Inspection on 23/06/05 for The Orchards

This inspection was carried out on 23rd June 2005.

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

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

Other inspections for this house

The Orchards 16/10/08

The Orchards 10/10/06

The Orchards 04/10/05

The Orchards 09/09/04

The Orchards 05/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Orchards (The) 1 Perry Lane Wroughton Swindon Wiltshire SN4 9AX Lead Inspector Bernard McDonald Unannounced 23 June 2005 at 8.45am 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. Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Orchards (The) Address 1 Perrys Lane Wroughton Swindon Wiltshire SN4 9AX 01793 812242 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) Buckland Care Limited Mrs Lisa Jane Lewis Care Home 35 Category(ies) of DE Dementia 1 registration, with number DE (E) Dementia - over 65 16 of places OP Old age 32 Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 The maximum number of service users who may be accommodated in the home at any one time is 35 2 17 service users in total with dementia (DE and DE(E)) may be accommodated. This is a temporary arrangement and subject to conditions 3 and 4 below 3 When the accomodation occupied by the 10 of the 16 current service users with dementia aged 65 years and over (including those named in the variation application dated 4 October 2004) is no longer required, the maximum number of service users in the category DE(E) must be reduced to a maximum of 6 4 Only the younger, female service user with dementia named in the variation application dated 4 October 2004, may be aged between 18 - 65 years. When this accommodation is no longer required by the named service user, occupancy must revert to the category OP 5 No service users with dementia to be accommodated on the second floor Date of last inspection 9 September 2004 Brief Description of the Service: The Orchards is one of a number of homes owned by Buckland Care Limited. The Orchards provides accommodation and personal care to a total of 35 service users. The home is located in the village of Wroughton and is close to local shops and public amenities. The home is a large three-storey building set in its own well-maintained grounds. Service users’ bedrooms are located on three floors and can be reached by either a passenger lift or a stair lift and each room has an emergency call bell installed. The home has an attractive conservatory that is appropriately furnished and allows service users the benefit of extra communal space. Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over nine and a half hours. The inspector viewed all areas of the home and met the majority of service users eight care staff and the relatives of four service users. The inspector had the opportunity to interview service users and staff in private. A number of records were examined including five service users care plans, risk assessments, health and safety records and three staff recruitment files. The inspector found two requirements from the last inspection had not been met. Since the last inspection a new manager has been appointed at the home. The inspector was concerned to find that a number of policies and records that had been previously available at the home were not available for inspection. The manager had only been in post for three weeks and had not had time to fully review the policies and procedures in place at the home. It is expected that the number of requirements should reduce significantly at the next inspection. What the service does well: The admission procedure is service user focussed and provides opportunities for service user to visit the home and meet with staff prior to admission. Two service users confirmed they did visit the home and have been allowed to bring items of personal furniture into the home. The relatives of three service users also confirmed they had opportunity to visit the home prior to their relative moving in and are able to visit the home at anytime. Service users are overall satisfied with the general care being provided. Comments received from service users included that “staff are wonderful” and Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 6 “nothing is to much trouble”. The relatives of four service users also shared these opinions. There is evidence to demonstrate service users safety is being considered in relation to restricted window openings, radiators being guarded and hot water temperatures regulated close to 43c. The home provides service users with a good standard of accommodation One service users commented they had recently had a private phone line installed into their bedroom. The home has attractive well-maintained gardens that can be used by service users. What has improved since the last inspection? What they could do better: Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 7 The unannounced inspection has identified fifteen statutory requirements and five recommendations, which clearly identify areas that the home can improve upon. A number of requirements have been made in relation to the need to improve care plans. These requirements are essential to ensure service users are receiving the care they need and that their care is being reviewed on a regular basis. The improvements made in the assessment of service users prior to admission are being has not been developed in comprehensive care plans based on the pre admission assessment. Risk assessment need to be reviewed especially in relation to service users at risk from falls. The home must improve and review the procedures for recording and monitoring medication in the home to ensure it is being correctly administered to service users and any deficits in medication stocks can be quickly identified. The home needs to improve the recreational and leisure activities provided to service users. One service user did comment “there was nothing to do” and that they were bored. The home needs to ensure safe recruitment practices are being followed in the home. 