Inspection on 13/04/05 for The Paddocks

This inspection was carried out on 13th April 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

The Paddocks 08/01/09

The Paddocks 10/01/08

The Paddocks 26/04/06

The Paddocks 22/09/05

The Paddocks 20/09/04

The Paddocks 16/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

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

CARE HOMES FOR OLDER PEOPLE Paddocks (The) Hilperton Road Trowbridge Wiltshire BA14 7JQ Lead Inspector Sally Walker Unannounced 13th April 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Paddocks (The) Address Hilperton Road Trowbridge Wiltshire BA14 7JQ 01225 752018 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) The Orders of St John Care Trust Vacant Care Home Only 30 Category(ies) of DE(E) Dementia - Over 65 (14) registration, with number MD(E) Mental Disorder - Over 65 (14) of places OP Old Age (30) PD Physical Disability (1) Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than 14 service users over the age of 65 years with either a mental disorder or dementia may be accommodated at any one time 2. Only the one named, male service user currently in residence under the age of 65 years with a physical disablement may be accommodated 3. The maximum number of service users who may be accommodated in the home at any one time is 30 Date of last inspection 20th September 2004 Brief Description of the Service: The home was originally built by the local authority as a home for people with a visual impairment in the 1970s. The home is situated on the outskirts of Trowbridge within a mile from the town centre. All the service users accomodation is to the ground floor and all single bedrooms. If service users wish to share, the second bedroom would be set up as a sitting room. Small items of furniture may be accommodated if the bedroom allows. The home is divided into three units all leading off from a central area of sitting room, dining area, kitchen, bar, visitors room, administrative offices and laundry. Each of the units has its own small sitting area, bathroom and toilets. The home offers 1 respite bedroom and a 10 place day service. This day service operates from Monday to Friday and is separately staffed. Service users can join in with the activities and trips organised by the day service. There are plans to increase the accommodation and provide a separate day service facility. The staffing rota provided for a minimum of 4 care staff on duty including a care leader in the mornings, 3 care staff during the afternoon and evening with 2 waking night staff and a member of sleeping in. In addition there are housekeepers, chefs, kitchen assistants, the handyman and the administrator. Miss Jessica Young had only been in post as proposed Manager since 4th April 2005. Before that she had worked in the home for five and a half years and had been a care leader for 3 years. Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place between 9.45am and 16.50pm. The care plans and service users files were examined, together with the environmental risk assessments. A tour of the building was made to look at bedrooms and communal areas. Five service users and 2 relatives were spoken with in some detail. Three staff gave comments on induction, training, support and the new manager. What the service does well: What has improved since the last inspection? What they could do better: A specialist programme of training in dementia and mental health for all staff would ensure a greater understanding of the care and social needs of those service users with a diagnosis. Care plans need to be reviewed as care needs change as well as at the monthly review. Care plans must reflect the complex care needs of service users including those service users who have mental health and dementia Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 Page 6 diagnosis and those who may be very ill. Care plans must direct the care with good detail and clear guidance to staff. A specialist programme of activities would be of great benefit to those service users with dementia. The refurbishment programme already underway must include the toilet bowls and some of the baths. The call bell system must be regularly checked to ensure that call bell alarms are functioning. The environmental risk assessments must be reviewed and revised if necessary. The organisation must support Miss Young with a proper induction programme in order that she succeeds with both her aims for the home and the organisations own objectives and with gaining the NVQ Level 4. There must be an analysis of the levels of administrative and care duties expected of staff, to ensure that service users care needs are fully met. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 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 Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 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) 3 & 5 All service users and their families have benefited from a positive admission process. Information was available to all prospective service users. Staff were ready to meet service users assessed needs from the start of their stay. The lack of a structured training programme for all staff hinders their ability to expand upon their inherent understanding of the needs of older people with dementia and mental health problems. EVIDENCE: There was a range of experience by both service users and relatives in the admission process. All stated a positive admission process in terms of information about the home, making visits before making a decision and being made welcome by staff. Many of the service users said they had relied on family to make the initial arrangements. A copy of the statement of purpose, service users guide and latest inspection report were available for people to read in the front entrance. The requirement to include needs identified in the care management assessment in the care plan had been actioned. Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 Page 9 The home is registered for up to 14 older people with dementia and whilst the lack of a programme of staff training in dementia care was evident in care plans, there were other elements which showed that staff had some understanding of the needs of people with dementia. For example, every clock seen during the day was showing the correct time, including service users wrist watches, staff engaged with service users and answered queries, giving reassurance when needed and there were no service users who wandered aimlessly or were agitated or constantly seeking staff attentions. Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 Page 10 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 & 10 Although much work had been done to ensure that every care plan was reviewed each month, some work is still to be done to ensure that care plans direct the care. Care plans did not show an understanding of how complex care need were to be met and mainly focussed on physical care needs. However staff did have some inherent understanding of working with people with dementia. Service users had good access to healthcare specialists and staff were working to any advice given although this was not always in the care plan. Service users were respected and their privacy upheld. EVIDENCE: Each service user had a care plan including those recently admitted or using the respite service. Medical diagnoses identified at time of admission were not always evident in care plans; for example, an epilepsy profile and guidance to staff on how to manage seizures, and management of diabetes. The requirement from the last inspection that care plans were reviewed and amended as service users’ needs changed was generally met with monthly reviews. Significant changes in need had not prompted a revision of the care plans. Miss Young immediately changed one care plan once this was identified. There was evidence of monitoring food and fluid intake together with turning charts for those service users who were at risk of developing pressure sores. Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 Page 11 Some advice given by the district nurse recorded in the daily report was not in the care plan. Miss Young was also advised to implement body maps in relation to wounds and to report on the progress of healing. The use of bed rails [often referred to as ‘cot sides’] was well documented in the care plan. However not all staff had signed to show they had been trained in safe use of the rails. Pressure relieving equipment was in place and the district nurse visited for advice and any treatments. One service user’s care plan matched exactly what they said about their care and medical needs. There was good evidence in some file of staff researching service user’s social histories with them and their families and they had also asked for photographs which could be used in reminiscence therapy. All of the service users spoken with and the relatives said that service users were well looked after. Service users said they experienced no problems in asking staff for the GP to visit them at the home. One service user and their relative reported on the rapid referral to the GP following a fall and the relative said that staff had immediately telephoned them to keep them informed of progress. This relative said they were involved in six monthly reviews. One relative said they were pleased to be able to still be involved in their relative’s personal care. The requirement for all staff to be trained in the safe handling of injection syringes following a needle stick injury was not now relevant as following this incident the injections had been done by the district nursing service then the service user moved. The requirement that all service users who self medicated did so under a specific risk assessment framework had been actioned. Some service users only had topical creams in their possessions and these were noted in risk assessments. The requirement that where dosages of prescribed medication was likely to vary following a blood test, the home must obtain written confirmation from the prescriber had been actioned and Miss Young said all changes in medication were now confirmed by letter or fax. Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 Page 12 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 and 15 The home promotes independence and choice for those service users who were able to pursue those activities and pursuits as they had done in their own homes. Service users with dementia would benefit from a specialist range of activities suited to their needs. Relatives were not restricted in visiting. Contact was maintained with friends and family. Those service users with dementia are not benefiting from a specialist range of activities suited to their needs. The range of meals was enjoyed by all service users. EVIDENCE: Service users said they started their day when they wished and one gave an example of staff asking them every morning if they were ready to get up or stay in bed a little longer and their breakfast would be brought when they were ready. Service users said they did not feel pressured to do anything they did not want to do. Service users talked about their social lives which included trips out to the seaside, shopping, going to the sitting room to join in with the games and sing songs. There did not appear to be a structured programme of activities suited to service users with dementia or for people with mental health problems. Miss Young said that the provision of activities was an area which could be developed. This home was not included in the piloting of a separate activities co-ordinator that the organisation had commenced in other homes. A relative Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 Page 13 said that they were pleased that the hairdresser did not give all the female service users the same hairstyle. One service user explained that there was a portable telephone with which they could make and received calls or a private line could be installed to each bedroom. Two relatives said there did not