Inspection on 25/07/05 for Rochester House

This inspection was carried out on 25th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 no outstanding requirements from the previous inspection report, but made 15 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rochester House 12/12/06

Rochester House 23/01/06

Rochester House 31/03/05

Rochester House 14/01/05

Rochester House 28/01/04

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

CARE HOME ADULTS 18-65 Rochester House 221 Maidstone Road Rochester Kent ME1 3BU Lead Inspector Lucy Ansell Unannounced 25 July 2005 10:00 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Rochester House Address 221 Maidstone Road Rochester Kent ME1 3BU 01634 847682 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 Regard Partnership Limited Mrs Joanne Bungay Care Home 13 Category(ies) of LD Learning Disability (13) registration, with number of places Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31 March 2005 Brief Description of the Service: Rochester House is owned and managed by The Regard Partnership; it is registered to accommodate thirteen Adults with learning disabilities, but regards full capacity being 10. There are three floors, the visitor’s room, administration area, laundry room and a room used for physiotherapy are situated in the basement. Service users bedrooms are situated on the ground and first floor; there is a lift available to all levels. The house is situated on the outskirts of Rochester town centre and public transport is easily available.Service users receive 24-hour support. The home employs a manager, a deputy manager, 2 seniors, and support workers the home is fully staffed at this time. Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection under the terms of the Care Standards Act 2000 carried out by two inspectors, Lucy Ansell and Andrea Leverett who were in the home from 09.30 to 2.00 on the 25th July 2005. During the inspection the Deputy and the Manager represented the home. Documentation and records were read, including care plans. A tour of the premises was undertaken. The inspectors spent time talking with residents and observing other residents, to ensure standards are being met and a good quality of life is being enjoyed by the residents. Following this inspection five immediate requirements were made to ensure the safety and welfare of the resident. These can be found throughout the body of the text and at the back of the report under requirements. What the service does well: What has improved since the last inspection? The quality of the paperwork has considerably moved forward and improved in the standard of care plans and risk assessments that were seen. The home has invested in decorating the property in the main hallway and two service user bedrooms. New bedding has been purchased for all service users as well as new fridge, freezer and washing machine. Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 6 What they could do better: The home could provide documentation of care plans and risk assessments for the residents. However through completion of paperwork held for residents, this does not necessarily mean the care provided is service user led. Evidence of reviews being monitored closely will ensure that care plans are used as a working tool to enable clearer, and consistent support, which is service users focused by care staff. To ensure consistent and accurate recordings within the daily log, staff must records times, leave no spaces between lines and sign each entry. There were insufficient records of the service users day; also it was felt insufficient activities were being undertaken with the client. There was no evidence seen of all staff completing basic training, supervision or induction training, leaving the residents vulnerable to inexperienced staff. The homes recording and policies and procedures were also not seen, resulting in a lack of health and safety, cross infection and residents welfare and safety being jeopardised. The home as part of the immediate requirements has been asked to deep clean the home, provide window restrictors for two rooms, provide evidence that furniture in service users bedroom was bought by the company. The home also needs to seek advice from the fire service and make suitable the heating and lighting in the care home. Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 7 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. Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3 The home’s statement of purpose contains the required information however the home is not delivering the services that is indicated within this document. There is no system of pre assessment at the home that enables staff to assess the needs of residents. EVIDENCE: The statement of purpose has been updated. Information regarding staff names and staffing numbers have now been added to this document. Information gathered from inspection of care plans and daily evaluation notes indicated that services described within the statement of purpose are not being delivered to service users, and that the current service differs greatly from the one described in these documents. There was no pre assessment seen in the residents file. Care plans generated by assessments are in place, but the daily routines of staff and service users do not reflect the meeting of assessed needs. The home now has a policy in place regarding new referrals and a standard letter is sent to potential residents that are accessing the service stating whether the home can meet their needs. Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7,9 Service users do not benefit from effective care planning as there is little correlation between care plans and service delivery. EVIDENCE: Several residents care plans were looked at. These documents contained, risk assessments; individual plans for daily living, weekly plans and health needs. It also included a strengths and needs list and likes and dislikes list however when checking that activities from the likes list were being carried out it was found they did not happen with any regular occurrence. It was evident through reading the plans of service users that these were not drawn up in joint agreement. The resident’s reviews need to be person centred and formatted to suit the individual’s personal wishes and capabilities. The Manager stated that a key worker system is in place in the home and weekly meetings are held between the key worker and the service user to discuss the care plan and from these a new action plan will be formulated. The goals around this intervention need to be more specific and achievable. Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 11 There was clear evidence of three monthly reviews taking place and long and short-term goals being set. The home would benefit from monthly reviews made up of the weekly sessions and this could provide of a user-led service. The care plans viewed did not really include information about the preferred life style of the individual service users. There were detailed descriptions of guidance on how to care for the resident, but no clear evidence of service users making informed decisions. Where service users’ rights to make decisions are limited, the home has recorded reasons on the care plans and in risk assessments. These risk assessments are very detailed and staff signing they have seen and understood the risk assessments, which are also in a separate file, is good practice. A service user spoken to during the inspection spoke of an environment in which they are not really encouraged or enabled to make decisions. Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11-14 Resident’s opportunities for personal development are poor in this home with little chances to maintain and develop independent living skills. The home does not facilitates enough leisure activities to enable residents to maintain appropriate and fulfilling lifestyles. Links with the community are poor and resident’s social and educational opportunities are very limited. EVIDENCE: The resident’s care plans and daily recordings, as well as direct observations made during this visit, continue to clearly evidence that the resident’s are not stimulated with appropriate social and educational opportunities and are not offered educational or vocational experiences. The more able resident’s are developing practical life skills to the best of their abilities however staff have no assessment of life skills highlighting what long or short-term goals to aim for so this is quite basic. Some resident do go out to the bank or shopping with staff once a week but this does not maintain strong local community links, however family and personal relationships are encouraged and promoted. Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 13 Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 The physical health needs of residents are being met and the multi-disciplinary working taking which takes place on a regular basis enhances the care offered to residents. EVIDENCE: The home promotes and maintains residents physical health through supporting and facilitating medical appointments as required. The member of staff stated that the service user is registered with a GP, optician and dentist of their choice. Written evidence could be found of this. Limited documentation was seen of the input from the mental health services, although staff stated that weekly visits are made for regular treatments with the District Nurse. The home also accesses the local health Authority challenging behaviour workers which compromises of a Psychologist, psychiatrist, epilepsy nurse and C.P.N. Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Residents are aware of how to complain, however feel that their views are not listened to or acted upon. The home’s policies and procedures do not ensure residents are protected from abuse, neglect and self-harm. EVIDENCE: The home has a clear step-by-step procedure that meets the requirement of the regulations. The complaints procedure was displayed within the home and evidence was seen of it included in the statement of purpose and service user guide. The home has received complaints since the last inspection; evidence was not seen that these complaints had been acted upon. One resident who had complained his light was not working a month ago still had not had it fixed. The inspector concludes that the complaints procedure is ineffective. Service users are raising complaints, but these are not addressed by the home or recorded on a complaints form The staffing levels in the home although fully staffed seemed low due to sickness and holidays, are insufficient to ensure the health, welfare and safety of service users is protected. All staff has still to receive adult protection training although staff inductions now appear to be happening and POVA and CRB checks were on all staff files. Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26, 27,28,30 Residents do not benefit from living in a clean environment and poor maintenance in this home is compromising resident’s safety. The very poor standards of hygiene standards of the home put service users` at risk of contamination and cross-infection. EVIDENCE: A tour of the premises was undertaken and with few exceptions most bedrooms and communal areas were cleaned to a very poor standard. Dirty walls, paintwork, toilets, sinks, carpets and furniture represented a risk to service users health and presented as a very unpleasant environment for service users to live in. One service user’s room had no working lights a broken toilet flush with an extremely dirty toilet bowl, broken wardrobe doors and a broken desk. The bedroom window opened fully and represented a risk to the safety of the service user. The service user told the inspector that he had reported the broken light and toilet flush several weeks ago. He told how the maintenance man had replaced the bulb in his bedroom light which then blew again with sparks coming from it. Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 17 The inspector was concerned to find that the homes maintenance monitoring sheets showed that this and other rooms had been checked weekly and that some of these had been undertaken by the manager. A second bedroom window was also found to have an unsafe window opening. The upstairs kitchen fridge had unlabled, opened food in it and two halve empty loafs of bread which were both very stale . Again the kitchen monitoring check sheet showed that this fridge is checked daily. The homes cleaning rota had been filled in but a tour of the premises showed that cleaning is not appropriately being carried out The last environmental health report required the Home to replace the homes kitchen floor by April 2005. This is still outstanding. Three service users told the inspector that they had had to pay for some items of furniture and soft furnishings. One staff member said she did not think that the service user had paid for his own curtains, although the manager thought that another service user had paid for a new wardrobe. Consequently the inspectors have required the Home to evidence that it has paid for furniture and fittings as listed in standard 26.2 for all service users. Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33, 35,36 Poor staff morale and high staff turnover and sickness affects the consistency of care to the people using this service. The number of staff employed is not sufficient to provide the level of care required for the residents. The staff team need to develop their knowledge and skills so as to provide a more competent and skilled workforce better able to provide a high standard of care to all residents. EVIDENCE: All recognised that the home is experiencing difficulties, and agreed the previous inspection report was a true reflection of Rochester House. That said, the staff impressed the inspector with their commitment and enthusiasm towards the home and the service users who live there. Staff were observed to be professional and caring towards service users. Discussions with staff evidenced a working knowledge of learning disability and of challenging behaviour. Staff rotas were seen and evidenced that staffing was inadequate to provide appropriate shift cover. The home needs to have at three members of staff on, covering hands on care and two staff designated to the office. Evidence seen suggested staff training was not meeting the required standard. One member Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 19 of staff spoken to required basic training on First Aid and Adult Protection. The manager is working towards all staff being up to date on training needs and a training plan was seen to evidence this. The member of staff confirmed two members of staff had completed NVQ 2 and one was on the course. One member of staff had completed NVQ 4 and 6 staff are on the course for NVQ 3. All members of staff on duty have received induction training however the home was not aware that the home needed to have a staff member trained to provide this, and no evidence was found to support all staff inducted. Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, 41,42 The home is not run in the best interest of the residents and the home’s policies, procedures and management do not safeguard the residents’ rights and best interests. The health safety and welfare of residents are not protected. EVIDENCE: Resident meetings are taking place and minutes were seen. Quality assurance needs to be more robust as the home not aware of the resident’s comments and complaints. The homes policies and procedures are not adhered to. Records seen are not kept to a satisfactory standard, although they are kept securely. Rochester House is failing to safeguard the health, safety and welfare of service users. At present the home has an ineffective complaints procedure, and allows new staff to commence work without any formal induction. The physical environment is filthy, hazardous and shabby and risk assessments Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 21 regarding the property have not been undertaken. Service users assessments and care plans do not appear to be followed, and residents social and vocational aspirations are not even considered. The Environmental Health Officer visited the home in January and made several recommendations about equipment and food safety and hazard analysis some of these do not appear to have been actioned. Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x 2 x x Standard No 22 23 ENVIRONMENT Score 1 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x 1 1 1 x 1 Standard No 11 12 13 14 15 16 17 1 1 1 1 x x x Standard No 31 32 33 34 35 36 Score x 3 2 x 1 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rochester House Score x 3 x x Standard No 37 38 39 40 41 42 43 Score x x 1 x 1 1 x H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 23 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 YA2 Regulation 14(1)(d) Requirement Timescale for action sept 2005 2. YA3 12(1)(a)( b) 3. YA6 15(1) The registered person shall not offer accommodation to a service user at the care home unless, so far as it shall have been practicable to do so –The registered person has confirmed in writing to the service user that having regard to the assessment the care home is suitable for the purpose of meeting the service users needs in respect of his health and welfare The registered person shall sept 2005 ensure that the care home is conducted so as – (c) to promote and make proper provision for the health and welfare of service users; (d) to make proper provision for the care and, where appropriate, treatment, education and supervision of service users. Unless