Inspection on 22/06/06 for Milner House

This inspection was carried out on 22nd June 2006.

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

Milner House 20/02/08

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Milner House Ermyn Way Leatherhead Surrey KT22 8TX Lead Inspector Mavis Clahar Key Unannounced Inspection 09:00 22nd June 2006 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 Milner House DS0000066030.V299405.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. Milner House DS0000066030.V299405.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Milner House Address Ermyn Way Leatherhead Surrey KT22 8TX 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) 01372 278922 01372 278046 Ashbourne (Eton) Limited TBA Care Home 58 Category(ies) of Dementia (5), Old age, not falling within any registration, with number other category (58) of places Milner House DS0000066030.V299405.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Of those accommodated, 5 (five) beds are registered for people with Dementia. 27th October 2005. Date of last inspection Brief Description of the Service: Milner House is a large detached property that has been converted to provide accommodation for fifty-eight service users. Part of the accommodation has been provided in the original building, the remainder in extensions added over the years. The home is currently owned and managed by Ashbourne Homes, and is located on the outskirts of Leatherhead. Access to shops, churches, public transport and other community services are a distance away; however, the home has its own mini bus, which is used to transport service users. The accommodation for service users consists of twenty-six single bedrooms, and thirteen double bedrooms all with en-suite facilities, is situated on three floors, with passenger lifts and stairs to all floors. Communal areas are available throughout the home, compromising of lounge on each floor, dining room on each floor, and a number of quiet areas. The home is surrounded by well-tended gardens and adequate parking facilities. Fees at this home are within the range of £525.36 to £750.00 per week. Hairdressing, chiropody, personal newspapers and toiletries are not included in this price Milner House DS0000066030.V299405.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection to be undertaken in the Commission for Social Care Inspection year April 2006 to March 2007.The home received an unannounced inspection on 6th February 2006 following concerns raised by a relative of a service user, which resulted in the issuing of two immediate requirements which were complied with in the agreed time scale. The findings of this inspection was not published, but is held at the Eashing office. This unannounced inspection was undertaken by Mrs Mavis Clahar and lasted eight hours. No one at the home or within the company knew of the inspection. The home is undergoing refurbishment. The manager of the home was on annual leave and the deputy manager was on a course on the day of the inspection. The inspector would like to thank the senior staff, nurse the administrator and all staff at the home for their support during this inspection. The information contained in this report was obtained from speaking with service users and from carers, from observation of carers and service users interactions, from reviewing of service users documents and staff files. Further evidence was obtained from cross-referencing some policies and procedures of the home. This is a home for older people and due to the ageing processes which affects mental agility, some service users were not able to answer questions fully. The inspector used other methods of communication such as “grip my hand for yes,” but it is not conclusive that even with this form of communication full understanding took place with these service users. Generally, service users with mental frailty who responded indicated that they were contented in their home, that they had enough food, the food was good the care staff were kind and that they were treated with respect. The inspector spoke with a number of service users who were able to converse in a knowledgeable way. One service user said, “I came in for a trial period and I was so well looked after I told my family I am staying. They now have to sort out my property, putting it on the market and so on”. Another service user said, “The staff are so helpful. There is nothing they would not do for me. I love it here”. Another service user said she had not been out last week as there is sickness in her family, and she really missed going into town for tea. Service users said they knew how to complain if they had a complaint. The inspector spoke with one visitor to the home who was very complementary about the care his relative was receiving. The first part of the inspection was spent with the senior nurse and the administrator explaining the new inspection process as neither of them had ever been involved in an inspection process. The inspector outlined the way Milner House DS0000066030.V299405.R01.S.doc Version 5.2 Page 6 the inspection would be conducted. This was followed by a tour of the home; with time spent talking to service users and carers in between their busy schedules. Time was spent with service users during their mid-day meal. A tour of the grounds was conducted. The second part of the inspection was spent tracking the notes and medication records of three of the service users with whom the inspector spoke. This was followed by a random sample of service users files and medication records, and of carers’ files, which were all up to date. During the tour of the home many faulty health and safety issues were identified which resulted in immediate requirements being issued. (See requirements and full information under Environment). The final part of the inspection was spent giving feedback to the senior staff nurse and the operations manager about the findings of the inspection. What the service does well: What has improved since the last inspection? The appearance of the home continues to improve. On approaching the front doors of the home it was heartening to see that the dead leaves were swept away and the foyer was transformed, exposing the magnificent fireplace. The home continues with its programme of redecorating and refurbishment. The home has bought: New garden furniture, two new air mattresses, six crash mats for the sides of service users beds, new weighing scales, a new Trixie hoist and new bed linens. They have also purchased three new generators for the home (these could supply the beds and peg feeds in case of emergency), eight mobile emergency lights, three big halogen lamps and two calor gas heaters. Milner House DS0000066030.V299405.R01.S.doc Version 5.2 Page 7 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. Milner House DS0000066030.V299405.