Inspection on 11/05/06 for St Anthony`s

This inspection was carried out on 11th May 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

St Anthony`s 09/05/07

St Anthony`s 09/01/07

St Anthony`s 07/02/06

St Anthony`s 23/05/05

St Anthony`s 02/11/04

St Anthony`s 10/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE St Anthony`s 3 Mildred Avenue Watford Hertfordshire WD18 7DY Lead Inspector Mrs Sheila Knopp Unannounced Inspection 11th May 2006 10:25 X10015.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 St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 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. 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. St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Anthony`s Address 3 Mildred Avenue Watford Hertfordshire WD18 7DY 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) 01923 226 174 0208 8688375 RMD Enterprises Limited Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th February 2006 Brief Description of the Service: St Anthonys is a care home providing personal care and accommodation for 22 older people. It is owned by RMD Enterprises Limited, which is a private company. The home is situated in a popular residential area of Watford, within 15 minutes walking distance of the town centre, with easy access to local transport links. The home was opened in 1985 and consists of a two-storey house that has been extended and improved over recent years. There are 20 single rooms and 1 double room. None have en-suite facilities, but all have a washbasin. Six of the bedrooms are smaller than the 10 square metres required of newly registered services since 2002. There is a passenger lift. The home has a beautiful and well-designed garden to the rear of the property, which is both safe and accessible to all the service users. The current fees for accommodation range from £435.00 - £470.00 based on room sizes. St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on an unannounced visit to the home by one inspector who spent a total of 5 hours 35 minutes in the home. The report includes information provided by service users (10), visitors (3) and staff (4). Information received about the home since the last inspection in February 2006 has also been reviewed. Mrs D. Souter was appointed as the new manager of St Anthony’s on 3 May 2006 and had only been in post for a week before this inspection. What the service does well: What has improved since the last inspection? The registered owner has recently reviewed the service user contract and signed copies are now being kept in the home which meets a requirement made following the last inspection. The new manager is supernumerary to the staff team which has increased the support available to service users during the day and enables her to monitor standards and develop the service provided. The programme of replacing carpets in service user bedrooms has continued. St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 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. St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 – standard 6 does not apply to this service. Overall quality in this outcome area is assessed as adequate. This judgement has been made using available evidence including a visit to this service. An assessment is carried out before individuals are admitted to ensure that their needs can be met within the home. However the pre-admission assessment details for a person admitted before the new manager was appointed were not available for review. Service users are issued with contracts setting out the terms and conditions of their stay. Details of new contracts issued were available in the home meeting a requirement from the last inspection. EVIDENCE: The pre-admission assessment leads to the development of a care plan following admission. The pre-admission assessment and the care plan of a recently admitted service users were not available to enable the inspector to review the admission process. The care plan had been sent to the company head office to be typed. A copy needs to be retained in the home for staff to refer to and to be available for inspection. St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 9 A new service user confirmed that had felt welcomed on arrival and provided with the information they needed to reassure them. A discussion with staff confirmed that their general practitioner and community nurse had been involved in the pre-admission assessment. The provider agreed to forward copies of the recently revised Statement of Purpose and Service User Guide to the Commission. The company have just revised their standard contract and have re-issued it to service users. Copies will be kept in the home as required. St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Overall quality in this outcome area is assessed as adequate. This judgement has been made using available evidence including a visit to this service. All the service users observed had been helped to achieve a good standard of personal care and hygiene. Their health needs are supported by access to local general practitioners and community health staff, including community psychiatric nurses and consultants. Although service uses stated that their privacy and dignity was upheld, some of the practices seen during this inspection do not support privacy and dignity. Overall the systems for receiving and administering medication safely were found to be in order. It is recommended that a review of the storage arrangements is carried out to fully comply with current practice. EVIDENCE: The sensitive approach observed from staff and the comments made by service users confirmed that they felt their privacy and dignity was respected. However some working practices were observed which do no support this. St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 11 Details of how service users wish to be supported are set out in a brief plan of care. Specific details for example in relation to management of moving and handling needs were found to be very basic and did not provide staff with clear instructions. The new manager has identified this as an area to review. As stated in the previous inspection the details of how care was to be provided to one of the service users was not available in the home. Individual service