Inspection on 03/05/05 for The Grange

This inspection was carried out on 3rd May 2005.

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

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

Other inspections for this house

The Grange 10/05/06

The Grange 27/09/05

The Grange 20/01/05

The Grange 18/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Grange 154 Reddish Road Reddish Stockport SK5 7HZ Lead Inspector Kath Oldham Unannounced 3 May 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Grange Address 154 Reddish Road, Reddish, Stockport, SK5 7HZ 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) 0161-476-0702 01782-215415 Mr Zahid Yasin and Mrs Bobbie Baljit Walia Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number of places The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20 January 2005 Brief Description of the Service: The Grange is a detached care home situated in the Reddish area of Stockport, close to local amenities . The Granges current owners, Mr Yasin and Mrs Walia, purchased the property in February 2001. The home is registered to provide care for 18 elderly service users. Accommodation is available on two floors, with the majority of bedrooms being on the first floor. Access to the bedrooms on the upper floor is by means of stairs, passenger lift or chairlift. A number of bedrooms on the upper floor cannot be accessed by the lift. There are gardens with a fence around the perimeter. Off road parking is available at the front of the house. The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was undertaken as a result of adverse comments received about the service and care provided by The Grange. Numerous unannounced visits have been undertaken in the months since the last inspection. Primarily, the visits were to monitor medication issues and service users’ weights, in addition to the investigation of a complaint. On this inspection service users, relatives and staff were spoken to. The inspector observed practices, routines and records. The inspection took place at the beginning of May. The deputy manager and senior carer were on duty in addition to a cook and a housekeeper. What the service does well: What has improved since the last inspection? The appointment of a deputy manager has improved the manner in which care is provided. Staff are able to ask for her advice and, with direction and assistance, are able to help the service users as they need it. A dining room carpet was fitted during the inspection. New curtains had been purchased and the wallpaper had been painted in the dining room. Service users commented “not before time”. The care plan form and the recordings have also been improved by the deputy manager, which helps staff to be clear on the needs of the people they are looking after and improve the care given. The radiators within the home have had guards fitted which minimises the risk of scalding. The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 6 A cook has been appointed since the last inspection when care staff were undertaking this task. The failings identified on previous inspections in relation to medication storage administration and training has been improved upon. 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 Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3 & 5 Sufficient information is not provided to all service users to enable them to make an informed choice about living at The Grange. EVIDENCE: A service user guide is in place at the home. Service users were not sure if they had received a copy. There were no contracts or terms and conditions of residency or an assessment in the sample of care files inspected. Staff were not able to discuss the impact of mental ill health on their ability to care for service users. Staff practice in relation to moving and handling service users was, in the main, observed to be appropriate. Staff have not had training in moving and handling which compromises the safety of service users and themselves. Service users and relatives are able to visit the home to assess it and its facilities prior to admission. Service users said they came in initially for a couple of weeks to see if the home was alright. The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.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 & 10 Shortfalls in the recording on service users’ care plans have the potential to place them at risk of not receiving the care and support they need. EVIDENCE: The care plans have been developed since the last inspection. Further development is necessary as the specific care needs of service users are not well detailed. One service user said staff know what she likes and how she likes it. Professional interventions were appropriately recorded. One representative said that the home had not arranged for their service user to access a health care professional and they had to do this themselves after months of waiting. One service user was not responding well to catheter care at night, the plan set up was not suiting their sleeping pattern and the service user would not accept the alternatives. This had led to a continence problem for the service user. The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 10 Service users’ weights are maintained and recorded centrally. Two service users had put on a lot of weight over past months; there was no evidence that this had been monitored for action in the future. Improvements have been made in the administration of medication, however medication administration on the inspection identified staff handling medication inappropriately. Improvements have been made in the storage and recording of medication which safeguards service users’ health and wellbeing. The home still needs to develop a medication policy in relation to nonprescribed medication to ensure that staff are aware of when and if service users can have access to over-the-counter medicines. On the inspection a service user’s health was deteriorating and they were being appropriately cared for in bed. However, their privacy may have been compromised by staff propping the door open. The two double bedrooms continue to be without privacy screens. The hairdresser used one of these bedrooms to set service users’ hair. This practice does not promote or respect service users’ private space and belongings. Staff were observed being discreet during personal care provision. Service users said they receive visits from their GP and the district nursing service. Staff were observed using wheelchairs without footrests where no appropriate risk assessment had been carried out. The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.