Inspection on 24/05/06 for St Nectans Residential Care Home

This inspection was carried out on 24th 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

St Nectans Residential Care Home 30/07/08

St Nectans Residential Care Home 14/08/07

St Nectans Residential Care Home 13/02/06

St Nectans Residential Care Home 09/08/05

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE St Nectans 3 Cantelupe Road Bexhill-on-Sea East Sussex TN40 1JG Lead Inspector Lindy Latreille Unannounced Inspection 24th May 2006 08:00 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 Nectans DS0000063996.V290212.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 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 Nectans DS0000063996.V290212.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Nectans Address 3 Cantelupe Road Bexhill-on-Sea East Sussex TN40 1JG 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) 01424 220030 01424 219657 pl.finn@tesco.net St Nectans Residential Care Home Ltd Patrick Finn Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places St Nectans DS0000063996.V290212.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is thirtythree (33). Service users must be older people, aged sixty-five (65) years or over on admission. 13th February 2006 Date of last inspection Brief Description of the Service: St Nectans is situated on a residential street a short level walk from Bexhill town centre and railway station. The building has been adapted from four adjacent properties, which are now interlinked. Accommodation is provided on four floors and consists of well-sized single bedrooms with ensuite facilities. All areas of the home are accessible to all residents by means of a shaft lift. There is a lounge with open access to the dining area. There are two further areas where residents may sit on the ground and first floor and take their meals with visitors if they wish. There are assisted baths on each floor and communal lavatories with safety features. The home is registered to accommodate up to 33 older people. There is flat access to the rear of the building and steps up to the front door, though a further door on the front of the building does allow flat access to the home. There is a paved and lawn area to the rear of the home where residents may sit out. There are building works taking place at present to provide a further two large bedrooms with ensuite and a lounge. One of the owners has been acting manager for the past year, has now been registered as the manager of the home. The service does not advertise; but a brochure is available to all callers at the home as is the last inspection report. Fees are between £365.00 and £485.00. St Nectans DS0000063996.V290212.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was took place between 0800 and 16.15. Interviews were carried out with most of the residents, a visitor, the Registered Manager, the Head of Care, a senior carer, and the laundry person. Care plans were examined together with menus, the activity programme, complaints and compliments, the signing in book and a tour of the home. A further visit was made at 08.15 on 29/05/06 to interview the cook. What the service does well: What has improved since the last inspection? What they could do better: The statement of purpose should give details of admissions for respite and all residents should be assessed prior to admission and have a care plan in place. All residents must have a care plan that guides staff in the care of the residents’ identified needs and choices. Comprehensive risk assessment of falls should be in place and reviewed following each fall for the safety of the residents. When the community psychiatric nurse is seeing residents there must be an assessment in place to ensure that the residents needs are being met by the service and that they are not out of category. Nutritional screening should take place for all residents on admission. Reviews of care plans must take place monthly and be recorded. Gaps in medication administration must be monitored. The Registered Manager needs to develop his hands-on skills so that he knows the residents individually within the home. The monthly visits St Nectans DS0000063996.V290212.R01.S.doc Version 5.2 Page 6 that check the quality assurance of the home should be carried out by some one in the organisation not involved in the daily running of the home. All fire doors must have a door guard fitted so any doors that need to be open to allow staff to work more easily still maintain safety for residents. Supervision should be recorded and a copy given to the carer. Trends in accidents should be audited. Portable appliance testing should be recorded. The Control of Substances Hazardous to Health (COSHH) file should contain all the product information leaflets relating to the products in the home. 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 Nectans DS0000063996.V290212.R01.S.doc Version 5.2 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 Nectans DS0000063996.V290212.R01.S.doc Version 5.2 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): 1 and 3. Quality of this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. All long-term residents are assessed to ensure that the service can meet their needs before admission, but not those admitted for respite; so the residents’ health and safety may be compromised. EVIDENCE: The statement of purpose has been recently up dated but does not detail the procedure for admitting residents who are only staying for a short respite period. At present the assessment is superficial and mostly takes place during the prospective resident’s visit to the service. The Head of Care, and usually the Registered Manager, assess all prospective residents in their home or hospital as appropriate. The pre admission assessment is comprehensive, though the history of falls could