Inspection on 04/05/06 for Melton House

This inspection was carried out on 4th May 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Melton House 29/08/07

Melton House 02/10/05

Melton House 25/04/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Melton House 47 Melton Road Wymondham Norfolk NR18 0DB Lead Inspector Ruth Hannent Key Unannounced 4th May 2006 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 Melton House DS0000065210.V293599.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Melton House DS0000065210.V293599.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Melton House Address 47 Melton Road Wymondham Norfolk NR18 0DB 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) 01953 606645 01953 857390 Four Seasons Health Care (England) Limited (wholly owned subsidiary of Four Seasons Health Care Ltd) Josephine Barrett Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Melton House DS0000065210.V293599.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd October 2005 Brief Description of the Service: Melton House is a care home providing personal care and accommodation for 34 older people. The home is a large detached building situated in the market town of Wymondham. Bedrooms are on the ground and first floors and consist of five double bedrooms (four with en suite facility) and twenty-four single bedrooms (twenty-two with en-suite facility) The home has a variety of communal rooms, one of which is designated for service users who wish to smoke. A shaft lift is provided to aid service users to the first floor. Car park to the front with a small garden to the rear of the premises. The fees range from £385 - £410 per week. Email melton.house@fshc.co.uk Melton House DS0000065210.V293599.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place with the Deputy Manager over a period of five and a half hours. The post of Manager has been vacant since the beginning of April and a new Manager is about to take up this position shortly. Throughout the day residents were spoken to both during breakfast, lunch and in the lounge. Staff members were spoken to, three visitors were seen and a few questions were asked. The records looked at included care plans, health and safety records, medication records, accident forms and personnel files. A tour of the building took place with most of the bedrooms seen plus the communal areas and the outside garden. The pre inspection questionnaire had not been completed but will be returned to the Commission once the Deputy has collated all the information. Four relatives/visitors and four residents comment cards had been received prior to the inspection What the service does well: What has improved since the last inspection? The Home appeared cleaner and tidier since the last inspection. Agency staff are now being used when an identified gap on the staff rota is seen. Menu’s have improved with choice readily available. Melton House DS0000065210.V293599.R01.S.doc Version 5.1 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. Melton House DS0000065210.V293599.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Melton House DS0000065210.V293599.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 5 The quality of this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Not all residents are assessed fully, prior to moving into the Home. Residents/relatives and friends are invited to see the facilities and assess the suitability of the Home. EVIDENCE: The assessments of residents were looked at and the latest resident to be offered a place did not have an assessment in place, although evidence on other residents were found, the details were not always clear and one particular event showed the Home that unless they assess fully the needs of the person an inappropriate placement can happen. (A recent situation of the lack of information meant a return to hospital for one person might have been avoided if the full details had been obtained). (Requirement) Melton House DS0000065210.V293599.R01.S.doc Version 5.1 Page 9 The visitors signing in book and comments received both verbally on the day of inspection and comment cards received prior all reflect how welcoming the Home staff are when anyone first visits the Home and will answer the questions asked efficiently. Key standard 6 is not applicable to Melton House as intermediate care is not provided. Melton House DS0000065210.V293599.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 The quality of the outcome area is adequate. This judgement has been made using evidence including a visit to this service. The care plan does not reflect all areas of the care needs. Health care needs met appropriately. The staff do not follow the Homes procedures for administration of medication. The residents are treated with respect and privacy upheld. EVIDENCE: In total three care plans were seen and two residents details were looked at in more detail through conversation and observation. The recording in the care plans did not reflect the full needs of the people, with no evidence found of person centred care. Residents were able to give the Inspector lots of information that was not recorded about the social support and interests that would make her life more enjoyable. One person talked about the personal care needs that, although offered by kind caring staff were not given at times Melton House DS0000065210.V293599.R01.S.doc Version 5.1 Page 11 that suited them and one particular comment was “I like to go to bed between seven and eight but sometimes have to wait until the night staff have arrived and that can be eleven or eleven thirty”. On discussing this with the Deputy Manager this does occur on occasions. (Outstanding Requirement) The residents are registered with local GP’s from practises