Inspection on 21/10/05 for Rock House

This inspection was carried out on 21st October 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Rock House 27/07/07

Rock House 07/06/06

Rock House 23/05/05

Rock House 11/10/04

Rock House 04/05/04

Similar services:

St Vincents

The Cotswold Home

Winton House

Newbeech House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Rock House Austenwood Lane Chalfont St Peter Bucks SL9 9DF Lead Inspector Joan Browne Mike Murphy Announced 21st October 2005 9:30am 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. Rock House Version 1.10 Page 3 SERVICE INFORMATION Name of service Rock House Address Austenwood Lane, Chalfont St Peter, Bucks SL9 9DF 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) 01753 882194 Gold Hill Housing Association Susan Shadloo Care Home 37 Category(ies) of Old Age, not falling within any other category registration, with number of places Rock House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd May 2005 Brief Description of the Service: Rock House is a care home for older people, which provides personal care and accommodation for thirty-seven service users who are elderly, physically and mentally frail. Gold Hill Housing Association owns the home, which is a public limited company. The home is located in Chalfont St Peter, at the top of Gold Hill Common. It is close to shops, pubs, the post office and other amenities. Rock House was developed from two large semi-detached houses and consists of three floors. Access to floors is via a passenger lift. All the home’s bedrooms are single and twelve of the bedrooms have en suite facilities. The home has its own pleasant landscaped garden. Rock House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection of the home, which took place on the 21st October 2005 from 09.30 am to 18.10 pm. The lead inspector was Ms Joan Browne who was accompanied by Mr Mike Murphy (Inspector). The inspection consisted of discussions with residents, staff, examination of care documentation and records. The requirements and recommendations from the previous inspection were discussed. Comment cards were received from four residents, ten relatives, and one health and social care professional. Some relatives raised concerns on the attitudes of senior managers. However, overall they were satisfied with the care that was being provided. Comments from residents were generally favourable. One particular resident commented that she would like to be much more involved in the decision making within the home especially personal decisions. A tour of the communal areas, general kitchen and some bedrooms was carried out. The serving of lunch was observed. Feedback was given to the manager, chief executive and the project manager at the conclusion of the inspection. What the service does well: What has improved since the last inspection? All care staff have undertaken training in care planning and report writing. Medication administration record sheets and care plans are monitored regularly. Carpets in the lounges have been replaced. A generic risk Rock House Version 1.10 Page 6 assessment for bed rails has been developed. Protocols for the administration of Insulin and Forsamax medication have been developed. A new induction training pack for care staff has been developed. There is now a treatment room where residents could be treated by the general practitioner (GP), district nurse and chiropodist in private. Some residents with support from the activity organiser have developed a collage welcome pack. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rock House Version 1.10 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 Rock House Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 & 3 The service user’s guide should be amended to ensure that the document conforms fully to the standard. Each resident has a written contract. However, the contract should be amended to clarify additional fees chargeable. Detailed assessments were carried out prior to admission to ensure the appropriateness of any placement in the home. EVIDENCE: The home has reviewed and updated its service user’s guide. The revised document was reviewed with the registered manager. The document is informative on the philosophy and facilities of the home. It includes reference to the adjacent flats which are managed by the same organisation but do not form part of this registered service. Amendments to ensure that the document conforms fully to the standards were discussed with the registered manager. Rock House Version 1.10 Page 9 The contract meets most aspects of this standard but needs amending to clarify the additional fees chargeable for services provided by the Gold Team (such as escort to hospital). The registered manager and other experienced care staff assess residents’ needs. Records of assessment examined were comprehensive, detailed and provided a sound foundation for a plan of care. Rock House Version 1.10 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 9 Care plans were in place to ensure that residents’ care needs are fully met. However, day-to-day progress on residents’ identified needs were limited. Arrangements were in place to ensure that residents’ health care needs are fully met. There has been an improvement in the recording of medications. However, there are still inconsistencies in the administration of medication as identified in the body