be further detailed and provide a more informed view to be included in the care plan. All residents spoke positively of their daily needs being met supporting the assessment process. St Nectans DS0000063996.V290212.R01.S.doc Version 5.2 Page 9 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, and 10. Quality of this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. New care plans are being developed but the recording of care does not confirm that all health and care needs are fully met. EVIDENCE: Staff spoke positively of the training on care plans, delivered from the general manager of the organisation; and that the new process will support the improved management of care. At present care plans do not always clearly guide staff in their practice so that they can ensure the best outcomes for residents. Care plans are not being routinely recorded as being reviewed each month, but changing needs are recorded each day, in a separate book, for residents as appropriate and actioned by staff and this system works well as the residents positively confirmed. Staff, aware of the recording short falls, felt that they were gaining confidence and developing a more joined-up system to record the identified care needs and the care given to the residents. Residents admitted for respite do not have a care plans or risk assessments written for them. Daily records give staff immediate information but this does not fully St Nectans DS0000063996.V290212.R01.S.doc Version 5.2 Page 10 address their holistic needs or confirm that the service can meet them. A community psychiatric nurse sees some of the residents; and the care plans sampled do not contain a mental health assessment to show clearly the primary needs of the residents. It is essential that the residents are admitted within the registration of the home. Residents are supported in their choice to be taken to, or receive in the home, services from health professionals that they attended prior to admission. District nurses are contacted as necessary as is the continence nurse, and supplies are maintained and meet the need. No nutritional screening takes place on admission so no baseline is established from which informed judgements can be made about health at the care plan reviews; but some monthly weights were recorded for some residents. The management of medicine administration is closely monitored by the Head of Care on a monthly basis. The general manager of the organisation checks this audit on her regular visits to the home. Unsigned medicine records were identified on the day of the inspection. The Head of Care had already checked the medication remaining in the locked drugs trolley and had established that the medicine had been given and planned to speak to the member of staff with the Registered Manager. All staff have recently had training in medicine administration and at the inspection a senior carer was supervising a newly trained carer during the procedure; contributing to the outcome of maintaining health and safety for the residents. The maintenance of privacy and dignity was observed to be an integral part of the carers’ work and residents all spoke positively about the care that they received. One resident spoke at length about her move into the home, her concern and that of her family, and how surprised she was to find herself settled so quickly and enjoying her life so much. All this she attributed to the way the staff had assisted her in the early stages. St Nectans DS0000063996.V290212.R01.S.doc Version 5.2 Page 11 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 and 15. Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to exercise their choices in all areas of the daily routine, which all contributes to their health through raised self-esteem and independence. EVIDENCE: Until the middle of March the home had an activity co-ordinator. Now a member of staff has been assigned to organise this and is planning activities for next month. The activity programme for March included a range of seasonal and musical activities, tabletop games and Holy Communion. The home hosts coffee mornings with “Bring and Buy” involving two local charities and members of the public are invited. Residents give informal consent to this arrangement by attending. There is a shop in the home that is open each afternoon. A hairdresser visits weekly and there is a scrabble club twice a week. Many of the residents when asked said that they enjoyed the activities and would like more organised. There is a separate dining area for residents to sit in some privacy with their visitors. Residents spoke of the welcoming attitude of staff to visitors to the home; and one visitor confirmed the positive attitude of the home and of the contact when there were issues of concern. St Nectans DS0000063996.V290212.R01.S.doc Version 5.2 Page 12 Residents bring furniture and furnishings into their bedrooms and many spoke of how this helped them to settle into the home. Most of the residents confirmed that they made choices about all aspects of their daily routine. In the care plans sampled residents choices were not fully detailed and if staff are not given this guidance there is the possibility of conflict and upset for the resident. There are two dining areas, though at present only one is used as the other is close to the building works. Menus are put on the board for residents to view, this task is undertaken by a resident who clearly enjoyed this area of responsibility; their choices are made during the morning for lunchtime and the afternoon for supper. A quality assurance questionnaire highlighted that residents wanted changes to the menus and this was carried out successfully. Most residents were very positive about the food provided and spoke of good quality and plentiful meals; the menus seen supported balanced and nutritious meals. Some residents would