Inspection on 10/08/05 for Ruby Rhydderch

This inspection was carried out on 10th 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.

Other inspections for this house

Ruby Rhydderch 14/01/08

Ruby Rhydderch 27/02/06

Ruby Rhydderch 25/11/04

Ruby Rhydderch 11/08/04

Ruby Rhydderch 24/02/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Ruby Rhydderch 2 Ipstone Avenue Stechford Birmingham B33 9DZ Lead Inspector Ann Farrell Announced 10 August 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Ruby Rhydderch Address 2 Ipstone Avenue Stechford Birmingham B33 9DZ 0121 784 2195 0121 789 9367 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) Birmingham City Council Bridged C. Seelal Care Home 45 Category(ies) of Old Age (45) registration, with number of places Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the home is registered to accommodate 45 adults who are over the age of 65 who are in need of care for reasons of old age and may include mild dementia. Registration category will be 45 OP. 2. That minimum staffing levels are maintained at 7 care assistants a senior member of staff throughout a 14.5 hour waking day. 3. In addition to the above minimum staffing level there are 3 waking night staff plus a senior awake or on sleeping-in duty. 4. Care/shift manager hours and ancillary staff should be provided in addition to care staff. 5. Completion of the BTEC Higher Diploma in the Management of Care Services by April 2005 6. That one service user aged between 50 and 65 can be accommodated in this home to receive interim care for a period not usually exceeding six weeks.. Date of last inspection 25 November 2004 Brief Description of the Service: Ruby Rhydderch is a purpose built two-storey building that was commissioned in 1974. It is owned and managed by the Local Authority and accommodation is available for fourty-five residents for reason of old age for both long term and respite care. The home is divided in to four units, each having a lounge and kitchen. All accommodation is provided in single rooms that are equipped with wash hand basin and call bell. In addition, there are a number of communal sitting areas around the home, where residents may sit and smoke if they wish. There is a day centre attached to the home, which is managed and run as a separate entity. Off road parking for two cars is availble to the front of the home with further parking to the side of the building. The home has a passenger lift and is accessible to wheelchair users throughout. There are pleasant enclosed gardens to the rear that are also accessible to all residents. The main kitchen is situated on the ground floor with a light, pleasant dining room adjacent where main meals are served. In addition, there is a furhter small dining room on the first floor. Bathing facilities are situated on each corridor with a choice of shower or bath. Laundry facilities are also situated on the ground floor, where residents laundry is undertaken. The home is situated close to local amenities such as shops, off licence and is well serviced by public transport. Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection was conducted over one full day commencing at 8.15 am on 10th August 2005. This was the first statutory inspection for 2005/2006. The manager was on sick leave and the assistant managers were present for the duration of the inspection. During the inspection process the inspector toured the home, sampled residents files and other documentation. The assistant managers, approximately eight members of staff, twelve residents, three relatives, the district nurse and G.P. who were visiting were spoken to. Nineteen comment cards were received about the home from residents, relatives and health care professionals. The feedback was generally very positive One stated “ A warm and welcoming establishment; nothing is too much trouble. I am very impressed with the level of care and attention”. What the service does well: The home has a friendly and relaxed atmosphere. The office is situated on the ground floor enabling relatives easy access to senior staff to discuss any issues or concerns and this was noted on the day of inspection. Staff were noted to be welcoming to visitors. There are flexible routines and no rigid rules. One relative stated “my mom has not only had good care and attention, but has also found friendship in everyone”. There is a range of communal areas attached to each unit and on the ground floor providing a choice of areas to sit. Visiting is flexible and feedback indicated that visitors are always made welcome and kept up to date with any changes. Staff are attentive to residents needs; treating them as individuals and their privacy and dignity is respected. Staff provide very good standards of care and the response indicated that everyone was happy with the care provided. Feedback from health professionals supported this and stated the staff were professional and caring. There are regular meetings with residents and staff. The home responds positively to inspections and tries to address requirements promptly. The home is always clean, odour free and well maintained providing a safe environment. Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.doc Version 1.40 Page 6 A varied menu with a choice of meals is provided, which was appreciated by all residents spoken to at the time of inspection. The medication system was of a good standard. There is strong evidence of a systematic approach towards training and development of all staff groups in the home with a high number of staff having completed NVQ level 2. Management systems are very well organised. