CARE HOMES FOR OLDER PEOPLE
Rossetti Lodge Residential Home 3 Sea View Road Birchington Kent CT7 9LB Lead Inspector
Christine Grafton Unannounced 08 June 2005 09.45 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. Rossetti Lodge Residential Home H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Rossetti Lodge Residential Home Address 3 Sea View Road, Birchington, Kent. CT7 9LB 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) 01843 841571 01843 848180 rossetti@rossetticare.co.uk Ms Kiki Cole Lisa Abdullah Care Home 24 Category(ies) of Old age registration, with number of places Rossetti Lodge Residential Home H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 23/11/2004 Brief Description of the Service: Rossetti Lodge is a detached building with 15 ground floor bedrooms and 4 bedrooms on the first floor. There are 5 registered double bedrooms, including one that is only 12.8 sq.m. currently used as a single. The remainder are all singles. Bedroom sizes were previously agreed as a pre-existing home and several are smaller than the national minimum standards specify. There is a stair lift to the first floor. All bedrooms have a call bell point and some rooms have television points. There are 3 lounge areas and 2 dining areas, all interlinked. The majority of the ground floor bedrooms have a patio door leading to the enclosed rear courtyard garden, with lawn and flowerbeds. The home is within easy reach of the railway station, seafront and local shops. The home is staffed by a manager, senior carers, carers, a cook and a cleaner. Care staff work a rota that currently consists of two waking carers on duty at night. According to the homes statement of purpose, it aims to provide the best possible care and consideration in comfortable surroundings within a homely atmosphere. Rossetti Lodge Residential Home H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by two inspectors over one day, which lasted 6 hours 35 minutes. Additional time was spent in preparation and report writing. The main focus of the inspection was to check progress made in meeting the 19 requirements and 3 recommendations from the announced inspection of 23rd/24th November 2004. Time spent in the home comprised of: looking round the communal areas, toilets, bathrooms, the laundry and sampling some bedrooms; talking to 8 residents, 3 staff, 1 volunteer; plus reading some records. The registered manager was off sick, so the registered provider attended for the last hour when some verbal feedback was given on the inspection findings. What the service does well: What has improved since the last inspection?
The menus have been changed since the last inspection and include various home cooked meat meals at lunch time, which residents clearly appreciate. There have been some improvements in the medication procedures and practices, with less errors being identified, although further progress is required. The staff room is also the area where medications are kept. This was cleaner and more organised. A radiator guard in a toilet has been replaced to ensure safety from the risk of burns.
Rossetti Lodge Residential Home H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rossetti Lodge Residential Home H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Rossetti Lodge Residential Home H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 4 The admission process for a recently admitted resident did not ensure that the home could appropriately meet the person’s needs. EVIDENCE: A resident has been admitted from another home within the Rossetti Care group, which is registered for people with dementia. The manager completed a pre-admission assessment on the day before the resident’s admission to Rossetti Lodge. The care plan states that the resident has dementia, but the registration for Rossetti Lodge is for older people and not for people with dementia. The home had not completed its own assessment, or care plan following admission. Evidence was seen that the resident is in the early stages of dementia, but even if it was felt that Rossetti Lodge is appropriate for the resident, the Commission should have been consulted about an application to vary the registration. A carer said that the resident had settled in and there had been no problems with behaviour, but when spoken to, it was clear that the resident has memory loss. Rossetti Lodge Residential Home H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc Version 1.30 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 and 10 Care plans are not being regularly reviewed. Inconsistencies in the care plans place residents at risk of their needs not being properly met. There was concern that one resident’s needs were not being met. Medication storage still does not meet the required standard and this potentially places residents at risk. One resident’s dignity was not being upheld. EVIDENCE: The care of three residents was case tracked by observing and speaking with the residents, reading the care plans and talking with staff. One of these residents requires total care. The care plan format has been changed since the last inspection and is better organised and easier to follow. Although needs assessments have been carried out, the care plans were not being regularly reviewed and updated. There is still inconsistency in the way staff have been completing the various different assessments that are supposed to inform the care plans. The care plan for one resident with high dependency needs had not been reviewed since 11th March 2005. The resident’s needs had obviously changed quite significantly since then. A personal hygiene assessment in January states that staff are to assist to wash and dress, whereas a review in March
