Inspection on 26/04/05 for The Close

This inspection was carried out on 26th April 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 Close 18/09/08

The Close 01/11/07

The Close 05/12/06

The Close 12/06/06

The Close 03/10/05

The Close 17/01/05

The Close 07/07/04

The Close 24/02/04

Similar services:

Fairfields Country Rest Home

Fairfax House

Claremont Nursing Home

Doveridge Care Home

Dunmore

Chatsworth

Dunraven Lodge

Eastleigh Care Homes, South Molton

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Close (The) Littleton Panell Devizes Wiltshire SN10 4ES Lead Inspector Jacqui Burvill Unannounced 26th 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 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. Close (The) D51_S28334_TheClose_V223159_250405_stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Close (The) Address Littleton Panell Devizes Wiltshire SN10 4ES 01380 812304 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) Mr John Roche Mrs Aurora Roche Care Home 12 Category(ies) of 1 DE Dementia registration, with number 12 DE(E) Demntia - over 65 of places Close (The) D51_S28334_TheClose_V223159_250405_stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 One named service user under the age of 65 in the category (DE) Dementia, until 22 November 2004 as requested in the application dated 28 October 2004. This condition will be removed as it is not longer applicable. Date of last inspection 17th January 2005 Brief Description of the Service: The Close is a privately operated care home. It provides personal care and accomodation for up to 12 people with dementia. One of the owners also manages the home. They live on site. Both of the owners have close invlovement with all aspects of care on a daily basis. The home is situated in village of Littleton Panell. There are local shops, pubs and GP surgery near by. The Close is a detached property set in its own grounds. It has been extended in the past. Service users accomodation is on ground and first floor. There is a passenger lift. There are eight single bedrooms and two shared bedrooms. None of these rooms are ensuite. All have hand washbasins. Commodes are provided in all bedrooms. There are three bathrooms, one of which has a hoist. There are six toilets for service users. There are always at least two staff on duty during the day. There is always one waking night staff on duty. Because owners live in the building, they are ususally available if needed. Close (The) D51_S28334_TheClose_V223159_250405_stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day, taking 6 hours. The inspector spoke to three staff on duty, the owner/manager and four service users. Not all of the service users are able to comment directly on the care they receive. The inspector used a book with pictures to help with communication. The inspector sampled the meal at lunchtime, and looked at the following records; care plans, daily notes and risk assessments, medication and medication records, accident and incident records, the staff rota, the records relating to one staff member, staff training records, activity records, fire records and policies and procedures. There was a partial tour of the premises. What the service does well: What has improved since the last inspection? What they could do better: The owner/manager has not completed the requirements or recommendations from the last inspection. This is disappointing as the owners were met with in the CSCI office in October 2004 to explain the reasons why they had not completed the requirements and recommendations from previous inspections. At this meeting, there was some evidence to suggest that work would take Close (The) D51_S28334_TheClose_V223159_250405_stage4.doc Version 1.30 Page 6 place on improving the home and the structures within it, such as staff training records. This has an impact on the lives of service users who may not receive the most up to date care and practice that should be available in a specialised service. There must be regular staff training, staff meetings and supervisions. There is occasionally conflicting care advice from the owners to the care staff about the service users, there should be consistent advice based on current best practice. The statement of purpose talks about 24 hour care mapping and person centred care, but there is little to no evidence of this training in the home, nor could some of the staff on duty clearly describe to the inspector the range of needs for service users with dementia. The owner/ manager immediately explained that she had not been able to meet any of the requirements and recommendations from the last inspection, due to staffing difficulties. She had just worked as the waking night staff member. This practice was to have stopped as a new staff member had been recruited to this post. The person had recently left. This did not explain the lack of action as the last inspection took place on 17th January 2005 and the staff member left on 3rd April 2005. There are grave concerns among the staff team about the level of hours that the owner/manager is working. This is a specialised service for people with dementia and there is very little evidence of the specialised training and support for staff in managing the care and emotional needs of this vulnerable group of service users. The environment does not reflect the current guidance in terms of signs and support for service users in making their way around the home safely and easily. There is no training for the staff responsible for providing the activities, and this specialised area is not up to date with current guidance. 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. Close (The) D51_S28334_TheClose_V223159_250405_stage4.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 Close (The) D51_S28334_TheClose_V223159_250405_stage4.