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Inspection on 04/07/05 for Potton House Nursing Home

Also see our care home review for Potton House Nursing Home for more information

This inspection was carried out on 4th July 2005.

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

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

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

The home has a very good manager who makes sure there are enough staff on duty when residents need the most help. The manager also makes sure she sees every resident each day and works alongside the staff for a part of the day to make sure that everyone is being helped in the right way. The staff talk to residents in a kind and respectful way and make sure that they keep their dignity and privacy. The catering staff make sure that there are nutritious meals available and that people who need soft diets have plenty to eat throughout the day and evening. The home is kept clean and hygienic and staff know that it is important to control infection. The plans which are written for each resident set out clearly how each person is to be looked after so that all staff know what each person needs and how they like to be cared for. Residents` healthcare needs are also looked after and other professionals like GPs, chiropodists and dieticians are called in when they are needed.

What has improved since the last inspection?

The plans which set out what care each resident needs have improved since the last inspection and, when certain things need to be monitored, for example if someone is losing weight, this is now done and the results written down. The staff are now giving care in a way which respects the dignity of residents, whereas this was a problem sometimes before. The manager has also looked at the number of staff on duty when residents need help most and found ways to make sure there are enough available. Several people who visit the home had mentioned that it was difficult to communicate with some of the staff, but this seems to have got better recently. Since the last inspection, the catering staff have been on a course so they know how to provide meals for people who need their food liquidised. The home has also now put restrictors on all the windows where they are needed so that no-one can get out or in through the windows. The fence around the home has been replaced so that the home and grounds are more secure and a new washing machine has been bought so the washing is done at the proper temperatures.

What the care home could do better:

The home needs to have adjustable beds for all the residents who need them so that staff can get them in and out safely. The home also needs to look at the furniture in the lounges and dining rooms to make sure it is homely and attractive. The staff have had quite a lot of training but it is important that they all are trained to meet the needs of the residents who have dementia or mental health problems. There is also a need for a member of staff to be responsible for organising activities for the residents. Some more attention needs to be paid to the way in which staff are recruited to the home, particularly in making sure where people have worked before and where their references come from. The staff who work at night need to be very sure what they must do if there is a fire at night and the Fire Safety Officer must have a look at the garden gates to make sure they would be safe if there was a fire. The radiators in the home should be covered to stop residents hurting themselves on them.