within Wymondham. One comment card received gave favourable comments about Melton House. The District Nurse visits and offers medical support to those who need it. It was noted on one care plan a resident who had a red area, recorded by a care staff member, had this attended to by the District Nurse on the same day. Another resident who had shown signs of sudden confusion had a urine sample taken immediately to the health centre for testing with the correct medication returned to be administered straight away. (Records seen) Concern was shared with the Deputy Manager over the administration of medication. On arrival to the Home the staff member who opened the front door had left the trolley in the dining room unlocked and unsupervised to answer the door. (Requirement) On observation during the administration procedure the medication was removed from the blister packs and placed in a medicine pot with the medication chart initialled before the medication was taken to the resident to ingest. (Requirement) It was also noted that the morning medication round was continuing up until 10.30 with the lunchtime medication starting again at 12.30 with not enough time elapsing between some of the medication. (Requirement) The Home is about to move to a new medication process with Boots MDS system and to be sure staff are competent and trained with all the procedures when changing over, a full training programme must be carried out. Many of the residents spoken to could not praise the staff highly enough. This was also reflected in the comment cards received from both families and the residents. “They are worth their weight in gold” “they all treat us well” were some of the comments. Throughout the day conversations were heard and the cheerful, well-mannered and correct approach were noted. Doors were knocked upon and with any task observed the resident were asked what they would like, where they would like to go and if they needed anything further before being left. Melton House DS0000065210.V293599.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 The quality of this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is little social or recreational interests met for residents. Contact with relatives/friends is maintained for residents as they wish. Residents are assisted to make choices over their lives. A good choice of meals provided according to individuals taste. EVIDENCE: The residents have little or no regular and ongoing stimulation/activities. The majority of the residents spoken to talk about just sitting and doing nothing in between meals and appear to have accepted that this is the way life now is. Three residents who were spoken to have been at the Home a long time and say they are happy just to sit but some residents had written in their comment cards that there was nothing happening and although the staff try on occasions it was rare to have an activity. It was noted on the day of the inspection that residents went to the main lounge after lunch and sat. The odd one or two talk about a crossword but most of the rest went to sleep while the staff had a Melton House DS0000065210.V293599.R01.S.doc Version 5.1 Page 13 break leaving all the residents on their own in this lounge.(Outstanding Requirement) Two families visited during the inspection and spoke of how often they visited and praised the staff highly for the care they give to their relatives. There are areas within the Home where relatives can entertain or use their bedrooms as they wish. It was noted the kindness and assistance given to a visitor who needed help to get in and out of the building to enable her to visit her relative. Some residents still manage their own financial affairs and are encouraged and helped to maintain that independence. Those resident’s who need assistance with their finances will be supported by staff who will ask the families for assistance if required. Helping people with their money was discussed with a staff member who stated and showed that any transaction carried out by the home on behalf of the resident is fully recorded and witnesses sign the financial sheet along with the Deputy Manager Residents do bring personal possessions with them to the Home and this was noted in the personalised bedrooms where small items of furniture, pictures and ornaments were. The meals within the Home are displayed on a wipe board with the choice for lunch on the day of the inspection was sausages, mash and spaghetti or Cornish pasty with salad and ice cream sundae or jam tart and custard for pudding. (The two different puddings were seen, brought to the table so residents could see the food before making their choice). The inspection began at nine o’clock with some residents having breakfast, which offered a large choice. Bacon, egg, mushrooms and tomatoes for one, bacon sandwich for another, weetabix and toast for a third with the cook being very evident in the dining room to ensure the food was as suitable. One comment card praised the support and choice of food offered by the cook and that the quality was good. Talking to a group of gentlemen it was evident that they valued the cook and her active support in providing what they liked and how much time she spent with the residents to get to know their likes and dislikes. Melton House DS0000065210.V293599.