Inspection on 09/08/05 for Peartree House

This inspection was carried out on 9th August 2005.

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

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

Other inspections for this house

Peartree House 31/07/08

Peartree House 02/08/07

Peartree House 23/08/06

Peartree House 07/12/05

Peartree House 02/02/05

Peartree House 23/06/04

Peartree House 17/03/04

Peartree House 17/02/04

Peartree House 11/06/02

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

CARE HOMES FOR OLDER PEOPLE Peartree House 24 Gordon Road Chingford London E4 6BU Lead Inspector Rob Cole Unannounced Inspection 9 August 2005 at 10:00am th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Peartree House Address 24 Gordon Road, Chingford, London, E4 6BU Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8524 7680 020 8529 9773 Tamaris Healthcare (England) Ltd (wholly owned subsidiary of Four Seasons Health Care) Mrs Brenda Roach Care Home 55 Category(ies) of Dementia (0), Dementia - over 65 years of age registration, with number (0), Old age, not falling within any other of places category (0) Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 2nd February 2005 Brief Description of the Service: Peartree House is registered to provide accommodation and personal care to 55 elders of either gender, aged over 65, who may have dementia. Peartree House is not registered to provide nursing care. The registered providers are Tamaris, part of the Four Seasons Health Care Group, an organisation that operates a number of residential care homes and nursing homes across the country. The home is situated in a quiet residential area of Chingford, in the London Borough of Waltham Forest. It is close to a shopping centre, and local bus and rail transport links to London and Essex. The home is divided into five areas, comprising 3 communal areas in the main building, and two separate units known as the House and Flats. There are 45 single bedrooms, 28 of which have ensuite facilities, and 5 double bedrooms. Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 9/8/05 and was unannounced. The inspector had the opportunity of speaking with service users, their relatives, staff and the homes manager was present throughout the inspection. Service users and relatives spoken to expressed generally high levels of satisfaction with the care and support provided. Care is provided in an individual manner, and the environment has improved since the last inspection. However, there are still a number of areas that require attention, as outlined in the report. What the service does well: 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. Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 Page 7 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 standard(s) 1,2,3,4 and 5 The inspector was generally satisfied that service users are provided with sufficient information about the home to enable them to make an informed choice. This information is provided through documentation and visits to the home. However, the home must ensure that service users are provided with accurate and up to date information. EVIDENCE: The home has a Statement of Purpose. The Statement of Purpose is a comprehensive document, which includes all the information required by the National Minimum Standards. There is also a Service Users Guide in place, which includes details of the staff team and management of the home, services provided, fire procedures and a copy of the homes complaints procedure. Both the Guide and the Statement of Purpose have been updated since the previous inspection to reflect the change in registration category, i.e. the home is now registered to provide accommodation to service users with dementia. However, the Guide does not contain all information required, for example it does not include details of qualifications and experience of the staff team, or a description of the accommodation, this must be addressed. Copies of the Guide were seen in some service users bedrooms, and both documents were written Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 Page 8 in plain English. Service users are given a statement of terms and conditions, which includes what fees are payable, by whom, what they cover and what is extra, and periods of notice required. However, not all service users have such a contract/statement of terms and conditions in place, the inspector checked the files of the two most recent admissions to the home, and found they had not been given a contract/statement of terms and conditions, and it is required that all service users are provided with such a contract. A pre admission assessment is done for all service users, usually with the involvement of the homes manager. Assessments include sensory information, personal care needs, oral health, medical usage, social activities and daily living details. From observation of staff, and discussion with service users there was evidence that staff are able to meet the assessed needs of service users. The staff team has many years experience of working with the client group, and appeared able to meet the direct care needs of service users. There was evidence from the Statement of Purpose and the Service Users Guide that service users and their representatives would be invited to visit the home prior to admission. The inspector spoke to service users and their relatives who confirmed that they were able to do this. The home does not provide intermediate care. Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 and 11 Although the inspector was satisfied that the home is meeting the personal care needs of service users, more needs to be done to meet their health needs. For example the home must ensure that medication is correctly recorded and administered, and that service users have access to dental care. EVIDENCE: All service users have a plan of care in place. These have been improved since the last inspection, and now clearly set out how the home can meet individual service users needs. Plans include information on health, mobility, medication and social and leisure needs. The manager informed the inspector that all service users were supposed to have an annual review of their needs with the placing authority. However, as at the last inspection this could not be evidenced for all service users, for example for one service user there was no evidence of such a review having taken place since they moved into the home in 2000. All service users have clear risk assessments in place, these not only identify