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Inspection on 08/08/05 for Roxburgh House

Also see our care home review for Roxburgh House for more information

This inspection was carried out on 8th August 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Approximately 15 residents commented and had no complaints on the standard of service and staff conduct. One resident said "staff are very helpful and pleasant." Another said "They are kind and work hard." Records are well maintained and secured in the offices. Policies and procedures were under review following a change of ownership. There is a secure medication room. Residents are issued with contracts of residence, terms and conditions and a service user guide, on admission. The care plans were well maintained and there was evidence of ongoing assessment and reviews. There is a robust recruitment procedure and all staff had current CRB clearance at the time of inspection. Training was ongoing and over 50% of care staff have NVQ3. Staff vacancies had been advertised or appointed. The recently appointed manager, Mrs. Ruth Baggs, has applied for registration with CSCI.

What has improved since the last inspection?

Requirements and Recommendations from the inspection of 13/1/05, were discussed with the manager. Standard 7 Regulation 15. This had been addressed, care plan reviews were up to date in the sample which were read. Standard 31, Regulation 8. This had been addressed, the manager, Mrs. Baggs has applied for registration with CSCI. Standard 36, Regulation 18. This had been addressed, the manager confirmed that she has established a formal supervision system in the home. Standard 3 Regulation 14. This had been addressed, the manager confirmed instances where residents had been referred for professional assessment as their levels of dependency increased. Standard 33. This had been addressed by the manager, who has distributed QA questionnaires to residents and their families. There was a nil response. The recommendation is repeated in this report. The refurbishment programme is ongoing and a number of bedrooms and communal areas have been decorated and furniture and fittings replaced since the last inspection.

What the care home could do better:

Standard 8. The manager should ensure that residents receive regular chiropody services and the frequency of visits, in accordance with assessment, is recorded on the care plan. Standard 12. The manager should arrange for the hours allocated to activities co-ordinator to be increased in accordance with resident numbers and preferences. Standard 15. The manager should arrange for the menu to be made available to residents each day, prior to the mealtime. Standard 19, Regulation 13 (4) (a) The manager must arrange for the hall carpet to be replaced. Standard 19. The manager should arrange for garden furniture to be placed on the patio adjacent to the lounge.Standard 19, Regulation 23 (o) The manager must make arrangements for the grounds be made secure from intruders. Standard 19 Regulation 23 (o) The manager must make arrangements for the grounds to be maintained to a good standard. (This was a recommendation from the inspection of 13/1/05). Standard 33. The manager should arrange for Quality Assurance questionnaires to be distributed to residents and their families within three months.

