Inspection on 29/05/07 for Milliner House

This inspection was carried out on 29th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Milliner House 13/10/09

Milliner House 20/11/08

Milliner House 29/01/08

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

CARE HOMES FOR OLDER PEOPLE Milliner House 23 - 29 Marsh Road Luton Beds LU3 2QS Lead Inspector Katrina Derbyshire Unannounced Inspection 29th May 2007 11:15 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 Milliner House DS0000066373.V334479.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. Milliner House DS0000066373.V334479.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Milliner House Address 23 - 29 Marsh Road Luton Beds LU3 2QS 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) 01582 490080 01582 491080 millinerhouse@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Healthcare Services Limited Manager post vacant Care Home 40 Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (10) Milliner House DS0000066373.V334479.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th September 2006 Brief Description of the Service: Milliner House is situated on the Marsh Road in Luton within easy reach of the town centre amenities by car or public transport. The home is within walking distance of community resources, which include churches, shops, pubs and restaurants. An enclosed garden area is at the rear of the building alongside parking. The home provides personal care for up to 30 people over the age of 65 years who have dementia and 10 people over the age of 65 who have mental health needs. Accommodation is provided across two floors, there are 40 single rooms providing en suite facilities. The home consists of 4 unit areas, each area consisting of bedrooms, and lounge/dining facilities. The home has a rear garden which is accessible to people living in the home and car parking is also available. Access to the first floor is via a shaft lift or stairs. Various communal areas are located throughout the home. The manager at the home provided the following information on charges in June 2007. The fees for this home vary from £450.00 per week, to £763.00 plus per week, depending on the funding source and assessed need of the person. Additional charges are made for hairdressing and chiropody services. Milliner House DS0000066373.V334479.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was to undertake a key inspection. This unannounced inspection was carried out on 29th May 2007. During the inspection several areas of the home were visited and the inspector spent time with many of the people who live at the home in the communal areas. The care of four people was examined by looking at their records and interviewing them and staff who look after them, alongside speaking with other people that live at the home and two relatives. No views of people living at the home or their relatives were received through comment cards sent by the Commission for Social Care Inspection to the home to distribute. Written evidence in the form of a pre inspection questionnaire was used in part to assess the outcomes within each standard. Evidence used and judgements made within the main body of the report include information from this visit. Observations of care practice and communication between the people living at the home and staff was also made at the inspection. The focus of this inspection was to look at the key standards and to follow up on previous requirements. What the service does well: When someone moves into the home the staff make sure that an assessment of their needs is carried out before their admission to the home. This means that they have information on what each person will need and the support that the staff will have to provide, to meet those needs. Staff at the home had been good at making referrals under a scheme known as the Protection of vulnerable Adults policy. There is a certain way that Luton Borough Council, Police and Commission for Social Care Inspection should be told if something has happened to any person living in the home. This might be for example if someone has fallen, but no one had witnessed this happening so it may not have been an accident. Staff had reported incidents so that a decision could be taken by the lead agency to ensure people at the home were being protected. Many of the people living at the home feel that the standard of food is good. One person said, “ I find the food lovely, and there always seems to be plenty”. The home offers a choice in meals and people living at the home also Milliner House DS0000066373.V334479.R01.S.doc Version 5.2 Page 6 said that if they did not like any of the options on offer the cook would make them something else. What has improved since the last inspection? What they could do better: Some of the areas that need to change include: the way complaints have been managed. At the previous inspection the manager at that time had been following the company’s procedure in investigating and replying to any concerns that they had received, clear records were kept of all action that had been taken. However the way that complaints had been responded to over the past six months were not satisfactory. It is not clear what was done and how the interim manger had responded. One complaint received in writing in April 2007 for example only had an entry of ‘dealt with’. Management must show how they have investigated any complaints or concerns raised and must demonstrate that they act on any shortfalls, so that people feel that they are listened to and their concerns are acted upon. Some of the staff reported that they found the amount of staff on duty was not enough in one area of the home to meet the needs of the people living in that area. There were two staff allocated to work in this area, however one person needed the constant support of one member of staff. This meant that the other 8 people living on the unit had only one staff member available immediately if they were to call for assistance. One member of staff said, “It is very difficult we have said about this but the management do not listen, we just don’t have enough time”. In not having sufficient staff in this area places people at risk of not receiving the care and support that they need. Some of the people living at the home have dementia. There are several things that are in place to help them with orientation in their daily lives and around the home. One item was a board used to help people know the day, date and Milliner House DS0000066373.V334479.R01.S.doc Version 5.2 Page 7 what is available for lunch. The information on this board was 4 days old, the day of this inspection for example was a Tuesday but the board was showing that it was Friday. This undermines the usage of these orientation tools having information available that is wrong and informing the people with dementia of the wrong date, day and what they could have at mealtimes. 