of the report, which has the potential to put residents at risk. EVIDENCE: Rock House Version 1.10 Page 11 The home uses the Standex care planning system. Records have been rationalised over the past twelve months. Assessments were detailed and provided a good foundation for the plan of care. Records included assessments of tissue viability, risk, moving and handling and overall dependency. Records of day-to-day progress were variable. Many were limited to records of physical care provided but a somewhat lower proportion than on previous inspections. Plans contained references to psychosocial aspects (i.e. thoughts, emotions and participation and response to social activities) of residents’ lives in the home. The home is continuing to address this matter. Care plans are reviewed monthly. Care staff maintain the personal and oral hygiene care of residents. Waterlow assessments were in place for each resident and they were reviewed monthly. The district nurse provides continence advice, as well as aids and equipment. Some residents were in the process of having their continence assessments reviewed by the district nurse. The activity organiser provides gentle armchair exercises daily. All residents are registered with a general practitioner that visits the home and have access to the visiting chiropodist and optician that visit the home. Residents have access to National Health Service facilities via the general practitioner. The home uses the Boots Mandrex medication monitored dosage system. The medication administration record sheets (MARS) were examined and it was noted that there has been an improvement in the recording of medication. No gaps were noted on the MARS. Weekly monitoring of MARS was taking place. However, inconsistencies in handwritten entries recorded on MARS were noted. Entries were recorded with one staff member’s signature; this indicated that a second staff member did not check the entries. Scribbled over entries were also noted. Staff are reminded that entries recorded in error should have a line drawn through and a note recorded on the back of the sheet with the reason. For example, ‘recorded in error.’ At the back of a particular resident’s MAR sheet it was noted that 5 mls of diazepam had been administered. There was no entry on the MAR sheet to indicate it was prescribed by the general practitioner (gp). The manager stated that the drug had been prescribed for the individual when necessary (PRN). However, it was not recorded on the current month’s MAR sheet. It is required that all prescribed medications must be recorded on individuals’ MAR sheets. Eye drops, which were in use, did not have the date it was opened recorded on the box, and some liquid medication bottles were sticky. The controlled drug register was checked and the stock levels of drugs in the cupboard corresponded to balances in the register. However, it is recommended that the system in place for recording new entries in the controlled drug register should be improved, to reduce the risk of errors in stock balances occurring. Rock House Version 1.10 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 Arrangements are in place to ensure that residents’ social religious and recreational interests are catered for. Visitors are welcome to visit at anytime this ensures that residents maintain contact with their families and friends. The home needs to promote the services of an advocate this would ensure that residents are allowed to exercise choice and control over their lives. An appropriate range and variety of meals were on offer to residents. However, the practice in place, of staff feeding more than one resident at the same time, should be reviewed to ensure that residents have a pleasant dining experience. EVIDENCE: Rock House Version 1.10 Page 13 Residents spoken to confirmed that they are able to rise and retire at a reasonable time. The home has several activity organisers who provide one to one stimulation to individuals and arrange group activities. Daily activities provided are flexible and varied and encourage residents to continue with any interests and hobbies that they may have. Some residents spoken to were finding the art classes that were available interesting. Residents’ interests are recorded in their care plans. On the day of the inspection some residents participated in a card game in the morning and songs of praise in the afternoon. The week’s activities were displayed on the notice board for residents’ attention. Residents are encouraged to maintain contact with family and friends. The home does not have any restrictions on visiting. Residents are able to receive visitors in private in their own rooms if they wish to. Feedback on comment cards from some relatives confirmed that staff are hospitable and always make them feel welcome. The home has close links with the local church. On the day of the inspection there were no residents using the services of an advocate. There was also no information displayed in the home to advice residents and their relatives how to access the services of an advocate. This was discussed with the manager and she was advised to contact the local age concern advocacy agency and invite a representative to meet with residents at an informal meeting. Residents are made aware that they are able to bring personal possessions with them if they wish to. This was evident in some residents’ bedrooms, which