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. Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 8 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 Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 4, 5, 5, 6. The home has improved the assessment procedures for the admission of service users but is failing to ensure care plans fully reflect the assessed needs of service users. EVIDENCE: Following a requirement made at the last inspection the home has ensured that service users admitted to the home had a completed assessment of their care needs. The inspector examined the records of the last three service users admitted to the home. The records contained a completed assessment and following admission the home had developed care plans for daily living. However, these care plans did not fully reflect the care needs of the service users. Care plans did not reflect deterioration in the care needs of one-service user and risk assessments had not been completed where service users had been identified at risk from falls prior to admission. It is requirement that care plans are improved to ensure they fully reflect the needs and ensure the safety of the service user. Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 10 Discussion with two service users confirmed the home had provided opportunities to visit the home prior to moving in to meet the staff and view their bedroom. The relatives of three service users also confirmed they had opportunity to visit the home prior to their relative moving in. It was a requirement at the last inspection that care staff receiving training in dementia care. Discussion with staff confirmed additional training had been provided and staff commented that they found this training useful. Observations made during the inspection would demonstrate this training has been beneficial to staff and the care provided to service users. There was a more relaxed atmosphere in the home and staff were more confident on their ability to meet the needs of service users. The home does not provide intermediate care. Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 11 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. The home is failing to demonstrate how the needs of service users are being safely met in the home. EVIDENCE: The inspector examined five service users care plans and found they did not reflect the care needs of service users and had not been reviewed in the past month. One care plan examined identified a service user who was in bed required turning every two hours and a fluid chart was to be kept to monitor fluid intake. The inspector found the turning chart did not demonstrate the service user care plan was being followed and they had not been turned for periods up to six hours. There was no record of any fluids being given to the service user, although the inspector was advised drinks are being given regularly throughout the day. Examination of the care plan did not demonstrate why the service user was in bed 24 hours a day. In addition another service user was confined to bed. Discussion with the district nurse confirmed the service users had not required any nursing input since March 2005. It is a requirement that the needs of the service users are reassessed to ensure the care provided is appropriate to their needs. Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 12 One service user whose mobility needs have increased since moving to the home is accommodated on the second floor. Staff have reported difficulty in using the new lift with a wheelchair as the lift is not large enough to accommodate a wheelchair and a member of staff. The care plan does not reflect their changing needs although the manager did confirm the service user had been offered a room on the ground floor. There is improvement in the nutritional risk assessments being completed at the home. Discussion with the district nurse confirmed they visit the home as required. Pressure relief mattresses are in place for reducing the risk of pressure sores to service users. Continence advice is obtained as required. The manager confirmed all service users are registered with the local GP practice and the GP visits the home every Tuesday. Service users were complimentary about the care provide at the home and stated that staff provide good care and were helpful. Discussion with the relatives of four service users confirmed they were very satisfied with the care provided at the home. There was a noticeable change in the atmosphere at the home, staff appeared more at ease in their work and spoke positively about the care they provide. The inspector was concerned to find risk assessments had not been completed following an accident to one-service user. The lack of action on the part of the home could have resulted in injury to other service users and it is a requirement that risk assessments are completed or updated on service users at risk from falling. Examination of the records for administration of controlled drugs found serious deficits in the recording of drugs held at the home. Two entries in the controlled drugs book had not been doubled signed, as good practice requires. A total of twenty-five tablets could not be accounted for and the manager was advised to contact the Police to report the loss. The name of one drug being administered had not been recorded in the drugs book and one drug was not always being administrated as directed. These concerns were brought to the attention of the manger at the time of the inspection to ensure the administration and recording of controlled drugs at the home are immediately improved to reduce any risk to service users. Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 13 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 The home needs to ensure service users are provided with regular opportunities for stimulation, leisure and recreational activities. The home does provide opportunities for service users to maintain contact with friends and relatives. EVIDENCE: A recommendation was made at the last inspection that service users should be consulted on what activities they would like provided at the home. Discussion with service users would indicate this recommendation had not been met. Service users commented that there was very little to do during the day. The home has however continued to bring in outside entertainers which service users enjoy watching. The service users care plan did have a section to record social activities but the care plans examined none had been completed. It is recommended that consideration be given to developing a post of activities coordinator to provide more opportunities and choice for service users leisure and recreational past times. One-service users did confirm they have been able to maintain contact with friends and the local community since their admission to the home. This Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 14 contact has mainly been supported by the service users friends and not by staff at the home. The inspector met the relatives of four service users who commented they could visit the home whenever they wished. Service users are able to met visitors in the privacy of their room or in one of the communal areas. Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 15 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 home is aware of the need to ensure service users rights and welfare are protected, however the service is failing to record all complaints and their outcomes. EVIDENCE: The home has a complaints procedure that is on display at the entrance to the home. The policy specifies that complaints will be responded to within twentyeight days. Discussion with the relatives of two service users confirmed they were aware of the homes complaints procedures. The Commission has received two complaints about the home since the last inspection. One complaint was not substantiated and the provider is still investigating the second complaint. There was evidence to demonstrate complaints had been received but not all complaints had been recorded. The manager confirmed the home is holding money on behalf of one service user. The manager is in the process of updating the financial records to ensure the system used is robust and clearly demonstrate money being held at the home. Since the last inspection several staff have attended abuse awareness training. Additional training is being provided for the remaining staff over the coming months. Staff were clear about their responsibilities in alerting managers about any concern affecting the welfare of service users. Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 16 Policies and procedures are in place to ensure the protection of vulnerable adults. Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25, 26. The home is providing service users with a clean and comfortable living environment but needs to improve fire safety arrangements. EVIDENCE: Since the last inspection the home has employed a maintenance person who is responsible for minor repairs around the home. The inspector viewed all areas of the home and was concerned to find a number of fire doors were being wedged open. This practice could put service users at risk if a fire was to occur at the home. If doors need to be kept open then the manger should consult with the local fire service ensure the safety of service users. There is however evidence to demonstrate service users safety is being considered in relation to windows in service users bedrooms being fitted with window restrictors to restrict the opening, radiators have been guarded and hot water temperatures are regulation close to 43c. Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 18 Service users were very happy with the standard of accommodation at the home. Service users commented they have been able to bring items of personal furnishings to the home and one service user commented they have just had a personal phone line installed in their room. The inspector viewed the majority of service users rooms and found they were all comfortably furnished and had been personalised with photographs and ornaments to reflect the individual taste of the service users. The inspector found one bedroom had been fitted with a Yale lock. This should be removed and replaced with a lock that would allow privacy to the service users and access to staff in the event of an emergency. Locks should also be replaced on bathroom and toilet doors on the ground floor and first floor. This was recommended at the last inspection and it is now a requirement that these locks are replaced with locks that ensures the safety of service users. The homes has the benefit of attractive grounds and gardens and on the day the inspection were being used by service users to meet with relatives and also enjoy the benefits of a warm sunny day. Since the last inspection the home has purchased an additional washing machine. This ensures that service users laundry is returned more promptly to them. Service users commented that the laundry service is “first class” and always returned quickly. A recommendation was made at the last inspection that the plaster and paintwork behind the washing machines should be repaired. This work has not been completed and the increased risk of infection due to the laundry walls not being easily cleanable still remains. It is a requirement that this work is completed within the timescale specified. Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29. There have been occasions when staffing levels have not been sufficient to meet the needs of service users. The home is failing to demonstrate safe recruitment practices are being followed. EVIDENCE: The inspector examined the rota and found there were normally six staff on duty in the morning and four staff on duty from in the afternoon and early evening till 8.00pm and three staff on duty till 10.00pm. There two waking night staff. Discussion with staff identified that at times there are insufficient staff on duty and that they had raised these concerns with the manager. Discussion with the manager confirmed that there have been occasions when staffing levels have been low but these have mainly been due to staff sickness and holidays and has now taken steps to avoid this happening again. Service users were very positive about staff in the home and commented they were helpful and always busy. The inspector examined the recruitment records of three members of staff. The inspector found only one of the records examined contained all the records required in Schedule 2 of the Care Homes Regulation 2001. Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 20 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, 37, 38 Record keeping needs to be significantly improved to ensure service users are being safeguarded from risk of fire and injury. EVIDENCE: Since the last inspection the home has appointed a new manager. The manager confirmed she has completed the registered managers award and she now needs to make application to CSCI for registration. It was a requirement at the last inspection that records held in the home are accurate and up to date. The inspector found there are still a number of deficits in records being held at the home and records that were available at previous inspection could not be found. This requirement will be carried forward to the next inspection to give the new manger sufficient time to meet the requirement. Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 21 The inspector was concerned to finds a number of records were missing or had not been fully completed or reviewed approximately two months before the resignation of the previous manager. This is also reflected in a number of health and safety records held at the home. The inspector found no fire drill had been completed since July 2004 and it is a requirement that a fire drill is completed within seven days. There were no records to demonstrate safety checks on emergency lighting and fire alarms were taking place, although the manager and deputy stated these checks were happening. The home needs to develop risk assessments on the environment paying particular attention to the area where one service user had an accident. Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 22 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 2 3 3 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 x COMPLAINTS AND PROTECTION 2 3 2 x 3 2 3 2 STAFFING Standard No Score 27 2 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 2 x x x x x 3 3 Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 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 3&7 Regulation 15 (1) Requirement The registered person must ensure the service user care plan fully reflects the assesed needs of the service user The registered person must ensure care plans are reviewed a minimum of once every month, or earlier if the needs of the service user changes. The registered person must obtain an assessment of the care needs of the two service users confined to bed to ensure the care they receive is appropriate to their needs. The registered person must accurately record all medication held at the home. The registered person must ensure all medication is administered as prescribed by the service users doctor. The registered person must ensure all medication in the controlled drugs book is signed by two competent members of staff when it is administered The registered person must keep a record of all complaints made in the home and action taken. The registered person must Timescale for action 01/08/05 2. 7 15(2)(b) 01/08/05 3. 7 14(2)(a)( b) 01/08/05 4. 5. 9 9 13(2) 13(2) 01/07/05 01/07/05 6. 9 13(2) 01/07/05 7. 8. 16 19 17(2)Sch 4 13(4)(c ) 01/08/05 01/07/05 Page 24 Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 9. 21 10. 11. 26 27 12. 29 13. 31 14. 37 15. 38 ensure that fire doors are not wedged open. 12(4)(a) The registered person must provide suitable locking mechanism on bathroom and toilets doors. Any locks fitted must ensure the privacy of service users and allow access to staff in the event of an emergency. 23(2)(b) The registered person must repair the wall behind the back of the washing machines 18(1)(a) The registered person must ensure there are sufficient staff on duty to meet the needs of service users at all times. 19 The registered person must Sch 2 ensure all records as specified by Schedule 2 of the Care Homes Regulations 2002 have been obtained for all staff working in the home and are made available for inspection. Care The registered person must Standards ensure the manager submits an Act application to CSCI for Section 12 registration. 17(1)(a) The registered person must (b)(2)(3) ensure all records held in the (a)(b) home are accurate and up to date. This was a requirement at the previous inspection 23(4)(a) The registered person must (c)(iii) ensure a fire drill is completed by 30/06/05 01/09/05 01/09/05 01/07/05 01/09/05 01/08/05 01/09/05 30/06/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 7 Good Practice Recommendations The registered person should not accomodate service D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 25 Orchards (The) 2. 3. 4. 5. 9 12 19 38 users who require a wheelchair to assist with mobility above the first floor. The registered person should report the loss of medication identified during the inspection to the Police. The registered person should consider developing a post of activities coordinator. The regstered person should consult with the fire safety officer to identify a safe methods of keeping fire doors open. The registered person should ensure all fire safety checks are recorded. Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 26 Commission for Social Care Inspection Suite C, Avonbridge House Bath Road Chippenham Wiltshire SN15 2BB 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 Orchards (The) D51_D01S50595THEORCHARDSV221009_230605STAGE4.doc Version 1.40 Page 27 - 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. 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