care staff who may wish to read care plans. The home does not currently have separate storage facilities for the management of controlled drugs as required by law. Several discrepancies were noted during the inspection, which the deputy manager undertook to put right. It was also noted that medication trolleys did not have chains to secure them when not being used by a nurse or carer administering medication. The expert by experience and the inspector spoke to a number of people who live in the home and observed interactions between staff and people. People said that staff treated them well and that they were satisfied with their life in the home. Staff working in the part of the home where personal care was provided appeared quite busy and there were few opportunities for spontaneous interactions between staff and people. However, the manager commented that this was during a busy period of the day. Staff appeared to have more time for conversation and activities during the afternoon on the unit providing care for people with dementia. The expert by experience observed one activity which did not fully take into account the dignity of people and which should have taken place in the privacy of the person’s own bedroom. Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 13 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): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home can take part in activities offered but the range on offer could be expanded to make sure that all the people living in the home d give them choices in their daily lives. EVIDENCE: A member of staff is employed at the home to provide activities five days a week for five hours a day. The manager acknowledged that the home would benefit from a second person to help with activities and is hoping to recruit a further staff member to do this. Activities provided at the home include reminiscence work, music, talking about or showing objects/pictures from the past. Other activities enjoyed by people were bingo, quizzes, dominoes and other games. Several people on the unit for people requiring personal care commented that there were few activities taking place and one person wanted to attend church but was now unable to do so. During the afternoon a local entertainer played the organ. Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 14 It was noted that televisions were on in both units at different times of the day although no one appeared to be watching them. The volume was turned down in one lounge as music was playing and in the other the volume was turned up and there was also music playing making it difficult for anyone to listen to the music or watch the TV. Several staff took part in activities with people on the dementia unit during the afternoon and people appeared to be enjoying these activities. A social worker who visits the home wrote, “I have observed residents in different activities and staff and service users interacting comfortably”. The manager said that the home has an activities committee to which relatives are invited. Staff at Mayfield House have also got in touch with a variety of outside organisations to help maintain links with the local community. Although the home has not organised any outings for some time it is planned to do so later in the year. People said that they enjoyed the meals provided and that there was a choice available. There were no printed menus either on display or on the tables. However, staff said that the next day’s menu is discussed with each person the night before to find out their preference for the main course at lunch. The manager said that changes to the tea time meal have been well received. She also commented that vegetables are served separately at mealtimes so that people are encouraged to help themselves and maintain independence. A photograph catalogue is being developed to help people choose what meals they prefer by pointing if they cannot communicate verbally. Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 15 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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Mayfield House makes sure that complaints received are acted upon so that people know their concerns are being listened to. The home has appropriate policies and procedures for adult protection and most staff have received training so that people are protected from possible harm. EVIDENCE: The complaints procedure for Mayfield House is on display. The manager said that the complaints procedure is also included in the information pack given to people about the home. People said they would know who to speak to if they had any concerns. The home’s record of complaints indicated that any complaints or concerns were investigated and appropriate action taken. The home has a number of policies and procedures relating to the protection of vulnerable adults. These include a whistle blowing policy so that staff can report any situations where they feel abuse may have taken place. Most staff have recently undertaken training in this subject and the remaining staff are working towards completing this training so that people in the home are protected from possible harm or abuse. Mayfield House DS0000006654.V342811.R01.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): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Mayfield House is well maintained, well equipped, clean, decorated and furnished to a good standard, which helps to create a comfortable and welcoming environment for people living in the home. EVIDENCE: The manager wrote that various improvements have been made to the environment of the home over the last year. These include redecoration and new carpets. A new door system has been provided to allow visitors easier access whilst still maintaining the safety of people in the home. Outdoor equipment has been purchased following a request by staff and people in the home. During a tour of the premises it was noted that the environment was clean, tidy and free from any odours. No maintenance problems were found. Before Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 17 the inspection the manager provided CSCI with information which indicated that equipment has been regularly serviced and maintained. The manager has taken appropriate steps to control any infection in the home so that people are protected from infectious illnesses. People’s rooms have been personalised so they can have familiar objects around them to help them feel more at home in their own personal space. The dining areas and a number of corridors have hard surface flooring, which makes these areas appear less homely. The manager said that this was due to the number of spillages that occur. The expert by experience noted that a seating area was provided outside and several people said they were able to go outside or walk round when the weather was fine. Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are enough trained staff to make sure that people who live in the home receive good care. Some recruitment documentation was not available so the home could not show that all the staff are suitable to work with vulnerable adults. EVIDENCE: Staffing levels at Mayfield House appeared to be good during the inspection visit. One person considered that more staff could be employed. A social worker commented that the skill mix appeared to be appropriate, which indicates that staff have received sufficient training to perform their role. A number of staff have undertaken training in dementia so that they have knowledge about the needs of people with dementia. The training records for the home showed that all staff have received an induction to the home and that new staff are working towards completing this. The senior carer who manages the other seniors working at the home is being supported to do the registered manager award. She confirmed that she has supervision with the registered manager about three to four times a year so that she receives feedback about training and any issues relating to practice. Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 19 The recruitment records of three staff members were seen. There was only a character reference on file for one person although there were two satisfactory references for the other two staff. Although there was a security check from the Criminal Records Bureau (CRB) for all staff members there was no initial security check (POVA first) for any of the three staff members. This means that there is no evidence that staff were clear to start work until a full, enhanced disclosure had been received from the CRB or if they had been supervised whilst waiting for this disclosure. All other recruitment documentation was satisfactory. There is a strong commitment to staff training at the home. Two thirds of care staff have achieved NVQ 2 in care and five staff have NVQ 3. Staff are trained to become assessors for NVQs; there are now eight, so other staff can be assessed in the workplace and make quick progress with their NVQ training. The joint managers also run a training organisation and have developed workbooks in various topics such as dementia, which have been accredited by the City and Guilds organisation. This means that training material is of a very good standard. The manager holds a training meeting every four to five weeks. The minutes and action plan from these meetings show what progress is being made. Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The members of the new management team are very experienced in providing care for older people. The home is well organised so it is run in the best interests of the people who live there to promote and protect their health, safety and welfare. EVIDENCE: Since the last inspection one of the owners has taken over the role of manager as a joint appointment with her daughter. Both are first level registered nurses. The managers have twelve years experience of working together and have built a successful training company. Both managers have achieved the registered managers award. One manager has level 4 in management and the other level 5, so both are well qualified to perform their role. One manager is Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 21 working towards a degree in dementia care. They have recently appointed a deputy manager to further assist with running the home. Various strategies have been undertaken to monitor the quality of care at Mayfield House. A suggestion box has been placed in the main entrance so that anyone can put forward their own ideas. A questionnaire for relatives was distributed in March this year and an employee survey was carried out in June this year. A staff member has been appointed to look into quality assurance in the home and make any necessary changes. The managers said that they carry out monthly audits of different aspects of care. The manager wrote that the monies of people in the home are now managed by the management team more effectively. The training records indicated that a number of staff have not undertaken an update in moving and handling training which might put people at risk of injury when they are being moved. The manager said that further training had been organised for November but that staff not attending training sessions made it difficult to ensure that all staff have done mandatory training. The manager said that the fire risk assessment was being updated and would be reviewed in the next three months. The training records showed that a number of staff had not attended a fire safety training refresher course in the last year but that this was to be organised for November this year. The last fire drills were held in January and March of this year so that some people had not taken part in a fire drill for some time, potentially putting people at risk if staff do not know what to do in the event of a fire. There were no thermometers to test water temperature on the dementia unit and a carer said that they used their hands to check the water temperature. This method is not reliable and may lead to water temperatures, which are either too hot or cold. Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME 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 X 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 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 OP29 Regulation 19 (1)(b & c) (11) Schedule 2 Requirement Timescale for action 30/01/08 2 OP38 23 (4)(c) All necessary recruitment documentation must be obtained before the staff member starts work, including a reference from the person’s must recent employer and a POVA first check so that people living in the home are protected from possible harm and poor practice. All staff must take part in a fire 30/01/08 drill at least twice a year so that people living and working in the home are safe. Records of these fire drills, including the staff members involved, should be kept to show that all staff have taken part in the required number of fire drills. Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP3 OP7 OP9 OP9 Good Practice Recommendations Assessments should include detailed information, where this is necessary, and include information about the social, cultural and leisure care needs of service users. The care being provided should be evaluated as part of the monthly reviews so that people’s changing needs are recorded and appropriate actions taken. An appropriate controlled drug cupboard should be provided so that this medication is stored as required by law. All staff involved in the management of medication should undergo refresher training in the management of controlled drugs so that they fully understand their responsibilities. Medication trolleys should be chained to the wall or an immovable object when not in use. The spiritual needs of people should be recorded and people given the opportunity and support to continue to worship should they wish. Consideration should be given to the level of noise in the lounges when music is being played at the same time as the television being on. Consideration should be given to providing information about meals available either in a printed format or on a wipe on/off board so that people know what is available. Staff who have not yet undertaken training on adult protection should do so as soon as possible so that all staff know what to do if there is an allegation of abuse. Staff should undertake annual training updates in moving and handling so that people are protected from unsafe practice. Thermometers should be provided in bath and shower rooms so that staff can check that water temperatures are safe and correct. 5 6 7 8 9 10 11 OP9 OP12 OP12 OP15 OP18 OP38 OP38 Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Mayfield House DS0000006654.V342811.R01.S.doc Version 5.2 Page 26 - 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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