CARE HOMES FOR OLDER PEOPLE
St Huberts Lodge St Huberts Road, Great Harwood, Lancashire, BB6 7AR Lead Inspector
Helen Tomlinson Unannounced 19 April 2005 07:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION
Name of service St Huberts Lodge Address St Huberts Road Great Harwood Lancashire BB6 7AR 01254 888581 01254 872685 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Thomas Cardwell Mrs Selina Cardwell Mr Ian Carwell Care Home Only Personal Care (PC) 13 Category(ies) of Old Age, not falling within any other category registration, with number (OP) 13 of places St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 20th October 2004 Brief Description of the Service: St Huberts Lodge offers care to 13 older people. The building is a large detached house which has been converted into a care home. It is situated in a residential area of the town of Great Harwood. Opposite the home is a Catholic Church. It is within walking distance of local shops and the town centre. The bedrooms are 50 single and 50 shared, most without en-suite toilets. A hand wash basin is present in all bedrooms. There is one communal toilet on the ground floor and 2 communal bathrooms, with toilet, and 1 communal toilet on its own, on the first floor. There are 2 communal lounges with dining facilities. The first floor can be accessed via a passenger lift. Ramped access is available to the front entrance. Car parking is available to the rear of the home. St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was the first unannounced inspection in 2005. It took place over 1 day. 12 residents were accommodated at this time. The inspector arrived at 7.30am and talked to the night staff on duty. The inspection continued until 6pm. Over the course of the inspection all 12 residents, 2 visitors, 4 staff members and one registered provider were spoken with. 2 residents files were examined in detail, with information gained from others. 1 new member of staff had been appointed since the last inspection and this file was examined. A tour of the premises took place, including all bedrooms. Documents were read and care observed. During the inspection the Environmental Health officer visited the home. Her findings were discussed with the inspector. What the service does well: What has improved since the last inspection?
The residents and staff spoke enthusiastically about the recent changes, due to the introduction of a senior member of staff. They said, “things had changed for the better” and described a “quiet and calm atmosphere.” Most of the paperwork required at the last inspection had been written. Some of this was not yet in full use in the home. St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 6 The admission of new residents had been improved with a full assessment having been carried out before they became accommodated. New care plans had been produced and where these had been completed the resident and next of kin had been involved. Assessments of health care needs, plans of how to meet these and plans to reduce risks were in use. Residents and relatives had been involved in these. New systems to reduce the risk of the spread of infection had been introduced. Staff and residents said the home was much cleaner. Staff had the things they needed to protect residents from infection. The recruitment of a new member of staff had been carried out correctly with all information needed gained by the registered provider before they started work. One to one supervision of staff had begun. This was described as a good time to discuss changes needed to provide better care in the home. There was an increase in training with some care staff doing their NVQ 2 qualification. Good techniques and the use of equipment for the moving and handling of staff were seen. The garden area at the front of the home was much improved, with pebbled beds and attractive fencing. High hedges had been taken down which the residents said improved the light in the building and they could now “watch the world go by.” What they could do better:
The procedures for giving residents their medication, the records, which are kept, and the training for staff in this area need improvement. The Pharmacist inspector was asked to visit the home 1-week after this inspection to provide advice. The written information for staff about reporting suspected abuse must be clear and available. Several areas of fire safety must be improved to safeguard all residents. The written procedures for staff and residents must be up to date and given to all in the home. Some staff had not received fire safety training since they were employed at the home and others had not had any for a long time. Training for staff and carrying out of fire drills must be up to date. The inspector will monitor that this has been carried out within 1 month of this inspection. Residents said that additional toilet facilities need to be available on the ground floor. Several discussed how having only 1 toilet lead to problems of having to wait. The bathroom with toilet on the first floor must not be used as a storage area. St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 7 Some staff and residents said that, at times, the numbers of staff on duty were not enough to safely help all the residents. The number of staff on duty must be adequate at all times. The registered person was not clear about the training some staff had completed. Certificates must be kept in the home. Not all staff on duty or employed in the home had received up to date moving and handling and health and safety training. Assessments for the general risks involved with areas of the home and equipment in it had not been done. This must be completed to safeguard the residents and staff against the risk of harm. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 and 3. The written information provided a clear picture of the home’s facilities and services. This included the responsibilities of all parties. The admission procedure for new residents ensured that all information about their care needs was obtained before they arrived. This enabled the staff to have a clear understanding of what they needed to do for them. EVIDENCE: A new statement of purpose and service users guide had been written since the last inspection. This contained all the information needed for a prospective resident to understand how the home was run and what facilities were offered. The service users guide was on the table in the hallway. The plan was for all residents to get their own copy. New statements of the terms and conditions of living at the home had been written. 5 of the residents had received these and signed copies were seen by the inspector. These clearly laid out the responsibilities of both parties.