were personalised with their own furniture. Lunch was observed and consisted of fish cakes, creamed potatoes, broccoli and baby carrots. Dessert was eve’s pudding and cream. Some poor care practices were observed for example, a member of staff was feeding two residents at the same time. Examples of poor moving and handling techniques were observed, including staff were moving residents’ seated in chairs at the dining table, which has the potential to put Staff and Service Users at risk. Rock House Version 1.10 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The home has an appropriate complaints process in place. However, this could be improved by recording more detailed information of the outcomes of complaints investigated. EVIDENCE: The complaints folder was examined and it was noted that information recorded relating to the actions and the outcomes of complaints investigated were very brief. It is recommended that more detailed information regarding the action and outcome of complaints investigated should be recorded. Rock House Version 1.10 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, 24 & 26 Issues relating to the environment, which have been highlighted in this report, need attention to ensure that residents’ health and welfare is not compromised. EVIDENCE: The home is located on three floors. Access to floors is via a passenger lift and stairs. A record of routine maintenance work carried out to the premises were in place. Grounds and garden were maintained and accessible to residents. A recent inspection by the local fire services department had taken place. The report was not available at the time of the inspection Bedrooms examined were homely and personalised with family pictures and mementoes. However, it was noted in two bedrooms that the divan bases on two beds were saturated with urine and required replacing. There was also a strong odour in two particular bedrooms, which indicated that carpets in these room maybe in need of replacing. Three bedroom doors were wedged open with obstacles. The manager is required to ensure that those residents who Rock House Version 1.10 Page 16 wish to keep their bedroom doors open must have the appropriate door holding devices or dor-gards fitted to doors after consultation with the local fire service department. The laundry room is situated in an appropriate area of the building away from where food is stored prepared and cooked. Washing machines are equipped with the specified programming to meet disinfection standards. However, it was noted that two washing machines were leaking and required attention. There was a build-up of dust behind the washing machines and driers, which required attention. Communal areas on the day of the inspection were free from offensive odours. It was noted that covers on the sanitizer bins in some bathrooms and bedrooms were missing. General waste bins in some areas of the building and in toilets were of the swing top type and needed to be replaced with foot pedal bins to prevent the spread of cross infection. Rock House Version 1.10 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 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) 28, 29 & 30 Arrangements are in place to ensure that staff achieve an NVQ qualification. This would ensure that competent staff are caring for residents. The organisation of staff files has improved. However, some weaknesses in procedures were noted, which has the potential to put residents at risk. The home has a training programme in place to ensure full competence amongst the staff team EVIDENCE: The home is actively working towards achieving the objective of having 50 of care staff trained to National Vocational Qualification (NVQ) in level 2 by the end of December 2005. At the time of this inspection eight staff were working towards NVQ 2 and one towards NVQ 3. The home is a City & Guilds NVQ assessment centre with external verification being provided by Thames Valley University. The home’s recruitment documentation and staff files were examined. The home’s application form does not require the applicant to record their previous work experience at the time of application. In this respect the form fails to conform to guidance issued when the Protection of Vulnerable Adult (‘POVA’) register was established in July 2004 in requiring a statement as to why a person who has held a care position for more than three months ceased to Rock House Version 1.10 Page 18 work in that position. This information is obtained at interview and recorded on a separate form. Four staff files were examined. The organisation of staff files was good and much improved on previous inspections. However, some weaknesses in procedures were noted and need to be addressed by the registered manager. Information did not appear to be routinely sought from previous employers on the reason why applicants had left a previous care position. Some staff appeared to have started employment a few days in advance of a Criminal Record Bureau (CRB) certificate or POVA first being obtained. However, at the time of this inspection a POVA first or enhanced CRB had been obtained for all staff. In one case discrepancies in dates of employment did not appear to have been explored at interview or otherwise be followed up by the registered manager. In two files the description of previous positions held were brief and inadequate. The status of some