Inspection on 27/04/05 for Strensham Hill

This inspection was carried out on 27th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 11 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 12/10/05

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 B13 8AG Lead Inspector Sean Devine Unannounced 27 April 2005 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Strensham Hill Address 1 Strensham Hill Moseley Birmingham B13 8AG 0121 442 4580 0121 456 3625 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) Servol Mark Daniels Care Home 8 Category(ies) of Younger Adults, Mental Disorder registration, with number of places Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents must be aged under 65 years. 2. That the home can care for named service user over 65 years for reason of Mental disorder 1 MD(E). 3. That the service user will have regular reviews to ensure that the home can continue to meet individual care needs.. Date of last inspection 11 November 2004 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 AfroCaribbean residents. Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection has been conducted by one inspector on an unannounced basis. At the time of inspection one resident was at home, two residents were away on leave and two were at day centres. The inspector was able to have a comprehensive discussion with the resident. The manager was available at the home, he had worked at the home the previous night to cover a “sleeping in” night duty due to a support worker being absent. Records in relation to care being provided and the health and safety practices of the home were seen. Support staff and the manager were observed whilst in the course of their duties including whilst working on a one to one basis with the resident. The home has made very little progress in improving the service for residents as identified at the last inspection. The majority of requirements from that inspection have been carried forward to this inspection as not met. Details of some immediate requirements were left in the home. What the service does well: What has improved since the last inspection? The home has improved the risk assessment process to ensure that areas of concern for residents have adequate plans to reduce the level of risk. As part of this process staff have undertaken training including protecting residents from abuse and increasing their knowledge of safe handling of medicines. Infection control measures such as providing good hand washing facilities have been implemented. The home has reviewed and updated residents contracts Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 Page 6 to include all details of the terms and conditions of residency which ensures residents have all important information. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 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 standard(s) 1,2,4 The home does not provide adequate information to prospective residents to enable them to make an informed choice and does not fully complete a preadmission assessment with prospective residents which would identify all possible areas of support needed. EVIDENCE: The home does not have a statement of purpose that fully describes the service and resources available at the home. The manager confirmed that amendments had been completed in draft form. This needs to include information in relation the fixtures and fittings that are provided by the home in residents rooms. Sampled residents files included some pre-admission assessments, these had been completed by social workers under the Care Programming Approach and were informative. They also included a completed referral form, these were completed by social workers. The home confirmed that prospective residents do visit the home, however details of the visits are not recorded. Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 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 standard(s) 6,7,9 Residents’ individual plans do not reflect their assessed and known needs which impacts on the homes ability to meet residents needs. Residents are encouraged and supported to make decisions about their lives, which is included within relevant risk assessments, this supports their rights and freedom of choice. EVIDENCE: A written care plan for one resident was seen, it did not include plans for all areas of need as highlighted in the pre-admission documents such as the Care Programming Approach assessment and care plan and the referral form. The manager confirmed that all other care plans were similar and confirmed that they did not inform of the aim, actions and review. The inspector has made previous requirements for the care planning process to be improved and involve residents, this has not been addressed and as discussed with the manager an urgent improvement is needed. Residents confirmed that they are able to make decisions about their lives, for example; planning meals and shopping, when they need to see their doctor Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 Page 10 and when they wish to go out. Where the personal choices of residents indicate a risk a risk management plan is identified. Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 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 standard(s) 12,14,15,17 The individual lifestyles of the residents are met by the home, residents are assisted and supported to take part in the local community, use local amenities and maintain links with family and friends. The home does not adequately monitor the dietary intake of residents to ensure their well being. EVIDENCE: Residents confirmed that they are able to mix with other people including staff from the same or similar backgrounds and cultures, within the home and externally, such as at day centres. The residents confirmed that they are able to regularly access local shops, at the time of inspection a resident went out to the local chemist with staff. Residents also commented on using local parks, going on holidays and attending day centres. At the time of inspection one resident was on leave and staying with family and one had gone to visit parents, one resident confirmed that visitors are received frequently. One resident confirmed that staff ask about the weekly menu and help with shopping and then cooking the food. However this is not recorded. The home maintains a menu book, which records the meals eaten by residents. Many residents are very active and either buy their own lunches or have meals at Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 Page 12 the day centre. The food eaten by some residents was well recorded and reflected a healthy well balanced diet, it also reflected the cultural and medical needs of one resident, however many entries were seen as eating out and it was not clear how frequent and how nutritional the meals were for these few residents. Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 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 standard(s) 18,19,20 The personal and healthcare needs of residents are generally well met, Residents are not provided with a medication system that is safe and well recorded in order to meet their needs and provide appropriate levels of support. EVIDENCE: A resident commented about being happy with the approach of staff and the personal and care support offered although it was evident that more support was required. Residents were complimentary of staff who assist with hair care and informed the inspector they are able to see their doctor when needed and receive support from the district nurses when necessary. Daily records in relation to healthcare support are well maintained. The self-medication system for residents who take medicines home has not been risk assessed. The home retains copies of GP prescriptions and uses the copies to ensure that they receive exactly what has been prescribed. Recording needs to improve, gaps were seen on the medication administration records and the dates when medicines were received had not been recorded. All staff have recently attended a course run by the supplying chemist on Care of Medicines. Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 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 standard(s) 22,23 The homes’ practice in relation to managing complaints and protecting adults from abuse is adequate, however this must be supported by policies and procedures that support and guide residents and staff. EVIDENCE: The home has a Complaints policy that requires amendment; this has been a requirement of previous inspections and has not been addressed. The home has not received a formal complaint since November 2003, the manager and resident described how individual concerns that are not of a sensitive nature are often discussed in residents meetings. Staff have recently attended training on protecting adults from abuse, the new policy on protecting residents from abuse was not seen at this inspection. The home assists some residents to manage money. Accounts are detailed included all transactions, money spent by staff on behalf of residents is fully receipted and balances are correct. Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 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 standard(s) 24,30 The building in communal areas is generally well maintained to meet the needs individually and collectively of residents. Infection controls measures within the kitchen need to be improved, to promote the health and safety for residents and staff. EVIDENCE: The furnishings and fittings in communal areas are well maintained, minor repairs identified at the last inspection have not been fully addressed including repainting a bath panel and repainting the walls in the kitchen. The kitchen paint work is worn and chipped inhibiting effective cleaning. The temperatures of the freezers are not recorded. Food items in the fridge were clearly labelled and properly wrapped. Communal wash hand basins were sited in toilets and in the kitchen, they had liquid soap and paper towels available. The manager confirmed that staff have not completed infection control training, although an infection control policy is in place. Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34,36 Recruitment practices are not adequate to protect the safety of residents. Staff are not effectively monitored and supported by the management team ensuring their competencies and qualities promote positive outcomes for residents. EVIDENCE: Recent new employee files were sampled, the recruitment process included an application form, two written references and identity documents but no criminal records bureau disclosure or POVA check had been gained prior to appointment, both of which are required by regulation to protect residents. One new employee, commenced in post in December 2004 as a support worker has not received supervision, the diary identified the first supervision as due week commencing 2/5/2005. The manager confirmed that the requirement to increase the frequency of supervision to provide adequate ongoing support for all staff as identified at the last inspection had not been addressed. Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 Page 17 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39,42 The conduct and management of the home is inadequate, including little effective consultation with residents, their representatives, staff or stakeholders for their views and opinions. The manager is not appropriately qualified and safe working practices based upon good risk assessments are not in place to ensure residents and staff are safe. EVIDENCE: The manager although recently returned to work following a period of sickness absence has enrolled on the Registered Managers Award, he has confirmed that little progress has been made in achieving this award and plans to return to college to study the award shortly. The manager has a good understanding of the cultural and mental health needs of the residents, however as identified in standard 6 he must ensure that the care of residents is well planned. A requirement of the last inspection was to further develop a system of self audit in relation to the quality of the service provided, the manager confirmed that no progress has been made. Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 Page 18 The home has in place up to date records in relation to the testing, servicing and maintenance of the fire system, gas supply and portable electrical appliances. The five yearly test of the electrical supply / installation had expired. COSHH products used at the home have appropriate data sheets. The manager confirmed that the development of risk assessments pertaining to the premises, food, fire and staff has not been further developed. It was also clear that some staff have not received safe working practice training including recent fire safety. Fire drills are well attended by staff and residents and are frequent enough to provide knowledge and practice in relation to fire safety. Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 Page 19 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 2 2 x 2 x Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 1 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 2 Standard No 11 12 13 14 15 16 17 x 3 x 3 3 x 2 Standard No 31 32 33 34 35 36 Score x x x 2 x 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Strensham Hill Score 2 3 2 x Standard No 37 38 39 40 41 42 43 Score 1 x 2 x x 1 x v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 Page 20 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 1 Regulation 4,5 Requirement Timescale for action 31/07/05 2. 4 14(1c) 3. 