Inspection on 24/07/07 for Park Riding

This inspection was carried out on 24th July 2007.

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

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

Other inspections for this house

Park Riding 15/12/08

Park Riding 20/12/07

Park Riding 02/08/06

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

CARE HOMES FOR OLDER PEOPLE Park Riding 66 Greenfield Road Holmfirth Huddersfield HD7 1LA Lead Inspector Gillian Walsh Key Unannounced Inspection 24th July 2007 09:20 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 Park Riding DS0000066741.V338428.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. Park Riding DS0000066741.V338428.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park Riding Address 66 Greenfield Road Holmfirth Huddersfield HD7 1LA 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) 01484 684503 F/P01484684503 Mr Avtar Singh Samrai Mrs Angela Hinchliff Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Park Riding DS0000066741.V338428.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd August 2006 Brief Description of the Service: Park Riding care home offers accommodation and personal care for up to 15 older persons. It is a well established home situated in a residential area of Holmfirth. Rooms are situated on the ground and first floor, which is accessed by the use of a stair lift. There are two homely lounges a conservatory and a separate dining room. All bedrooms have a toilet and wash hand basin. The home serves traditional home cooked food. It has its own private grounds including a small putting green. The home is unable to accept service users who are immobile owing to the absence of a passenger lift and lifting equipment. The manager informed the Commission that the charge for living at the home, as of July 2007, is £358.80 per week with extra charges made for hairdressing and other incidentals such as some activities. Information about the home is available within the Statement of Purpose and the Service User Guide, which are given to everybody who lives at the home and people enquiring about moving into the home. A brochure about the home is also available. Details of the Commission for Social Care Inspection are included within the Service User Guide Park Riding DS0000066741.V338428.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. As part of this full inspection, one inspector from the Commission for Social Care inspection (CSCI) undertook an unannounced visit to the home. The visit started at 9.20am and finished at 4.30pm on 24 July 2007. The inspectors’ time was spent speaking with people who live at the home, staff, reviewing documentation and looking round the home. Alongside this, the service provider was asked to provide information about the service, which was returned prior to the visit. Surveys to gain the views of those involved in the service were sent to people who live at the home, their relatives, visiting professionals and GPs. Of 10 surveys sent to people living at the home 5 were returned. Responses were positive although few specific comments were made. Of 10 surveys sent to relatives, 5 were returned. Again these were very positive and included comments such as “They provide a kind and loving help for all the residents” and “ I think as a regular visitor, it is a homely happy place”. 2 professionals surveys were returned, one from a GP and one from a social worker, both indicated satisfaction with the service with the social worker adding, “The care home presents as being well run”. Information and evidence was not only obtained by visiting the home but also from notifications and information obtained by CSCI, information about the home supplied by the home manager and from considering developments since the last CSCI inspection report. The inspector would like to thank everybody involved for their time and assistance during this inspection. What the service does well: All of the people spoken with during the visit and who responded in surveys, comment on the friendliness of the staff and the homely and comfortable atmosphere at Park Riding. One relative said, “Park Riding is a nice friendly home with pleasant staff and residents are often occupied with pleasant pastimes”. Another said, “I think one of the major advantages of Park Riding is that there are a small number of clients. All staff get to know the clients and are not dictatorial or obsessive about rules, etc. They allow for an individuals foibles and requirements. The staff are a happy, smiley group”. Park Riding DS0000066741.V338428.R01.S.doc Version 5.2 Page 6 People also commented on how, with the support of the staff, their relatives health and well-being has improved. Compliments were also given in relation to the cleanliness of the home and the choice and standard of food. The manager is clearly working hard to develop the service and introduce new care planning documentation to support the care given to people living at the home. Systems are in place to protect people living at the home. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Park Riding DS0000066741.V338428.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 Park Riding DS0000066741.V338428.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): 3. People who use the service experience Good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are not admitted to the home without the manager and staff being able to confirm that they are able to meet their needs. The home does not provide intermediate care. EVIDENCE: The pre admission assessment for a person recently admitted to the home was seen. This included details of the individual’s personal care, physical, psychological, social and recreational needs and also information about their lifestyle choices and preferences. This information is then used to form the basis of an initial care plan and is sufficient to enable staff to help the person settle into the home. Park Riding DS0000066741.V338428.