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Inspection on 06/04/05 for Nairn Close - Orkney Close

Also see our care home review for Nairn Close - Orkney Close for more information

This inspection was carried out on 6th April 2005.

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

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

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

Staff have made good use of photography as a means of communicating information to service users. Key workers are meeting regularly with service users to monitor and review care plan programmes. Service users are fully involved in the planning of their lifestyle activities. Independence is strongly promoted in this home and this is reflected in care plan, house meeting and team meeting minutes.

What has improved since the last inspection?

Decoration and furnishings are being gradually improved and both houses are looking more welcoming and homely. Service users are actively contributing to keeping a record of their activities in a personal diary. Family members are being informed when inspection reports are available and how the report can be accessed. Questionnaires have been sent to family members to seek their views on the service. Health and safety procedures are improving with information being more available at both the homes.

What the care home could do better:

The recording practise of the recruitment of staff must improve and include a copy of all Criminal Record Bureau and POVA checks that take place for new staff. Care practice could be improved in maintaining up-to-date records of medication in the home and ensuring that service users preferred method of taking their medication is identified. To ensure that the home is safe and comfortable for people at Nairn Close, the hall and lounge carpet and threepiece suite must be replaced. The staircase tread must be backed before the carpet is laid. The removal of unused equipment and rubbish in the garden, repair to chipped plaster on internal walls, and adherence to cleaning schedules would improve management of infection control. Menu records must contain sufficient information to show service users have healthy and well-balanced diet. Tenant profiles (care plans), must be completed so that staff working with service users have up to date information.

