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Inspection on 26/07/06 for Mount Ephraim House

Also see our care home review for Mount Ephraim House for more information

This inspection was carried out on 26th July 2006.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service users can access information about the home before moving in and visits are encouraged, there is a trail period. Mount Ephraim House provides a well-maintained, clean and homely environment for service users. Individual rooms are decorated to personal choice. Care plans are clear and reflect the needs of service users. Carers are well trained and competent and treat service users with respect and dignity. Daily routines are flexible within the restrictions of group living, and service users are encouraged to make choices.

What has improved since the last inspection?

A new fridge to store medication has been purchased. Repair has been made to the laundry floor and window frames. All complaints are now recorded in the complaints book. Plans for the renovation, improvement and extension of the property have been submitted. The number of care staff NVQ trained or on training has increased.

What the care home could do better:

The statement of purpose needs to accurately reflect the number of staff on shift in the daytime. Regular recorded staff supervision and appraisal needs to be reinstated, the home is revising its` supervision procedures. It is advisable that CRB checks are update 3 yearly. A temperature gauge needs to be fitted to monitor the temperature in the medication room, and the list of signatures of staff giving medication must be updated. The health and safety of service users would be improved by ensuring that cleaning materials are not left unattended, pedal bins rather than open top bins are used throughout the home, the misleading sign on the boiler room door be removed, and open jars and bottles of food in the fridge be labelled with date of opening.