St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 10 2 new residents admitted since the last inspection had been seen by a senior member of staff before moving into at the home. Written information which gave a clear picture of their needs and abilities had been documented at this time. This information included their personal needs, mobility, physical and psychological health, preferences and risks identified. Written consent was obtained, from the resident, for this assessment to be completed. A letter confirming the ability of the staff and facilities at the home to meet the needs of the residents was present. St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 and 10 The health care needs of the residents were identified and met. The new documents used for recording the plans to meet these needs were a significant improvement. Resident’s privacy and dignity were respected by the staff. Some improvements in the practices and recording of medication administration were needed to safeguard the residents. EVIDENCE: At the time of this inspection new documentation was being introduced. Where this had been used it resulted in thorough information being recorded and a clear picture of the resident being present. 2 of the residents were case tracked and their care plans examined. These varied in the type and amount of information recorded. This was because one had the new documentation and one did not. Where the new documents had been used the resident and/or their relative had been consulted and signed their agreement of the plans of care. For the resident with the new documentation in place their health care needs had been thoroughly assessed and plans to meet these were clear. Staff and
St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 12 the resident themselves were aware of how their identified needs were to be met and this took place as planned. Residents were aware of what was being done to reduce identified risks with their agreement e.g. measures to stop falling out of bed. These were not always clearly recorded on the old documentation. Residents discussed the involvement of other health professionals in their care. They had good relationships with the district nurses and G.P.s. Several issues of concern were raised with the manager and staff regarding the recording of medication. No risk assessments had been done for residents who administered their own medication. An absence of recording the administration of a controlled drug was identified. Medication records were handwritten without appropriate checks in place. Staff administering the medication had not received appropriate training. None of the above issue had resulted in errors occurring and residents had received their medication as prescribed. An advisory visit from the pharmacist inspector was requested following this inspection. The residents spoke highly of the way staff delivered their care stating “they always do it in calm and respectful way.” St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15 The home was run to make sure the residents enjoyed their life. Their individual preferences and choices were known and respected by the staff. Meals were varied and provided a social occasion on a daily basis. EVIDENCE: The residents discussed both individual and group activities, which they enjoyed. Quizzes, sherry afternoons and games took place. Residents said it was their own decision whether to take part or not. Individual activities were taking place, with assistance from staff where needed. Residents had large print books and newspapers, wrote diaries, watched T.V. and kept a budgie. 1 resident had been on a holiday, accompanied by a staff member, and said she had “ really enjoyed it and was going again in the summer.” Assistance was provided to attend local concerts and events. The residents had an interest in each other’s lives and visitors said they felt like they visited everyone in the home and not just their relative. A questionnaire had been devised for the residents and relatives about the activities offered and suggesting more which could be introduced. St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 14 Varied meals were eaten by the residents at the time of this inspection. At breakfast time the residents said they could choose to eat in the dining room or in their bedrooms, as they wished. The times of serving breakfast varied to meet the rising times of the residents and went from 7am to 10am. Lunch was served in 2 dining rooms and consisted of a wholesome meal, with a choice available. Fresh fruit and vegetables were served. Hot drinks were given out frequently during the day and cold drinks were always available. Assistance to eat and drink was given by the staff where needed. A record of food eaten had been kept since the last inspection. The Environmental Health Officer visited the home to carry out an unannounced inspection on the day of this inspection. They reported, to the inspector, that they were satisfied with the practices and cleanliness of the