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 4, 5, 6 The home has information available for prospective residents enabling them to make an informed decision about moving into the home. There were good procedures for admission of residents to the home and written assessments were available. EVIDENCE: The majority of residents admitted to the home require permanent care, but there are also facilities to provide respite care for a small number of residents. There is written information available for prospective residents, enabling them to make an informed decision about moving into the home, but this was not viewed at the time of inspection. The staff liaise with social workers that provide written assessments or care plans for residents who wish to enter the home. They also invite prospective residents to the home enabling them to view the facilities, meet staff and other residents and partake in a meal. At this stage the home is able to undertake an initial assessment to determine if they are able to meet residents needs. On inspection of records for a resident who had recently been admitted to the home there was evidence that an assessment had been undertaken and it was of a good standard. Some residents who had recently moved into the home Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.doc Version 1.40 Page 9 expressed satisfaction with the home confirming that they had visited before moving in. Staff care for a some residents who suffer with dementia/confusion and staff require training in this area. Following admission staff draw up an Individual Service Statement (ISS), which outlines resident’s needs and the action required by staff to meet their needs. A review is undertaken at the end of one month with resident, family and staff in the home to determine if everything is satisfactory. There was evidence of contracts of some files inspected, but there was no evidence of the terms and conditions of residency. Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.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 has good arrangements in place to meet resident’s health care needs. The care plans are generally of a good standard and staff had a good knowledge of residents needs. The medication system is managed to a good standard so protecting residents. EVIDENCE: Senior staff draw up an Individual Service Statement (ISS) for each resident following admission outlining how the resident’s needs are to be met by staff. On inspection of a small sample they were generally found to be of a good standard and had been reviewed monthly. However, the ISS for one resident who had been in the home for a number of years was rather vague. It was also noted that nutritional screening had not been undertaken on all residents. Daily records they were found to be of a good standard and care plans were in place for residents on respite care. Staff will need to ensure that care plans for those residents who have been in the home for a number of years are enhanced to provide more detailed and specific information. All residents are registered with a local G.P. practice and staff liaise with health professionals from the multidisciplinary team such as district nurses, social workers and continence adviser. At the time of visiting the district nurse and the G.P. were visiting and they stated that staff are aware of the resident’s Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.doc Version 1.40 Page 11 needs and any presenting problems. Also staff support residents when visited by the doctor if they require assistance in expressing concerns. Records indicated there were regular visits form health professionals such as dentist, chiropodist and optician, but there was no evidence of health checks for residents with chronic diseases such as diabetes and asthma. It is suggested that this be discussed with the practice nurse from the G.P. surgery. Medication is provided in a monitored dosage system and is stored in the medical room. The medication was found to be of a good standard. It was noted that oxygen was in use, but there was no signage in the area to advise visitors of precautions. The nebuliser dispenser had not been washed and dried after use, which should be done to reduce the risk of legionella. A number of residents stated they were happy living in the home, found the staff very good and helpful. One stated “ Its one of the best – staff are good, management are good, food is good. I am happy here”. Residents are consulted about their wishes in respect of holding keys to their bedroom door and all rooms have lockable facilities for the storage of valuables or medication. A public telephone is available in a corridor, but if privacy is required suitable arrangements can be made. During inspection residents were well presented, their privacy was respected and staff treated them with respect. Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.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, 15 Catering and meals are well managed with a choice and variety of nutritious food available. Residents are able to make choices about daily living activities and there is a relaxed, flexible and welcoming atmosphere in the home. There has been an improvement in the range of social activities and staff are hoping to develop this further. EVIDENCE: Residents are free to come and go as they wish and there are no rigid rules. Visiting is flexible and feedback indicated that relatives can visit at any time with a variety of areas to sit. There is also a pleasant enclosed garden with seating that can be used when weather permits. Each of the lounges has a television and there is also a television with video recorder, which is used for film sessions. Residents were observed to be reading newspapers, listening to music and watching television. Since the last inspection the home has appointed two members of care staff to be responsible for activities, which includes arts, crafts, bingo, games e.g. dominoes and quizzes. Some of these were observed to be occurring during the day and residents stated they enjoyed them. In addition, there is access to day centre transport, but outings have not taken place recently as there was no driver available. This has been addressed with the recent employment of a maintenance operative, who will be responsible for driving the mini bus. Some residents stated they missed the tips out in the mini bus. Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.doc Version 1.40 Page 13 There is a separate hairdressing room and the hairdresser visits regularly. The home receives a supply of library books from the mobile library bi-monthly and talking books from the blind institute. Staff also run a trolley shop and funds raised are deposited into the comforts fund, which is used for residents social activities. Contact is maintained with local places of worship and clergymen also visit the home on a regular basis, when a service is held. Residents make take items of furnishings into their rooms and some rooms had been personalised. Separate catering staff are employed and provide three full meals per day. There is a five-week menu with choices available and it was stated that alternatives were available if residents did not like the menu of the day. Residents stated they enjoyed the meals, were offered extras and were also offered sandwiches at night. The inspector had lunch with the residents and found the meal to be of a good standard. Staff were observed to offer assistance to residents and the meal was unhurried. Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.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) 16, 18 The home handles complaints appropriately and residents are assured that any concerns would be addressed appropriately. EVIDENCE: The home has a copy of the complaints procedure displayed. Records indicated that the home had not received any formal complaints, but some informal complaints had been recorded and addressed appropriately. Feedback from professionals indicated that they had never received any complaints. One stated “a very professional and caring home”. On discussion with residents they had no complaints with the exception of one person who mentioned activities and written feedback indicated that the home provided suitable activities sometimes. The home is currently addressing this issue with members of staff taking responsibility for this area. The home has a copy of the vulnerable adults procedures and staff have undertaken some training in this area. On discussion with staff they were aware of the action to take in the event of any allegation of abuse. Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.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, 20, 21, 23, 24, 25, 26 The standard of décor and furnishings in the home is good providing residents with a pleasant, warm and homely environment to live. EVIDENCE: Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.doc Version 1.40 Page 16 The building is a purpose built residential home, which was cleaned to a good standard and odour free. There is a very pleasant garden and patio area to the rear of the building, where seating is available for use by residents when weather permits. On entering the home there is a pleasant reception area, which is carpeted, but corridors through the remainder of the home are covered with floor tiles and replacement with an alternative would provide a more homely appearance. The home is divided into four units and each has a lounge and small kitchen area. The lounges are pleasantly decorated and furnished providing a homely atmosphere. Some re-decoration and replacement of carpets has taken place since the last inspection and this is ongoing. During the inspection it was noted that the carpet in room 8 required replacement. Some of the lounge chairs have also been replaced and new curtains provided. There is one large dining room on the ground floor, which is bright and pleasantly decorated. In addition, there is a smaller dining room on the first floor. All bedrooms are single and have a wash hand basin and call bell. On inspection of a sample of rooms it was noted that they were pleasantly decorated and had been personalised by residents. A number of bedrooms only have two single electrical sockets, which limits the number of electrical appliances that residents can safely use. Eleven bedrooms have a TV aerial point and three have telephone points. Doors are provided with locks and lockable facilities are available for valuables or medication. Records indicated that residents are consulted about the door key to the bedrooms. There is a range of bathrooms with a bath or shower enabling residents to have a choice of bathing facility. There are a number of toilets throughout the home within easy access of dining rooms and lounges. Rooms are individually and naturally ventilated. All areas are centrally heated, but controls cannot be accessed by residents to adjust the heating in their bedrooms. On the day of inspection it was rather hot and the heating was on. It appears that the heating is controlled centrally. This area will need to be reviewed as it was necessary to have number of fans on to maintain comfortable temperatures. Hot water outlets have thermostatic valves fitted to control the temperature of hot water so reducing the risks from scalding. There is a separate laundry, which is adequately equipped and undertakes the laundering of residents clothing. Separate sluice facilities are situated throughout the home and since the last inspection hand gel has been provided for staff in these areas to ensure adequate infection control procedures are adhered to. The main kitchen was clean and well maintained. Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.