CARE HOMES FOR OLDER PEOPLE Mount Ephraim House Mount Ephraim Tunbridge Wells Kent TN4 8BU Lead Inspector Debbie Sullivan Key Unannounced Inspection 26th July 2006 09:00 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 Mount Ephraim House DS0000023986.V301396.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. Mount Ephraim House DS0000023986.V301396.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mount Ephraim House Address Mount Ephraim Tunbridge Wells Kent TN4 8BU 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) 01892 520316 01892 523180 mountephraim_house@tiscali.co.uk Greensleeves Homes Trust Mrs Julia Main Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Mount Ephraim House DS0000023986.V301396.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 20th December 2005 Brief Description of the Service: Mount Ephraim House provides personal care and accommodation for up to thirty-eight older people. Greensleeves Homes Trust, a charitable organisation, owns the home. Mount Ephraim House is located in a residential area of Tunbridge Wells. The nearest shops and other usual town amenities are approximately a half-mile away. The home was first registered on 8th March 1991. It consists of a detached property with large secluded gardens to the sides of the premises. There are limited car parking facilities to the front and side of the house. Accommodation currently includes thirty-seven rooms for single occupancy, six of which have shower and WC en-suite facilities. Thirteen of the bedrooms are located on the ground floor; separate facilities can be made available for guests to stay. There are two shaft lifts in the main house enabling wheelchair access to the upper floors in the main house and a stair lift in the annex. There is a staff call system with television points in all the bedrooms. A number of residents have their own phone lines installed. The home employs care, administrative and ancillary staff. Mount Ephraim House DS0000023986.V301396.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection unannounced site visit took place over seven hours. Time was spent with the homes’ manager, assistant manager, service users, visitors, care and ancillary staff. Three service users were case tracked, a tour of the property took place and information was also gained from records, other documents and the pre inspection questionnaire completed by the manager. Comment cards were received from a number of service users and one GP. Throughout the day staff were helpful in providing information. The home was fully occupied with one resident moving in on the day of the inspection, and there was one kitchen assistant vacancy. The fees for the home are £ 390 to 410 per week; extras are hairdressing, chiropody, toiletries and newspapers. Comments made by service users during the inspection and on comment cards were, “ You wouldn’t get a better home” “Staff make every effort to help” “The manager and other managers are very efficient” “ I have asked to be moved to a quieter room” “ Staff are all most helpful” Comments made by visitors included, “We feel the home is excellent” “Best care possible” “Thankful (relative) is in a lovely place like this” Comments from staff included, “I enjoy working here” “We take residents out when possible” “Residents are becoming more dependant” Mount Ephraim House DS0000023986.V301396.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Mount Ephraim House DS0000023986.V301396.R01.S.doc Version 5.2 Page 7 The statement of purpose needs to accurately reflect the number of staff on shift in the daytime. Regular recorded staff supervision and appraisal needs to be reinstated, the home is revising its’ supervision procedures. It is advisable that CRB checks are update 3 yearly. A temperature gauge needs to be fitted to monitor the temperature in the medication room, and the list of signatures of staff giving medication must be updated. The health and safety of service users would be improved by ensuring that cleaning materials are not left unattended, pedal bins rather than open top bins are used throughout the home, the misleading sign on the boiler room door be removed, and open jars and bottles of food in the fridge be labelled with date of opening. 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. Mount Ephraim House DS0000023986.V301396.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 Mount Ephraim House DS0000023986.V301396.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): 1,2,3,4 and 5 The outcome in this quality area is good. This judgement has been made using available evidence including a visit to the service. Prospective service users are able to access information about the home to help them make an informed choice. Assessment takes place prior to admission and service users are only admitted if needs can be met. EVIDENCE: The homes statement of purpose and service user’s guide were revised in 2005,a colour brochure is also now available and was displayed in the hallway. The statement of purpose is clear and easy to read, information about staffing levels in the daytime is however misleading and needs to be amended, as it could be interpreted that eight carers rather than 4 or 5 are on each shift. One service user spoken with said they and their family had received written information about the home, and all had been able to visit or relatives had done so on their behalf before they moved in. Each service user receives a contract which they or a representative signs. Mount Ephraim House DS0000023986.V301396.R01.S.doc Version 5.2 Page 10 Assessment takes place prior to admission and a trial period takes place before the place is made permanent, relatives spoken with verified that a review took place after the six weeks. The home offers respite care when a room is available; one service user case tracked had been admitted for respite and chosen to stay at the home. Mount Ephraim House DS0000023986.V301396.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 and 11 The outcome in this quality area is good. This judgement has been made using available evidence including a visit to the service. Care plans are thorough and reflect the needs of service users. Medication procedures are thorough, and would be further improved by monitoring of the medication room temperature and updating of staff signatures. Carers treat service users with dignity and respect privacy. The wishes of service users near the end of their lives are recorded and respected. EVIDENCE: The care plans of those service users case tracked and one other were read. The care plan format allows for information to be easily accessed, each included, assessment, medical information, personal details, wishes in the event of death if the service user or relatives agreed to this being included, records of contact with health professionals such as district nurses or GP’s, Mount Ephraim House DS0000023986.V301396.R01.S.doc Version 5.2 Page 12 daily log sheets and reviews. One care plan was without up to date review. A key worker system is in place; the manager said that a system is being introduced to better highlight when reviews are due. The service users or their representatives sign care plans. Evidence was in place of contact with health professionals where a change in health was causing concern; the manager gave an example of a service user currently in hospital for assessment due to changing needs. One service