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 Milner House DS0000066030.V299405.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 3 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are given the opportunity to spend time in the home. A named nurse is then allocated to the service user, to enable the service user to become comfortable in their new surroundings and to answer any questions about life in the home the service user or their relative might have. For service users who are self-funding the service is able to demonstrate that they have undertaken a pre admission assessment, followed by a full assessment of needs. These were satisfactory. Evidence suggests that all other service users had a needs assessment carried out prior to being admitted to the home. Copies of care plans and summaries from assessments carried out through care management arrangements were available. Full needs assessments by the home are available for each service user. Standard 6 does not apply to this service. Milner House DS0000066030.V299405.R01.S.doc Version 5.2 Page 10 EVIDENCE: Review of randomly selected service users files and in discussion with service users it was evident that service users had the information they needed to make an informed choice about becoming a resident of the home. They had a trial period before deciding to make this home their home. A random sample of service users files demonstrated that pre admission assessment was undertaken prior to the service user being admitted to the home. Discussion with service users and staff revealed that care workers had the knowledge necessary to meet the care needs of the service users in their care. Milner House DS0000066030.V299405.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 Quality in this outcome in area is good. This judgement has been made using available evidence including a visit to this service. Each service user has a care plan, but the practice of involving service users in the development and review of the care plan is variable. The plan in most cases includes the basic information necessary to plan the service user’s care and includes a risk assessment element. Care staff are trained and accredited to meet the health care needs of the service users, and have access to training in health care matters such as attend seminars lectures arranged by local health care organisations. Copies of health care magazines were observed at the nursing stations. The home has a medication policy which is accessible to staff, medication records are generally up to date for each service user, and medicines received, administered and disposed of are recorded. Where medication systems are in need of action, the acting manger is working towards improvement. Particular attention is given to ensuring privacy and dignity when delivering personal care. Staff makes every effort to enable service users to choose who delivers their personal care and respect their preferences. EVIDENCE: Milner House DS0000066030.V299405.R01.S.doc Version 5.2 Page 12 The randomly selected care plans were clear and easy to read, identifying actual and potential risks to service users. The daily work sheets along with discussion with service users demonstrated that service users assessed needs are being met. However, a number of the care plans were not signed by staff or service user/relative, thereby questioning the degree of involvement of the service user/relative in developing the care plan. A requirement was issued on this standard. In discussion with service users, one relative and care staff it was evident that the care needs of the service users were being met. This was further supported by the random review of service users documentation, and care workers training records. No service user at the home on the day of inspection was responsible for their medication. In discussion with the senior staff nurse, it was evident he was knowledgeable on what the home’s policy and procedure s were should this situation arise. Good clear records are kept of medication received, stored and returned. Documentation on the Medication Administration Record (MAR) chart was not in line with the home’s policy in that carers were not entering on the back of the MAR chart reasons why medication was not administered. A requirement was issued on this standard The inspector observed care workers knocking on service users bedroom doors and asking permission to enter before entering their bedrooms. In discussion with service users it was clear they each had their favourite carer whom they liked to help them with personal care. The home operates a named carer system, but if a service user would rather a different named carer this is usually arranged with no embarrassment to either carer or service user. Service users spoken to on the day of the inspection said they were contented in their home even though it is not like being in their own homes. Milner House DS0000066030.V299405.