Inspection on 30/06/05 for The Cedars

This inspection was carried out on 30th June 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 but made no statutory requirements on the home.

Other inspections for this house

The Cedars 30/06/09

The Cedars 22/03/07

The Cedars 16/05/06

The Cedars 03/11/05

The Cedars 05/01/05

The Cedars 01/07/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Sutton Lodge Nursing Home

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

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

CARE HOME ADULTS 18-65 The Cedars The Cedars (2-4) The Old Grove Surrey GU26 6BW Lead Inspector Susan McBriarty Unannounced 30 June 2005 10:00 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. The Cedars H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Cedars Address The Cedars (2-4), The Old Grove, Surrey, GU26 6BW 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) 01428 608726 Robinia Care - South Region Victoria Johnston CRH Care Home 14 Category(ies) of LD Learning Disability, 14 registration, with number PD Physical Disability, 14 of places The Cedars H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age range of the persons to be accommodated will be: 18-50 years. Date of last inspection 5th January 2005 Brief Description of the Service: The Cedars consist of three bungalows, numbered 2, 3 and 4, that provide care and accommodation for fourteen adults with a learning disability and a physical disability. Each of the bungalows provides single service user bedrooms and offers a communal lounge, two bathrooms or shower rooms, a large kitchen and a laundry room. A garden area has recently been landscaped and surrounds the three bungalows. A fence surrounds the garden area and this provides a safe environment for service users. Bungalow 2 provides accommodation for four service users, and also accommodates the office facility for the service. Bungalows 3 and 4 each provide accommodation for five service users. All bungalows are suitably equipped for wheelchair users. The Cedars H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken by two Regulation Inspectors, Ms S. McBriarty and Mr G. Cheney. This is the first inspection for 2005- 2006. The inspection formed part of the review of the services provided by Robinia South Limited in Surrey. The CSCI instigated the service review as concerns had been expressed regarding the provision of care and support services and the management of the finances of service users. The inspection therefore focussed on those areas. A report will be provided under separate cover to address any concerns and or issues raised by the review. A tour of the home took place and documents sampled included: the leisure and socialisation needs of the service users, Criminal Record Bureau checks on staff members, service users finances including bank accounts, medication administration records and storage. A number of requirements have been made and these are found at the end of this document. The inspectors would like to thank the manager and staff of the home for their help during the unannounced inspection. What the service does well: What has improved since the last inspection? Robinia South Limited have introduced new policies and procedures for the management of service users finances and managers were in the process of receiving the necessary training at the time of the inspection. The pathway to the laundry area had been cleaned and the improvement was noticeable, however the area will require regular cleaning to ensure it stays safe for staff and service users. The concerns regarding storage found at the last inspection had been resolved. The bed had been removed from the cupboard where medication is stored and the stepladder from another small cupboard. The Cedars H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 Page 6 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. The Cedars H58_s13588_The Cedars_v217348_300605_stage4.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 The Cedars H58_s13588_The Cedars_v217348_300605_stage4.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, 4, 5 The statement of purpose requires adjustment in order to enable prospective service users or their representatives to have the information they require to make an informed choice about where they live. The document had received some updating since the last inspection however further work is needed. Contracts or statements of terms and conditions are not in place for service users; this made it unclear as to what services are to be provided to some service users. Previous requirements have been made by the CSCI regarding the provision of contracts or statements of terms and conditions these requirements have not been met. Enforcement action will be taken if this requirement is not met. Prospective service users are able to visit the home for a trial visit. EVIDENCE: The statement of purpose states that the home meets The National Minimum Standards regarding the environment. However it needs to be made clear that it meets the requirement of those homes that were registered prior to The Care Standards Act 2003. The bedrooms do not have en-suite facilities as would be required post The Care Standards Act 2000. As the home provides for service users with complex needs it would help prospective service users and their representatives to make a decision about whether the home could meet their needs if the statement of purpose made clear what needs they were able The Cedars H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 Page 9 to meet. At present it states the home is for people with a learning disability or physical disability. The home is being provided with equipment to enable them to provide the statement of purpose and service user guide on audio compact disc. This would assist those service users who are not able to read or understand symbols but are able to understand plain English. Clear statements of terms and conditions for each service user are required, the terms and conditions must set out the terms and conditions in Standard 5 of The National Minimum Care Standards, Care Homes For Adults 18-65yrs 2003. The Cedars H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 Page 10 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, The care plans require updating in relation to activities. The difference between the information held on the care plans against the daily records may create confusion for staff and service users and uncertainty as to what to expect during the day. These differences were not able to show that service users were involved in the decision making regarding what they might prefer to do during the day. EVIDENCE: The care plans sampled showed what service users planned to do during the course of the day, however the daily notes did not reflect the plans. The daily notes did evidence that service users were doing something else however it was not made clear whether the changes were temporary, permanent or that the service user chose not to go to the day centre, or whether there was some other reason. The care plans require review to ensure the information regarding day activities is correct and the daily notes are required to note the reason for any change. The Cedars H58_s13588_The Cedars_v217348_300605_stage4.