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, and 10. People who use the service experience Poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. This judgement is particularly affected by issues relating to medication. People’s health and care needs are met in a way that promotes their dignity but support plans need further development. People could be placed at risk by current systems for dealing with medication. EVIDENCE: The manager provided information to the Commission, prior to the visit, that new individual support plans have been developed as part of the care planning process. During the visit four care plan files, including the support plans were examined. Care plan files included risk assessments for areas such as mobilising, moving and handling and going out from the home. Also included are assessments for skin integrity, nutrition and moving and handling needs. Assessments for nutrition and skin integrity for some people were incomplete and inaccurate as the person concerned was unable to stand on the weighing scales. Sit on Park Riding DS0000066741.V338428.R01.S.doc Version 5.2 Page 10 scales must be provided to make sure that assessments are completed properly and definite needs identified. Support plans had been developed for needs such as continence, personal hygiene and oral care. Disappointingly support plans had not been developed relating to the assessments. Examples of this were where people had been assessed as being at high risk in the skin integrity, moving and handling and nutritional assessments, support plans were not available to inform staff what the individuals particular needs were and what actions should be taken to meet these needs and maintain the persons health and safety. It was also of concern that a person who suffered from epilepsy had not had a support plan developed in relation to this. Despite this, it was clear that a lot of work had gone into developing and reviewing the new support plans and the manager said that she would make sure that each care plan file was reviewed and a support plan put in place where the assessment identifies particular needs. Further discussion took place with the manager about the need to develop support plans in relation to people’s social, recreational and religious needs and to put enough detail into the plans to inform staff of individuals preferences about how their needs should be met. Each care plan file included a sheet to record when medical professionals such as GP, district nurse, optician or chiropodist had been to attend to the individual concerned. These sheets indicated that professional healthcare support is sought whenever the need arises. People who live at the home and their relatives who responded to the Commissions surveys confirmed this. One GP who responded to the survey indicated that they were happy with the support given to their patients at the home. One person who lives at the home has very poor mobility and is sometimes unable to weight bear, which results in staff lifting the person, as moving and handling equipment is not available. Professional help must be sought to assess this persons needs and advise on the correct equipment needed. People who live at the home said that care staff are kind and helpful and observations made during the visit indicated that staff are observant of people’s needs in relation to privacy and dignity. Within the information sent to the Commission prior to the visit, the manager said that monthly audits of medication systems are now completed and examples of these audits were seen. Unfortunately when the medications were checked during the visit, a number of anomalies were found in relation to the systems for receipt of medication, stock-balancing administration. Park Riding DS0000066741.V338428.R01.S.doc Version 5.2 Page 11 Several of the balances checked for medications supplied in boxes were inaccurate, sometimes with double the amount of tablets being available, to the amount that should have been, according to the administration records. Other areas of concern were that staff had altered the dosage on some of the boxes of medication but no record could be found of the conversation with the GP to support this change of dosage. In another case the dosage indicated on the box was different to that given on the MAR (Medication Administration Record) but staff had not identified this. Concern was also expressed to the manager that some medications prescribed by the GP to be given on a regular basis were not being given as prescribed and staff had indicated when the medication was to be given by putting crosses in the boxes in the MAR where they did not think the medication should be given. In one case Movicol, which had been prescribed to be given three times each day was only being given once every three days. The manager said that the people concerned did not need the medication as often as the prescription indicated but rather than appropriately asking the GP to review the prescription, staff had made the decision when to give the medication. Further problems were identified with the home’s system for obtaining and administering medications not supplied by the GP. The manager was informed that she must establish a proper system for the administration of homely remedies. In view of the safety implications of the poor management of medication systems, a notice was left with the manager requiring that action be taken within 24 hours of the visit to make the system safe. Park Riding DS0000066741.V338428.