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Inspection on 11/07/05 for Rectory House Nursing Home

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

This inspection was carried out on 11th July 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.

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 an experienced team of staff who enjoy their work and have a good understanding of the needs of the people living at the home. Residents spoke highly of the support received by staff and positive relationships were observed. Feedback from residents about the staff, the care they get at Rectory House was very positive, comments from residents included "the staff are very kind" "the staff are excellent" "they`re always willing to help you" "I am very happy, I think it`s a lovely place. They look after me very well". The environment is relaxed and friendly and residents have use of a range of communal areas in addition to their individual rooms. There are a range of activities which residents said they enjoy. One resident commented that she felt quite young again when she had attended a turkey and tinsel afternoon tea. Residents are supported with their personal routines and this support was seen to be offered and carried out with dignity and respect.

What has improved since the last inspection?

A full and robust assessments of residents needs is now carried out before residents come to live in the home and used to ensure that the Rectory House is going to be a suitable place for them to live. Since the last inspection, the home has reviewed its system of care planning and risk assessments, which is completed and identifies residents` needs and the individual support required to meet them. The temporary Care Manager for the home has now introduced a system to provide one to one formal support for staff and induction training has commenced for new staff. All staff and other records were found to be neat and easily assessable. There are now regular resident, relative and staff meeting to ensure the management are aware of all current issues that effect the quality of life for the residents at Rectory House.

What the care home could do better:

Some maintenance issues were identified throughout the inspection process and these should be addressed as not only do they impact on the appeal of the home, but some are also matters of health and safety. In the older part of the building some of the radiators still do not have covers on them, which means people, could get burnt if they fell against them in the winter. Some of the hot water taps do not have regulators to control the hot water. This could cause scalding if a person left their hand under a running tap for too long. There are however notices up to warn residents. The temporary manager informed the inspectors that all the radiators would be covered by the end of August. Caring Homes Ltd still needs to appoint a registered manager.