like smaller portions and some more ethnic foods. The cook feels that she manages diets well and liaises with staff following residents’ clinic appointments. She has worked at the home for ten years, and has a current qualification in basic food hygiene, and takes a pride in producing appetising meals. Fresh produce is used daily, meat and fish from local suppliers and meals are predominantly home cooked. If residents want a cooked breakfast they come to the dining room, but others have a breakfast tray in their rooms. Some residents do not choose to go to the dining room and are provided with meals in their rooms. The cook showed a good understanding and rapport with the residents and the kitchen is clean and well organised. On the residents’ notice board there is a notice to tell them that their comments are welcomed so that this can inform the planned menus. St Nectans DS0000063996.V290212.R01.S.doc Version 5.2 Page 13 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 and 18. Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff listen and action concerns for residents but may lack the ability to protect them from abuse as training has lapsed. EVIDENCE: Residents spoke of being well listened to and confirmed that staff attend to their concerns quickly. Staff clarified that the concerns of each day are not logged but actioned quickly to meet the residents’ needs. The residents all sited the Head of Care as being able to quickly and effectively manage concerns. Some residents said that they would not ask the Registered Manager as he did not know them, their names or which room they were in. The service has not received any complaints nor have the Commission for Social Care Inspection. The home has a book where comments are made and these were of a positive nature. The last inspection in February identified that the staff team needed training in the home’s procedures and policies for adult protection. This training is arranged for later this month and next. Following the training the Registered Manager and the Head of Care are taking further training to enable them to be trainers. Residents spoke of feeling safe in the service. St Nectans DS0000063996.V290212.R01.S.doc Version 5.2 Page 14 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 and 26. Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has been considerably upgraded and provides a homely and safe environment for residents. EVIDENCE: Significant investment has been made to the home to replace, or refurbish, windows with restrictors, carpeting, call bells and fire detection equipment. Thermostatic valves have been fitted to hot water outlets. The environment is homely, warm and comfortable and the residents were all positive in their comments about the home. Staff have received training in infection control that enables them to provide improved protection for the residents. The home is kept clean and there are enough resources to maintain this. There is now a dedicated person to manage St Nectans DS0000063996.V290212.R01.S.doc Version 5.2 Page 15 the laundry, which is a clean and organised area with two washing machines, one spin dryer and a tumble dryer. The management of soiled laundry is appropriate and resourced adequately. Most of the washing is completed in the available hours, and the night staff complete the remainder before midnight when the sleeper-in settles. Some wheel chairs are kept in the residents’ bedrooms at their request, even though there is space to store them within the building. Carers need to record these choices the care plan and be vigilant to ensure necessary maintenance and hygiene is not overlooked under these circumstances. St Nectans DS0000063996.V290212.R01.S.doc Version 5.2 Page 16 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 and 30. Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team is competent, enthusiastic and focused in providing a good quality of life to the residents at the home. EVIDENCE: The staff team always consists of a senior and at least two carers, and this remains the case when activities are taking place. The Head of Care is not counted in the numbers and that allows for flexibility within the team. The last senior on duty is on-call over night and there is a rota of night waking staff and those who sleep-in. There are no staff under 18 years who give personal care. There are sufficient cleaners to maintain a clean and fresh home, and residents commentated to that effect. Of the staff team of sixteen, five are qualified in care at level 2 and three hold level 3. One member of staff is near completion of a level 4 qualification and one is following an apprenticeship. Recruitment is robust meeting all the requirements of good practice. All staff have a contract. There are no volunteers involved in the home. St Nectans DS0000063996.V290212.R01.S.doc Version 5.2 Page 17 There has been a great deal of training for staff over the past six months; first aid, incontinence, fire prevention, moving and handling, infection control and care planning. All the staff said how useful this has been in the development of their practice. The induction of new staff is managed by the Head of Care. As the Registered Manager is not yet hands-on he admitted that he had not taken the opportunity to speak with staff at the end of an induction period, but he would be developing this in the future to support his quality assurance programme. St Nectans DS0000063996.V290212.R01.S.doc Version 5.2 Page 18 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): 31,33,35,36 and 38. Quality of this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Registered Manager is developing systems and his own vocational skills to ensure that the home provides a quality service for the residents. EVIDENCE: The Registered Manager has been in post for the past year and has just been registered by