Inspection on 20/07/05 for Rosswood Gardens (4-10)

This inspection was carried out on 20th July 2005.

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

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

Other inspections for this house

Rosswood Gardens (4-10) 25/05/07

Rosswood Gardens (4-10) 20/07/06

Rosswood Gardens (4-10) 14/10/04

Rosswood Gardens (4-10) 15/04/04

Similar services:

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Edenvale

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Chatsworth Care - Dawson House

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Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Rosswood Gardens 4-10 Rosswood Gardens Wallington Surrey SM6 8QZ Lead Inspector Rin Saimbi Unannounced 20th July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Rosswood Gardens Address 4-10 Rosswood Gardens, Wallington, Surrey, SM6 8QZ 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) 020 8647 8193 020 8647 6671 sara.anderson@threshold.org.uk Threshold Housing and Support Mrs Sara Anderson Care home 22 Category(ies) of Learning disability (22) registration, with number of places Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 8th April 2005 Brief Description of the Service: Rosswood Gardens is within a short distance of Wallington town centre, with shops, library, pubs and post office all near by. There are good transport links with British Rail station and a number of bus routes within walking distance. There is only limited parking available at the home. The home is owned and run jointly by Threshold Support and Open Door, this merger took place on the 1st April 2005. This joining of the two organisations will not affect the daily lives of the service users, but will over time change the policies and procedures that are in place. Rosswood Gardens provides a home for upto 17 people with a learning difficulty. The home is divided into three separate units. There is a smaller home for 5 people who come to the home for a break, this is known as respite care. All rooms within the home are single, with their own sink, bed and wardrobe. Service users have their own key to their room and are free to home and go as they wish. Some of the downstairs rooms have their own bathroom, these are for people who are wheelchairs or need a lot of care. Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes second inspection for 2005/06. It was an unannounced inspection starting at 2 pm and taking place over four hours. The time chosen for the inspection was to ensure that there was maximum opportunity to meet with service users on their return from daytime activities. The inspection took the form of looking at policies and procedures, talking to staff and the deputy manager and a tour of the building. The rest of the time was spent talking to service users and observing staff interaction with service users. The home’s last inspection was in early April, and for many of the requirements that were made at that time, the timescale given was three months. Therefore the time limit has not as yet expired. The requirements do still appear in this report and are identified. The manager of the home was not available at the time of inspection. It is noteworthy that the deputy was able to manage the delegated tasks effectively, balancing the needs of the service users with the demands of the inspection. What the service does well: The home remains effective in enabling service users to make decisions about lives. These decisions range from what to eat, what colour to paint their bedrooms and where to go on holiday. There is a real commitment in terms of support to enable this; there is the ‘quality assurance’ co-ordinator whose role is to listen to service users and assist them making choices. There are the residents meeting which is co-ordained by independent individuals, rather than staff. With regard to new service users being admitted, the home has a thorough and thoughtful introduction process, which tries to cover as many eventualities as possible. Prospective new service users are given real choice about whether they want to live at the home or not. Emergency admissions do arise, however, care is taken to ensure that the home is able to meet the needs of the individual. Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 6 The staff team within the home have a range of experience and qualifications for working within the home. Individuals showed knowledge of service users and there appeared to be a genuine warmth and affection. The member of staff working in the respite unit also appeared to have knowledge of the service users and their needs. Service users themselves spoke positively about the staff and of the care that they received. What has improved since the last inspection? What they could do better: The home address the health needs of service users by keeping a record of all appointments kept; accompanying service users to appointments if required; and by using the expertise of health professionals when it is necessary. However, there is no overview kept of appointments required. For example, when a service user needs to see the dentist next. With regard to the environment of the home, some improvements have been made since the last inspection. However, some remain outstanding, which could improve the atmosphere of the home quite considerably, these include ensuring that the curtains in the lounges are fitted properly and that the carpet is cleaned. Please contact the provider for advice of actions taken in response to this Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 4 and 5 Prior to any new service users coming to live