Inspection on 29/08/06 for Orione House

This inspection was carried out on 29th August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Orione House 02/07/08

Orione House 18/12/07

Orione House 18/04/07

Orione House 14/11/05

Orione House 08/06/05

Orione House 11/02/05

Orione House 23/08/04

Orione House 18/12/03

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Orione House 12-14 Station Road Hampton Wick Kingston-upon-Thames Surrey KT1 4HG Lead Inspector Sharon Newman Unannounced Inspection 29th August 2006 08:50 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 Orione House DS0000017385.V309222.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. Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orione House Address 12-14 Station Road Hampton Wick Kingston-upon-Thames Surrey KT1 4HG 020 8977 0754 02089770105 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) The Sons of Divine Providence Ms Ursula Harrison Care Home 34 Category(ies) of Dementia - over 65 years of age (8), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (2), Old age, not falling within any other category (34) Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th November 2005 Brief Description of the Service: Orione House is a purpose-built care home owned by the Sons of Divine Providence. They are a Catholic Missionary Order of Priests, Nuns and Brothers who welcome all faiths to their Homes. Personal care is provided for thirty-four service users. Accommodation is provided in single rooms. The home is situated in a residential area close to Hampton Wick Station and local shops. There is a large conservatory to the front of the home which leads to a garden and car park. At the rear of the house is an enclosed garden with flower beds, mature trees and a pond. A chapel is situated in the garden which is for use by all service users at Orione House. Fees range from £452 per week for a single room and £483 per week for a single room with ensuite facilities. Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One regulation inspector conducted this unannounced inspection. The inspection took place over one and a half days and the manager was present on the second day. Records examined included care planning documentation, medication records and health and safety information. A tour was also taken of the premises. Staff members and residents were spoken to during the course of the inspection. Surveys were left for residents, relatives and staff to complete and return. Three were retuned from residents prior to completion of this report. Some surveys were sent to health professionals prior to the inspection visit and five were returned. These were all positive about the home. Residents were complimentary about life at the home and one said that they ‘really enjoyed’ living at the home. What the service does well: What has improved since the last inspection? The home has now had a new passenger lift installed. Questionnaires were sent out to gain residents views about life at the home. All COSSH products such as cleaning products or bleach were observed to be locked away securely. Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 7 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 Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 8 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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are given good information to enable them to make a decision about whether to live at the home. There are appropriate procedures for the assessment and admission of service users. This helps to ensure that care plans can be drawn up that meet the needs of the residents. This home does not offer intermediate care. EVIDENCE: An informative ‘Service Users Guide’ is in place to help residents and relatives decide if this home can meet their needs. It contains a location map and information about the home. Other information contained within this documentation includes: the philosophy of care, a standard contract, a copy of the home’s Statement of Purpose and the complaints procedure. The Statement of Purpose contains information about: the home’s aims and objectives, facilities and services, staffing, admission criteria and social activities. Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 9 Full assessments are carried out by the manager prior to a prospective resident being admitted, and they are invited to visit the home or undertake a trial stay before choosing to live at the home. Assessments were in place in the residents’ files that were looked at. This enables the manager to decide if this home is suitable for the prospective resident. The complaints procedure and the last inspection report are displayed on notice boards around the home. This helps to create an open atmosphere as it enables residents to be aware of this procedure. The manager reported that any issues raised by residents or relatives would be taken seriously and thoroughly investigated. Contracts were in place for those residents whose files were examined. As reported in the previous inspection report the manager is experienced and competent and reads widely to ensure she keeps up to date with developments in care. Residents looked well dressed and clean on the day of inspection. A social/health care professional wrote that they had ‘always been satisfied with the care provided’ at the home. Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Not all care plans are up-to-date and some risk assessments are not in place. This could affect whether residents needs are met. Although health needs are being addressed, errors in the recording of medication and creams and discrepancies between the amount of medication recorded as given and that still in stock could place residents at risk. EVIDENCE: Four residents files were examined at this inspection visit. They were informative, and contained concise information about personal details, dietary requirements, allergies, diagnosis, social history and their likes and dislikes were also recorded. Long term need and care plans were in place and they covered areas such as cleansing, dressing, eating and drinking, mobility, skin integrity, sexuality, emotional wellbeing and hobbies and interests. Although some of this documentation was seen to be updated on a monthly basis some had not been. The care plans must be updated monthly to ensure that any change in need is documented and appropriate action taken. Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 11 One residents care plan stressed the importance of them being well turned out and this resident looked very well dressed on the day of inspection and obviously was encouraged to take a pride in their appearance. This resident reported that they were ‘very happy here.’ A pressure sore risk assessment had not been completed in one file and must be completed to ensure that this resident is not placed at risk. Activity charts were not completed in three files. These must also be completed to ensure that the needs of the residents are being met. Risk assessments were in place for issues including risk of falling. However they were available for other activities. For example, some residents were observed to remain in wheelchairs for lunch and risk assessments were not in place for this. Detailed risk assessments must be in place to show that this is the resident’s choice and these must demonstrate the involvement of the service user and health and social care professionals. Evidence was seen in care plans of input from health care professionals including physiotherapists, GP’s, community nurses and social workers. The manager reported that the home has a good relationship with the local GP surgery and that health professionals from the surgery visit the home. A district nurse was seen to be visiting a resident on the day of inspection. A health professional wrote that they had ‘absolutely no concerns about Orione House’s standards of care.’ There was no evidence of medication training for a staff member who is involved in giving out medication. All staff that administer medication must receive appropriate training to ensure residents are not placed at risk. It was discussed with the manager at the time of inspection that it would be good practice to implement a way of identifying residents when staff are administering medication. This could be in the form of photographs on the medication administration records (MAR). The manager reported that she would look into a way of addressing this. Some omissions of signatures were seen in the MAR sheets which could indicate non-administration of medication or creams. All entries must be signed. When medication is not given then the key on the bottom of the MAR sheets must be used to indicate the reason it was not given. There was a discrepancy found in the amount of medication left for one resident and the amount that should have been left according to the MAR sheet. Also the quantity of medication carried over from one month to the next was not clearly recorded. This was discussed with the manager at the time of inspection. Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Although residents are offered a range of activities, they are not given enough information about the activities on offer or the menu at meal times. This affects their ability to exercise choice in their daily lives. They are offered a choice of nutritious food in a pleasant environment. EVIDENCE: There is a strong emphasis on religion at this home, weekly and evening Mass takes place and residents may choose to participate. Some residents spoken to said that they enjoy attending Mass. A designated activities officer works at the home from Monday to Fridays for five hours each day. However, on the day of inspection a staff member reported that the activities officer was not on duty and there were no structured activities on offer. Residents were seen to be seated in their chairs in the lounge area, sleeping or looking at the television. Two staff members sat and chatted to residents. Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 13 The activities board could appear confusing to the elderly and those with dementia. It listed many activities but did not say which activities were on offer that day. It would be easier to read if it was simpler and perhaps stated the date and day of the week with the activity on offer that day. One resident reported that they enjoy walking in the garden. A hairdresser visits the home weekly and some residents choose to visit hairdressing salons outside the home. There was no menu written on the board in the dining room on the day of inspection. A resident said that they did not know what was for lunch and a staff member asked did not know either. Residents should be aware of the choices on offer so that they can make an informed choice at mealtimes. The lunch on offer was a choice of chicken curry or a vegetarian option. It looked nutritious and good-sized portions were offered to residents. Tables were attractively laid and residents were seen to be chatting to each other. Residents were complimentary about the food. One said ‘its very nice’, two more reported ‘its very good,’ and others said ‘the food is lovely.’ Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Policies and procedures are in place to help protect residents from abuse, however all staff need to undertake training in abuse awareness to ensure that residents are not placed at risk. EVIDENCE: A complaints procedure is in place at the home and there is a well organised complaints log available. Details of complaints and the outcomes were seen to have been fully recorded. There have been no complaints since the previous inspection. The three surveys returned from residents indicated that they knew how to make a complaint. Residents spoken to said that they would have no hesitation in approaching the manager if they wished to raise an issue. The home follows the London Borough of Richmond Protection of Vulnerable Adults Policy and also has it’s own organisational abuse policy. There is a whistle blowing policy in place. The whistle blowing policy needs to be updated to remove the references to NCSC and replace them with the Commission for Social Care Inspection (CSCI). Some staff spoken to had a good knowledge of the importance of whistle blowing in maintaining good practice. However some staff spoken to did not have a clear idea about whistle blowing and not all staff have attended training Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 15 in abuse awareness. All staff must attend training in this area to ensure that residents are not placed at risk. Risk assessments must be in place for those residents choosing to remain in wheelchairs for periods throughout the day. This helps to ensure that their wishes are documented and that staff at the home have considered their safety. Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19. 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The environment at this home remains comfortable and homely. The large mature garden is beautifully maintained and the attractive conservatory remains an asset to the home. Residents live in a comfortable and wellmaintained environment. Their bedrooms are personalised and they can have their personal possessions around them. The home is clean and hygienic. EVIDENCE: The lounge area has a homely atmosphere and contains a fish tank, book cases, plants and ornaments. It leads into a spacious and attractive conservatory which is situated to the front of the building and contains a small feature fountain. There is attractive furniture in this area and it also contains a cold water dispenser. There is a large and bright dining room that is situated next to the kitchen and leads out to the garden. Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 17 Some shortfalls in the environment were brought to the attention of the manager at the time of inspection. A pull cord for the light in one of the first floor toilets was damaged, the extractor fan in this room was not working and the flooring in some of the toilets and bathrooms was marked and stained. The manager reported that these issues would be addressed. As reported in the previous inspection report the large garden is well maintained and contains a pond and mature shrubs and trees. A secluded area to the side of the garden contains a grotto shaded by trees where open air Mass can take place. A chapel for the use of staff, service users and their families is situated across the garden. Bedrooms were seen to be clean, comfortable contain items of the residents own possessions and furniture. A new passenger lift has now been installed at the home and the manager reported that there are plans to decorate the upstairs lounge area and the dining room. She was enthusiastic about this and stressed they wanted to ensure that the residents lived in an attractive and comfortable environment. Standards of cleanliness have improved since the previous inspection visit. The home was clean, hygienic and free from offensive odours. Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Staff are caring towards the residents. However numbers need to be maintained to ensure that residents needs are met. Mandatory training is not up-to-date for all staff, this needs to improve to help ensure the safety of staff and residents. EVIDENCE: A staff member spoken to said that they enjoyed working at the home and have achieved their NVQ levels 2 and 3 whilst working at the home. They reported that they felt well supported. Another staff member also said that they felt supported at the home. The manager discussed staffing issues and reported that there was currently a lack of senior care staff at the home. She reported that she is addressing this issue and one new senior member of staff was on duty at the time of inspection. The home has been using care staff from an agency to make up the numbers of staff. Although staff rotas seen indicate that at times there are lower levels of staff on duty than usually needed. The home needs to ensure that there are sufficient numbers of trained staff on duty to meet the needs of the residents. Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 19 Four staff files were looked at and all contained two references apart from one file where the staff member had been employed over fifteen years ago. All the files contained evidence of criminal record checks. Although some staff have received training in mandatory areas there was not enough evidence to show that all staff are up-to-date in areas such as moving and handling, food hygiene and first aid. All staff need to be up-to-date with this training to ensure that residents are not placed at risk. Although some senior staff meetings were taking place there was not sufficient evidence to demonstrate that meetings involving all care staff were taking place regularly. It was discussed with the manager that this would be a good idea to help ensure that staff were up-to-date with what is happening within the organisation and can put forward any views about the home. A staff member commented that they felt the home ‘focused on the residents’ and said ‘people do care’ at this home. Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The manager is experienced, enthusiastic and suitably qualified, her management style is open, inclusive and positive. She is approachable and continues to provide clear direction and leadership within this home. However, staff supervision needs to take place regularly to ensure that they have the support and direction they needs to carry out their roles. EVIDENCE: The manager is experienced and has been at the home for many years. She has achieved the NVQ Level 4 and the Registered Managers Award, is an NVQ assessor and continues to work closely with the local college. She also continues to keep herself up-to-date by reading on a wide range of care and social issues. Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 21 Residents spoken to praised the manager, one said ‘the manager is nice’ two more said that she was ‘lovely.’ Another resident commented that ‘the manager is efficient and very good.’ Another reported ‘I like the manager she is very good.’ Staff also reported that she was approachable and supportive. A health professional wrote that the manager ‘is particularly good.’ Although some staff reported that they do have one-to-one supervision and feel well supported there was not enough evidence to suggest that staff supervision is taking place regularly. This should be put in place and be fully documented to ensure that staff receive the support and direction they need to carry out their roles. This was discussed with the manger at the time of inspection. The manager said that the home has been trying to obtain the views of the residents to aid the quality assurance programme at the home. Completed questionnaires from residents were seen in the activity folder to show that the home has been trying to seek their views about life at the home. The manager reported that all the residents’ finances/ monies are kept separately and that she does not look after any of their individual finances. Hot water checks are being carried out weekly, however as found at the previous inspection visit temperatures were seen to be variable with some recorded at 45 to 47 degrees centigrade. Hot water temperatures must not rise above 43 degrees centigrade. First aid box checks are being carried out monthly and it was discussed with the manager that some method of ensuring that the expiry dates on the items kept in this would be good practice. Fridge and freezer temperatures were seen to be recorded daily and checks for gas safety, five yearly electrical installation, and water disinfection were in order. However the portable appliance checks need to be carried out to help ensure the safety of residents and staff. A health professional wrote that they would ‘have no reservation about relatives of mine being cared for at Orione House.’ Another wrote that staff at the home were ‘very caring.’ Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 2 Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES 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 2 Standard OP7 OP9 Regulation 15 (2) 13 (2) Requirement The registered person must ensure that care plans are kept under regular monthly review. The registered person must ensure that: 1. The administration of all medication is recorded accurately. (Previous timescale of 15/11/05 not met). 2. The medication in stock agrees with the amounts indicated on the administration record. 3. All staff have received appropriate training before administering medication to service users. 3 OP14 12(1)(2)( 3)(4)13(7 ) The registered person must ensure that service users are given the opportunity to be seated in chairs rather than wheelchairs. Wheelchairs must not be used as a form of restraint. Any decision for a service user to remain in their DS0000017385.V309222.R01.S.doc Timescale for action 01/10/06 01/09/06 01/10/06 Orione House Version 5.2 Page 24 4 OP18 13 (6) 5 OP19 23(2)(b) & (d) 18 (1) (a) 6 OP27 7 OP30 18 (1) 8 OP36 18 (2) 9 OP38 13 (4) 10 OP38 13 (4) wheelchair must be based on their wishes and should be subject to advice from relevant health care professionals. (Previous timescales of 01/05/05 and 01/12/05 not met) The registered person must ensure that all staff receive upto-date training in abuse awareness and adult protection procedures. The registered person must ensure that all maintenance issues outlined in Standard 19 of this report are addressed. The registered person must ensure that there are sufficient numbers of trained and experienced staff on duty at all times to meet the needs of the service users. The registered person should ensure that staff training is upto-date. Refresher training must be provided for staff as required with regard to Manual Handling, First Aid and Food Hygiene. (Previous timescale of 01/02/06 not met). The Registered Persons must ensure that all care staff receive one-to-one supervision at least six times a year. (Pro-rata for part-time staff). The Registered Person must ensure that hot water temperatures do not exceed 43 degrees centigrade. (Previous timescale of 01/12/05 not met). The registered person must ensure that a portable appliance testing certificate is obtained. 01/11/06 01/12/06 01/10/06 01/01/07 01/11/06 01/09/06 01/10/06 Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 25 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. 4. Refer to Standard OP9 OP9 OP18 OP36 Good Practice Recommendations It is recommended that the quantity of medication carried over from one month to the next be recorded on the administration record. It is recommended that a method of identifying service users at the point of medication administration is put in place. It is recommended that the whistle blowing policy be amended so that references to NCSC are changed to CSCI. It is recommended that staff meetings are held more frequently. Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Orione House DS0000017385.V309222.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!