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) No outcomes were assessed on this occasion, as no new service users had moved into the home since the last inspection. EVIDENCE: Close (The) D51_S28334_TheClose_V223159_250405_stage4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 The service users care needs are not being met, through a lack of clear and comprehensive information in the care plans and risk assessments leads service users to be potentially at risk. Medication practices and advice have not been followed up and put into place that leaves service users at serious risk. EVIDENCE: Four service users records were case tracked. The inspector spoke at length with two of these service users. Assessment forms are in place, following admission, with other relevant details, from any previous placements. The care plans are written under headings of interventions, problems, goals and evaluations. The end result is they look messy, with additions having been included. Often, this is not clearly linked to change in medication, or to the changing needs for example; following falls, there is no evidence that risk assessments have been reviewed. Incidents such as behaviour as a result of care needs is described in the daily notes, but not described as an intervention in the care plan, nor how this need could be met. Risk assessments do not cover all aspects of the behaviour the inspector observed during the inspection, such as walking through the kitchen. This Close (The) D51_S28334_TheClose_V223159_250405_stage4.doc Version 1.30 Page 10 occurred at times when the meal was being prepared and the cooker was hot. There is a risk top service users when there is another route through to the small dining room and the conservatory. Care plans have been reviewed, but this is not consistent, as some have been reviewed monthly, and others have not. The community pharmacist has inspected twice since the last inspection. On the second visit, she noted that ‘staff are having training organised’. There is no evidence to support this. There are additional handwritten notes regarding which medication should not be crushed. No up to date changes have been recorded on the relevant care plan. Handwritten entries on the medication administration sheet are not being countersigned by another member of staff, this was part of a requirement at the last inspection, where the CSCI pharmacy inspector spent time with the owner explaining medication systems. There are inconsistencies with the accident forms. Staff are required to complete two types, this may lead to some confusion, and sometimes the forms are duplicated and sometimes they are not. Staff were observed supporting service users getting up and down out of chairs, respecting privacy and dignity when supporting them going to the toilet and when eating meals. Close (The) D51_S28334_TheClose_V223159_250405_stage4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15 The activity record although inconsistently kept, does show a range of activities and which service users took part. There are frequent visitors to the home. Service users appear to enjoy their meals. EVIDENCE: Service users were sat in the sitting room for the majority of the inspection. Some service users were seen walking independently to other parts of the home. Staff were observed to either support them in returning to the sitting room, or to ask them what they wanted. One service user wanted to go for a walk outside, but this did not happen. Staff tried to engage service users in some activity in the morning, but most service users were very sleepy. Staff commented that this was unusual. Service users were not able to explain what their preferences were. There is an activity record, which has not been kept consistently. This is an important record, as it shows the level of activity in the home and how each service user is involved and how this is relevant to their needs and interests. Staff explained that there are more activities in the afternoon and service users did appear more alert at this time. Close (The) D51_S28334_TheClose_V223159_250405_stage4.doc Version 1.30 Page 12 Service users spoke about their families. Although none were in the home at the time of the inspection, there are frequent visitors as the record of visitors in service users’ daily notes shows. The meal was sampled and was tasty and appetising. Service users had good appetites. There is one choice for the main meal and service users do not appear to be unsatisfied with this. There are two courses and drinks are served to the service users at the table. The menu shows that there is a two course evening meal. No cook has been appointed, as the owner /manager is cooking homemade food for staff to re – heat and serve. Close (The) D51_S28334_TheClose_V223159_250405_stage4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 The complaints procedure has been used which suggests that families are familiar with it and that the owner/manager takes all complaints seriously. Staff are not fully aware of the signs and symptoms of abuse or how to report to other authorities. There is a risk that service users could be abused as staff are not confident in identifying or reporting abuse. EVIDENCE: There is a bound record book of complaints. This shows that relatives concerns are followed up, with details of action taken. The policy and procedure has not been changed following the recommendation at the last inspection. This is to include timescales to say when the complaint will be dealt with. Staff were asked to describe what they would do if they saw signs and symptoms of abuse. Staff could name the ‘No Secrets’ booklet, but were not familiar with the procedure. There was also some confusion about what abuse was. Staff had been told that leaning over a resident was abuse. Staff need to understand what the difference is between abuse and poor practice and how this can lead to abusive situations. Close (The) D51_S28334_TheClose_V223159_250405_stage4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 21, 22, 25, 26 The service users movements around the home can place them at risk. This has not been properly assessed for those individuals. There is not enough signage around the home that is appropriate for service users with dementia. There are sufficient toilets for service users near communal areas. Commodes are used in bedrooms. Due to the lack of hygiene around the use of toilets, there may be a lack of infection