CARE HOMES FOR OLDER PEOPLE Rectory House Nursing Home West Street Sompting West Sussex BN15 0DA Lead Inspector Judith Farrell Announced 11 July 2005, 09.30am, V229213 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. Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Rectory House Nursing Home Address West Street, Sompting, West Sussex, BN15 0DA 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) 01206 828290 Caring Homes Ltd Post Vacant Care home with nursing (N) 48 Category(ies) of Old age, not falling within any other category registration, with number (OP) - 48 places of places Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st February 2005 Brief Description of the Service: Rectory House is a Care Home which is registered to provide nursing care for up to forty eight service users. The home is a detached property arranged on three floors and is situated within Sompting village. The accommodation includes two lounges/dining room areas, private acomadion consists of thirty eight single and five doable bedrooms. There is a lift to all floors and a pleasant garden area. Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over a day on the 11th July 2005. Three inspectors were involved in the inspection. Mrs Farrell who was the lead Inspector, Mrs Peel who was the second Inspector. Mrs Datoo was the third inspector. Mrs Datoo is a specialised inspector in pharmacy and only looked at the regulations and the standard regarding medication. She spent four hrs at the home. Both other inspectors spent seven and half hours touring the home, talking to residents and staff. A further two hours were spent talking to the temporary manager, and examining records. Prior to the inspection fifteen service user and relative comment cards were received. Feedback from those comment cards has been used in this report. The inspectors spoke with thirteen residents in depth who were in their own rooms and communal areas about their experiences of living at Rectory House. Residents spoke highly of the establishment, but did have negative comments regarding what they perceive to be low staffing levels. Ten members of staff and two relatives were spoken with during the day. The residents have different levels of communication abilities and therefore it was difficult to ascertain all their views on how their needs are met. What the service does well: The home has an experienced team of staff who enjoy their work and have a good understanding of the needs of the people living at the home. Residents spoke highly of the support received by staff and positive relationships were observed. Feedback from residents about the staff, the care they get at Rectory House was very positive, comments from residents included “the staff are very kind” “the staff are excellent” “they’re always willing to help you” “I am very happy, I think it’s a lovely place. They look after me very well”. The environment is relaxed and friendly and residents have use of a range of communal areas in addition to their individual rooms. There are a range of activities which residents said they enjoy. One resident commented that she felt quite young again when she had attended a turkey and tinsel afternoon tea. Residents are supported with their personal routines and this support was seen to be offered and carried out with dignity and respect. Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 Stage 4.doc Version 1.30 Page 6 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. Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 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 Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 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) 1, 3, 4, 5, 6 There are systems in place to ensure residents and their representatives’ make an informed choice about the home. No resident moves into the home without having had a thorough assessment of their needs discussed with them. EVIDENCE: Thirteen residents and two relatives spoken with in private and in communal rooms were able to provide information and stated that they had been given a copy of the homes Service Users Guide. They said they had visited the home prior to being admitted on a trial short stay. A review of their care needs was discussed with them during the first two days of their stay. One resident who had only been resident for a short while said she thought her health had considerably improved since entering the home. Residents said they found it particularly helpful to have met with the temporary manager prior to entering the home. The Statement of Purpose states the qualification details of the staff. Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 Stage 4.doc Version 1.30 Page 9 There was evidence to demonstrate that residents are offered a trial period at the home, before a placement becomes permanent. This should be followed up by the home informing residents in writing that they are able to meet their needs at the end of the trial period. This home does not provide intermediate care. Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 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, 9, 10 Staff practice reflects a good understanding of residents’ healthcare needs. The documentation in place does fully reflect the high level of care provided. Since the previous inspection improvements had been made to medicine storage and recording. EVIDENCE: The care needs of residents are set out in their individual files. The inspector examined five files at random including two new residents. This sample of care plans showed a significant improvement has been made in this area. Residents said they were aware that information is recorded about them and that staff members refer to it in order to meet their varying needs. Individual files contained all relevant information, including risk assessments for moving and handling and special dietary needs. From discussion with the residents they gave a clear and concise pen picture of the person. Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 Stage 4.doc Version 1.30 Page 11 The review notes for one resident included positive feedback from the relevant Social Worker, which highlighted the progress that had been made in respect of her client’s care plan. It was possible to audit how advice from a range of healthcare professionals had been incorporated into care notes. The inspector observed staff members entering resident’s bedrooms. They knocked the door and waited for permission to enter. Staff members said that there was strict guidance about respecting resident’s privacy. However it was noted that bathroom and bedroom doors have no locks on them. This could lead to resident’s dignity and privacy not being respected. The nurse in charge advised that there is now a very good working relationship with the residents GPs, the district nurse service and specialist nurses. The resident’s can choose which GP they wish to register with, in the locality. Residents spoken with discussed how they are assisted to attend all hospital outpatients, dentist, eye, and hearing appointments. Though not all staff interviewed had attended training on how to look after people who are dying, they did however show considerable compassion and understanding of the dying process. Staff had access to new policies and procedures and were getting used to the new recording for ordering and receiving medicines. Medicine administration records were clear. There was a written assessment for a resident who retains responsibility for some medicines and a locked drawer was available. Improved storage facilities were tidy with good stock rotation. Daily temperatures of the medicine refrigerator are recorded. Full use of the minimum maximum thermometer was discussed. Two services users said that night-time medicines had been given after eleven o’clock one evening in the last week. Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 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, 13, 15 Residents said that their social needs were met as far as possible taking into account their increased physical frailty. The home has made progress in providing a balanced and varied diet and some residents are able to exercise choice and control over their diet. EVIDENCE: Rectory House promotes an open door policy during the day. Residents spoke of visitors they had received and the home maintains a record of the contact each resident has with his or her relatives and friends. Conversations with residents highlighted that community presence and participation in social activities was varied across the home. Some residents are able to go out independently and do so frequently. For others, staff support is required and the frequency of their outings is dependent upon staff availability. Residents spoken with said that they were encouraged to maintain their chosen hobbies in and out of the home. Notices of forthcoming residents meetings are displayed and items for the agenda are requested. A resident told the inspectors that she often attended these meetings. Individual care plans clearly state the social and recreational preferences of the resident. Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 Stage 4.doc Version 1.30 Page 13 An activities organiser has been employed to broaden the scope of activities for residents. Residents stated that they were looking forward to the forthcoming garden party. Residents told inspectors that they are able to handle their own finances if they wish. They are also able to bring in personal possessions with them to the home if these can be accommodated. Residents have access to personal records if requested, but the nurse in charge told the Inspectors that the current group of people living at the home have not requested to do so. Currently all the residents, have family or friends to assist them, but if advocacy assistance was required this would be sought from an external agency. Two of the Inspectors ate a lunch time meal with the service users. Each resident is offered three full meals each day, all of which may be cooked according to what they choose. The cook compiles 4-weekly rotating menus, which are changed according to season, and which take into account any suggestions made by the residents. Hot and cold drinks and snacks are provided throughout the day and in the evening. Staff take a list of the main meals round to residents the day before so that they can choose from the alternatives offered for the next day. The resident’s comments about meals were mixed. The temporary manager has just undertaken an audit of the food provided and will analyse and action the comments and suggestions. Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 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) 16, 18 Complaints are not being forwarded to the management from care staff. Therefore residents and relatives are not confident that their concerns are being listened to, or taken seriously. There has been progress on training staff on the correct way to respond to any suspicion or allegation of abuse and this will safeguard the residents. EVIDENCE: The home has a clear complaints policy. Residents and relatives are provided with information on how to contact external agencies should they wish to complain. Residents and relatives spoken with advised that they had made complaints and raised concerns about a variety of issues, including poor response time to call bells, some staff unable to work in a flexible manner, poor interpersonal skills between staff and residents and low staffing levels. The inspector was unable to confirm that these issues had been investigated, as the temporary manager had not been informed of these concerns or complaints by caring staff. The Inspectors were pleased to note that training has now been provided to most staff on the important area of how to identify possible abuse and what to do about it. The staff interviewed were knowledgeable about the vulnerability of residents and the systems in place to protect them. Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 Stage 4.doc Version 1.30 Page 15 Staff spoken with were less confident in describing the importance of the POVA (Protection of Vulnerable Adults) register introduced in July 2004. Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 22, 24, 26 The environment is subject to ongoing improvement, which is needed to maintain and raise the standard of accommodation. Bedrooms are furnished with some items of resident’s own belongings and meet their needs. The home is clean and hygienic. EVIDENCE: Since the last inspection the home has continued with the redecoration and refurbishment programme. There were numerous pleasant floral displays at the front of the building. Residents and visitors were using the garden area on the day of the inspection. Outdoor space was easily accessible to residents and a number of residents talked about enjoying being taken outside when the weather is fine. Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 Stage 4.doc Version 1.30 Page 17 The home was clean and tidy and a new resident commented on how often her room was being cleaned. She was please with her room, which has views of the Sussex Downs. Staff interviewed were clear on the guidelines for the control of infection. Though it was noted that two member of staff were not following these practice guidelines. A number of areas require attention. A staff call system is provided in every bedroom and in the lounge area. One Inspector monitored the time it took to answer two call bells; one was fifteen minutes and the other ten minutes. A resident commented that it was not uncommon to wait for anything up to thirty-five minutes for staff to answer a call bell. A temporary manager commented that unless one is viewing the control monitors for the alarm call system it is not possible to establish the length of response time as calls are overlaid and the sounder remains “in action” until the last call is answered. During a tour of the building, the Inspectors noted some maintenance issues, which require attention. For example, one bathroom has a bath and a toilet but no hand basin; another bathroom on the same floor requires new sealant around the bath. One window requires a restrictor. A carpet is in need of pulling to iron out creases, which is presenting as a trip hazard. Some of the radiators are not covered and not all of the hot water is being regulated. This places vulnerable people at risk. There are however notices up to warn residents. It was noted that some fire doors are still being wedged open and that some fire doors do not close effectively. An immediate requirement notice was issued at the time of inspection, which was followed up with a letter of serious concern. The Inspectors will be undertaking an additional monitoring inspection to ensure these matters have been rectified. Six resident at this home have the benefit of adjustable beds even though most residents are receiving nursing care. Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 deployment, time management and number of staff may not be sufficient to meet the needs of the residents. The procedures for the recruitment of staff are robust and ensure staff are trained and competent to do their jobs. Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 Stage 4.doc Version 1.30 Page 19 EVIDENCE: At present there are thirty-three residents at the home. It is clear that the home is using the recognised tool for calculating staff level recommended by the Department of Health. These hours relate to personal care and do not include hours that are also needed to provide assistance with social, recreational and cultural activities or time spent by staff on administration, paperwork, training or meetings. The home is employing staff to the ratio of resident’s dependency and their perceived care needs. This was evidenced through the duty rotas and discussion with the temporary manager. All day staff interviewed stated that at times there are insufficient staff to care for the needs of the residents. One member of staff described a day when a full complement of staff was present; they could undertake all the tasks needed without rushing the residents. Other staff talked about the problems of using agency staff and how the resident’s care was affected, as they did not know what to do. All residents and the relatives spoken to confirm that the staffing shortages and the use of agency staff are having a direct impact on the quality of care received by the residents. Several residents talked about the problems of having to wait for a call bell to be answered and the response they get from care staff when they do come. The response is often that staff state they are busy and they will come later, but they do not return for a long time, or they are short of staff and residents will have to wait. All residents and relatives spoken with said that staff at the home were kind, caring and committed but were always too busy and could spend little time with them. There has been significant improvement to the staff files and they now hold enough information to prove to the Inspectors that all the checks that are undertaken before a person starts working at the home. Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 Stage 4.doc Version 1.30 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 33, 36, 38 Residents 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 her responsibilities fully. EVIDENCE: The temporary manager is very experienced having worked in nursing and residential homes for many years. Relatives said the home is run efficiently for the last six months and they said this they thought was down to strong leadership. Staff made positive comments about the management and gave good examples of best practice. Staff confirmed that regular meeting, handovers and one-to ones were held where the manager informed them of any changes in legislation. Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 Stage 4.doc Version 1.30 Page 21 Eight staff files randomly selected gave indications of induction, supervision, training and development staff had received. One trained nurse interviewed talked about induction as being three full days with another trained nurse and then more supernumerary days to become confident and competent. Most staff interviewed reported to the Inspectors that they had had supervision and their entire mandatory training. The files indicated that supervision had been started but there was insufficient evidence to show that it was occurring six times a year. The temporary manager of the home discussed a recent audit of resident’s opinions and this highlighted some of the resident’s wishes within the home. No action has been taken regarding this issue as yet. It was clear from speaking to staff on the day of inspection that they were aware of the health and safety issues however some poor practices were observed. Staff stated this was due to shortage of staff. Throughout the inspection, a number of issues in relation to health and safety were identified. These included a window restrictor, which needed replacing, doors which needed to be locked. Fire doors being wedge open and hot water taps not regulated. Policies and procedures are in place to ensure the smooth running of the home. The staff on duty demonstrated that they were aware of their responsibilities under Health & Safety. A maintenance person is employed to undertake a variety of checks and audits and to keep the home in a good state of repair. The registered manager post is still vacant. Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 3 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 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x 3 x 2 2 3 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 x x 3 x x 2 x 1 Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 Stage 4.doc Version 1.30 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard Op19& OP38 OP19& OP38 Regulation 13(4)(a)& 23(4)(a) Requirement Timescale for action 12/07/05 3. 4. Op31 That fire doors must not be wedged open and they must all meet the fire regulations 13(4)(a)(c Unnecessary risks to the health 01/09/05 and safety of service users are identified, and as far as possible eliminated. This includes scalding and burns from hot water. 8 A care manager must be 01/09/05 appointed and registered with the CSCI. 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. Refer to Standard OP 24 27 Good Practice Recommendations Fit locks of a suitable type to all bedroom doors and bathroom doors. That the home reviewes the staffing level and the way they are deployed in the home in such a way as to ensure that at all times suitable qualified and experienced care and domestic staff are working in sufficient numbers to ensure the health and welfare of service users. That service users assessed as requiring nursing care be provided with an adjustable bed. H60-H11 S52037 Rectory House V229213 110705 Stage 4.doc Version 1.30 Page 24 3. 24 Rectory House Nursing Home 4. 36 That all care staff receive formal supervision at least six times a year. Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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 Rectory House Nursing Home H60-H11 S52037 Rectory House V229213 110705 Stage 4.doc Version 1.30 Page 26 - 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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