Rossetti Lodge Residential Home H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc Version 1.30 Page 10 states “no change” when “full assistance” was written in capital letters at the top of the page and highlighted in green. An entry in the daily records on 13th April 2005 clearly shows that a health care professional assessed this resident as total dependency. Nutritional needs and skin integrity risks had not been properly followed up. The nutritional section of the care plan had details added around the edge of the page highlighted in green “liquidised meals” and “assisted with feeds/fluids”. A carer said that fluid charts were being kept, but these had not been done for two days and entries finished at 13.30 hours on 22nd May and 15.30 hours on 30th May. A volunteer was feeding the resident with a liquidised meal that was all one colour. All the food had been liquidised together as a green fluid. Very little had been eaten when the bowl was taken back to the kitchen. An air flow pressure relieving mattress was set on firm, even though the resident was of small stature. The skin integrity score on the dependency assessment was incorrect. The dependency assessment had not been completed since April. Poor quality daily reports do not provide enough information about the care given and food intake. Another resident’s skin integrity risk was under scored. This resident had been identified as at risk of pressure sores and risks due to a leg ulcer had not been transferred to the care plan. Different parts of the care plan assessments were not followed up in the care plan. A cataract operation was referred to in the daily reports, but was not mentioned in the care plan. The resident was having eye drops, but this was not recorded in the care plan. Staff were following a care plan recorded at another home within the Rossetti Care group for a resident transferred on 13th March 2005. This care plan was not applicable, as the resident’s needs had changed. Some action has been taken to address medication shortfalls identified at previous inspections last year. The medication area was cleaner and a new metal cupboard has been obtained. However, the new cupboard is not attached to the wall and is not a purpose made medication cupboard. There were still some discrepancies in the medication administration records. Evidence was seen that liquid medicines were not being given as prescribed. A resident had not been given a liquid antibiotic for a whole day because the medication cool box key was lost. The medication cool box temperature readings were too high. Condensation had caused a puddle damaging the packaging of some eye drops. Residents’ appearance and dress indicated that care had been paid to maintaining dignity. However, an observation was made that a resident’s dignity was not being maintained.
Rossetti Lodge Residential Home H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13 & 15 The routines of daily living in this home suit some of the residents’ needs. Residents are provided with some opportunities for stimulation. A nutritious diet is provided but there was concern that the special dietary requirements and nutritional needs of a resident were not being met. EVIDENCE: Residents spoken with said they are happy with the home. Several residents were reading newspapers and some were watching television. A leisure therapist works two afternoons a week and residents appreciate the activities organised. Decorative collages made by residents were displayed. A four week menu plan indicates a nutritious diet, but meals could be more varied throughout the 4-week period. Week 1 menus mainly consist of beef meals or other red meat options. Other meats are provided throughout the remaining three week period. Alternatives for the lunch time meal mainly consist of cold options such as salads or omelettes. Residents spoken to said they like the food provided. The record of food provided indicates some choices, such as: a resident had chosen to have porridge and four slices of toast for lunch. A liquidised diet was presented in an unattractive and unappealing way in terms of texture, flavour and appearance.
Rossetti Lodge Residential Home H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc Version 1.30 Page 12 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 a satisfactory complaints procedure. Residents feel their concerns are listened to and would be acted on. EVIDENCE: Complaints notices are displayed, but the notice in the dining room had outdated details for the Commission. A complaints book had no entries recorded since August 2000. Residents said they had no complaints and would speak to staff if they had any. Residents said that staff listen to them and provide support. Rossetti Lodge Residential Home H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc Version 1.30 Page 13 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, 22, 23, 25 & 26 There was little evidence of improvements in the building maintenance, décor and furnishings since the last inspection. This detracts from the homeliness of the environment for residents. The call bell system is outdated and does not provide sufficient protection for residents. More attention is needed to ensure wheelchairs are kept clean. Some areas of the home were unclean and infection control procedures were not being followed properly, posing a risk to residents and staff. EVIDENCE: There has been no change in most of the environmental issues identified at the last inspection of 23rd/24th November 2004. A requirement for an action plan with timescales for repairs/additions or replacement of the call bell system has not been adequately responded to. A bath hoist fitted in the first floor bathroom still has no leg room for getting in or out of the bath. The sliding door does not close properly and the call bell is a push button on the wall adjacent to the bath. The call bell system is old. Call bells throughout the home can only be reached at source and there is no way of attaching pull cords. The call bell system does not provide a means to summon help from