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. Milliner House DS0000066373.V334479.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 Milliner House DS0000066373.V334479.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): 1, 3 & 6 People who use this service experience Adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Information to prospective people who may wish to move into the home is insufficient for them to know the management and terms of the service so they can make an informed decision on whether to move into the home. EVIDENCE: It was noted that the statement of purpose was displayed in the home; a copy was seen to be in place in the front reception. On examination of the record it showed that the statement of purpose was out of date, information on current fees was not correct and it still made reference to the previous Home Manager, even though she no longer worked there and had not done so for over 6 months. In addition a previous responsible individual was named who had also Milliner House DS0000066373.V334479.R01.S.doc Version 5.2 Page 10 left the employment of the company. Therefore information detailed within the complaints section was inaccurate, as the two points of contact when making a complaint were no longer employed. Assessment documentation as previously assessed was also noted to be in place within the care records of people whose care was tracked at this visit. The standard of information was good and gave information on the physical, social, emotional and psychological needs of the individual. Intermediate care is not offered at this home. Milliner House DS0000066373.V334479.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 & 10 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The systems for arranging access to healthcare are good therefore promoting better health for the people living at the home. EVIDENCE: Care plans examined provided clear information on the level of support to be provided by staff to each person to meet their needs; entries were also seen to show that staff had reviewed plans each month. Daily entries continue to be made to describe the progress and care of person, and changes to their needs are recorded. Written records and observation at this visit indicated that personal care is carried out appropriately. Observation of the interaction between people living at the home and staff on the ground floor of the home showed staff speaking Milliner House DS0000066373.V334479.R01.S.doc Version 5.2 Page 12 in a supportive and encouraging manner. Appropriate equipment was in place for the treatment and prevention of pressure ulcers, and risk assessments alongside nutritional screening is in place, and reviewed regularly. Care documentation indicated access to appropriate external health care professionals such as a dentist, optician and General Practitioner. Medication was noted to be stored in locked cupboards within the units at the home. Medication administration records contained signatures to show the times that medication had been given, and no gaps were seen. The amount of medication in stock was recorded on the medication records and documents were seen to show the returns of any medication not in use. Staff confirmed that training in the administration of medication was undertaken prior to them being allowed to undertake this role in the home. Balances checked were correct and the Deputy manager at the time of this visit had overall responsibility for managing the medication systems in the home. People through discussion confirmed that they felt that staff at the home maintained their privacy and dignity. Staff were seen to use the term of address preferred by the person and spoke to them in a courteous manner. Staff were also seen to knock on residents doors before entering. Milliner House DS0000066373.V334479.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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People at this home feel that arrangements in place for activities are good and meet their social needs. EVIDENCE: People living on the ground floor of the home said that they were invited to partake in scheduled activities but at times they chose to decline, as they preferred to read or watch television. As previously described staff again through discussion confirmed that a choice of activities is available in the home and records of these are in place. Within the areas of the home, where people with dementia are accommodated, signposting and sensory boards are in place. However one that was seen had information that was four days old, describing the wrong menu, date and day. In addition bedroom doors are designed to look like ‘front doors’ with letterboxes and door knockers, this is an approach used by the home in which, corridors become known as streets. Cleaning items and a cot are some examples of what is available to aid in the Milliner House DS0000066373.V334479.R01.S.doc Version 5.2 Page 14 socialisation of people, these were seen to be used and engaged the people living at the home and staff in conversation. A choice of meals is available and menus are displayed in the home, a brief observation of the lunchtime meal, showed it to be unrushed and enjoyed by the people living at the home. Meals were seen to be taken in small dining areas within each unit of the home. One person did not want either of the lunchtime menu choices so the staff member offered a further alternative, which the person accepted. Relatives of four people were seen to visit at this inspection. Staff were seen to greet them in a courteous manner and information was shared with them on the well being of the person that they were visiting The manager confirmed that people living at the home are able to have visitors at any reasonable time. People continue to be able to bring personal possessions into the home and evidence of this was seen in the individual rooms and included photographs, pictures and ornaments. People said they are consulted and are given choices as to how they conduct their lives within the home; choices offered included meals, activities and relationships. Milliner House DS0000066373.V334479.