Inspection on 17/12/08 for Roseberry Gardens 36

This inspection was carried out on 17th December 2008.

CSCI found this care home to be providing an Adequate service.

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

Roseberry Gardens 36 13/04/07

Roseberry Gardens 36 06/06/06

Roseberry Gardens 36 22/02/06

Roseberry Gardens 36 12/04/05

Roseberry Gardens 36 01/09/04

Roseberry Gardens 36 27/05/04

Roseberry Gardens 36 03/03/04

Roseberry Gardens 36 10/02/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 07/08/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Roseberry Gardens 36 Roseberry Gardens 36 London N4 1JJ     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: David Hastings     Date: 1 7 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Roseberry Gardens 36 Roseberry Gardens 36 London N4 1JJ 02088003230 02082118098 roseberrygardens@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Angelina Espino,Mr Jessie Espino care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Limited to 3 people of either gender who have a mental disorder (MD) and who may also fall into the category of old age (LD(E)). and who may also fall into the category of old age (MD(E)) or have a learning disability (LD) Date of last inspection Brief description of the care home 36 Roseberry Gardens is a small care home situated in Haringey, close to the facilities of Green Lanes and within a short bus journey to Wood Green Shopping Centre. There are three single bedrooms, a galley kitchen and two small lounges. One of the bedrooms is on the ground floor and the other two are on the first floor. There are small front and rear gardens. The home is owned by Mr and Mrs Espino who live in the home. The weekly fees of the home depend on the assessed needs of service users but currently the weekly fee is four hundred and twenty pounds. Following Inspecting for Better Lives the provider must make information available about the service, including inspection reports, to service users and other stakeholders. Inspection reports Care Homes for Adults (18-65 years) Page 4 of 30 3 3 Over 65 3 3 Brief description of the care home produced by the Commission of Social Care Inspection (CSCI) are available upon request from the registered manager/provider. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We carried out this unannounced key inspection of Roseberry Gardens on Wednesday 17th December 2008. We were assisted by the registered manager of the home who was open and helpful throughout the inspection. We spoke with two people who use the service who were both positive about the standard of care provided at the home. We looked around the home and examined various care records, staff files and health and safety documentation. The home also prepared a self assessment (AQAA) and this was submitted to the Commission for Social Care Inspection in April 2008. This information was used as part of the inspection. Care Homes for Adults (18-65 years) Page 6 of 30 Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: Fifteen new requirements and two good practice recommendations have been issued as a result of this inspection. Comprehensive assessments must be carried out for all prospective residents of the home to make sure that the staff at the home are aware of all the needs of the people they support. The service agreement or contract between the home and the placing authority must be reviewed to make sure all parties are clear about what service is provided by the home. Although the manager is aware of the needs of people at the home, these needs must be recorded in each individuals plan of care. More written detail is also required in each persons risk assessment so the home can take action to reduce risks faced by people who use the service. Records must be maintained of all meals taken by residents at the home so the manager can provide evidence that people are receiving a balanced, nutritious diet. The kitchen needs to be cleaned on a regular basis to ensure that food is prepared and cooked in a satisfactory environment. We also made a good practice recommendation that the manager consults with the local environmental health department for more advice on improvements to hygiene. Peoples medication must be reviewed on a regular basis to make sure that the medication people are taking is still right for them. All medication coming into the home needs to be accurately recorded so that people always have enough medication. If a resident is self medicating the manager must carry out a risk assessment to ensure that the resident can do this safely. Paper towels must be provided in all toilets so that the risk of cross infection is reduced. Care Homes for Adults (18-65 years) Page 8 of 30 To make sure that residents and other stakeholders are kept up to date with how the home is meeting its aims and objectives, the results of any quality monitoring surveys must be collated and published. We have required the home to send us copies of the fire alarm certificate and the electrical installation certificate so that there is written evidence that the fire alarm has been serviced and the electrical installations at the home are safe. The fire risk assessment must be updated so that the people who live at the home are better protected. The manager must obtain advice from the local fire officer about the fitting of fire doors throughout the home. We have also made a good practice recommendation that the communal areas in the home are redecorated. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are not always being properly assessed before they move into the home. This means that the service may not know if they can support the person properly. Contracts or agreements with the placing authority and the home are not always accurate and do not reflect the care provision at the home. Evidence: Since the last inspection of this service two new residents have been admitted to the home. One person had been admitted to the home in June of this year as an emergency placement. Although the manager told us that she had carried out a pre assessment on this persons needs, this could not be found on the day of the inspection. There was no information about this person from the placing authority although the manager told us that she had requested this on several occasions. The manager told us that she had visited the person before they moved in. This lack of information means that a comprehensive assessment of the persons needs would be difficult to complete. It is important that the service has a detailed Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: knowledge of a residents needs before they move into the home. A requirement relating to pre assessments has been issued. It was noted that the resident has been seen by a consultant psychiatrist who was satisfied with the care provided by the home. The second person to be admitted to the home had a pre assessment carried out by the manager and information had been received from the placing authority. We spoke with the resident who told us that they had been involved in this assessment and had visited the home on several occasions before deciding to move in. They told us they were happy with the service. We examined the written contract between the home and the placing authority. This stated that the home provides twenty four hour waking staff at the home. This is not the case. The manager lives at the home and sleeps there during the night. The manager told us that if anyone needed help during the night they can always knock on her door. This is not twenty four hour waking care. A requirement has been issued that all contracts or agreements with local authorities are reviewed so that they reflect the actual care arrangements provided by the home. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are involved in their care development and are supported to exercise choice and control over their lives. The manager understands the needs of the people living in the home. Care plans do not contain enough written information about all the needs of the individual or how peoples needs are to be met. The manager must review all risk assessments at the home to ensure the safety of everyone receiving a service. Evidence: All three care plans for the people using the service were examined. These plans consisted of a number of tick boxes and some brief information about care needs of the individual. Plans had been reviewed and people who use the service told us they had been involved in reviewing these plans. One resident has been at the home for a number of years and it was clear from discussion with the manager that she understood their needs very well. It is important that care plans detail all the needs of people living at the home and written information must be recorded regarding how Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: peoples needs are to be met. A requirement relating to care plans has been issued. People who use the service told us that they were supported to choose how they spent their day and were given freedom to make decisions about their lives. One person told us the home allows, maximum freedom. It was clear from discussion with the manager that she supports people to make their own choices and decisions about their lives within safe boundaries. Risk assessments had been carried out for all residents at the home. These assessments were brief and did not always cover all identified risks. For example one resident is known to smoke in their room despite being told this is not safe. This was not mentioned in their risk assessment. Another resident visits their family on a regular basis. Although the manager told us that she had accompanied the resident on the bus to see if they were OK, this issue was not mentioned on the persons risk assessment. A requirement relating to improvements needed in risk assessments has been issued. The manager later told us that the resident who smokes in their room has now stopped and is smoking in the designated areas only. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are free to pursue their own leisure and recreational interests and are supported to treat the home as their own. The manager encourages religious and cultural observance. People like the food at the home, however, standards of hygiene need to improve. Evidence: We saw from written daily notes that all the people who use the service are out and about most days. One person has a job for three days a week. One person regularly visits their family and the other resident goes out most days either alone or with the manager. People who use the service told us that they were happy with the activities they undertake and it was clear that they enjoy the freedom to come and go as they please. All residents have their own key to the home. The manager told us that she has offered to take residents to religious services of their choice but no one has Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: requested this. One person told us about their religious beliefs and that the manager supports their religious observance. People who use the service told us that the staff were respectful towards them and upheld their privacy. Currently no one at the home has any special dietary requirements. People who use the service told us that the food was nice at the home. One person commented that the food was, Excellent. No record is being maintained of what residents are eating so it was difficult to ascertain the nutritious value of meals at the home. A requirement has been made that a record of food given to residents is maintained. It was noted that the kitchen was in need of a thorough clean. This includes cupboards and the cooker. A waste bin was on the kitchen counter, with no lid, which is not hygienic. A requirement has also been issued relating to cleaning the kitchen on a regular basis. A good practice recommendation has also been issued that the manager contacts the local environmental health department to visit the home to offer advice on hygiene matters. The manager told us that residents sometimes help with preparing meals and washing up. We spoke with a CPN who supports one of the newly admitted residents. He told us he was pleased that the resident was putting on weight since being at the home. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service generally have good access to health care professionals. The proper procedures regarding medication are not always being followed and could put people at risk. Evidence: Although no one at the home currently needs direct assistance with personal care, people told us the manager and staff were respectful towards them and upheld their privacy. People who use the service appeared appropriately dressed for the season. Records examined indicated that people have good access to health care professionals and we were informed by residents that they were satisfied with how the home was supporting their health care needs. We noticed that one resident has not had their medication reviewed by their doctor for over a year. A requirement has been issued relating to this. Since the last inspection the manager has revised the way medication is administered and the service now uses blister packs that have been prepared by the pharmacist. The amount recorded by the manager of medication received by the pharmacist did not match up with the actual amount in the blister packs. The manager said this was Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: an issue with the pharmacist. A requirement has been issued that all medication coming into the home must be accurately recorded. The manager informed us that one person self medicates. The manager told us that she had discussed this with the consultant psychiatrist who was happy with this arrangement. However there was no risk assessment relating to self-medication. A requirement has been issued that a risk assessment must be completed for the resident who self medicates and that this is signed by the relevant health care professionals. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are listened to and know how to complain should they wish to. People are protected from abuse by clear policies and procedures and an appropriately trained staff team. Evidence: People who we spoke to said they had no complaints about the service but knew what to do if they did have a problem. There have been no complaints recorded since the last inspection. The service has a satisfactory policy regarding complaints and adult protection. The manager told us that all staff have attended adult protection training recently. We saw up to date certificates on staff files we examined. The manager was able to describe the action she would take in the event of an allegation of abuse occurring at the home. People who we spoke to during the inspection told us they felt safe at the home. Care Homes for Adults (18-65 years) Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Roseberry Gardens has a homely and friendly atmosphere. The standard of cleanliness and decoration are adequate however a programme of redecoration would benefit the people living at the home. Evidence: The home is located in a residential street close to shops and cafes. Each person has their own room and there are two communal lounges and a kitchen. The two people we spoke to said they were satisfied with their bedrooms and the facilities available to them. There is a small garden at the back of the house where residents are requested to smoke. We toured the premises with the manager. The communal areas in the home did not appear to have been decorated for some time. A good practice recommendation has been issued that an improvement plan be sent to the Commission outlining how the home will be redecorated in the near future. The manager told us that residents could control the heating in their rooms. Although bathrooms and toilettes contained anti bacterial soap, all toilettes must contain paper towels to limit the risk of cross infection. A requirement relating to this has been issued in the relevant section of this report. Care Homes for Adults (18-65 years) Page 20 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported by a staff team who are appropriately trained and who have undertaken the required checks to ensure the safety of residents. Evidence: The registered persons live at the home and one or both of them are always available. This was confirmed by residents we spoke with. Sometimes the manager or her husband are not available and one of the managers family will cover the shift. Satisfactory criminal record checks were seen for the other family members. Two of the four family members who cover shifts at the home have an NVQ level 2 in care or equivalent. We saw training certificates that indicated the manager and her family attend regular training. Recent training has included fire awareness, food hygiene, infection control, medication, mental health awareness and adult protection. The manager has undertaken the appropriate management qualification. People who use the service told us that the manager and her family were very friendly and they felt comfortable with them. Care Homes for Adults (18-65 years) Page 21 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The results of any quality assurance surveys are not being made available to residents and other interested parties so people do not know how well the home is doing to meet the aims and objectives of the service. Although some improvements have been made in relation to fire safety, more work is needed to protect the people living at the home. Evidence: Mrs Espino has been the manager of the home since 1987 and she told us that she has had a long experience of working with people with mental health needs. We saw evidence that the manger attends regular training. People who use the service were positive about the manager and her family. The manager has sent out quality assurance questionnaires to see what people feel about the quality of care provided by the home. Although these responses were positive, this information needs to be collated and published and made available to all interested parties. A requirement relating to this has been issued in the relevant Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: section of this report. This will enable the manager to identify improvements needed to