CARE HOMES FOR OLDER PEOPLE Potton House Nursing Home Potton Road Biggleswade Beds SG18 0EL Lead Inspector Linda Cappello Announced 04 July 2005 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. Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Potton House Address Potton Road Biggleswade Beds SG18 0EL 01767 314782 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) Health & Care services (NW)Ltd Care Home with Nursing 24 Category(ies) of DE(E) - Dementia over 65 registration, with number MD(E) - Mental Disorder over 65 of places Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th February 2005 Brief Description of the Service: Potton House provides places for up to twenty four older adults with mental health care needs. All the places at Potton House are contracted to the local health authority with admission via referral to a placement panel. Potton House is a purpose built care home with nursing situated in the grounds of Biggleswade Hospital on the outskirts of Biggleswade in mid Bedfordshire. Biggleswade has good road access and there is a limited bus service with the nearest train station in Sandy. The home is single story with accommodation separated into three wings with their own living areas as well as some communal space. The home has a large garden and there is a large parking area at the front. Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection at the home, however, the inspector arrived at 05.30 hours which was 4 hours earlier than expected. The inspector was, therefore, able to meet with the night staff, as well as day staff, and observe residents getting up in the morning and having breakfast. The manager was present from 07.00hrs and the inspection finished at midday. The care plans for 5 residents were assessed and several bedrooms and all the communal areas were visited. The inspector is grateful for the help of staff, residents and the manager. What the service does well: What has improved since the last inspection? The plans which set out what care each resident needs have improved since the last inspection and, when certain things need to be monitored, for example if someone is losing weight, this is now done and the results written down. The staff are now giving care in a way which respects the dignity of residents, whereas this was a problem sometimes before. The manager has also looked Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 Page 6 at the number of staff on duty when residents need help most and found ways to make sure there are enough available. Several people who visit the home had mentioned that it was difficult to communicate with some of the staff, but this seems to have got better recently. Since the last inspection, the catering staff have been on a course so they know how to provide meals for people who need their food liquidised. The home has also now put restrictors on all the windows where they are needed so that no-one can get out or in through the windows. The fence around the home has been replaced so that the home and grounds are more secure and a new washing machine has been bought so the washing is done at the proper temperatures. 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. Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,4 The home carries out assessments before residents are admitted but needs to make sure that it has all the necessary equipment and that staff have all the necessary training so that residents’ needs are fully met and in a safe manner. EVIDENCE: A resident had been admitted to the the home on a respite basis in the previous two months but, because of circumstances, had then been admitted as a permanent resident. Whilst the home had assessed her needs prior to admission, it was apparent that there were some difficulties in caring for her. The manager and staff were trying hard to look after her well but a major difficulty was the lack of an adjustable bed in her bedroom. Following the last inspection when the lack of adjustable beds was raised as an issue, the manager had asked the owners of the home to purchase some beds but these had still not been ordered. Staff were having considerable difficulty in helping the new resident to get out of bed and it was needing 4 carers to do this. This was putting the staffs’ health and the care of residents at risk and an Immediate requirement was, therefore, issued which stated that the home must provide adjustable beds to every resident who needed them. The home Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 Page 9 must be able to meet the needs of every resident who is admitted and part of the assessment process must include whether the home has all the necessary equipment to provide for their care safely. The home must be aware that it cannot admit residents who fall outside of their registration category. One resident was found to be under 65 years of age and the home must apply immediately to the Commission for Social Care Inspection for a variation to the registration conditions for this person. This home provides specialist care to people who have dementia or mental health problems but many of the staff have not received any training in working with people who have these problems. While the staff are, overall, meeting the needs of residents in a positive and caring manner, the home must take steps to ensure that this specialist training is provided to all the staff. The manager is not qualified in mental health nursing but has undertaken research into current ideas for caring for residents with dementia and this is discussed later in the report. Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10 Care plans were comprehensive, detailed and regularly reviewed which ensured that staff were clear about how to meet residents’ needs. The healthcare needs of residents were being met which ensured their physical and emotional well-being and staff were treating residents in a manner which respected their privacy and dignity. EVIDENCE: The care plans for five of the 24 residents were examined and found to be comprehensive and regularly reviewed. All the necessary assessments had been undertaken when people were first admitted such as nutrition, pressure sore, risk of falling. Where risk assessments were needed, these had been completed and these, as well as the care plans were reviewed monthly. Some care plans were also seen which addressed the psychological and emotional well-being of residents. Several residents had been assessed as needing to have their fluid and nutrition intake monitored and this monitoring was taking place. Records were also being kept in circumstances where residents were at risk from, or suffering from, pressure sores, and it could be clearly seen how often people needed to be turned and that this was being done. Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 Page 11 There were good records kept of visits by health professionals to residents and it could be seen that they had been visited by GPs, podiatrists and dieticians, for example. It could be seen that where concerns about health issues had been identified, such as weight loss, appropriate action had been taken, for example by referral to the dietician, giving food supplements, regular weighing and being very clear about what foods the resident particularly likes. Staff were observed to be taking care to respect people’s dignity by knocking on doors before entering, giving personal care in privacy and by talking to them in a sensitive and caring manner at all times. Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,14,15 Residents are helped to exercise control and choice in aspects of their lives where this is possible and have a wholesome nutritious diet. However, more staff hours need to be allocated to give more time for activities to be coordinated and run. EVIDENCE: Residents were observed getting up in the mornings at the time that suited them and were able to eat their breakfast at the time and in the way that suited them best. The manager and a qualified nurse were in the dining room greeting residents and they clearly knew the preferences of each resident. For example, one gentleman prefers to eat while he walks around the dining room so he was given small sandwiches which he could easily manage and by enabling him to eat in his preferred way, the staff were able to ensure that he maintained an adequate nutrition intake. The care plans included life histories for most residents, usually taken from relatives who know the person well and included their known likes and dislikes. These should now be developed to indicate the activities which residents may be interested in and, therefore, be a focus for staff when spending one to one time with them. Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 Page 13 The home did not have an activities co-ordinator but has recently managed to provide one member of staff with an hour a day to undertake some activities with residents. This is clearly not enough and the owners need to ensure that that more staff hours can be allocated to this important task. The manager has a keen interest in developing suitable activities and had bought books on the subject which she is discussing with staff. She has bought some sensory aids, such as cushions and has been able to set up the visitors room as a quiet, calm space with snoezelen equipment and other suitable activity equipment. Occupational Therapists do visit the home twice a week and the work they do needs to be co-ordinated within the care plans and with the other activities. The occupational therapists are going to do some training with the care staff to show them some suitable activities. Newspapers are brought into the home each day and staff, including the maintenance person were seen discussing items with residents over breakfast. The residents in this home are not able to manage their own financial affairs or their own medication but the home enables them to retain control over area that are achievable, like what they wear, where they sit etc. There are details of a local advocacy service and the Alzheimers Society displayed on the noticeboard which relatives and friends can see. The breakfast which was served on the morning of the inspection was wholesome and nutritious. There was hot porridge which was of a good consistency and many residents opted to have a banana with it, either sliced or whole, according to their own preference. Also some residents had sandwiches with jam or marmalade after their porridge. There were sufficient staff to assist all of the residents in an unhurried and sensitive manner. There is a varied menu for the mid-day meal with some choice and the cook has attended a course on nutrition for older people so liquefied diets are properly catered for. Attention has also been paid to providing a more substantial tea in the afternoon with provision for supper before bed. Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards will be inspected on the next occasion. EVIDENCE: Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,22, 24,26 The home was found to be clean and hygienic and the manager was working towards making the environment more suited to residents’ needs. However, residents who need adjustable beds must be provided with them so they, and staff are safe. EVIDENCE: The home was being well-maintained, with a member of staff responsible for maintenance who was able to attend to jobs promptly. However, the home was required, after the last inspection to review the safety of the radiators and provide covers where necessary and the covers have not yet been provided. The grounds are level and attractive with a high perimeter fence but the home must consult with the local Fire Safety Officer about the padlocks on the perimeter gates to ensure that they do not compromise safety in the event of a fire. As has been discussed above, the manager has effected some very positive changes in the visitor/quiet room. The furniture in the communal dining/lounge areas could be more homely and a programme of renewal of Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 Page 16 chairs and tables is needed. The manager is keen to improve the environment and make it more suitable to residents’ needs. For example, one resident commented on the noise the dining room chairs make when they are moved and suggested that the feet are protected in some way. The manager was interested in this idea and will look into ways of achieving this. Although residents’ bedrooms were clean, personalised and adequately furnished there is a substantial shortfall to meeting the standard because, as has been discussed above, the home cannot currently supply adjustable beds to all the residents who need them. This is a matter which the owners must address as a matter of urgency as it compromises the health and safety of both staff and residents. The home also needs scales which can weigh both mobile and immobile residents as the current scales are not suitable for everyone and monitoring weight can be a vital indicator of health. The home was clean and hygienic and staff were observing good routines to control infection. Staff responsible for the laundry in the home were fully aware of the procedures necessary to deal with soiled laundry. Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 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, 28,29,30, The home is organised so that there are sufficient staff on duty at peak times so that residents’ needs can be met. However, all staff must receive specialist training so that the needs of residents are fully understood. EVIDENCE: The night shift were on duty when the inspection commenced and this consisted of one qualified nurse and three care staff. The rota showed that, on occasions when extra care needs are identified, there have been 4 care staff on duty in recent weeks. The staff were able to regularly check on the welfare of residents in the night and to do specific tasks such as turning residents or attend to personal care needs as needed. The manager came into the home at 7am as well as 2 qualified nurses and a handover took place during which each resident was discussed. During the day there is a need for 2 qualified staff and five carers and, where necessary through staff sickness etc, agency staff are brought in. The manager organises the rota to ensure that there are enough staff available at peak periods of activity, for example, there would be 8 staff on at lunchtime. This makes sure that all the residents can be fed in an unhurried way in a reasonable timescale. The home also employs domestic, laundry and catering staff so that care staff can concentrate on meeting residents’ personal care needs. The communication skills of some staff had been raised as an issue both in previous inspections and by visiting professionals. However, it was notable during this inspection that this has improved with many staff having benefited from attending English lessons. Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 Page 18 The home currently has 30 of its care staff qualified to NVQ2 and is trying to arrange for more staff to commence the process. The manager is also exploring NVQ2 for the catering staff. Three staff files were examined and were found to be generally satisfactory, however, more attention must be paid to ensuring that the employment history given is consistent and that any anomalies or gaps are explained fully. Also the actual source of references must be verified to ensure that the references come from people who are in a position to comment and, in particular, that the reference comes from the last social care employer. Many staff have been on training courses in the last 12 months which includes Fire Training, Infection Control, Food Hygiene, Emergency First Aid, Elder Abuse, Managing Challenging Behaviour and Dementia Care. However, given the specialist nature of this home, it is imperative that all staff receive training promptly in dementia care, challenging behaviour and mental health. Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 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) 31,32,38 The manager provides clear leadership so that the care given to residents is good overall. Some health and safety issues arose which could potentially place residents and/or staff at risk. EVIDENCE: The manager of this home is a qualified general nurse who had previous experience of managing in hospital settings. She has recently successfully completed the process to become the registered manager of this home. She is not qualified in mental health herself but had a deputy who was. He has recently left for a promotion and a new deputy, who is qualified in mental health, is currently being recruited. The manager does, however, have a keen interest in developing and improving the service and has sought out support, guidance and literature to assist her. The home was well-organised and staff spoke of the improvements made and appeared clear about their role and duties. The manager makes sure that she is involved in the day to day Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 Page 20 running of the home and is familiar with the needs of residents, by for example, being involved in serving breakfast and giving out medication in the morning. This also serves as a role model for staff and is an effective method of monitoring what staff are doing and whether residents’ needs are changing and are being met. Health and safety practice in the home was satisfactory overall, however, in order to prevent residents from wandering out of the grounds without supervision, padlocks have been put on the perimeter gates. Although the grounds are extensive, the home must consult with the Fire Safety Officer to ensure that this does not compromise safety in the event of fire. The home must also make sure that the night staff are familiar with the action they must take if a fire occurs at night. After the last inspection, the home was required to put covers over radiators where risk assessments showed the need for them and the covers have not been installed. Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 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 x x 2 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 2 2 x 1 x 1 x 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 x x x x x 2 Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 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 3,4,22 Regulation 16(2)c 23(2)n Requirement An adjustable bed must be provided to the resident identified and to all other residents where the risk assessment identifies this need. All staff must receive training in dementia care, managing challenging behaviour and mental disorder. Meaningful activities of the service users’ choice or arising out of consultation with relatives, and based on current best practice must be provided for service users throughout the day. Original timescale of 31st March 2005 not met Radiators in the home must be covered to ensure service user safety Original date of 31st March 2005 not met.. Weighing scales which are suitable to the needs of all residents must be provided The employment history of new employees and the references provided must be verified and any anomalies investigated. The fire officer must be Timescale for action 5th July 2005 2. 4,30 18((1)a,c 30th September 2005 New date: 30th September 2005 3. 12 16(2)m,n, 4. 19 13(4) New date: 31st August 2005 30th September 2005 31st July 2005 31st August Page 23 5. 6. 22 29 16(2)c 23(2)n 19 Schedule 2 23(4) 7. 38 Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 8. 38 23(4) consulted about the padlocks on the perimeter gate. The night staff must be confident in their duties in the event of fire. 2005 31st August 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 20 Good Practice Recommendations The furnishings in the communal areas should be reviewed and replaced where necessary to make the areas more homely. Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Clifton House 4a Goldington Road Bedford MK40 3NF 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 Potton House Nursing Home I51 s17688 POTTON HOUSE v226033 040705 stage 4.doc Version 1.30 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. 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