Inspection on 07/07/05 for Royal Hill

This inspection was carried out on 7th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Royal Hill 31/07/08

Royal Hill 26/03/07

Royal Hill 20/02/06

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 SE18 6PY Lead Inspector Sue Grindlay Unannounced 7 July 2005 00:00 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. Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Royal Hill Address 101 Royal Hill Greenwich SE18 6PY 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 8694 3652 London Borough Greenwich Susan Wiseman CRH 7 Category(ies) of LD 7 registration, with number LD(E) 7 of places Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 7/2/05 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 G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection over four hours on, coincidentally, the last day of the present manager’s tenure. There is to be some staff movement within Greenwich, and Royal Hill is to be managed temporarily by the current Assistant Manager who has only been in post since April this year. Four tenants were on the premises during the inspection. Three staff members and one relative were spoken to, a tour of the building was made and four bedrooms were viewed. Documents and care plans were also scrutinised. What the service does well: What has improved since the last inspection? What they could do better: Staff should receive appropriate supervision and the procedure for reporting incidents of concern should be tightened up. Issues relating to health and safety should have a higher profile. Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 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. Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards have been met and all the current tenants have been in placement since the Home opened in May 2003. EVIDENCE: All the tenants have been in the Home since it opened, and the standards were met on the last 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. Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 and 9 Tenants’ individual and changing needs are well monitored at Royal Hill and service user consultation is good. EVIDENCE: Two care plans were looked at. Both files were well kept and had evidence of up to date records including fortnightly reports. Tenants have a care plan, and there is clear evidence that changing needs are both monitored and recorded, for example, one tenant is spending more time in his wheelchair, and so the wheelchair service is to reassess to make sure he is properly fitted. He has also purchased a motor for his wheelchair, and this makes it easier for staff to push. Another tenant has shown some improvement in her behaviour, and is to remain at the Home whereas it had been thought that she would need to move elsewhere. A previous inspection noted an excellent life story on one file, and the manager said that she hoped to do more in this area. It is recommended that key workers take this forward for other tenants as time permits. One care plan seen had no review date. It merely stated, “To be arranged”. It is recommended that a review date is set, and amended if necessary. Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 Page 10 The tenants at Royal Hill are mostly non-verbal, so staff need to develop ways of communication, and of understanding their needs and wishes. All staff have undertaken training run by a psychologist with the Community Learning Disability Team in ways of interacting. One tenant has no active family members and two befrienders, both ex-staff members, advocate strongly on her behalf. Tenants’ meetings are held regularly although sometimes the tenants choose not to attend. A service user questionnaire was sent out earlier this year to canvas tenant’s views about the care given. As the tenants would have difficulty answering the specific questions, the questionnaires were sent to each tenant’s representative with the expectation that they would assist he tenants to answer the questions. An analysis of the results has been published and is to be sent to families. All the staff highlighted that staff spend time talking to the tenants and listening to their wishes. One tenant is to be consulted about the colour of her bedroom, due to be decorated shortly. This standard is exceeded. Risk assessments are introduced and revised as necessary. Following the death of a service user in another Home, risk assessments for all service users with epilepsy have been revisited. Guidelines for one tenant for wearing his helmet are being finalised, and will be given to staff, put in his care plan and discussed at team meetings so that everyone is aware of them. Some holiday risk assessments were made prior to the recent group holiday. Working alone assessments are in process, tailored to individual staff members. Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 and 17 Tenants at Royal Hill are enabled to lead active lives and maintain relationships with significant people. EVIDENCE: Some tenants attend Day Centres. One attends a music and dance course at Greenwich Community College. All the tenants enjoy outings to the cinema, shopping, local pubs and restaurants. Some enjoy activities such as football or hydrotherapy. A neighbour joined them with his baby at a recent barbecue in the garden to celebrate two years in the house. All the tenants had a group holiday at the end of April, to enable contractors to come in and re-lay the floor in the corridor. They went to cottages in Suffolk, and spent the time visiting the beach and places of interest. One tenant additionally went on a cruise with a former staff member, although the manager said that she found it rather too exhausting! At least four of the tenants have regular contact with their families, two going for overnight and weekend stays. One relative who was visiting on the day of the inspection said that he often visited the Home, and considered that his son Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 Page 12 was very settled there. He commented on the fact that many of the staff have worked with his son for some considerable time. The analysis of the service user questionnaire said that the variety and choice of food is very good and well balanced. One person commented that they would like to see a permanent cook. The relative mentioned this at the inspection, and said that staff were sometimes under pressure to put a meal on the table especially when they had been out for the day. There is usually a printed menu for the week, but on the day of the inspection there was no record available since 30/6/05. The assistant manager said that tenants are asked in the morning what they would like for dinner that day. A board on the wall told tenants that today’s meal was steak and mushroom pie. There seems to be no record of meals that are eaten, and it is recommended that a record be kept of individual choices if different from the printed menu. A large bowl of fruit was in the kitchen. Tenants sometimes help to prepare meals, or enjoy a session of baking. At the last tenants meeting one of the tenants requested more burgers and chips. It is recommended that healthier options be considered, such as homemade hamburgers with lean mince and potato wedges instead of chips. Having a cook would make this a more feasible option, so this is also a recommendation. Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 and 21 The Home’s systems for administering medication are sound. New procedures for recording tenants’ wishes in respect of death and dying are particularly good. EVIDENCE: The G.P. or the consultant psychiatrist reviews medication. One tenant had medication changed to liquid form and another had some medication represcribed to address low mood. No tenants self-administer medication. The Home uses the Boots Monitored Dosage system. One tenant had refused medication on two occasions recently, and the record correctly logged this. New medication was delivered on the day of the inspection, and the manager said that two members of staff would check this and record details of the delivery on the MAR charts. A list of staff signatures and initials could be found at the front of the file. The new Assistant manager had not been added to this list, and this should be done and is a recommendation. A medication error was not notified to the Commission on a Regulation 37 form. This is a requirement. The policy on death and dying has now been completed, and, over time staff are to discuss this with the service user and their families. A document entitled “When I die” using pictorial representations of choices to be made puts the issue simply and without emotion. The Assistant manager wants to take this forward and expressed her wish to “make it not a sad thing”. One tenant who Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 Page 14 lost her “social uncle” was taken to see him in the chapel of rest, was supported to attend his funeral and has a photograph taken of them together on her wall. In the light of the progress made in this area this standard is exceeded. Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Tenants at Royal Hill know that their views are taken into account, and their welfare safeguarded. EVIDENCE: There have been no complaints at the Home since the last inspection. It was recommended at the last inspection that copies of the complaints procedure should be sent out to relatives, and this is now being done. The Home is also sending the Commission’s new leaflet, “Is the care you get the care you need?” which invites feedback from service users and their families. It was also recommended that compliments received are also logged and this recommendation is renewed. From comments made by each staff member, it is clear that tenants’ wishes and feelings are given a high priority at Royal Hill. Systems to ensure tenants’ welfare and protection are robust. There is a whistleblowing policy in operation, and a member of staff reported a colleague for sleeping on duty. This is being dealt with appropriately under the borough’s misconduct policy, and gave an opportunity for the manager to discuss the implications of POVA in a staff meeting. One staff member said that staff are “always looking out for the clients’ safety”. Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 27, 29 and 30. The premises at Royal Hill are well designed for the tenants and enable them to have space, some independence with privacy and dignity for their personal care. EVIDENCE: At the last inspection it was noted that the floor was lifting in the downstairs corridor. This has now been re laid, and a new dark blue carpet put down. This gives a very comfortable and homely look to the Home. One of the tenants helped her mother plants some bright petunias in pots for the back garden, and they made an attractive splash of colour along the fence. The user survey analysis stated that the general standard of furniture and decoration is good. A new dishwasher has been installed in the kitchen. Upstairs in the wide corridor on one side of the house there is a low table with nothing on it. It is recommended that a plant or some decorative objects be placed there, to make sure the table is not a stumbling hazard and to attract the eye. Several bedrooms were looked at. They were all bright and attractively decorated with items of personal interest. One tenant is to choose the colour Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 Page 17 for her room to be decorated. All the rooms have their own shower and toilet ensuite and all are of a generous size. This standard is exceeded. A glass sided lift is in the Home to assist one wheelchair user in going up and downstairs. One tenant has an up and down bed that helps staff to lift him, and one tenant has a wheelchair. The assistant manager plans to set up an alcove in the downstairs corridor as a sensory area, and a curtain and sensory equipment is to be purchased for this project. The Home was clean and tidy throughout and hand-washing facilities were available in the laundry and kitchen. No paper towels were available in the kitchen and this is a requirement under standard 42. Laundry is being done more frequently to prevent the build up of dirty washing in tenants’ rooms. Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 and 36 Staff have opportunities to develop their practice, but regular supervision must be part of this process. EVIDENCE: The recent survey undertaken by the Home canvassed the views of other professionals about staff at the Home. Staff at the Day Centres considered there was good communication between their staff and staff at the Home. They felt that any suggestions or concerns regarding service users were addressed and listened to by staff at Royal Hill. All the staff recently undertook initiation training run by a psychologist with the Community Learning Disability Team. This helped staff to look at means of communication with tenants. One relative, while stating that many staff had worked with his son for some time said, “I go more for staff rather than the place”. He indicated that a staff member who works with his son would, “go by how he is”, meaning that he would be sensitive to the mood and feelings of the tenant while interacting with him. Staff spoken to on the day of the inspection expressed a genuine regard for the tenants, and, in respect of their sometimes challenging behaviour, a wish to overcome this. The manager said that they are fully staffed, and one staff member said that it is a good team. One staff member, an agency worker, has worked at the Home Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 Page 19 for some time, giving continuity to the tenants. However it is noted that agency workers do not have the same access to training opportunities as permanent staff, and this militates against a skilled and competent workforce. An allegation of misconduct was responded to rapidly. In this case, senior managers have made night visits to check that all is well. No new staff have been recruited since the last inspection. The staff records consist of a laminated sheet, with endorsements that references, medical clearance, evidence of identity and criminal records bureau checks have all been received and verified appropriately. The staff member signs this record as does a senior manager. Staff can apply for training courses run by the borough. This year staff have undertaken a range of training in subjects such as epilepsy, autism, managing challenging behaviour and assertiveness training. Specialist subjects such as autism and epilepsy had been requested in the past, so it is commendable that these have now been provided. Some staff are completing their NVQ2s. The assistant manager is compiling a database of staff training, and the recommendation made at the last inspection for a training needs assessment for the whole staff team is renewed at this inspection. A requirement was made at the last inspection around supervision for staff. The new supervision arrangements have hardly begun, and the change of management may threaten this once again. In addition the assistant manager has had no training in supervision, and this is a further recommendation. The requirement for all staff to have supervision at least six times a year is also restated. Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 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 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) 37, 38, 39, 40 and 42 Royal Hill is well managed, and tenants are safe and well cared for. EVIDENCE: The manager is completing her managers’ award and the assistant manager is beginning hers. Both managers have attended training accredited by the Learning Disability Award Framework. The present manager came to the Home two years ago with the tenants, and has been responsible for creating the ethos that the Home now conveys. She is clearly well loved and respected by the tenants and the staff. One staff member said that she was a “people’s manager, very fair with people, very client orientated”. Although there will be new management in the coming months, the good work done by this manager is acknowledged at this inspection, and this standard is therefore exceeded. It was recommended at the last inspection that when the tenants survey was analysed, the results should be published and circulated to tenants, their relatives, professionals involved with the tenants and the commission. This has Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 Page 21 been done, and this is commendable. The managers commented that the format of the questionnaire was difficult to complete, especially