user’s rooms must not be used for communal activities such as hairdressing or the sorting of laundry. The care plans briefly set out the preferred plan of care for each service users. These had been signed by the service user or relative and regular monthly reviews had been carried out. The manager and inspector identified that the moving and handling assessments were not in line with current practice in this area. There was no care plan available for a new service user as it had been sent to head office for typing. The inspector was not able to verify what risk management plan had been put in place for a significant problem. It was verified from the care records and discussions with staff that a full range of health & social care professionals are available to meet the health needs of service users. The community nurses provide support as required. It was reported that none of the service users were being treated for pressure sores. The medication is stored in a lockable box, which is locked in a cupboard in the manager’s office. The office is very hot as there is a boiler in it. It was previously required that the temperature of the storage areas are recorded to ensure medicines are kept at the required temperature. Although the room was hot the temperature in the storage cupboards was found to be within the required range. Staff need to ensure they record the temperature of both storage areas. Although not a legal requirement under the Misuse of Drugs (Safe Custody) Regulations 1973 for care homes which do not provide nursing care it is recommended under standard (NMS 9.5) that controlled drugs such as Temazepam are stored in a controlled drug cupboard which complies with these regulations. A spot check of medicines confirmed that the stock levels matched the entries on the administration charts. The manager is planning to meet with the pharmacist who provides services to the home to get them to carry out regular audits. St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Overall quality in this outcome area is assessed as good. This judgement has been made using available evidence including a visit to this service. The service users expressed contentment with how they spent their day. Discussions with service users and their visitors confirmed that they were made to feel welcome and supported to continue to maintain contact with their friends and local community. Service users expressed a high level of satisfaction with the choice of meals that they are served. EVIDENCE: The visitors to the home on the day of inspection were positive about the friendly support being provided. They confirmed that they were offered cups of tea and coffee and got on well with the staff and the proprietors. A part time activity organiser is employed and a programme of activities is in place. Service users had access to books, games and puzzles. Service users are supported to continue to follow their religious and cultural beliefs. St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 13 Individual rooms had been personalised by service users bringing in furnishings and possessions that were important to them. A hairdresser was present on the day of inspection. The home has a regular cook and a part time cook who also works as a carer on other days. A three week rotating menu is in place. The kitchen was clean and well organised. Food and refrigerator temperatures are recorded in line with food safety legislation. The meal on the day of inspection was nicely served and well presented. It was hot and tasty. A service user was overheard telling staff how nice it was. Service users did not have to wait to have their meal served as they were brought into the dining room and their meal brought to them. The tables were nicely laid and service users had linen napkins. One person felt that the evening drinks were too early. It was also suggested to the manager that staff are able to show service users a range of evening snacks from which to choose. Service users with a degree of memory loss may not think to ask for a sandwich if they feel hungry. St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Overall quality in this outcome area is assessed as good. This judgement has been made using available evidence including a visit to this service. Service users and their relatives can be confident from the approach of staff and the procedures in place that their concerns will be listened to and followed up. Describing their experience at St Anthony’s a service user said we are ‘listened to’. Staff receive training in protecting service users and there are procedures in place detailing the action to take if concerns are identified. EVIDENCE: The new manager has invited relatives to meet her and is making individual arrangements to meet others at a time convenient to them. The registered owners report they make unannounced visits to the home four times a week at different times. Clearly the visitors who were present and the service users were familiar with Mr Merali’s presence in the home and would be able to discuss any issues with him. The new manager has a good working knowledge of the Hertfordshire County Council Protection of Vulnerable Adult Procedure. Previous reports have confirmed staff have received abuse awareness training. St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 15 The homes Whistle Blowing policy is displayed on the staff notice board. It was advised that the procedure is discussed from time to time during staff meetings or supervision sessions as 2 of the staff interviewed seemed unsure of it’s purpose. St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Overall quality in this outcome area is assessed as poor. This judgement has been made using available evidence including a visit to this service. St Anthony’s provides service users with accommodation that has a homely domestic feel to it. Service users have been able to personalise their rooms with familiar possessions. There is a well-tended private garden to walk and sit in. All areas of the home were found to be fresh and clean. A number of areas do not meet the safety standards required of new services and health & safety issues were identified which required immediate action. There is outstanding work required to bring carpeting and unstable flooring up to a suitable