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience Good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People have choices in and enjoy their lifestyles in the home. EVIDENCE: All of the people spoken with during the visit were happy with the support they receive from staff to meet their social and recreational needs. During the morning of the visit people were seen to filling their time with activities of their choosing. Some were reading, others listening to music or watching television and in the afternoon some people joined with staff for a game of indoor bowls, whilst others chose to sit out in the garden. The manager said that although the home does not employ an activities organiser, staff engage people in various activities on a daily basis. Record of what activities have taken place was seen in the diary. In addition to in house activities, the manager said that a lady comes in on a monthly basis to engage people in craftwork and people from a local church come to the home. Trips out are organised as often as possible and people are escorted, as they wish, to local shops. Park Riding DS0000066741.V338428.R01.S.doc Version 5.2 Page 13 Very little is recorded in peoples support plans about their social, recreational and spiritual needs. The manager said that as part of the review of the support plans, she would make sure that these needs are included. Every care plan file contained a pen picture of the person concerned, which talks about their childhood, jobs, families and interests. This is very positive as pen pictures help staff to get to know the person and talk to them about their lives. Relatives who responded to surveys said that they felt involved in the care of their relative and were made to feel welcome when they visit the home. All of the people spoken with said they enjoyed the food and could choose from a range of options if they didn’t fancy the main meal. The lunchtime meal of corned beef pie, new potatoes, carrots and peas followed by treacle sponge and custard was nicely presented and nutritious. Throughout the day people were offered a choice of drinks and at teatime people chose from a range of options. The manager said that they have made changes to the menu recently, both in response to people’s tastes and in trying to earn the local authorities’ ”scores on the doors” award for healthy living. Park Riding DS0000066741.V338428.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience Good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are confident that they are listened to and protected by staff at the home. EVIDENCE: The manager said that no complaints have been received by the home since the last inspection. People who responded to the Commission in surveys said that they knew who to speak to if they had any concerns and had confidence that staff would listen to them and act on their concerns. One relative said in a survey “I am asked regularly by the manager if there is anything I think could make things better”. The complaints procedure is included in the Service User Guide. The manager said that she had recently completed a course with the local authority, which enables her to train the staff in safeguarding people. Telephone numbers to report suspicion of abuse are available to staff in the home. Although the manager has already given training to staff, it is recommended that they be reminded about the process of reporting safeguarding issues, as they were a little unsure when asked during the visit. Park Riding DS0000066741.V338428.R01.S.doc Version 5.2 Page 15 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, 22, 23 and 26. People who use the service experience Poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. This judgement is particularly affected by the lack of safe systems for moving and handling and the risk of scalding from very hot water. People who live at the home enjoy a comfortable and clean environment, but some people may be placed at risk due to a lack of necessary equipment and unsafe moving and handling practices. EVIDENCE: All of the people who responded to the Commission in surveys said that the home is kept clean and tidy and this was observed to be the case on the day of the visit. The manager said that a cleaner is employed for six hours each week and that care staff maintain the standards at other times. Communal areas are comfortable and homely. The manager explained that the home has recently obtained a grant from the local council which they intend to spend on fitting a wet room, a bathroom with Park Riding DS0000066741.V338428.R01.S.doc Version 5.2 Page 16 hoist, new blinds for the conservatory and new furniture in communal areas. The manager said that she had discussed plans for refurbishment with people who live at the home and some relatives before the final decisions were made. Discussion took place about priority being given to the bathroom with hoist, as people who have mobility problems are currently unable to take a bath. No handling equipment is currently available in the home and staff were observed having to lift a person with very limited mobility. The lift used by staff was unsafe and could cause discomfort or injury to both the person being lifted and the staff involved. Staff were aware from their moving and handling training that they should not manually lift people but had no option due to the lack of equipment. A requirement made at the last inspection about providing a safe system for moving and handling people has not been complied with. One person who has recently moved into the home had chosen the decoration for their bedroom and the manger said that this choice would be available to all people as the programme of redecoration continues. The registered person should also consider fitting single action door locks to bedroom doors, as the current locks require dexterity and would be difficult for people with arthritis or similar problems. All of the bedrooms in the home have a toilet and washbasin but in many of the rooms the toilet is only separated from the room by a shower curtain. Other rooms have had doors built around the toilet, which gives a muchimproved appearance to the room and affords much better privacy. Hot water temperatures were checked in some areas and were found to far exceed the safe limit of 43 degrees C in the communal bathroom. The water was at least 50 degrees C and could cause scalding. The home was required to take immediate action to Park Riding DS0000066741.V338428.R01.S.doc Version 5.2 Page 17 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 and 30. People who use the service experience Good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are protected and supported by a team of staff who are kind in their approach