Inspection on 11/05/06 for Tripletrees

This inspection was carried out on 11th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Tripletrees 11/12/08

Tripletrees 18/02/08

Tripletrees 18/07/07

Tripletrees 04/10/05

Tripletrees 24/05/05

Tripletrees 07/10/04

Tripletrees 15/06/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

1 Marten Road

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Tripletrees 70 Ferndale Road Burgess Hill West Sussex RH15 0HD Lead Inspector Mrs J Hough Key Unannounced Inspection 11th May 2006 07:00 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 Tripletrees DS0000014806.V290435.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. Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Tripletrees Address 70 Ferndale Road Burgess Hill West Sussex RH15 0HD 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) 01444 243054 01444 248344 Follett Care Limited Mrs Mary Follett Care Home 28 Category(ies) of Dementia - over 65 years of age (3), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (3), Old age, not falling within any other category (28) Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. A maximum of 28 service users may be accommodated at any time. A maximum of 3 service users over the age of 65 years in the DE(E) Dementia service user category may be accommodated. A maximum of 3 service users over the age of 65 years in the MD(E) Mental Disorder service user category may be accommodated. 4th October 2005 Date of last inspection Brief Description of the Service: Tripletrees is a care home, registered to provide personal care for a maximum of twenty-eight older persons to include a maximum of three residents with dementia/mental disorder. Tripletrees is a large detached and extended property, situated in Burgess Hill, being close to shops, local amenities and transport links. The accommodation is arranged on three floors and comprises of twenty-four single bedrooms and two double rooms that are served by a passenger lift and stair lift. Residents benefit from a large lounge and dining room on the ground floor. The home is owned by Follett Care Limited and is managed by Mrs M Follett. Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over 9 hours with two inspectors. The Care Manager Christine Margetts was the person in charge on the day and provided the information required. A follow- up visit was made the following day to provide the Registered Manager Mrs Mary Follett with feedback from the inspection. A tour of the premises was made and the resident’s rooms were seen. Records were examined with regard to the resident’s assessments and care plans, staff files, medication, complaints, accidents, staff rotas, menus, quality assurance, staff training and maintenance. Both residents and staff were spoken with to find their views on what it was like living and working in the home. The inspectors arrived early in the morning so had an opportunity to speak with the night staff as well as the day staff. The key standards were inspected on this inspection plus those standards not assessed at the last inspection in October 2005. Two additional visits were made to the home in November 2005 and February 2006 following concerns raised about some of the procedures carried out in the home and the staffing levels. As a result of these visits three requirements and three recommendations were made some of which have been addressed. The issues that remain outstanding from those visits were assessed on this inspection. There were seven requirements made as a result of this inspection. The current scales of fees are from £400 to £550 per week. What the service does well: The residents spoken with said they were well looked after by the staff and the staff were kind and courteous to them. From observations made of the staff and the residents it was clear that they had built up good relationships and the Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 Page 6 staff had a good understanding of the residents individual needs although the documentation did not support this. What has improved since the last inspection? What they could do better: The arrangements in place for staff to administer the medicines at night and during the night need reviewing so that the residents are able to take their medicines at a time that suits them and also follows the prescribed times set by the doctor. The medication policy needs amending to a policy that suits the purpose of the care home. At present the policy relates to a nursing environment that is not applicable to the home. The resident’s care plans and assessments are inconsistent in the information making it unclear what the needs of the resident are and the level of assistance required. When a need was identified on the assessments it was not in all cases included on the care plan. An observation was made of poor manual handling practice when two members of staff were seen lifting a resident with the aid of a handling belt. The staff were aware this was not good practice but confirmed that due to the size of the resident’s room the hoist could not be used. Some areas of the home need some maintenance work carried out and some furniture needs replacing. Risk assessments must be completed for the garden area. New staff must not commence work in the home until a satisfactory Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks have been cleared to ensure the protection of the residents. The policies and procedures for the home are in need of reviewing and updating. A robust quality assurance system should be in place with an audit carried out annually that is made available to residents and their relatives. Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 Page 7 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. Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides prospective residents with all the relevant information about the home. All residents have an assessment carried out prior to moving into the home EVIDENCE: A revised Statement of Purpose and Service User Guide was completed in May 2006 that includes all the relevant information about the home. Both documents were available in the reception for reference. The Statement of Purpose states that all residents have a pre-admission assessment carried out prior to admission to the home to ensure the home can meet their needs. All residents are admitted on a 30-day trial period. The home has an emergency admission policy that states emergency admissions are only accepted provided the referring agency has carried out an assessment, and no decision would be made to make the placement permanent until a full assessment and review had been carried out by the home. Although the home admits residents who may have dementia there was no evidence that the staff had received training on dementia. The home does not provide intermediate care. Tripletrees DS0000014806.V290435.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. Quality in this outcome is poor. This judgement has been made using the available evidence including a visit to this service. Some of the residents are not being given their night -time medicines at the appropriate times. Training on medication is still outstanding for the night staff. The care plans were not clear in identifying all the resident’s needs and the level of care that is provided. EVIDENCE: Concerns had been raised about the poor practice in the administration of medicines and the night staff not having access to the medicines during the night. An additional visit was carried out in February as a result and two recommendations and two requirements were made, and some aspects of the medication procedures that were causing concern had now ceased. Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 Page 11 Arrangements had been made for the night staff to give the medicines that were only to be given as required and these were contained in a locked metal box and kept in the staff room. However, the night staff could not access a Controlled Drug that may be needed for a resident and the plans in place for contacting the senior member of staff on call to administer this medicine was considered unsatisfactory due to the length of time it may take for that member of staff to reach the home. The medication administration records were examined and found to be satisfactory. Training for staff on medication was in the process of being planned with the supplying pharmacist and it was confirmed that it would be the responsibility of senior care staff to assess the competency of staff to administer medication. Senior care staff working on the late shift were still responsible for administering the night time medicines. All residents had been risk assessed that included asking them what time they wanted their night time medicines. On checking the assessments it showed that times given were either 8pm or 9pm. Discussions were held with the Registered Manager with regard to medicines being given at the prescribed times and not the times that suit the home. The medication policy needs amending to a policy that suits the purpose of the care home. At present the policy relates to a nursing environment that is not applicable to the home. Observations were made of the administration of medicines during lunchtime and it was noticed that the medicine trolley was left unattended and unlocked by the reception while the member of staff went into the dining room to give residents their medicines. On speaking with the staff it was confirmed that the home had one mobile hoist, one handling belt, and one turntable to assist with mobility. Three care plans and assessments were examined and it was found that the care notes were fragmented and inconsistent in the information given and in some cases made it difficult to identify the individual needs of the resident. Care plans generally did not identify the level of assistance needed by staff but this information was given on the personal care chart. Emotional and psychological needs were not indentified on the care plans. When it had been assessed that the resident suffered from depression or anxiety there were no actions in place to assist staff on how to deal with this. One nutritional assessment was incomplete and one identified the resident needed weighing weekly, but this had not be carried out since January 06 with no reasons given for discontinuing. Care plans did not contain evidence that the resident/relative had been consulted or included in the completion of the plan. It became clear that the documentation was not a true reflection of the care provided as when talking to the residents they said they were looked after and all their needs were attended to by the staff. One new resident admitted for respite the day before the inspection had no care plan or risk assessments completed although was diagnosed with dementia and had a tendacy to wander. On arrival at the home in the early Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 Page 12 morning to carry out the inspection the front door was wide open with no staff responding to the doorbell for some considerable time. Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. The residents said that their social needs were met as far as possible taking into account their increased physical frailty. The residents are offered a well-balanced diet. The residents are able to have visitors at any reasonable time. EVIDENCE: The inspector was impressed at the flexibility of the breakfast meal, which was seen to be served over a number of hours. However it was clear from observation that the care home is substantially routine driven, particularly in relation to lunch and supper meal times and the provision of personal care. There is little flexibility about what time residents can take these meals and rotas for getting up, bedtime, bathing and room cleaning unless a resident can clearly communicate their wishes Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 Page 14 The residents spoken with confirmed that the visiting times in the home are open and visitors can come and go as they please. Copies of the four- week menu were seen that showed a well-balanced and varied diet is offered. An alternative of a salad, omelette or fish is provided at lunchtime for those residents who may not like the main meal The inspection took place on a Thursday and during this time service users were observed watching television or listening to music. A quiz was held in the morning and staff were observed playing cards with the more able residents in the afternoon. A resident commented that ‘staff will put on music or a video without asking if we want to have these on’. The home does not employ an activities organiser at present and so the care staff take on this responsibility as well as their care duties. Some residents did say they would like to have a more robust programme of activities. The manager stated that there was a programme of activities however this was not always followed. Staff stated that during the summer residents like to go into the garden. Staff also stated that no activities take place at the weekends because they are so many visitors. They were unaware of what type of activities they might be able to undertake with more dependant residents, as this had not been mentioned to them. As part of the quality assurance it is recommended that residents be asked about what entertainment they would like to have. Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome is poor. This judgement has been made using available evidence including a visit to this service. The recruitment process may not protect residents from abuse. The residents are provided with the relevant information about making a complaint should the need arise. EVIDENCE: It was reported that most staff have had some training on how to protect residents. The staff interviewed had mixed levels of knowledge about the vulnerability of residents and what constitutes an abuse. A copy of the protection policy, which now includes the guidelines set out by West Sussex Multi-Agency Policy and Procedure for Protecting Vulnerable Adults, was confirmed by the manager, as in place. Staff files were seen and all contained CRB checks, however some staff confirmed that they had started work before Criminal Records Bureau had been returned. The manager stated that first POVA checks had been carried out but there was not evidence to support this. The complaints log was seen and there were no recorded complaints since the last inspection in October 2005. A discussion was held with regard to what would be considered as a complaint and recorded in the book and the care Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 Page 16 manager said that small issues or concerns that can be dealt with and resolved quickly would not be recorded. The complaints procedure includes incorrect details as states the National Care Standards Commission (NCSC) instead of the Commission for Social Care Inspection (CSCI). A copy of the complaints procedure is available in the Service User Guide kept in reception. Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,24,26 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. Some areas of the home need some maintenance carried out and some furniture needs replacing. The manager confirmed that the requirements made by the fire officer had been met. EVIDENCE: A tour of the premises took place and most of the residents rooms were seen. Many of the rooms were small and due to there size and layout would not accommodate a hoist. It was also noted that some maitenance work is needed is some areas of the home and some furniture could benefit from replacing. Some of the bedroom doors had locks fitted and call bells were situated in all bedrooms. One of the residents rooms contained a fire exit that should be Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 Page 18 accessible at all times for a means of escape. There was no evidence available that the resident living in that room had agreed that the room be kept unlocked for this purpose. On the very top floor accessed by very steep stairs and not accessible via the lift the bathroom was not very clean although most areas of the home were clean and fresh. In some areas there were no handrails on stairs. The lounge and dining areas were comfortable and homely. The manager confirmed that the fire officers requirements had all been met. However it was noted tht the fire door between the back stairs and hall was very slow to close and another fire door looked in poor repair. The handyman was informed. The garden to the rear had a pond that contained stagnant water and debris that was in urgent need of cleaning out. There were railings around the pond for health and safety purposes. The outdoor steps and pathways had no handrails and some of the paths were uneven and considered to be a health and safety risk. No risk assessment had been completed for the garden area but the path had been cordon off. Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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. Quality in this outcome is poor. This judgement has been made using available evidence including a visit to this service. Staffing levels were generally felt sufficient for the staff to look after the residents. The recruitment process in the home in some cases is unsatisfactory and fails to protect the welfare of the residents. EVIDENCE: Following a series of complaints an additional visit was carried out in November 2005 to check staffing numbers in the home. At that visit the staff rotas were examined and on some days the rotas did not reflect the actual numbers of staff on duty. The staff rosters received prior to this inspection showed staffing levels varied from four to five care staff in the morning and from four to five in the afternoon with two care staff working at night. However it was noted that two members of staff are employed as a general assistant and therefore are not able to provide personal care to the residents, but were included in the care staff numbers on the rota for the days they work. Two housekeeping staff work Monday to Friday and the kitchen is covered from 9am to 3pm by two persons except for Friday, Saturday and Sunday when one person is rostered in the kitchen. Care staff have to prepare or cook the teatime meal for the Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 Page 20 residents. Staff also said that at times they have to prepare the main meal at the weekends when there is no chef on duty. However, the day staff spoken with felt the staffing numbers were sufficient for them to look after the residents and spend time with them. The training programmed for staff shows that one care assistant has achieved NVQ level 4 and six care assistants are training for NVQ level 2 and four care assistants for level 3. As previously stated in this report, it was evident from checking the staff files and speaking with staff that Criminal Records Bureau checks (CRB) are applied for, but staff start working in the home before they are cleared. The manager states a Protection of Vulnerable Adults (POVA) checks are carried out before they start but no evidence was seen of this. Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 Page 21 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): 31,33,35,38. Quality in this outcome is poor. This judgement has been made using available evidence including a visit to this service. Management systems within the home do not ensure that residents receive a service, which meets its purpose, aims and objectives. Some practices, environmental issues and lack of documentation do not protect the health, safety and welfare of the residents. EVIDENCE: The manager is a first level registered nurse who is registered with the Commission and has worked in the care arena for many years. She confirmed that she started the Registered Managers Award in December 2005. Policies and procedures had not been updated since 2002 and health and safety policies were not dated. Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 Page 22 All staff interviewed were able to confirm that they had received formal supervision in the last six months. However staff were unable to confirm that they had received all mandatory training this included prevention of abuse, first aid and fire and the training records confirmed this. There was no evidence of a robust quality assurance system. The inspectors noted that the only evidence presented was the Commissions own comment cards and no annual audit was carried out. The manager was handling the money for two residents and records were maintained of all transactions. However it was recommended that a bank account be opened for one resident due to the sum of money being held. It was clear from speaking to staff on the day of inspection that they were aware of the homes health and safety policies however some poor practices were observed. This poor practice involved moving and handling where staff had to lift a resident with the aid of a handling belt. Staff confirmed that they had had training and that they were aware that they should not be lifting residents but confirmed they were instructed by the manager to carry out the lift. Tripletrees DS0000014806.V290435.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 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 2 X X X X 3 X 3 STAFFING Standard No Score 27 1 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 1 Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? No 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 OP7 Regulation 15(1) Requirement The registered person must ensure that all residents have a care plan setting out all the resident’s needs in respect of their health, and welfare. Timescale for action 31/07/06 2. OP9 13(2) The registered person shall make 30/06/06 arrangements for the safe administration of medicines. The registered person shall ensure that at all times suitably qualified, competent and experienced persons are working in the care home is such numbers as are appropriate for the health and welfare of the residents. The registered person shall not pay any money belonging to any resident into a bank account unless the account is in the resident’s name. The registered person shall ensure safe working practices including moving and handling to ensure unnecessary risks to the DS0000014806.V290435.R01.S.doc 3 OP27 18(1)(a) 30/06/06 4 OP35 20(1) (a) 30/06/06 5 OP38 13(4)(c ) 30/06/06 Tripletrees Version 5.1 Page 25 6 OP19 23(2)(a) 7 OP29 19(1)(b) health and safety of the residents and staff. The registered person shall ensure that the premises be kept in a good state of repair externally and internally. The registered person shall not employ a person to work at the care home unless a satisfactory Criminal Records Bureau Check has been received. 30/09/06 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Tripletrees DS0000014806.V290435.R01.S.doc Version 5.1 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. 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