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 & 18 People who use this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Systems in place at this home for receiving and investigating complaints is not sufficient for people to feel assured that their concerns will be acted upon. EVIDENCE: As described within the choice of home section information within the statement of purpose and service user guide was noted to be out of date. The persons named on whom to contact if you wished to make a complaint were no longer employed by the company, and had not done so for over 6 months. At the previous inspection in September 2006, records were seen at that time to show how complaints had been responded to and what action had been taken to remedy any shortfalls. However records seen at this visit of complaints received since that time were not of the previous standard. The companies own running log where a complaint is given a reference number had not been completed since the previous manager had left. One complaint received had no record of a response and the inspector was advised that this would be with the Head office. However the manager was not aware of its full content or the stage of the investigation, or if an acknowledgment had been sent to the complainant. A further written complaint received in April 2007 was seen, the Milliner House DS0000066373.V334479.R01.S.doc Version 5.2 Page 16 complaint was concerning no medication on two occasions for one person. The only entry was written on the actual complaint letter itself to state ‘dealt with S.J.N with a date 20 days after the complaint had been sent. Staff were not aware of a written response being sent to the complainant or if an investigation had been undertaken or the safeguards that should have been undertaken to reduce any risk. The inspector spoke with people living at the home. One person said, “ I wouldn’t even bother to complain anymore because they don’t take any notice anyway”. The management of complaints and concerns must follow the homes own policies and procedures and complainants must be responded to so that they feel that they will be listened to and their views will be acted upon. The home had in place a policy on abuse and a copy of the most recent guidance for the Protection of Vulnerable Adults that contained the correct reporting of any alleged abuse. Training records showed staff had received training in this area. During the interviewing of staff they were able to demonstrate that they knew how to report any concerns. Milliner House DS0000066373.V334479.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The general maintenance of the environment and furnishings in in the main are good however some areas are in need of re decoration to create a pleasing and pleasant environment for all people to live in. EVIDENCE: The home is divided into four separate areas, these are known as houses. Each house has a dining and sitting room alongside bedrooms, bathrooms and toilets. An activity room, sensory room and consulting room are also available for people to use. There is an enclosed rear garden for use by the people living at the home. Milliner House DS0000066373.V334479.R01.S.doc Version 5.2 Page 18 The furnishings, fittings and décor are of a good standard. All people seen spoke highly of their environment as they did previously at the inspection in September 2006, and felt that the home catered very well for their needs. However there was evidence of staining on several ceiling areas throughout the home, this had been caused by a problem with the heating system earlier in the year. This needs to be addressed. All areas visited were noted to clean, tidy and free of odours. Staff were observed to wear suitable protective clothing when carrying out certain activities. Cleaning schedules were in place and clinical waste was disposed of in an appropriate manner. Milliner House DS0000066373.V334479.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The systems in place when recruiting staff need improvement to be of a sufficient standard to fully protect people. EVIDENCE: Several people spoken to at this visit felt that in the main staff would respond to them when they needed assistance, however several also commented that there were times when they felt that they had to wait too long as staff always seemed to “be busy”. On one house in the home one person needed the support of one staff member at all times, this was for their own safety. Staff advised the inspector that this left just one other staff member to care for the remaining people living in this area, and that they could not meet their needs properly. Staff stated that they had raised this with the management in the home, but nothing had changed. A review of staffing arrangements needs to be undertaken and a requirement is made. Records examined showed that the home meets the National Occupational Standards for the induction of staff. Staff also confirmed that they had attended several training courses and certificates of attendance and Milliner House DS0000066373.V334479.R01.S.doc Version 5.2 Page 20 qualifications are available for inspection. Information submitted by the recently appointed manager to the Commission for Social Care Inspection indicates that training undertaken by staff include moving and handling, dementia care and fire safety training. However please refer to evidence that is detailed within the management and administration section of the report concerning moving and handling practice. The homes recruitment policy and procedures as previously assessed are clear and comprehensive. Examination of three staff files was undertaken to look at recruitment practices in the home. Evidence of an application form and Criminal Records Bureau check was seen in all files, however two of the three files seen only contained one written reference. Staff were given the opportunity to locate the other reference but were unable to do so. Therefore a requirement is made, two references must be secured prior to the commencement of staff being employed in the home. Milliner House DS0000066373.V334479.