CARE HOME ADULTS 18-65 Fch - Nairn Close/Orkney Close 2 Nairn Close Nuneaton Warwickshire CV10 7LG Lead Inspector Sheila Briddick Unannounced 6 April 2005 08:15 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Fch - Nairn/Orkney Close Address 2 Nairn Close Nuneaton Warwickshire CV10 7LG 02476 353399 02476 344357 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) FCH - Housing and Care Bernadette Taylor PC 6 Category(ies) of LD 6 registration, with number of places Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17 November 2004 Brief Description of the Service: 2 Nairn Close and 9 Orkney Close are part of FCH Housing and Care that is a voluntary organisation. The home provides long-term accommodation and 24 hours services for people with learning disabilities. The houses are in very close proximity to each other and each home provides single bedroom accommodation for 3 people. Each house functions as a separate unit although staff now work across both homes. The team leader also oversees both houses. 2 Nairn Close is a detached property with 1 bedroom, a lounge, dining room and kitchen on the ground floor. Upstairs there are further 2 bedrooms, a bathroom and toilet, and a combined staff bedroom/office. There is a garden with a paved patio to the rear of the property. 9 Orkney Close is a semi-detached house with 1 bedroom with en-suite shower and toilet, a kitchen, dining area, lounge and conservatory on the ground floor. Upstairs there are a further 2 bedrooms, a bathroom and toilet, and a combined staff bedroom/office. There is a garden with a paved patio to the rear of the property. The properties are in an established residential area of Nuneaton, close to local shops and on a bus route to the town centre. Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over six hours and was unannounced. A tour of both properties took place and staff and care records were inspected. Two of the three staff on duty and two of the six service users were spoken with. What the service does well: What has improved since the last inspection? What they could do better: Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 6 The recording practise of the recruitment of staff must improve and include a copy of all Criminal Record Bureau and POVA checks that take place for new staff. Care practice could be improved in maintaining up-to-date records of medication in the home and ensuring that service users preferred method of taking their medication is identified. To ensure that the home is safe and comfortable for people at Nairn Close, the hall and lounge carpet and threepiece suite must be replaced. The staircase tread must be backed before the carpet is laid. The removal of unused equipment and rubbish in the garden, repair to chipped plaster on internal walls, and adherence to cleaning schedules would improve management of infection control. Menu records must contain sufficient information to show service users have healthy and well-balanced diet. Tenant profiles (care plans), must be completed so that staff working with service users have up to date information. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 and 5. The assessment process is good and fully involves the service user providing staff with the information they need to be able to meet the needs and wishes of the individual. The absence of individual Contracts puts service users rights and responsibilities at risk. EVIDENCE: There have been no new service users coming to live in this home for some time. There is an admissions policy that is completed with any new service user when their personnel and healthcare and social needs would be discussed. Family members or advocates are able to support if necessary. Care management assessments are accessed prior to a decision being made about the home being able to meet the service user needs. Three care plans were looked at and copies of the care management assessment were attached in each case. The support service users need to be safe in the home are planned and agreed with other professionals and this includes community learning disability nurses, occupational therapists and psychology services. Two staff spoken with were knowledgeable of the individual needs, likes and dislikes of people living in the home. The staff confirmed that they had written guidelines to follow to ensure that specific needs can be met safely. Diary records show that activities take Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 9 place to meet individual cultural and faith needs. Recent activities have included celebrating the Chinese New Year and St Patricks Day. At the last inspection visit a requirement was made for service users to have written contracts between themselves and the provider. There was no evidence that this action had been taken. Without contracts or terms and conditions of residency the rights and responsibilities of service users remain at risk Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6. The care planning system is clear and consistent ensuring that staff have the information they need to meet service user’s needs. EVIDENCE: Care plan reviews take place to ensure that all aspects of personal and social support and healthcare needs are identified. Key workers are currently completing a new care plan system with individual service users. The timescale in which this is being completed varies. Some plans have been up dated well whilst a number still remain incomplete. Staff work closely with psychologists and learning disability nurses in developing guidelines to ensure that service user’s can be supported safely. Staff spoken with described some specific guidelines used that promote positive outcomes. Staff are recording the changing needs of service users well. Service users are contributing to the planning process as much as they are able. This involvement is particularly evident during the care plan review. The record of the review includes the views of the service user, how their views have been communicated, the area of need discussed and the action agreed. Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 11 Reviews are taking place six monthly and monthly to discuss progress. Changing needs are reviewed as necessary with psychologists and community learning disability nurses. A variety of communication methods are being used with service users and this includes photographs, pictures, symbols and makaton signing. It is planned for a summary of the care plan to be produced in a symbol format for service users. Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15 and 17. Social activities are being well managed providing opportunity for service users to live ordinary and meaningful lives. Menu records are not sufficient to show that service users are offered a healthy diet. EVIDENCE: Four service users were attending their day services when the visit took place. Two service users were at home during the visit. A service user spoken with was happy for their diary to be looked at. The diary showed that a visit to the cinema had taken place the evening before. The service user expressed pleasure with this activity when it was talked about with them. Another entry in the diary described a birthday celebration that had taken place, involving family and friends. The service user involved was delighted to talk about this event. Photographs in personal life story records and on display in the homes show that service users enjoy a wide variety of leisure and social activities. These include visits to local parks, restaurants, and college for art and craft Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 13 activities, Gateway Club and swimming. Holidays, trips to a health spa and drama activities are being planned. Staff spoken with confirmed that time with service users is flexible to ensure support is available at weekends and evenings. Service users are choosing menus individually and can eat their meals at times they prefer. One service user was having a late breakfast whilst others had eaten earlier before going to their day centre. Drinks and snacks are readily available. Dietician guidance is followed and service users meet with their dietician regularly to review their needs. Daily menu records assist with the review. To ensure it can be demonstrated service users are being offered a healthy and nutritious diet clear records must be maintained. Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 and 21 Policies are in place for the safe administration of medicines in the home. Care practice in recording and administration of medicines has the potential to place service users at risk. Service users wishes as they grow older are being discussed sensitively. EVIDENCE: When possible service users consent to medication has been recorded on their care plan. When consent has not been given an explanation for this has been recorded on the care plan. Medication is administered by staff that have been trained. Staff spoken with confirmed their understanding of protocols in place for the administration of medication to be given as required (PRN). Promoting independence is practised well in his home and it is recommended that this be extended, following risk assessment, to offer service users the opportunity to develop skills in managing their own medication. There are policies for the recording of all medicines coming into and leaving the home. There was an inconsistency on medication records of the number of Diazepam tablets coming into the home against the number held. Care practice must be reviewed to ensure there is no mishandling of medication, which puts service users health needs at risk. Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 15 At Nairn Close individual administration records have a photograph of the service user attached. This ensures service users are not at risk of having wrong medication administered. Photograph identity was missing on records held at Orkney Close. The preferred way of service users in taking their medication is described on their care plan. The description on one care plan was for tablets to be given with food following advice given during the service user’s admission some years previously. This practice must be reviewed to enable the service user to consider other options available when taking their medication. Service users are having the opportunity to discuss and plan arrangements concerning growing older. Relatives are being involved and supporting their family member with this. Advocacy support has not been considered for service users without family support. This option was discussed with the registered manager. Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) x These standards were not assessed at this visit. EVIDENCE: The standards were fully met at the last inspection visit. There had been no complaints made to the home or any vulnerable adult issue reported to the Commission since the last inspection. Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26, 27, 28 and 30 Service users are able to live in a home that is comfortable, accessible, and homely. There has been improvement to the decor in both houses. The home is failing to ensure that satisfactory standards of hygiene are maintained throughout. Provision of equipment must not exceed service user needs. EVIDENCE: Since the last inspection redecoration has begun to take place and shared areas have been redecorated. New carpets are to be laid at 2 Nairn Close and lounge and dining room furniture has been ordered to replace the existing. The bathrooms in both properties have been refitted and are now more bright and cheerful. A number of other areas require attention, in particular: • • The existing staircase at Nairn Close is open plan and does not allow for easy cleaning of the stair well. Placing a backing to the staircase would assist more effectively with cleaning. Some minor repair work is needed to chipped paintwork behind the toilet in the bathroom at Orkney Close. This will enable effective cleaning as part of infection control and reduce risks to service users. E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 18 Fch - Nairn Close/Orkney Close The people living in this home have bedroom facilities that reflect lifestyles and choices are being respected. One service user does not have enough storage space in their bedroom for personal belongings. Personal care equipment no longer used is cluttering up room space in one service user bedroom and must be removed. Furniture in bedrooms is generally in good condition however one bed base is in very poor condition and must be replaced. There has been some improvement to the area at Orkney Close where people relax with sensory equipment and music. Plans are in place to provide beanbag seating for relaxation, pictures and sensory lighting. Worktops have been purchased to cover the washing machines stored in this area to make the room more homely in appearance but have not been fitted. Infection control procedures are in place and staff receive training in this as part of their induction. Toilets and bathrooms are clean and fresh. Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 4 and 36 Service users benefit from well supported and supervised staff. Recruitment records in the home do not demonstrate that necessary checks for the protection of service users from harm have taken place. EVIDENCE: Friendship Care and Housing has a robust recruitment and selection policy. It requires that satisfactory Criminal Record Bureau, (CRB) and Protection of Vulnerable Adults, (POVA) are confirmed and any gaps in employment explained. Three staff files were seen, two of which were for new starters. No confirmation of CRB and POVA checks being satisfactory could be found on one new starters employment file. It was confirmed verbally at the inspection that POVA clearance had been accessed. There was however a delay with CRB clearance due to further documentation being required. This must be provided without delay. Copies of the original application and interview forms for new starters must also be held on the home record. Poor practice in recruitment has the potential to play service users at risk. The other staff files examined was more complete with a record of the induction and supervision activity. The staff member spoken with confirmed they had regular supervision, which covered all aspects of their role and responsibility. The staff member also said that they had their training needs discussed and planned during supervision. Learning Disability Award Framework, (LDAF) training is completed by new staff. Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 20 A staff member spoken with had accessed training in challenging behaviour and was planning for further training in this area shortly to develop the skills necessary to meet the specific needs of individual service users. Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 and 41 The leadership, guidance and direction to staff in this home is creating an open, positive and inclusive atmosphere. This ensures that service users are being listened to and involved in all aspects of life in the home. EVIDENCE: The people living in this home meet regularly with the manager to talk about all aspects of life in the home. Staff made positive comments about the manager and gave examples of the support they receive from the manager through supervision and training opportunities. There was an atmosphere in the home of well being with service users being at ease with the manager and staff. Team meeting minutes show that the manager encourages the staff team to voice their concerns and affect the way in which the service is being delivered. This is particularly evident in the area of promoting independence and providing quality time in supporting personal care needs of service users. Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 22 Records in the home regarding health and safety and fire safety were up-todate and in good order. Facilities were generally in good order however food preparation areas, including, worktop areas, the sides of the cooker and kitchen utensils at Orkney Close, needed cleaning, to ensure service users health is not placed at risk. There has been some improvement in the garden areas at both properties for making access safer and providing a welcoming environment for service users. There is some garden rubbish as a result of recent improvements that needs to be removed to prevent accidents to service users SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x x x 2 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 Fch - Nairn Close/Orkney Close Score 3 Standard No 24 25 26 27 28 Score 2 x 2 x 2 Version 1.20 Page 23 E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc 7 8 9 10 LIFESTYLES x x x x Score 29 30 STAFFING 2 2 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x 2 Standard No 31 32 33 34 35 36 Score x x x 2 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x 2 3 Standard No 37 38 39 40 41 42 43 Score x 3 x x 2 2 x Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 24 yes 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 5 Regulation 5 Requirement Service users must have a written contract or statement of terms and conditions. The contract must be in a format which will meet service users communication needs. (Previous timescale of 30/03/04 not met) All-new care plans must be completed and maintained up to date. The record of all food provision in the home must be sufficient to demonstrate that service users are being offered a healthy and nutritional diet. Medication records held in the home must be up-to-date and in good order. This must include photographic identity for each service user being attached to their medication record. The preferred way of service users in taking their medication must be reviewed with a pharmacist. Suitable storage facilities must be provided for service users to keep their personal belongings. Personal care equipment no longer used must be removed from their home. E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Timescale for action 30 July 2005 2. 3. 6 17 15 16 30 July 2005 7 April 2005 (Met within agreed timescale) 7 April 2005 (Met within agreed timescale) 30 May 2005 30 May 2005 30 May 2005 Page 25 4. 20 13 5. 20 13 6. 7. 26 26 16 16 Fch - Nairn Close/Orkney Close Version 1.20 8. 9. 10. 26 28 28 16 23 16 11. 12. 28 34 16 19 13. 42 23 The bed base in the downstairs bedroom at Orkney close must be replaced. Worktops must be fitted over laundry equipment in the sensory room The open plan staircase at Nairn Close must be adapted to provide a backing to the staircase. Chipped paintwork behind the toilet at Orkney Close must be repaired All information and documents specified in paragraphs 1 to 7 of Schedule 2 of the Care Homes Regulations must be held in the care home. Food preparation areas must be kept clean at all times. 30 May 2005 30 May 2005 30 June 2005 30 May 2005 30 May 2005 14. 42 23 The garden rubble in the garden at Nairn Close must be removed. 7 April 2005. (Met within agreed timescale) 30 May 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 20 21 30 Good Practice Recommendations It is recommended that service users have the opportunity to develop skills in managing their own medication based on an assessment of risk. It is recommended that advocacy support is available for any service user planning arrangements for their needs as they grow older. • Infection control would be improved in toilets and bathrooms if disposable toilet brushes were used. Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 26 Commission for Social Care Inspection Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Fch - Nairn Close/Orkney Close E53 s4360 Fch NairnOrkney v221436 060405 Stage 4.doc Version 1.20 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!