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, 14 & 15 Service users are not always able to exercise choice and make decisions but are able to receive their visitors. There are limited choices at lunchtime. EVIDENCE: Service users continue to be without occupation and stimulation. They are reliant on their families or friends taking them out, or providing stimulation through their visits. Some service users were observed and said that they move around the home, talk in the lounges or watch television. Some service users were observed sitting in the lounge for long periods, with no opportunities being provided to offer mental or physical stimulation. Service users’ personal possessions were observed to be used communally. A new cook has been appointed at the home. Service users said the meals were fair. The records, which must be maintained to detail the meals served, and a menu were not in place. This does not enable anyone wanting to use the record for nutritional assessment to do so. The Regulations state these records must be kept. Service users said that they didn’t have a choice at the lunchtime but had a choice for tea. The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 12 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 Service users are not safeguarded by the practices in the home. EVIDENCE: There has been no development in the recording of complaints. The deputy stated that, invariably, the complaints come via CSCI. Service users said they would tell the deputy manager if they had any complaints. Service users made comments to the inspector that were seen as complaints that had been dealt with by the deputy. These were not recorded. Despite requirements being made on previous inspections, staff continue to lack training in the definitions of abuse and how to identify abuse. The lack of staff awareness and training can increase the potential for abusive practices and routines. It appears that one service user controls the television, what is watched and when. Residents should be consulted about their feelings about this and ways of dealing with any problems expressed. The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 13 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, 23, 24, 25 & 26 The lack of repair, replacement and upkeep of the home does not promote the safety, security, comfort and respect of service users. EVIDENCE: Service users were not provided with suitable furniture on which to place cups and saucers when having a drink in the lounges. Service users were seen struggling to hold hot drinks; some used the footstool to put their drinks on. Despite requirements to address the shabby appearance of the home, the carpets in the lounges were in a poor state. Bathrooms have furniture and other items stored in them which could result in service users or staff having an accident. Bathrooms would benefit from redecoration. Service users said the rooms were not welcoming. The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 14 There was evidence of broken furniture within service users’ bedrooms. The carpets are stained, old and worn. The service users’ bedrooms do not contain seating for two people. One service user said they never take their visitors to their bedrooms as there is nowhere for them both to sit. Service users and representatives said that wardrobe doors do not close properly and drawer fronts were missing from the chests of drawers. Despite requirements made at previous inspections, the registered person has not addressed this. The home was clean and free from odours. Representatives said that the housekeepers do a good job but are restricted by the poor furnishings in the home. Service users said they had become used to the poor appearance of the home and soon become accustomed to living in a home that needed things mending and replacing. Service users said the home is full of good intentions but nothing ever happens to improve the place. The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 15 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, 28, 29 & 30 Employment practices are not robust and compromise the safety of service users and staff. Staff are unable to meet the needs of service users due to a lack of training. EVIDENCE: The care staff on duty demonstrated an insight into the needs of the service users and identified areas they felt required improving, including stimulation and choices. Service users commented on how nice specific staff were. Staff files were not available for inspection, despite requirements in the past to ensure these are available. A second unannounced inspection was carried out to examine these records. On that inspection the deputy was not aware or did not have access to them. The appointment of the deputy manager has improved the skills and knowledge of the staff team. Staff appeared confident to ask for advice and support. Further training and development of the staff should be undertaken to underpin advice and support with the relevant background knowledge. Service users said that they were happy with the way the