Inspection on 26/09/07 for Richmond Court Dudley

This inspection was carried out on 26th September 2007.

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.

Other inspections for this house

Richmond Court Dudley 26/02/07

Richmond Court Dudley 28/03/06

Richmond Court Dudley 07/09/05

Richmond Court Dudley 16/11/04

Richmond Court Dudley 25/06/04

Richmond Court Dudley 02/12/03

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Richmond Court Dudley 16 St James Road Dudley West Midlands DY1 3JD Lead Inspector Mr Richard Eaves Unannounced Inspection 26th September 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Richmond Court Dudley Address 16 St James Road Dudley West Midlands DY1 3JD Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01384 254442 Mr Dharam Pal Sahni Mrs Sangeeta Sahni Care Home 14 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (13), of places Physical disability over 65 years of age (6) Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service Users to include up to 13 OP, 6 PD(E) and up to 5 DE(E) That the service user named in the variation report dated 3 June 2004 must be moved to a room that meets the requirements of the National Minimum Standards as soon as the new extension is registered. That the room is used soley for the purpose of accommodating the service user named in the variation report dated 3 June 2004. When that person is re-accommodated the room must not be used until it meets National Minimum Standards. One service user identified in the variation report dated 14 June 2005 who is 61 years and over may be accommodated at the home in the category OP. This will remain until such time that the service users placement is terminated. 26th February 2007 4. Date of last inspection Brief Description of the Service: Richmond Court is located in a residential area, close to the centre of Dudley, and benefits from a variety of services and amenities, including shops, library, post office, religious facilities and the main bus terminal providing access to neighbouring towns and places of interest. The Home is a traditional style, detached house, with extensions which offers twelve single bedrooms, one double bedroom, lounge, dining room, two bathrooms, seven WCs, kitchen and laundry. There are no en-suite rooms but all bedrooms have wash-hand basins. Richmond Court has a large garden to the rear of the property, but, at the present time, this is not easily accessible to residents, as it is much lower than the house and the connecting steps are steep. However, residents have a view over the garden and there are well-advanced plans for an extension to the property, which will provide a net increase of seven new single bedrooms with en-suite facilities, a new laundry, enlarged and up-graded kitchen, new shower room and improved access to the garden. At present there is some car parking space to the front of the Home, but the proposed extension should increase this facility and provide extra office space and storage. Fees: £360 Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection visit was undertaken by an Inspector from the Commission for Social Care Inspection using the following information: reports from the organisation relating to the conduct of the home, records maintained at the home, the annual quality assurance self assessment, comment card responses from service users and reports by other agencies. The inspection involved a full tour of the property including, a number of bedrooms, the communal rooms and service areas and provided an opportunity to speak with most of the service users. What the service does well: What has improved since the last inspection? While the extension is under construction previous requirements are on hold to be completed with this work, but in the meantime to maintain a safe environment the organisation of monitoring night rounds have been increased and all staff have received infection control training to minimise the risks within the laundry provision. Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 – 5 Quality in this outcome area is good. The homes statement of purpose and service user guide are good sources of information providing details of the service enabling service users and families to make informed decisions about admission to the home. Pre-admission assessments are undertaken by the most experienced staff and confirmation is given to the service users that their needs can be met by the home and further confirmed by contract at the time of admission. Service users are invited to visit and trial the home before committing themselves to staying at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 9 The homes statement of purpose and service user guide are good sources of information providing details of the service enabling service users and families to make informed decisions about admission to the home, both documents were reviewed during January of this year. Copies of contracts/ terms and conditions issued at the time of admission were seen on files. Pre-admission assessments are undertaken by the most experienced staff and confirmation is given to the service users that their needs can be met by the home. The homes commitment to staff training further confirms the ability of the home to meet individual needs. Evidence from 3 randomly selected case files and discussions with Residents showed the assessment process to be comprehensive. Prospective service users are offered the opportunity to visit and try out the home before deciding whether to stay. The home does not accept service users for intermediate care. Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7 – 10 Quality in this outcome area is good. Care needs are identified in Care Plans and the necessary directions of actions required to ensure that service users care needs are fully met and health is promoted. Care Plans are regularly reviewed and revised as necessary. Service users are fully involved in all aspects of life at the home and are supported to make decisions for themselves and encouraged to be as independent as possible, even though this may mean taking risks. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of 3 Case files were case tracked and other case files inspected to confirm findings and these showed Care Planning documentation to be well organised, current, clearly written and comprehensively encompassed the range of ‘care areas’ necessary to ensure the delivery of care appropriate to the needs of each Resident with minor exceptions. Risk assessments and risk reduction plans were generally good. Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 11 All service users are registered with a GP and have access to allied services such as dentistry and ophthalmology, chiropody is provided and district nurses attend as required. The home uses the Boots monitored dosage system for most medications and their pharmacist undertakes quarterly audits of the arrangements. A controlled drugs book is available but currently none are held. The medication fridge is situated in the kitchen but used solely for medicines, a record of temperature is maintained. An inspection of the medication administration record (MAR) shows very good completion but it was noted that on this supply the medication had not been signed in. A number of service users receive as required medicines such as occasional analgesia or laxatives, a care plan should be devised to detail the circumstances when these are to be given. One service user has an oxygen concentrator in 24 hour use and has Oxygen cylinders as back up, these are stored in the residents room. The medication policy is within the policy folder as is the Pharmaceutical Society Guidelines. A recommendation is made to keep a copy at the front of the MAR chart folder and be reviewed against the guidelines. The induction programme includes a section on treating service users with respect and their privacy is upheld, locks are not currently fitted to all bedroom doors except where it has been requested, staff were observed to knock before entering bedrooms and interact in a friendly and open way using the service users choice of name. The home has one double room occupied by two ladies, a portable screen is provided. It is recommended that a fitted screen be fitted during the refurbishment to enhance the sense of privacy. There is no public telephone available at the home but the manager says that the office phone may be used. This arrangement should be written clearly in the ‘Service User Guide’. One service user has her own mobile. Service users spoken with said they liked the home and thought they were well cared for. An elderly service user who spends considerable time in bed should have a record of attendance and attention from staff maintained in the bedroom. Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12 – 15 Quality in this outcome area is good. The home provides varied social and recreational activities that provide interest and pleasure for the residents, suiting their preferences and capabilities. Visitors are welcome and help to keep service users informed about the wider community. Many aspects of care evidences that service users exercise choice and control over their lives. Food served is nutritious and well balanced and offers a healthy and varied diet for residents the menus do not demonstrate the choices available in meals served other than lunch and so deprive some of opportunity. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A printed programme of activities, for the forthcoming weeks, demonstrated a good and varied range of options available to those Residents who wish to be involved. Discussion with Residents, and a review of Care Plans, confirmed the majority of Residents regularly take part in these activities, which include:Reminiscence, sing-a-longs, underway during the visit, bingo, exercising to Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 13 music, games, a group of six played dominoes during the morning. Crafts such as card making are undertaken to meet seasonal events, dancing is very popular and a session is programmed for today following tea. Residents, who are able, undertake escorted shopping trips into Dudley Town Centre and Merry Hill centre and the Inspector was advised this is something they look forward to. Over the summer a day trip was taken to Weston SuperMare, a joint BBQ with Richmond Court sister home. A number of service users like to attend a bingo club. The home arranges for external entertainers to visit a number of times a year. There are no rigid routines and service users rise and retire as they wish the majority of residents had finished their breakfast at the start of the visit, but one service user came down after 10am was offered a full choice of items. One resident informed the inspector that he usually gets up late. The home has an open visiting policy and a notice in the hallway close to the visitors book confirms this. No visitors were seen to arrive during the visit, the manager advised that during the week visitors mainly come during the evening. Rooms visited show that service users have their personal possessions with them and in conversation it was clear that service users could decorate and furnish their room as they wished. The manger advised that currently families are responsible for service users finances. The case files record that service users and or their families are fully involved in the processes of assessment, care planning and reviews. The home maintains a system that informs families of any changes occurring. Currently the 4-week rotational menu applies only to lunch which offers choices, other records show the choices made at breakfast and tea. A recommendation is made to develop menus for all meals. Lunch was served during the visit and looked appetising, plentiful and nutritious, service users confirmed that they enjoyed the meals. Fresh fruit is served during the afternoon and special diets can be provided for. Currently there are no cultural dietary requirements. Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18 Quality in this outcome area is good. The home complaints and protection policies are robust providing a safe environment in which service users feel they can voice concerns and that these will be listened and responded to. Staff can demonstrate knowledge and understanding of adult protection issues which contributes to an environment that is safe from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A clear and concise Complaints Procedure is displayed in the hallway, which includes reference to the Commission for Social Care Inspection as the regulatory body, together with contact details. No complaints have been received in the previous year by the Commission. Six survey responses all said they new how to complain and in conversation, the service users were comfortable with the relationships between themselves and staff and would happily raise any concerns they had. Policies relating to the protection of Residents from abuse were observed to be in place and readily accessible, these included, ‘Whistle Blowing’, ‘Abuse Awareness’ and ‘Adult Protection’. A flow chart for safeguarding referrals is displayed on the staff information notice board. Staff training files indicated that Staff had received training in respect of these Policies. Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26 Quality in this outcome area is adequate. The Home provides a comfortable, attractive, mostly safe and ‘homely’ place to live. Specialist equipment, consistent with the needs of the Residents and the demands of tasks carried out by care staff, is available to facilitate the provision of care. The home is clean, hygienic and free from odours. A extension is underway which will address a number of environment deficiencies. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the Home confirmed Residents live in accommodation, which meets their needs and is generally comfortable, clean and safe. Arrangements are in place to protect service users from the extension works. The extension should address the issues that previous requirements have identified and these remain while the work is ongoing, there will be a new kitchen, laundry, sluices, additional storage space and improved access to the garden area, including a conservatory and decking. Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 16 During the tour it was observed that a number of extra large radiators remain to be covered. The double room has a mobile privacy screen and consideration should be given to upgrading this to a fitted system that provides for improved privacy. Many elements such as worn carpets are included in the development programme. Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27 – 30 Quality in this outcome area is excellent. Staff are clear as to their individual roles and responsibilities and are enthusiastic, sufficient in numbers, well trained, supportive and committed to maximising the service users quality of life. The recruitment practices and staff training contribute to ensuring service users benefit from the skills and knowledge of the staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The current staffing rota, and those from the immediately preceding weeks, were examined. Staffing numbers are sufficient to enable a good service provision meeting the care needs of the Service Users. The Home Manager is in addition to care staff numbers and a full complement of domestic, catering, and maintenance staff are also available through out the day. The number of care staff with a National Vocational Qualification (NVQ) level two or equivalent is now at 64 . Two seniors hold NVQ level 3 and the manager has the Registered Managers Award. The home has standard procedures for the recruitment of staff and these include interviews, taking up two references and checking staff through the Criminal Records Bureau. Three sampled files provided evidence that these had been followed. Once employed, staff undergo induction training in addition to Skills for Care and records are maintained of this process. Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 18 Evidence observed in Staff Files, and in proposed future training plans, demonstrated Staff have undertaken training appropriate to their individual learning needs. The training matrix shows that mandatory training is in date and other training opportunities are provided such as dementia training. Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36 & 38 Quality in this outcome area is good. Leadership of this home is good and staff demonstrate an awareness of their roles and responsibilities. The managers approach is open and positive and develops positive relationships amongst service users and with staff. The home regularly reviews its performance which includes seeking the views of service users and their families. Staff supervision prepares staff to deliver good care. Environment management and staff training in respect of health and safety ensures service users safety and welfare are protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is experienced and well qualified and undertakes regular care and management updates, she achieves a good atmosphere in the home through her open and positive style. Staff receive a copy of the code of practice. Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 20 There are very good systems for monitoring the quality of care provided, including an audit against the standards and service user, relatives, staff and stakeholders feedback forms. The kitchen follows the ‘Better food, Better Business’ system of quality management. There are detailed plans for the future development of the home, which ensure that any shortfalls identified by the audit and the Commission for Social Care Inspection inspections are addressed. There are detailed plans for the future development of the home, which ensure that any shortfalls identified by the audit and the Commission for Social Care Inspection inspections are addressed. The home holds money for a number of residents. Good records are kept of all transaction and two staff sign. Receipts were available to confirm expenditure. Evidence was available to confirm that all staff are receiving one to one supervision, records show that not all staff are up to date. Documentation was seen of a full range of servicing, maintenance and regular monitoring of services and equipment is undertaken, staff receive training in health and safety and first aid. The monitoring records of hot water temperatures requires to provide guidance when action must be taken to correct e.g. below 41°c or above 44°c. Fire safety including tests, staff training and equipment maintenance were seen to be up to date. Records of all accidents are recorded, using data protection compliant documentation and reported as necessary. Induction and foundation training is provided to Skills for Care standards. Overall the premises were observed to be well managed to meet safety requirements. Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 3 X 3 Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP25 Regulation 23(2)(p) Requirement Timescale for action 31/03/08 2. OP26 23(2)(k) 3. OP22 23(2)(l) 4. OP24 23(2)(e) The necessary changes to the radiators in all bedrooms thus enabling Residents to adjust heating to meet their individual needs must be completed at the same time as the building of the new extension underway. The process of fitting radiator covers must be completed. Adequate sluice facilities must be 31/03/08 provided for the Home in the extension, preferably a sluicing disinfector. This must also be completed as part of the new extension programme underway. Arrangements must be made for 31/03/08 large pieces of equipment to be appropriately stored, e.g. wheelchairs, in order that there are no obstructions to the use of bathroom facilities. This may be completed as part of the new extension programme underway. Doors to private accommodation 31/03/08 must be fitted with locks of an approved design. This may be completed as part of the new extension programme underway. Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 23 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. 4. 5. 6. 7. 8. Refer to Standard OP2 OP10 OP8 OP9 OP15 OP24 OP26 OP38 Good Practice Recommendations The contract document and or terms and conditions require the inclusion of room number. The access to telephone facility should be clearly stated in the service user guide. A record of attendance should be maintained in bedrooms for service users receiving long periods of bedroom care. The medication policy should be reviewed against the Pharmaceutical Society Guidelines. Menus offering choice should be developed for high tea and supper meals. The portable screen in the double room should be replaced with a fitted system that affords privacy and free movement simultaneously. The washing machine should be replaced with an industrial machine with sluice and disinfection programmes. Guidance for hot water monitoring should include when mixing valves should be adjusted. Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Halesowen Local Office West Point Mucklow Office Park Mucklow Hill Halesowen B62 8DA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Richmond Court Dudley DS0000047902.V351525.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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