appear to be any restriction on visiting at any time during the day or evening. One said they had been told to telephone first if they intended to visit in the night. Both relatives had been given the code to the front door. One service user said they had to lock their bedroom door at night as a service user would come into them during the night. This was confirmed by Miss Young who said that the night staff were vigilant in ensuring this service user did not disturb other service users who had been given keys to their rooms in an effort to stop any unwelcome visits. All of the service users said that they enjoyed the range of food offered although some did not necessarily know what they were having for lunch. One service user said they often had a takeaway meal in the evenings. Another service user said they could have all their meals in their bedroom as they did not want to eat with the other service users. One relative said that the home celebrated all the major festivities on the calendar and gave examples of Easter and Mother’s day meals and parties. Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 Page 14 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 Management’s open attitude allowed service users to comment on the service without reprisals. Complaints were taken seriously and investigated fully. Staff were aware of the procedure for reporting abuse of vulnerable adults. EVIDENCE: The home had a complaints procedure produced by the organisation which was included in the service users guide. Suggestions and feedback forms were available. The complaints log showed good detail of the investigation process. A relative said they had mentioned a problem with the laundry service which had been addressed to their immediate satisfaction. Service users said they were always being asked to make comments on the service at the monthly residents’ meetings [Miss Young later confirmed that these were 3 monthly meetings for each of the units]. Miss Young said that all staff had a copy of the local Vulnerable Adults procedure entitled “No Secrets in Swindon and Wiltshire”. There was evidence in the training file that some staff had attended training in the process. Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 21, 23 & 26 The home’s maintenance and repair systems ensured a safe environment. However risk assessments were not up to date. The stained toilet bowls and baths detracted from the work that had been done to enhance the decoration of the bathrooms and toilets. Service users’ bedrooms were considered their own private space which they could lock. Bedrooms were personalised. Call bells were within reach of service users but their functioning was not checked regularly. Service users were supported by a good laundry system and diligent housekeepers. Service users benefited from a well cleaned home with no unpleasant smells. EVIDENCE: Service users identified their personal possessions that they had brought with them. One relative said their relative’s room had been decorated and recarpeted just before they had moved in and they were pleased with the attention to detail, for example, fresh flowers in all the bedrooms. Housekeeping staff talked about their pride in keeping service users bedrooms clean and tidy and did not appear to mind cleaning delicate items of pottery collections. Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 Page 16 All service users said they had a key to their bedroom door and relatives said they had been given the access code to the front door. Most of the service users who were in their bedrooms had their call bells within easy reach. One call bell was not working as the jack plug was not fitting into the socket. Staff were asked to check the socket of all call bells to ensure that leads fitted and that call bells were functioning. All service users spoken with said that staff attended them immediately when using the system and this was demonstrated by a test of the system. Service users said they could use their commodes whenever they wanted if they could not get to the toilets. They said they could have a bath whenever they wanted and could have more than one a week. However the poor state of the toilet bowls and some of the baths, being difficult to clean, detract from the attempts to create pleasant bathrooms and hinder any attempts by the staff to provide a good service in this area. Service users said that the laundry system was good with items being returned quickly and in good condition. One service user said that ironing was not done but there was evidence in the laundry area that ironing was in progress. The requirement that a programme of replacing the low sitting room chairs which some service users were finding it difficult to get out of, has been actioned with new higher chairs. The home was cleaned to a high standard and no unpleasant odours were detected at any time during the visit. There was a sluice and evidence of protective clothing and gloves in the toilets, bathrooms and some service users bedrooms. Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 Page 17 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 & 30 Those service users who had a mental health problem or diagnosis of dementia were not supported by staff who are regularly trained in those areas. Staff were well motivated to care and support service users and had good relationships with them and their families. EVIDENCE: All service users reported good relationships with staff and in particular their keyworkers. They said that staff were very kind and one said that nothing was too much trouble. One relative said that the home had a friendly atmosphere and that staff always spoke to them when they came to visit. Staff laughed and joked with service users in a respectful way. Staff knocked on service users’ doors and waiting to be invited to enter bedrooms on many occasions. One relative said they thought the home did not have enough carers on duty and that staff had to do the laundry as well as caring. The care staffing rota