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Inspection on 30/08/07 for The Firs And Hewlitt

Also see our care home review for The Firs And Hewlitt for more information

This inspection was carried out on 30th August 2007.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The homes` successfully provide services for a diverse range of service users and staff are well trained and motivated. Care plans are well maintained and ensure that standards of care are maintained. There is also a thorough admission process. Service users enjoy full support from local community health and learning disability services. Staff are courteous and were seen to treat service users with respect at all times. Service users are encouraged to retain control of their personal lives, where possible and as they wish. Staff are conversant with the processes designed to protect vulnerable adults against the risk of abuse. The premises and gardens are well maintained and provide a safe environment. The homes` are maintained to an adequate level of cleanliness. Staff stated that they benefited from good leadership and training. There are robust recruitment practices in the home which means that service users are in safe hands. There are a number of care management systems in operation that focus on the wellbeing, autonomy and independence of service users. Generally recording systems were good and provided evidence that safety procedures are being followed.

What has improved since the last inspection?

The Firs have been fortunate enough to recruit a new manager since the last inspection took place. The manager and staff have worked hard to improve medication practices. Auditing practices are now in place and on the day of this inspection there were no errors discovered on the medication recording sheets or in the storage and administration of medication. The current manager is in the process of applying to the CSCI for her registration. Staffing levels werechecked and confirmed as adequate to meet the needs of the current service users. The inspector was concerned that these two homes are still registered as one although there was clear evidence during the two inspection days that these homes are run independently of each other. Although this report combines the two inspections it was necessary to carry out these inspections on two separate days.

