Inspection on 02/02/06 for The Rock

This inspection was carried out on 2nd February 2006.

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 Rock 27/09/06

The Rock 14/07/05

The Rock 18/01/05

The Rock 07/09/04

The Rock 17/05/04

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 The Rock 1 Station Road Buckfastleigh Devon TQ11 0BU Lead Inspector Megan Walker Unannounced Inspection 2nd February 2006 14:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Rock DS0000003840.V282221.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 Rock DS0000003840.V282221.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Rock Address 1 Station Road Buckfastleigh Devon TQ11 0BU Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01364 642706 the.rock1@btinternet.com Mr Julian Roger Smith Mrs Ruth Millicent Smith Care Home 14 Category(ies) of Dementia - over 65 years of age (14), Old age, registration, with number not falling within any other category (14) of places The Rock DS0000003840.V282221.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th July 2005 Brief Description of the Service: The Rock is registered to provide accommodation and care for a maximum of fourteen people in the registration categories of Dementia - over 65 years of age and Old Age, not falling within any other category. The Registered Service Providers are Mrs Ruth and Mr Julian Smith. Mrs Smith is responsible for the day-to-day management of the home, which is situated in a residential area of Buckfastleigh, close to the village shops and amenities. The house is detached and set in attractive gardens. There is a private car park directly opposite the house that provides ample off street parking for the staff and visitors. The home is attractively decorated, comfortably furnished and clean. The residents’ private accommodation consists of six double and two single bedrooms. Residents are encouraged to personalise their rooms. There is a shared lounge/dining room and a separate sitting room. The night staff room is also available during the day as a quiet area and for any relatives/visitors who may prefer to use it for more privacy. There is one bathroom that has a bath with a hoist; another bathroom for those able to bathe unassisted, and there is also a separate shower room. Adequate toilet facilities are provided. The Registered Provider provides home cooked meals on the premises. Care staff are employed on a twenty-four hours basis and the home has a good record of long-term employment of its staff. The Registered Providers have two dogs that visit the home. In the past residents have moved in with their pets when it has been feasible. The home also has two chinchillas kept in a cage in the one of the communal rooms. The home does not provide intermediate care and it is not registered to provide nursing care. The Rock DS0000003840.V282221.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection between 14h00 and 18h30 on Thursday 2nd February 2006. Sarah Stevens was the Senior Carer on duty at the time of the inspection. Mrs. Ruth Smith (Registered Provider) and Ms Theresa Smith (Business Manager) were also present and provided much of the information during the inspection. One Relative’s Comments’ Card and a Pre-Inspection Questionnaire were received prior to this inspection. During a tour of the premises the inspector saw all of the residents and spoke to seven of them. One resident described her care provided by the home as “They spoil us all”. Those residents able to offer an opinion spoke favourably about the home, their care and the staff. Care plans and Individual Residents’ files were seen as well as other documentation. As a consequence of this inspection there were six requirements, three of which are outstanding from the previous three inspections and therefore require immediate action by the Registered Provider to avoid Enforcement Action being taken by The Commission. What the service does well: The residents receive a high level of care. Mrs Smith and her staff team encourage families to maintain contact and try to ensure that any resident without family receives outside contact. Mrs Smith takes time to get to know every resident, their likes, dislikes and personal preferences. She has very high standards and expectations of any staff in her employ. The atmosphere in the home encourages residents to feel at home and to enjoy an easygoing lifestyle with very few restrictions other than those designed to protect residents and ensure their safety. The home is tastefully decorated and provides a comfortable, homely environment. Residents can bring in their own personal belongings if they so wish, and each bedroom is arranged to suit individual choice and preference. Dogs and chinchillas are kept at the home, and are appreciated by the residents. If it is practicable, new residents may bring their pets (by arrangement) into the home with them. Staff receive daily informal supervision and regular recorded one-to-one supervision with Mrs Smith. Regular staff team meetings are also held including meetings to feed back to staff outcomes after each inspection. The Rock DS0000003840.V282221.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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 Rock DS0000003840.V282221.