what risks service users face, but also include strategies to minimise and reduce the risk. Risk assessments have been regularly reviewed. All service users are registered with a GP, the manager informed the inspector that service users were able to keep the GP they had prior to admission Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 Page 10 wherever practical. Clear and comprehensive records are maintained of medical appointments. These evidenced that service users have access to a variety of health professionals, including physiotherapists, CPN’s and opticians. However, the manager informed the inspector that not all service users have regular access to dental care, and records evidenced that this was indeed the case. This must be addressed. The home makes use of the Continence Advisory Service, who supply advice and continence products. Used continence products are disposed of appropriately. The home has a comprehensive medications policy, and all staff receive training before they are able to administer medication. Records are maintained of medications entering the home and those that are returned to the pharmacist. Medication Administration Records (MAR) charts are maintained, and since the last inspection guidelines are in place on the administration of medications prescribed on a PRN basis. However, several unexplained gaps were found on MAR charts, and hand written entries had not all been signed for. This must be addressed. MAR charts did not contain a photograph of the service user, and this is recommended. Service users are supported to manage their own personal care as much as possible, as outlined in their care plans. Staff were observed to interact with service users in a sensitive and respectful manner, and to knock and wait before entering bedrooms. All service users were appropriately dressed on the day of inspection. The manager informed the inspector that service users are able to see visiting health professionals in private. Indeed, on the day of inspection an optician was visiting the home, and they were observed to see service users individually and in private. The home has a policy in place on death and dying, and has made efforts to seek the views of service users or their family were appropriate on arrangements to be made in the event of their death. The manager informed the inspector that service users are able to stay in the home with a terminal illness, as long as the home can meet their medical needs. The inspector viewed a letter from the family of a recently deceased service user praising the home for the sensitive care their relative received in the last few weeks of their life. Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None The standards in this section were not tested during this inspection, but will be tested as part of the next inspection. EVIDENCE: The standards in this section were not tested during this inspection, but will be tested as part of the next inspection. Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 Page 12 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 standard(s) 16,17 and 18 The inspector believes that the home has appropriate systems in place for dealing with complaints. However, service users are been put at risk by poor policies and lack of staff training around the issues of adult protection. EVIDENCE: The home has a complaints log, there was evidence that since the last inspection this is now appropriately maintained. The home also has a complaints procedure, which is prominently displayed within the home. The procedure includes timescales for responding to any complaints made, and has contact details of the CSCI. Service users and relatives spoken to demonstrated a good understanding of whom they could complain to if they so wished. The home has a copy of the Local Authorities adult protection procedures, and also its own policy on adult protection. However, this policy is not in line with current legislation, for example it states that the homes manager will be responsible for carrying out any investigations into allegations of abuse, where as the decision as to who caries out any investigation should be made by the Local Authority. The manager informed the inspector that most of the staff at the home have received training in adult protection issues, but not all. Staff spoken to by the inspector demonstrated a poor understanding of issues around adult protection, and it is required that all staff receive appropriate training in adult protection issues. The inspector was satisfied that the legal rights of service users are protected. For example all service users are on the electoral register, and service users spoken to informed the inspector that they are able to vote in elections. Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 Page 13 Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25 and 26 The inspector was satisfied that the home provides adequate communal and private space for service users. However, despite some recent improvement, the inspector believes that the home is still in need of some decorating work. EVIDENCE: The home is situated in the Chingford area of the London Borough of Waltham Forest, close to shops, transport networks and other local amenities. Since the last inspection a considerable amount of redecoration work has been carried out both internally and externally. Whilst the inspector was pleased to note that the overall appearance of the home has improved, there are still some areas in need of redecorating, and many window frames are in a very poor state, which must be addressed. The home provides a number of communal lounges, and also a specific area for activities. In addition there are a number of places were service users can sit and meet with visitors. The home also provides several smoke free communal areas for service users. At a previous inspection, it was noted that the home provides a poor quality of lighting, this has been addressed, and all areas of the home are now adequately lit. There is Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 Page 15 a courtyard that is attractively maintained with flowers that service users can enjoy, however, at the rear of the building there is a large tarmac area, which at present has nothing in it. The manager informed the inspector that there are plans to develop this area for service users use, and this is recommended. The home has a spacious garden, however, discarded furniture left in the garden must be removed. Further, on the day of inspection a pipe was leaking from the ceiling