standard. A further visit on 12 June 2006 confirmed this work had been completed. The laundry and hand washing provision for staff do not meet current infection control guidelines for managing soiled linen and personal care. Poor working practices were observed in this area. St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 17 EVIDENCE: The work to repair flooring, which has become unstable and replace carpet on the first floor remains outstanding. The registered provider reported that work to replace flooring and fit new carpets is due to start on 1.6.06. Six of the bedrooms are smaller that the 10 square meters required of newly registered services since 2002. Not all bedrooms are provided with low surface temperature radiators (NMS 25.5). Thermostats are in place to enable service users to control the temperature of their room. Risk assessments should be recorded for each individual in these areas and suitable covers provided where a risk of accidental scalding is identified. The hot water in one of the bathrooms was 60.1 degrees centigrade, which is above the health and safety limit of 43 degrees centigrade to prevent accidental scalding. As the handyman was unable to adjust the thermostatic valve the water supply to the bath was turned off while a new valve is obtained. It is recommended that a record of regular checks on the temperature of hot water in areas accessible to service users is kept. Window restrictors are fitted on first floor windows. It is recommended that regular maintenance checks are recorded to ensure they remain in place as they can be disconnected and could present a risk to service users. Some of the bedroom doors do not have locks. This needs to be reviewed and suitable locks with override facilities provided to enable service users to have a key to their own room on admission subject to an assessment of risk. The provider needs to ensure that a replacement programme is in place for mattresses. One service users said that the edge of theirs was very soft and they were worried about falling out. The manager agreed to review this and look at providing a grab rail to assist the person get out of bed. Door wedges were not observed in use on this occasion therefore a requirement made following the last inspection has been met. It was clear from discussions with service users that there were a number of doors that they liked open during the day. The registered owner confirmed that automatic door closures where going to be tested to see if they were suitable. These must conform to current fire safety legislation. The manager was asked to remove a wheelchair, which had been left in front of a fire exit. St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 18 The manager needs to review the laundry procedures and staff working practices to ensure they meet current infection control and health & safety guidelines. The first floor laundry is very small which means there is no space for staff to sort clean items. This work was being done in a bedroom. The washing machines are of a domestic type and do not have a sluice facility to manage soiled items. Staff are not working to a no touch policy and reported that they are hand sluicing soiled items, which is contrary to current practice and is a health & safety risk to staff. The hand washing facilities for staff are poor. To prevent the spread of infection, liquid soap and disposable paper towels or other suitable hand cleansing systems should be provided in the laundry, sluices, bathrooms and bedrooms where personal care is being carried. Since this inspection a fax machine has been provided as required under Regulation 16(2). St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Overall quality in this outcome area is assessed as good. This judgement has been made using available evidence including a visit to this service. Service users expressed a high level of satisfaction with the staff team and their relationships with them. The home has not yet achieved the 50 level of care staff with National Vocational Qualifications in care (NVQ). EVIDENCE: The manager is supernumerary to the staff team, which provides additional management support to the service users and their relatives and enables the manager to supervise staff and review working practices without reducing the time available for caring activities. The personal care needs of the service users had been met in a timely manner on the day of inspection. The rotas indicate the home is well staffed during the day. The staff team reduces to 3 in the late afternoon and one person is required to prepare the supper. This needs to be kept under review to ensure the roles of staff providing care and cooking the supper remain separate but still meet the needs of service users requiring attention at this time. Staff did say it was sometimes very busy in the evening. St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 20 No concerns were raised by service users which would indicate they were having to wait or felt staff were rushed. Two staff are provided at night. The provider supports NVQ training and a number of the overseas staff employed have nursing qualification in their country of origin. This is an area for the manager to develop as only 6 out of the 18 reported care staff employed have qualifications at NVQ level 2 or an equivalent award. A requirement has not been made, as there is clear intention at this stage to train staff to the required level. An induction programme is in place for new staff, which the provider reported, had been recently reviewed against the new Skills for Care standards. It was advised that the manager review this against the Skills for Care guidance and documentation so staff training can be verified. A check on the records of 3 recently recruited members of staff indicated that the required checks, references and criminal record bureau clearance is being obtained before they are employed in the home thereby helping to protect service users. St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Overall quality in this outcome area is assessed as adequate. This judgement has been made using available evidence including a visit to this service. A number of standards in this area are not fully met including standard 38 which is a key health & safety standard and affects