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, 28, 29, 30 Generally there are adequate staffing levels to meet resident’s needs. The recruitment policies and procedures are robust for the employment of staff ensuring that residents are adequately protected. EVIDENCE: Information indicated that there are times when there is only five staff on the units during the day and two staff overnight. In addition to the care staff are the managers, domestic, catering, maintenance and administration staff. At the time of inspection there were between nine and eleven residents who required two staff. The conditions of registration indicate there should be six staff on duty during the day and three staff overnight. The manager will need to ensure staffing levels are maintained in accordance with the conditions of registration. A small sample of staff files were inspected and were found to be of a good standard with evidence of robust recruitment procedures. The home has an ongoing training programme and over 50 of staff are trained to NVQ level 2. All newly employed staff attends induction training, which is organised centrally. Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.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) 31, 33, 36, 38 The home is managed in the interests of the residents and their health, safety and welfare is protected. EVIDENCE: The manager is suitably qualified and has been in post for a number of years. She was not available at the time of inspection due to sick leave and one of the assistant managers was acting up. Records indicated that staff meetings, residents meetings and supervision occurred on a regular basis. Feedback from residents and relatives was positive indicating that they were happy with the standard of care provided in the home. One relative stated “ we are very pleased with mom’s care and rate it first class”. A sample of records were inspected in relation to maintenance and they were found to be up to date and satisfactory with the exception of the gas safety certificate which indicated that mechanical air input was required in the kitchen. Hot water temperatures from bathing facilities are checked regularly Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.doc Version 1.40 Page 19 by the maintenance operative, but it appears that water from wash hand basins are not checked. It was recommended that advice be sought from the health and safety department. Records of staff training indicated that mandatory training in respect of fire prevention, first aid, infection control, manual handling and basic food hygiene was being undertaken. Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.doc Version 1.40 Page 20 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 2 3 2 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 3 3 x 3 2 2 3 STAFFING Standard No Score 27 2 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x x 3 x 2 Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.doc Version 1.40 Page 21 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 1 Regulation 4 Requirement The registered person must review and enhance the statement of purpose to provide specific and detailed information as outlined in the guidance given. This area was not assessed and has been carried forward. The registered person must review and update the service user guide to ensure it provides up to date information. This area was not assessed and has been carried forward. The registered person must ensure that each resident receives an up to date copy of the terms and conditions of residency. Timescale of 30/3/05 not met. The registered person must ensure all staff undertake training in respect of caring for people with dementia and challenging behaviour commensurate with their position in the home. The registered person must ensure care plans for residents who have been in the home for a number of years are reviewed Timescale for action 30 December 2005 2. 1 5 30 December 2005 3. 2 5(1)(b) 30 December 2005 4. 4 18(1) 30 December 2005 5. 7 15 30 October 2005 Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.doc Version 1.40 Page 22 6. 19 16(2)(j) 7. 19 16(2)(c 8. 24 16(2)(c 9. 25 23(2)(p) 10. 27 18(1) 11. 38 13(4) and enhanced to provide more detailed information and nutritional sceening is undertaken for all residents. The registered person must review units in kitchenettes with a view to replacement. Timescale of 30/3/05 not met. The registered person must ensure the floor tiles are replaced with an alternative to enhance the homely atmosphere. Timescale of 31/3/04 not met. The registered person must ensure there are two double electrical sockets available in all rooms. Timescale of 31/3/04 not met. The registered person must ensure residents can adjust the radiators in their bedrooms. Timescale of 31/3/04 not met The registered person must ensure there are adequate staff on duty at all times and that they meet the conditions of registration. Where the conditions of registration are not being met they must inform the Commission. Timescale of 30/11/04 not met. The registered person must ensure the issue identified on the gas safety certificate is addressed. 30 January 2006 30 March 2006 30 March 2006 30 December 2005 20 August 2005 30 October 2005 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 8 Good Practice Recommendations It is recommended that senior staff seek advice about health checks for residents with chronic diseases such as E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.doc Version 1.40 Page 23 Ruby Rhydderch 2. 3. 9 38 diabetes and asthma. Staff need to ensure signage is in place when using oxygen and nebuliser dispensers are washed and died after each use. It is recommended that the advise is sought from the health and safety department about testing hot water temperatures at wash hand basins. Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.doc Version 1.40 Page 24 Commission for Social Care Inspection Birmingham & Solihull Local Office 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham, B2 4UZ 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 Ruby Rhydderch E54 S33591 Ruby Rhydderch V235722 100805 Stage 2.doc Version 1.40 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!