CARE HOMES FOR OLDER PEOPLE Roxburgh House Roxburgh Street Bootle Liverpool L20 9PS Lead Inspector Trish Thomas Unannounced 8 August 2005 th 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. Roxburgh House F53 F03 S5417 Roxburgh House V245955 080805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Roxburgh House Care Home Address Roxburgh Street Bootle Liverpool L20 9PS 0151 525 7547 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) Southern Cross Home Properties Limited N/A Care Home 38 Category(ies) of OP Old Age (38) registration, with number of places Roxburgh House F53 F03 S5417 Roxburgh House V245955 080805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Service users to include up to 38 OP. Variation to admit 1 named out of category service user under pensionable age. This variation is only applicable to the named service user, should the service user leave the home or become of pensionable age, the variation will cease to apply. The service should, at all times employ a suitably qualified and experienced manager who is registered CSCI. Date of last inspection 13/01/05 Brief Description of the Service: Roxburgh House is a care home for 38 older people. The registered provider is Southern Cross Healthcare and the appointed manager, Ms. Ruth Baggs. Mrs. Baggs has applied for registration with CSCI. The home is purpose-built, situated in a quiet residential street, close to main roads, shops and bus routes. The home is set in secluded gardens, with a car park at the front of the property. The home is staffed throughout the day and night, and provides personal care, full board, laundry and single accommodation. All Service Users admitted to the home are registered with a G.P. and supported by staff in accessing health and paramedical services. Roxburgh House F53 F03 S5417 Roxburgh House V245955 080805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The manager, Mrs. Ruth Baggs, was on duty and provided the records and certificates which were requested. The methods used during the inspection were, discussion with residents and staff, reading documents and direct observation of practices in the home, and the environment. Residents looked well cared for and expressed satisfaction with the service provided in the home. Their comments are included in the body of this report. They were spending time in communal areas and in their bedrooms, reading or watching television. Activities were arranged in the main lounge after lunch. It was a warm day and one resident went out to sit in the garden. There was a pleasant atmosphere in the home and residents appeared relaxed in the company of staff. Requirements and Recommendations from the last un-announced inspection (January 05), were discussed with the manager. Most had been addressed but a recommendation under standard 19, as to Roxburgh House employing a gardener, had not been carried out and is a requirement of this inspection. What the service does well: Approximately 15 residents commented and had no complaints on the standard of service and staff conduct. One resident said “staff are very helpful and pleasant.” Another said “They are kind and work hard.” Records are well maintained and secured in the offices. Policies and procedures were under review following a change of ownership. There is a secure medication room. Residents are issued with contracts of residence, terms and conditions and a service user guide, on admission. The care plans were well maintained and there was evidence of ongoing assessment and reviews. There is a robust recruitment procedure and all staff had current CRB clearance at the time of inspection. Training was ongoing and over 50 of care staff have NVQ3. Staff vacancies had been advertised or appointed. The recently appointed manager, Mrs. Ruth Baggs, has applied for registration with CSCI. Roxburgh House F53 F03 S5417 Roxburgh House V245955 080805 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Standard 8. The manager should ensure that residents receive regular chiropody services and the frequency of visits, in accordance with assessment, is recorded on the care plan. Standard 12. The manager should arrange for the hours allocated to activities co-ordinator to be increased in accordance with resident numbers and preferences. Standard 15. The manager should arrange for the menu to be made available to residents each day, prior to the mealtime. Standard 19, Regulation 13 (4) (a) The manager must arrange for the hall carpet to be replaced. Standard 19. The manager should arrange for garden furniture to be placed on the patio adjacent to the lounge. Roxburgh House F53 F03 S5417 Roxburgh House V245955 080805 Stage 4.doc Version 1.40 Page 7 Standard 19, Regulation 23 (o) The manager must make arrangements for the grounds be made secure from intruders. Standard 19 Regulation 23 (o) The manager must make arrangements for the grounds to be maintained to a good standard. (This was a recommendation from the inspection of 13/1/05). Standard 33. The manager should arrange for Quality Assurance questionnaires to be distributed to residents and their families within three months. 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. Roxburgh House F53 F03 S5417 Roxburgh House V245955 080805 Stage 4.doc Version 1.40 Page 8 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 Roxburgh House F53 F03 S5417 Roxburgh House V245955 080805 Stage 4.doc Version 1.40 Page 9 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) 2,3 The home was meeting standard 2. All residents are issued with a written contract/statement of terms and conditions. The home was meeting standard 3. All prospective residents have had their needs assessed and a care plan formulated in consultation with them/and or their representatives. Standard 6. The home does not provide intermediate care and standard 6 does not apply. EVIDENCE: Standard 2. Contracts of residence are in place for permanent residents of Roxburgh House. (Examples were read). Contracts include rights and obligations, fees payable, charges for extras, and notice periods. Standard 3. Residents’ files contained assessments, which had been carried out at the time of referral and after admission to the home. Social work assessments are provided for residents who are placed by local authorities. Additionally, the home has an assessment process by which a range of personal care, health and social needs are assessed, prior to and post admission to Roxburgh House. The home does not provide intermediate care and will not be assessed against standard 6. Roxburgh House F53 F03 S5417 Roxburgh House V245955 080805 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 The home was meeting standards 7,9 and 10. Care plans were in place for all residents. The home was not meeting standard 8, as to chiropody arrangements for one resident and district nurse visit for a second resident. There are systems in place in the home for residents to be registered