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Inspection on 04/07/07 for Orme House Residential Home

Also see our care home review for Orme House Residential Home for more information

This inspection was carried out on 4th July 2007.

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.

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

All residents have a preadmission assessment prior to moving into the home. The information collected is used as the basis for the care plans, which were detailed and informative. Resident`s health needs were clearly documented and there was evidence that the staff work with a range of health professionals to meet residents needs. The meals served on the day of the inspection were freshly cooked and there was a choice of two main courses. Cakes are freshly baked. Residents reported that the staff were cheerful and helpful.

What has improved since the last inspection?

A new deputy manager has been appointed to strengthen the management arrangements at the home. There was evidence that residents bedroom had been redecorated.

What the care home could do better:

The statement of purpose, service user guide and complaints procedure are available on request, however these should be provided to residents as a matter of course. Resident`s files were disorganized and contained information relating to other residents who were living at the home, which is unsatisfactory as it does not show sufficient respect to resident`s private information. One resident who was relatively independent was observed using the toilet with the door open.Greater thought should be given to how staff can promote independence but ensure privacy. A more comprehensive programme of activities for residents to choose from should be developed. All but two residents are up and dressed by 8am in the morning and these routines must be reviewed with residents to ensure that they fully take account of their care preferences. One of the doors was found to be propped open and the home has been advised that this could compromise the fire safety measures within the home and further advice must be sought from the fire officer. A better system should be set up for undertaking repairs to ensure that these are undertaken quickly. A number of radiators on the ground floor did not have low surface temperatures or safety guards and consideration must be given to the fitting of radiator covers. The laundry was in a poor state of repair and organisation and concern was expressed about resident`s ability to access an adjoining flat, which posed significant health and safety risks. Following the inspection the manager confirmed that new locks had been fitted on the door of the adjoining flat and the laundry had been improved. The inspector found that there were occasions where staffing levels dropped to below what is required. The homes management must ensure that minimum staffing levels are maintained and that the hours worked by the manager are recorded on the staffing rota. There were shortfalls in the process for the recruitment of staff. The home had taken up a reference from the prospective member of staff`s colleague but not their previous employer. There was no CRB or POVA first check in place. A more robust system for recruiting staff must be implemented.