Rossetti Lodge Residential Home H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc Version 1.30 Page 14 the lounge area. Residents and a relative have identified this as cause for concern at previous inspections. A wheelchair user spoke of a wish for a bigger room. The wheelchair had a thick coat of dust and grime on the metal frame under the seat and on the wheel spokes. A vacant bedroom on the first floor was being used to dry laundry, including sheets, blankets and continence sheets. A bedroom had torn wallpaper. A bedroom window still had no handle and did not close properly (identified at the last inspection) and the rotten window sill was filled with wood filler. Bedroom carpets were dirty and in need of vacuuming, but this had not been done as the cleaner was off sick. One bedroom carpet was covered with talcum powder and another had ant powder on the skirting board under the washbasin. One bedroom had a strong offensive urine odour. A replacement radiator guard had been fitted in a toilet/shower room following a requirement made at the last inspection. The radiator in the bathroom on the ground floor has not been guarded and was very hot to touch. This poses a risk of burns as it is in close proximity to the toilet. There was still no lockable cupboard in the laundry for storage of hazardous liquids and there were still no water soluble alginate bags for fouled laundry. Some liquid soap containers were empty and paper towels were missing in areas where they are needed to ensure good hygiene. Rossetti Lodge Residential Home H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc Version 1.30 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30 The number of staff available is not sufficient to meet the dependency needs of all residents. Contingency measures to deal with staff absence are not effective. Recruitment procedures have not been consistently followed, posing a potential risk to residents. The induction training of new staff is sufficient to ensure they have the required basic skills of care. The home should have achieved the 50 of NVQ trained staff, when some staff have completed the course. EVIDENCE: There were two care staff on duty, plus the cook. The manager and cleaner were off sick. There was also a volunteer at the home, who was on the duty rota for the morning shift. There were 16 residents, two of whom are wheelchair users and one resident was very high dependency, requiring total care in bed. Three weeks duty rotas were provided, which indicate two carers on duty during the day, plus someone to do the cooking in the mornings between 08.00 and 15.00 hours when the cook is on duty, or between 10.00 and 13.00 hours when care staff cover. Afternoon rotas indicate that from 15.00 hours when the cook is off duty, there are only two carers, who have to do the evening meal, as well as care for the residents. The cleaner had been off sick for the previous week and up to the time of inspection. Rotas indicate that when the manager is on duty she is in addition to the two care staff and steps in to cover the cooking on occasions. Agency staff are used to fill in gaps in the rotas, however, at the time of the inspection, no agency staff had been requested to cover the staff sickness. Rossetti Lodge Residential Home H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc Version 1.30 Page 16 The volunteer was doing care duties, such as dealing with the laundry, giving out drinks to residents and feeding the highly dependent resident, who was in bed. The volunteer spends three mornings and one afternoon at the home each week. Bedrooms had not been cleaned and carpets were dirty. Three staff files were sampled and records indicate a generally satisfactory recruitment process, but only one written reference had been obtained in two cases and the files did not contain all the required information, such as proof of identity, including recent photographs. Induction records follow the Skills for Care specification and records indicate these had been completed within appropriate timescales. The staff training matrix indicates that three staff have achieved their National Vocational Qualification (NVQ) levels 2 and 3 in care and a further three staff are currently working towards their NVQ level 3. The rota indicates there is a total of 10 care staff. Residents spoken to said that the staff are kind and caring and they felt they receive good care. Rossetti Lodge Residential Home H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc Version 1.30 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32, 33 & 38 The management of the home does not ensure consistent good practice. Management responsibilities have not been fulfilled properly and do not safeguard the health, safety and welfare of the residents. EVIDENCE: Management shortfalls with regard to medications, care plans, reviews, healthcare, building maintenance and health and safety are identified throughout this report. Many of the requirements made in this report have been made at previous inspections over the last 18 months. Although some action has been taken to address the serious medication shortfalls identified at previous inspections, discrepancies are still not being promptly followed up, such as: medications not given due to late receipt of drugs, or not checked in until the following day. The registered provider has responded to a previous requirement that the manager should be given sufficient time to attend to her management tasks. The manager is being provided with regular formal supervision. The registered