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The quality of this outcome area is adequate Residents and families are confident their complaints/concerns are listened to but the recording of these must be in place to show the evidence of the outcome of the complaint/concern. Residents are protected from abuse but staff need up to date training. EVIDENCE: The Home does have a complaints procedure but there is no evidence held in the Home of any complaint being recorded or investigated. The Deputy Manager was able to recall a complaint that occurred in the later half of 2005 but no written record could be found. On discussion with staff and residents they feel all concerns/complaints are dealt with at the time. With nothing recorded there is no proof how well a situation has been dealt with. (Requirement) Comment cards from residents stated that they would complain and know who to go to if necessary. The Home has a team of workers who have long-term experience and have an understanding of abuse but have not received training in this area. The residents spoken to feel the staff care for them appropriately but the Inspector was unable to get a clear understanding from a staff member what different types of abuse there could be but she would talk to her manager if at all concerned about anything within the home that caused her concern. Melton House DS0000065210.V293599.R01.S.doc Version 5.1 Page 15 Melton House DS0000065210.V293599.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21 and 26 The quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is safe and well maintained. The bathroom facilities are in need of upgrading. The home kept clean and pleasant. EVIDENCE: The Home has an efficient Maintenance Officer who has all records up to date of all the maintenance checks. Seen were the fire records, water temperature checks and service records of equipment within the building. The washing line is about to be re-sited so that residents have easy access to the back garden, which is well maintained and safe. The outside of the property is about to be painted and three new carpets are on order to replace Melton House DS0000065210.V293599.R01.S.doc Version 5.1 Page 17 some stained ones (message received during the inspection of when the carpet fitters were coming). The majority of the Home is suitable but the bathrooms are in need of redecorating and made to feel more inviting and cosy. The walls are plain and have no pictures or plants. The flooring in one is in need of replacing and upgrading. Two comment cards received from residents all state the “tired” bathrooms as part of their personal comments. (Requirement) Throughout the inspection it was noted how clean everywhere was which is an improvement since the last inspection. All bedrooms were in order, with beds made and commodes/toilets all clean. The laundry facilities, which were improved last year still need to have a new sink area added but everywhere was in order and there were no odours. Two large industrial machines were in use with a sluice cycle available and all personal clothing items in individual boxes or hanging on a rail. Melton House DS0000065210.V293599.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 The quality of this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. There is a lack of staff throughout the later part of the day which means the needs of residents cannot be met appropriately. There is a slow increase of the staff gaining a qualification, which is an improvement. The Homes procedures for recruitment are followed. Very little staff training and development is in place to ensure competency in their jobs. EVIDENCE: The staff rota’s were seen and discussed with the Deputy Manager and it was noted that the correct staff were on duty. (Two waking night staff, three carers and one senior for the morning shift and two carers and a senior for the afternoon shift). At present the Home accommodates twenty-three residents and does not have enough staff on the afternoon shift to offer the care required. Through the morning the home has one domestic, one laundry domestic, one cook, one kitchen assistant and one maintenance officer and although they are not directly linked to care do support and carry out tasks that in the afternoon cannot get done. It was noted during the inspection that Melton House DS0000065210.V293599.R01.S.doc Version 5.1 Page 19 the maintenance officer took a urine sample to the surgery and the cook and kitchen assistant were making the drinks and entertaining the residents. In the afternoon this is expected to be carried out by just three staff members and with quite a few residents requiring assistance from two staff members it is evident why some residents are not being helped to bed at times that they would like. The rota’s need to be rewritten to ensure more staff are on duty in the afternoon/evening. (Requirement). There is also the need to have allocated hours for activities/stimulation seen separate from the care hours to ensure some purposeful activity is in place for each resident. (Requirement). The Home has slowly increased the level of staff who have achieved an NVQ qualification but more staff need to be encouraged to achieve this award to ensure staff are fully competent in the work they do. (Requirement). The latest staff member to be recruited has moved from a relief carer to a permanent carer. On looking through the personnel file it was noted that all the relevant paperwork was in place. Seen was :-POVA and CRB, two references, application form, two forms of ID with a driving licence photograph and a P45. A contract is yet to be issued but other staff were noted to have a signed contract. The staff have received very little training over the past couple of years and some of the statutory dates of training are out of date. The moving and handling for all staff is overdue and they have not received any training in adult abuse. Records of training are incorrect and not all certificate copies are held with personnel files. The most recent training has been for the senior staff by Boots to enable the staff to use the new medication system efficiently. (Requirement) Melton House DS0000065210.V293599.