service they received was developing. One service user said the deputy manager was “firm and fair with staff and asserted her authority appropriately”. The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 16 There were insufficient hours allocated to laundry and cooking duties. Care staff were undertaking meal preparation and laundry and reducing the time for direct care. Service users and representatives commented on clothes not always being ironed and the table linen being creased. The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 17 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, 37 & 38 Management systems are not in place to put the best interests of service users at the foremost of the service that is provided. Health and safety practices do not promote the welfare of service users. EVIDENCE: The home does not have a registered manager in place. An application has been made to CSCI by the registered person to undertake this role. Service users and representatives viewed the deputy manager to be in charge and commented on her leadership, skill and experience. Staff appraisal does not take place. Staff and service user meetings are not regularly arranged. The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 18 Aids were provided to service users without written assessments, agreements, reviews or maintenance having taken place. Service users’ needs must be assessed fully and records maintained of decisions regarding specific aids to ensure suitability and safety to service users. Health and safety records were inspected and included fire safety and accident records. The records were not completed routinely. Accident reports were not recorded in line with data protection. The records maintained to record fridge temperatures identified temperatures, which exceeded health guidelines. Freezer temperatures were not routinely recorded which compromises service users’ health. The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 1 1 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 1 COMPLAINTS AND PROTECTION 2 x x x 3 2 2 1 STAFFING Standard No Score 27 1 28 2 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 x 1 1 x 2 x x 2 1 1 The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 OP1 Regulation 4 Requirement The registered person must update the Statement of Purpose to include the information identified in Regulation 4.1(a)(b)(c) and Schedule 1 of the Regulations. (Timescale of 28/02/05 not met). The registered person must make suitable arrangments to provide a safe system for moving and handling service users and train staff in its use. (Timescale of 28/02/05 not met). The registered person must ensure that a policy is developed which covers the storage, administration and recording of homely remedies. (Timescale of 31/03/05 not met). The registered person must ensure that staff members who have the responsibilty for medication administration do not handle medication inappropriately. (Timescale of 27/01/05 not met). The registered person must consult with service users about their social interests and make arrangments to enable them to engage in local, social and Timescale for action 30/06/05 2. OP4 13(5) 30/06/05 3. OP9 13(2) 30/06/05 4. OP9 13(2) 30/06/05 5. OP12 16(2)(m) 30/06/05 The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 21 6. OP15 18(1)(c) 7. OP16 Schedule 4(11) 8. OP18 13(4), 13(6) 37 9. OP19 16(2)(c) 10. OP20 23(2)(n) (p) 11. OP21 23(l)(m) 12. OP21 23(2)(p) community activities and to visit places of interest outside of the home. Timescales of 30/09/04 and 31/03/05 not met). The registered person must provide the cook and any other staff responsible for food preparation with training to enable them to safely prepare meals for service users. (Timescale of 31/03/05 not met). The registered person must maintain a record of all complaints made by service users, their representative or relatives, or by persons working at the home and the action taken in respect of any such complaint. (Timescales of 30/09/04 and 28/02/05 not met). The registered person must ensure that all staff are familiar with the procedures to protect service users from abuse, ensuring the theory is transferred into practice. (Timescales of 30/09/04 and 31/03/05 not met). The registered person must replace the carpets in the lounge and conservatory. (Timescale of 31/03/05 not met). The registered person must provide mechanical air extraction in the conservatory to ensure smoke does not pervade the lounge areas of the home. (Timescale of 31/03/05 not met). The registered person must remove the stored items from within the bathrooms. (Timescale of 28/02/05 not met). The registered person must install light shades to light 30/06/05 30/06/05 30/06/05 30/06/05 30/06/05 30/06/05 30/06/05 Page 22 The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 13. OP24 23(c)(b) 14. OP27 18 15. OP27 Schedule 4(7) 16. OP28 18 17. OP29 Schedule 2 18. OP29 17(3)(4) fittings in all bathrooms and toilets. (Timescale of 28/02/05 not met). The registered person must replace the broken drawers within service users bedrooms. (Timescale of 31/03/05 not met). The registered person must ensure that there are sufficent, laundry and cooking staff on duty to ensure care delivery is not compromised by care staff performing domestic duties. Timescales of 30/09/04 and 28/02/05 not met). The registered person must ensure that the duty roster clearly indicates the full names of staff on duty, the hours worked and accurate records of start and finish times. (Timescale of 30/09/04 and 28/02/05 not met). The registered person must provide evidence of how they intend to provide training to care staff to ensure that 50 of staff are trained to NVQ Level 2. (Timescale of 28/02/05 not met). The registered person must ensure that the selection and recruitment procedures are in place to safeguard service users and include at a minimum the competion of an application form, the receipt of two satisfactory references, and satisfactory enhanced disclosure checks. (Timescales of 30/09/04 and 28/02/05 not met). The registered person must ensure that all records required by regulation are available at all times. (Timescale of 28/02/05 not met). 