Inspection on 20/06/05 for Ridgeway House

This inspection was carried out on 20th June 2005.

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

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

Other inspections for this house

Ridgeway House 27/11/07

Ridgeway House 21/02/07

Ridgeway House 16/11/05

Ridgeway House 01/12/04

Ridgeway House 10/06/04

Ridgeway House 20/01/04

Similar services:

2 Perhaver Park

The Vicarage

Fairfields Country Rest Home

St George`s

5 Seafield Road

Credence House

Poldhu

Queensmount

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

CARE HOMES FOR OLDER PEOPLE Ridgeway House The Lawns Wootton Basstt Wiltshire SN4 7AN Lead Inspector Thomas Webber Unannounced 20th June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ridgeway House Address The Lawns Wootton Bassett Wiltshire SN4 7AN 01793 852521 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) The Orders of St John Care Trust Mrs Sally Hobson Care Home 43 Category(ies) of DE(E) Dementia - over 65 (10) registration, with number OP Old Age (33) of places Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st December 2004 Brief Description of the Service: Ridgeway House was built in the 1970’s as a purpose built residential home offering accommodation and personal care to a total of 43 service users over the age of 65 who require care primarily through old age together with 10 service users who have dementia. Two of the 43 beds are also used for respite care. There is also a separate unit, within the complex of the home, which provides day care facilities for up to 16 people. The home is situated in a quiet part of the busy market town of Wootton Bassett and is within walking distance of all the amenities afforded by this town. The home was originally opened in the 1970’s as a local authority home and has since been taken over by the Orders of St John Care Trust. The registered manager is Sally Hobson. The home provides all single accommodation for residents’ use which all meet the national minimum standards of 10 square metres each. Married couples are catered for and they would either be provided with individual bedrooms or provided with two bedrooms, one of which could be used as a lounge. Residents’ bedrooms are located on the ground and first floor levels and are serviced by a passenger lift. The home has created a private and enclosed rear garden, which is suitably designed, and well maintained providing raised beds, a water feature and additional seating. Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, undertaken during the course of one day from 10:10 to 16:40. The inspection primarily focused on the direct care provided to the residents. A tour of the premises was undertaken and the views of twelve of the thirty-nine residents, in situ, were sought on an individual and group basis, regarding the care and services provided by the home. The views of six care staff were also sought. The inspector also joined the residents for the main meal of the day. In addition, a check was carried out with regard to the requirements and recommendations previously identified at the last inspection together with a range of the core standards. The records in relation to medication, complaints, menus, staff rotas and fire prevention were checked. The staffing levels of the home were discussed with the manager at some length. What the service does well: What has improved since the last inspection? The home continues to strive to address the outstanding requirements previously identified which includes ensuring that residents’ care plans contain accurate and up to date information, with staff training records and fire prevention records being updated. There have been a number of improvements to the physical environment of the home. Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.doc Version 1.30 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. Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.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 Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.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) 6 EVIDENCE: The home does not offer intermediate care therefore this Standard is not applicable. Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 8, 10 and 11 The health care needs of the residents are being appropriately met. Residents are treated with respect and their right to privacy is upheld. The staffing resources do not enable staff to always spend the time that they would wish with residents who are terminally ill. EVIDENCE: Residents tend to be registered with the local surgery situated a short walk from the home. GP appointments now tend to be held within the home where residents are seen in the privacy of their bedrooms. In addition other health professionals visits are conducted in the privacy of residents’ bedrooms. Residents also have access to other health care services such as dental, opticians, chiropody and hearing, as and when required. Appropriate aids are provided for those residents who require aids for incontinence and mobility. Observations and discussions with residents confirmed that they are provided with their own bedroom where they can conduct all their personal affairs in complete privacy. They can also choose who and where to see any visitors. Residents’ mail is given directly to them unopened, staff knock before entering their bedrooms and residents can lock their bedroom doors. There is a telephone room where residents can make and receive calls in complete privacy. In addition residents can also have a telephone installed in their Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.doc Version 1.30 Page 10 bedrooms and some of them have availed themselves of this facility. Residents commented that they are happy with the care and services provided. The home has established a written policy regarding death and dying. Residents who require long term nursing care would be transferred to an appropriate environment. However, where residents require short-term intervention can remain at the home where they would be able to spend their final days in their own bedrooms, surrounded by their personal belongings, unless there are strong medical reasons to prevent this. Staff spoken to are aware of the sensitivity needed on such an occasion but continually express their concern about the fact that because of staffing levels they do not always have enough time to just sit with the resident who is gravely ill or if they do it means that the staffing available to the rest of the residents is reduced. Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 The lifestyle experienced by the residents matches the residents’ expectations and preferences which includes the opportunity to pursue their own individual interests as well as being able to participate in the various organised activities arranged by the home. Suitable arrangements are in place for residents to maintain contact with their families and friends. Residents are enabled to exercise choice and control over the various aspects of their lives, with support provided where required. A satisfactory and varied menu is provided which gives residents a choice and caters for their preferences. EVIDENCE: From observations and discussions with residents it was apparent that they can choose where and how to spend their time, including rising and going to bed. Residents have the opportunity to pursue their own individual interests as well as being able to participate in the various organised activities arranged by the home, should they so wish. Organised activities are provided within the home two to three times per day, although the level of these activities is reduced at weekends. The manager reported that the post of activity co-ordinator has been advertised as the person currently in post is due to leave. A church service is held within the home on a monthly basis and some residents continue to attend church services within the community and they are either collected by members of the church or taken by staff within the home. There is also a regular hairdressing service available and the mobile library visits the Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.doc Version 1.30 Page 12 home on a six weekly basis. The friends of Ridgeway House visit and continue to raise money for the home, which is used for the benefit of the residents. The manager reported that residents are fully involved in how the money raised is spent. Visitors are welcome at all reasonable times and a policy has been established regarding residents maintaining contact with their families, friends and representatives. Residents can choose whom and where to see any visitors, either in the privacy and comfort of their own bedrooms or the communal rooms available. This was evident during the inspection. Observations and discussions with residents indicated a number of ways of how residents can exercise personal autonomy and choice. Residents can and have brought items of furniture and personal possessions to make their bedrooms more homely, they can choose what time to get up and go to bed, where to spend their time, where to eat, and what activities to participate in. They can handle their own financial affairs in the privacy of their own bedrooms, if they are capable. Residents are provided with a lockable storage space within their bedrooms, which can be used to store personal possessions. Information is available to residents on how to contact external advocates should they wish to do so. Residents’ meetings are held on a regular basis, which provides them with the opportunity to comment and contribute to the running of the home. One resident commented that he regularly attended these meetings and found them useful. A satisfactory and varied three weekly menu is in operation, which provides a choice at all mealtimes, except when a roast is provided, although alternatives for this meal and others would be made available, if required to take into account residents’ preferences. A cooked meal is available for those residents who use the dining room for breakfast. Special diets would also be catered for. Drinks and snacks are also available at other set times of the day. Residents can choose where to eat their meals, either in the dining room or their bedrooms. The residents were joined for the main meal of the day which was conducted in a relaxed and congenial manner. The vast majority of residents spoken to, commented very favourably about the quality and quantity of food provided, confirming that they are provided with a choice, they receive plenty of food and can have seconds if they wish. This was evident during inspection. Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.doc Version 1.30 Page 13 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 and 18 Information is provided to residents on how to complain should they wish to and the residents felt that their complaints would be listened to and acted upon. Although appropriate procedures are in place to protect the residents from abuse it is questionable whether they are being rigorously and consistently followed. EVIDENCE: Each resident has been provided with a copy of the home’s complaints procedure, which specifies how and who would deal with any complaint. The procedure also informs complainants that they can contact the Commission for Social Care Inspection at any stage should they wish to do so. Since the last inspection the home has received two complaints, which related to the poor condition of sinks to some of the residents’ bedrooms and the attitude and conduct of a member of staff. Both complaints were upheld and action was being taken to rectify the situations. The vast majority of residents spoken to commented that they had no complaints or concerns and they felt confident that if they did they could discuss these with the manager or staff who would listen and act