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, 16 The information held on service users files regarding access to activities requires updating. There were discrepancies that would be confusing to service users and staff. The home has two vehicles for use by the service users. EVIDENCE: The care plans sampled, though detailed, had discrepancies regarding the day activities planned for service users. The information held on the file had not been updated to show changes taking place. For example one service user was shown as attending the day centre on weekdays however the daily notes did not support this statement. The inspector and home manager checked individual cash belonging to service users and no discrepancies were found. A recent letter from Robinia’s head office stated that it was not Robinia Care’s policy to accept loans from one service user to another. There was no evidence to show that this was occurring at this home. The Cedars H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 Page 12 Robinia Care has recently reviewed and updated its financial polices and procedures and all home managers were expected to attend the training being provided to ensure they were fully aware of the changes. The review was to ensure that all staff members assisting service users with their finances kept accurate records and sought permission for expenditure over a set amount of money. Those service users who were able indicated that they enjoyed some of the activities provided and raised no concerns to the inspectors. A discussion was held about favourite bands and the type of music preferred. The home had been able to organise a number of trips to enable service users to see and hear bands of their choice. The Cedars H58_s13588_The Cedars_v217348_300605_stage4.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, 20 As previously noted the service users care plans with regard to activities required review. The lack of clarity regarding how the service users day care needs are met do not meet Standard 18.11(ii) of The National Minimum Standards for Young Adults age 18-65 years. Staff members need to be mindful of the language used when completing documents in order to remain respectful of the individual. Further consideration needs to be given to the storage of medication within the home as unexpected changes in the prescribing of controlled medication may lead to a delay in being able to provide the necessary medication. EVIDENCE: Those service users spoken to raised no concerns regarding the support provided and the relationship between staff and service users appeared warm and friendly. However, the daily notes showed that some staff require additional information or training in order to cease the use of language that may be seen as disrespectful or age inappropriate. For example; ‘has been good today’ or ‘attitude becoming unpleasant’. In addition there were notices in the home informing staff of the particular needs of specified service users these must be removed. The information is personal to the specified service users and may be read by anyone visiting the home is a breach of their privacy and dignity. The Cedars H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 Page 14 Standard 18.11 sets out the need to ensure that the work record notes the preferred routine of the service user and their likes and dislikes. The difference between the care plans and the daily records of the those files sampled do not enable the home to fully evidence that they are meeting the service users needs regarding the provision of day activities. The staff members need to ensure that they record in full why the service user is not attending any planned activity. The home does not have a controlled medication cabinet available for use. Whilst none of the present service users are prescribed controlled medication delays may take place if they were. The home would not be able to accept a completed prescription, as they do not have the ability to store the medication. Alternative arrangements would have to be made as an interim measure. It is recommended that a controlled drug cabinet be provided within the home. Each service has their own container for their medication held within the medication cupboard, however the storing of internal (oral) and external medications in the same container must cease. The separation of oral and external medications will reduce the possibility of errors being made. Any notices containing personal information regarding any of the service users in any of the houses must be removed and information relayed to the staff in an alternative way. The Cedars H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 Page 15 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) These standards were not assessed during this inspection. EVIDENCE: The Cedars H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 Page 16 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, 25, 26, 27, 28, 29, 30 While individual service user bedrooms had been personalised; further work is required to ensure that all the equipment needed to safeguard service users and staff is provided. Some minor repair work is required to ensure that the environment can be kept clean and hygienic for service users and staff members. EVIDENCE: All the service users bedrooms were seen during this inspection, each had been personalised and reflected the interests of the service users and their families. Photographs of events and family members were also seen. A number of the fire door closers require work, some closed very quickly and may cause injury if the service user or staff member were not quick