Inspection on 30/08/05 for Middlesbrough Intermediate Care Centre

This inspection was carried out on 30th August 2005.

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

Middlesbrough Intermediate Care... 30/08/07

Middlesbrough Intermediate Care... 04/10/06

Middlesbrough Intermediate Care... 16/01/06

Middlesbrough Intermediate Care... 15/02/05

Middlesbrough Intermediate Care... 27/05/04

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Middlesbrough Intermediate Care Homerton Road Pallister Park Middlesbrough TS3 8PN Lead Inspector Brenda Grant Unannounced 30 August 2005 9:45 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 and Care Homes for Adults 18 – 65*. 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. Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Middlesbrough Intermediate Care Address Homerton Road Pallister Park Middlesbrough TS3 8PN 01642 513120 01642 513126 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) Middlesbrough Council Miss Margaret Ann Mett Care Home 23 Category(ies) of PD(E) Physical dis - over 65 (23) registration, with number OP Old age (23) of places Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: (1) That the home can take 10 service users, in total, aged 40 years plus. These 10 service users can be either of the two categories, for which the home is registered. Date of last inspection 15th February 2005 Brief Description of the Service: Middlesbrough Intermediate Care Centre is a large detached two-storey purpose built home that has been completely refurbished to provide personal care and accommidation for 23 older people and older people with physical disabilities, up to 10 of whom could be 40 years plus. The home provides intermediate care, with physio and occupational therapy available as part of the rehabilitation process. The home is located near to a shopping complex which enables service users to have access to a wide variety of shops, a public park, post office, leisure centre and public transport. Middlesbrough Intermediate Care Centre has an enclosed garden, to the rear of the building, that is lawned and there are plant pots, it provides a safe seating area during warm weather. All bedrooms are for single occupancy and there are two flatlets to provide for the monitoring of independent living. All bedrooms have an en-suite with bath or shower, WC and wash basin. The home has communal bath/shower rooms and WCs. There are also lounges, dining rooms, meeting/training rooms, a therapy room, a main kitchen and two domestic training kitchens. There is a separate access to the first floor of one wing at the home, that is office accommodation for: the domiciliary care service, therapists and associated staff, the Stroke Association, mobile response team and the reenablement officer. Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over five hours, the inspector looked around the building and the grounds of the home as well as inspecting a number of records. Five residents, two staff, the Occupational Therapist, the Modern Matron, the Administrator and the manager were spoken to on the day of the inspection. The intermediate care service moved to the newly refurbished premise less than a week prior to the inspection. Although management, staff and service users were getting used to their new surroundings, all were managing very well. Some initial ‘teething’ problems have been found but the home is addressing them as quickly as possible. What the service does well: What has improved since the last inspection? There has been an enormous improvement to the building and all requirements and recommendations from the last inspection have been addressed. All bedrooms have en-suite facilities; there is new furniture; furnishings and fittings all a round the home; a new kitchen and a new laundry have been developed as well as two domestic ‘training’ kitchens. The large therapy room is well equipped for the purpose. Office accommodation for therapists and other office staff is completely separate from the home environment. Staff have completed annual fire training and training for basic food hygiene. Training for infection control is to be completed by the end of September 2005. The provider makes arrangements for a person to care out monthly monitoring visits and there is a written report on the findings. Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 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. Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Standards Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3 & 6 The home provides service users with a written contract stating terms and conditions but not all contracts are dated. All service users needs are assessed before admission to the home. Service users are assessed solely for intermediate care and service users are helped to maximise their independence to return to their homes in the community. EVIDENCE: Service users have a signed copy of their contract with the home. Contracts state the terms and conditions. Only one of the four contracts, that the inspector looked at, had a commencement date. Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 Page 9 The home has initial care manager assessments for each service user. Assessments identify the needs that are to be met and the home devises a plan for the longer-term outcomes. The home is undergoing a transition from providing intermediate care and interim care, to that of only intermediate care. All service users, admitted to the home, are now assessed solely for intermediate care. The home aims to provide intensive rehabilitation to enable service users to maximise their independence. Care staff have completed ‘enabling’ training and are to become more involved with promoting activities of daily living and mobility, that will complement the work carried out by the therapists. Four service users spoke positively about their rehabilitation programmes and of the progress they had achieved. The Occupational Therapist said that service user’s rehabilitation programmes are to be divided into shorter-term goals that will assist care staff to more clearly define the work they are to carry out. The home has an equipped therapy room and domestic ‘training’ kitchens, to assist service users with their daily living tasks, but the kitchens have not been installed with a refrigerator. Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for standard(s) 7 & 8 Service user’s health, personal and social care needs are set out in individual plans of care but there is no confirmation that service user agree with the plans. Service user’s health acre needs are fully met. EVIDENCE: The home devises a Care Plan for each service user that also includes a Risk Assessment. There are also Occupational Therapy Treatment Plans. All are regularly reviewed and updated as necessary. Service users have not signed their plans to confirm they agree with them. Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 Page 11 Service users said they were satisfied that their health care needs were being met. One service user, who had a pressure sore, said the home make arrangements for a registered nurse to regularly attend to the sore. The manager said service users are assisted to have their general and specialist health care needs addressed. The Occupational Therapist said the home has equipment, for assisting service users, but if extra equipment was needed the home would ensure it was provided. The manager said, the health needs, of service users, is one of the main priorities at the home and that there is regular monitoring of all incidents that occur. There is a regular analysis of falls, or when service users have been found on the floor, to identify the cause so that the home can take action to reduce such occurrences. Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with asssistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 & 13 Service users can live their lives as they wish but the home does not arrange regular recreational activities for service users. Service users maintain contact with family/friends and representatives and the local community. Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 Page 13 EVIDENCE: Service users said the daily routines at the home were flexible and that service users can live their lives as they wish. There were choices of: when to get up and go to bed, whether to sit in private or in communal rooms and a variety of food was offered. Three service users said, “the days are long.” Service users said they would join in with recreational activities if the home offered them but none are. One service user said, “I would even like to play a game of dominoes.” Staff said they encouraged service users to maintain contacts with families and friends. Service users said staff always made visitors welcome at the home. Visitors could be received in private or communal rooms. Staff said they assist service users to use the local community facilities if that is what service users wish. Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Service users are protected from abuse. EVIDENCE: Records confirmed that staff have completed ‘No Secrets’ and Whistle Blowing training, for the protection of service users. Staff said they follow the policies and procedures that are set out by the home and they try to ensure that service users are protected from any form of abuse. Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 23, 25 & 26 Service user live in a safe well-maintained environment but some further equipment needs to be provided. Service users’ own rooms suit their needs. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 Page 16 EVIDENCE: The recently refurbishment has brought the building up to the required standards and passed all of the required checks. The requirements of fire and environmental health regulations have been met. The grounds are kept tidy and safe; the Administrator informed that the garden area is soon to be landscaped. In the main, the home is equipped for the purpose but the main kitchen does not have a water boiler and the home is using a ‘boiler in one of the ‘training’ kitchens. Additionally, hot food is brought to service users by means of a trolley that is not heated, therefore the food could have cooled before is consumed. There is new furniture and furnishings that are homely and domestic in nature. All bedrooms are for single occupancy and bedrooms have an en-suite facility. The home has wide doorways for wheelchair users and larger bedrooms are provided for service users who require extra equipment. All bedrooms have a lockable storage space that can be used for medication, money and valuables. Heating, lighting and ventilation is satisfactory. Rooms are centrally heated and heating may be controlled in service user’s own rooms. Hot water outlets are by means of thermostatically controlled valves. The manager said the home is to commence weekly water temperature checks. The premises, on the day of the inspection, was clean, hygienic and free from offensive odours. There are satisfactory laundry facilities that, the manager said, can be used as part of service user’s rehabilitation programmes. The home also has sluicing facilities. Staff said they follow policies and procedures for the control of infection. The manager said all staff will complete training, for infection control, by the end of September 2005. Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 29 and 30 (Older People) and Standards 34 and 35 (Adults 18-65) the key standards to be inspected at leat once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 29 Service user’s needs are met by the numbers and skill mix of staff. In the main, service users are protected by the home’s recruitment policies and practices. EVIDENCE: The home has a stable staff group that have many years of experience. The home accepts trainee ‘Modern Apprentices’ to gain an insight of working in a care home environment; experienced members of staff supervise the ‘Modern Apprentices’. The home has satisfactory numbers of day and night care staff for the size, layout and purpose of the home. The home has domestic and kitchen staff to ensure that food standards are met and that the home is maintained in a clean and hygienic state, free from dirt and unpleasant odours. Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 Page 18 Staff said, before they were recruited, they had completed an application form, references were taken up and they were interviewed for their present post. Staff files had most of the required documentation but not all files had copies of Birth Certificates, passports and Criminal Records Bureau (CRB) checks; the manager said, Middlesbrough Council has ensured all staff have had CRB checks but the home did not have a reference, or a copy, of all the checks. Staff confirmed they had a contract for their employment at the home. Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s polies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 33, 35 and 38 (Older People) and Standards 23, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 & 36 Service user’s financial interests are safeguarded. Staff are appropriately supervised. Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 Page 20 EVIDENCE: Staff said they do not get involved with service user’s finances. The manager said service user’s money, if looked after by the home, is kept safe. The temporary locked facility and the recording of service user’s monies was found to be satisfactory. The home’s management structure involves senior care staff supervising the work of Care Assistants and the manager directly supervises the senior care staff. Records confirmed that staff received regular one to one supervision. Supervision covers all aspects of practice, the philosophy of the care home and career development needs. Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 2 3 3 4 x 5 x 6 2 HEALTH AND PERSONAL CARE ENVIRONMENT Standard No 19 20 21 22 23 24 25 26 STAFFING Score 2 x x x 4 x 3 3 Score Standard No 7 8 9 10 11 Score 2 4 x x x Standard No 27 28 29 30 3 x 2 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 x COMPLAINTS AND PROTECTION Standard No 16 17 18 Score x x 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 x 32 x 33 x 34 x 35 3 36 3 37 x 38 x Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 Page 22 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. 2. 3. 4. Standard 2 2 19 29 Regulation 5 15 16 19 Requirement Service users contracts must be dated. Service users must sign their Care Plans to confirm they agree with the plans. The main kitchen must have a water boiler and the home must have heated food trolleys. Staff files must have: copies of Birth Certificates and passports and confirmation of staffs CRB checks. (Previous timescale of 31st March 2004 not met). Timescale for action 30th September 2005 30th September 2005 30th September 2005 30th September 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 6 12 Good Practice Recommendations Training kitchens should have a refrigerator. The home should have a programme of recreational activities. Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Unit B, Advance St Marks Court Teesdale, Stockton-on-Tees TS17 6QX 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. Middlesbrough Intermediate Care B51-B01 SN36142 Middlesbrough Intermediate Care Centre VN246194 300805 Stage 4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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