Inspection on 28/04/05 for Redwood Care Centre

This inspection was carried out on 28th April 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Redwood Care Centre 26/11/08

Redwood Care Centre 29/08/07

Redwood Care Centre 31/07/06

Redwood Care Centre 13/06/05

Redwood Care Centre 07/10/04

Redwood Care Centre 24/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Redwood Care Centre 179 Epsom Road Merrow Guildford GU1 2QY Lead Inspector Mrs C Campbell-Ace Unannounced 28 April 2005 11:00 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. Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Redwood Care Centre Address 179 Epsom Road, Merrow, Guildford, Surrey, GU1 2QY 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 752552 Care UK Community Partnership Limited To be confirmed CRH Care Home 50 Category(ies) of OP Old Age, 50 registration, with number of places Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age range of the persons to be accommodated will be: Over 65 years of age. 2. 50 beds providing nursing care for elderley people from the age of 65 years, of which 20 beds may be used for intermediate care. Date of last inspection 7 October 2004 Brief Description of the Service: Care Uk is owned and operated by Care UK Partnerships LTD. The service is situated in Merrow, close to the town of Guildford. The service is a ground level building comprising 5 units called Oak, Elm, Birch, Cedar and Ash. The main concourse is called Maple. The accomodation is arranged in 50 single occupancy bedrooms, 30 for long term nursing care service users and 20 beds catering for delivering intermediate care. There is ample communal and quiet space throughout the premises. The gardens are well-maintained with parking places to the front and rear of the premesis. Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection lasted six and a half hours and was under taken by Mrs C Campbell-Ace and Ms R Coler. The inspectors were assisted by the residents, Manager and staff. The Acting Manager had been in post a short time, and has applied to the CSCI to be the Registered Manager. Daily records, care plans, risk assessments, lifestyles and interests records were inspected. These were written clearly to assist the service users in achieving their goals and aspirations. It was pleasing to see that the care plans included working life of the service users before admission, and present interests. Some changes are necessary to daily recording to ensure that these reflect all aspects of the care plan, risk assessment etc. The sample of plans reviewed showed there was little reference to how service users social needs are met. One resident told the inspectors: ‘I can’t speak highly enough of the home, I cannot fault it at all.’ Another said that the staff were very kind, especially to the frail residents. The inspectors also received some negative comments regarding changes to the premises whereby the room allocated as a smoking area had been taken away and also in relation to when service users had received their medication on the day of inspection. The home was clean and comfortable, with specialist equipment such as assisted baths and hoists. The home has relaxing sitting areas overlooking landscaped gardens. Residents may bring their own personal items to add to the homely surroundings. What the service does well: The home has a relaxed and friendly environment. The service users gave a mixture of views regarding the home, but on the whole these were positive. The home is divided into units, which gave a homely atmosphere for the residents; one said that it was like being in their own home, and she could receive visitors at any time. Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 6 The service users are able to use the services of Physiotherapy and Occupational Therapy. The Occupational Therapist was very complimentary about the standard and usefulness of the care plans. What has improved since the last inspection? What they could do better: The Manager had been employed by Care UK for five weeks by the date of inspection. Staff reported that they were concerned that one of the units was understaffed. However, it must be noted that the manager reported that there was to be an increase of a further care assistant on that unit from the Monday following the day of the inspection. The Manager has been required to provide an assessment of service user’s needs and staff accordingly. When the building was inspected it was noted that the fire doors in the corridors were difficult to open, and an immediate requirement has been made for the Fire Safety Officer to check these doors. The cupboard, which stocked the COSHH materials, was unlocked and the fire door to the kitchen area was wedged open with paper. The Manager was asked to lock the COSHH cupboard door when not in use and to keep all fire doors shut and not wedged open. The bath and shower water temperatures were noted not to be recorded before Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 7 baths are used by service users, and an immediate requirement was made for the bath and shower water to be recorded before the baths and showers are used. The standard of recruitment was inadequate, and the Manager must make the appropriate checks on staff to protect service users. All recruitment records listed in The Care Homes Regulations 2001, including CRB checks, must be available for inspection on the home’s premises. Formal staff supervision had commenced since the latest new manager had started work at the home and must take place 6 times a year for each member of staff. The Statement of Purpose was checked and found to be out of date. This must be updated. A recommendation was made for the Manager to assess the adequacy of the storage space in the home, as the bathrooms were cluttered with equipment such as wheel chairs. The staff had not received adequate training regarding the protection of vulnerable adults and none of the senior staff interviewed had attended Surrey County Council’s multi agency Adult Protection training. When questioned it was of grave concern that staff did not understand the actions they need to take to protect service users. 