accordingly. The home has appropriate procedures for responding to suspicion or evidence of abuse, including a whistle blowing procedure. This procedure includes a copy of the full version of the Wiltshire and Swindon Vulnerable Adults procedures in line with the Department of Health Guidance “No Secrets” document. Copies of the shortened version of this document have been obtained and distributed to all staff. The staff confirmed they had received copies. However, there is some suggestion that the home may not be following the Wiltshire and Swindon Vulnerable Adults procedures in all Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.doc Version 1.30 Page 14 circumstances as identified in a complaint made against a member of staff. The complaint refers to an incident of verbal abuse whereby a member of staff is alleged to have shouted at the resident whilst shaking her frame. This complaint appears to have been investigated internally as opposed to being initially referred through to the Vulnerable Adults unit for consideration and investigation. Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25, and 26 The location and layout of the home is suitable for its stated purpose. It is accessible, safe and suitably maintained to meet the residents’ individual and collective needs. Residents are provided with their individual bedrooms which they can personalise to their individual wishes. Residents have access to adequate and suitable toilet and bathroom facilities. Residents have appropriate equipment to maximise their independence. The home is maintained to a good standard being clean, tidy and comfortable. EVIDENCE: The home has an ongoing maintenance programme to enhance the residents’ living environment. Improvements made since the last inspection have included redecoration to a couple of bedrooms, replacement windows to some residents’ bedrooms and the front door and a fire exit door have been replaced. The home is maintained to a good standard being clean, tidy, and comfortable and provides sufficient lighting and ventilation. The decoration and furnishing and fittings are also suitably maintained. Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.doc Version 1.30 Page 16 The home provides a range of communal areas for residents’ use, which include a large dining room and three lounges, two of which are located on the first floor with one providing drink making facilities and the other being designated as the only smoking area within the home, thus providing a smoking free zone to the other communal rooms and residents’ bedrooms. In addition, there is also a shop and a hairdressing salon. The home has created a private and enclosed rear garden, which is suitably designed, and well maintained providing raised beds, a water feature and additional seating. Residents use this facility to relax in weather permitting and this was evident during the inspection. The home provides sufficient bathrooms, a walk in shower and toilet facilities, which meet the needs of the residents. These are suitably located on both the ground and first floor levels. However, the shower room is currently out of action whilst tests are being carried out in relation to legionella. Residents have free access to the communal areas and to their bedrooms and a passenger lift has been installed to enable residents to access the first floor of the building. In addition items such as grab and hand rails, mobile hoists, assisted baths and zimmer frames are provided where appropriate, to meet the needs of specific individuals and groups of residents. A call bell system is installed in each room, which can be used by residents to call for staff assistance. The home provides all single accommodation for residents’ use which all meet the national minimum standards of 10 square metres each. Married couples are catered for and they would either be provided with individual bedrooms or provided with two bedrooms, one of which could be used as a lounge. Residents’ bedrooms are located on the ground and first floor levels. Residents’ bedrooms vary in size but are suitably furnished and equipped to ensure comfort and privacy. Residents can bring items of furniture and personal possessions to make them homely and they have personalised their bedrooms to their individual wishes. Locks have been fitted to all bedroom doors and residents have been provided with a lockable storage space. Residents spoken to, commented very positively about the standard of cleanliness of their bedrooms, stating that they are kept clean and tidy. They were also happy with the level of accommodation available to them. Residents’ accommodation provides suitable heating, lighting and ventilation and radiator covers are fitted for the protection of residents. However, the type of construction does not enable residents to regulate them for themselves. Although some work has been undertaken to rectify this situation, some still need to be modified. The manager reported that this outstanding work is due to be completed by July/August 2005. Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.doc Version 1.30 Page 17 The home is maintained to a good standard being clean, tidy and, in the main, free from offensive odours. The laundry room is located on the ground floor and provides suitable facilities to meet the needs of the home. Residents’ clothing is labelled to ensure that their garments are appropriately returned. Residents spoken to, commented very favourably about the laundry arrangements in place, stating that their clothing is returned in good condition. A laundry person is primarily employed to undertake the laundry duties and the care staff and waking night staff also assist in this task. Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.