Inspection on 12/10/05 for Strensham Hill

This inspection was carried out on 12th October 2005.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Strensham Hill 20/08/09

Strensham Hill 19/08/08

Strensham Hill 20/02/08

Strensham Hill 10/05/07

Strensham Hill 11/10/06

Strensham Hill 05/04/06

Strensham Hill 27/04/05

Strensham Hill 11/11/04

Strensham Hill 24/05/04

Similar services:

The Lodge Nursing Home

Bracken House

Sunnycroft

Field Farm House

Edgeview Nursing Home

Church Terrace Nursing & Residential Home

The Forbury

The Maples

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

CARE HOME ADULTS 18-65 Strensham Hill 1 Strensham Hill Moseley Birmingham West Midlands B13 8AG Lead Inspector Sean Devine Unannounced Inspection 12th October 2005 09:10 Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 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 Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Strensham Hill Address 1 Strensham Hill Moseley Birmingham West Midlands B13 8AG 0121 442 4580 0121 456 3625 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) Servol Mark Daniels Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (8) of places Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Residents must be aged under 65 years That the home can care for named service user over 65 years for reason of Mental disorder 1 MD(E). That the service user will have regular reviews to ensure that the home can continue to meet individual care needs. 27/04/05 Date of last inspection Brief Description of the Service: The home is a large house on the corner of Strensham Hill Road. It is close to local amenities such as shops and places of worship. Moseley is also within easy reach. Cannon Hill Park, where there is a range of facilities, is also within easy walking distance. Within the home residents have their own rooms, and there are communal living and kitchen areas, as well as a self contained flat which provides an opportunity for more independent living. The main lounge is bright and airy, and faces on to Strensham Hill. The kitchen is to the rear of the property and has individual storage facilities for each resident. There is a garden to the rear of the property, which is private, residents make good use of it in the summer months. To the rear of the garden there is space for some car parking. The home is geared towards providing rehabilitation to residents with enduring mental health issues with a specific focus on the needs of African-Caribbean residents. Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was conducted on an unannounced basis by one regulation inspector. The inspector was able to meet with some residents and two members of staff. Records in respect of care provision, services and health and safety were viewed. One member of staff was formally interviewed. There has been a concerted effort from the Servol organisation, staff team and manager to address concerns from previous inspections these improvements are detailed below, however not all requirements previously made have been fully addressed and these remain outstanding. To fully reflect these improvements it is recommended that the last inspection report dated the 27/04/05 be considered when reading this report. What the service does well: What has improved since the last inspection? Improvements have been made in consultation with residents to assess their needs and then to plan how the service will support and assist in meeting these needs. The needs assessment and subsequent care plans now include the lifestyles and physical and mental health support for residents. Some residents now have an activity plan covering social, domestic, educational and cultural pursuits. Medication management for residents is now safer as systems and practice are regularly monitored and where needed improvements made. Policies to help guide and inform staff and residents including accidents and complaints are in place and reflective of good practice. Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 Page 6 Risk assessments and management plans to reduce risks are being developed for fire safety, food safety and the health and safety of the premises. Staff are receiving all mandatory health and safety training and are receiving frequent supervision. What they could do better: The manager must ensure that time is adequately managed on the staff rota to provide essential support for residents during busy periods of the day and that time for his management responsibilities is also highlighted. Risk assessments for staff need to be developed to include such areas as lone working and escort duties. Risk assessments for residents are needed to ensure that management plans to reduce the levels of risk are in place and that staff and residents are aware of such actions. A system of quality review to include the opinions of residents and their representatives must be undertaken and annual report made a available. Current concerns and the need to continue the positive improvements made were discussed with the manager. It is the opinion of the CSCI that a meeting with the provider and manager maybe needed to discuss the intentions of both to address these areas of concern. 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. Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 5. Residents are not fully provided with information to enable them to make an informed choice on whether to live at the home. Residents’ needs are fully assessed prior to admission, which enables the service to make a decision on whether they can meet the identified needs. EVIDENCE: The manager advised that the statement of purpose and residents guide were not available in the home. He advised that the documents had been written and had been sent to the committee at the Servol Head Office for scrutiny. Assessments are completed prior to the admission of residents’, this includes Care Programming Approach care plans, risk assessments, summaries and reviews. As part of the admission protocol social workers usually complete a full referral form detailing the needs of residents, including physical, social, emotional and cultural support. Sampled residents files all included a licence agreement detailing the terms and conditions of residency, this included fees to be paid, room to be occupied and all contracts were signed by a home representative and the resident. Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 and 10. Residents are involved in assessing and planning their care, they are able to make choices and decisions that are important to them. This is managed in an accessible yet confidential manner. The risks for residents associated to daily living and mental disorder, are not effectively managed which may compromise their health and safety. EVIDENCE: There have been considerable improvements in the development of care and support plans. Sampled plans included detailed assessments such as mental health and relapse, social skills, physical health including specific health, work and occupation, culture and recreation. Following assessment, plans are developed, some in consultation with residents and in line with the Care Programming Approach. These care plans inform staff in respect of daily and weekly support for residents and also include short and long term goals. The manager advised that these plans would shortly be subject to review where possible with individual residents. Some residents have an activity plan based upon their assessed needs. The manager advised this would be completed for all residents. Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 Page 10 Where possible residents are involved in the assessment and care planning process, however some residents do decline to be involved. Some residents are supported to manage their own money and their ability to do this safely is fully assessed. Some residents are able arrange and choose their own activities such as where they shop and where they socialise. The manager advised the inspector on the new framework for risk assessments, which are to be completed shortly. Sampled residents files varied in respect of the quality of risk assessments. Some residents’ files did not contain any, although risks were evident and some residents had very detailed risk assessments completed through the Care Programming Approach process. Staff were interviewed and adequately described how they would protect the confidentiality of residents. Access to information is available for residents and staff practice when given information from residents in confidence is to share this with the manager and others where needed and important. Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13 and 17. The residents are provided with support and the opportunity for selfdevelopment and to develop and maintain life skills including accessing community facilities, interests and hobbies. The diets of residents are not altogether adequately monitored to ensure any risks to health are identified. EVIDENCE: Some residents have an activity plan this includes such activities as attending day centres (education classes), visits to and from relatives, shopping, cooking and healthcare appointments. The manager advised that this will be further developed to include access to other community services such as libraries and places of worship and that domestic skills within the home would also be included. The manager advised that some residents visit hairdressing salons, which specialise in Afro-Caribbean styles and care products. Some residents and the manager advised that holidays are regularly taken, most residents and some staff are going to Pontins at the end of October 2005. Other activities communal and in-house include books, music, celebrations, Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 Page 12 barbecues and film nights, socialising at local public houses and a monthly Karaoke. It was a concern at the last inspection that information about the dietary intake for some residents is not recorded, since this time daily records now reflect where residents who are active within the community have eaten. It has been discussed since the inspection with the manager that residents who are at risk due to not eating a healthy diet must have a respective risk assessment completed. The manager must ensure that any outstanding actions following the recent environmental health visit and subsequent report are completed. Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 20. The residents are provided with healthcare support and a system to manage their medicines that is individual to their needs, responsive, accessible and mainly safe. EVIDENCE: Residents confirmed they are able to see community healthcare professional as needed, sometimes they make their own appointments otherwise this is arranged by staff. Residents receive individual support depending on their needs to attend appointments with GP, hospital, district nurses, CPN’s, dentist and opticians. It is recommended that healthcare records are maintained separately to daily records to facilitate quick and relevant access to information. The safety of medicine management has continued to improve. The GP and community mental health teams prescribe medicine for residents and a community based chemist dispenses the medicine using a monitored dosage system. Frequent audits by the chemist are completed and identify areas for improvement. At this inspection the manager must ensure that medicine carried forward from one cycle to another are fully recorded on the medication administration records including dates and that the fridge used for storing medicines is maintained at a temperature that is safe. Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. The homes’ practice in relation to managing complaints and protecting vulnerable adults from abuse is adequate and is supported by policies and procedures that guide residents and staff. EVIDENCE: The complaints policy has recently been updated, it now includes details of the home taking complaints seriously, types of complaints, how complaints will be managed and the different types and stages of the complaint process. There is also a summary of the complaint process and a form to make complaints upon. The policy needs to include contact details of the local CSCI office and be available for residents within the home. Staff records continue to indicate a commitment to training staff in protecting vulnerable adults from abuse. Staff who were interviewed were able to describe what they would do should abuse be apparent or suspected, the response was clearly in the best interests and safety of residents. Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. The premises in communal areas is well maintained to meet the needs individually and collectively of the residents. Infection controls measures are mainly good, minor improvements are needed to fully protect residents and staff. EVIDENCE: The manager advised that most minor improvements to the premises had been completed in line with the requirements from the last inspection. Communal areas being the lounge, kitchen and small dining area are domestic in style and generally well maintained. The garden area is tidy and continues to be used frequently by residents and staff. Staff records confirm that training in infection control practices has been undertaken. The laundry area is sited away from any food storage and preparation areas and all high-risk areas such as the laundry and toilets have good hand washing facilities. The walls in the kitchen have not been repainted and remain in a poor and unsafe condition. The manager advised that repainting the walls has been included in a programme of redecoration and a copy of the action plan to redecorate will be available shortly. Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 33, 34, 35 and 36. The staff team are well trained and supported through supervision, which provides them with the skills to meet the health and safety needs of residents. Adequate numbers of staff are not always available to meet the needs of residents and some staff are not trained to support their mental health needs, this may lead to residents not receiving the care they need. EVIDENCE: Staff who were interviewed confirmed they had completed the NVQ level 2 in Care and wished to progress to level 3. One staff member has returned to university to continue health studies. Residents are supported normally by two members of staff, this does include the manager. Consideration needs to be given within the staff rota for the manager to be given specific and separate time to adequately complete specific management duties. At less busy times of day this does reduce to one support worker or manager. At night, one sleeping-in member of staff is on duty. On-call arrangements for staff are in place and this needs to be included with a lone working risk assessment. Staffing levels will need to be reviewed should the number of residents’ increase or the needs of residents change. Recruitment practices are in line with legislation, all new employees have criminal records bureau disclosures completed they also complete an Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 Page 17 application form including two written references. Medical questionnaires and interviews are conducted to further ensure the fitness of potential new employees. Staff files included details of current training, it was evident that all safe working practice training is undertaken for example fire safety, first aid and food hygiene. Further training is needed to fully support and develop staff within the service aims of caring for residents with mental health needs. Staff confirmed that they receive regular supervision and records reflected this. The supervision for staff included an action plan after consulting about roles and responsibilities, work programme, training and development and personal issues. However it was evident that the manager does not fully receive supervision and no records were available within the home. On the day of inspection the manager cancelled his supervision (the manager advised that this would have been his second supervision of the year), which was to take place at Servol Head Office. It maybe beneficial for the service to review the appointment time for supervision of the manager as this coincided with a busy part of the day at the home when only one member of staff was on duty. Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Residents are not supported by a fully qualified manager. Systems to reflect the views and opinions of residents on the service they receive are not in place. Health and safety practices are good, with some minor improvements needed to enhance safety within the home. EVIDENCE: The manager advised he has recently returned to studying for the Registered Managers Award and is close to completion. The manager advised and some training records reflected that he keeps up to date with TOPSS training specifications, however not all training could be evidenced. There has been some consultation with residents on an ongoing basis as they have a frequent residents meeting, however it is not clear that this involves gathering feedback from residents in respect of the standards of service they receive. The manager advised that the organisation will shortly be involved within the Investors in People quality assurance assessment process and have invited an external company to develop a health and safety quality tool. The manager advised that the Servol Organisation had not provided reports in Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 Page 19 respect of unannounced visits under Regulation 26 of The Care Home Regulations 2001. There has been considerable improvement assessing hazards within the home. The manager has implemented risk assessments for fire safety, food safety and the premises. This was discussed with the manager and it is clear that these are developing risk assessment documents and will need to be further developed to consider all risks and how they will be managed, this must include a risk assessment for the security of the building as identified at the last inspection. Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 1 3 X X 3 Standard No 22 23 Score 2 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 2 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 2 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 2 3 2 2 CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Strensham Hill Score X 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 X 1 X X 2 X DS0000016874.V258125.R01.S.doc Version 5.0 Page 21 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 YA1 Regulation 4,5 Requirement The manager must ensure that a statement of purpose and service users guide is developed, that reflects the service and is fully informative to prospective residents. Previous timescale of 28/02/05 not met, this requirement has been carried forward. All residents must have a risk assessment completed this must include a risk management plan and where possible involve the residents. Residents nutritional needs must be fully risk assessed and include where needed education and support to eat a healthy diet. The manager must ensure that any outstanding actions following the recent environmental health visit and subsequent report are completed. All medicine carried forward from one cycle to another must DS0000016874.V258125.R01.S.doc Timescale for action 31/12/05 2 YA9 12(1) 13(4) 30/11/05 3 YA17 12(1) 13(4) 16(2)(I) 30/11/05 4 YA20 13(2) 14/11/05 Strensham Hill Version 5.0 Page 22 have dates recorded on the medication administration record. The refridgerator used for the storage of medicines must have the temperature maintained at a safe level. The complaints policy must be amended to include contact details of the CSCI local office, it must be available to residents and their representatives. All residents accommodation including bathing and toileting facilities must be individually risk assessed and regularly reviewed. The manager must ensure the rooms are audited against the National Minimum Standards with regard to required furniture and fittings, any shortfalls must be either addressed or alternative arrangements made. The shortfalls must be included within the homes statement of purpose. 5 YA22 22(7) 31/12/05 6 YA26 13(4)(a)(c) 31/01/06 7 YA30 Previous timescale of 31/12/04 not met, this requirement is carried forward. 13(3), The kitchen walls must be 13(4), repainted as they are in places 23(2)(b)(d) worn and painted surfaces are chipped. Previous timescales of 31/01/05 not met requirements are carried forward. The staff rota must be reviewed to ensure that: 1. The manager is allocated adequate time to complete his duties. DS0000016874.V258125.R01.S.doc 31/12/05 8 YA33 18(1)(a) 18(2) 12(1), 13(4)(c) 14/11/05 Strensham Hill Version 5.0 Page 23 9 YA35 18(1)(c)(i) 10 11 YA36 YA39 18(2) 24, 26 2. At all times adequate numbers of staff are on duty to support residents with their needs and for all staff and managers to receive supervision. 3. Staffing levels are reviewed should the amount of residents’ increase or the needs of residents change. Staff must receive service 31/03/06 specific training including Mental Health Awareness and or Mental Illness. The manager must receive 31/12/05 regular supervision and records must be available. 31/03/06 The registered provider must make monthly visits, and reports of such visits must be made available at the home. A continuous self monitoring tool, using an objective, consistently obtained and reviewed and verifiable method (preferably professionally recognised quality assurance system) must be introduced. It must involve residents and have an internal audit which takes place at least annually. Previous timescale of 31/03/05 not met requirements are carried forward. A staff risk assessment must be completed and include such details as lone working and escort duties. Following the homes decision to keep the front door open, a risk assessment for the security of the building must be completed. Previous timescale of 12 YA42 13(4) (a)(b)(c), 12(1) 31/12/05 Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 Page 24 31/12/04 not met, this requirement is carried forward. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA8 Good Practice Recommendations The organisation should consider involving residents in the recruitment processes for new staff. Not assessed and is carried forward. The organisation should consider purchasing a computer for the home to assist residents to develop information technology skills. Not assessed and is carried. The home should produce a policy for smoking in the home Not assessed and is carried forward. It is recommended that healthcare records are maintained separate to daily records to facilitate quick and relevant access to information. The manager should consider redecorating the bathroom, utilising soft furnishings, lighting and décor to elicit a relaxing experience whilst bathing. Not assessed and is carried forward. There should be a business and financial plan for the home and the service, available to CSCI for inspection and reviewed annually. Not assessed and is carried forward. 2 YA12 3 4 5 YA18 YA19 YA27 6 YA43 Strensham Hill DS0000016874.V258125.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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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