the service. We saw records that indicated fire drills are taking place on a regular basis and that the fire alarm and emergency lighting are also being checked weekly. Although it was recorded that the fire alarm had been tested and serviced, the manager could not locate the fire alarm certificate. A requirement has been issued that a copy of this certificate is sent to the Commission and the original kept on file at the home. The fire risk assessment had not been updated and referred to a resident who was no longer receiving a service. A requirement has been issued that the fire risk assessment is updated and includes the two new residents at the home. During a tour of the home we saw a number of doors, which the manager told us were fire doors. Some of these doors had domestic glass in them and it is unclear if these are functioning fire doors. A requirement has been issued that the registered manager obtain advice from the local fire authority that the home has appropriate and safe fire doors within the home. Appropriate fire doors must be provided throughout the home. The electrical installation certificate was out of date and the manager told us she had booked an electrical inspection for the home. A requirement has been issued that a copy of this updated certificate is sent to the Commission. Satisfactory records were seen in relation to gas safety and portable appliance testing. Care Homes for Adults (18-65 years) Page 23 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 2 14 The registered person must 24/03/2009 ensure that a detailed assessment is carried out for all people before they are admitted to the home. This is to ensure that the potential resident to the home knows that the home can meet all their assessed needs before they make a decision to move in. 2 5 5 The registered person must ensure that all contracts are reviewed. This is to ensure that all contracts accurately reflect the actual care arrangements provided by the home. 24/03/2009 3 6 15 The registered person must 24/03/2009 ensure that a written plan of care is provided for each person detailing how the care needs of the individual are to be met. Care Homes for Adults (18-65 years) Page 25 of 30 This is to ensure that the needs of all the people who use the service are recorded along with a detailed description about how each persons needs are to be met. 4 9 13 The registered person must ensure that detailed risk assessments are carried out for all residents including information about how any risks are to be reduced. This is to ensure that the service is aware of any potential risks to residents and what action the service is taking to reduce any risks. 5 17 23 The registered person must maintain a written record of meals taken by residents at the home. This is to ensure that there is evidence that people who use the service are receiving a wholesome and nutritious diet. 6 17 23 The registered person must ensure that the kitchen is cleaned on a regular basis. This is to ensure food can safely be prepared in the kitchen. 7 20 13 The registered person must ensure that all people who use the service have their medication reviewed on a regular basis. 24/03/2009 24/03/2009 24/03/2009 24/03/2009 Care Homes for Adults (18-65 years) Page 26 of 30 This is to ensure that the medication people are taking is still suitable for them. 8 20 13 The registered person must 24/03/2009 ensure that risk assessments are carried out for all residents who self medicate. These risk assessments must be signed by the the appropriate health care professionals. This is to ensure that people who want to self medicate are able to do so safely. 9 20 13 The registered person must ensure that medication coming into the home is accurately recorded. This is to ensure that people who use the service always have enough medication. 10 30 23 The registered person must 02/04/2009 ensure that all toilettes must contain paper towels for staff and residents to use. This is to ensure that the risk of cross infection from using cloth towels is reduced. 11 39 24 The registered person must ensure that the results of any quality monitoring exercises are collated and made available to interested parties. This is to ensure that people who use the service and other stakeholders can see 02/04/2009 24/03/2009 Care Homes for Adults (18-65 years) Page 27 of 30 how well the home is doing to meet the aims and objectives of the service. 12 42 23 The registered person must fit appropriate fire doors after consultation with and obtaining advice from the local fire authority. This is to ensure that people who use the service are protected in the event of a fire. 13 42 23 The registered person must 02/04/2009 ensure that an electrical installation inspection is carried out at the home and a copy of the certificate sent to the Commission. This is to ensure that the electrical installations at the home are safe. 14 42 23 The registered person must ensure that a copy of the certificate for the yearly testing of the fire alarm is sent to the Commission and the original certificate is kept at the home and available for inspection. This is to ensure that the home has evidence that the fire alarm has been tested and is in working order. 15 42 23 The registered person must ensure that the fire risk assessment for the home is updated yearly and includes reference to the new residents at the home. 02/03/2009 02/03/2009 02/04/2009 Care Homes for Adults (18-65 years) Page 28 of 30 This is to ensure that the manager and staff are aware of potential fire risks at the home and residents at the home are properly safeguarded. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 17 The registered person should obtain advice from the local environmental health department regarding improvements in hygiene in the kitchen area. The registered person should ensure that a programme of redecoration for the communal areas in the home is produced with timescales and a copy sent to the CSCI. 2 24 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 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. 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!