it is impracticable to carry sept 2005 out such consultation, the registered person shall, after consultation with the service user, or a representative of his, prepare a written plan (“the service user’s plan”) as to how the service user’s needs in Version 1.40 Page 24 Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc 4. YA7 12(2) 5. YA11 12(1)(b) 6. YA12 16(1) 7. YA13 16(2)(m) respect of his health and welfare are to be met).The registered person is required to ensure the staff employed at the home carries out all individual service user plans. The registered person shall so far as practicable enable service users to make decisions with respect to the care they are to receive and their health and welfare. The registered person shall ensure that the care home is conducted so as –To make proper provision for the care and, where appropriate, treatment, education and supervision of service users.The registered person is required to ensure that staff employed at the care home enable service users to have opportunities to maintain and develop social, emotional, communication and independent living skills Subject to regulation 4(3), the registered person shall provide facilities and services to service users in accordance with the statement required by regulation 4(1)(b) in respect of the care home.The registered person is required to ensure that (as stated in the homes statement of purpose), staff help service users to find and keep appropriate jobs, continue their education or training, and/or take part in valued and fulfilling activities. The registered person shall having regard to the size of the care home and the number and needs of service users –Consult service users about their social interests, and make arrangements to enable them to engage in local, social and sept 2005 sept 2005 sept 2005 sept 2005 Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 25 8. YA14 16(2)(n) 9. YA22 22(2)(3)( 4) 10. YA23 13(6) community activities and to visit, or maintain contact or communicate with, their family and friends.The registered manager is required to ensure that staff support service users to become part of, and participate in, the local community in accordance with assessed needs and the individual plans. The registered person shall, sept 2005 having regard to the size of the care home and the number and needs of service users –Consult service users about the programme of activities arranged by or on behalf of the care home, and provide facilities for recreation including, having regard to the needs of service users, activities in relation to recreation, fitness and training.The registered manager is required to ensure that staff employed at the home ensure that service users have access to, and choose from a range of appropriate leisure activities The complaints procedure shall sept 2005 be appropriate to the needs of service users.The registered person shall ensure that any complaint made under the complaints procedure is fully investigated.The registered person shall, within 28 days after the date on which the complaint is made, or such shorter period as may be reasonable in the circumstances, inform the person who made the complaint of the action (if any) that is to be taken. The registered person shall make sept 2005 arrangements, by training staff or by other measures, to prevent Version 1.40 Page 26 Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc 11. YA24 23(2)(a)2 3(2)(b)23 (2)(d)23( 2)(i)23(2) (p) 12. YA26 16(2)(c ) 13. YA27 16(2)(j) 14. YA33 18(1)(a) service users being harmed or suffering abuse or being placed at risk of harm or abuse The registered person shall having regard to the number and needs of the service users ensure that – (c ) the physical design and layout of the premises to be used as a care home meet the needs of the service users; (d) the premises to be used as the care home are of sound construction and kept in a good state of repair externally and internally. (d)all parts of the care home are kept clean and reasonably decorated. (p) ventilation, heating and lighting suitable for service users is provided in all parts of the care home. The registered person shall have regard to the size of the care home and the number and needs of service users –(c) provide in rooms occupied by service users adequate furniture, bedding and other furnishings, including curtains and floor coverings, and equipment suitable to the needs of service users and screens where necessary. Provide evidence of whom has paid for these. The registered person shall have regard to the size of the care home and the number and needs of service users –(j) after consultation with the environmental health authority, make suitable arrangements for maintaining satisfactory standards of hygiene in the care home; The registered person shall, having regard to the size of the immediate requiremen t immediate requiremen t immediate requiremen t Sept 2005 Page 27 Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 15. YA39 24(1)(a)( b) 16. YA 26 16.2(c ) care home, the statement of purpose and the number and needs of service users –(a) ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. The registered person shall establish and maintain a system for – (c) reviewing at appropriate intervals; and(d) improving,the quality of care provided at the care home. The registered person is required to evidence that the home provides service users with all furniture and fittings listed in standard 26.2 . sept 2005 Sept 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 28 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent. ME16 9NT 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 Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 29 Rochester House H56-H06 S28968 Rochester House V241089 250705 Stage 4.doc Version 1.40 Page 30 - 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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