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. Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 8 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 Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 9 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) 1,2,3,4,6 Whilst information was available this was not up to date nor was it clear that this was always provided to service users and where appropriate their families before admission to the home. Service users and families were given the opportunity to visit the home before admission. EVIDENCE: Service users’ records showed that the pre admission process included an assessment being carried out in the service user’s own home. This was in order to check that the home was able to provide the care required. The relatives were included in developing the care plan and the key worker was introduced to the resident and family before admission. The manager stated that a brochure and a Service User Guide were given out at this time. However, some service users did not confirm that they had received these and in discussion with staff inspectors could not get a clear view of whose responsibility it was to provide service users with these documents. Therefore the home is required to reissue these documents and agree a procedure whereby these are given to service users prior to admission. It would also be advisable to ask that key workers go through the service user guide with service users and where appropriate their families. The regulations also Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 10 require homes to provide service users with a letter prior to admission detailing how they will meet their needs. This was not evidenced in service users files nor did service users confirm that they had received such correspondence. The Statement of Purpose was checked and found to be out of date. This must be updated. Staff were not clear they had seen the home’s statement of purpose or knew what it stated. The management must take action to ensure that staff are fully aware of the home’s statement of purpose and where to find copies of this document. The inspectors were provided with copies of both the Service User’s Guide and the resident’s written contract. Copies of the Service Users Guide were available in the lobby of the home. However these did not include all the information required in The Care Homes Regulations 2001. For example the service user guide did not include copies of a service user contract. The service users could access Physiotherapy and Occupational therapy provided within the home. The Occupational Therapist was very complimentary about the care plans and said that they helped him when assessing and setting service user’s treatment and goals for returning home. Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 11 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) 7,8,9,10,11 Overall the records maintained on residents were comprehensive, although some shortfalls were identified. Medication administration was found in some cases to be inadequate. EVIDENCE: Individual care plans were inspected, and included information about service users’ lifestyles and interest. One person’s care plan stated: ‘I like to have the bible read to me.’ and also included that this person liked golf, bowls, and ‘songs of praise’. Family birthdays were included in the plan, and signed by the service user. The service user’s health care needs were documented, with risk assessments, diabetes monitoring, nutritional assessment and daily progress reports. The service users’ records included a 72 hour ‘settling in’ plan, which gave a good guide to the needs of the service user when first moving in to a new home, a night care plan was included in the documentation, and wishes in the event of death and dying were incorporated. Daily records were kept about each service user. The records mainly related to how service users health and physical needs were being met. No records of how the home supported their social needs was kept. Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 12 The service users said that they were treated well, the staff were very kind, helpful and supportive. They reported that staff upheld their privacy for example by knocking on their doors before entering. It was noted that two service users had not received their medication at the correct time on the day of the inspection, and when the inspectors examined the medication administration record for one service user, it was found that the Registered Nurse (RN) gave the medication at 11.30am and signed that it was given at 9am. The inspectors spoke to this RN and enquired about the discrepancy in the time the medication was signed. The RN admitted that she had given the medication at 11.30 and signed that it was given at 9am. The inspectors informed the RN that she must sign when the medication is actually given to the resident. An immediate requirement was made in relation to this serious matter. A CSCI Pharmacy Inspector reported on the 21st April as follows: “Medication stocks and records were sampled and showed that the majority of residents were receiving their medication as intended by their doctors. However two residents had each been out of stock of one medication on the first three days of the current medication cycle and a further two residents had each not received a prescribed medication on the night before the inspection. At this time no residents were administrating their own medications. Medication was stored securely for the protection of residents.” If the home continues to provide inadequate medication administration legal action may be taken by the CSCI. Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 13 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) 1213,14,15 The home offers opportunities for the service users to make choices in their lifestyles and encourages visits from relatives. The home provides an adequate meals system and there was some evidence that this was not enjoyed by a number of service users. EVIDENCE: Several service users were receiving visitors when the home was inspected. One relative said that he ‘could not speak highly enough’ of the home and the staff were treating his wife very well. This view was echoed by his wife. A service user said that the sitting room attached to her room was ideal for having visitors because it was ‘just like home.’ The care plans inspected gave evidence of how service users choose to spend their days, including which activities they would like to participate in. However, records of daily activities could not evidence how these needs had been met and on the day of inspection there were no activities taking place. The inspectors noted that a newly appointed activities co-ordinator was in place and on the day of inspection was out receiving training. However, some other service users complained that there were few activities for them to participate in. When asked how they could access the local community some service users said they had not been offered this choice. Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 14 The food was pre and chilled cooked by an outside food company and then reheated in the kitchen by the home’s kitchen staff. It is not cooked freshly on the premises. Some residents said the food was very nice, and some said the food was ‘awful.’ In one unit the service users were noted to be pushing the food around their plates and commented that the food was unappealing. The inspector looked at the menu for the month, which was balanced and varied. On the day of inspection the lunch consisted of a choice between cottage pie and tuna bake with carrots as the vegetable. Apple pie was served for desert. One of the service users said that the home did not cater for his low fat diet, when asked the home’s manager said this was catered for but because this often included a low fat variety of foods on offer to other service users as well that the service user may not realise this was the case. The inspectors suggested that the manager ensure this information was available. The use of pre-cooked meals whilst providing adequate nourishment and a balanced diet did not in the opinion of inspectors provide a home cooked type of feeling to the meals provided. Stores for prescription pre-prepared drinks etc. were inspected. A large store for individual service users was noted, in some cases this stock was dispensed nearly ten months ago. The home must review its ordering systems to allow for fewer stocks to be kept. Over ordering had led to some stocks being stored on the floor outside of this cupboard. Many of the service users in one unit ate their meals in armchairs rather than move to the dining area. The manager informed inspectors that she had noted this but service users said they preferred to do this. The inspectors question whether this is habit and asks that the management continue to monitor this and promote service users eating in the dining areas of each unit. Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 15 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 It was not clear that all service users knew how to access the complaints procedure. In addition the procedure does not provide the information required. The home’s polices and procedures for the protection of vulnerable adults were found to be unsatisfactorily implemented within the home’s operation. EVIDENCE: The service users said that they did not know of any complaints policy, but a member of staff said that the complaints policy was in every service user’s room behind the door. There had been three complaints since the beginning of March 2005, which had been investigated and appropriate action had been taken. Some service users said they had no reason to complain, but they knew they could complain to the Manager if they had a problem. The complaints policy and procedure was inspected. It was noted that the procedure could lead service users to believe that they could only contact the CSCI Surrey Local office regarding a complaint once they had initiated the home’s own procedure. The manager was asked to review this to include the ability to contact the CSCI if service users or staff wanted to, before contacting the manager of the home. A Whistle Blowing Policy was evidenced, and it was noted that the address and telephone number of the CSCI appeared on this document. Staff reported that they had not had training in the protection of vulnerable adults procedures and did not know about Surrey County Council’s Adult Protection Procedures. Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 16 When answering questions about how they would handle concerns staff gave answers whereby the procedures would not be followed adequately. It is therefore essential that staff receive training in these procedures as a matter of priority and that senior members of staff, who will be in charge of a shift, attend Surrey County Council Multi Agency Training in respect of the protection of vulnerable adults. Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 17 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) 19,20,21,23,24,25 The standard of the environment within this home was good providing service users with an attractive and homely place to live, although some safety issues must be addressed immediately. EVIDENCE: The home was divided up into five units. The units comprised of ten single bedrooms, two bathrooms and lavatory, one small kitchen, a dining room and sitting room. There were ample quiet sitting areas observed around the home. The inside of the premises were inspected and it was noted that the fire door in the central corridor was very difficult to open. The door to the kitchen storage area was wedged open and the cupboard containing COSHH material was not locked. The bathrooms were used for equipment storage. An immediate requirement was made for the Fire Safety Officer to visit and for the COSHH cupboard to be locked when not in use. The inspectors noted that the bath temperatures had not been recorded regularly, and the maintenance staff said that the thermostatic temperature Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 18 valves were not reliable. An immediate requirement has been made to record bath temperatures every time the bath is used. One of the store cupboards outside the kitchen contained supplementary food from previous service users, and it was observed that there was an overstock of supplementary food for a service user residing in the home at present. The manager was asked to send the items back to the Chemist. The laundry was found to be clean and tidy with two washing machines and two dryers in place. The home was clean, pleasant and hygienic. Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 19 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 After a period of instability in staffing there is now a good match of RGNs and Care Staff staff offering consistency of care within the home, however, it was noted that the staff training was not up to date, particularly in training in The Protection of Vulnerable adults. EVIDENCE: When the staff were interviewed they expressed concern that one of the units was inadequately staffed. They said that one care staff was employed to care for five service users with high dependency, and they did not think that this was safe. The inspector spoke to the Manager about this, who said that one extra member of staff was to commence employment next week, making two staff on the high dependency unit. A requirement has been made for the manager to undertake an assessment of the service user’s needs and review staffing levels to ensure these are appropriate for the health and welfare of the service users. The Manager was asked to forward a copy of this assessment to the CSCI Surrey Local office immediately The recruitment records were evidenced, and were found to be not up to standard. One staff member had started employment before written references were obtained. CRB disclosure forms were not on the premises, and one employee had a CRB from 2002, which should have been re applied for. One staff record had no copy of passport or birth certificate. Staff did not have any individual training plans, and when asked about Protection of Vulnerable Adult procedures they were unable to answer. Training Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 20 had taken place for ‘PEG’ feeding, which all the RNs had attended. Five staff ware to start NVQ 2 training the following week, and more were to be booked on the course when these had completed their course. Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 21 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) 32,33,36,37,38 The manager is supported well by the senior staff in providing clear leadership throughout he home. Staff training was evidenced to be inadequate to fu EVIDENCE: The service users informed inspectors that they receive excellent care, and that they felt happy and secure. They were informed that communication had improved since the manager had commenced employment at the home, and a keyworker and named nurse system had been implemented. One service user said that the staff answer the call bell quickly. The inspectors were informed that formal Staff Supervision sessions were to start this week- a requirement has been made that this must be fully operational within two months. The service user’s records were evidenced to be in good order, and updated regularly. The complaints policy needed to be reviewed, and the Statement of Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 22 Purpose updated. Risk assessments were in place and care plans comprehensive, and evidenced to be read by staff. Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 23 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 3 2 2 x 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 1 3 3 3 3 3 1 3 STAFFING Standard No Score 27 1 28 1 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 1 x 3 3 x x 1 3 1 Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 24 no 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. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11 Standard 19 27 19 19 29 1 29 36 19 18 9 Regulation 12,23 18 13 23 19 4 19 18 23 18 18 Requirement Bath temperatures are tested and recorded each time the baths and showers are used An assessment of residents needs and to review staffing levels as a result COSHH cupboards are to be kept locked at all times. Fire doors must not be wedged open. The recruitment process must be followed as stated in Regulation 19. The Statement of Purpose must be updated. All CRB forms must be kept on the premises Formal supervision for care staff must take place six times a year Fire doors to be checked and the fire Officers report to be forwarded to the CSCI Protection of Vulnerable Adults training must be arranged for all staff. Registered Nurses must sign for all medication at the correct time of administration. Timescale for action Immediate 28/04/05 07/05/05 Immediate 28/04/05 Immediate 28/04/05 Immediate 28/04/05 28/05/05 Immediate 28/04/05 07/05/05 Immediate 28/04/05 28/05/05 Immediate 28/04/05 Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 19 16 16 Good Practice Recommendations Another storage area should be considered for service users equipment. A review of the meals should be undertaken, to ensure that the meals are more appealing to the service users. This must be a requirement?? The large numbers of supplementary food items stored should be returned to the supplier. Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 Page 26 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Redwood Care Centre H58_s59510_Redwood_v222810_280405.doc Version 1.30 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!