with a GP on admission and for them to access paramedical and hospital appointments. The home has a policy and system in place to manage residents’ medication or for them to self-medicate, in accordance with assessment. The home provides single accommodation and a number of bedrooms have en-suite facilities. EVIDENCE: Standard 7. Four care plans were tracked. There is a comprehensive care planning and assessment system in place for residents. Care plans provided evidence of the full range of health, personal care and social needs assessment, and the methods in place to meet assessed needs. There is a process for the evaluation of care plans in place, and regular reviews have been undertaken. Standard 8. All residents are registered with a G.P. and have access to health and paramedical services. Two shortfalls were observed as follows :- a gentleman who has pressure sores was visited in his bedroom and he complained of pain at base of spine. Mrs. Baggs (manager) was informed and said she would arrange for the district nurse to visit him that day. Roxburgh House F53 F03 S5417 Roxburgh House V245955 080805 Stage 4.doc Version 1.40 Page 11 This resident’s file contained a Waterlow assessment and care plan and a pressure-relieving mattress had been provided. Visits from the district nurse had been arranged, to monitor pressure areas. Last chiropody visit for one resident is on record as two months prior to the date of inspection. The manager is advised to ensure that all residents receive regular chiropody services and the frequency of treatment, in accordance with assessment, is recorded on individual care plans. Standard 9. Management of medication was discussed with the manager and a member of staff who administers prescribed medication to residents. The home has suitable arrangements in place for residents to self-medicate or for the management of the prescribed medication of residents whose medication is administered by staff. The drugs trolley is secured in a locked room. Staff who administer medication receive suitable training and records and returns audits were satisfactory at the time of inspection. Standard 10. Twelve residents were asked if they were treated respectfully by staff and they were all satisfied with staff conduct in this. All residents have single bedrooms and they said that they receive their mail un-opened and there was no undue intrusion into their personal affairs. All records and files were secured in the office at the time of inspection and no shortfall in this standard was observed during the inspection. Roxburgh House F53 F03 S5417 Roxburgh House V245955 080805 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 The home was meeting standards 13 and 14. The home advocates consultation with residents and for them to have regular contact with their families and friends. Shortfalls were noted with regards to standards 12 and 15. EVIDENCE: Standard 12. Since her appointment in December 04, the manager has taken steps to improve consultation with residents as to their preferences in social activities and outings. An activities file containing a register of participation and photograph album, is maintained and was available for inspection. The photographs show a number of residents enjoying social events arranged in the home. The home has an activities co-ordinator (allocated 14 hours a week). In speaking with residents it was clear that their expectations and tastes differ, with regards to social events. One resident said “I don’t want to go out, I like to stay in my bedroom.” Other comments include “I have been out in a taxi for lunch.” “My uncle prefers to go out to the library in a wheelchair with a member of staff.” “We do different things during the afternoon.” The manager said that quizzes/drafts are arranged and some of the gentlemen like darts. Efforts have been made to provide a range of crafts, games and outings to suit the wide range of needs and preferences expressed by those in residence, through social profiling and residents’ meetings. Further outings had been arranged, to Harry Ramsden’s and Knowsley Safari Park. Roxburgh House F53 F03 S5417 Roxburgh House V245955 080805 Stage 4.doc Version 1.40 Page 13 Residents said they have visited a local football club for social gatherings. The manager confirmed that staffing levels are increased to support social activities. Transport was discussed and the manager said that there are no staff employed in Roxburgh House, who have full driving licenses. The home does not use the organisation’s mini bus as there is no qualified driver on site. A suitable alternative is provided by use of disabled taxis and the home has an account with a local taxi firm. A budget for travelling expenses has been established and the manager said that taxi fares for outings are at no charge to residents. A recommendation is made that the hours allocated to activities co-ordinator are increased, to be in line with the registered number, 38, and the range of preferences of those in residence. Standard 13. Residents said that they often have visitors and they are made welcome. A visitor to the home who commented said that she calls in regularly and is always made welcome by staff and left to talk in privacy with her relative. There was evidence in care plans inspected, that residents go on outings with their families and all contacts with family or representatives are recorded. There are ongoing links with the wider community in partnerships with a local school, premiership football club, visiting religious ministers and use of the local library and amenities. Standard 14. There is evidence of resident participation in the care planning process. At the time of inspection, residents were spending time as they chose, in their bedrooms, in the garden or in communal areas of the home. Some residents did not choose to take part in arranged activities and were left undisturbed. At the time of inspection, residents’ opinions on their life in the home, had been expressed either through the care planning and review processes, informal discussion with staff, or resident meetings. The manager said that she has an open-door policy and residents and their families feel free to make contact with her on an informal level. (Comments on resident/family questionnaires are made under standard 33). Standard 15. Ten residents were asked about food in the home and availability of drinks and snacks throughout the day/night. They expressed satisfaction with their meals and availability of hot and cold drinks. They said they are not usually aware of the main meal on the menu until they sit down. The kitchen was visited and meals were discussed with the cook. Menus display a good range of meat and fish dishes, seasonable vegetables and desserts. A recommendation is made that the menu be made available to residents, each day, prior to meal times. Roxburgh House F53 F03 S5417 Roxburgh House V245955 080805 