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection The Rock DS0000003840.V282221.R01.S.doc Version 5.1 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 the following standard(s): 2, 3, 4, 5 All prospective residents are assessed prior to moving into the home and they and/or their families know that their assessed care needs will be met by the home. Intermediate care is not provided by the home. EVIDENCE: All the residents’ files seen had a written contract and terms and conditions of residency. There were also contracts for those funded by a local authority. The Registered Provider stated that there is always a pre-assessment for a prospective resident. A high proportion of referrals come from Templar House and Assessment Units such as in Totnes, and Social Services. In these instances a care manager or medical practitioner will also provide a care plan. There is also a four-week assessment period. At the time of this inspection there had only been one person who chose to move after this period and this was for practical reasons to be nearer family than because the home was unable to meet specific needs. The Rock DS0000003840.V282221.R01.S.doc Version 5.1 Page 9 The home is well known in the local community hence is extremely popular. The Registered Provider does not keep a waiting list because she is aware that placements are needed as soon as possible and according to need at the time. She therefore recognises that to keep a list would be unfair practice and that the home could not guarantee meeting an individual’s needs if they waited too long for a vacancy. The Registered Provider confirmed that all prospective residents’ families/representatives receive a telephone call to confirm that the home can meet the individual’s assessed care needs. The home does not usually write to confirm this. Anyone considering The Rock may visit to assess for themselves its facilities and suitability. The Registered Provider stated that as most of the bedrooms are shared, she is very clear about this when receiving enquiries about single rooms. She also confirmed that for most residents who accept to share a room this has proved to be a better option and they have settled well knowing they have someone else in the bedroom with them. Families have also seen the benefits of a shared room for their relative. The Rock DS0000003840.V282221.R01.S.doc Version 5.1 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 the following standard(s): 7, 8, 9, 10, 11 Individual health, personal and social care needs are clearly set out in individual care plans, and the home endeavours to meet those wishes and needs as far as it is practicable. EVIDENCE: A random selection of individual residents’ files was seen. They each had a plan of that resident’s care needs, preferences, likes and dislikes. The Daily Log was also seen and this gave sufficient information to provide staff with a working knowledge of an individual and could be cross-referenced with the care plan. In the event of an accident, slip or fall, this was all clearly documented both in the Accident Book and also on the individual’s file. All visits by GPs, district nurses and other professionals to an individual resident are recorded on their file. Since the last inspection, Mathias Foundling, CSCI Pharmacy Inspector, has inspected the home’s medication practice and policies. He made several recommendations and these had been instigated by the time of this inspection. Several staff had received accredited training in May 2003 by an external body The Rock DS0000003840.V282221.R01.S.doc Version 5.1 Page 11 in the “Handling and Administration of Medicines” and this was updated in March 2005. Staff try to provide privacy for the residents as much as it is practically possible. Most residents require a lot of personal care and staff were observed as being discreet about providing this. In conversation with staff too it was evident that they respect the residents and treat them as individual people rather than collectively as “residents of the home”. Screens were seen to be available for use in shared bedrooms. The home has a “Quiet Room” available to residents and their visitors if they wish to be away from the main communal areas of the house. This room is at the rear of the house, next door to the manager’s office. It is comfortably furnished and cannot be easily accessed accidentally by anyone wandering. It also doubles up as the night sleeper’s room. At the earliest possible time, usually in early stages of moving into the home, staff will request information about last wishes and preferences for burial or cremation after death. This is recorded on the individual’s care plan. The Registered Provider gave an example of how the home had recently met a deceased resident’s wishes after death. The Rock DS0000003840.V282221.R01.S.doc Version 5.1 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 the following standard(s): 12 Residents can feel assured that their expectations and preferences will be met within a protective environment. EVIDENCE: At the time of this inspection the residents were of Christian faith and either Church of England or Methodist denomination. The Registered Provider stated that in the past when there have been Catholic residents the monks from Buckfastleigh Abbey had visited weekly to bring in Holy Communion to residents. The local Protestant minister calls regularly although at the time of this inspection none of the residents wished to receive Holy Communion. Also there were two residents who were from European countries of origin, now British citizens, however staff have not been able to ascertain their religion, if any, due to advance stages of dementia. Language is proving some communication difficulties too for these two residents. The advance of dementia has caused one resident to revert to their first language although a visitor of the same language has informed staff that even when speaking that language, it is patchy and forgetful. The Rock DS0000003840.V282221.R01.S.doc Version 5.1 Page 13 The Rock DS0000003840.V282221.R01.S.doc Version 5.1 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 the following standard(s): These standards were inspected at the previous inspection. EVIDENCE: The Rock DS0000003840.V282221.R01.S.doc Version 5.1 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 the following standard(s): 19, 20, 21 23, 24 Residents live in a safe environment that meets their care needs. EVIDENCE: A tour of the premises showed that each bedroom is individual and reflects the style of its occupant(s). There was evidence of personal items having been brought into the home by residents. There are six double and two single bedrooms, none of which has en-suite facilities. Some of the wash hand basins have push taps. These are put in or removed according to the assessed need of the occupant of that bedroom. There were no risk assessments to support this action. The Registered Provider confirmed that a lock could be fitted to each room when there was a change of resident, or if the current occupant should change their mind. She and the