of the activities room, and this must be repaired. Thirty-two of the fifty bedrooms are ensuite, and the remaining bedrooms all have hand basins. Toilets, bathrooms and shower rooms are situated throughout the home, in sufficient numbers to meet service users needs. Bathrooms were clean, tidy and free from offensive odours on the day of inspection, and all had working locks fitted. However, two toilets were not in working order during the inspection, and these must be repaired. Bedrooms inspected were decorated to service users personal tastes, and service users were able to bring their personal belongings into the home. Rooms had adequate furniture including wardrobes and chest of draws. Hand basins are provided in those rooms which were not ensuite. However, as with the rest of the home, several bedrooms are in need of redecorating, and several items of furniture were coming towards the end of their useful life, and this must be addressed to fully meet this standard. The inspector noted that several bedrooms had a strong offensive odour, and this must be addressed. Bedrooms meet National Minimum Standards on size requirements. All bedrooms have central heating, and all heating appliances in bedrooms have been boxed in since the last inspection. Bedrooms have adequate natural light and ventilation, and lighting was domestic in character. There was no evidence of any assessment of the premises by a suitably qualified person having taken place and no evidence of aids and adaptations been provided, despite this been identified in previous inspection reports. It is a requirement that such an assessment is undertaken and that the registered person provides any necessary aids, adaptations and equipment to meet the needs of service users. The home was generally clean and tidy. The home has a policy on infection control, and staff are provided with protective clothing such as aprons and latex gloves. Hand washing facilities are situated throughout the home, and records are kept of water temperatures. The home has a designated storage cupboard for COSHH products, and this was found to be securely locked on the day of inspection. However, one of the empty bedrooms is currently been used as a storage room to store materials that are been used to decorate the home. On the day of inspection the door of this room was found to be wedged open, and inside were open cans of paint and bottles of white spirits and tools used in decorating. It is required that all dangerous substances and tools are stored safely. The laundry room was well maintained, with appropriate clothes washing facilities for the home, and each service user has their own clothes basket in the laundry room. Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 Page 16 Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30 It is the view of the inspector that the home is staffed in sufficient numbers to meet service users needs. However, the home needs to tighten up its recruitment procedures in regard to checks carried out on staff. EVIDENCE: The home provides 24-hour support, including an emergency on-call procedure. There was a staffing rota on display, which accurately reflected the staffing situation on the day of inspection. Since the last inspection the hours worked in the home by the manager are recorded on the staffing rota. The inspector was satisfied that current staffing levels are adequate to meet service users needs. However, the home has recently had a change to its category of registration, and is now registered to provide care to service users with dementia, and staffing levels may need to be reviewed as service users needs change over time. The home has policies in place on recruitment and selection and equal opportunities. Since the last inspection the homes recruitment practice is now in line wit its policy, in that all recruitment interviews are now conducted by at least two persons. All staff are provided with a copy of their job description. The inspector checked several staff employment files at random. Not all files contained all documentation required by National Minimum Standards and the Care Homes Regulations 2001, for example some files had no proof of ID, no evidence of CRB checks and no full written record of employment history. This needs to be addressed. Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 Page 18 All staff receive a structured induction programme when they commence work at the home. This includes service user issues, the environment and health and safety. There is an on-going training programme, and staff have recently undertaken training in fire safety, moving and handling and infection control. Most of the staff have received training in issues around dementia, and the manager informed the inspector that it was planned that all staff, including domestic staff, would have this training by the end of September 2005. The inspector was informed that at present only 8 of care staff employed in the home have a relevant care qualification, although several staff are currently working towards a qualification. The manager said it was the intention of the organisation that all staff would be given the opportunity of completing a relevant qualification. Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,36,37 and 38 The inspector is satisfied that the homes manager is sufficiently qualified and experienced to manage the home. However, greater detail needs to be paid to the management of health and safety issues. EVIDENCE: The homes manager has thirteen years experience of working with elders, including eleven years in a managerial capacity. They are currently working towards the Registered Managers Award and NVQ Level 4 in Care, and informed the inspector that they hoped to have completed these qualifications by the end of this year. The manager presented as having good working relations with staff, service users and families. Staff were observed to interact with the manager in a relaxed manner, and the management approach has helped to create an open, positive and inclusive atmosphere. Relatives spoken to by the inspector said that they found the manager to be approachable, and that they were always kept informed of any issues relating to their relative. Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 Page 20 The home holds regular service user meetings, staff meetings and staff supervisions, all of which contribute to the quality assurance within the home. Copies of previous inspection reports were available to view in the home, and there was evidence of monthly Regulation 26 visits having taken place. Since the last inspection the home now issues questionnaires to service users to gain their feedback on the running of the home. However, these questionnaires are sent directly to the organisations offices, and the manager of the home does not have an opportunity of seeing them. It is required that the manager has access to feedback from service users, to help inform future planning within the home. Records were stored securely in lockable filing cabinets in the office, and were generally well maintained and well organised. The inspector was informed that staff and service users can access records as appropriate. All staff receive formal supervision from the homes manager. Records are maintained of supervision, and staff receive a copy. Supervision covers performance, service user issues and training needs. All staff also receive an annual appraisal. Staff receive training in various health and safety subjects, for instance fire safety and moving and handling, and the home has relevant health and safety policies in place such a food hygiene and fist aid. Fire fighting equipment was situated throughout the home, and last serviced in June 2005. Fire exits were clearly signed and free from obstruction on the day of inspection. The Local Fire Authority visited the home in July 2005 and set requirements, and it is required that the home complies with any requirements set by the Fire Authority within the timescales given. The home carries out various routine health and safety checks, for example recording fridge and freezer temperatures, and weekly testing of fire alarms. However, the home could not evidence that it carries out checks of hot water temperatures used for personal care, and this must be addressed. Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 2 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 2 2 2 2 3 2 3 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 2 3 3 2 x x 3 3 2 Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 Page 22 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP22 Regulation 12 Requirement The registered person must arrange for an assessment of current provision by a qualified occupational therapist and ensure that appropriate adaptations and equipment are provided. (Timescale 31/5/05 not met) The registered person must provide a programme of decoration and maintenance which ensures that the premises are kept in a good state of repair both internally and externally, and that all parts of the home are kept clean and reasonably decorated and furnished. (Timescale 31/5/05 not met) The registered person must ensure that the homes adult protection policy is amended to be in line with local authority procedures. (Timescale 31/5/05 not met) The registered person must ensure that all bedrooms are decorated to an adequate standard, and that furniture in bedrooms is well maintained. (Timescale 31/5/05 not met) The registered person must G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Timescale for action 30/11/05 2. OP19 23 30/11/05 3. OP18 13 30/11/05 4. OP24 23 30/11/05 5. OP24 23 30/11/05 Page 23 Peartree House Version 1.40 6. OP29 19 7. OP1 5 8. OP1 5 9. OP7 15 10. OP8 13 11. OP9 13 12. OP9 13 13. OP18 13 14. OP19 23 15. OP20 23 ensure that all bedrooms are free from offensive odours. (Timescale 31/5/05 not met) The registered person must ensure that the home has a written record of staff’s employment history. (Timescale 31/5/05 not met) The registered person must ensure that the homes Service User Guide is in line with National Minimum Standard 1. The registered person must ensure that all service sers are provided with a statement of terms and conditions in line with National Minimum Standard 2. The registered person must ensure that all service users have an annual review of their care in conjunction with their placing authority. The registered person must ensure that service users have access to health care as appropriate, including dental care. The registered person must ensure that all hand written entries on MAR charts are signed. The registered person must ensure that all medications administered are appropriatly accounted for. The registered person must ensure that all staff employed at the home receive appropriate training in adult protection issues. The registered person must ensure that the leaking pipe in the homes activity room is repaired. The registered person must ensure that the discarded furniture left in the homes garden is removed. G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc 30/11/05 30/11/05 30/11/05 30/11/05 30/11/05 30/11/05 30/11/05 30/11/05 30/11/05 30/11/05 Peartree House Version 1.40 Page 24 16. 17. 18. OP21 OP26 OP29 23 13 and 23 19 19. OP33 24 20. OP38 13 and 23 21. OP38 13 The registered person must ensure that the two broken toilets in the home are repaired. The registered person must ensure that all COSHH products are stored securely. The registered person must ensure that all necessary pre employment checks are carried out on staff, including proof of ID and CRB checks, before they commence working in the home. The registered person must ensure that the homes manager has access to feedback gained by the organisation on service users views on the home, in order to inform future planning. The registered person must ensue that the home complies with any requirements set by the Local Fire Authority within the timescales provided. The registered person must ensure that the home checks and records the temperature of all hot water outlets used for personal care at least once a week, to ensure they are maintained at 43 degrees centigrade. 30/11/05 30/11/05 30/11/05 30/11/05 30/11/05 30/11/05 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. Refer to Standard OP20 Good Practice Recommendations It is recommended that consideration is given to the development of the rear tarmac courtyard to provide accessible outdoor space for service users, including service users with physical, sensory or cognitive impairments. It s recommended that the home attaches a recent photograph of service users to their MAR charts. G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 Page 25 2. OP9 Peartree House Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection Gredley House 1-11 Broadway London E15 4BQ 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 Peartree House G56 G06 S7235 Peartree House V243860 090805 Stage 4.doc Version 1.40 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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