Inspection on 15/12/05 for Ruksar

This inspection was carried out on 15th December 2005.

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

Ruksar 06/02/09

Ruksar 29/04/08

Ruksar 28/09/07

Ruksar 10/04/07

Ruksar 09/01/07

Ruksar 12/09/06

Ruksar 05/05/06

Ruksar 08/03/06

Ruksar 14/09/04

Ruksar 21/04/04

Ruksar 16/12/03

Similar services:

Aston Court Nursing Home

Breme

Ravenhurst

Westmead

Ashcroft Hollow Nursing Home

Bricklehampton Hall Nursing Home

Briar Hill House

Radbrook Nursing Home

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Ruksar 26 Park Avenue West Park Wolverhampton West Midlands WV1 4AH Lead Inspector Joy Hoelzel Unannounced Inspection 15th December 2005 10:00 X10029.doc Version 1.40 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 Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 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 Older People and 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. Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ruksar Address 26 Park Avenue West Park Wolverhampton West Midlands WV1 4AH 01902 420605 01902 561199 mariamathet@aol.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) Mr Mustak Jalal Maria Teresa Cendana Care Home 27 Category(ies) of Physical disability (27), Physical disability over registration, with number 65 years of age (27) of places Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. No number division between categories Date of last inspection 4th October 2005 Brief Description of the Service: Ruksar is a care home that provides nursing, accommodation and personal care to 27 people. It is registered for adults with physical disabilities both over and under 65 years of age. The home is located close to Wolverhampton city centre, close to shops, pubs, local parks and other amenities. The home first opened in January 1993. Mr Jalal taking ownership of the home in 2002. It is a two-storey building with bedrooms, communal rooms, toilets and bathrooms on both floors. There is a passenger lift accessing the first floor. There is a ramp to the front of the house but limited access to the gardens for wheelchair users. Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over three and a half hours on Thursday 15th December 2005 and is the second of the statutory inspections for 2005/06. Twenty-one service users were resident at the time of inspection and staffing numbers were at the agreed levels with a mix of first level nurses, care and ancillary staff. A tour of the premises took place, two service users care plans were examined in depth, and discussions were held with five service users and four staff members. An application for variation to the premises has been received and included alterations to the double occupancy bedrooms to be made into single rooms, the sitting room on the first floor to be re-sited and then changed into two single occupancy bedrooms. The registered manager discussed the problems with arranging the contractors to commence the works but is hopeful that the works will begin in the New Year. What the service does well: What has improved since the last inspection? The appropriate closures have been fitted to communal and private accommodation doors where there is a need or personal preference for the doors to remain open. Locks have been fitted to bathroom and toilet doors ensuring that privacy is upheld for service users. Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 Page 6 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. Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 1, 2 Information regarding the home is readily available and in an appropriate format. EVIDENCE: A copy of the statement of purpose has been distributed to the service users, and is available on request; it is produced in English and other languages to suit the needs of all the people living at the home. The care file of a recently admitted person to the home was inspected; a copy of the terms and conditions/contract with the home was filed but had not been completed or signed by the service user and or representative. Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for the following standard(s): OP 7,9,10 The lack of an accurately documented care plan may not be providing staff with all the information they need to fully meet resident’s needs. Staff are not following the home’s own or pharmaceutical guidance when administering and disposing of medication and as a result are not promoting a safe working practice. EVIDENCE: Two care files were randomly selected for inspection, care plans had been generated following an assessment of need and had been reviewed on a Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 Page 10 monthly basis. Service users are involved in the care planning and risk assessment process whenever possible, the care files include the signature of the service user and comments by the representative are included. Nutritional assessments are carried out but in the care plans inspected, recorded differing information, the admission sheet indicated a vegetarian preference but the assessment of activities of daily living stated a non vegetarian diet was preferred. The care plan formulated for the care of pressure areas differed from the actual type and frequency of the current dressing regime. Separate recording documents are being used to indicate the treatment plan and are kept separately from the care file. The care file inspected did not include a detailed plan for maintaining skin integrity, diabetes or challenging behaviour, these had been identified in a previous assessment of need review but a plan has not been formulated by the home as to how to deal with these requirements. The plan did, however, detail a risk assessment for the possibility of an over indulgence of alcohol on occasions. One service