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15. Quality in this outcome in area is good. This judgement has been made using available evidence including a visit to this service. Service users spoken to were complimentary about their home, the care they receive and their life styles within the home and community, the choices they make and variety of meals they receive. EVIDENCE: The home employs an activities co-ordinator who provides activities for service users. Many of the service users spoken to on the day of inspection informed the inspector that they are aware of the activities provided by the home but they don’t wish to attend. Some said the list is advertised and they choose which activity to attend. In discussion with the activity coordinator, it was evident she had a good grasp of the needs of the service users. She compiles a weekly report on each service user, which is inserted into the service users care notes. Only one visitor was available to speak with the inspector on the day of inspection, but from the visitors signing in book, it was evident that a number of visitors had visited on the day. Service users said they were able to receive Milner House DS0000066030.V299405.R01.S.doc Version 5.2 Page 14 their visitors any time of the day, and that they can share a meal with them so long as enough time is given to the Chef. The inspector noted that the home is so arranged with seating strategically placed so that service users can entertain their guests in private away from their bedrooms if they so wish. Service users said they are able to make choices and control over their lives. This was reflected in the care plans, which were signed by the service users to show they were consulted about their care needs. It was noted that not all care plans were signed by service users. This is dealt with under standard 8. The inspector did not sample the food, but the service users said the food is good, and plentiful. In discussion with the Chef, it was apparent she was knowledgeable about the dietary needs of the service users and prepared their food to their tastes. The Chef operates from a four-week menu with the summer menu being discussed with service user now. There is always a choice of two hot meals per day at mid-day, or salad at mid-day or the service user can choose their own food e.g. omelette etc. The evening meal is always soup followed by hot meal or sandwiches filled with service users choice. There were ample amount of fresh fruit, dry food and frozen food available in the home. The inspector noted that cold drinks were available in the lounges for the service users. Milner House DS0000066030.V299405.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 18. Quality in this outcome in area is good. This judgement has been made using available evidence including a visit to this service. Service users and relative associated with the home state that they are very satisfied with the service provision, feel very safe and well protected and supported by the manager who has their protection and safety as a priority. Robust POVA policies are in place to protect the service users from abuse. EVIDENCE: The random sample of staff training files and discussions with staff evidenced that staff are being trained on recognising and reporting acts or suspicion of abuse. The new whistle blowing policy is now in place, and staff are signing it as they read it. Complaints received in the home are logged with their outcomes. This demonstrated that service users and relatives complaints are taken seriously and are dealt with within the company’s time frame. Milner House DS0000066030.V299405.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 24 26 Quality in this outcome in area is poor. This judgement has been made using available evidence including a visit to this service. One or two areas pose a potential risk to service users, for example, following testing of all emergency lighting on the 18/05/06 it was found that thirty two lights were not working, and fire extinguishers were not being checked on a regular basis. EVIDENCE: On reviewing the Hard wiring test report carried out on the 18/05/06, it was found that the thirty-two non-working emergency lights were not replaced. Further more, the fire company did not check the fire extinguishers at the home since December 2004. Immediate requirements were issued on this standard. At 10:00 am on the 23rd June, the deputy manager rang the office to say the requirements were completed. Bedroom 62, the 3 gang lighting switch is faulty and damaged. Also in the kitchen the switch spur point to he fly insector unit is to be replaced. In the main entrance lounge, the 2 Gang 13 amp socket outlet on the side of the Milner House DS0000066030.V299405.R01.S.doc Version 5.2 Page 17 staircase is damaged and is to be replaced. Requirements were issued on this standard. It was noted by the inspector that not all bedroom doors have fire door guards fitted. A requirement was issued on this standard. On the day of the inspection the home was presented as clean and tidy, with no unpleasant odours. Milner House DS0000066030.V299405.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30 Quality in this outcome in area is good. This judgement has been made using available evidence including a visit to this service. Service users have confidence in the care workers that cares for them. Rotas show that the home is staffed efficiently, with special attention given to busy times of the day and changing needs of the service users. The standard of vetting and recruitment practices are good with appropriate checks on the suitability of staff being carried out thereby ensuring service users are being protected and their needs can be met. The staff rota for the month showed the number of staff on duty day and night and in what capacity; ensuring that service users are in safe hands over the twenty-four hour period. The manager ensures that staff are trained and updated regularly to meet the assessed needs of the service users. EVIDENCE: There are a number of care workers currently undertaking the NVQ course. No staff providing personal care to service users is under the age of twenty-one years. Domestic staff and maintenance staff are employed in sufficient numbers to ensure the safety of service users in this home. Milner House DS0000066030.V299405.R01.S.doc Version 5.2 Page 19 Recruitment of staff to the home is through a process of equal opportunity, and in accordance with the code of conduct and practice set by the GSCC. All staff are CRB and POVA checked prior to commencing employment and they are in receipt of terms and conditions of employment, as evidenced in their randomly reviewed personal files. There was evidence in staff’s personal files that they are supervised on a one to one basis, however, the new forms for documenting supervision are not being completed. A recommendation was placed on this standard. The new member of staff has completed an induction programme. Care workers spoken to on the day of inspection demonstrated high staff morale, which results in an enthusiastic workforce. This must be good for service users. Staff confirmed that the service was clear about what was involved at all stages of their recruitment and was robust in the following of its procedure. Milner House DS0000066030.V299405.