at Rosswood Road, the home gathers as much information as it can so that everyone can be sure that it is the right place for the individual. Prospective new service users are then given the opportunity to ‘test drive’ the home before making a final decision about whether to live there or not. In this way, service users should feel that they are not just be slotted into a vacancy but instead making an active choice. EVIDENCE: The London Borough of Sutton places new service users coming into Rosswood Road. Sutton produce an assessment, and from this information the home decides if it is able to provide the individual with an appropriate placement. The home then gathers as much information as possible from the new service users, their family and friends. There is then an introduction period which involves the new service users coming to visit the home at different times of the day and at the weekend so that they get the opportunity to meet everyone at the home. This period can be as long as is needed. Finally, there is an overnight stay, a weekend stay and then moving in. There is then a review at 4 – 6 weeks, and then again at three months so that the service user and everyone involved has the opportunity to say if they want the placement to continue or not. Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 10 The home completes its own assessment within 72 hours of the service users coming into the home. This covers all aspects of the person’s life including the strengths, social and cultural needs and psychological needs. Rosswood Road does take people in emergency situations. They do still need to gather as much information as possible before anyone new comes to stay at the home. This can be quite a complicated process, as the information needs to come from Social Services. The majority of service users have a contract, which gives details of the terms and conditions, fees charged, and the rights and responsibility of the home and the service user. The service user or their advocate then signs the contract. There was at least one service user, who did not have a signed contract, The contracts themselves are not in a format or in language that would be appropriate to service users. Instead, they are complicated and written using jargon. A requirement has therefore been made that the contracts must in written in a way that is understandable to service users, and that the new contracts must be signed by the service users themselves or their advocates. Service users must then have their own copy of the document available to them. Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 8,9 and 10 Service users are enabled to take as much control of their lives as is possible, and to make choices with support, information and guidance. Risk taking is managed and the issues of confidentiality are understood thereby enabling service users to have an independent lifestyle. EVIDENCE: Service users are encouraged to make decisions about all aspects of their lives, this ranges from what to eat, wear and how they would like their bedrooms decorated. There are regular residents meetings, and in addition, the home employs a ‘quality assurance co-ordinator’. The main focus of the co-ordinator is to listen to what service users want and to try and put it into place. Each service user has a range of risk assessments in place, which looks at all aspects of their lives. The aim of the risk assessments is for service users to live as independently as possible, and that if there are risks involved, that these are managed. There were a variety of risk assessments in place for activities of daily living, absconding, aggressive behaviour etc. One example was of a service user who Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 12 chose inappropriate clothes to wear, the key worker had identified all the possible risks of this, but the outcome was always the same, and that was that the service user should still have a choice what to wear. These risk assessments are updated on a six monthly basis, and it was clear that they were being used as a working document. The home has a policy on confidentially which also outlines what should be done if there is a breach of confidentiality. Staff have signed and dated the document as an indication that they have read and understood it. Discussions with staff indicated that they understood the principals of confidentiality and how it should be maintained. All service users files are kept in the main office, which is locked when not in use. Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,14 and 17 Service users within the home live ordinary and meaningful lives, they vote, cook and go down to the pub. There are always a variety of activities that are on offer, and service users choose want they want dependent upon their needs and wishes. EVIDENCE: Service users at Rosswood Gardens do a variety of activities depending upon their wishes and needs. Many attend day centres, college and some within the respite service go to work. One service user has ‘retired’ from day centres In their spare time service users choose what they want to do, some watch television or videos. Others are more active like attending the gym. Service users are all offered a holiday, and most have been away already. This year, this has included two separate holidays to Canada. One of the service users chooses to go to church on a regular basis. In the recent election, most of the service user did vote. The local MP did visit the home, and because of the party’s visible presence in Wallington, all the service users were very clear whom they wanted to vote for. Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 14 Each of the houses compiles a weekly menu, usually on a Sunday. However, if service users decide that they do not want a particular thing to eat, and then an alternative is always available. The home is able to cater for people on special diets; currently this includes someone who is on a gluten free diet, one service users who is Muslim and therefore eats Hahal meat, and someone who is a diabetic. Service users are encouraged to be involved in the preparation and serving of meals. Meals being prepared on the day of inspection, appeared nutritious, balanced, and attractively presented. The meals were taken in the dining areas of the various houses, which were congenial in setting. Various snacks and drinks were available, and service users were observed moving freely around the kitchen areas. The home is in the process of introducing menu picture cards, which are being devised by the deputy manager. The cards have a colour picture of the meal, the ingredients needed, the time taken to prepare. The aim of these cards is that service users will effectively have greater choice and that some will be able to prepare the meals themselves. Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 and 20 Service users within the home have access to healthcare, and are supported in keeping appointment if this is required. The home could improve its procedures for ensuring that regular check up appointments are kept and therefore a requirement in this regard has been made. Staff were knowledgeable and experienced in knowing about the personal care that individual service users needed, and providing that care which ensured privacy and dignity EVIDENCE: During discussions with staff, and from observation it was clear that staff within the home provide personal support to service users ensuring their dignity and privacy. Service users choose their own clothes and toiletries, with some guidance from staff on occasions. Service users health needs are assessed by appropriate professionals. Most are registered with a local GP, but there is a choice of who to register with. A Community Psychiatric Nurse and chiropodist visit the home on a regular basis; the home uses the Dentist at Orchard Hill and a community dietician and optician. The consultant psychiatrist visits as and when it is required. Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 16 The home keeps a record of all appointments and the outcome of these. However, although there appears an accurate running record of appointments, there was no overview of the appointments. So for example, it was not clear from the health records, or the review minutes when one particular service users had last seen a dentist, or when the next appointment would be due. A requirement has therefore been made that the home must ensure that all service users health needs are reviewed by appropriate health professionals on a regular basis. The administration of medication was checked. The home uses ‘Dosette’ packs, which arrive from the pharmacist on a regular basis. ‘Boots the Chemist’ also complete an audit of medication. A previous requirement that the home must dispose of medication, which is not in use, has now been met and therefore the requirement has been removed. Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The home takes complaints seriously and listens to service users about their views of living within the home. The manager and staff ensure that service users are protected, safe and free from harm. EVIDENCE: The home has a complaints policy, which is in a user-friendly format, copies of which are displayed throughout the home. There is also a complaints logbook, which indicated that no complaints have been made since the last inspection. The ‘quality assurance co-ordinator’ assists service users in making complaints, as does the representative from an advocacy group. In addition, the residents meetings are only attended by service users and co-ordinated by independent people. The independent advocates then take any issues, which arise from the meetings, to managers. There were discussions with staff that indicated that they had an awareness and understanding of vulnerable adults, and what to do if they had any concerns regarding service users. Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29 and 30 The home is reasonably maintained, and is furnished and decorated with domestic style furniture. There are improvements that must be made to the building so that a homely environment is maintained. In addition, the home must take into consideration the increasing frailty of its service users, and make sure that aids and adaptations that are provided are suitable for their use. EVIDENCE: The lay out of Rosswood Gardens allows for each home to be a separate unit, with its own front door, kitchen/dining room, and lounge and laundry room. Internally there is access through the home should it be required. There is a large shared garden to the rear of the building. The home is generally well furnished with domestic style furniture that is of a reasonable quality. There is a pleasing degree of personalisation in the bedrooms, with service users choosing their colour for the room and decorating them how they wish. All rooms are well equipped with a single bed, wardrobe, chest of drawers and a wash hand basin. Some of the ground floor bedrooms have en-suite facilities. Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 19 The previous inspection identified areas that needed attention, many of which still need to be addressed in order to improve the material condition of the home. Namely, the condition of the carpet must be reviewed and the curtains in the lounge rooms must be secured to the curtain rails. In addition, the increasing fragility of some of the service users requires that specialist aids and adaptations are suitable for their purposes. Specifically, the en-suite facilities in Houses 8 and 10 do not provide all the adaptations needed for people with physical difficulties to be cared for effectively with the minimum risk to service users, and the safety of staff undertaking the care. In House 10, there is also a sink, which is effectively been used as a grab rail because of its position. An appropriate grab rail must be fitted; a requirement has therefore been made in this regard. In general the home is kept clean and hygienic, although it was noted that there was an offensive odour on the first floor of House 10. This must be removed. Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 35 and 36 Staff within the home are in general well trained and supported. There is a range of experiences and an understanding of the needs of people with learning difficulties. EVIDENCE: Staff appear generally to have qualities and attitudes that are important in interaction with service users; they are good communicators, comfortable with the service users and aware of their needs. With regard to training and qualifications, all new staff employed by the home have a period of induction during which they shadow another of staff, read polices and procedures and undertake some basic training. The induction period then leads onto the Learning Disability Award Framework, and then finally onto the National Vocational Qualification (NVQ) Level 3. The home currently has two members of staff who have completed NVQ Level 3; a further six are currently undertaking the qualification, which should be completed by 2006. The deadline for homes to achieve 50 of care staff qualified to NVQ Level 2 has been extended to 2007, however, the home needs to monitor this situation as they are in danger of not meeting the extended target. Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 21 Staff within the home feel that there are adequate levels of training available to them, and that if there were areas that they are interested in then these would be considered by the managers. The home retains a copy of all training undertaken by staff, and when refreshers courses need to be undertaken. The Human Resources department also holds this information. The previous inspection identified that supervision was not taking place at the required level. This requirement has now been withdrawn as supervision is taking place on a six-weekly basis; these meetings are recorded for both parties. Annual appraisals are also in place for the majority of staff. Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 40 and 42 Policies and procedures are in place to ensure that the home fulfils its stated purpose and objectives, and to meet the needs of the people who live there. EVIDENCE: Rosswood Road have a raft of policies and procedures that are written centrally, a random selection indicated that all appropriate areas are covered as identified by Appendix 3 of the National Minimum Standards for Younger Adults. Staff then sign and date the policies as an indication that they have read and understood them. All documentation is stored in the main office; a selection of documentation is given to staff. The home takes seriously its responsibility towards health and safety towards service users and staff. Fire testes were completed weekly; fire drills are undertaken approximately every three months and all equipment was last checked on the 18.7.05; Portable Appliance Testing was completed in October Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 23 2004 and gas installation was checked in February 2005. The home has current Employers Liability Insurance. Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x 3 2 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 2 2 Standard No 11 12 13 14 15 16 17 3 3 x 3 x x 3 Standard No 31 32 33 34 35 36 Score x 3 x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rosswood Gardens Score 3 2 3 x Standard No 37 38 39 40 41 42 43 Score x x x 3 x 3 x G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 25 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 5 Regulation 5(1)c Requirement The home must provide each service user with a written contract which is a format that is appropiate to each individual, and that this contract must be signed by the service users or their representative The home must ensure that all service users health needs are met and that they are offered a minimum annual health checks, with particular emphasis on vision and hearing a. The condition of the carpet must be reviewed thoughout the building b. The curtains in the lounges must be secured properly to the curtain rails a. Bathrooms designed for the use of people with physical disabilites must be accessible to them, and for the staff that may assist in the care b. A suitable grab rail must be installed in House 10 The home must ensure that it is free from offensive odour Timescale for action 20.10.05 2. 19 12(1)(a) 20.10.05 3. 24 23(2)(b) 15.8.05 From previous inspection 4. 29 23(2)(n) 15.8.05 From previous inspection 5. 30 16(2)(k) 20.7.05 Immediate Page 26 Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Rosswood Gardens G53-G53 S7189 rosswood V238516 120705 stage 0.doc Version 1.40 Page 27 Commission for Social Care Inspection CSCI 8th Floor Grosvenor House 125 High Street, Croydon CR0 9XP 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. 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