6 15(1) 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. Visits to the home by prospective 31/07/05 residents must be fully recorded and information gathered used as part of the ongoing assessment of need. The home must revisit the care 31/05/05 planning process using the assessment documents and put in place plans with specific actions that staff take to support the residents within the following areas, mental health, physical health, personal and social care, aspirations and goals, lifestyles including jobs, training and education, and cultural needs. This must include detailed care plans for residents with specific health conditions such as Diabetes. Previous timescale of 31/12/04 not met, this requirement has Version 1.30 Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Page 21 been carried forward. 4. 11 15(1) Independent living skills including shopping, cooking, cleaning, laundry, social contacts and recreational activity must form part of an individual activity programme recorded within the written care plan. Previous timescales of 31/01/05 not met, this requirement is carried forward. The manager must revisit the assessment of residents and where identified as an individual goal or aspiration for the service user, put plans into action to support residents access in gaining appropriate jobs, training and education. Full documentation of this process is required. Previous timescales of 31/01/05 not met, this requirement is carried forward. Systems to monitor the eating and dietary intake of independent residents must be developed. The manager must ensure that all personal care of residents is regularly undertaken where a need is identified. All medicines received into the home must be fully recorded on the medicine administration records (MAR) including date received. Previous timescale of 31/12/04 not met, this requirement is carried forward. The manager must fully investigate gaps on the MAR and then take corrective actions. The homes complaints policy must be further amended to include the following: v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc 31/07/05 5. 12 14(1a) 15(1) 31/07/05 6. 17 16(2i) 31/07/05 7. 18 12(1a) 31/07/05 8. 20 13(2) 27/04/05 9. YA22 22 31/08/05 Strensham Hill Version 1.30 Page 22 · A commitment by the home to take complaints seriously must be added. · An assurance that the complainant or resident will not be victimised following a complaint. · The policy must be made available within the home, i.e. upon the notice board. Previous timescale of 31/01/05 not met, this requirement is carried forward. 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. Previous timescale of 31/12/04 not met, this requirement is carried forward. The panel on the side of the communal bath must be repainted or replaced as it is heavily scratched. Previous timescales of 31/12/04 not met, requirement is carried forward. Freezer temperatures must be taken daily and fully recorded. The kitchen walls must be repainted as they are in places worn and painted surfaces are chipped. Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 Page 23 10. YA26 13(4a&c) 31/08/05 11. YA27 23(2b) 13(4a-c) 31/08/05 12. YA30 13(3) 23(2b&d) 30/09/05 Previous timescales of 31/01/05 not met requirements are carried forward. All staff must receive training in relation to good infection control. Staff records must be available 31/08/05 at the home for inspection at all times, they must include: Evidence that staff are fit to carryout their duties. Previous timescale 31/12/04 not met requirement is carried forward. All staff must have a POVA and Criminal Records Bureau Disclosure completed prior to appointment. A training needs assessment for each member of staff must be completed. This must cross reference all mandatory, induction, foundation and NVQ training. All staff must receive relevant training. Previous timescale 31/03/05 not met requirement is carried forward. The frequency and content of staff supervisions must reflect the targets in the National Minimum Standards Previous timescale of 31/03/05 not met requirment is carried forward. 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, Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 Page 24 13. YA34 19 & 2(7) 14. YA35 18(1ci) 30/09/05 15. YA36 18(2) 31/08/05 16. YA39 24 & 26 31/08/05 consistently obtained and reviewed and verifiable method (preferably professionally recognised quality assurance system) must be introduced. It must involve service users and have an internal audit which takes place at least annually. Previous timescale of 31/03/05 not met requirements are carried forward. The accident policy must be 30/09/05 further developed to include: staff who provide support are first aid trained and informing the next of kin of the accident. Previous timescale of 31/12/04 not met requirement is carried forward. Completed entries in the Accident Book must be removed and filed in accordance with the Data Protection Act. 17. YA40 13(4c) 18. YA41 12(4a) 31/07/05 19. YA42 13(4a-c) 23(4d) Previous timescale of 31/12/04 not met requiremnt is carried forward. Risk assessments for the 31/08/05 premises (including managing infection control), food (including a hazard analysis), fire and staff are in need of further development. All risk assessments must be subject to review at least once every six months. 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 31/12/04 not met requirement is carried forward. All staff must receive at least Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 Page 25 twice each year training in fire safety and fire prevention. The five yearly certification of the electrical installation to confirm its safety must be made available. 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. Refer to Standard YA18 YA39 Good Practice Recommendations The home should produce a policy for smoking in the home Not assessed and is carried forward.. There should be an annual development plan for the home, based on a systematic cycle of planning-actionreview, reflecting aims and outcomes for service users. 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. The organisation should consider purchasing a computer for the home to assist service users to develop information technology skills. Not assessed and is carried. The organisation should consider involving service users in the recruitment processes for new staff. Not assessed and is carried forward. 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. 3. YA43 4. *RCN 5. YA8 6. YA27 Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection 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. Extracts may not be used or reproduced without the express permission of CSCI Strensham Hill v223991 e54 s16874 strensham hill 1 v223991 270405 stage 4.doc Version 1.30 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!