the Commission for Social Care Inspection. He is expecting to complete his Registered Managers Award very soon. He works closely with the Head of Care and is developing his skills in hands-on care. He has followed recent training in administration of medicines and infection control and appraisals and later this month will undertake training in prevention of adult abuse, with additional training to be a trainer in adult protection. Some residents said that the Registered Manager did not know them by name or which rooms they were in. St Nectans DS0000063996.V290212.R01.S.doc Version 5.2 Page 19 Questionnaires are used annually to gauge a recorded view of the residents and are soon to be repeated. The Registered Manager does not have a programme to monitor all areas of the home on a systematic basis throughout the year and he needs to develop this so that he can be assured that the home is effective and efficient. The general manager of the organisation is updating policies and procedures and the Registered Manager said that he would use the staff meetings to bring this to the attention of the staff. The monthly visits have been carried out by the Registered Manager to date. In discussion at the inspection he confirmed that he would ask the general manager of the organisation to do this in future to ensure a more transparent report. Five residents have small amounts of monies that are kept by the Head of Care and individually recorded with receipts and audited by the general manager monthly. Accounts seen confirmed that this was well managed. The general manager supervises the Registered Manager regularly. Within the home the Registered Manager needs to develop a schedule for the senior staff to supervise the carers, and they may need training before being able to do this. The Head of Care supervises the senior carers and domestic staff but this is informal and not recorded. Without records it is not possible to see that the requirements of supervision for carers, as written in the standards, is addressed. Mandatory training is scheduled and a matrix is in place. During the past year much work has taken place to ensure that fire prevention, maintenance of the building and servicing has been achieved. The one remaining door must be fitted with a door guard linked to the fire alarm so that carers are not propping open a door for ease of access. No system is yet in place to monitor the hot water, although regulators are being fitted to hot water outlets. Weekly monitoring is still essential as it confirms the safety of the system. Similarly the hot water system must be able to be monitored to ensure the temperatures prevent the spread of Legionella. Risk assessments were done for the home and the gardens earlier in the year; and the latter are maintained to a pleasant and safe standard. There was no evidence at the inspection that any electrical appliances being brought in from resident’s homes were PAT tested (Portable Appliance Testing) before being used in the home. Accidents and incidents are satisfactorily recorded but at present there is no monitoring to establish trends and patterns that can be used to inform the care given. Some product information leaflets have been collected but the home does not have them for each hazardous substance in the home. St Nectans DS0000063996.V290212.R01.S.doc Version 5.2 Page 20 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 2 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 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 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 2 X 2 St Nectans DS0000063996.V290212.R01.S.doc Version 5.2 Page 21 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 2 Standard OP3 Regulation 14(1)(a) 15 Requirement That residents admitted for respite are fully assessed and have a written care plan. That care plans must be maintained up to date and accurately, notably in respect of changing care needs being incorporated within the main care plan as and when necessary. That psychiatric assessment is in place for residents being seen by a community psychiatric nurse. That a comprehensive history of falls is assessed at pre-admission and informs the care plan and risk assessment. That care plans are reviewed monthly. That nutritional screening is in place for all residents. That unsigned medicines are robustly managed and recorded. That the Registered Manager develops his hands-on skills. That a member of the organisation external to the home conducts the Regulation 26 visits. DS0000063996.V290212.R01.S.doc Timescale for action 24/05/06 13/08/06 OP7 3 4 OP7 OP7 13(1)(b) 13(4)(c) 24/07/06 24/07/06 5 6 7 8 OP7 OP8 OP9 OP31 15(2)(b) 13(1)(b) 13(2) 9(2)(b)(i) 26(2) 24/07/06 24/07/06 24/05/06 24/10/06 24/07/06 8 (a) OP33 St Nectans Version 5.2 Page 22 9 10 11 OP36 OP38 OP38 18(2) 13(4)(b) 13(4)(a) That a record of individual supervision is kept and a copy is given to each carer. That alternative measures are in place to prevent the necessity of propping open fire doors. That the home should keep records of regular hot water temperature checks and measures to prevent Legionella. That all electrical appliances are PAT tested prior to use in the home. That a COSHH file is fully maintained. 24/08/06 24/05/06 24/07/06 12 13 OP38 OP38 13(4)(a) 13(4)(a) 24/07/06 24/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 5 6 Refer to Standard OP10 OP18 Good Practice Recommendations That residents’ choices are recorded in the care plans. That all staff should receive training regarding the processes associated with allegations of abuse, neglect or harm. That wheel chairs are cleaned and maintained when stored in residents’ bedrooms. 8 OP26 St Nectans DS0000063996.V290212.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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. 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