Inspection on 11/05/05 for Tandy Court

This inspection was carried out on 11th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Tandy Court 12/03/09

Tandy Court 04/10/07

Tandy Court 26/07/06

Tandy Court 07/12/05

Tandy Court 11/11/04

Tandy Court 15/07/04

Tandy Court 23/02/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Tandy Court Tandy Drive Maypole Birmingham B14 5DE Lead Inspector Ann Farrell Unannounced 11th May 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 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. Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Tandy Court Address Tandy Drive Maypole Birmingham B14 5DE 0121 430 8366 0121 430 7581 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) Anchor Trust Acting Manager Pat Jackson Care Home 40 Category(ies) of Dementia - over 65 years of age (40), registration, with number Mental Disorder, excluding learning disability or of places dementia - over 65 years of age (40), Old age, not falling within any other category (40), Physical disability over 65 years of age (40) Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to accommdates 40 adults over the age of 65 who are in need of care for reasons of old age, not falling within any other category OP (40), Physicially Disability over 65 years of age (40)(PD)(E), Dementia over 65 years of age (40)(DE)(E), and Mental Disorder over 65 years of age (40)(MD)(E). 2. Minimum staffing levels must be maintained to at least 4 care staff at all times during waking day. This must be increased at peak times in additon to the manager, deputy manager plus catering, ancilliary staff and activities coordator. 3. The automatic fire detection system is to be extended to the roof voids by April 2006. Date of last inspection 11th November 2004 Brief Description of the Service: Tandy Court is a two-storey purpose built home, which opened in 1985 and is situated in a quiet cul-de-sac in the south of Birminham. The home is situated close to shops, public house, post office and public transport. It provides accommodation to 40 residents in single bed-sits each with kitchen facilities. Thirty seven of the flats have en-suite facilities consisting of a bath or shower, toilet and hand basin. The baths within the flats have low-level access and may not be suitable for all residents. In addition, there are communal assisted bathing facilities situated throughout the home and a portable bath seat that may be used in the low-level access baths. Staff are available to provide assistance in any of the homes bathing facilities. Communal areas consist of one dining room on the ground floor, which looks out onto a patio area and this leads to the garden. Three lounges are spread across the two floors providing a choice of areas for people to sit in. There is limited parking to the front of the property. The home and gardens are generally well maintained. Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted on an unannounced basis over a full day commencing at 9.30am on 11th May 2005 by one inspector and the pharmacist inspector. The registered manager has taken up an alternative position with the organisation. The new manager and deputy were present for the duration of the inspection. During the inspection process the inspector toured the home, sampled residents files and other documentation. The managers, two members of staff six residents and two relatives who were visiting were spoken to. What the service does well: What has improved since the last inspection? There have been improvements in the environment with the addition of four flats that have en- suite facilities, a further assisted bathroom, a quiet room and some re-decoration in communal areas. It was also stated that a patio area is be developed to the side of the building in the near future Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 Page 6 Staff have worked hard with the medication and the pharmacist inspector found the medication to be of a good standard. The home has now got a full staff team, which will assist with consistency of care. The home has now employed an activities co-ordinator and the new chef manager has identified a need to review the menus for residents. 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. Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 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 standard(s) 3,4,5 The home has a suitable system in place for admitting residents into the home. However, the assessments and communication systems require development to ensure all staff are aware of residents needs. EVIDENCE: The home has information available for prospective residents and their representatives. On discussion with a resident who had recently moved into the home she stated she had received one and it was very useful. The home statement of purpose was not seen at this inspection. The home liaises with social workers who provide written assessments/care plans for residents who wish to enter the home. The home also invite prospective residents to the home enabling them to view the facilities, meet staff and other residents and partake in a meal. At this stage the home is also able to undertake an initial assessment to determine if they are able to meet residents needs. Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 Page 9 On admission to the home a pen sketch is drawn up, which is followed up with a further assessment and an individual lifestyle agreement (ILA) and there is a trial period of one month when a review is held with resident, staff and family. On inspection of the records relating to admission to the home the inspector did not see the pre admission assessment as they were filed separately. The pen sketch gave basic information and the assessment gave some further details, but generally they did not cover all areas of need or the areas outlined in the National Minimum Standards. Risk assessments had not been fully completed and there was no assessment in respect of mental health where residents suffered with dementia or a mental health condition. On discussion with the deputy manager she had a good knowledge of residents. On discussion with some members of staff it became apparent that they were not fully aware of certain areas. The home is registered to care for a variety of needs such as dementia and mental illness, but records indicate that many of the staff has not received training in this area. This area will need to be addressed as the home has a number of residents with these conditions and the staff will need the knowledge and skills in order to meet their needs. Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 There are systems in place to meet resident’s health needs, but the lack of comprehensive records, follow up and some deficiencies in knowledge cannot guarantee consistency of care given to residents. The home has installed clear comprehensive arrangements for medicine management to ensure resident’s needs are met. EVIDENCE: The home draws up an individual lifestyle agreement (ILA) for each resident following admission to the home outlining how the resident’s needs are to be met by staff. On inspection of a sample of records they were found to be rather basic and address physical needs. They were vague in areas, lacking detail and all needs had not been included in the plan of care. It was also noted that they had not be reviewed on a monthly basis and changes in treatment /care had not been included in the plan. When reviews had been undertaken at the end of the first month they were very brief giving no detail and some of the documents were not signed or dated. Daily records did not consistently indicate follow up to areas of concern. Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 Page 11 On talking to senior members of staff they demonstrated a satisfactory knowledge and were aware of needs and issues, but this is reliant on them always being available plus good verbal communication and memory. In order for a consistent approach in care to be afforded detailed care plans should be in place for all staff to access. Manual handling assessments had been completed, but details had not been included in the plan of care and other risks had not been identified or there was a lack of information in respect of how to minimise the risk. The home monitors resident’s nutritional status through regular weighing and screening. However, it was noted on one file that there was no indication of weight or BMI and another file indicated loss of weight and no action taken. Staff liaise with health professionals from the multidisciplinary team such as district nurses, social workers, CPN’s, continence adviser. Residents informed the inspector that they saw the chiropodist, optician and dentist when required. However, on inspection of records for residents who were unable to discuss this with the inspector it could not be demonstrated these health professionals saw these resident’s regularly. The home had a range of pressure relieving equipment. On inspection one resident had a pressure-relieving mattress, but it was not clear if a suitable cushion was in place. It was also noted that they had been admitted from hospital with a high waterlow score indicating that they were at risk of pressure sores. However, it was not until some time later when problems commenced that the home contacted the district nurses for advice. The staff will need to undertake some training in respect of tissue viability in order to equip them with the appropriate knowledge for the future. There is one resident in the home with a urinary catheter and the care plans did not indicate any care related to the catheter and some staff were rather vague in their responses. Training will be required in this area. The care staff responsible for medicine management had worked hard to improve this within the home to a safe standard. Systems had been installed to check the dispensed medication received into the home. Risk assessment for self-medication of medicines had taken place. Records were clear and concise and staff understood the clinical needs of residents. On discussion with resident’s they stated they were happy living in the home, found the staff helpful and kind and responded promptly to call bells. They confirmed they had keys to their flats, their privacy was observed to be respected and they were well presented. There is also a pay phone is available on the first floor and some have had telephones in their own flats. Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 There is a relaxed, friendly atmosphere in the home with flexible visiting and contact with the local community. The home had identified the need to make changes and improvements in respect of meals and activities and had commenced the process in order to meet resident’s needs and preferences. EVIDENCE: The home has recently employed an activities co-ordinator, which should prove to be of a significant benefit for residents as some stated they would appreciate more social activities. At the time of inspection there was an exercise class in progress and it was stated that special days such as V.E. day, St Georges Day, St Patrick’s Day and birthdays are celebrated. The hairdresser visits the home on a regular basis. Ministers of various religions visit the home regularly. Visiting is fairly flexible and residents have a choice of areas, including a new quiet lounge to receive visitors. This was evidenced at the time of inspection from discussion with a relative. They stated their mother was happy; the home is always clean when they visit and they are kept informed of any problems. Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 Page 13 On discussion with residents and staff it was stated that they are able to make choices about the times for getting up/going to bed, meals and how to spend their time. However, on inspection of records it was noted that there was an entry indicated that they had not actually been consulted about the regularity of bathing and this was discussed with the managers. Residents take their own furniture into the home enabling them to create a home from home environment, but the home does not maintain records of items brought in. Residents may continue to handle their own finances if they wish although assistance is available in the home. The home employs separate catering staff who provides three full meals per day, which includes a three-course lunch, snacks and supper are also available. On discussion with residents there was a mixed response in respect of the meals one resident’s stated “they keep you well fed and washed”. The inspector was informed that a new chef manager had recently taken up post and he was in the process of reviewing the menus and would discuss them with residents. Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Feedback from staff indicated a lack of knowledge in some of the procedures for the protection of residents. Residents and their relatives are confident that the home deals with complaints appropriately. EVIDENCE: The home has a complaints procedure displayed on the notice board and leaflets are available on entering the home. On discussion with residents they stated they had no complaints and would speak to the staff in charge if there were any problems. At the time of inspection there had been one compliant, which was investigated by the organisation and the Commission separately in respect of handling of mail and the homes response. The compliant was upheld and the home has addressed the issues. On discussion with staff some were not aware of the vulnerable adults procedure and the action to take in the event of an allegation of abuse. This will need to be addressed through training. Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,23,24,25,26 The standard of décor and furnishings in the home is good providing residents with a pleasant and homely environment to live. EVIDENCE: The home is a modern two-storey building, which is clean, odour free and well maintained. There is limited parking to the front with a patio area to the rear of the property and a large area of grass to the side of the property. At the time of visiting it was stated that another patio area is to be provided to the side of the building, as currently there are some uneven paving slabs and the area is not suitable for residents use. There is one dining room on the ground floor that in decorated and furnished to a good standard. There is a choice of three lounges, one of which has recently been decorated and refurbished to provide a quiet room. Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 Page 16 All flats are provided with locks and letterboxes to doors; they are carpeted and generally service users provide all their own furnishings, although furniture is available if required. All flats are singly occupied and meet the minimum size requirements. Each flat has an en-suite facility consisting of a toilet, wash hand basin, low-level bath or shower plus a small kitchen area. A sample of rooms were inspected and a number were found to be decorated to a good standard, comfortable and personalised. There are two rooms that still require re-decoration and one requires new flooring, which remains outstanding since the last inspection. Staff have a master key in the event of an emergency. Doors have appropriate locks and some rooms have lockable facilities. Flats are individually and naturally ventilated and windows are provided with restrainers. Radiators are of the low surface temperature type and water from hot water outlets is regulated. The home has a manger bath seat, which may be used in the low level en-suite bathrooms to enable easier access. In addition, there are assisted bathing facilities on each floor of the home. It was noted that one of the bathrooms did not have a call bell next to the toilet and bathing facility. Laundry facilities were appropriately sited with a washing machine with sluice cycle and segregated sluice facilities. At the time of inspection the laundry door was not locked when left unattended. Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 Adequate staffing levels are maintained to meet resident’s needs. The homes recruitment policies are adequate to ensure residents are protected, but evidence indicated they are not fully complied with. EVIDENCE: Staffing levels are maintained at one senior carer plus four carers on duty during the day. In addition there is a manager, deputy manager, catering, domestic, administration and maintenance staff employed. A small number of staff files were examined and were found to be generally satisfactory with the exception of one that had no application form and two of them had only one reference, one of which had not been signed and dated. Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,35,38 The home is managed in the interests of the residents and their health, safety and welfare is protected. EVIDENCE: At the time of inspection an acting manager had been in post for two days and was supported by the deputy manager. On discussion with staff some stated they had just met the new manager. They felt they got on well and found the deputy manager approachable. There was evidence that residents are consulted about aspects of the home through meetings and on discussion with a number of residents they stated they were happy, one stated “ It could not be better”. A sample of records was inspected in relation to maintenance and they were found to be of a generally good standard. There are two ceiling hoists and there was no evidence of servicing. The new manager stated that she would check this area. On touring the home it was noted that one residents door was propped open with a wedge. Fire doors should not be propped open. Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 Page 19 The home is in the process of updating training in respect of fire prevention, health and safety and back care. Senior staff have undertaken training in respect of first aid. However, some staff need to undertake training in respect of first aid, basic food hygiene and infection control. Also it was not clear if all staff had undertaken two fire drills in the last year. This will need to be followed up. Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 2 2 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION 2 3 2 x 3 2 3 2 STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 x x x x x x 2 Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 Page 21 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 Requirement The registered person must review and enhance the statement of purpose ensuring it provides sufficient detail and covers all areas outlined in the standards and regulations and provide a copy to the Commission. (This was not assessed and has been carried forward. ) The registered person should review the assessment process and ensure that a full assessment is undertaken for all residents covering the areas in standard 3 of the National Minimum Standards, include risk assessments and mental halth assessments where appropraite. Timescale of July 2003 not met. The registered person must ensure all staff undertake training in caring for people with dementia and mental helath disorders comensurate with their position in the home. The registered person must review communicaiton systems in the home to ensure all staff are awre of residents needs and how they are to be met. Timescale for action 30/9/05 2. 3 14 30/8/05 3. 4 18(1) 30/9/05 4. 4 10(1) 30/5/05 Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 Page 22 5. 7 15 6. 8 12(1) 7. 8 14 ! 8. 8 18(1) 9. 14 12(2)(3) 10. 14 17(2) Sch 4 11. 18 13(6) The registered person must ensure a care plan is drawn up for all service users that outlines in detail the action to be taken by staff to meet their needs. Care plans must be reviewed at least every month and updated where there are any changes in the residents condition. They must be signed and dated. Timescale of July 2003 not met. The registered person should review current systems and ensure arrangements are in place for service users with chronic diseases such as diabetes, asthma etc to receive regular medical checks. All residents should have opportunity to see chiropodist, dentist and optician on a regular basis and records must be retained in the home to demonstrate this. Timescale of November 2004 not met. The registered peson must ensure a nutritional assessement is undertaken for all residents and where any changes are noted appropriate action taken. The registered person must ensure that staff undertake training in respect of tissue viability, continence and the care of residents with catheters. The registered person must ensure that residents are consulted about aspects of care e.g. bathing. The registered person must keep a record of all furnishings brought into the home by service users. Timescale of July 2002 2003 not met. The registered person must ensure all staff underake training in respect of vulnerable adult procedures and are aware of 30/8/05 30/6/05 30/5/05 30/6/05 30/5/05 30/6/05 30/7/05 Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 Page 23 12. 21 23(2)(n) 13. 24 23(2)(m) 12(4)) 13(4)(a) 14. 26 15. 29 19 16. 38 23(4) 17. 18. 38 38 13(4) 16(2)(j) 19. 38 13(4)(c) 20. 38 23(4)(e) 21. 24 action to take in the event of an allegation of abuse.. The registered person must ensure a call bell is accessible to all toilet and bathing facilities in bathrooms. The registered person must provide lockable facilities in all flats. Timescale of November 2004 not met. The registered person must ensure the laundry door is kept locked at all times when not attended by a member of staff. The registered person must ensure a robust recruitment process to include full information about past employment and two satisfactory written references that are signed and dated.l The registered person must ensure fire doors are kept closed when not in use. If there is a need to keep them open they should be linked into the fire detection system. Timescale of November 2004 not met.. The registered person must follow up servicing details of ceiling hoists. The registered person msut ensure all staff undertake training in respect of basic food hygiene. The registered person must ensure all staff undertake training in respect of first aid and records are retained in the home. The registered person must ensure all staff undertake at least two fire drills each uear and records are retained in the home. The registered person should redecorate and replace flooring where required in the two flats 30/9/05 30/6/05 20/5/05 30/5/05 30/5/05 30/5/05 30/6/05 30/8/05 10/6/05 30/6/05 Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 Page 24 identified at the time of insepction. Timescale of July 2004 not met. 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 9 Good Practice Recommendations Staff shoul write protocols for occasional use medication Staff should install a facing page for each residents Medicine Administration Record (MAR) chart. Staff should obtain written consent for immunisations such and flu injections.. 2. Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection 1st Floor Ladywood House 45-56 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 Tandy Court E54 S16916 V225881 110505 Stage 4.doc Version 1.30 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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