showed that there were three carers on duty together with a care leader during the morning, 2 care staff and a care leader during the afternoon and evening. At night there were 2 waking night staff and one member of staff sleeping in. The requirement that all staff were trained in mental health and dementia to reflect the Categories of Registration had been actioned in part with some staff attending a course on dementia in January 2005. However the training matrix of core subjects did not include dementia or mental heath. Miss Young was advised to seek the training outside of the organisation, for example, from the Community Psychiatric Nurse, Age Concern and Dementia Voice. Two staff said they had good access to training and had recently completed first aid, moving and handling and fire training. One staff said they had missed the dementia course but had covered some aspects at their induction. One staff Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 Page 18 was undertaking NVQ Level 4, two staff undertaking Level 3 and seven staff undertaking Level 2. Two staff have gained NVQ Level 3 and five staff have Level 2. Staff said they had regular supervision and had their own group staff meetings as well as the full staff meeting. Staff said they contributed to the agenda and felt that they were kept informed of all events. One relatively new member of staff said they had been inducted into their senior role and had been given delegated responsibility for assessing and arranging respite care. The organisation’s review of the amount of time staff spend on administrative work exclusive of care is still awaited. Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 36 & 38 Miss Young’s application to register as manager is in progress and she has yet to be approved. She had only been in post since the 4th April 2005 although she had previously been a care leader in the home. Miss Young was well liked by service users and staff and had a good understanding of how she was going to develop the home. Miss Young had yet to be given an induction by the organisation into the management role. Miss Young was relatively new to the role of manager although she had worked in the home as a care leader and was familiar with the day to day running of the home. She will need to be supported by the organisation with completing the NVQ Level 4. Service users, relatives and staff all made very positive comments about Miss Young’s appointment. She was very clear about how she intends to develop the service. EVIDENCE: Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 Page 20 All of the service users said that Miss Young was very friendly and approachable. One relative said that they were pleased that Miss Young was now in charge and that they felt confident in her abilities based on their experience of her as a care leader. Miss Young said that she had enrolled on NVQ Level 4. The organisation will need to support her in completing this course whilst inducting her into the manager’s role, organisational systems and financial management. Miss Young is well supported by an administrator. The environmental risk assessments had not been reviewed or updated for some time. Clearly this needs to be actioned, however given the other areas which Miss Young needs to address as a new manager, it was agreed that this could be delegated or addressed in stages. Miss Young agreed to inform the Commission of her action plan. Miss Young had a good working knowledge of the running of the home based on her experience as a care leader. Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 Page 21 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x 2 x 3 x x 3 STAFFING Standard No Score 27 2 28 3 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x x 3 x 2 Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 Page 22 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 OP 37 Regulation 15 Requirement The person registered must ensure that the care plans are reviewed and amended as service users care needs change. (Not actioned in full at 13.4.05) The registered person must ensure that there is an ongoing programme of specialist training for all staff in mental health and dementia care. (Not actioned at 13.4.05). The person registered must review the allocation of staffing hours to ensure that care needs are met. Management and administrative duties must be clarified. The registered person must ensure that all the complex care need of service users are detailed in their care plans together with clear guidance to staff on how those needs are to be met. The person regisitered must ensure that the activities programme includes sessions suitable for the needs of those service users with dementia and mental health problems Timescale for action 13th April 2005 2. OP 30 18(1)(c)(i ) 31st July 2005 3. OP 27 18(1)(a) 13th April 2005 4. OP 7 15(1) 31st July 2005 5. OP 12 16(2)(m) &(n) 31st July 2005 Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 Page 23 6. OP 21 23(2)(b)& (j) 7. OP 22 13(4)(c) 8. OP 19 13(4) 9. OP 31 8 &10(1)(2) &(3) The person regisitered must ensure that all of the toilet bowls are replaced in the current allocation of funding and an action supplied to the Commission. The person registered must ensure that the call alarm points are regularly checked to ensure that they are functioning and that the jack plugs are secured in their housing. The registered person must ensure that the environmental risk assessments are reviewed and revised where necessary The organisation must ensure that the manager is inducted into the role of manager and supported to gain NVQ Level 4 31st March 2006 13th April 2005 31st July 2005 31st July 2005 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 Good Practice Recommendations Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 Page 24 Commission for Social Care Inspection 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 Paddocks (The) CS0000028296.V195503.R01.doc Version 1.20 Page 25 - 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!