CARE HOME ADULTS 18-65 The Firs And Hewlitt Woodside Road Abbots Langley Watford Hertfordshire WD5 0HT Lead Inspector Julia Bradshaw Unannounced Inspection 30th August and 20 September 2007 10:00 th The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Firs And Hewlitt Address Woodside Road Abbots Langley Watford Hertfordshire WD5 0HT 01923 681157 01923 681157/8 hewlitt@lifeopportunitiestrust.co.uk tanners@lifeopportunitiestrust.co.uk www.lifeopportunitiestr Life Opportunities Trust Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Care Home 15 Category(ies) of Learning disability (15), Learning disability over registration, with number 65 years of age (15), Physical disability (15), of places Physical disability over 65 years of age (15) The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 5th December 2006 Brief Description of the Service: The Firs and Hewlitt is a home providing personal care and accommodation for fifteen adults with learning disabilities, some of whom also have a physical disability. The home is owned and managed by Life Opportunities Trust (LOT), which is a voluntary organisation. The Firs and Hewlitt is located on the outskirts of Abbots Langley, a short walk from a shopping precinct that includes a surgery, pharmacist, convenience store and a restaurant. A little further away is the village of Abbots Langley, which has shops, pubs and a library. There is a local bus service to the towns of Watford, St Albans and Hemel Hempstead. The home was opened in 1993 and consists of two purpose-built detached buildings that are accessed via a private drive. The Firs is a bungalow comprising a lounge, dinning room, kitchen, laundry room, seven bedrooms and two bathrooms, one with a shower and hoist and one small toilet. Hewlitt is a chalet style house, with a similar layout to the Firs, except that it has six bedrooms on the ground floor and two on the first floor, accessed by a stair lift. All the home’s bedrooms are single; none of the bedrooms have en-suite facilities. The home has a large, well maintained garden area. The home has a Service User’s Guide and Statement Of Purpose, which sets out information about the home and the services offered for prospective service users. Current charges are £860 per week (as at 30/08/07). Additional charges are made for hairdressing, personal toiletries and newspapers. Copies of the previous inspection report by the Commission for Social Care Inspection (CSCI) are available in the home. The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken by one inspector who was present at The Firs for a period of just over five hours and a visit to Hewlitt was carried out on the 20th September and took 4 hours. There were 6 service users in residence at the Firs and 5 people in Hewlitt whilst these inspections were carried out and in during the inspection at least nine spoke with the inspecting officer. In addition, a tour of both premises was undertaken, several of the staff on duty were spoken to with and all records were examined. The manager of The Firs was on duty but the manager for Hewlitt was on annual leave. These were positive inspections with the majority of standards being met. The atmosphere of the homes were calm and friendly. The staff work hard to maintain a homely environment for its service users. The homes have good systems in place for assessing service users needs and review their care plans regularly. What the service does well: What has improved since the last inspection? The Firs have been fortunate enough to recruit a new manager since the last inspection took place. The manager and staff have worked hard to improve medication practices. Auditing practices are now in place and on the day of this inspection there were no errors discovered on the medication recording sheets or in the storage and administration of medication. The current manager is in the process of applying to the CSCI for her registration. Staffing levels were The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 Page 6 checked and confirmed as adequate to meet the needs of the current service users. The inspector was concerned that these two homes are still registered as one although there was clear evidence during the two inspection days that these homes are run independently of each other. Although this report combines the two inspections it was necessary to carry out these inspections on two separate days. 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 summary of this inspection report can be made available in other formats on request. The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1-5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Information to people who may choose to use the service is available. Full assessments are carried out prior to the admission of an individual. EVIDENCE: The homes have in place both a statement of purpose and service user guide, which were both last updated in June 2006. Although both these documents give a detailed view of the services provided they should be produced in a format that is easily understood by both its current service users and prospective service users. The bulk of the current documentation has been produced only in the “written word”. Full assessments are carried out prior to the admission of an individual. All service users have a current contract in place and can be found in their personal file. The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6 –10. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents’ goals are identified and assessments detailed in their care plan. Risk have been identified and minimised where possible. Service users feel secure within the home and can be confident that staff would treat them with respect and promote their privacy. EVIDENCE: The care plans inspected have been further developed since the last inspection was carried out in December 2006. Detailed records of visits carried out by other professionals were recorded and up to date. The manager and staff are working hard to fully implement the person centred planning system. Individual notes and guidelines for the service users were observed within the home. The service users are supported within the care management and whole life reviews frameworks and reviews have been carried since the last key inspection took place. The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 Page 10 This ensures changing needs are continuously assessed and reviewed. Risk assessments are in place and include both individual assessments (epilepsy, risk of choking) and generic assessments. (Fire safety social outings, travelling in the minibus) These are detailed and contain all the required information. Activities and outings enjoyed by the service users determine that service users are supported to take risks as part of their every day lives. The manager must ensure that there is a written and up to date consent for using listening devices in individual service users rooms. Staff work with people to assist them to lead safe and enjoyable lives, consulting with them as appropriate, regarding decision making and offering guidance where needed. Positive interaction was observed between the staff and the service users living at both Firs and Hewlitt during this inspection, demonstrating a high level of respect and patience. Several positive comments were made during this inspection relating to the staff. “ Everyone is lovely here, they let me be do what I like and take me on holiday”. The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11 –17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Personal development opportunities are encouraged for all service users ensuring interactions with the outside community are encouraged. EVIDENCE: The service users have the opportunity for personal development. One service user was able to explain the day care opportunities available to them with the inspector. People are supported to access services within the community via the on site transport provided. Some service users living at Hewlitt attend two day centres within the local area and due to the aging group within both homes some service users have retired and are provided with daytime support at home by care staff. The homes support service users in accessing a range of activities outside of the home, which include, day trips to the coast and holidays, where appropriate. The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 Page 12 The homes encourage people to assist, where appropriate, with daily tasks and routines within the home. These include cooking, washing up and cleaning their own rooms. Menu planning is completed in conjunction with the service users. Meals are offered on a flexible basis. Daily routines promote independence for all service users, using a person centred approach at all times. Staff were observed to interact with the service users living at both Firs and Hewlitt and it was clear that mutual respect was held within the home for both staff and service users. The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18 –20. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users emotional and physical needs are being protected and met in a positive manner. EVIDENCE: All personal and health care support records were well maintained ensuring individual needs, choices and preferences are met at all times. All care provided is individual and tailored to each person, with service users needs, choices and preferences being promoted. A policy and procedure is in place to support the administration, storage and receipt of medicines. All staff receives training prior to being deemed competent to administer medication. The training is provided by Alliance and Boots pharmacy services. Good practice principles of medication administration were being used and witnessed as part of this inspection. The date of opening was recorded on all on blister pack and liquid medication. Staff were seen to be administering medication as per the home’s policy and guidelines. The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 Page 14 All files checked confirmed that the service users have regular health checks including, mental health out patient appointments and CPN visits. People living within both homes have complex physical and emotional needs and it was encouraging to see that all five care plans checked on the day of the inspection were produced and maintained to an excellent standard. The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 – 23. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Policies and procedures, provided in a format that can be readily understood by service users, are in place to protect them from abuse, neglect and selfharm. EVIDENCE: The home follows the Hertfordshire County Council Safeguarding Adults procedure and staff receive training in safeguarding, what it is, how it might be recognised and the appropriate action to take if it is. Documentation seen contains records of occasions when meetings have been held under the above policy in order to discuss how service users may be best protected from potentially abusive situations. There are a regular service user meetings held in addition to key worker review meetings, which allow opportunity for service users to make their concerns, if any, known within the home. A complaints procedure is in place and the service users confirmed that they would know who to go to if they wished to make a complaint. The complaints file was inspected and no complaints had been received, for either home. The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 –30. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Maintenance and housekeeping in these homes are adequate, however some areas within both homes appear tired and worn. EVIDENCE: There have been several areas of improvement since the last inspection was carried out. These include, new flooring in three bedrooms, a new hoist has been purchased. Some re-decoration has also taken place in the Firs Unfortunately the corridors in both homes suffer from regular damage due to the restrictions in managing wheelchair users, where inevitably corners and walls get chipped and scuffed. In Hewlitt one bedroom carpet has been replaced with laminate flooring a new fridge has been purchased and new side tables for the lounge. The homes’ provide all the necessary specialist equipment to manage the physical needs of the service users and there was evidence on the day of the inspection that these are serviced regularly. The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 Page 17 The homes’ provide adequate numbers of both assisted bathrooms and toilets. However one of the bathrooms in Hewlitt requires some attention as there is some water damage to the tiled area of one wall as this is potentially a health and safety risk. Both homes have bedrooms that are reflective of people’s interests and present as homely and comfortable. The external grounds of both homes appear tidy and have garden furniture in both for people to enjoy in the warmer months of the year. Both homes presented as clean and tidy on the days the inspections were carried out. The manager and staff should refrain from using sticky labels on service user’s bedroom furniture as this is only for staffs benefit and presents as quite institutionalised. The hand drying facilities in Hewlitt were found to be inadequate. All paper towel dispensers were taped up an unable to be used. The home must make arrangements for appropriate hand drying facilities throughout the home. All fire records were checked for both homes. The fire checks in the Firs were out of date for the week of the 22/08/07. All other checks were accurately recorded. The last environmental health check was carried out on the 02/11/06. The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 –36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s recruitment, training and supervision practice are good and offer protection to service users and to ensure that staff are provided with the necessary skills and training to do so appropriately and safely meets their care needs. EVIDENCE: The Firs has benefited from having a permanent manager in post since the last key inspection was carried out. The current arrangement is that the appointed manager in the Firs overall manages both homes, although there is a deputy manager based in Hewlitt. However due to the complex and changing needs of the service users in both homes, there may be a time where a registered manager may be required in each of the homes. The staff spoken to in Firs during this inspection stated that they felt very positive about the service provided since the manager’s post had been filled, on a permanent basis. The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 Page 19 The deputy manager was on annual leave on the day of the inspection carried out in Hewlitt and therefore the staff files and staff training records could not be inspected. However based on the previous inspection report from December 2006, information received by the commission and discussions with staff on the day of this inspection. It was felt that staffing procedures were being adhered to. Staff in both homes confirmed they receive regular training and supervision. The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37 –43. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is run in the best interest of those who live at Firs and Hewlitt .The Health and Safety of service users is currently compromised. EVIDENCE: The current structure within both homes regarding the management arrangements should be reviewed and the possibility of the two home being regisitered and run separately. This has clearly benefited the service user groups in both homes and staff spoken to during the inspection confirmed that the stability of having a permanent manager in the Firs has greatly improved staff morale. However the manager must submit a registered manager application by the 31/10/07 to the regional registration team. The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 Page 21 Quality assurance in both homes are carried out in a variety of ways, these include regular checks by the manager and deputy managers on medication, finances and care plans. The registration of the home does allow for the provision of care and accommodation of service users over the age of 65 years. As the proportion of the overall number of service users over the age of 65 years increases, it does have implications for the admissions policy of the home, as the ethos and overall feel of the home may change as a result and may make the admission of younger service users more problematic. The home is not registered to provide dementia care and must not admit service users for whom this is the principal determinant of their care needs. The manager must ensure the following issues are addressed as part of this inspection: Fire records in the Firs must be maintained regularly and in line with health and safety policies. There must be adequate hand-washing facilities provided in all toilets/bathrooms in Hewlitt as currently the hand towel dispensers are taped up and people have to dry their hands in the kitchen. This presents as an infection control risk and this practice must cease. The manager should investigate an alternative system on hand drying. A discussion was held with the manager in the Firs regarding the current arrangements for waking night care checks. It was agreed that in line with safe working practices that all waking night care staff would pro- actively record each check made with regard to service users, during the night. The representative of the Company must ensure that all Regulation 26 visit reports are held within the home and up to date. The service users spoken to during the inspection appeared to be happy with the home and appeared to be generally comfortable in their environment. The relationship between the service user and the staff is well balanced with interactions observed being appropriate and supportive. The management approach of the homes endeavours to create an open and positive atmosphere, staff and the service user spoken to commented that they feel supported. A clear commitment is made to equal opportunities within the home, with staff and the service users expressing positive views with regards to this. Data Protection Act 1998 ensuring that service users rights and best interests are safeguarded by the home’s polices and procedures. Records regarding staff were inspected and found to contain all the necessary information to meet the standard. The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 3 3 2 x The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 Page 23 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 YA37 Regulation 9 Requirement In order to determine the fitness of the manager, an application must be made to the CSCI for registration. The manager must implement a recording system for waking night care checks. The manager must ensure that all fire records are maintained in line with health and safety procedures. (The Firs) The manager must ensure that there are adequate handwashing facilities provided in Hewlitt. The representative from the company must ensure that all regulation 26 visit reports are kept up to date and held within the home. Timescale for action 30/11/07 2. 3. YA42 YA42 13 (4) (c) 23 (4) 30/09/07 21/09/07 4. YA30 16 (2) (j) 30/09/07 5. YA41 26 (4) (c) 30/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 Page 24 No. 1. Refer to Standard YA2 Good Practice Recommendations The home should consider undertaking a review of the home and its future structure, taking into account the challenges that it will face with an ageing service user group presenting with increasing and different care needs. The Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Firs And Hewlitt DS0000019569.V349476.R01.S.doc Version 5.2 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!