the overall rating. The new manager will be required to register with the Commission. Until this process has been completed standard 31 will not be fully met. The proprietors are regularly in the home as part of their approach to monitoring the quality of the service, which includes seeking the views of service users and relatives. However the number of health & safety issues identified at this inspection indicates a more formal approach to checking standards is required. It is recommended that a professionally recognised quality monitoring system is introduced to obtain the views of service users and others with an interest in the service. St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 22 There are systems in place to enable service users to have access to small amounts of personal money for day-to-day expenditure such as newspapers hairdressing and toiletries. EVIDENCE: The new manager had only been in post for one week at the time of this unannounced inspection. From discussion it was identified she had suitable experience and qualifications to bring to the job and was aware of the regulations under which the home is registered with the Commission. She had already identified areas requiring systems to be put in place and had set up a programme of formal staff supervision. The proprietors report that they are in the homes at least 4 times a week unannounced at varying times throughout the 24-hour day. This hands on involvement with the day to day running of the home is the basis of their approach to monitoring the quality of the service provided and having contact with service users, relatives and staff. The manager reported that she plans to set up service user and relatives meetings. Money can be deposited for safekeeping. This is kept separately for each service users and receipts are maintained to support the transactions. Key health and safety standards, which have an impact of the safety of service users and staff have been described under standards 19 and 26. These relate to the safety of flooring, radiators, hot water, laundry procedures, infection control procedures, developing monitoring systems and reviewing working practices. Copies of maintenance and servicing records were checked. Weekly fire alarm tests are recorded and the fire safety systems were serviced on 7.3.06. The lift is regularly serviced and an annual review is carried out by the insurers. The annual gas safety check is due and the provider agreed to forward a copy of the certificate to the Commission. Training records were available for staff. The new manager is going to put together a training matrix to ensure any gaps are easily identified and addressed. Statutory training is supported and 5 staff have first aid certificates. Accidents records are maintained and the incidence of falls monitored. St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 23 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 1 x x x x x x 1 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 3 x x 1 St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? YES 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 OP7OP3 Regulation 17(1)(3) Requirement Timescale for action 30/06/06 2. OP19 23 (2) The pre-admission assessment and plan of care referred to under Regulations 14(1) & 15(1) must be kept in the home and be available for inspection – Schedule 3 (1). The proprietor must repair and 01/06/06 level out the flooring outside rooms 13,14,18 and replace the corridor carpet. Start date confirmed as 1.6.06 This requirement remains outstanding from the last inspection 23.5.05. A further visit on 12/06/06 confirmed this work has now been completed. 3. OP19 13(3) 4. OP26 13(3) Hand washing facilities must be across the home to ensure that they meet current infection control guidelines. Liquid soap and disposable paper towels must be provided in areas where personal care is carried out. The current hand cleansing provision in areas such as sluices must be reviewed. The laundry procedures must be reviewed to ensure that the systems in place meets current DS0000019534.V293836.R01.S.doc 30/06/06 30/06/06 St Anthony`s Version 5.1 Page 25 5. OP38 13(4) 12/06/06 confirmed this work has now been completed. infection control standards – details can be obtained form the local health protection agency Confirm action taken to ensure hot water in areas accessible to service users is delivered at 430C. (hot water supply in area of concern shut of on day of inspection while new valve obtained). Put a system of regular testing and recording of hot water temperatures in place to maintain the safety of service users. A further visit on Record risk assessments for individual services users in rooms which do not have low surface temperature radiators and provide protective coverings where a risk is identified. Radiators in communal areas should also be risk assessed to ensure a safe surface temperature is maintained. Provide a copy of the annual gas safety certificate. 02/06/06 6. OP38 13(4) 31/07/06 7. OP38 23(2) 31/07/06 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. 2. 3. Refer to Standard OP9 OP10 OP24 Good Practice Recommendations Provide a metal cupboard for the storage of controlled drugs, which complies with the Misuse of Drugs (Safe Custody) Regulations 1973. Review working practices to ensure that service users rooms are for their own use and not used by the hairdresser for other residents or staff to sort laundry. Review the provision of suitable locks on bedroom doors and introduce a system for offering service users keys to DS0000019534.V293836.R01.S.doc Version 5.1 Page 26 St Anthony`s 4. OP33 their rooms on admission subject to an assessment of risk. Introduce a professionally recognised quality monitoring system. Ensure policies procedures and practices are regularly reviewed in light of changing legislation and good practice from the department of health and other specialist authorities and organisations. Provide the Commission with a copy of the outcome of the recent service users / relative survey as detailed under Regulation 24(2). St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 St Anthony`s DS0000019534.V293836.R01.S.doc Version 5.1 Page 28 - 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. 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