Inspection on 26/03/07 for Royal Hill

This inspection was carried out on 26th March 2007.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Royal Hill 31/07/08

Royal Hill 20/02/06

Royal Hill 07/07/05

Royal Hill 07/02/05

Royal Hill 28/06/04

Royal Hill 11/03/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

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Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Royal Hill 101 Royal Hill Greenwich London SE10 8SS Lead Inspector Sue Grindlay Unannounced Inspection 26th March 2007 09:40 Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 1 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 Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 2 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 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. Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Royal Hill Address 101 Royal Hill Greenwich London SE10 8SS 020 8694 3652 0208 692 8211 key.gordon@btconnect.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Greenwich Council Angela Margaret Gibbons Care Home 7 Category(ies) of Learning disability (7), Learning disability over registration, with number 65 years of age (7) of places Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th February 2006 Brief Description of the Service: Royal Hill is a Home for seven adults with a severe learning disability and complex needs, who are also residents of the London Borough of Greenwich. The Home is owned by Hyde Housing Association and managed by the London Borough of Greenwich. The Home is purpose built and is situated on a corner site in a residential area of West Greenwich. There is limited parking in the drive to the front of the building. The Home is within walking distance of the heart of Greenwich with its shops, markets, park, river walks and Maritime Museum. Greenwich station is close by and buses routes run to Lewisham, Blackheath and Woolwich. Tenants have spacious single-occupancy rooms with ensuite toilet and shower facilities. A kitchen and laundry are on the ground floor. Two communal lounge-diners open out onto the enclosed garden, which is mainly laid to lawn. Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection over four hours on a spring day. The Registered Manager is currently also managing another Home, and dividing her time between the two buildings. Three tenants were on the premises during the inspection, and were seen having breakfast, doing their laundry or just relaxing. The manager and two staff members were spoken with, a tour of the building was made, and the communal areas and several bedrooms were viewed. Records and care plans were looked at. What the service does well: What has improved since the last inspection? What they could do better: The movement of managers has created some instability in the Home, less perhaps for the tenants than for staff. Although the rationale for the moves has been discussed with the Commission, it is recommended that, once the new manager is appointed, further changes be minimised to ensure consistency of care for the tenants of Royal Hill. As tenants have such diverse needs, a greater staff ratio would ensure that tenants have better opportunities for going out. Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): These standards have been met on all previous inspections, and all the current tenants have been in placement since the Home opened in May 2003.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: No standards were assessed under this section on this occasion. All the tenants have been in the Home since it opened, and the standards were met on the first two inspections. Tenants received a personal letter before admission from the manager stating that their needs could be met within the Home, and this is good practice. Compatibility according to tenants’ changing needs is constantly reviewed. Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Tenants’ individual and changing needs are well monitored at Royal Hill and service user consultation is good. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standard 6 Two care plans were looked at. These had been recently reviewed and updated. A new review date was set for six months ahead. Standard 7 Staff respect service users’ right to make decisions, and support is offered to enable tenants to exercise this right. A club leader encourages staff to leave one service user unescorted, but the manager said that the risk of this young person leaving the building is too great. As in all such cases, the risks are weighed against the benefits to the service user. Standard 9 Risk assessments had been updated and were seen on the two service users’ files that were looked at. The range of risks has been widened, and the manager is encouraging staff to be proactive in anticipating risks, for example the risk of service users choking if they lie down after having a meal. Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 10 Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Tenants at Royal Hill are enabled to lead active lives and maintain relationships with significant people. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standard 12 Tenants at Royal Hill are not able to take up employment. However they attend Day Centres and take part in constructive pastimes. One service user enjoys baking or playing backgammon with her one to one worker. Standard 13 Tenants at Royal Hill use local resources such as pubs, restaurants and cinemas. Staff ratios and diverse service user needs mean that excursions are less frequent than would be hoped. One tenant went out for lunch on the day of the inspection with a staff member. Standard 14 Individual interests are catered for. Indoors their rooms have evidence of individual interests in films or music. Tenants also enjoy shopping, baking and going to dance classes. One likes going to Guides. The proximity of Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 12 the river gives scope for summer activities. In the minutes of a residents’ meeting last year, it states, “[The tenant] said she had a nice time when she went out to the London Aquarium and on a river boat”. All the tenants enjoyed a holiday away last year, and talk at the latest residents’ meeting was about their ideas for this year’s holiday! Standard 15 Links with family members are promoted. One care plan file had a list of family members and relatives’ birthdays at the front, and staff said that they would help the tenant to choose presents as appropriate. One had sent her mother flowers for Mother’s Day. All five of the relatives who responded to the Living Options questionnaire said that staff helped the tenants to keep in touch with family and friends. Standard 16 The Tenants’ Guide for Royal Hill states that ‘You will be offered your own key to the house and your bedroom’. In fact none of the service users holds a key, but rooms can be locked at the tenant’s request, if they go away for the weekend for example. Post is given to tenants to open themselves. Tenants are encouraged to help around the house within their own capacity. Staff were observed to knock on bedroom doors, and not go in unless invited to do so. Tenants were free to choose where they sit and relax, and whether they were on their own or with company. Standard 17 Tenants were observed having breakfast or lunch of their own choosing. The meal for that evening was to be liver and bacon casserole, and this was to be prepared from fresh ingredients seen in the fridge. Healthy eating is promoted, and one tenant has healthier snack as part of her weight control. Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Tenants’ physical and emotional health needs are well met at Royal Hill, and specialist advice is sought appropriately to manage changing needs. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standard 18 Two tenants were on their day off on the day of the inspection, and they were allowed to get up and dress in a leisurely way. Tenants’ health needs are monitored and any changes to their health or behaviour are noted, and specialist advice sought appropriately. One tenant has had some medical investigations, and the consultant psychiatrist stopped one of the tenant’s medications. A further referral has been made to the Community learning Disability Team for advice on self-harming behaviour. All the relatives who responded to the Living Options questionnaire said that staff respected the dignity and privacy of tenants when delivering personal care. Tenants can choose what clothes to wear. One young woman looked particularly well turned out in a fashionably-styled green skirt with matching tights and beads. This standard is exceeded. Standard 19 Routine medical examinations are made, and staff are vigilant for changes in health or well being that might require investigation. Staff have Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 14 requested a home dental check for one tenant who becomes fearful in the dentist’s surgery. Another has been referred for gynaecological investigation. A new health chart on the wall in the office gives staff dates of appointments at a glance. Standard 20 At the last inspection, it was noted that there had been a number of medication errors in the prior months. The manager said that staff attended medicine administration training in June last year, and greater accuracy is now being achieved. In the profile at the front of a tenant’s file, under medication it states, “My medication is often changed. Please refer to my medication sheet”. This is a good safeguard. The G.P. or the consultant psychiatrist reviews medication. No tenants self-administer medication, but one tenant who is prone to seizures carries with him a lockable tin with medication for use in an emergency situation. The Home uses the Boots Monitored Dosage system. The MAR charts were checked for two residents and were clearly and accurately completed. All the homes in the Greenwich Living Options scheme have devised a new medicine administration policy, and this will be sent to the commission’s pharmacist for her comments. Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): The Home gives opportunities for tenants to express their views. Staff are responsive to feedback from colleagues and relatives of service users. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standard 22 At the last inspection it was recommended that there should be a log of complaints, compliments and concerns. There is now a hard-backed book for this purpose, and two compliments have been received from professional colleagues! One, from a consultant psychiatrist congratulates staff on “consistent management of [the service user’s] complex physical and mental health and social support needs”. There have been no complaints received at the home since the last inspection. However, the parent of a tenant has complained to the service manager about the disruption of staff being moved, and the service manager has responded to this. This issue is further considered under standard 39. Four out of five relatives who returned the Home’s own questionnaire said that they knew how to make a complaint, and all were satisfied with the service offered (2 excellent, 1 very good, 1 good). Standard 23 There have been no adult protection concerns since the last inspection. Five out of six respondents to the questionnaire said that residents were ‘safe and supported to share any concerns in relation to their protection and safety’. One said that the residents are unable to convey such concerns. The demeanour and obvious contentment of the tenants indicates that they feel safe and well-cared for. Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): The premises at Royal Hill are well designed for the tenants and enable them to have space to move around, and privacy and dignity for their personal care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standard 24 The Home was purpose built and provides a comfortable and spacious environment for service users. Bedrooms are a good size, and there is a range of communal space including a large level garden, laid mainly to lawn. Some new garden furniture was purchased last year, and tenants enjoyed meals in the garden during the long hot summer months. At a resident’s meeting in August it was recorded, “Two residents said that the new garden furniture is nice”. The maintenance of the building is good. Standard 26 Several bedrooms were looked at on this visit. All were bright, well decorated, and personalised with tenants’ own pictures and items. At the last inspection it was noted that the bed base in one room looked a little frayed, and it was recommended that a valance be used to improve the look of this room. The tenant was supported to buy a valance in his choice of colour. Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 17 Standard 28 A range of comfortable, safe and accessible shared spaces are provided. Tenants can choose whether to sit in one of the two communal lounges, the securely fenced garden or stay in their rooms. Others have favourite spots to sit, such as at the end of the corridor or in the sensory area. Standard 29 A glass sided lift is in the Home to assist one wheelchair user in going up and down the stairs. One tenant has an up and down bed that helps staff to lift him, and one tenant has a wheelchair. The plans to set up an alcove in the downstairs corridor as a sensory area have now been realised, and the space is a delightful area to sit with sensory equipment, bright mobiles, wall ornaments and soothing music. A staff member said that this was the favourite place for one service user, who, “Chills out there, with his music”. Standard 30 The Home was clean and tidy throughout and hand-washing facilities were available in the laundry and kitchen. There were no odours in any part of the building. Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 18 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Staff at Royal Hill are competent, effective and well supported. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standard 32 Some staff at Royal Hill have worked there for a very long time, and have got to know the tenants well. This consistency of care is inestimable in creating a stable and harmonious environment, and the service users seen on the day of the inspection appeared relaxed and comfortable with staff. The professional relationships with other colleagues seem to be good, and two professional colleagues had written compliments in the compliments book. One said that the writer was impressed with the enthusiasm and level of competence shown by the staff. There is an acceptance that staff will register for their NVQ2 and five staff already hold this qualification. Two staff members have just commenced their NVQ2 and two their NVQ3. This makes an impressive 75 of staff working on or having obtained a vocational qualification. In the last inspection report a comment made by a relative was quoted, and this is reproduced again, “We have full confidence in the staff at Royal Hill and we consider ourselves very fortunate that [the client] has secured a place in a kind, caring and secure establishment”. This standard is exceeded. Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 19 Standard 33 Staff meetings take place each month, and deal with a range of issues relating to the tenants. Two new staff members are transfers in from other homes. Although they could still do with more staff to facilitate extra excursions for the tenants, one staff member said that the manager had put extra staff on to allow some tenants to attend a music club. One meeting recently noted, “It has been noted by staff that the staff morale is on the up and Royal Hill is becoming more enjoyable to work in”. This will clearly have an impact on the tenants. Night visits were happening at the time of the last inspection to ensure that staff were appropriately vigilant. An issue arose recently which was dealt with robustly by management. Two staff members said that staff at Royal Hill form a “good team”. Standard 36 The manager of Royal Hill is also managing another Home, and is giving some priority to this one as it takes clients for respite. However she is currently supervising all the staff at Royal Hill, and there was evidence that all staff had received one supervision session this year. She said that staff have “pulled together”, and staff spoken to indicated that they were able to deliver a service although, in the words of one, “It’s not the same as having someone on the premises”. Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 20 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Royal Hill is well managed, and tenants are safe and well cared for. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Standard 37 The manager has now registered with the commission, and is currently completing her Registered Manager’s Award. Before she was able to fully establish herself in the role at Royal Hill, she was asked to take over the management of a second Home in close proximity to Royal Hill. Although this means she is effectively dividing her time, she seems to be doing this without too much difficulty, and has actually brought new ideas back to Royal Hill on systems and procedures. A new manager is to be appointed at Royal Hill in the next couple of months. Standard 38 The registered manager has established a good rapport with staff and service users, and staff say that she is responsive to new ideas and Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 21 change. All the recommendations made at the last inspection have been actioned appropriately. She has recently introduced an appointments spreadsheet that enables staff to see at the glance what medical appointments tenants have had. Standard 39 Monthly Person in control reports were available in the Home up until July 2006, and these have also been sent to the Commission. However there do not appear to be any reports since then. This is therefore a restated requirement (Requirement 1). There is a suggestion from the Tenants’ Survey of March last year that tenants want more involvement in running the Home. The manager said that they could participate according to their ability. However, the other aspect of this is, “being kept informed about changes in their environment”, and this may relate to the management changes. The parent of one tenant has made a complaint about this, and the service manager has responded. From the limited contact during the inspection, there is no discernible impact on the service user. However, other professionals have been vocal about the changes, and claims they do impact upon clients. One stated, “My concern is the frequent movement of staff to other establishments. Key worker and manager have been moved at short notice and often not involving service users or staff views”. The complainant claims that there has been an increase in psychology referrals and this is detrimental to the well being of clients. Although the rationale for the moves has been discussed with the Commission, it is recommended that, once the new manager is appointed, further changes be minimised to ensure consistency of care for the tenants of Royal Hill (recommendation 1). Standard 42 The fire alarm installation was checked in September last year and some reparative work was recommended. This has been done. Magnetic door closures have been installed on the lounge and dining room doors. Fire drills have been carried out each month, and the record shows the names of all staff and tenants who participated, evacuation time and any comments around non-compliance, including action taken to safeguard tenants’ welfare. The Home has its own fire risk evacuation plan. A gas safety check was made on 15/5/06, the electrical installation certificate was dated 29/4/03, and is not due again until 2008, and the lift had a routine service on 13/2/07. Water temperatures appear not to have been checked regularly, and this should be done to ensure tenants’ safety (requirement 2). Carpets were secure, and there were no observable hazards in any part of the house. Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 4 33 3 34 X 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 3 2 X X 3 X Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 23 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 YA39 Regulation 26(5)(a) Requirement Responsible Person reports should be made monthly and be unannounced, and copies of the reports of these visits should be sent to the Commission (Restated requirement, previous timescale 05/05/06 not met). The Registered Person must ensure that all parts of the Home are free from hazards to the safety of the tenants, specifically hot water temperatures must be checked regularly to ensure they do not exceed 43 degrees. Timescale for action 18/05/07 2. YA42 13(4)(a) 18/05/07 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 YA39 Good Practice Recommendations It is recommended that, once the new manager is appointed, there is a period of stability for staff and tenants, without further changes, to ensure consistency of care. DS0000043007.V291732.R01.S.doc Version 5.2 Page 24 Royal Hill Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Royal Hill DS0000043007.V291732.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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