Business Manager also confirmed that this would be impractical for most of the people living at The Rock. Likewise, the provision of suitable lockable facilities. There were no risk assessments to support these comments or actions. The Rock DS0000003840.V282221.R01.S.doc Version 5.1 Page 16 The Registered Provider stated that families are advised to keep anything of value on behalf of their relative, or if there is no representative, valuables are kept locked safe by the Registered Providers. Evidence of this was seen during the inspection. Also the home does not hold monies for any resident and again families are encouraged to take care of financial matters on behalf of their relative. Most of the rooms did not have any sort of door closure. A member of staff stated that all the bedroom doors were always kept shut unless a resident went into their room unsupervised. A downstairs bedroom had a fire door closure fitted because the occupant chose to use the room most of the time and preferred to have the door open. One upstairs bedroom had a door closure fitted but only to the door. The landing door was seen held open by a wedge. A staff member confirmed that the landing door was kept closed at night. There were no risk assessments to support the lack of fire door closures. All the communal bathrooms and toilets had bars of soap and cotton hand towels provided for residents’ use. A fixed liquid soap and fixed cabinet for paper hand towels were provided for use in the kitchen. In a conversation with The Registered Provider and other staff about the risks of infection and/or residents possibly eating the soap, they explained that due to the advanced stages of dementia, residents were all supervised when using the toilets and bathrooms. Staff also stated that it was easier for residents to recognise a bar of soap and understand its use when prompted than using liquid soap. It was easier for staff to assist residents to dry their hands using cotton hand towels rather than paper towels for similar reasons. The Registered Provider stated that it would be easier and preferential for staff to replace a cotton towel each time it had been used than to try and install paper towel cabinets. Staff also stated that a clean towel and new bar of soap is always provided in a resident’s bedroom when a GP or District Nurse visits to examine or treat that resident. Staff explained that the layout of the building because it is a large house, allows staff to take residents for circular walks around the building. Examples given were: bedtimes when the length of the landing enables staff to walk from the stair lift the length of the landing in the opposite direction from the person’s bedroom and then back towards the room; Downstairs it is possible for a circular tour around the gardens going out of the kitchen patio doors and re-entering by the back door. Staff stated that this worked well for residents who then were satisfied that they had been somewhere other than either going to bed or out into the garden and back indoors again. It was suggested that the home consider contacting Dementia Voice for advice as there have been difficulties finding an Occupational Therapist to assess the building. There are plans to make the home’s greenhouse accessible to residents. One resident spoken to during the inspection is keen to help out with small tasks around the home such as in the kitchen and ironing. Staff have recently bought flowerpots and other gardening equipment for this resident to enjoy The Rock DS0000003840.V282221.R01.S.doc Version 5.1 Page 17 more activities outside such as pottering in the green house, and the garden when the weather improves in the Spring. The Rock DS0000003840.V282221.R01.S.doc Version 5.1 Page 18 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Residents can feel confident that they are protected by the home’s recruitment policy and in safe hands at all times. EVIDENCE: At the time of this inspection the home employed eleven care assistants – four part-time (including one sleeping night staff) and seven full-time (including one waking night staff). There were no additional domestic staff however parttime staff are employed on a separate contract for domestic work. The Registered Provider stated that no one worked in a mixed capacity, i.e. they were either on a shift working as a care assistant or working as a domestic assistant. Mrs Smith does all the cooking in the home on a daily basis. The home is actively recruiting staff at present due to a recent resignation of a fulltime care assistant. The Registered Provider offers an employment policy of Equal Opportunities. She stated at this inspection that she would consider employing anyone of any race, colour or religion and always employs on merit. She also stated this would apply to prospective residents as long as she could meet their assessed cultural and religious needs. All current staff have worked at the home for a minimum of two years, and most for longer. Individual staff files seen all had: two written references, CRB checks, photocopies of personal identification with a photograph (passport or photo’ The Rock DS0000003840.V282221.R01.S.doc Version 5.1 Page 19 driving license), birth certificates, and a photograph of the individual on the front of the file. Staff are all following NVQ courses and over 50 have achieved a minimum of NVQ Level 2 in Care. Five staff are trained in the “Handling and Administration of Medicines”. Twelve staff hold a current First Aid certificate. They have also received Fire Training, Infection Control, Food Hygiene, Managing Continence, and, Aftercare for Stroke Survivors. Future training planned is Dementia Care, Mental Health Awareness, Health and Safety, and, Moving and Handling. Observation of staff during the inspection showed good interaction with residents and an understanding of individuals. Staff confirmed that they would take any necessary measures to meet residents’ wishes regarding visitors or if required, intervene if a visitor was distressing a resident. The Rock DS0000003840.V282221.