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People who use this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Management at the home has not been sufficient to ensure effective service delivery so people have not received a satisfactory level of provision of care. EVIDENCE: The home had been newly registered in March 2006; at the time of this visit the third manager for the home since its registration had recently commenced employment. A requirement was made at the previous inspection regarding management support to the service and an improvement plan was submitted Milliner House DS0000066373.V334479.R01.S.doc Version 5.2 Page 22 to the Commission for Social Care Inspection. A manager was appointed as outlined in the services improvement plan, the inspector was advised that this person had now moved to another home owned by the company following a successful application. On speaking to staff at this visit the inspector was advised that they had found “it difficult over recent months”. One person said, “ sometimes the previous manager was only here once a week, he managed two other homes” the names of the other homes were given. The management of certain areas were poor through this period. As described within the complaints section the management of complaints did not follow the company’s own procedure and action taken was not clear, a request from the Commission for Social Care Inspection to complete a pre inspection questionnaire had not been done, staff confirmed that the previous manager had been aware of this and they themselves had made attempts to fill in what they could. Other examples include the missing references; no staff meeting minutes or other record of this since November 2006. One staff member said, “ He was very personable but just not effective”. The newly appointed manager of the home had been in post for two weeks at the time of this visit. She had received a handover from the previous manager, she had not yet received supervision and she confirmed that a session was not booked. The assessment of standard thirty-three was not undertaken in September 2006 as the home had only been open for six months at that time. However the manager in post at that visit had stated that it was the intention to undertake an annual resident and relative survey as the company have systems in place for this to be undertaken and would be completed in the next 3 to 4 months. The current manager confirmed that this had not been undertaken and a requirement has been made. A sample check was undertaken on balances for monies held on behalf of the people living at the home. All balances were correct. However the system for cashing cheques for the use of spending is dependant on certain signatures of staff, only one of which now works at the home. As two signatures are needed if the administrator is on leave they have to come in and other cheques are signed and then sent through the post. This causes a delay and an improved system is needed. The home has a Health and Safety policy. There was evidence within the training records that staff had undertaken fire, manual handling, food hygiene and first aid training. Risk assessments have been undertaken and were seen within the individual records examined. The inspector observed during this visit unsafe moving of a person living at the home by two staff. The person was not able to bear their own weight and needed assistance to move from chair to chair, the use of an underarm lift be used to transfer them. This lift is both unsafe and harmful to the person and staff and a requirement has been made. Records of the testing of water temperatures, emergency lighting and fire equipment are maintained. Milliner House DS0000066373.V334479.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 x 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 1 X 2 X X 2 Milliner House DS0000066373.V334479.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4 & 5. Requirement Timescale for action 31/08/07 2. OP12 16(1) 3. OP16 12, 13 & 37. 4. OP19 23(b) &(d) A statement of purpose and service user guide containing all matters detailed in the relevant regulations, must be made available in a format suitable to all people in the home and prospective people so that they know what services the home can and will provide. The use of orientation boards 31/08/07 must ensure that they contain up to date information so that people living at the home benefit from receiving accurate information on the day and date and menu available to them each day. 15/07/07 Complaints must be managed and responded to so people feel that their concerns will be listened to and acted upon appropriately. Information on how to complain must be updated so people know whom they can complain to. Repair or re decoration of the 30/09/07 ceiling areas in the home damaged by water must be undertaken so people have a DS0000066373.V334479.R01.S.doc Version 5.2 Milliner House Page 25 5. OP27 18 6. OP29 12(1)(a) & 19 7. OP31 10, 12 & 13 8. OP33 24 9. 10. OP35 OP38 12(1)(a), 17, 20. 18 pleasant environment in which to live. There must be sufficient numbers of staff on duty to meet the needs of the people living at the home. Staff must not be allowed to commence employment prior to securing two references to protect the people living at the home. Management must be sufficient to ensure effective service delivery so people receive a satisfactory level of care provision. Management must seek the views of people living at the home and then demonstrate how they have used their views to influence the running of the home, and report on and make available this information to people living at the home. Arrangements must be in place so there is no delay in gaining money for purchases. The moving of all people living at the home must follow safe practice at all times to prevent injury to them and staff. 15/07/07 15/07/07 31/08/07 30/09/07 31/08/07 15/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Milliner House DS0000066373.V334479.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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 Milliner House DS0000066373.V334479.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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