Inspection on 16/08/06 for Shalom Homes

This inspection was carried out on 16th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Shalom Homes 08/12/05

Shalom Homes 15/08/05

Shalom Homes 14/03/05

Shalom Homes 08/09/04

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

CARE HOME ADULTS 18-65 Shalom Homes 110 Griffin Road Plumstead London SE18 7QD Lead Inspector Lorraine Pumford Unannounced Inspection 16th August 2006 14.00p Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Shalom Homes Address 110 Griffin Road Plumstead London SE18 7QD 020 8855 8673 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 Bode Fadojutimi Cecilia Fadojutimi Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered as a Care Home, with a service category of (PC) Care Home Only, with a Service User Category of (MD) Mental Disorder, excluding Learning Disability, 3 of both sexes. 8th December 2005 Date of last inspection Brief Description of the Service: Shalom Homes is located at 110 Griffin Road in a terraced house on two floors in a residential area of Plumstead, a short distance from the town centres of Woolwich and Plumstead with their shops and markets. Plumstead train station is at the end of the road, and the 53 bus passes close by. The Home offers care for three adults between the ages of 18 and 65 who have a mental disorder. Service users are supported in their daily living and encouraged to live as independently as possible. Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken by one inspector who spent a total of six hours in the home over a two day period, the first visit being unannounced and the second announced. During this time the three service users who reside at the home were spoken with and the manager and staff on duty were also spoken with; their comments have been included in this report. During the course of the inspection a number of documents and records were examined, including those specifically relating to the care of two service users. A tour of the premises was also undertaken. Fees for the service provide are currently £ 880.74 to £933.71. What the service does well: The manager has kept the staffing levels under review and increased the number of staff working in the home to meet the increased needs of service users accommodated. Service users are able to participate in relevant social and leisure activities and are provided with a varied nutritional diet. Staff address service users in a respectful manner and respect their privacy and dignity. Service users benefit from staff liaising regularly with appropriate health and social care professionals. The home is staffed by a suitably qualified and competent staff who receive appropriate training on a regular basis. Service users benefit from the home having its own transport available. Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 6 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. Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective Service users are given the opportunity to testdrive the home to establish if they are happy to move in and further to enable staff to assess if they are able to meet the service users needs. Service users need to be provided with relevant information regarding the home they are living in. EVIDENCE: The three service users have resided together at the home for a number of years; therefore there have been no other admissions to this service. However the manager stated that in the event of a vacancy arising a full assessment of the prospective service user’s needs would be undertaken and would include input from relevant social and health care professionals. Prospective service users would then be offered a place on a trial basis. A copy of the companys Statement of Purpose/Service User Guide was seen in one of the service user’s bedrooms. It was evident that information in this document pertained to the companys other home, for example information for service users regarding contacting the CSCI provided details of the Stratford office rather than the Sidcup local office. The manager stated an amended document would be formulated. Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff must be provided with clear up-to-date written information and guidance to minimise the risk to service users and staff. EVIDENCE: Each service users has a care plan and since the last inspection risk assessments have been prepared in relation to a service user who exhibited aggression towards both other service users and members of staff. Records seen indicated that a further incident of aggression towards a member of staff had taken place recently necessitating the need for the police to be summoned. It was apparent from discussion with the manager that she has identified triggers which cause these outbursts of aggressive behaviour and these triggers need to be included in the risk assessment along with action to be taken by the staff in the event of a further incident occurring. Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 10 One of the service user’s physical health has deteriorated and it has been necessary for him to spend a brief spell in hospital. The manager stated this service user would not be able to remain in the home in the long-term due to his increased frailty and the unsuitability of the building; however the staff group wished to support him until such times as a suitable nursing home placement could be found. Discussion took place with the manager regarding the need to implement a risk assessment to meet this service user’s increased physical care needs. The manager was advised to contact the district nurse for assistance in developing a care plan regarding moving and handling, continence management and advice regarding pressure relieving equipment. Generally one member of staff works alone in the home with all three service users. However the manager stated that due to the increased frailty of the aforementioned service user