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 38. Quality in this outcome in area is adequate. This judgement has been made using available evidence including a visit to this service. The manager, who is currently undergoing registration with CSCI, fosters an atmosphere of openness and respect in which service users and staff all feel valued and that their opinions matter. The home has clear policies and procedures, which the company reviews on a regular basis, and the acting manager implements. Care worker are positive in their approach to translate policy into practice. Efficient systems are in place to monitor staff adherence to policy and procedures during their practice. The home does not become involved in any aspect of service users finance. Service users are consulted about their health and personal care, interests and preferences. Milner House DS0000066030.V299405.R01.S.doc Version 5.2 Page 21 EVIDENCE: The Acting manager at the home has been appointed. He is a Registered nurse with many years nursing and management experience. He is currently undergoing registration with CSCI for managing the home. A recommendation was made that he commence the Registered Managers Award (RMA) as soon as possible and that CSCI should be notified as soon as he starts the course. There were a number of issues pertaining to the safety of service users, which were not addressed in a timely fashion. (See Environment and Statutory Requirements). Documentary proof was provided that these issues were brought to the attention of the owners on many occasions, with no satisfactory outcome. A requirement was issued on this standard. The home does not act as appointee for any service user finance. The home manages the pocket monies for those service users who have handed over their pocket monies for safekeeping. Good records are kept of all transactions carried out. The health, safety and welfare of service users and staff could be compromised by the failure of the owners to keep the home safe by regularly servicing and maintaining the fire prevention systems in the home. A requirement was issued on this standard. Milner House DS0000066030.V299405.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 X X X X 2 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 1 Milner House DS0000066030.V299405.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 12 (2) Requirement The registered person shall so far as practicable enable service users to make decisions with respect to the care they are to receive and their health and welfare. Care plans must be signed by service user/relative to signify compliance with the care offered The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. The back of the MAR sheet must be completed when service users refuse their medication. The registered person shall ensure that the home is conducted so as to promote and make proper provision for the health and welfare of service users. Fire door guards are to be fitted on all bedroom doors. The registered person shall ensure that unnecessary DS0000066030.V299405.R01.S.doc Timescale for action 20/09/06 2 OP9 13 (2) 22/06/06 3 OP19 12 (1) (a) 22/09/06 4 OP19 13 (4) © 22/06/06 Milner House Version 5.2 Page 24 5 OP19 23 (4)(iv) 6 OP19 23 (4) (a) 7 OP24 16 © risks to the health or safety of service users are identified and so far as possible eliminated. Immediately replace the thirty two emergency lights found not working on 18/05/06 The registered person must make adequate arrangements for the maintenance of all fire equipment. All fire extinguishers to be tested immediately The registered person shall take adequate precautions against the risk of fire, including making adequate arrangements for maintenance of electrical equipments. The requirements included in the report of the hard wiring inspection carried out on the 31/03/06 are to be carried out. (a) Bedroom 62, the damaged 3 gang lighting switch is to be replaced. (b) The switch spur point leading to the fly insector unit in the kitchen is damaged and must be replaced. (c) The 2 gang 13 amp socket outlet situated on the side of the staircase leading from the main entrance lounge is damaged and must be replaced. The registered person must provide in bedrooms occupied by service users equipment suitable to the needs of the service users. The home must purchase fire door guards for each service DS0000066030.V299405.R01.S.doc 22/06/06 20/08/06 20/09/06 Milner House Version 5.2 Page 25 8 OP33 10 (1) 8 OP38 13 (4) © users bedroom The registered provider and the registered manager shall, having regard to the size of the care home, the statement of purpose, and the number and needs of the service users, carry on or manage the care home with sufficient care, competence and skill. The manager along with the registered providers have a duty of care to the service users and must ensure that requirements made to maintain the safety and welfare of service users are carried out promptly. The registered person shall ensure that unnecessary risks to the health or safety of service users are identified and as far as possible eliminated. In future, CSCI is to be notified of any potential health and safety risks to service users that is not rectified by the registered provider within the given timescale. 22/06/06 22/06/06 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 2 Refer to Standard OP30 OP31 Good Practice Recommendations The manager is to commence using the new forms designed for recording one to one supervision with care workers. The manager to notify CSCI when he has commenced on the RMA course. Milner House DS0000066030.V299405.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Milner House DS0000066030.V299405.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. 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. 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