user spoke of regular district nurse visits. Relatives said that home had managed a period over Christmas when staff and service users were affected by a stomach bug very well, and praised the care given to their relative who recovered well. Service users are able to self medicate if they wish. Informatiion on this is on care plans. Medication is stored securely in a dedicated room; a new drugs fridge is now in place. A thermometer is needed in the room, although it was not over hot despite the extreme heat on the day of the inspection. MAR sheets were correctly completed and included photographs of the residents, the staff signature list of those administering medication needs to be updated. Carers receive medication training, and unless there is an unexpected absence, such as due to illness, two staff administer medication. If this is not possible medication is administered from the trolleys in the lockable room. Service users spoken with were happy with their care and were complimentary about their carers given. Throughout the day carers attended to service users discreetly and respected privacy and dignity. Those near the end of their lives are able to remain at the home if their needs can continue to be met. Mount Ephraim House DS0000023986.V301396.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 and 15 The outcome in this quality area is good. This judgement has been made using available evidence including a visit to the service. Service users are able to exercise choice and control over their lives and the routines of the home are as flexible as possible within the bounds of group living. Meals are well cooked and varied with choice available. EVIDENCE: One of the deputy managers at the home is responsible for organising activities, outings and events. Service users, staff and relatives spoke of a recent fete held in the garden, trip to a circus and a planned trip to the coast. All residents are offered the opportunity to go on outings. Within the home activities include quizzes, bingo, slide shows, musical sessions, exercise to music sessions and reading groups given by a volunteer. Service users spoken with said they chose whether or not to attend activities and although staff encouraged them to socialise, if they preferred to stay in their room this was respected. The home has pleasant gardens that service users were using throughout the day; a games room and library offer quiet space. There is also a main lounge and sitting area near the entrance. Mount Ephraim House DS0000023986.V301396.R01.S.doc Version 5.2 Page 14 Carers and service users said that when there is time carers take service users out, one service user went out to lunch and another had attended a social club in the morning. One service user spoke of regular visits to their family. Visitors are welcomed and those spoken with said they could come at any time. The routines of the day are flexible, service users can choose to eat in the dining room or their room, and a daily meal choice is offered with a vegetarian option. Meals are varied; service users make weekly choices and can change these. One service user recently returned from hospital had temporarily chosen to take meals in their room. Times for getting up, bathing and going to bed are as flexible as possible within staffing levels. Service users were joined at lunchtime, the meal was well presented, freshly cooked and those on the same table enjoyed it. Individual prefences and special diets are catered. Service users said that the evening meal is also varied and there is choice. Mount Ephraim House DS0000023986.V301396.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): 16,17 and 18 The outcome in this quality area is good. This judgement has been made using available evidence including a visit to the service. Service users can feel confidant that any concerns and complaints will be listened to and acted upon. The homes adult protection procedures and policies protect service users from abuse. EVIDENCE: The home has a complaints procedure; complaints leaflets are on display near the entrance. Service users spoken with said that they would approach senior staff with any complaints, staff were aware of the procedure. The complaints book was inspected there had been four complaints since the last inspection, made by staff members and one resident. The Commission had been aware of some staff complaint content. Complaints had been responded to appropriately and within timescales. The resident who had complained was spoken with and did not express any continued dissatisfaction. There had been one adult protection alert since the last inspection, following investigation by the Social Services Department no further action was taken. The home has adult protection policies and procedures in place, staff spoken with said they had had POVA training, the manager said more POVA training is scheduled later this year. Mount Ephraim House DS0000023986.V301396.R01.S.doc Version 5.2 Page 16 CRB checks are taken up on all staff and volunteers and staff are POVA checked. Service users manage their own affairs and finances independently as far as possible with support from relatives if necessary. Mount Ephraim House DS0000023986.V301396.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 and 26 The outcome in this quality area is good. This judgement has been made using available evidence including a visit to the service. The home provides a safe, well-maintained, clean and homely environment. Planned extension, improvement and renovation would improve opportunities for independence and accessibility. EVIDENCE: The home occupies a period building with accommodation over 3 floors. There is a ground floor annexe and a stair and two shaft lifts. One shaft lift was out of order; a request was in for repair. Due to the nature of the building some areas and bedrooms can only be accessed via a step or a few extra stairs on landings. This is can be a problem for those less mobile. One service user said that they had moved from upstairs to the annexe due to mobility problems and were happy with the arrangement. The last and previous inspections had identified a need for the home to improve and renovate to allow for more independence and accessibility. Plans Mount Ephraim House DS0000023986.V301396.R01.S.doc Version 5.2 Page 18 have now been submitted to Tunbridge Wells Borough Council for approval. The Commission will be kept informed of any decision and progress. The home was very clean throughout, well maintained, well decorated and homely. The maintenance man was undertaking minor repairs during the inspection. Cleaning materials were left unattended in two areas and not all waste bins in toilets had lids on. A cleaner said that in one case the service user preferred to remove the lid. There is plenty of communal space offering different environments for service users to access, and areas where visitors can be received privately. Currently only two bedrooms have ensuite toilets and a further two have showers and toilets. Bathrooms are located on each floor. The majority of bedrooms were seen, all were attractively personalised and decorated to the individual’s taste, and one even contained a grand piano that is played by the service user. One service user with some hearing problems in a room at the front of the house was concerned about traffic noise and noise from others TV’s. The manager said that when another room becomes available it could be offered. Service users bring their own furniture if they wish and this was the case with the service user moving in that day. Mount Ephraim House DS0000023986.V301396.