and the fact that two members of staff are required to provide assistance with his personal care, staff have informally been working in twos throughout the waking day. Additionally the issue of aggressive behaviour being exhibited by another service user necessitates that two staff members are required in the home throughout the waking day to protect the health and safety of service users and staff, particularly as Staff confirmed that it would not be possible for any of the service users accommodated to contact the emergency services or other staff in the event of an accident or incident taking place. This issue was discussed with the manager who agreed to increase the staffing levels from one to two during the waking day. Records seen indicate, and the manager confirmed verbally, that at present all three service users accommodated sleep through the night. At present one member of staff is on duty at night, sleeping in the house. The manager was asked to keep the current staffing levels at night under review in relation to the service users’ changing or increased needs, which she agreed to do. Records seen indicate staff and service users meet on a regular basis and discuss issues that affect their day to day lives, for example activities or holidays. Records in relation to service users’ personal allowances were examined. Service users all need some input from staff to manage their personal allowance. A record is kept of personal allowance deposited and withdrawn; in some instances this is on a daily basis to enable service users to purchase papers and cigarettes. Both the member of staff completing the record and the service user sign the personal allowance sheet at the time of each transaction. Records for two service users were examined. A small anomaly was highlighted in relation to one service user who had more money in his account than was Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 11 recorded on the document. Staff assisting were able to ascertain the reason for this inaccuracy and the record was amended during the course of the first inspection. Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 12 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 the following standard(s): 12,13,15,16,17 The overall quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. It was apparent that staff endeavour to promote service users’ independence on a day-to-day basis. Residents are provided with relevant social and leisure activities and a varied nutritional diet. EVIDENCE: None of the service user group are able to participate in full-time education or employment. From discussion with the service users it is apparent that they enjoy a variety of activities. One service user enjoys playing musical instruments and making model aircraft. Another service user said he enjoyed listening to his TV and music centre. The third service user has a daily newspaper and enjoys discussion with members of staff regarding current issues. Other activities including aromatherapy sessions are regularly arranged for service users in the home. Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 13 A local priest also visits one of the service users in the home on a regular basis. Service users are free to come and go as they please, the home benefits from having its own transport, and staff assist service users to use local shops and community amenities. Since the last inspection all three service users have been on a one week summer holiday. Two members of staff accompanied the service users who paid for the holiday themselves. Staff stated that the homeowner paid for the members of staff who accompanied them. It was apparent from discussion with service users that they had enjoyed the holiday very much; in addition to photographs displayed in the home, staff had provided service users with an album as a reminder of the event. None of the service users have relatives who they see on a regular basis. Staff stated that one service user has intermittent contact with a relative, who following his last visit wrote to staff thanking them for the help and support they provide to this service user. It was apparent from discussion with service users and from evidence seen that service users are able to choose when they want to be alone or in the company of others. A recommendation was made at the time of the previous inspection in relation to prayers being said during the course of the service users house meetings. The manager stated that this remained an important issue for one of three service users and so it has been agreed that prayers will be said at the conclusion of the meeting enabling any service user who does not wish to participate to leave before the service users and staff begin the prayer. Bedroom doors are provided with locks and service users are able to choose if they wish to hold the key or not. Staff stated that service users receive their mail unopened. Menus seen indicated that service users are provided with a varied nutritional diet. One service user stated that one member of staff in particular was a very good cook. The staff stated they felt the budget provided for purchasing food was realistic and allowed them to purchase a take-away for service users each week as a treat. Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 14 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 the following standard(s): 18,19,20 Quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Service users receive personal support from care staff working in the home and appropriate professional health care and support when required. EVIDENCE: Service users require varying levels of assistance with personal care. Two service users require minimal support. The third service user currently requires the assistance of two staff members. It was evident that staff respect service users’ privacy and dignity when assisting with their personal care. Good interaction was seen between service users and staff. The manager stated that they have recently employed additional male carers and service users have responded positively to support from them. Service users’ care plans indicated that they visit the GP when necessary and receive regular routine health checkups. They also access community health care professionals such as dentists, chiropodists and opticians as and when required. In addition service users have access to more specialised health care Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 15 professionals when needed. The manager stated that they find considerable support from the community mental health team; whilst they do not visit service users on a routine basis, they respond promptly with advice and support for service users and staff when necessary. An audit of medication was undertaken. Medication was found to be securely stored. A record of staff signatures was being maintained, this enables persons inspecting the records to undertake an effective audit. A photograph of each service user was attached to their MAR sheet. Discussion took place between the manager and inspector regarding medication for one service user; it was agreed that the inspector would seek further advice and clarification from the CSCI pharmacy inspector regarding this medication. Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 16 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 the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Adult protection training is in place to safe guard the wellbeing of service users. Procedures are in place to enable service users to formally raise any concerns they may have. EVIDENCE: The manager stated that she had received no complaints in relation to the service. To date the CSCI has received no complaints with regard to the service. Staff spoken with understood the turn whistleblowing and stated they had received training in relation to this and other adult protection issues. The manager stated that further training in relation to adult protection had been arranged for the forthcoming weekend. Discussion took place with the manager regarding the need for a certificate of competence to be issued when staff had successfully completed any course. The manager provided written evidence of scenarios that staff would be expected to complete both verbally and in writing before a certificate would be issued. The manager stated that staff had also attended courses run by the local authority in relation to adult protection. Information for service users regarding the complaints procedure is included in the Service User Guide (see standard one). A copy of the homes complaints procedure is also kept by the visitors book to the home. Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 17 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 the following standard(s): 24,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Whilst service users are provided with a comfortable appropriately furnished environment, not all areas of the home are well-decorated or maintained. EVIDENCE: Service users’ bedrooms are individually personalised. Service users at home showed the inspector their bedrooms or gave permission for a staff member to do this. As far as possible staff had assisted service users to personalise their bedrooms. Two service users spoken with stated they were happy with their bedrooms and had everything in them they needed. All of the service users have a lockable facility in their bedrooms. The inspector observed cracks to the kitchen wall, both internally and externally. Furthermore, the floor to the bedroom directly above the kitchen is sloping downwards. Action is required to investigate the reason for this, and a suitably competent person should examine these cracks to establish if the Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 18 building is safe or whether an appropriate course of action is required to rectify the problem. The bathroom would benefit from redecoration. The window frame in particular needs attention with paintwork flaking extensively. With the increasing age and frailty of service users accommodated it is recommended that handrails be positioned by the bath to assist service users. The wardrobe in the first floor rear bedroom is very unstable and potentially hazardous; this requires urgent remedial work or replacement. The first floor front bedroom window is badly cracked and needs replacing. The light fitting raised in the previous inspection as needing attention has been replaced. The home was clean and free from any unpleasant odours. Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are cared for by a suitably qualified and competent staff. There are robust recruitment procedures in place to protect service users. EVIDENCE: The majority of care staff working in the home have obtained either an NVQ 2 or 3 qualification in care. A sample of two staff files were seen in relation to recruitment and training; these indicated that staff had completed application forms and provided the names of referees which had been taken up. Members of staff had also provided proof of identity and POVA/CRB checks had also been undertaken. The manager stated that following the last inspection she has taken action to update the CRB checks for all staff working on the home. Copies of staff CRB checks had been retained on staff files; discussion took place with the member of staff assisting regarding current practice in relation to CRB documents as present guidelines recommend that photocopies should not be held on staff files. Discussion took place with the manager regarding suitable format for storing this information. Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 20 Copies of staff training certificates were seen. Discussion took place with the manager regarding the need for certificates to be awarded for competence rather than solely for attendance. The manager stated that formal staff appraisals take place six monthly and in addition staff receive formal supervision every two months. The manager stated that a number of staff currently working in the home had originally commenced employment in another home run by the same homeowner and therefore copies of their original induction programme had remained at head office. However all staff undertook a further shortened induction programme when commencing employment to ensure they are familiar with the care needs of the service users accommodated and health and safety issues in relation to this home. The manager stated that the homeowner uses an outside organisation who have developed specific policies and procedures to this home. This organisation also provides relevant training. Discussion took place with the manager regarding the need to ensure that the company providing the training were qualified to do so. Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident the manager takes action to maintain the health and safety of people living and working in the home. Service users can be confident the homeowner maintains standards of care and service in the home. EVIDENCE: In order to address a requirement made at the time of the previous inspection the manager has taken action to secure a place on an NVQ 4 course in care management commencing in September of this year. A current insurance certificate for the home was seen. The manager stated the homeowner visits the home at least once a week, talks with service users and staff and undertakes a tour of the home, checks health and safety documents, etc. He then completes a written audit of service and care provided in the home on a regular basis. Discussion took place with Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 22 the manager regarding the need for copies of these reports to be forwarded to the CSCI to comply with Regulation 26 of the Care Home Regulations 2001. Records seen indicate that the home has regular maintenance and safety checks to electrical and gas appliances and the fire detection system. Records seen indicate that the home has also undertaken a recent fire drill. The manager stated that safety valves are fitted to the hot water system to prevent the service users from sustaining any injury. Discussion took place in relation to one service user who persistently continues to smoke in his bedroom. There was evidence of cigarette burns to furniture and a recent confrontation has occurred between the manager and service user when he had been asked to refrain from smoking in his bedroom. Staff expressed concern regarding the possibility of the service user falling asleep whilst smoking. The manager agreed to investigate the possibility of purchasing appropriate fire retardant furniture and furnishings including bedding to reduce the risk of a serious accident occurring. Records seen indicate that staff maintain detailed accident and incident reports and where appropriate informed the CSCI in accordance with regulation 37 of The Care Home Regulations 2001. The manager stated that the majority of staff working in the home hold a current first aid qualification. Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 3 X 2 X X 3 X Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 24 no 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 YA1 Regulation 5 Requirement Timescale for action 30/10/06 2 YA24 23(2)(b) 3 YA24 23(2)(d) 4 YA24 13(4)(a) The Service User Guide for the home needs to be altered to correlate with Griffin Rd and not the other home operated by the homeowner. Amended copies need to be circulated to Service users their advocates and the CSCI. 30/10/06 The registered person must, having regard to the number and needs of the service users, ensure that the premises to be used as the care home are of sound construction and kept in a state of repair externally and internally. In this instance the reason for the cracks to the rear of the building and sloping first floor must be investigated and if required appropriate work undertaken. The registered person must, 30/11/06 having regard to the number and needs of the service users, ensure that all parts of the care home are reasonably decorated in this instance first-floor bathroom. The registered person shall 30/10/06 ensure that all parts of the home DS0000043857.V305145.R01.S.doc Version 5.2 Shalom Homes Page 25 5 YA39 26 to which service users have access are as far as reasonably practicable free from hazards to their safety, in this instance by taking action to repair or replace the wardrobe situated in the first floor back bedroom. Where the registered provider is an individual but not in day-today charge of the home he shall visit the home in accordance with this regulation. The registered provider should supply a copy of the report record to be made under paragraph 4(c) to the commission. 30/10/06 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 YA6 Good Practice Recommendations Risk assessments need to form part of service users care plans and provide staff with information regarding action to be taken by them in response to behaviour demonstrated by a service user. With the increasing age and frailty of service users accommodated it is recommended that handrails be positioned by the bath to assist service users. Current guidelines state original and photocopies of CRB checks should not be held on staff files. It is recommended that an alternative format be used. It is recommended that the responsible person investigates the possibility of purchasing appropriate fire retardant furniture and furnishings, including bedding, to reduce the risk of a serious accident occurring. 2 YA24 3 YA34 4 YA9 Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup 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 Shalom Homes DS0000043857.V305145.R01.S.doc Version 5.2 Page 27 - 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!