30/06/05 30/06/05 30/06/05 30/06/05 30/06/05 30/06/05 The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 23 19. OP30 12(1) 18(1)(a) (c) The registered person must provide all staff with induction training within their first six weeks to National Training Organisation specification. The registered person must also provide all staff with foundation training to National Training Organisations specifications. (Timescales of 30/09/04 and 28/02/05 not met). The registered person must ensure that quality assurance systems, an annual development plan and an audit system are put in place. (Timescale of 30/09/04 and 31/03/05 not met). The registered person must ensure the recording of accidents complies with Data Protection legislation. (Timescales of 30/09/04 and 31/03/05 not met). The registered person must ensure that all service users have a contract and terms and conditions of residency a copy of which must be maintained in their file and available for inspection at all times. The registered person must ensure that assessments are undertaken by the home prior to service users coming to live at the home. The registered person must update the care plan to reflect the action to be taken by care staff to ensure all aspects of health, personal and social care needs of the service user are met and conduct risk assessments on service users, paying particular attention to prevention of falls. The details of service users eviews should be recorded at least once a 30/06/05 20. OP33 24 30/06/05 21. OP38 Schedule 3 30/06/05 22. OP2 4.8 30/06/05 23. OP3 14(1) 30/06/05 24. OP7 15 30/06/05 The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 24 25. OP8 23(2) 26. OP14 12, 13 27. OP15 16(4)(13) 28. OP30 29. 30. OP37 OP38 13(4)(c) 23(4)(d) (e) 23(4) 31. OP38 32. OP38 16(2) 33. 34. 35. 36. 37. OP38 16(2) month and care plans updated to reflect service users needs. The registered person must ensure that wheelcharis are used with footrests in place and are cleaned and maintained regularly. The registered person must ensure that wheelchairs that belong to specific service users are not used communally. The registered person must ensure that the home has a menu, which provides alternative meals and must also maintain a record of food served to service users. The registered person must ensure that the roles and functions of staff are defined and that their performance is monitored. The registered person must ensure that risk assessments for the use of bed rails are in place. The registered person must ensure that all staff receive fire drill practices and training at a minimum of six monthly. The registered person must ensure that checks to the means of escape, fire equipment and emergency lighting are undertaken at intervals expected by the fire authority. The registered person must ensure that the fridge is maintained between 5-8 deg C at all times. The registered person must ensure that freezer temperatures are maintained. 31/05/05 30/06/05 30/06/05 30/06/05 30/06/05 30/06/05 30/06/05 30/06/05 30/06/05 The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 25 38. 39. 40. 41. 42. 43. 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. 5. Refer to Standard OP4 OP10 OP15 OP18 OP24 Good Practice Recommendations The registered person should provide staff with training in care for service users with dementia. The registered person should re-position the service users’ payphone. The registered person should ensure that the detail maintained in the records is an accurate reflection of meals served to service users’. The registered person should update the abuse policies. The registered person should, when a shared room becomes vacant, provide the service user with the opportunity to choose not to share, by moving to a different room if necessary. The registered person should repair/replace residents’ bedside cabinets. The registered person should replace the carpets and curtains in service users’ bedrooms. Conduct an audit of the condition of furniture and furnishings and replace them in a timely manner. The registered person should provide screens within double bedrooms. The registered person should maintain a record of the content of service user/representative meetings/discussions at the home available for inspection. The registered person should conduct formal supervision with staff at least six times a year and maintain a record of the supervision signed by staff and the supervisor within staff files. Files should be made available for inspection. The registered person should undertake at a minimum a monthly analysis of accidents, incidents and occurrences at the home, recording the detail. F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 26 6. 7. OP24 OP24 8. 9. 10. OP24 OP33 OP36 11. OP38 The Grange 12. OP38 The registered person should carry out risk assessments for all working practices and record significant findings. Research legislation to ensure knowledge and compliance. Obtain checks to the regulation of water temperatures and design solutions to control risks from hot water/surfaces ensuring the systems are in keeping with Health and Safety legislation. 13. 14. 15. 16. The Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.doc Version 1.30 Page 27 Commission for Social Care Inspection 2nd Floor Heritage Wharf Portland Place Ashton under Lyne, OL7 0QD 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 Grange F54 F04 s8556 the grange U v224695 030505 Stage 4.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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