prevention and control. There is no specialised equipment in use in the home, despite the visit of an occupational therapist. The home has not used the current guidance available to ensure that service users are in a safe and comfortable environment. EVIDENCE: The sitting room has single chairs and two dining tables, where service users eat their meals. There are word signs on some doors, such as ‘kitchen’, ‘toilet’ ‘lounge’. The signage could be improved by including a picture, as this may be more relevant to the communication needs of the service users. There is a toilet for service users next to the lounge and there was no soap, hand wash wipes, or towel available in the toilet. There is a risk to service users from cross contamination. Close (The) D51_S28334_TheClose_V223159_250405_stage4.doc Version 1.30 Page 15 All of the bathrooms were clean and tidy on the day of inspection. One of the service users would like a single room, but at this time, there is none available. There mostly double rooms, which are divided by furniture and personal possessions. Service users were observed walking to the conservatory area through the kitchen, at times when the cooker was hot and at other times, this presents a risk as service users may be burnt or scalded. There is a conservatory beyond the kitchen as well as a small office/ dining room. There are three steps leading up to the conservatory and there is a banister. Service users were observed using the stairs very unsteadily. There were no accompanying risk assessments about these movements in the home in these service user’s care plans. The conservatory area has been re organised with cane style seating and this makes a more relaxed area for service users to sit in. Close (The) D51_S28334_TheClose_V223159_250405_stage4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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, 30 Lack of staff training means that the philosophy of the care in the home is not being shared or developed and this could have a detrimental effect on service users, as they may not receive the most up to date practice that would benefit them. The home is not being effectively managed, as the owner /manager has so many other duties and roles to carry out. EVIDENCE: The owner/ manager explained that the night staff member employed last year had recently left. As a result, the owner/ manager is working 4 nights a week. The rota showed a number of changes, where staff have been asked to work extra hours. It is not clear if this has been included in their employment contracts, as the hours worked had been left blank, or whether the European Working Time Directive has been taken into consideration. At the time of the inspection, the owner/manager had worked all night and was discussing a new NVQ training package with a staff member. She had worked three nights in a row. This will continue until another night staff member can be found; this may involve recruiting a staff member from abroad, which will take time. During this time, the manager and the staff team will be working additional hours. The owner/ manager stated there has been no response to the two adverts for a cook. As a result, the owner /manager does these duties as well. Close (The) D51_S28334_TheClose_V223159_250405_stage4.doc Version 1.30 Page 17 It is difficult to see how the home can be effectively managed while the owner/ manager has so many other duties to attend to. There is a direct link between this role and the lack of attention to requirements and recommendations. In the staff training file, there was evidence that the owner/ manager attended a course in Memory Rehabilitation in Dementia training on 6th April 2005. There were notes about discussions with staff members relating to service users conditions on 4th March 2005 and other notes dated November 2004. There are printouts of material related to person centred care, but there is no evidence that staff have received this formally or informally. This is at the heart of care in the home, as it is described in the statement of purpose. There is a statement in the policy and procedure file that ‘all staff are encouraged to do the necessary training, or attend in house training, covering all the different regulations and understand all of the implications. All staff should know how to do a risk assessment and the different measures to control risk.’ There is little to no evidence to support the home’s philosophy. Close (The) D51_S28334_TheClose_V223159_250405_stage4.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, 33, 36, 38 There is a serious lack of attention to management tasks and duties by the registered manager, who is not doing any relevant management qualification. The current practice regarding dementia care is not being used to benefit the service users. There is no evidence that the practice described in the home’s statement of purpose is being carried out. Staff are not being supervised, nor having regular staff meetings. This leads to poor development of the staff team which reflects onto the level of care for the service users. The policies and procedures do not reflect current best practice, nor enable staff to support service users safely. COSHH guidance is not fully detailed, which will have an adverse effect on service users or staff. EVIDENCE: The formal accident records and the other accident/ incident records were looked at and cross- referenced. Sometimes, the informal record is used in Close (The) D51_S28334_TheClose_V223159_250405_stage4.doc Version 1.30 Page 19 place of the formal record, as at the time, the nature of the injury is not apparent. There is an emergency procedure for staff to follow. Staff were observed using special equipment to support a service user when moving. There is no evidence that the COSHH file has been updated with more detailed safety data information as recommended at the last inspection. This is relevant as there is no detail of how to deal with an emergency or adverse reaction to a product. Staff were seen wearing protective aprons at all times. It is not clear if these aprons were changed every time they assisted a person to the toilet and then returned to other duties, as during observation, there appeared to be no changes made. The code of practice regarding moving and handling needs to be updated, as this is dated 2002 and may not reflect current best practice. The principles include the words ‘care must be taken and pushing and pulling to be kept to a minimum.’ Following this guidance may result in injuries to service users and staff. Staff have had fire safety training in the last quarter and this has also been signed by staff. 3 staff have attended fire drills between January and March 2005. All other regular fire safety checks have been carried out. Close (The) D51_S28334_TheClose_V223159_250405_stage4.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 x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x 2 2 x x 2 1 STAFFING Standard No Score 27 1 28 x 29 x 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 1 x 2 2 x 1 1 2 Close (The) D51_S28334_TheClose_V223159_250405_stage4.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 OP7 Regulation 18 (1) (a) Requirement There must be evidence that all staff have received specialist training in Dementia and related conditons. (Carried forward from last inspection with a deadline of 30th June 2005)Continued noncompliance will result in enforcement action. Care plans must describe the range of care needs for service users. This must include emotional and behavioural support Risk assessments must contain range of risks that affect service users, such as any specific activity they would like to take part in. The registered person must ensure that medicines are administered safely. Any changes to the normal method of medication must be checked with the prescriber and noted in the service user plan. (Carried forward from last inspection. Met in part, but insufficient evidence on the service user plan, as well as evidence form the prescriber) All staff must receive training in basic knowledge of how Timescale for action 30th August 2005 2. OP7 15 (b) (2) 30th June 2005 3. OP7 13 (4) (b) 30th June 2005 4. OP9 13(2) 30th June 2005 5. OP9 13(2) 30th August 2005 Page 22 Close (The) D51_S28334_TheClose_V223159_250405_stage4.doc Version 1.30 6. OP9 13(2) 7. OP18 13(6) 8. OP19 13 (4) (a) 9. OP29 19(b) 10. OP30 17 (2) Schedule 4.6. (f) medicines are used and how to recognise and deal with problems in their use, in additon to training needed in the use of NOMAD systems and the homes procedures. (Carried forward from last inspection) Continued non - compliance will result in enforcement action. Where handwritten entries are made on the medication administration sheet, this must be checked and signed by two staff members. All staff must receive training in awarenss of abuse and Wiltshire No Secrets guidance. Evidence of this trainignmust be kept. (Carried forward from the last inspection with a deadline of 30th June 2005) Continued non compliance will result in enforcement action. Individual service users must have risk assessments when they walk around home independently. This must take into consideration the risks from walking through the kitchen and walking to the conservatory. All staff must have a completedCRB check or a POVA First check prior to employment being confirmed. (Carried forward from last inspection) Continued non - compliance will result in enforcement action. Staff employed since the last inspection, must complete an induction that can be evidenced. This induction must be in house as well as a foundation induction linked to TOPPS (Carried forward from the last inspection) Continued non compliance will result in enforcement action. 30th May 2005 and from now on. 30th August 2005 30th June 2005 30th May 2005 and from now on 30th June 2005 and from now on. Close (The) D51_S28334_TheClose_V223159_250405_stage4.doc Version 1.30 Page 23 11. OP33 24(2) The qulaity assurance process 30th June must be completed and a copy of 2005 analysis sent to the CSCI. (Carried forward from the last inspection) Continued non compliance will result in enforcement action. 12. 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. 3. 4. Refer to Standard OP7 OP12 OP12 OP15 Good Practice Recommendations Care plans should be reviewed monthly with evidence kept. (Carried forward from last inspection) Records on activities that service users have taken part in should be made consistently. Service users private diary entries should be held in a service users own file, rather than the folder with activity notes. The registered manager should consider employing cooks in the home, to alleviate some of the duties completed by the registered manager. (Carried forward from last inspection. This was a recommendation from inspection 12.7.04. Met in part, as the post has been advertised but not filled) The complaints procedure should include timescales complaints will be dealt with. (Carried forward from the last inspection.) An ocupational therapist report should be used to assess and recommend equipment that may benefit service users. An occupational therpaist visietd the home on 16/11/02. It is not clear what recommendations were made. Soap, towels and /or wipes be available in service users toilets at all times. Interviews be conducted in pairs and interview notes kept.( Carried forward from the last inspection.) The quality assurance process should include the views of health and social care workers who have contact with the home.( Carried forward from the last inspection) The COSHH file should contain the safety data details from manufacturers on the products in use in the home These Version 1.30 D51_S28334_TheClose_V223159_250405_stage4.doc Page 24 5. 6. OP16 OP22 7. 8. 9. 10. OP26 OP29 OP33 OP38 Close (The) can be obtained by calling the telephone number on the product. ( Carried forward from the last inspection) Close (The) D51_S28334_TheClose_V223159_250405_stage4.doc Version 1.30 Page 25 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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 Close (The) D51_S28334_TheClose_V223159_250405_stage4.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. 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!