Inspection on 18/10/06 for Somerset House

This inspection was carried out on 18th October 2006.

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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Somerset House 17/02/09

Somerset House 13/02/06

Somerset House 04/11/05

Somerset House 09/03/05

Somerset House 24/08/04

Somerset House 03/03/04

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

CARE HOME ADULTS 18-65 Somerset House 17 Somerset Road Heaton Bolton Lancashire BL1 4NE Lead Inspector Lucy Burgess Unannounced Inspection 18th October 2006 10:30 Somerset House DS0000009321.V297675.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 Somerset House DS0000009321.V297675.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. Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Somerset House Address 17 Somerset Road Heaton Bolton Lancashire BL1 4NE 01204 493126 01204 493126 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) Perpetual (Bolton) Ltd Mrs Tricia Varey Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th February 2006 Brief Description of the Service: Somerset House is a small care home providing residential care for up to 6 people with mental health needs. The range of fees are …… The home is part of a small group of two homes, the other being Hartington House. Both homes share the same staff team and are situated near to each other in the residential area of Heaton in Bolton. The main office base for the two homes is at Somerset House, although there is a small office at Hartington House. A local company, Perpetual Care, own the homes, with the day-to-day management carried out by the registered manager. Somerset House is an end terrace house, and comprises of six single bedrooms and communal areas. The home is close to a main road leading into Bolton town centre and is accessible to local transport. Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over one day for a period of 5½ hours. The inspector took the opportunity to look round the home, view records as well as talk with residents and staff. Discussion and feedback was also held with the Senior Carer on duty. A pre-inspection questionnaire was completed and feedback surveys were received from 3 GP’s, a CPN and a Social Worker. Comments have been included within the report. The home is registered to provide accommodation for up to 6 people with mental health needs. At the time of the inspection there were no vacancies. What the service does well: What has improved since the last inspection? Staff have recently undertaken training in relation to mental health. This was looked at from a service users view of having a mental health problems as well as exploring types of treatment, medication and the relevant legislation. This has provided staff with a good insight into the needs of residents and the support required. Information about the residents was up to date having been reviewed on a regular basis. Where concerns are found the Manager and staff will involve the relevant health professionals so that the right support can be provided. Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Somerset House DS0000009321.V297675.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 Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All relevant assessment information is gathered prior to individuals moving in. The enables the prospective residents and staff to make an informed decision about the suitability of the placement ensuring needs can be fully met. EVIDENCE: Somerset House is very settled with residents having lived at the home for sometime, therefore no new admissions have been made. The Manager of the home also supported the ‘sister’ home Hartington House where recent referrals have been made. The process of referral and admission followed by the Manager has involved sourcing all relevant information including medical history and assessments from relevant health and social car professionals as well as previous placements, if relevant. Time is also spent meeting with prospective residents’. This can involve visits to their home or hospital etc. Individuals are also encouraged to visit the home to meet with other residents and staff. This would take place over a period of weeks or months depending on the individual. Care is taken in ensuring that placements are suitable and that staff are able to meet the needs of the individuals. Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans and risk assessments are updated and reviewed on a regular basis with the involvement of residents. Information is detailed and reflect the current support needs of residents. EVIDENCE: Comprehensive information is held in relation to each of the residents. Care plans are drawn up between the resident and their key worker. This is done on a six monthly basis, however should it be necessary an early review would be made so that information is up to date and accurate. It was noted that residents had not signed their plan, staff should encourage them to do so to evidence that they are in agreement and involvement in recording the information. Formal reviews also take place with individual social workers and consultant in line with Care Programme (CPA) set out following admission. This allows for further monitoring and supporting individuals in maintaining their mental health. Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 Page 10 Files were looked at for 2 of the residents. Information included assessment information, CPA review minutes, evaluation sheets, correspondence, record of appointments/professional visits and financial information. Further information was held on one file where referral had been made for additional aids and adaptations as the resident has been experiencing some physical problems. On one of the plans it was stated that the residents’ diet/food intake was to be ‘observed’ as this at time became a neglected area when unwell. On reviewing the evaluation sheets where meals are recorded, little information had been recorded and several entries stated ‘not observed’. Whilst it is acknowledged that the resident spends some time away from the home due to work or college commitments or when visiting family, when he is at home all relevant information should be recorded. Alternatively this area within the plan should be revised. A communication book has also been introduced. This briefly details what individuals have done each day, appointments, tasks completed by staff, compliance with medication. This is used as part of the handover during shift changes as well as for monitoring purposes. As part of the care planning process, risk assessments are completed were areas of concern have been identified. These may include, behaviours, diet, self-medicating, home leave, seizures, bathing and travel etc. Assessments are reviewed in line with the care plan. As previously identified the home is relatively small therefore informal day-today contact is made between residents and staff with the views and opinions of both parties being easily aired. A volunteer also visits residents’ from MHIST, a mental health support group, who meets with them to have discussions or advise them on particular matters. Feedback was received from a number of health and social care professionals. Each confirmed that they were able to see residents in private, that there was clear communication, that information was included within the care plans and that medication was appropriately managed. Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents continue to follow a lifestyle of their choosing, both in and away from the home. The meals are good and offer choice, providing residents with a varied diet. The cultural and religious needs of residents are also met. EVIDENCE: Residents living at the home vary in age, as do their routines. Whilst some individual prefer to spend the majority of time at home, watching television, reading papers, using the computer, doing puzzles and relaxing, others follow interests away from the home. One resident is very active and attends both college courses and supported employment. Another resident has recently joined a walking club, so that he can develop other relationships away from the home. Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 Page 12 Other activities include residents accessing the local shops, take away and pubs, which are within walking distance of the home. Those choosing to spend time at home have their own televisions, DVD’s, stereos, which they relax to. One of the residents enjoys keeping tropic fish and is very skilled on the computer. Residents had enjoyed a summer holiday earlier in the year. One resident spent time away with his brother in Blackpool, whilst the other residents shared a cottage in the Lake District. Those wishing to follow their religion and culture are encouraged/supported in doing so. One resident has taken part in the fasting over Ramadan and attend the local Mosque with family and friends. Arrangements were also being made for an Eid party, this is to be held at the home and friends and family are to be invited. As part of their routines residents continue to be encouraged to develop and maintain their independent living skills. Residents are involved with household tasks, including cooking, cleaning and laundry. During the visit one resident explained that staff had supported him in cleaning his room and changing his bed. Residents continue to maintain contact with family and friends. With visits taking place both away from the home and at Somerset House. Two residents continue to make regular visits to the family home. Individuals are able to see visitors in private using the large lounge or their bedrooms. Meals at the home are flexible. Support is offered where necessary ensuring individual follow a healthy diet. Residents generally help themselves to their breakfast and lunch. The staff on duty usually prepares the evening meal or occasionally residents have a take-away. The home has a large kitchen where meals are eaten, however individuals are able to chose if they wish to eat elsewhere. As already stated the cultural/religious preferences of residents are also catered for. Provisions are made available with regards to an halal diet. Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and well-being of residents are consistently met. The home continues to maintain effective relationships with mental health professionals who provide positive support networks for the residents ensuring their health needs are promoted. The medication system was found to be safe however minor improvements were needed to the records to evidence practice is safe. EVIDENCE: Within individual care plans their physical, emotional and mental health is considered. Where needs or risks have been identified, assessments are carried out and action is recorded outlining what support is to be provided by the staff team. Should the staff need any further support or advice the relevant agencies would be contacted, for example, mental health teams, occupational therapy, district nurses etc. Residents also have access to other NHS entitlements such as GP’s, hospital, diabetic clinic, Parkinson nurse etc. Support is offered for appointments. Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 Page 14 The residents continue to receive a visit from a volunteer from MHIST, a mental health support group. Visits take place on a monthly basis and provide residents with an opportunity to discuss any issues they may have. The emotional/mental health needs of residents continue to be monitored and reviewed by appropriate mental health professionals during regular review meetings. Whilst some residents are support under the Care Programme Plan others are more informal. It was again noted that the mental health and wellbeing of residents is stable. One resident who was spoken to during the last visit continues to have some difficulties in his physical health and alcohol intake. Staff are providing support and encouragement and some improvements have been made. A referral was made to the OT’s for aids to assist with meals. These were said to have helped. Rising and retiring times are quite flexible. Residents are able to manage their own personal care needs however staff will prompt and offer encouragement where necessary, particularly with one resident who has a colostomy bag. Residents are also able to move around freely and do not require any physical support, therefore no aids have been fitted. Records are also maintained with regards to individual weights. It was found that each of the residents had a significant weight increase over the last few months. The manager is said to be aware of this and is to address this with staff. Should the scales be faulty they should be replaced. The medication system was examined. Medication is stored safely and records are made of all items received as well as those returned to the supplying pharmacy. Regular audits are also carried out on the medication records sheets, ensuring these are completed appropriately as well as monitoring medication administered to residents. It was noted that there were gaps on the MAR sheets and where written entries had been made these had not been dated and signed to evidence that the information corresponded with the prescription. On examination of the controlled drugs register it was also noted that tablets had been returned to the pharmacy however the information had not been completed in full. The Manager must ensure that accurate records are maintained. Risk assessments have been developed for those individuals who take medication whilst going on home leave. Residents have been assessed in relation to their compliance and information is held on their file. Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home holds clear procedures regarding complaints and adult protection, ensuring that residents were listened to and protected. Relevant training has been provided for staff. EVIDENCE: Perpetual Care holds policies and procedures covering these standards. The home also has a copy of the Local Authorities Vulnerable Adults procedure. The team are aware of the procedure to follow and training has been provided. No complaints or concerns have been raised with the home or CSCI. The home also ensures that the relevant checks are carried out when employing mew staff. These include written references and criminal record checks, ensuring residents are protected. Residents’ finances were also examined. The manager/owner are appointee for three residents. A random check was made with regards to the residents’ personal finances, which are held at the home. Records are made of all transactions and receipts held, balances corresponded with money held. Residents also sign to evidence that they have received their money. Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Somerset House is a domestic dwelling providing comfortable, homely environment for the residents. EVIDENCE: As previously identified Somerset House is a large domestic dwelling providing good sized accommodation. The home is comfortable, homely and welcoming and is situated near to a main road leading into Bolton town centre and is easily accessible to public transport. Accommodation comprises of six single bedrooms, 2 bathrooms, 2 lounges, a conservatory, dining kitchen and small laundry room. There is also a staff office and sleep-in room provided on the ground floor. The homes designated smoking area is within the conservatory. The home’s laundry is situated along the hall away from the kitchen area. Each of the residents have a day set aside for their laundry, those who are Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 Page 17 able to manage independently, do so. The team supports those requiring assistance. Cleaning materials are held within the laundry so that both residents and staff can easily access, as individuals are encouraged to take part in cleaning the home. Coshh assessments and general risk assessments have been reviewed and updated. Arrangements should be made for suitable hand-washing provisions to be provided in the laundry to prevent any cross infection. The home also has a front garden and paved area to the rear with seating. Each of the residents spend time relaxing in all areas of the home. Over the last year bedrooms have been redecorated and refurbished. Rooms have also been personalised by residents’ with their own belonging. Each have a key to their room. One resident spoken with expressed that he had recent bought a new large screen television so that he could watch football in his room. On the day of the visit the home was found to clean, tidy and free from odour. Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The organisation is clear about its responsibilities when recruiting new staff as well as providing training opportunities for staff ensuring they are equipped with the knowledge and skills in meeting the needs of service users as well as ensuring their safety and protection. EVIDENCE: Staff at Somerset House also support residents living at Hartington House. The team comprises of the Manager, 2 Senior Carers, 6 full-time and 4 parttime carers and 2 bank staff. As identified during the Hartington inspection the organisation has become involved with Bolton Partnerships, which enables them to access training opportunities. The Manager has also received a copy of the North West Skills for Care Training Directory, which provides information on courses available within the region. No new staff have commenced employment since the last inspection. A random sample of staff personnel files were looked at. All relevant information Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 Page 19 had been gathered including employment history, written references, identification and evidence of the enhanced criminal record checks. Courses have been planned in moving and handling, fire safety, 1st aid and protection of vulnerable adults, TCI and mental health awareness. Dates and staff have been scheduled to attend. These sessions are on-going and are planned for all staff to attend. Additional training such as NVQ level 2 and 3 have also been made available to staff. Staff spoken with expressed that the training around mental health had been useful and provided an insight into the needs of the residents. One session was from service users perspective and how it feels to have a mental health problem. The second session was about recognising symptoms, types of mental health, medication used and basic legislation. Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The overall management of the home is consistent and reliable for the people living there. Systems are in place for the reviewing of the service provision along with satisfactory arrangements with regards to providing a safe environment however could be improved in some areas. EVIDENCE: The Residential Manager is responsible for the day-to-day management of both units, Hartington House and Somerset House. Training with regards to the NVQ level 4 has previously been completed. At present she is completing the final units for the Registered Manager Award. On completion copies of certificates should be forwarded to the CSCI. The Registered Provider supports the Manager in her role. She receives regular supervisions and appraisals as well meeting on a more informal basis. Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 Page 21 In relation to the monitoring of the service feedback is sought through the health care reviews of residents where staff meet with health and social care professionals. Earlier in the year residents where given a questionnaire to complete about their views. The Manager expressed that this still needs to be done with health and social care professionals, as this had not been done for some time. Information was not seen during the inspection in relation to the Regulation 26 reports. The Manager is asked to forward recent copies of the reports to CSCI. As identified earlier within the report residents continue to meet privately with an advocate from MHIST to discuss any areas they wish to, where necessary information would be shared with the Manager. Feedback continues to be sought from staff during the periodic team meetings and supervisions. With regards to health and safety, regular checks are carried out by the home along with annual checks. Information was provided with regards to checks carried out on the fire alarm and equipment, electric, small appliances, gas and emergency lighting. Staff also completed weekly health and safety checks within the environment and records are made. These include the recording of fridge, freezer and water temperatures. It was noted under water temperature that staff had written very hot and not stated the actual reading, this should be addressed. It was further noted on the risk assessment for water that outlets were to be maintained at 60oC, this should be amended to state that temperature outlets are maintained at 43oC. Action identified following the fire inspection had been addressed. Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 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 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X X 2 X Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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 YA6 Regulation 15 Requirement The Registered Manager must ensure that where additional monitoring and recording has been identified, that this is completed. The Registered Manager must ensure that accurate records are maintained with regards to medication, including controlled drugs. The Registered Manager must ensure that suitable hand washing provisions are made available in the laundry to prevent any cross infection. The Registered Manager must ensure that accurate records are held with regards to water temperature. Timescale for action 31/12/06 2. YA20 13 31/12/06 3. YA30 13 31/12/06 4. YA42 13 31/12/06 Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations The registered Manager should encourage both residents and staff to sign and date the care plans once reviewed and up dated. The Registered Manager should ensure that accurate records are maintained with regards to individual weights. The Registered Manager is advised that all written entries made to the MAR sheets are dated and double signed ensuring the information recorded is correct. The Registered Manager must provide evidence that all staff hove now completed training in the protection of vulnerable adults. The Registered Manager must ensure that at all staff receive a minimum of six supervisions per year. The Registered Manager is asked to forward copies of the Regulation 26 reports to CSCI. The Registered Manager should amend the risk assessment in relation to monitoring water temperature showing outlet reading are at 43oC and not 60oC. 2. 3. YA19 YA20 4. YA23 5. 6. 7. YA36 YA39 YA42 Somerset House DS0000009321.V297675.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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