Inspection on 05/09/05 for Noble Lodge

This inspection was carried out on 5th September 2005.

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

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

Other inspections for this house

Noble Lodge 17/12/08

Noble Lodge 14/06/07

Noble Lodge 11/12/06

Noble Lodge 03/05/05

Noble Lodge 09/09/04

Noble Lodge 10/05/04

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

CARE HOME ADULTS 18-65 Noble Lodge 143 Bounds Green Road London N11 2ED Lead Inspector Susan Shamash Unnannounced 5 September 2005 @ 01.00 pm 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. Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Noble Lodge Address 143 Bounds Green Road, London, N11 2ED 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) 020 8245 7560 Mr Shaukatally Hossenally Ellen McTaggart PC - Care home only 6 beds Category(ies) of MD - Mental Disorder registration, with number of places Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. One specified service user who is over 65 years of age may remain accommodated in the home. The home must advise the registering authority at such times as the specified service user vacates the home. Date of last inspection 03 May 2005 Brief Description of the Service: Noble Lodge is a care home providing personal care for 6 adults who have mental health needs. It is a private care home owned by Mr Shaukatally Hossenally. The home, which opened in 1990, is in Bounds Green close to the underground station and local shops and services. There are six single bedrooms on the ground, first and second floor. There is a dining room and lounge as well as a garden to the rear. The home is not accessible for wheel chair users. The stated aims of the home are to provide a quality service for people who have mental health needs and to promote their independence. Noble lodge aims to achieve this by providing support to help service users maximise their potential, physically, intellectually, emotionally and socially, within a homely atmosphere. One of the current service users is over the age of sixty-five. The home therefore has a condition on the registration certificate for one named person over sixty-five. Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place as part of the routine schedule of inspections for the home, and lasted approximately four hours. The registered manager was available throughout the inspection, and the registered provider was available towards the end of the visit. Prior to the current inspection, the CSCI had received a complaint regarding the home. This was investigated, and was not upheld. Five residents were living at the home at the time of the inspection, and the inspector had the opportunity to speak with four of them. One did not wish to speak to the inspector on this occasion, and two were out for part of the day but returned towards the end of the inspection. The inspector did not speak to any staff members on this occasion, due to one staff member being unavoidably delayed. Two completed feedback questionnaires were received from relatives/visitors to the home. The inspection also included a tour of the building and inspection of records maintained at the home. What the service does well: What has improved since the last inspection? Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 Page 6 Nine of the fourteen requirements made at the previous inspection have been fully met and one was partially met. Current photographs are now available on all residents’ files within the home, as appropriate. There has also been an improvement in the detail and recording of risk assessments for all residents, providing them with greater protection within the home. There has been a significant increase in activities provided for residents including several day trips to places of interest chosen by residents. Procedures for recording the storage and administration of medicines have also improved significantly with the manager taking a lead role in monitoring records. Medicines are checked by two staff members when they are dispensed, and the record for administering homely remedies now includes the time at which medicines are administered, further safeguarding residents. The garden furniture had been cleaned, so that it looks more inviting, and hand washing and drying facilities are now available in the laundry, as appropriate for infection control. The rota has been improved to indicate the management/provider cover at the home at all times, and a Criminal Records Bureau (CRB) disclosure had been obtained for the domestic worker, as appropriate to protect service users. Residents are further protected as systems are in place to ensure that all fire doors are appropriately self-closing. Finally an appropriate quality assurance monitoring system is available for the home, to ensure that the views of residents and their representatives are taken into account, and financial records for residents are kept appropriately, to ensure that they are not at risk of financial abuse. What they could do better: Requirements are outstanding from the last inspection regarding the need for greater detail to be included in residents’ care plans, to ensure accurate continuity of care. Current first aid training is required for all staff to protect residents. The homes’ policies and procedures must be reviewed annually to ensure that practices within the home are in the best interests of residents. Finally a gas safety certificate must be obtained for the home, and risk assessments, regarding the building, must be completed to ensure the safety of residents. New requirements are made regarding the need for medicines to be stored at an appropriate temperature, the need for the ground floor bathroom tiles to be Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 Page 7 repainted and the requirement that no staff member may commence work in the home prior to the receipt of two verified references. It is recommended that a risk assessment format be available for residents who may be able to self-medicate in the future. It is also recommended that the adult protection policy for the home be updated to include clear ‘step by step’ instructions for action to be taken by staff in the event of a disclosure/allegation, and that staff receive refresher training in this area. Finally it is recommended that the armchair hand rests in the lounge be removed/replaced where they are worn. 