references was unclear i.e. apparently unverified photocopies or no information on the status of the referee, or, where employers, the authority of the person to provide a reference. The home has not to date received faxed copies of POVA first clearances obtained by its ‘umbrella body’ (through which CRB applications are being processed) and it was advised to do so in order to provide evidence that such clearance had been obtained. A summary of the home’s training records was provided for inspection. The list included staff working with the Gold Team. The induction programme is now based on a workbook devised by Oxfordshire County Council. The chief executive said that the programme meets TOPSS (now ‘Skills for Care’) requirements. New staff work through the programme under the guidance of the registered manager or a mentor. The training programme includes moving & handling (in-house), fire safety (which the registered manager said is provided by the fire authority), first aid (provided by the Ambulance Service), food hygiene (in-house), infection control (currently run in conjunction with a nursing home) and medicines administration (currently a short course run by a local pharmacist). The home is in discussion with a local care home organisation (BACH – Buckinghamshire Association of Care Homes). The home was advised to consider using an ASET accreditated course in medicines control and administration run in Amersham. Refresher courses are based on handouts developed by the home. Rock House Version 1.10 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 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, 33, 35, 36 & 38 The manager has achieved the required level of formal professional qualification to demonstrate her fitness for the role. Overall residents’ financial interests are safeguarded. However, residents’ contracts and the service user’s guide must be amended to clarify charges for services provided by the administration team. The home reviews its performance regularly through a programme of selfauditing and seeking the views of residents and relatives. Arrangements are in place to ensure that all staff are appropriately supervised. Shortfalls in records pertaining to health and safety may put residents at risk. EVIDENCE: Rock House Version 1.10 Page 20 The registered manager is experienced and holds the NVQ4 in care management. At the time of this inspection the registered manager was about to acquire additional responsibilities for Graham House, an adjacent residential complex of 12 flats. This development had been discussed with the home’s inspector. The registered manager maintains her skills and over the past year has attended training in moving & handling, dementia, POVA, sling care and falls prevention. The registered manager’s job description was due to be reviewed with the chief executive. The home conducts a questionnaire based survey of residents and relatives views every four months. According to the registered manager and chief executive this covers care, communications, activities, the fabric of the building, and any general comments, which the respondent wishes to make. The results of recent surveys were not examined on this inspection. The Association’s management committee receives copies of regular visits conducted under Regulation 26. Residents meetings are held quarterly – the last being held on 5 August where food was the main topic of discussion. The home maintains an ongoing programme of refurbishment and new carpets and chairs have been purchased since the last inspection. The registered manager said that policies are reviewed annually although it is noted that these are not dated. The home does not normally look after residents’ financial affairs. Any expenses incurred for example hairdressing and chiropody is invoiced to the relative responsible on a monthly basis. However, on the day of the inspection the home was looking after one resident’s financial affairs that were recently transferred from another home. Funds that were sent with the resident were banked in a reserve bank account and arrangements were being made to develop a transaction sheet. It was noted that the home would expect residents to pay an administration fee of 2.5 interest for handling their finances. However, this information was not documented in the home’s service user’s guide and terms and conditions of occupancy. The manager is required to ensure that this information is clearly recorded in these two documents. Rock House Version 1.10 Page 21 Staff supervision takes place every two months. Sessions last for between 10 and 30 minutes and brief notes are taken. All staff have an annual appraisal. Evidence was available to indicate that the fire panel was recently serviced. The engineer recommended that the panel is replaced because of its age. The fire records examined indicated that the panel was checked weekly. However, the presentation of entries recorded in the folder was poor. An improvement in the presentation and layout of the folder is required. Hot water temperature records were in place. However, there was no evidence that the temperatures were within the required range as checking was indicated by a tick. It is required that the level of actual water temperatures be recorded. There was no Legionella certificate available to confirm that the home’s water system had been regulated to prevent the risk of Legionella. It