Inspection on 10/05/05 for Trafalgar House

This inspection was carried out on 10th May 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

Trafalgar House 24/10/06

Trafalgar House 26/10/05

Trafalgar House 07/12/04

Trafalgar House 07/06/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Trafalgar House 9 Sutherland Avenue Bexhill-on-sea East Sussex TN39 3LT Lead Inspector Mike Flint Unannounced 10 May 2005 10:00 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Trafalgar House Address 9 Sutherland Avenue Bexhill-on-sea East Sussex TN39 3LT 01424 222911 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) Care Management Group Limited Vacant post Care Home 7 Category(ies) of Learning disability (LD) 7 registration, with number of places Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the home is registered to accommodate up to seven (7) service users. 2. That the service users are aged between 18 and 65 years upon their admission. 3. That the category of service users admitted have a learning disability, not falling within any other category. Date of last inspection 07 December 2004 Brief Description of the Service: Trafalgar House provides social and residential care for seven adults with learning disabilities, who may present with challenging behaviour. It is one of a large number of around 80 specialist homes, owned by the Care Management Group (CMG), providing services to adults within this category. The home is a detached three-storey property with a small garden, situated in a quiet residential area of the town of Bexhill-on-Sea. The shopping centre and railway station are within easy walking distance. Service users accommodation is on three floors, having sufficient bathroom, shower and toilet facilities. There is office accommodation for the manager and staff. Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out during one morning in May, when there were seven (7) residents. Of these, three were away with staff on a seven-day canal boat holiday and one was attending college. The Inspector was able to speak individually with each of the remaining three, at the home. One of the residents’ community health care workers was also spoken with the following day. The acting manager assisted with the inspection, which included a tour of the premises, an examination of records, including care plans and medicines administration, and private discussions with each of the duty staff. At the time of the inspection, maintenance staff were re-decorating parts of the home. What the service does well: Each resident has an agreed and varied programme of weekly activities that offers choices. Two of the residents spoken with expressed their satisfaction with life at Trafalgar House. They were happy to show the Inspector their private rooms, each of which is furnished and decorated to reflect that resident’s interests and choices. The overall standard of furnishings and décor is good, which contributes towards making this a homely environment. The acting manager and staff maintain a high standard of day-to-day record keeping. Quality assurance records show that self-monitoring visits, by one of the senior managers in the organisation, are being carried out regularly. This helps to ensure that the home is performing satisfactorily. Care planning documentation is well presented, with individual risk assessments and review notes included. These provide staff with current information about resident’s care needs and how these are to be met. The CMG organisation delivers a wide-ranging programme of in-house training opportunities, including the TOPSS induction and foundation training and the National Vocational Qualification (NVQ) awards for care staff. CMG is an accredited assessment centre for NVQ training. Both the acting manager and staff said that they felt suitably trained and supported in performing their duties and this contributed towards good team morale. On the small number of occasions when the home has been found unsuited in meeting an individual’s need, the resident has been referred on to a better-suited placement. Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3 Despite comprehensive pre-admission assessment of individual needs the home is unable to meet these for all of the persons being admitted. Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 9 EVIDENCE: In all cases detailed individual assessments have been carried out and are included in the care planning documentation. However, from an examination of care plans it was clear that not all of the residents accommodated at Trafalgar House fall within the home’s category of registration. The acting manager confirmed that residents had on occasion been admitted at short notice by the organisation, without the home manager’s direct involvement in decision making. When spoken to, a resident said that he was not happy with the lifestyle, available to him at the home. The other residents spoken with stated that they did not think he fitted in well with them; duty staff confirmed they also had concerns about their ability to meet this resident’s needs. When the community health care caseworker was contacted on the day following the inspection, she said that circumstances at the time had meant that a quick decision was required. She also said she was aware that Trafalgar House was not providing all that was required for her client. For the majority of other residents, the home provides a suitable base, where opportunity and encouragement are offered. Weekly programmes of activity are agreed with each resident. These records show that individual lifestyles are respected and supported, within the constraints of the home’s resources; residents were able to confirm that this was so. One stated that he now wished to live somewhere, where he could be more independent. The acting manager was able to confirm from a recent review that this resident would be better suited to ‘supported living’ i.e. he no longer requires the level of support, provided at Trafalgar House. Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9,10 The staff have a good understanding of the residents’ support needs. This is evident from the positive relationships, which have been formed between staff and residents. EVIDENCE: Residents together with their key worker together carry out on-going care planning. In this way an assessment of all aspects of personal and social support and healthcare needs is achieved and residents may be encouraged to make choices about their day-to-day living. Residents confirmed that they had access to their personal files should they request this. The home’s Statement of Purpose and Service Users Guide informs residents and their families of the home’s policy on confidentiality. Records showed that as part of their induction training, staff receive this information. A staff member said that any information shared in confidence would only be passed on to a resident’s next-of-kin if the situation requires this and the resident has been told of the decision. Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 11 The risk assessment inspected, included daily household tasks, including food preparation, washing up and laundry that residents might choose to participate in, supported by staff. It was noted that one of the residents was involved in vacuuming his room and said that each resident has a house-day for cleaning and tidying their own rooms, on a weekly basis. Residents’ meetings are held; recorded minutes showed that their ideas and suggestion were acted on, wherever possible e.g. meal planning, activities and outings. Residents confirmed that they participate in the staff selection process, meeting with prospective support workers candidates and providing some feedback. In these ways residents are consulted with and participate in the day-to-day running of the home. However, it was unclear how it was made possible for the existing resident group to express their opinions, regarding any potential new admissions. Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16 From observations during the inspection, it was clear that not all the residents had the self-confidence, or motivation to engage in what was being offered, which hindered progress towards achieving their agreed individual goals. EVIDENCE: Review notes show that resident’s needs and abilities are regularly assessed and that goals are agreed at that time. The Statement of Purpose reflects on the home’s ethos that is based on personal and social development and the acquisition of life skills. From contact with the Community Health Care worker it is evident that individual counselling sessions are available to residents. Records show that a variety of daily activities are available to choose from and residents confirmed this. These include college courses, attending day centres and leisure outings in the home’s people carrier e.g. bowling, swimming and discos. Individual programmes showed that each of the residents is given the opportunity and encouragement to spend part of their week, engaged in these off-site activities. Although at a recent residents’ meeting there had been a request for more in-house hobbies and craft-type activities also. Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 13 Residents are encouraged to maintain contact with friends and relatives either through visits, or by telephone. Staff said that the people carrier vehicle was often used to facilitate weekend trips home for residents, who are also supported in their personal relationships and in maintaining links with friends they have made from other residential homes. Staff spoken with said that resident’s right to privacy was always respected and that they were encouraged to treat the home as their own, choosing to spend time together, or in the privacy of their own room. Staff were seen to be attentive to the needs of residents, giving encouragement to develop their selfhelp and social skills. Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 Residents are encouraged to exercise self-determination and control over their own lives, within a risk-assessed framework that supports their physical and emotional well being, as far as possible. EVIDENCE: Key workers together with a resident carry out the process of assessment, care planning and review. Any goals, agreed through this process, form an important part of the resident’s daily life-style. However, social skills amongst the residents vary greatly and in some cases there is resistance towards conforming with agreed targets e.g. room cleaning, daily routines. Resident’s preferences are taken into account when assigning key workers, who are there to give personal support and guidance wherever this is needed. Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 15 The home is known to receive good support from the local Community Health Care Services and the residents attend a ‘well person’ clinic every six months. Records show that regular chiropody and dental checks are arranged and that each resident has regular contact with their GP, or Consultant. The Inspector noted that not all the residents were inclined towards maintaining healthy lifestyles, where lethargy was apparent. This issue was discussed with the manager at the time of the last inspection. A record is kept of all accidents and incidents; notifiable events are duly referred to the Commission. The number of incidents at the home has reduced, where (physical) restraint has been required for the safety of the resident concerned; such incidents continue to be closely monitored by the Challenging Needs Team, who provide advice and guidance. CMG provide training for all care support workers in nationally accredited methods of restraint and deescalation techniques. None of the current residents manage their own medicines. Only the manager and staff, who have received training in the administration of medicines, have responsibility for this. The dispensing pharmacist visits the home on a quarterly basis and provides any additional, or specialist advice to staff as required. The record of medicines administered was up to date and accurate. Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 The home has a satisfactory complaints system, which records concerns that are raised by any party; however, some of the residents concerns are brought up at their regular meetings. Residents spoken with said that they feel their views are listened to and acted upon. EVIDENCE: Staff are trained to respond positively to service user’s worries, concerns, or complaints; observing interactions during the inspection was evidence of this. Two of the residents spoken with said that they felt they were listened to and that issues were sometimes raised that would be discussed at the residents meetings. A record is kept in the home of any complaints requiring investigation. Details of the complaints procedure are included in the terms and conditions of residency and there is a complaints and comments book kept in the office. As part of their induction, all staff receive training in the protection of vulnerable adults and in the techniques for managing challenging behaviour. There is clear policy guidance for staff within the policies and procedures manual. On the three occasions in the last 12 months, when matters involving residents’ challenging behaviours, where adult protection procedures have been required, these have been appropriately referred to Social Services and the Commission by the home’s manager. Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,28,30 The premises are adequately suited to the home’s stated purpose and in meeting the needs of the service users. However, the neglected garden gives an unnecessarily poor impression of the service. EVIDENCE: The standard of decoration and furnishings was generally satisfactory. The manager, or a senior staff carries out and records health and safety and fire safety checks around the home. However, there were items of furniture in residents’ private bedrooms found to be in need of repair, or replacement e.g. chest of drawers and shelving. A need for checks to be carried out more rigorously in the future was discussed and the need for further, preventative maintenance to be introduced. Residents are provided with adequate single room accommodation that meets their needs, although, due to fire safety regulations, no cooking may be undertaken in the self-contained resident accommodation on the second floor. The new occupant voiced his disappointment that this was the case and that his smoking was disallowed for the same reason. Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 18 The home provides a choice of communal rooms that are comfortably furnished in a homely style i.e. a dinning room and two lounges; a small, adjacent seating area is designated for those service users and staff who smoke. The layout of the domestic-style kitchen provides sufficient space for service users to assist with food preparation. The front lawn, rear garden and patio area for barbeques were poorly maintained; the acting manager said as there was little interest shown by the residents in gardening tasks. The home was clean and tidy in all the (internal) communal areas; residents have responsibility for their own, private rooms and are encouraged to undertake their own laundry tasks. There were no unpleasant odours, though one of the resident’s bedrooms was in a poor state of cleanliness. There is a policy for infection control that staff were familiar with. Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35 There is a good mix of experienced and qualified staff offering consistency of care within the home. EVIDENCE: The staff rotas produced showed that satisfactory staffing levels are maintained at all times, with three duty support workers during the mornings and four on duty during the late shift. The number of residents remaining at the home during the day varies according to their off-site activities. Some activities require care staff from the home to be in attendance, or for transporting individuals to and from; some individual service users require having two staff in attendance for off site activities. At all times there is a nominated first-aider on duty in the home and recent training has ensured this. Three staff are already qualified with National Vocational (NVQ) awards; others are currently part-way through the training; the target of 50 qualified staff has not yet been met. The organisation arranges on-going training opportunities for staff in developing their core skills e.g. risk assessing, safety awareness, food hygiene, infection control, fire safety and first aid, among others. The records of staff training were inspected. Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39,40,41,42 Trafalgar House is satisfactorily managed and efficiently run on a day-to-day basis by the interim, acting manager and an experienced staff team, ensuring the health, safety and welfare of residents as far as reasonably practicable, whilst the post of registered manager remains vacant. EVIDENCE: Residents appear to benefit from the way in which the home is run. Their views are formally sought at care plan reviews, during their house meetings and through sessions with their key worker. The residents’ involvement and participation in the planning and delivery of services is encouraged e.g. input during staff recruitment and planning for outings/holidays. It has previously been recommended that the manager produces an annual development plan specific to the home, reflecting aims and outcomes for residents, as part of a quality assurance and monitoring system. This remains outstanding. Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 21 The home’s written policies and procedures are those of the CMG organisation. These are comprehensive, well documented and reviewed at least annually. They cover all aspects of running the care home and are readily available for staff advice and guidance. Staff continue to be involved in helping to formulate policies and procedures, specific to Trafalgar House. The standard of record keeping in the home is high as was evidenced by the records inspected concerning residents, which were well maintained, accurate and up to date. Staff receive regular training opportunities specific to the health and safety aspects of their jobs and in safe working practices i.e. risk assessment, fire safety, the management of challenging behaviour, medications, health and safety and food hygiene. There are policies and procedures in place that support the health and safety of those who live and work in the home. Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 2 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 x x 2 x 3 Standard No 11 12 13 14 15 Trafalgar House 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 3 x x Version 1.20 Page 23 H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc 16 17 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 x Standard No 37 38 39 40 41 42 43 Score x x 2 3 3 3 x Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 24 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 03 Regulation 12(1) and 14(1) Requirement That the registered person shall only admit persons who are within the homes category of registration and for whom the home is suitable for the purpose of meeting their assessed needs. That the external grounds and garden are safe, appropriately maintained and accessable for residents use. That a manager is registered for the home, who has the appropriate experience and qualification. That the manager produces an annual development plan specific to the home, based on a cycle of planning-action-review, reflecting the aims and outcomes for service users. (Timescale of 01.04.05. not met) That 50 of (duty) care staff are qualified to NVQ level 2, or above. (Timescale of 01.01.05. not met) Timescale for action 01.06.05. 2. 24 23(2)(o) 01.06.05. 3. 37 9(2)(b) 01.06.06. 4. 39 24(1) 01.11.05. 5. 32 18(1) 01.01.06. Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 02 19 Good Practice Recommendations That, in every case, the organisation takes into account the opinion of the homes manager as to the suitabilty of any person referred for admission. That further steps are taken to develop meaningful activities, which engage residents interests and participation, and address their physical health and welfare needs. That a regular audit of furnishings and fixtures is recorded, ensuring any repairs, or replacements required are carried out in a timely fashion. (Previously recommended) That each resident, with responsibility for their own rooms, is satisfactorily supported to ensure that a safe and healthy living environment is maintained. 3. 4. 24 30 Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 Page 26 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Trafalgar House H59-H10 S21273 Trafalgar House V220559 100505 Stage 4.doc Version 1.20 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. 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!