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 The current staffing resources within the home are insufficient to enable staff to provide a high quality of care to the residents. EVIDENCE: The deployment of staff ensures that in the main there are five members of care staff on duty in the mornings with four on in the afternoons and evenings, Monday to Friday. However, at weekends the staffing levels are reduced to four members of care staff on duty throughout the waking day. The above staffing levels include a care leader on each shift but exclude the manager and various ancillary staff. Staff spoken to reported that there has been the odd occasion when there has been only three members of staff on duty in the evening. There are two members of waking night staff on duty each night with one member of care staff sleeping in. There is a care co-ordinator and two part time staff allocated to manage the day centre. Concerns continue to be expressed about the insufficient level of care staff on duty: given the size and layout of the building, the changing and increased dependency needs of the residents accommodated, together with the existing staff structure and various responsibilities/tasks undertaken by staff. This was further compounded in discussions with staff who continued to express concern about the current staffing levels which do not always enable them to have enough time to just sit with the resident who is gravely ill or if they do it means that the staffing available to the rest of the residents is reduced. Given the current resources available, staff are only able to meet the immediate care needs of the residents but cannot provide the type of quality care the staff would wish to aspire to and which would be endorsed by the Commission for Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.doc Version 1.30 Page 19 Social Care Inspection. The Trust has submitted a staffing proposal to Commission, which will be considered at a meeting in September 2005. The manager reported that a big recruitment drive is due to be undertaken next week. Residents spoken to, commented that the staff are marvellous, excellent and the staff could not get any better. However, residents also commented that staff are very busy and don’t have the time to spend quality time with them. Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.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) 31, 32 and 36 Residents benefit from living in a home, which is run and managed by a manager who is suitably experienced and qualified. The manager ensures that the management style of the home creates an open, positive and inclusive atmosphere, which benefits both residents and staff. Staff feel well supported and receive formal and individual supervision. EVIDENCE: The manager has appropriate management and supervisory experience in the care setting she manages. She has achieved a variety of qualifications which include the Advanced Management in Care qualification, the NVQ Assessor’s Award, the NVQ level 4 in Care and the Registered Managers’ Award. The manager undertakes periodic training to update her skills and knowledge and has overall responsibility for the management of the home which is set out in her job discription. Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.doc Version 1.30 Page 21 Discussions with members of staff indicated that there is an open, positive and inclusive atmosphere within the home. Staff felt that the manager is very supportive and approachable and they could discuss any issues with her. Regular staff meetings are established together with daily hand over meetings, which ensure that staff are kept fully up to date. Residents spoken to commented that they could approach her or the staff to discuss any concerns. Discussions with the care leaders and care staff on duty confirmed that supervision is being provided and that supervisors have undertaken appropriate training. However, it was acknowledged that the frequency could benefit from being improved to met the Standard of at least six times a year. Examination of residents’ medication sheets still showed that there are gaps where staff have not initialled for medication administered. A more robust monitoring system needs to be implemented to ensure that this deficiency is addressed. Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.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 x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 x 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 3 x x x 2 2 x Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.doc Version 1.30 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 18 Regulation 13(6) Requirement The registered individuals must ensure that all complaints which relate to inappropriate conduct/abuse are initially referred through the Vulnerable Adults procedures. The registered individuals must ensure that there are sufficient numbers of staff on duty to meet the needs/ quality of care to the residents. (Previous timescale of 31/10/04 not met) The registered individuals must ensure that the frequency of staff supervision is increased. (Previous timescale of 31/10/04 not met) The registered individuals must implement a more robust monitoring system to ensure that residents medication sheets are suitably initialled for medication administered. (Previous timescale of 31/01/05 not met) Timescale for action 31/07/05 2. 27 18(1) 31/10/05 3. 36 18(2) 31/12/05 4. 37 13(2) 31/07/05 Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.doc Version 1.30 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 25 Good Practice Recommendations The registered individuals should ensure that the type of radiator covers fitted enable residents to easily regulate the temperature to their bedrooms. Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.doc Version 1.30 Page 25 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire, SN15 2BB 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 Ridgeway House D51_D01_S28401_RidgewayHouse_V180559_200605_Stage4.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. 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!