is required that the water system is checked and inspected by a competent person yearly and the appropriate certificates are issued and available for inspection purposes. Records indicated that the portable mobile hoists were recently serviced. Food stored in the general kitchen was appropriately dated and labelled. Opened packets of food were stored in airtight containers. A record of daily fridge, freezer and food temperatures were in place. The practice in place regarding the afternoon tea is that soup prepared is left standing on the cooker and other cooked foods are placed in the hot trolley. It is recommended that the temperature of the food in the hot trolley is recorded before it is served to ensure that the temperature is within the food safety guidelines, which is 65 degrees Celsius or above. The diffuser cover on the strip light in the kitchen was cracked and needed replacing. It also required cleaning as it contained dead insects. It was noted that toiletries were left in bathroom 007. Staff are reminded of their duty to return residents’ toiletries to their bedrooms after use. Rock House Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 2 2 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 COMPLAINTS AND PROTECTION 3 x x x x 2 x 2 STAFFING Standard No Score 27 x 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x 3 x 3 x 2 3 x 2 Rock House Version 1.10 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 2 Regulation 5(1) Requirement The registered manager must ensure that the service users guide is amended to ensure that the document conforms fully to the standard. The registered manager must ensure that prescribed medications for residents are recorded on the medication administration record sheets. The registered manager must ensure that the practice of feeding two residents at the same time is ceased. The registered manager must ensure that the mattresses and divans in bedrooms 122 and 009 are replaced. The registered manager must ensure that bedrooms doors are not wedged open with obstacles. Those residents who wish to keep their bedroom doors open must have the appropriate door holding devices or dor-gards fitted after consultation with the fire officer. The registered manager must make every effort to eliminate the odour identified in bedrooms 023 and 122. Alternatively the Version 1.10 Timescale for action 12/12/05 2. 9 13(2) 30/12/05 3. 15 10(1) 30/11/05 4. 24 16(c)23 (2) (c ) 23(4) 30/11/05 5. 24 30/11/05 6. 24 16(k) 12/12/05 Rock House Page 24 7. 26 23(2)(c ) 8. 26 16(k) 9. 10. 29 2 19(1) 10(1) 11. 38 10(1) 12. 38 23(5) floor covering must be replaced after discussions with the residents and relatives. The registered manager must ensure that the leaks on the washing machines are remedied. A cleaning schedule in the laundry room must be implemented. The registered manager must ensure that missing covers on sanitizer bins in bathrooms and some bedrooms are replaced. Swing top bins must be replaced with the foot pedal type to prevent the spread of cross infection. The registered manager must address weaknesses in the homes recruitment procedure. The registered manager must ensure that information relating to administration charges for handling residents finances is documented in the service users guide and the contract. The contract must also be amended to clarify the additional fees chargeable for services provided by the Gold Team. The registered manager must ensure that there is an improvement in the recording and presentation of Fire Safety Checks and hot water temperature records. The registered manager must ensure that the water system is checked and inspected by a competent person to prevent the risk of Legionella. 30/11/05 30/11/05 12/12/05 12/12/05 12/12/05 12/12/05 Rock House Version 1.10 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 9 9 Good Practice Recommendations It is recommended that the registered manager should ensure that handwritten entries recorded on MAR sheets are checked and signed by two staff members. It is recommended that the registered manager should ensure that the date is recorded on eye drops when opened. Liquid bottles of medication should be wiped with a damp cloth after use. It is recommended that the registered manager should review the system in place for recording new entries in the controlled drug register to reduce the potential risk of errors in stock balances occurring. It is recommended that the registered manager should invite a representative from the local age concern advocacy agency to meet with residents. It is recommended that the registered manager should ensure that more detailed information regarding the action and outcome of complaints investigated be recorded in the complaints folder. It is recommended that the registered manager should ensure that faxed copies of POVA first clearances are obtained from its umbrella body. It is recommended that the registered manager should ensure that food temperatures be recorded for food stored in the hot trolley before it is served. 3. 9 4. 5. 14 16 6. 7. 29 38 Rock House Version 1.10 Page 26 Commission for Social Care Inspection Cambridge House 8 Bell Business Park Smeaton Close Aylesbury, Bucks, HP19 9JR 01296 737550 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 Rock House Version 1.10 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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