user discussed the regime he preferred for pressure area care and stated that the staff support him with his preferences. Another service user spoke at length about the support he was getting from the staff and his future plans for moving from the home to a more independent setting. An extractor fan has been fitted in the treatment room; the air temperature at the time of the inspection measured 26 degrees centigrade. The registered person discussed further work in this area for the temperature to remain at the required levels for the safe storage of medications. A blister type system is currently being used for the administration of medications with the additional use of some bottles and boxes. The boxes and bottles in the drug trolley are being stored all together; to reduce the risk of a drug administration error the medications must be stored separately in compartments for the individual service user. Observation of the Medication Administration Record evidenced that the incorrect coding is being used when medications are refused and disposed of. An ‘R’ is being recorded for the refusal of medication but instructions on the Medication Administration Record indicate the ‘A’ should be used. Unwanted and unused tablets were found placed in a container at the back of the medication trolley and not in the disposal container. The registered nurse explained that a container has been provided for the disposal of medication but was kept in the registered persons office. On further observation the disposal bin provided was unsuitable, (the lid could not be removed), the registered person contacted the supplier to obtain a suitable replacement. A procedure for the disposal of unwanted or unused medication is required and all staff must be aware of the procedures. The registered person was advised to ensure that a lockable cupboard is available within the treatment room for the safe storage of the disposal bin. An opened pot of Aqueous Cream was observed to be on the wash hand basin unit in a double-bedded room, it did Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 Page 11 not have an individuals name or date of opening. It could not be established for which of the two people it was being used for. During the tour of the premises it was noted that all bathrooms and toilets now have a suitable locking facility. Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 13,14. YA15 Staff work in close liaison with service users and their relatives to understand and support their individual lifestyles, cultures and ethnicity. EVIDENCE: A Christmas party was being arranged for the afternoon of the inspection, staff were very busy with the preparations. Service users spoken with stated that they were looking forward to the celebrations and that they usually have a ‘great time’, and their family and friends had been invited. The home is culturally and ethnically very diverse, staff commented that arrangements are made to celebrate the different festivals for each faith. Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 Page 13 Involvement in the local community continues with service users supported to attend their places of worship, colleges and recreational classes. The flower arrangements made by one service user were much in evidence around the home. One service user was observed to be accessing the local shops in his wheelchair and stated that he likes to go to the shops each day to get his cigarettes. One service user stated that he would be going to his family home for part of Christmas and indeed goes to see his family often. His family and friends are also very welcome to visit him at the home and ‘pop in when they are passing’. An environmental health officer was conducting an inspection of the kitchen at the time of this inspection. Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 18, YA 23. Arrangements are in place for the protection of residents from abuse. EVIDENCE: The Commission for Social Care Inspection have not received any complaints or concerns since September 2004. The registered person explained the procedures for dealing with the safe keeping of service users personal monies. Observation of the practice evidenced that all service users have a separate named wallet that is kept in the locked safe. The recording sheets confirm that two signatures are obtained for each transaction and receipts are kept of any expenditure. It was recommended to the registered person that a monthly audit be introduced to ensure the accuracy of the process. A lockable storage space is provided in the service user bedroom for the safe storing of cash or valuables where the service user wishes to hold their own money. Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 19,26 The apparent lack of maintenance and effective cleaning regimes, is placing service users, staff and visitors at risk, and it does not create a pleasing and pleasant environment to live or work in. EVIDENCE: Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 Page 16 During the tour of the premises it was noted that the appropriate closures had been fitted on bedroom and communal doors where there is a need or preference for the door to remain open. The treatment room door however continues to be wedged open when the room is in use. The registered nurse stated that the door is always kept locked at other times. Areas of the home are in need of a thorough clean notably the communal toilets and bathrooms, sluices and the treatment room. Most of the hand basins in the communal and private rooms did not have a plug attached. Some bars of soap and other toiletries were observed to be in the communal bathrooms. The drainage of parker bath in the bathroom on the ground floor continues to be problematic and must be repaired and/or replaced. The shower room on the first floor continues to be unsuitable for use, the shower door is broken, the whole area is dirty and in need of a thorough clean. Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP27, Generally there is a stable staff team who are committed and work positively and enthusiastically, to meet the needs of the service users, within the resources available. EVIDENCE: One first level nurse and four care staff were on duty at the time of the inspection, the registered person arrived at the premises during the morning. Additionally there were two kitchen and two domestic staff. The rotas appeared to maintain the staffing numbers at these levels. The registered manager and deputy manager now have allocated supernumery time to attend to managerial tasks. Bank and the occasional agency staff are used to cover for any deficits due to annual leave entitlements or any sickness of the permanent staff. During the tour of the premises it was observed that the home is in need of a thorough clean, some areas of the home were well below the required hygienic standards. Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 Page 18 Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 31, 35, 38 YA 42 Designated senior staff handles service users’ finances appropriately. The apparent lack of understanding for infection control procedures and preventing the spread of infection is potentially placing service users, staff and visitors at risk. EVIDENCE: Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 Page 20 The registered manager is currently on maternity leave; the deputy manager supported by the registered person is managing the home in her absence. A procedure is in place for dealing with the safe keeping of service users personal monies. Written records of all transactions are maintained. All money held at the premises is handled separately and stored in the locked safe. Two signatures are obtained for each transaction and wherever possible the service user is requested to sign. The record of the money held on behalf of one service user did not accurately tally with the actual amount of cash in the wallet. The amount was overstated by £1.71. It was recommended to the registered person that a monthly audit be introduced to ensure the accuracy of the process. Monthly safety checks continue for the fire alarm system, emergency lighting and hot water temperatures, records are maintained. Following the unsatisfactory standards of cleanliness observed throughout the premises staff must be instructed in the safe working practices of infection control and to gain an understanding of the prevention of the spread of infection. Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 Page 21 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 Standard No Score 1 3 2 2 3 X 4 X 5 X 6 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 ENVIRONMENT Standard No Score 19 1 20 X 21 1 22 X 23 X 24 X 25 X 26 1 STAFFING Standard No Score 27 2 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 X 33 X 34 X 35 3 36 X 37 X 38 2 Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 Page 22 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 OP1 Regulation 5(1)(b)(c) Requirement The terms and conditions/contract with the service user must be available at the point of admission to the home, completed and signed. A copy to be given to the service user and one kept on file. The service users plan of care must accurately detail and record all assessed needs. Service users medication dispensed in bottles and boxes must be stored in individual compartments. The Medication Administration Record must be accurately completed with the correct instructions A procedure must be implemented for the safe disposal of unused or unwanted medications. External medications must only be used for the person for whom they were prescribed. All external and internal medications must have an DS0000017194.V273502.R01.S.doc Timescale for action 01/01/06 2 3 OP7 OP9 15(1)(2) 13(2) 01/01/06 01/01/06 4 OP9 13(2) 01/01/06 5 OP9 13(2) 01/01/06 6 OP9 13(2) 01/01/06 7 OP9 13(2) 01/01/06 Ruksar Version 5.0 Page 23 8 9 OP19 OP21 10 OP26 11 OP27 12 OP27 13 OP38 appropriate dispensing label attached. 23(4) The treatment room door must not be wedged open. 23(2)(b)(c)(d) All lavatories and washing facilities must be clean and hygienic, repaired and/or replaced. Previous timescale 31st July 2005 not met 13(3), The sluice disinfector situated 16(2)(j) on the first floor must be repaired or replaced. Previous timescale 31st July 2005 not met 18(1)(a) Domestic staff must be employed in sufficient numbers to ensure that the home is maintained in a clean and hygienic state. 23(2)(c) The registered person must ensure that the equipment and cleaning substances are in sufficient quantities to enable the domestic staff to maintain the home in a clean and hygienic condition. 18(1)(c)(i) The registered person must ensure that all staff are instructed in infection control procedures, to gain an understanding in preventing the spread of infection. 31/01/06 01/01/06 01/01/06 01/01/06 01/01/06 01/01/06 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 OP9 Good Practice Recommendations It is recommended that external medication within tubs be discarded 28 days after opening. DS0000017194.V273502.R01.S.doc Version 5.0 Page 24 Ruksar 2 OP35 It is recommended that the registered person implement a monthly audit to ensure the accuracy of the procedure for dealing with service users personal monies and valuables. Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Wolverhampton Area Office 2nd Floor St. Davids Court Union Street Wolverhampton WV1 3JE 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. Ruksar DS0000017194.V273502.R01.S.doc Version 5.0 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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