CARE HOMES FOR OLDER PEOPLE Orme House Residential Home 59 Kirkley Cliff Lowestoft Suffolk NR33 0DF Lead Inspector Cecilia McKillop Unannounced Inspection 4th July 2007 10:40 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 Orme House Residential Home DS0000049444.V345069.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. Orme House Residential Home DS0000049444.V345069.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Orme House Residential Home Address 59 Kirkley Cliff Lowestoft Suffolk NR33 0DF 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) 01502 574068 01502 574068 sandy@sahadew.fsnet.co.uk None available Anglia Care Homes Ltd Mr Shriraj Sahadew Care Home 19 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (19) of places Orme House Residential Home DS0000049444.V345069.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 The home may accommodate one person, whose name was made known to the commission in June 2005, who is over 65 years and requires care by reason of dementia. 25th July 2006 Date of last inspection Brief Description of the Service: Orme House is registered as a care home providing personal care for 19 older people aged over 65 years. One of whom has dementia. Care assistants staff Orme House on a 24-hour basis. One of the registered proprietors, Mr Sahadew is also the registered manager. The layout of the home is on 3 floors with level access provided in most areas by means of a shaft lift. Rooms 5, 6 and 11 are not accessible by the shaft lift. A stair lift can be used to access rooms 5 and 6, but to access room 11 the occupant needs to use stairs. Single bedrooms and shared accommodation are available. The home looks out to Kirkley Cliff, a busy one-way thoroughfare. Kensington Gardens, with its many attractions and sea front. Parking is on the road. Fees for this home currently range from £331 to £336. Orme House Residential Home DS0000049444.V345069.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection that focused upon the core standards relating to Older People. It took place on a weekday between the hours of 10.30am and 4.00pm. The process included a tour of the building, discussions with residents and staff, observations of care and the examination of a number of documents including residents care plans, medication records, the staff rota, and records relating to maintenance and health and safety. Prior to the inspection the home completed an Annual Quality Assurance Assessment (AQAA) and this has been incorporated into the report. What the service does well: What has improved since the last inspection? What they could do better: The statement of purpose, service user guide and complaints procedure are available on request, however these should be provided to residents as a matter of course. Resident’s files were disorganized and contained information relating to other residents who were living at the home, which is unsatisfactory as it does not show sufficient respect to resident’s private information. One resident who was relatively independent was observed using the toilet with the door open. Orme House Residential Home DS0000049444.V345069.R01.S.doc Version 5.2 Page 6 Greater thought should be given to how staff can promote independence but ensure privacy. A more comprehensive programme of activities for residents to choose from should be developed. All but two residents are up and dressed by 8am in the morning and these routines must be reviewed with residents to ensure that they fully take account of their care preferences. One of the doors was found to be propped open and the home has been advised that this could compromise the fire safety measures within the home and further advice must be sought from the fire officer. A better system should be set up for undertaking repairs to ensure that these are undertaken quickly. A number of radiators on the ground floor did not have low surface temperatures or safety guards and consideration must be given to the fitting of radiator covers. The laundry was in a poor state of repair and organisation and concern was expressed about resident’s ability to access an adjoining flat, which posed significant health and safety risks. Following the inspection the manager confirmed that new locks had been fitted on the door of the adjoining flat and the laundry had been improved. The inspector found that there were occasions where staffing levels dropped to below what is required. The homes management must ensure that minimum staffing levels are maintained and that the hours worked by the manager are recorded on the staffing rota. There were shortfalls in the process for the recruitment of staff. The home had taken up a reference from the prospective member of staff’s colleague but not their previous employer. There was no CRB or POVA first check in place. A more robust system for recruiting staff must be implemented. 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. The summary of this inspection report can be made available in other formats on request. Orme House Residential Home DS0000049444.V345069.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 Orme House Residential Home DS0000049444.V345069.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 Quality in this outcome area is good. Residents can expect all their needs to be properly assessed before they move into the home and while information about the service is available to them they may have to request this. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In the entrance hall of Orme House there is the certificate of registration displayed along with a notice that states that anyone can access the Statement of Purpose, Service Users Guide and the complaints procedure. The inspector was informed that this information was kept in the office and was available on request. Residents who were spoken with as part of the inspection were unable to recall receiving this information. Four sets of resident’s records were examined. A senior member of staff had completed a preadmission assessment and information had also been obtained where possible from Social Workers or the hospital. The home does not offer intermediate care. Orme House Residential Home DS0000049444.V345069.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. People who use this service can expect to have an individual plan of care in place and can expect to have their health and medication needs attended to. Privacy could however be given a higher priority. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans and associated documents were examined in detail for four residents. Plans were accessible for care staff to read and make notes daily on the care given. Daily notes were an account of the personal care given, the dietary and fluid intake of each resident as well as how mobile and how well they were that day. Care plans contained dependency assessments, pressure area risk assessments, and falls assessment where needed. Instructions on each element of care for individuals varied from resident to resident and depended upon the assessed need. There was a record of all professional visits such as Social Workers and those from medical professionals. These included GP, District Nurses, Chiropody, Dieticians and appointments at hospital. Referrals, appointments and outcome of visits were all documented in care plans. Orme House Residential Home DS0000049444.V345069.R01.S.doc Version 5.2 Page 10 Staff were observed speaking with residents in a respectful manner and residents informed the inspector that staff were “cheerful” and didn’t rush them when providing care. Staff were observed knocking on doors before entering bedrooms. The shower door did not have a lock fitted to the door to protect resident’s privacy. One resident was observed using the bathroom independently with the door open. The inspector was informed that the resident was unable to close the door because there was insufficient room for the wheelchair. The home have been required to find alternative ways of maintaining the residents independence but ensuring that their privacy is respected. Orme House Residential Home DS0000049444.V345069.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. Residents independent enough to develop their own pastimes can expect to be satisfied, but those who wish to have activities supplied may be dissatisfied. Catering at the home is of a good standard. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was no evidence of any formal activities on the day of the inspection and the majority of the residents were observed sitting together in the lounge with the television on. The inspector was informed that some of the female residents have their nails painted and bingo is arranged on a regular basis. The deputy manager said that efforts were being made to set up arrangements with the local library. Residents interviewed reported that visitors were welcomed at the home. The inspector discussed the homes routines with both staff and residents and was surprised to find that all residents were up and dressed by eight in the morning. It was unclear from the documentation whether this was the resident’s preference. Orme House Residential Home DS0000049444.V345069.R01.S.doc Version 5.2 Page 12 The home stated in the AQAA that they have improved the menu over the last 12 months. The cook was met and spoken with; she explained that on the day of the inspection residents had a choice of meal between either sausages and mash or shepherds pie. Both had been freshly prepared and looked appetising. One resident was observed being taken a sandwich in their room by the cook as they were feeling unwell and they had requested a sandwich. The inspector noted in the kitchen some freshly prepared tarts and a fruit cake, which was to be served to residents for tea. Orme House Residential Home DS0000049444.V345069.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is adequate. The homes procedures offer some protection to residents but it is unsatisfactory that residents have to ask for the information on complaints before using the procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the last inspection the home was found to have an appropriate complaints procedure in place, which could be found in both the Service Users Guide and the Statement of Purpose. There was reference to this in the entrance to the home but it is not satisfactory that residents or visitors who wish to make a complaint have to request a copy of the procedure before proceeding. At the last inspection the home was found to have a copy of the Protection Of Vulnerable Adults (POVA) policy. Staff who were interviewed confirmed that they had received training on vulnerable adults. Orme House Residential Home DS0000049444.V345069.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is adequate. The residents who use this service can be assured that there is a programme of redecoration and improvement taking place, but some areas require improvement to offer a more pleasant and safer place to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home looks out to Kirkley Cliff, a busy one-way thoroughfare. Kensington Gardens, with its many attractions and sea front, is just across the road from the home and easily accessible. All the bedrooms and communal areas were visited along with the kitchen and laundry room. There was evidence of ongoing redecoration throughout the home. The bedrooms were clean although one resident reported that slugs were entering the room through a space under the skirting board. Orme House Residential Home DS0000049444.V345069.R01.S.doc Version 5.2 Page 15 Communal space comprises of a large lounge and conservatory/dining room. Both areas have a television and music provided. There was sufficient comfortable seating for the residents. The main bathroom is on the ground floor and residents access this through the main lounge. The bath is an assisted bath and the water temperatures, which were tested, were within the recommended levels. In the bathroom there were a number of unnamed toiletries and sponges. The laundry room was in an extremely poor state. There were soiled items on the floor and the room was dirty and dusty. There was an old bath on the floor along with mattresses, wheelchair parts a lawnmower and boxes of pads. The inspector was informed that the light had been out of order for some days. The door of the laundry was unlocked although the inspector was informed that staff could lock the door by using a coin or a screwdriver. Orme House Residential Home DS0000049444.V345069.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. Residents who live in this home can expect to be cared for by staff who have undertaken some training but cannot always be confident that staffing levels will be maintained or that staff will have been recruited to the required standard. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The duty roster for the week of the inspection and the previous week were examined as part of the inspection. The hours worked by the manager were not documented on the rota The home generally operates with three care staff on duty although the inspector was informed that there have been occasions where the levels of staff had reduced to 2 staff because of sickness. On the previous week the inspector noted that one of the three members of staff worked in the kitchen as the cook leaving only 2 carers to provide care to the residents. The manager stated in the AQAA that 50 of staff had NVQ level 2. The inspector was unable to examine the recruitment and training records of staff on the day of the inspection as these were in a locked cupboard to which staff did not have a key. The manager subsequently brought the records relating to a small number of staff to the Commissions offices. Orme House Residential Home DS0000049444.V345069.R01.S.doc Version 5.2 Page 17 One member of staff had been recruited by an agency on the home’s behalf. The agency had accepted “to whom it may concern ” letters as references, which is not satisfactory. References had been taken up on a second member of staff but the home had not made contact with the member of staff employer and was relying on a reference from a colleague. There was no CRB or POVA first check in place. The home said that they had seen a copy of the CRB which had been taken up by the member of staffs previous employer however this is unsatisfactory as this had been undertaken some time previously. There were copies of certificates on the sample of files examined relating to moving and handling, fire safety and the protection of vulnerable adults. Staff who were interviewed as part of the inspection confirmed that they had received an induction. Orme House Residential Home DS0000049444.V345069.