for some tenants who are non-verbal. It is recommended that a new format be drawn up for next year, taking these comments into account. It may also be possible to design a different questionnaire for other professionals. This standard would have been exceeded except for the fact that Person in Control reports were not available in the Home and have not been sent to the commission. The manager said that she sometimes receives immediate verbal feedback but the report arrives later. The report should be available without delay for tenants, their relatives and staff to read. This is a restated requirement. The Home has sets of policies that are the borough’s own policies for the service user group and management policies for staffing. Some tenants’ care plans have a copy of the schedule 3 requirements under the care homes regulations, showing that the Home is striving to be compliant with regulations for records for each service user. Notifications of significant events have not been received at the commission, though the Home’s manager said that they were sent. Two incidents of drug errors and an issue of staff misconduct should have been notified to the commission without delay under regulation 37. This is a requirement. It was noted on the inspection that two doors were propped open with wedges, as the doorstops that should close the door in the event of a fire were not working. These should be serviced and, if necessary, realigned in order to be effective. The assistant manager had not signed to say that she had received a copy of the local fire procedures, although the manager stated that she had been through them with her new deputy. In the kitchen, three jars of sandwich spread had been opened and none had the date of opening on them, and there were no paper towels for hand drying. These matters are the subjects of further requirements. On a positive note, a normal domestic trolley has been purchased to transport hot food from the kitchen to the dining rooms, and the manager said that, despite her misgivings, staff were finding it useful. The last fire drill on 29/6/05 showed a good record of all the names of staff and tenants who participated, time taken to evacuate, and the previous record showed action taken in respect of non-compliance. Fire appliances were checked in March and a certificate of conformity issued in April this year. The gas boiler was serviced on 13/5/05. Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 4 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 4 x 3 x 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 3 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Royal Hill Score x x 3 4 Standard No 37 38 39 40 41 42 43 Score 3 4 4 3 x 1 x Version 1.30 G51G01s43007RoyalHillv232933.7.7.2005stage4.doc 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 36 Regulation 18(2) Requirement Staff should receive supervision at least six times a year (Restated requirement, no timescale given). 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 not met). All jars and sauces in the refrigerator should be marked with the date of opening. Paper towels for hand washing must be available in the kitchen at all times. Door stops must be repaired to enable them to close in the event of fire. All events affecting the wellbeing of tenants must be notified to the Commission without delay. All persons working in the Home must receive training in fire prevention, and this should be evidenced in records. Timescale for action 2 Sept 2005 Immediate 2. 39 26(5)(a) 3. 4. 5. 6. 7. 42 42 42 42 42 13(4) 13(4) 23(4) 37 23(4) Immediate Immediate Immediate Immediate 2 Sept 2005 8. Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 Page 24 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. 5. 6. 7. 8. 9. 10. 11. Refer to Standard 6 6 17 17 17 20 22 24 35 36 39 Good Practice Recommendations It is recommended that plans to undertake formal life story work be taken forward by key workers as time permits. It is recommended that all care plans are dated, and a review date set, which can be amended later as required. It is recommended that a record is kept of individual meal choices for each tenant. It is recommended that tenant meal choice is respected but healthier options such as home made hamburgers and potato wedges are considered. It is recommended that the Home considers employing a cook to free up staff time and to enable the tenants to enjoy freshly prepared food. It is recommended that the assistant manager adds her initials and signature to the list of those administering medication. It is recommended that all complaints, compliments and suggestions are logged with date and any response made. It is recommended that the table in the top corridor be dressed with a plant or some decorative objects, to prevent a stumbling hazard and to be plaesing to the eye. It is recommended that a training needs assessment be carried out for the staff team as a whole. It is recommended that the assistant manager receives training in supervision to enable her to fulfil her role. It is recommended that the analysis of the tenants survey includes consideration of a different format for the next survey Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 Page 25 Commission for Social Care Inspection Riverhouse 1 Maidstone Road Sidcup Kent DA14 5RH 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 Royal Hill G51G01s43007RoyalHillv232933.7.7.2005stage4.doc Version 1.30 Page 26 - 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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