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. Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 Page 8 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 Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 Page 9 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) 2 and 3. Prospective service users can be assured that their needs and goals will be assessed prior to admission and that they will only be admitted if the home is able to meet their needs effectively. EVIDENCE: No new service users had been admitted to the home since the previous inspection. One service user remains at the home on a trial basis, following a recent admission to hospital, and appropriate assessments were available for them. The inspector had the opportunity to speak to four of the five service users (the other service user did not wish to speak to the inspector on this occasion). Records found within the three service user plans inspected indicated that the admissions policy had been followed in each case, using a comprehensive assessment of need. Assessment information found in the three service user’s files inspected, was detailed and of satisfactory quality. Service users spoken to confirmed that their needs were being met effectively and spoke very positively about the support provided by staff. Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 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, 7 and 9. Service users can be assured that their needs and goals are monitored and are consulted regarding the support to be provided to them. They are supported to make their own decisions about their lives and take informed risks according to their wishes. A significant improvement in the recording of risk assessments further protects service users from harm. However insufficient detail included within care plans places service users at risk of not receiving all the support that they require, should they be in need of support from a worker who is unfamiliar with their care. EVIDENCE: The three service user plans inspected were generally detailed and demonstrated service user involvement in the care planning process, with signatures included. Service users spoken to confirmed that they were encouraged to develop independent living skills with support from staff at the home. Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 Page 11 There was evidence that reviews of service users’ needs take place at least every three months. As required risk assessments were being reviewed at least six-monthly. Photographs of each service user were available in some files during the inspection. Following the inspection, evidence was provided that photographs had been placed in the remaining files, as required at the previous inspection. At the previous inspection, discussion with the manager, staff and service users indicated to the inspector that the service user plans (care plans and risk assessments) were not as detailed as they might be in describing how service users needs were being met. It was therefore required that care plans and risk assessments be updated to include a greater level of detail about the ways in which service users needs are met e.g. the exact nature of support needed by a service user when having a bath. A significant improvement was noted in the detail recorded in risk assessments for service users in the home. However it remains required that the level of detail recorded within the care plans must also be increased. Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 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, 14, 15, 16 and 17. Service users are encouraged to attend various day activities, be involved in the daily running of the home and maintain contacts with friends and family in accordance with their own wishes, so that they can lead lifestyles of their choice. There has been a significant improvement in the support provided to service users in participating in leisure activities of their choices. Dietary needs of service users are catered for with a balanced and varied selection of food available that meets their nutritional needs. EVIDENCE: Service users are widely mixed in age range and all are relatively independent at choosing their own activities and preferred lifestyles. There is evidence that staff have generally been able to provide individual opportunities relevant to service users’ needs and aspirations on a daily basis, and service users join in with some housework tasks according to their wishes. Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 Page 13 Some service users attend day centres during the week, two spend regular time away visiting family and another has a partner that they visit on a regular basis. Three service users were in the home on the day of the inspection, whilst others returned towards the end of the visit. One service user told the inspector that they were not feeling well enough to go out during the day, the other two said that they preferred to stay at home, and had the option of going out if they wanted to. Staff and service users spoken to confirmed that service users are encouraged to maintain contact with family and friends. The manager advised, and service users and records confirmed, that a number of day trips had been organised by the home over the summer. Recent trips had been arranged to Hastings, Bournemouth and Eastbourne, and staff and service users advised that they had been very successful. The manager advised that she had been less successful in arranging evening or weekend activities in the local area e.g. trips to the pub, cinema, bowling etc. as service users were not interested in participating in these activities. She noted, however, and service users confirmed, that they periodically went out shopping or for a meal out with staff. She was also intending to start escorting a couple of service users swimming on a regular basis. Further day trips are planned for service users, and the possibility of arranging a holiday for service users has also been discussed. All service users spoken to were satisfied with the selection of food provided to them within the home, and the home was stocked with a variety of provisions. Menus indicated that a varied and nutritious diet is provided to service users. One service user told the inspector “the food here is really good.” Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 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) 18, 19 and 20. Service users receive appropriate physical and emotional support, according to their needs and preferences. There has been an improvement in the recording and administration of medicines to service users in the home so that the risk of errors is minimised. However there is room for further improvement in the storage of medicines appropriately to fully protect service users. EVIDENCE: All service users have detailed healthcare records and service users have access to local health centre facilities as and when required. Attendance of health care appointments is recorded appropriately for each service user so that these can be tracked easily. Records are maintained of all medicines brought into the home or disposed of, and a system is in place for recording medicines given to service users for overnight stays. The inspector noted an improvement in the recording of medicines dispensed by two staff members into dossette boxes, and signing to show that these had been checked. The manager advised that she herself was now taking overall responsibility for the recording of medicines, so that any problems may be resolved straight away. Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 Page 15 No service users are currently self-medicating, but the manager was advised that a format, for assessing the risk to individual service users of administering their own medicines, should be available for future use. The inspector noted that one prescribed cream was being stored in a service user’s room at room temperature, although instructions on the container indicated that it should be refrigerated once open. A requirement is made accordingly. Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 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) 22 and 23. The home’s complaints procedure is satisfactory to ensure that the concerns of service users are acted upon effectively. Procedures are in place to ensure that service users are protected from abuse. EVIDENCE: There have been no complaints made to the home since the previous inspection. One complaint was made directly to the CSCI, and upon investigation was not upheld. The home has an adult protection policy including a clear procedure for all staff to follow, and as required a copy of the local authority adult protection procedure is available within the home. The manager had commenced work on a clear ‘step by step’ adult protection procedure for staff and service users. It remains recommended that a clear ‘step by step’ adult protection procedure be available for staff and that all receive training in this area. As recommended, the adult protection procedures for Islington and Newham had also been requested by the manager, as they are placing authorities for service users at the home. Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 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 and 30. Service users live in an environment that is homely and comfortable, with adequate private and communal space. The standard of decoration has been improved since the previous inspection, but service users’ comfort could be further enhanced by improvement of the décor in one bathroom. The safety and hygiene of the home for service users has been improved by the availability of hand washing and drying facilities in the laundry. EVIDENCE: A pleasant, reasonably well-maintained environment is provided for service users. The lounge had been painted and the stairways in the home had been painted prior to the previous inspection. Service users have personalised their own rooms, and one service user’s room had been refurbished prior to the previous inspection. Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 Page 18 Since the previous inspection, the fire brigade had visited the home and made a number of requirements regarding fire doors. On a second visit to the home these requirements were found to have been met. The manager advised that all fire doors are checked at least weekly during the fire alarm tests for the home. As required the garden furniture had been cleaned and hand towels and soap were provided in the laundry. It is required that the ground floor bathroom tiles be repainted. It is also recommended that the armchair hand rests in the lounge be removed/replaced where they are worn. Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 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) 32, 34, 35 and 36. Staff are generally adequately trained and supervised to meet the needs of service users safely. However insufficient training in first aid may place service users’ at risk. Service users are not adequately protected by the current recruitment practice of the home. EVIDENCE: The registered manager has worked in the home for a number of years and is supported by the registered person who is at the home on most days and works in the home at weekends. The rota had been improved to include the actual hours worked by the management/provider team, to evidence that there is adequate staffing cover in the home at all times. Due to insufficient toner for the computer, however, the rota for the week of the inspection was not available, so the rota of the week previously was inspected. Examination of staff files, and discussion with staff members indicated that training opportunities and regular supervision are provided for the staff. A new format for recording appraisal meetings had also been developed for the home. Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 Page 20 At the previous inspection the manager advised that a sufficient number of staff were taking/had achieved a relevant NVQ qualification to meet the national minimum standard of fifty percent by the end of 2005. Manual handling training had been provided to all staff and the manager said that she was looking to arrange continence training for the staff team. However a requirement is restated for the second time regarding the need for current first aid certificates to be available for the remaining two identified staff members. A selection of staff files including those of the most recently employed staff at the home, were inspected. The inspector was concerned to note that two verified references were not available for all staff prior to their commencing work at the home and a requirement is made accordingly. The home continues to employ a volunteer (ex-staff member). Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 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) 39, 40, 41 and 42. The home has a quality assurance policy and procedure that enables service users and their representatives to give their views about the way in which the home is run, and be sure that these will be taken into account. Adequate procedures are in place to ensure that service user’s finances are protected. However insufficient review of the home’s policies and procedures may mean that service users’ rights and best interests are not safeguarded. Whilst the majority of safety checks are up to date and appropriate to the home, insufficient risk assessments and gas safety inspections place service users’ health and safety at risk. EVIDENCE: At the previous inspection, quality assurance initiatives had been developed in the home and an audit had been conducted, but the results of this audit were not yet available. The audit summary was seen on this occasion and found to be satisfactory. As recommended the volunteer working in the home had Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 Page 22 assisted service users in completing questionnaires about their experiences of living at the home. A current employer’s liability certificate was available for the home. Although a comprehensive selection of policies were available for the home it remains required that these must be updated at least annually. Records of service users finances dealt with by the home were seen by the inspector, and these were found to be satisfactory. The manager advised that the home was no longer receiving money for a service user who is entitled to £4 weekly for incontinence aids, as incontinence aids are now being provided by the health authority. There are regular maintenance checks of the home’s equipment and installations including fire safety equipment, a current electrical installation testing certificate and portable appliances testing. It remains required that a current gas safety certificate be obtained for the home and that risk assessments with regard to the building must be undertaken for the home, and reviewed at least annually. Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 Page 23 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. 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 x 3 3 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 3 2 x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 x 2 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Noble Lodge Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 2 3 2 x G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 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 6 Regulation 14(1) 15(2) Requirement The registered persons must ensure that care plans are updated to include a greater level of detail regarding the exact nature of support needed by service users. (Previous timescale of 08/07/05 partially met). The registered persons must ensure that medicines that required refrigeration are stored appropriately. The registered persons must ensure that the ground floor bathroom tiles are repainted. The registered persons must ensure that two verified references are available for all staff members prior to their commencing work at the home. The registered persons must ensure that the identified staff members undertake first aid training and that evidence is available that this training has been undertaken. (Previous timescales of 26/11/04 and 22/07/05 not met). The registered persons must ensure that the homes policies and procedures are reviewed and Timescale for action 28th October 2005 2. 20 13(2) 16th September 2005 28th October 2005 16th September 2005 28th October 2005 3. 4. 24, 27 34 23(2)(d) 19 Sched 2 (5) 17(2) Sched 4(6)(c) 13(4), 18(1)(c) (i) 19 Sched (2)(5) 5. 35 6. 40 18(1)(c) 14th October 2005 Page 25 Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 7. 42 13(4)(a) 8. 42 13(4)(a) updated at least annually. (Previous timescale of 08/07/05 not met). The registered persons must ensure that a current gas safety certificate is obtained for the home. (Previous timescale of 10/06/05 not met). The registered persons must ensure that risk assessments are recorded regarding the homes building, and that these are reviewed at least annually. (Previous timescale of 08/07/05 not met). 30th September 2005 28th October 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 23 24 Good Practice Recommendations It is recommended that a format for assessing the risk to individual service users of administering their own medicines, should be available for future use. It is recommended that a clear ‘step by step’ adult protection procedure be available for staff and that all staff receive training in this area. It is recommended that the armchair hand rests in the lounge be removed/replaced where they are worn. Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection Solar House, 1st Floor, 282 Chase Road, Southgate, London N14 6HA 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 Noble Lodge G59 S10705 Noble Lodge V246293 05.09.05 Stage 4.doc Version 1.40 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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