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 and 38 The quality of this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. This Home is being run adequately while awaiting a new Manager.. The Home has no way of assessing the quality of the service at present. The quality of this standard is good and resident’s financial interests are safeguarded. No formal supervision sessions take place which is a poor outcome. The quality of this standard is adequate as some areas of the health and safety of residents is not in place. EVIDENCE: Melton House DS0000065210.V293599.R01.S.doc Version 5.1 Page 21 By the date of the interview there was not a Manager in post but a person was due to start shortly. Therefore this standard could not be inspected on this occasion. The Home to date has no measuring device to assess the quality of the service at Melton House and although when questioned the residents had no concerns a full annual quality assurance monitoring system must be in place to assist the annual development plan for the Home. (Requirement) The resident’s money that is handled by the Home has a full procedure in place with all transactions recorded and each one holding two signatures. All records and receipts are held safely. There are no records and on speaking to the staff one to one supervision or any kind of formal supervision has not happened on a regular basis. If any one has a need to talk about any aspect of the Home they will deal with it informally.(Requirement). The health and safety of residents is, as regards to equipment checks, safe storage of hazardous substances, water checks both for legionella and temperatures are all carried out by the Maintenance officer and all records are up to date. It was noted that the recordings for the hand wash-basins in the bedrooms were as high as 65 degrees and are too hot. On discussing this with the Deputy it was felt some of the residents who may be at risk should have a risk assessment in place (Recommendation) and that control valves be installed on bedroom sinks. (Requirement) COSHH data sheets are held in the office for all information on the chemicals used for cleaning within the Home. It is all ordered and supplied from one company. The sheets seen were held in a bounded file and the chemicals were seen in the locked cupboard. On asking a staff member, it was evident that she would know what to do in the case of an accident with any chemical. A recent fall by a resident had a record (Reg 27) of the accident sent to the commission and was followed up on the day of the inspection by looking at the daily records and accident form completed. All the correct information was written and procedures followed correctly. Melton House DS0000065210.V293599.R01.S.doc Version 5.1 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 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 2 3 x 2 X X X X 3 STAFFING Standard No Score 27 1 28 2 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 1 X 2 Melton House DS0000065210.V293599.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP33 Regulation 14 Requirement It is a requirement that all potential residents are assessed fully to ensure suitability for the care service offered in this Home. It is a requirement that care plans are completed to match the care required and includes all the information on social, personal and health care for each individual. (Outstanding requirement) It is a requirement that all senior staff who are responsible for medication have the training and competence to handle medication as written in the Homes procedures. It is a requirement that the medication trolley is locked at all times when left unattended. It is a requirement that times of administering medication is in line with the instructions issued by the pharmacist on each medication. It is a requirement that stimulation and activities are offered and recorded for DS0000065210.V293599.R01.S.doc Timescale for action 01/06/06 2 OP77 17 01/07/06 3 OP99 13 01/07/06 4 5 OP99 OP99 13 13 01/06/06 01/07/06 6 OP1212 16 01/07/06 Melton House Version 5.1 Page 24 7 OP1616 22 8 OP2121 23.2 9 OP2727 18 10 OP3030 18 11 OP3333 24 12 13 OP3636 OP3838 18.2 13.4 residents that is person centred (Outstanding requirement) It is a requirement that all concerns/complaints are recorded and dealt with as written in the Homes complaints procedure. It is a requirement that the bathrooms are decorated and flooring changed to provide an appropriate comfortable setting for resident’s to bathe. It is a requirement that enough trained staff are available at all times to ensure the social/ emotional care support for all residents is in place and not just the personal care needs.. It is a requirement that all staff are up to date with their skills and training (particularly statutory training) to meet the needs of the residents. It is a requirement that a quality reviewing system be in place to aid improvement and assist with development plans. It is a requirement that all staff receive appropriate supervision and records are kept. It is a requirement that the risk of scalding be removed by the temperatures of water within hand-wash basins reduced with a control valve. 01/07/06 01/09/06 01/08/06 01/09/06 01/07/06 01/07/06 01/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP38 Good Practice Recommendations Risk assessments should be in place for all residents who DS0000065210.V293599.R01.S.doc Version 5.1 Page 25 Melton House use the hand-wash basins and measures put in place to eliminate the risk while awaiting the control valves. Melton House DS0000065210.V293599.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Melton House DS0000065210.V293599.R01.S.doc Version 5.1 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!