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,3738 Quality in this outcome area is adequate. The homes operation is generally sound but more consistent management would improve outcomes for residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager of the home is Mr Sahadew, he and his wife are joint owners and have another home in Essex. Mr Sahadew is a qualified nurse. He was not present at the home on the day of the inspection and staff were not clear about when the manager would next be working at the home, but said that they could always contact him by telephone. Mr Sahadew said that he usually attended the home for four days each week. Orme House Residential Home DS0000049444.V345069.R01.S.doc Version 5.2 Page 19 The manager is assisted by a newly appointed deputy or acting manager, who although was on holiday attended the home for part of the inspection. The deputy manager was however unable to access key documentation such as staff records or residents moneys, which were being looked after by the home for safekeeping. The inspector expressed concern that residents could not access their moneys in the manager’s absence. Mr Sahadew subsequently brought a number of records to the Commission offices. The records of the money being held by the home for one resident were examined. The inspector found that a written record of transactions is maintained, which is signed by the resident. Mr Sahadew stated in the AQAA that a quality assurance questionnaire is undertaken on a yearly basis to ensure that residents are satisfied with the care and services provided. Resident’s files were disorganized and contained information relating to other residents who were living at the home, which is unsatisfactory, as it does not show sufficient respect to resident’s private information. In relation to health and safety matters reference has already been made in the report to the laundry but the inspector noted that there were gloves; aprons paper towels and liquid soap available at a number of locations throughout the home. Mr Sahadew provided the commission with the dates of the servicing of equipment as part of the AQAA. Accident records were being maintained and were examined on the day of the inspection. The section on the documentation, which should be completed by the homes management team, was blank and there was no evidence of ongoing monitoring of accidents. There was documentation available to evidence that checks were being undertaken on the fire prevention systems however a door was noted to be propped open and concern was expressed that this could compromise the fire safety systems. The inspector was concerned to find a door to an adjacent flat open. The flat was being used as a storage area for the home but posed significant health and safety risks to staff and residents as the floor was uneven and items had been poorly stored. Following the inspection Mr Sahadew confirmed that this door had been locked. Orme House Residential Home DS0000049444.V345069.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 X X X X X X 1 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 2 2 Orme House Residential Home DS0000049444.V345069.R01.S.doc Version 5.2 Page 21 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. Standard OP37 Regulation 17 (1) a Requirement Resident’s records must be maintained individually and in good order to make sure that resident’s needs are met and their privacy maintained. The laundry must be cleaned and alternative storage found for the items stored there to reduce the risk of infection to residents. The manager must ensure that residents receive care which is appropriate to their needs in a manner which respects their privacy and dignity A copy of the Service Users Guide and the complaints procedure must be supplied to each resident to ensure that they have all the information that they need about the home. Radiators in bedrooms, which pose a risk to residents, must be regularly re-assessed to take account of the changing needs of residents and covers provided. This will ensure that residents do not get injured. The registered manager must consult with the fire officer with DS0000049444.V345069.R01.S.doc Timescale for action 01/09/07 2. OP26 13 (3) 01/08/07 3. OP10 12(4) 01/08/07 4. OP1 OP16 5 (1) (2), 22(5) 01/08/07 5. OP38 13(4) 15/08/07 6. OP38 23(4)(a) 01/08/07 Orme House Residential Home Version 5.2 Page 22 7. OP19 23(2) (b) 8. OP19 OP38 23 9. OP12 16(2) m 10. OP14 12(2) 11. OP29 19 Schedule 2 12. OP27 18 (1) 13 OP27 17(2) Schedule 4 regard to the methods of keeping open fire doors. This will ensure that residents are not placed at risk by the inappropriate securing of fire doors The manager must ensure that there are clear arrangements in place to keep the premises in a good state of repair. This will ensure that matters raised by staff and residents are addressed quickly. The manager must ensure that the areas accessed by staff or residents are suitable and well maintained. This will ensure that people are not placed at risk by poorly stored items or building work. Residents must be consulted and a suitable programme of activities provided by the home. This is a repeat requirement. Residents must be consulted about their preferences for getting up and retiring. This will ensure that the homes routines meet the needs and wishes of the residents living at Orme House. The manager must ensure that staff are recruited as outlined in the regulations and appropriate referencing and criminal record bureau checks are undertaken. This will ensure that residents are better protected. Staffing levels must be maintained at the home and alternative methods found for covering staffing vacancies. This will ensure that resident receive the care they need when they need it. The staffing roster should record the hours of all the staff working at the home. DS0000049444.V345069.R01.S.doc 01/09/07 01/08/07 01/08/07 15/08/07 01/08/07 15/08/07 01/09/07 Orme House Residential Home Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Orme House Residential Home DS0000049444.V345069.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Orme House Residential Home DS0000049444.V345069.R01.S.doc Version 5.2 Page 25 - 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!