enough to catch the door, others required pulling closed. A requirement has been made to ensure that all the door closures are reviewed to ensure they work effectively and safely. One specified person requires a hoist; this has been assessed as a need by the occupational therapist who was spoken to during the inspection and they are compiling a report to support the provision. The manager was also required to The Cedars H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 Page 17 ensure that a risk assessment is in place for both the service user and staff members both whilst waiting for the hoist to be installed and once the hoist has been installed The bathrooms still contain communal shampoo and soap dispensers; the manager reported that they are no longer in use. The service users purchase their own toiletries and choose what they prefer to use. It has been recommended that the communal dispensers be removed and the area made good. In one of the bathrooms the ventilator was not working, this requires repair or replacement. It is required that the missing toilet seat be replaced. The manager reported that the staff had difficulty in using the showers when they had been fitted with ‘rings’ to ensure that the showerhead was able to drain fully. The rings made it difficult to use the shower effectively with service users. It was recommended that the manager discuss the problem with the water board in order to seek a safe but effective method of draining the water form the shower head when not in use. The laundry is now situated in a cabin outside of the home; the manager stated that staff members must not use the laundry after 11pm for safety reasons. However given the winter months and the early loss of light it was required that a risk assessment be completed. The risk assessment must include safe use of pathways and lighting levels. Staffing levels also require review to ensure that if a member of staff is out of the home that remaining staffing levels are able to meet the needs of the service users. The manager informed the inspectors that the sharp boxes did not have any start dates on them, however the boxes were in fact only used to store used razor blades and not clinical waste sharps. It is required that the home reviews the use of sharp boxes. The flooring in some areas of the home is splitting or the seals are peeling apart. This makes keeping those floors clean more difficult. It was required that all the flooring be reviewed and where required repaired or replaced. The home has reviewed its staffing provision and is awaiting the provision of two further sleep-in beds to complete this process. The inspectors were advised that the beds had been ordered, however a delivery date was not available. The ovens require deep cleaning and a date in July has been agreed by the home to complete this task. This will run along side the replacement of the front of the kitchen units, which is also taking place over the summer period. The Cedars H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 Page 18 Each unit of The Cedars will be completed separately in order that they can support each other regarding providing hot meals and drinks. Some of the liquid soap and paper towel dispensers were empty at the time of the inspection. The manager must ensure that they checked and refilled on a regular basis to ensure that all staff members can follow appropriate hygiene practice. The Cedars H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 Page 19 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, A recent staffing review has led to changes taking place regarding the staffing provision overnight. The home manager is aware of the needs of the service users and seeks any additional training necessary for the staff team. A review is required of those not employed by Robinia Care Limited but who are working at the home. Particular checks are required by The Care Homes Regulations 2001 to safeguard service users. Further work is required to ensure that Robinia Care Limited meets The Care Homes Regulations 2001 regarding their recruitment policy and practice. EVIDENCE: The Cedars will be providing two additional sleep-in staff as soon as the beds that have been ordered arrive. As yet the manager has not been given a delivery date. Staff work twelve hour shifts from 7am to 7pm, they are on duty for five days one week and two the next week in a rotating pattern. Cedars (2) has 2 day staff and one waking night and one sleep-in night. Cedars (3) has 2 day staff, one working 7 to 10 and the home will have two sleep-in staff when the bed is provided. Cedars (4) has two day staff, one waking night staff and one sleep-in member of staff. The Commission for Social Care inspection requires a date for the provision of the bed and additional staffing levels. The Cedars H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 Page 20 The manager informed the inspectors of the specialist training requested including autism, Prada-Willi Syndrome and Cornelia de Lang Syndrome. A number of people provide one to one support for a specified service user and attend the home in order to meet this need. It is required that any person who works at the home, even if they are not employed directly by the organisation, must receive satisfactory identity and Criminal Record Bureau checks and where there is a need for qualified personnel evidence of their qualifications. Requirements have been made previously regarding the keeping of all employment records and documents within the home. The inspectors requested the Criminal Record Bureau (CRB) checks for sampling. These had to be brought over from the nearby head office. However the inspectors were unable to check the documents as the information held by Robinia South Limited was not adequate. The full details of the CRB’s required to be kept by the organisation were not available. In a previous report Robinia Care had been informed that enforcement action may be taken if they do not comply with the regulation regarding CRB checks. Enforcement action is now being taken. The Cedars H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 Page 21 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) 41, 42 These standards were not assessed in full, however evidence found in other Standards are repeated here as they form part of the requirements in 41 and 42 of The National Minimum Standards Young Adults age 18-65 years. A further requirement was made regarding consistent