kitchen. St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Staff knew how to protect the residents in their care. The written procedures for responding to an allegation of abuse were not in place, but staff were aware of the procedures to follow. EVIDENCE: Since the last inspection several policies and procedures regarding the protection of vulnerable adults had been produced. These did not always contain correct information. Some staff had received training about the recognition of abuse and how to prevent this. Those staff spoke with were aware of the procedures to follow should they be concerned abuse had taken place, but had not received this in writing. There were no procedures for the manager to follow should an allegation be made to them. The procedures had been required following the last inspection. St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 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 standard(s) 19,21,25 and 26 The general layout and the décor of the home was suitable for the residents accommodated and provided comfortable surroundings. The home was clean, tidy, warm and free from offensive odours. Having only 1 lavatory on the ground floor creates problems for some of the residents. Fire safety precautions were adequate. Staff training regarding fire safety was inadequate. EVIDENCE: There is ramped access to the front of the home. The décor was clean. The garden to the front of the property had been tidied and allowed for more light to enter the 2 lounges. The residents commented on this saying it brightened up the whole house. The home was well maintained though some fixtures and fittings were dated. The manager discussed the replacement programme in place. The carpet on the stairs was becoming worn in places and although did not present a hazard at this time must be kept under review. There is 1 toilet on the ground floor and the residents spoke about how this resulted in them queuing to use it at times. The manager discussed that the
St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 17 layout of the building did not allow for another toilet to be added in the existing premises. The option of extending the building was being investigated. The bathroom on the first floor had items stored in it, such as a television, mattress and wheelchair. These must be removed. Several residents commented on how the cleanliness of the home had improved in recent months. They and a visitor said there was never an offensive smell in the home. They said there was now a routine for bed changes, they all had their own towels and face cloths and paper towels were in the toilets. They said this was a big improvement. Staff also said they thought the cleanliness had improved and they had been trained to carry out infection control measures such as using different cleaning materials, more thorough cleaning of commodes and wearing latex gloves and plastic aprons. Several areas of concern regarding fire safety in the home were raised with the manager. The staff training records showed no staff training had taken place since August 2003 and there had been no drills since August 2004. Staff spoken with gave differing responses to the fire procedure to be followed should the alarm sound. There was no fire risk assessment. Requirements regarding fire safety training had been made at previous inspections. The manager was required to have written procedures and train all staff in fire safety as soon as possible. The inspector will monitor the progress of this requirement and visit the home within 1 month. St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 and 30 The staff numbers are not always adequate to meet the needs of the residents. The procedures for the recruitment of staff had improved since the last inspection and all checks to safeguard the residents had been done. An increased amount of a staff training had taken place, but more was needed. EVIDENCE: Some staff and residents commented that there was not always enough staff on duty to meet their needs. At times there was only 1 care assistant on duty, during the day. There must be 2 care assistants, at all times, between 8am and 10pm. The manager discussed that he is sometimes the second care assistant and may be carrying out other duties. The inspector stated that whoever was on duty, must be in the home at all times during the above hours. Both care assistants must have the skills and knowledge to carry out all aspects of care for the residents. The duty rota showed that 2 people were on duty at these times and 1 care assistant, with an on call system, at nights. It was discussed with the manager that there had been an incident recorded where the night care assistant had not used the on call system correctly following a resident falling in the night. This had been dealt with internally. The recruitment in respect of 1 new care assistant employed since the last inspection was examined. All checks required to safeguard the residents had been carried out prior to the staff member starting work. There was no documentary evidence of their training on file.