and have under taken training appropriate to their roles. EVIDENCE: During the visit a selection of staff personnel files and training records were examined. Records show that staff training is ongoing and staff are up to date in subjects such as moving and handling, fire safety, first aid and health and safety. However, staff said that training in fire safety and moving and handling consists only of watching a video and completing a questionnaire. For fire safety the training is backed up by regular fire drills but, for safety reasons, staff should receive practical moving and handling training. Over fifty percent of the care staff have achieved NVQ (National Vocational Qualification) level 2 in care which has given them a better understanding of the needs of the people they are caring for. All new staff undertake induction training and the home has followed the TOPSS induction standards. The manager was not fully aware of the new common induction standards and the skills for care council but said that she will make sure that she gets all the information for any new staff. Park Riding DS0000066741.V338428.R01.S.doc Version 5.2 Page 18 All of the people who responded to the Commissions survey were complimentary of the staff, one person said “Their kindness and patience is evident”. Staff files evidence that people are safeguarded by recruitment processes. References and criminal record bureau checks are sought before any appointment is made. Park Riding DS0000066741.V338428.R01.S.doc Version 5.2 Page 19 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 and 38. People who use the service experience Poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Some management processes are good but people living and working at the home could be at risk due to some issues relating to health and safety. EVIDENCE: Since taking on the role, the home manager has completed the registered managers award and evidence shows that she has worked hard to introduce new systems and raise many of the standards of care within the home. All of the people spoken with and people who responded to the Commissions surveys said that they had respect and fondness for the manager and feel that she does a good job of managing the home. One person said, “Park Riding has proved to be a good, well run home” Park Riding DS0000066741.V338428.R01.S.doc Version 5.2 Page 20 The manager has started a system of quality monitoring. This includes monthly auditing of systems within the home such as house keeping, record keeping and medications and has introduced satisfaction questionnaires for people who live at the home. Following discussion about how this could be developed, the manager said she will also seek the opinions of relatives and professional visitors to the home and produce a report and action plan in response to the surveys. Small amounts people’s money is kept on their behalf in the home. This is so that people can pay for incidentals as they wish. Four balances of money were checked against documentation and found to be correct. It was recommended to the manager that two signatures be obtained for each transaction recorded. A handyman is employed by the home to attend to any small maintenance matters; decoration and checking of systems such as hot water and fire detection. The problems identified with hot water, lack of moving and handling equipment and unsafe medication systems all have the potential to affect the health and safety of people living and working in the home. Park Riding DS0000066741.V338428.R01.S.doc Version 5.2 Page 21 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 2 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 1 2 X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 1 Park Riding DS0000066741.V338428.R01.S.doc Version 5.2 Page 22 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 OP7 Regulation 15 Requirement People must have care plans which details and informs staff what actions they are required to undertake to meet the person’s needs. Previous timescale of 31/10/06 not met. The registered person must provide equipment as required by people who live in the home. In order for staff to undertake accurate assessments, a set of sit on scales is needed. Where required, professional advice must be sought to assess people’s moving and handling needs. The registered person must, to protect people living at the home, make sure that systems for dealing with medication are safe. The home must have suitable arrangements to provide a safe system for moving and handling people. Previous timescale of 31/10/06 Park Riding DS0000066741.V338428.R01.S.doc Version 5.2 Page 23 Timescale for action 30/09/07 2. OP7 23(2)(n) 30/09/07 3. OP8 13(1)(b) 31/08/07 4. OP9 13(2) 24/07/07 5. OP22 OP38 13 (5) 31/08/07 not met. 6. OP25 OP38 13(3) The registered person must ensure that: Running hot water temperatures must be maintained to deliver to 43 degrees centigrade to avoid scalding. 24/07/07 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 OP7 OP18 OP23 Good Practice Recommendations For people to receive more holistic care support plans should include details of people’s social, psychological, spiritual and recreational needs. To make sure that people are protected, staff should be reminded about how to report suspicion of, or actual abuse. • To afford better privacy and to improve the appearance of bedrooms, consideration should be given to fitting doors, rather than shower curtains around toilets in bedrooms. As part of the refurbishment plan, consideration should be given to fitting single action handles/locks to bedroom doors. Staff training, particularly in moving and handling, should include practical training. Two signatures be obtained for each transaction recorded in documentation relating to personal monies. • 4. 5. OP30 OP35 Park Riding DS0000066741.V338428.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND 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 Park Riding DS0000066741.V338428.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. 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