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) x The home was not measured against these standards during this inspection. EVIDENCE: N/A Roxburgh House F53 F03 S5417 Roxburgh House V245955 080805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26. The home was not meeting standards 19. The building is maintained to a good standard and an extensive refurbishment programme has recently been undertaken. A shortfall was noted regarding the hall carpet. A shortfall was also noted with regards to security of the grounds. The home was not meeting standard 19, regarding maintenance of the grounds. The home was meeting standard 26 with regards to cleanliness of the premises. EVIDENCE: Standard 19. The home has an ongoing maintenance and refurbishment programme a number of areas such as bedrooms, bathrooms, corridors and communal areas have recently been redecorated/refurbished. The standard of accommodation on offer is good but the entrance area would benefit as follows. The hall carpet is badly stained and greasy underfoot. A requirement is made under Regulation 13 4 (a) that the hall carpet be replaced, as it has the potential to constitute a tripping hazard underfoot. There has been recent evidence of intruders in the grounds. The manager said that during the evenings, youths enter the grounds and had been using the garden furniture previously placed outside the lounge. As a consequence, the furniture has been removed to the patio area outside the dining room. Roxburgh House F53 F03 S5417 Roxburgh House V245955 080805 Stage 4.doc Version 1.40 Page 16 This is unfortunate for residents as they previously had access to garden seating from the lounge via French doors. The exterior area in use at the time of inspection was not as pleasant or spacious as that adjacent to the lounge. A recommendation is made under Standard 19, that garden furniture be returned to the patio adjacent to the lounge. A requirement is made under Standard 19, Regulation 23 (o) that arrangements are made for the grounds be made secure from intruders. The grounds were receiving basic maintenance at the time of inspection. The lawns were being cut regularly. Flower-beds were overgrown and, as there are no gates to the grounds, rubbish was blowing in from the street. The exterior was letting down the good standards achieved in areas of the interior, which have recently been refurbished. The home does not have a gardener and the handy-person appears to be under pressure to maintain the grounds to their current level, alongside his other duties. A requirement is made under Standard 19 Regulation 23 (o), that the manager makes arrangements for the grounds to be maintained to a good standard. Standard 26. The home is maintained to a good standard of hygiene and this was evident at the time of inspection. The home employs domestic staff who a trained in C.O.S.H.H., infection control and health and safety. The home provides cleaning materials and protective clothing to domestic staff. Roxburgh House F53 F03 S5417 Roxburgh House V245955 080805 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29, 30 The home was meeting standards 27,28 and 30. Staffing levels were being maintained at the time of the inspection. The home’s recruitment procedure was being followed in appointing new staff and staff training was to a satisfactory standard. EVIDENCE: Standard 27. The staff rosters were inspected and recorded that staffing levels are maintained. Standard 29. The manager said that there has been some staff turnover in recent months and new staff were being recruited. Staff files showed evidence of references and CRB checks. The manager said that all staff had CRB clearance at the time of inspection. Standard 30. The manager confirmed that over 50 of staff have NVQ2 and mandatory training is ongoing. Moving and handling training for staff had been arranged for August 05. Staff who commented said they felt that training on offer was to their satisfaction. Roxburgh House F53 F03 S5417 Roxburgh House V245955 080805 Stage 4.doc Version 1.40 Page 18 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) 33 and 38 The home was meeting standard 38. The home was not meeting standard 33. The manager has distributed quality assurance questionnaires with nil response. Health and safety certification was up to date at the time of inspection. EVIDENCE: Standard 33. The manager has distributed QA questionnaires to residents and their families, with nil response. It was not possible to access this useful source of evidence of good practice or shortfalls in the home. A recommendation is made under standard 33, that the manager renews her efforts in obtaining formal written confirmation of residents’ opinions by distributing questionnaires within three months. Standard 38. Health and safety certification was up to date. Some remedial work to fire equipment had been undertaken following a detected fault in July 05. Roxburgh House F53 F03 S5417 Roxburgh House V245955 080805 Stage 4.doc Version 1.40 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 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 1 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 2 x x x x 3 Roxburgh House F53 F03 S5417 Roxburgh House V245955 080805 Stage 4.doc Version 1.40 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. 2. 3. Standard 19 19 19 Regulation 13 (4) (a) 23 (o) 23 (o) Requirement The manager must arrange for the hall carpet to be replaced. The manager must make arrangements for the grounds be made secure from intruders. The manager must make arrangements for the grounds to be maintained to a good standard. Timescale for action By 8/11/05 By 8/11/05 By 8/10/05 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. 4. Refer to Standard 8 12 15 19 The manager should arrange for garden furniture to be placed on the patio adjacent to the lounge. Roxburgh House F53 F03 S5417 Roxburgh House V245955 080805 Stage 4.doc Version 1.40 Page 21 Good Practice Recommendations The manager should ensure that residents receive regular chiropody services and that the frequency of visits, in accordance with assessment, is recorded on the care plan. The manager should arrange for the hours allocated to activities co-ordinator to be increased in accordance with resident numbers and preferences. The manager should make arrangements for the menu to be made available to residents, each day, prior to meal times 5. 33 The manage should distribute Quality Assurance questionnaires to residents and their families within three months of this report. Roxburgh House F53 F03 S5417 Roxburgh House V245955 080805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 2nd Floor Burlington House Crosby Road North Waterloo L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Roxburgh House F53 F03 S5417 Roxburgh House V245955 080805 Stage 4.doc Version 1.40 Page 23 - 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. 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