St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 19 Some staff training had taken place since the last inspection. This included moving and handling, general care practices and infection control. The records showed that not all staff had carried out the statutory training needed e.g. moving and handling, health and safety, medication and fire safety. St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,36,37 and 38 The attitude of the staff and management is to run the home around the needs and choices of the residents. Some practices, lack of training and written procedures do not safeguard the health and safety of the residents or staff. EVIDENCE: There was no formal measure of the quality of care in the home. Due to the size of the home, the daily involvement of the owner and the small staff team, informal discussions about the satisfaction of the residents took place daily. A more formal system was being devised at the time of this inspection. The residents spoke highly of the daily contact they had with one owner and felt he listened to them and acted on their comments. One to one staff supervision had taken place with 2 care assistants. Both parties involved thought this was useful to talk more formally about the running of the home. St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 21 Not all the records required to be kept had been produced at the time of this inspection. Much progress had been made since the last inspection and an increased number of policies and procedures were available. Not all measures to ensure the health and safety of residents and staff was protected were in place. Staff had not received appropriate training in health and safety, fire safety, medication administration and moving and handling. Risk assessments were not documented for safe working practices within the home. St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 22 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 2 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3
COMPLAINTS AND PROTECTION 1 x 2 x x x 3 3 STAFFING Standard No Score 27 2 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 x x 2 x x 2 2 2 St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 23 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 9 Regulation 13.2 Requirement All persons administering medication must receive appropriate training. Previous timescale of 31 January 2005 not met. All medication administered must be signed for on a medication administration record. Previous timescale of 31 January 2005 not met. Hand written entries on the medication administration sheets must be signed and witnessed, dated and cross referenced. Previous timescale of 31 January 2005 not met. All residents who self-administer medication must have a risk assessment completed. Clear procedures for the reporting of suspected abuse in the care home must be produced. Prevous timescale of 31 December 2004 not met. The fire procedures must be reviewed and reflect that to be followed in the home. A fire risk assessment must be recoreded. Fire drills must take place. Previous timescale of 30 November 2004 not met. Timescale for action 30 June 2005 2. 9 13.2 30 April 2005 3. 9 13.2 30 April 2005 4. 5. 9 18 13.2 13.6 30 April 2005 31 May 2005 6. 19 23.4 (c) 20 May 2005 St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 24 7. 8. 19 21 23.4(d) 13.4 (a) 9. 10. 21 27 23.2(j) 18.1(a) 11. 12. 29 30 Schedule 2 (5) 18.1 (c) 13. 38 13.4 (c) All staff working at the care home must receive fire safety training. All items stored in the first floor bathroom must be removed. Previous timescale of 30 November 2004 not met There must be sufficient numbers of lavatories to meet the needs of the residents. Sufficient numbers of staff who are trained and competent to meet the needs of the residents must be on duty at all times. Documentary evidence of any relevant qualifications or training must be obtained for all staff. Staff must receive training appropriate to the work they are to perform. Moving and handling, medication, fire safety and health and safety must be done by all staff. All staff preparing food must have food hygiene and suffiecient staff must have first aid to ensure there is one member of staff, with this, on duty at all times. Risk assessments for safe working practices must be completed. Previous timescale of 30 November 2004 not met. 20 May 2005 20 May 2005 31 August 2005 22 April 2005 30 June 2005 30 June 2005 31 May 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard 8 19 27 33 Good Practice Recommendations whilst the new care plans are being introduced ensure the current ones are kept up to date and reflect the risks and needs of the resident. Ensure the stairs carpet does not become a hazard. Ensure all staff use the on-call system correctly at night. Introduce a documented quality assurance system.
F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 25 St Huberts Lodge 5. 6. 36 38 All staff should receive supervision at least 6 times per year. Steradent tablets should be securely stored. St Huberts Lodge F57 F07 S9440 St Huberts Lodge V220935 April 19th 2005 Stage 4.doc Version 1.20 Page 26 Commission for Social Care Inspection 1st floor, Unit 4 Petre Road Clayton-Le-Moors- Accrington Lancashire. BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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