recording of fridge and freezer temperatures to ensure the safe storage of food. An immediate requirement was made to ensure that service users are provided with separate beakers for their toothbrushes in order to maintain good hygiene practice. EVIDENCE: The activity plans require updating to ensure they reflect what actually occurs during the course of the day. It has been required that Robinia Care Limited ensure that the documents required regarding recruitment and selection of staff are accurate and held securely on site at the home. The Cedars H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 Page 22 It has been recommended in the inspection report that the manager contacts the water board to discuss the issues regarding the placement of showerheads. It has been required that the staff toilets be either locked or the chemicals placed in the staff toilets removed. A requirement has been made to ensure that the needs of a specified service user be reviewed to ensure that a hoist is provided to safeguard the service user and staff and that the pathway and external lighting to the laundry area be risk assessed to ensure that staff are safe when going to and from the facility. A number of requirements have been made to ensure the environment within the home is safe and can be kept clean. The recording of fridge and freezer temperatures is required to be more consistent, where the temperature has not been taken the reason for this must be recorded. It was found that some service users toothbrushes were being held in the same beaker. An immediate requirement was made to ensure that any risk to the health of service users was minimised. The Cedars H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 Page 23 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 x x 3 2 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 3 3 3 2 2 Standard No 11 12 13 14 15 16 17 x 2 x x x 2 x Standard No 31 32 33 34 35 36 Score x x x 1 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Cedars Score 2 x 2 x Standard No 37 38 39 40 41 42 43 Score x x x x 1 2 x H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 Page 24 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, 8 Regulation 4(1)(a)(b) (c) Schedule 1 (2) Requirement The registered person must ensure that an updated Statement of Purpose is available, the document must be kept under review. Timescales of 15/10/04 and 11/03/05 have not been met. Enforcement action will be taken if this timescale is not met. The registered person must ensure that service users are provided with a statement of terms and conditions and to review any that are in place to ensure they contain all the information required in Standard 5 of The National Minimum Standards. Timescales of 01/11/04 and 11/03/05 have not been met. Enforcement action will be taken if this timescale is not met. The registered person must ensure that the service users care plans with particular reference to activities are updated with service users, where this is appropriate. That documents including daily notes are accurate and kept updated. Timescale for action 31st August 2005 2. 5 5(1)(b)(c) 31th August 2005 3. 6,7,12 15 (1)(2)(a) (b)(c)(d) 31st July 2005 The Cedars H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 Page 25 4. 18 18(1)(c) (i) 5. 20 13(2) 6. 24 13(4)(a) 7. 8. 9. 24 24 24 13(4)(a) 13(4)(a) (c) 13(4)(a) (b)(c) 10. 24 13(4)(a) 11. 24 13(4)( c) 12. 24 13(4)(a)( b) 13(4)(a) (c) 13(4)(c ) 13. 24 14. 29 The registered person must ensure that staff are trained to use sensitive, respectful and age appropriate language when completing any documentation on behalf of or regarding service users and notices in communal spaces must be removed The registered person must ensure that oral and external medications are stored seperately. The registered person must risk assess the pathway and lighting to the laundry area to ensure the area is safe for staff and service users. The registered person must ensure that the vent in the bathroom is working effectively. The registered person must ensure that the specified toilet seat is replaced. The registered person must liaise with the appropriate specialist service with regard to the showerheads and ensure any recommendations are met. The registered person must ensure that the flooring in specified areas is repaired or replaced. The registered person must ensure that refridgerator and freezer temperatures are consistently recorded and where this is not possible the reason. The registered person must review the use of sharp boxes for the storage of used razor blades. The registered person must ensure that all fire doors are working correctly and safely and that they are checked regularly. The registered person must review the provision of a hoist to a specified service user in light of 31st July 2005 31st July 2005. 31st July 2005 31st July 2005 1st July 2005 31st July 2005 31st August 2005 1st July 2005 1st July 2005 31st July 2005 1st July 2005 Page 26 The Cedars H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 15. 30 13(4)(b ) 16. 34 12(1)(a), 13(4)(6) 17. 42 13(3)(4) (b) 18. 42 13(3)(a) the occupational therapist report. The registered person must ensure that liquid soap and paper towels are available at all times. The registered person must ensure that all staff receive a CRB check and do not work unsupervised until such times as a satisfactory disclosure is received. Previous timescales of15/10/04 and 01/02/05 have not been met. This is already subject to a statutory enforcement notice.. The registered person must ensure that all service users are provided with an individual beaker in which to store their toothbrush. The registered person must ensure that the staff toilets remain locked or the chemicals are removed. 1st July 2005 28th August 2005 16th June 2005 Immediate. 16th June 2005 Immediate. 19. 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 20 24 Good Practice Recommendations It is strongly recommended that the registered person provide a controlled medication cabinet within each unit of the home. It is recommended that the unused soap and shampoo dispensers in the bathrooms are removed and the area made good. The Cedars H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 Page 27 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 The Cedars H58_s13588_The Cedars_v217348_300605_stage4.doc Version 1.30 Page 28 - 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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