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 The outcome in this quality area is good. This judgement has been made using available evidence including a visit to the service. Service uses are supported by a well trained and competent staff group. The homes’ recruitment procedures protect service users. EVIDENCE: The home was fully staffed except for a weekend kitchen assistant; the numbers of care and ancillary staff on duty were appropriate to the number of service users. The manager said that at times of full occupancy and if there is illness amongst the service users or they have other additional needs extra staff are put on shift. Staff spoken with felt that due to the increasing dependency of the service users, both newly admitted and established at the home, there was not always the opportunity to spend social time with service users or take them out, although again this varied, dependant upon demands and occupancy. Two care staff are on duty at night. Since the last inspection more care staff have gained NVQ 2 or above, and four more are due to start. Staff said that induction and other training available is good and plenty is on offer, both mandatory and internal and external trainers provide specialist Mount Ephraim House DS0000023986.V301396.R01.S.doc Version 5.2 Page 20 courses. COSHH training was due the day after the inspection and planned training included, POVA, sight awareness, bereavement and dementia. Staff said they were well supported during induction and shadowed a designated established carer before working alone. A sample of staffing files were read, of staff recruited in recent years, they included references, CRB disclosure information, application forms, conditions of service and a photograph of the staff member. Staff do not work unsupervised prior to a satisfactory CRB disclosure being received. The home is to be provided with a dedicated vehicle and the manager said that drivers will be CRB checked. It is recommendation that CRB checks be repeated three yearly. Mount Ephraim House DS0000023986.V301396.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37 and 38 The outcome in this quality area is good. This judgement has been made using available evidence including a visit to the service. The home is well managed in the best interests of service users and staff. Extra vigilance over some aspects of health and safety will further reduce risk to service users. Regular staff supervision will further support staff and evidence competency and training needs. EVIDENCE: The manager of the home is nearing completion of the NVQ 4 in management and care. Mount Ephraim House DS0000023986.V301396.R01.S.doc Version 5.2 Page 22 At the time of the last inspection a new management structure had been put into place comprising of the registered manager, deputy manager and two assistant managers. The new structure is becoming established. Currently staff are not receiving regular supervision, managers have received training in supervision and new documentation is to be introduced. At the time of the last inspection some staff received supervision. The atmosphere in the home is open and welcoming and visitors were free to come and go. All staff were pleasant and friendly and had a competent but friendly manner towards service users. Service users and relatives and visitors receive a quality assurance questionnaire annually and the home works to the trusts’ quality assurance procedures. The manager said that service user meetings are held at least quarterly. Development of the home is planned; planning permission is awaited for improvement and extension. A valid insurance certificate was on display in the entrance. The home does not manage the money of any service user, but spending money is held securely if service users do not wish to keep funds in their rooms, a manager and the service user sign this for. Records are held safely and securely in the office accommodation, service users can access them on request. Safe working practices are promoted and evidence was seen that training such as COSHH, manual handling and fire awareness are provided. During the inspection the fire officer arrived to undertake fire safety risk assessments. Health and safety practices are good and would be improved upon by the labelling of open jars and bottles of food stored in the kitchen fridge, and extra vigilance about the location of cleaning materials in areas accessed by service users. Mount Ephraim House DS0000023986.V301396.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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 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 3 18 3 2 3 3 2 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 2 3 3 Mount Ephraim House DS0000023986.V301396.R01.S.doc Version 5.2 Page 24 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 OP1 Regulation 4(1)(b) Requirement “The registered person shall compile in relation to the care home a written statement which shall consist of a statement as to the facilities and services which are to be provided by the registered person for service users” In that the statement of purpose must give clear correct information on ratio of staff to service users on daytime shifts. 2. OP9 13(2) “The registered person shall 30/09/06 make arrangements for the recording, handling, safekeeping, safe administration, and disposal of medicines received into the care home.” In that a temperature gauge must be fitted to monitor the temperature in the medication room and the list of staff signatures for those trained to administer medication must be updated. Mount Ephraim House DS0000023986.V301396.R01.S.doc Version 5.2 Page 25 Timescale for action 30/09/06 3 OP36 18(2) “The registered person shall ensure that persons working at the care home are appropriately supervised” In that care and other staff must receive formal supervision sessions at least six times a year. 30/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP18 Good Practice Recommendations It is recommended that CRB checks be renewed every three years. This was a recommendation from the previous inspection. It is strongly recommended that staffing levels be reviewed in line with the increasing dependency of the service user group. This will need to be considered in parallel with any changes to the home dependant upon planning permission, and dependant upon the timescale for any work to be completed and the need for higher staffing levels beforehand. It is stronglyrecommended that the following be put into place to improve health and safety measures. All pedal bins provided should have lids. All opened foodstuffs in fridges must be labelled with date of opening. The sign saying “kitchenette” the boiler room door be removed. All staff be reminded and or retrained in COSHH procedures and no cleaning materials be left unattended in areas accessible to service users. Mount Ephraim House DS0000023986.V301396.R01.S.doc Version 5.2 Page 26 2 OP27 3 OP38 Mount Ephraim House DS0000023986.V301396.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Mount Ephraim House DS0000023986.V301396.R01.S.doc Version 5.2 Page 28 - 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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