Rossetti Lodge Residential Home H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc Version 1.30 Page 18 provider appointed a person to carry out regulation 26 visits to the home to inspect the premises and report on the standard of care provided. Issues raised from one of these visits, in March 2005, were promptly and appropriately responded to and acted upon, by the registered provider. The fire safety log book indicated that in-house checks were not being done as frequently as required. A bedroom fire door was propped open with a cushion. Rossetti Lodge Residential Home H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 1 10 1 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 2
COMPLAINTS AND PROTECTION 2 x x 2 2 x 2 2 STAFFING Standard No Score 27 1 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 1 1 2 x x x x 2 Rossetti Lodge Residential Home H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc Version 1.30 Page 20 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Timescale for action 31/8/2005 2. OP4 3. OP8 4. OP8 Care plans must be accurately completed. Monthly reviews must be carried out and recorded. Care plans must be updated when changes occur. (Previous requirement 24/11/2004). 12, 14 The registered persons must ensure that residents admitted to the home are within the registration category for older people. Appropriate action must be taken to comply with registration for the resident with dementia. 12, 13, 14 Residents health care needs & 15 must be fully met. The registered persons must ensure that needs identified in the various assessment tools are followed up. New needs identified in the daily records must be followed up and recorded in the care plans. 12, 13, 14 The care plan for the resident & 15 with very high dependency needs must be urgently reviewed. The health care needs assessments and care plan must be accurately completed to identify all needs. Action must
H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc 15/7/2005 31/8/2005 10/6/2005 Rossetti Lodge Residential Home Version 1.30 Page 21 5. OP9 13 6. OP9 13 7. OP15 12, 16(2)(i) 8. 9. OP16 OP19 22 23 10. OP22 16(c) 23(2)(n) be taken to ensure that staff take appropriate actions to meet identified needs. The registered persons must take urgent action to provide safe cold storage for medication where temperature can be regulated. Clear and accurate records of administration must be kept. Drug storage facilities must be secure. A controlled drug cupboard and register to be provided. Medications must be administered at appropriate times in accordance with the BNF guidance. Prompt action must be taken when prescriptions are not provided by the GP/pharmacy and appropriate action taken. The registered persons must ensure that the special dietary requirements and nutritional needs of a highly dependent resident are met. Liquidised diet to be attractive and appealing in terms of texture, flavour and appearance in order to maintain appetite and nutrition. That the correct name of the Commission is included in the complaints procedure. Action plan to be submitted showing a building audit and a programme for delivering a safe, well-maintained environment, with planned timescales. To cover previous requirements from 24/11/2004 and those identified under text for standards 19, 23, 25 & 26. The registered persons must take action to ensure that the call bell system in the home is suitable to meet the needs of residents. Residents must be able to summon assistance from 22/6/2005 15/6/2005 9/6/2005 15/7/2005 31/8/2005 31/8/2005 Rossetti Lodge Residential Home H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc Version 1.30 Page 22 11. OP25 13(4) 12. OP26 13(3) 16(2)(k) 13. OP27 18 14. OP31 10 & 24 15. OP38 23(4) bedrooms, toilets, bathrooms and lounges with the addition of pull cords where necessary. Action plan to be submitted with timescales for replacement and interim measures to add additions. (Previous requirement of 24/11/2004). The registered persons must take action to address the risk of burns from the unguarded bathroom radiator. Action plan to be submitted. The registered persons must ensure that safe infection control procedures are followed, including arrangements for the transfer of foul laundry (provision of water soluble alginate bags) and appropriate hand washing facilities to be in place and regularly topped up. The registered persons must provide sufficient numbers of suitably qualified, competent and experienced staff on duty to meet residents needs. Staffing numbers must be appropriate for the health and welfare of all residents, including sufficient ancillary staff. Evidence to be submitted. (Previous requirement). The registered provider must ensure that the manager has the skill and competence to manage the home effectively. The registered provider must monitor the homes management and take any necessary action to ensure its effectiveness. The registered persons must ensure that fire safety tests are carried out at the required intervals and records kept. Fire doors must not be propped open. Suitable closure to be fitted to bedroom fire door that 30/9/2005 10/6/2005 10/6/2005 15/7/2005 15/7/2005 Rossetti Lodge Residential Home H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc Version 1.30 Page 23 needs to be kept open. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP10 OP15 OP23 Good Practice Recommendations That all people working or helping at the home are reminded on how to treat residents with respect for their dignity at all times. That the red meat content of meals is varied throughout the 4-week menu period. That hot alternatives are provided as a lunch time option. To ensure that single bedrooms accommodating wheelchair users suit their needs and if necessary offer a larger room if available. Rossetti Lodge Residential Home H56-HO5 S23514 Rossetti Lodge V230054 080605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent. TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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