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35, 36, 38 Mrs. Ruth Smith manages The Rock well and competently. She provides clear leadership promoting confidence and good morale amongst all staff members. Record keeping is improving. EVIDENCE: The home has a policy of encouraging resident’s family or a representative to be responsible for their personal monies and itemised invoices are sent approximately once a month. At the time of this inspection no monies were held for any resident. Ms Theresa Smith, the home’s Business Manager, is currently reviewing the home’s quality assurance system. A report should be available shortly. The Rock DS0000003840.V282221.R01.S.doc Version 5.1 Page 21 The home keeps records of all visitors to the home, however, it is the staff that note this information in a Visitor’s Book. The Registered Provider explained that too many people were doing “pop-in” visits and becoming frustrated about having to sign in and out. Staff are aware of who comes into and leaves the building because they have to open the front door for them. The Visitor’s Book is kept in the Staff Office, next to the kitchen, so is not readily accessible. It was not seen at this inspection. The method of recording residents’ personal information has been improved. Each person now has a file kept in the Staff Room so most of their information, assessments and care records are together. This enables staff to keep up to date more easily. Details about Contracts, and, Terms and Conditions of Residency, are kept in a locked filing cabinet in the Manager’s Office. Staff do not have access to these files without permission e.g. for inspections. Residents could see their own records should they so wish. Regular reviews are kept although information seen in example files was sparse, such as “No change”. There was no detail about how the resident and or their family/representative was involved in any of the review process. Staff receive regular supervision both individually recorded, and daily informal guidance. The home also holds regular staff meetings to keep staff up to date with information. Freezer and ‘fridge’ temperatures are monitored and recorded. A colour coding system is used for mops and buckets with clear instructions for all staff on which colour to use where. One member of staff commented that this is much better and now everyone is using the same mop for the same place, and knows what they should be doing. Staff have received fire safety training and all staff are First Aid qualified. There were no risk assessments to support the lack of fire door closures, lockable facilities or lockable bedrooms. The Registered Provider and Business Manager both stated their reluctance to write risk assessments for safe working practices. All accidents, injuries and illnesses are recorded. Since the last inspection nothing has been reported to the Commission about any of these. Certificates of staff foundation training were seen and the Pre-Inspection questionnaire stated that updates are due in the near future. No new staff have been employed for at last two years so no induction training information was available at the time of this inspection. The Rock DS0000003840.V282221.R01.S.doc Version 5.1 Page 22 The Rock DS0000003840.V282221.R01.S.doc Version 5.1 Page 23 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 3 3 X 3 2 X X STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 3 X 2 The Rock DS0000003840.V282221.R01.S.doc Version 5.1 Page 24 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 OP4 Regulation 14(1d) Requirement Timescale for action 2. OP7 13, 14, 15, 17 3. OP24 12, 13 & 23 The Registered Provider must write to confirm the home’s abilities to meet assessed needs 02/02/06 of an individual as well as confirming this verbally. The Registered Provider must ensure that risk management strategies are carried out, recorded and used by the staff to reduce identified risks. The registered person must provide evidence that the service users and/or their representatives have been actively involved in the assessment, care planning and review processes. 31/03/06 This requirement is outstanding from the previous three inspections and requires immediate action. Lockable storage facilities must be provided for each of the residents unless it can be demonstrated through individual risk assessments that it would not be safe to do so. 31/03/06 This requirement is outstanding from the previous three inspections DS0000003840.V282221.R01.S.doc Version 5.1 Page 25 The Rock 4. OP24 16,23 Sch115,8 Sch33q 5. OP33 24 Sch1(10) 6. OP38 134c Sch118 Sch33q and requires immediate action. Appropriate door locks must be installed when rooms become vacant or if individual service user requests this facility or if circumstances in the home change unless it can be demonstrated through individual risk assessments that it would not be safe to do so. 31/03/06 This requirement is outstanding from the previous three inspections and requires immediate action. The registered persons must introduce a quality assurance/quality monitoring system. This requirement was under 31/03/06 review at the time of this inspection so the timescale has been extended. The Registered Provider must ensure that risk management strategies are carried out, 31/03/06 recorded and used by the staff to reduce identified risks. This includes fitting (or not) of fire door closures on all doors, particularly bedroom doors. 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 OP22 Good Practice Recommendations To meet this standard the registered persons should arrange for the premises and facilities to be inspected by an occupational therapist with specialist knowledge of the needs of people with dementia. DS0000003840.V282221.R01.S.doc Version 5.1 Page 26 The Rock 2. OP31 This recommendation is carried forward from the previous inspection. To meet this standard the Registered Provider should complete a Registered Managers Award (NVQ at Level 4 in Management) or appoint a Registered Manager. This recommendation is carried forward from the previous inspection. The Rock DS0000003840.V282221.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Rock DS0000003840.V282221.R01.S.doc Version 5.1 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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