Inspection on 25/09/05 for WCS - The Limes

This inspection was carried out on 25th September 2005.

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

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

Other inspections for this house

WCS - The Limes 16/06/07

WCS - The Limes 01/08/06

WCS - The Limes 02/03/06

WCS - The Limes 27/01/05

WCS - The Limes 02/09/04

WCS - The Limes 30/03/04

WCS - The Limes 14/01/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE WCS - Limes, The Alcester Road Stratford On Avon Warwickshire CV37 6PH Lead Inspector Yvette Delaney Unannounced Inspection 25th September 2005 12:00 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 WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 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. WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service WCS - Limes, The Address Alcester Road Stratford On Avon Warwickshire CV37 6PH 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) 01789 267076 01789 414627 Warwickshire Care Services Limited Miss Lesley Jane Anderson Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th January 2005 Brief Description of the Service: The Limes is a home for twenty-eight older people. It was previously a Local Authority home, but was transferred in 1992, along with a number of other homes, to Warwickshire Care Services, a voluntary sector organisation. The Limes provides personal care to twenty-five permanent service users and has three rooms, which are reserved for short stays. The home also caters on weekdays for up to sixteen-day care service users. Accommodation is on two floors. There is a lounge/dining area on the ground floor and separate lounge and dining areas on the first floor. Eighteen of the bedrooms have en-suite facilities. Warwickshire Care Services plan to replace the passenger lift in 2004. The home is very close to the town centre of Stratford-upon-Avon. It has parking on site and is near to the train station. WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection, carried out on a Sunday afternoon between the hours of 12.00 midday and 6.00 pm. A tour of the premises was undertaken. Records were examined, which include care plans, risk assessments, medication administration records and some policies and procedures for the home. Conversations were held with three members of staff, two residents receiving respite care, eight day care persons and a visitor to the home. The inspection focused on the premises, environment, care practices and the daily life of residents in the home. The home provides facilities and service for up to twenty-seven residents older people requiring long-term care. The inspection started out with the support of all care staff on duty. Staff had varying lengths of experience working in the home. The majority of staff had worked at the home for sometime and therefore knowledgeable about the residents and the running of the home. Staff were receptive and positive throughout the inspection with a good level of knowledge about residents in their care. Conversations were held with eight residents and a relative visiting the home, other residents were spoken with during the process of the inspection. Residents were happy with the home, relaxed and able to speak openly about their day-to-day life in the home. What the service does well: What has improved since the last inspection? WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 Page 6 Work has commenced on addressing the requirements and recommendations from the last inspection. A new care planning system has been introduced, which is linked to a quality assurance system. Examination of the system shows that it could generate a lot of information, which will help to further improve the way the home is run and therefore the lives of residents living in the home. A pictorial Statement of Purpose and Service User Guide has been developed for residents, providing an informative and accessible document for residents. 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. WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 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 WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 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): 1 and 3 The home’s Statement of Purpose and Service Users’ Guide have been produced and are informative. The Statement of Purpose was not accessible to ensure that potential and current residents have the information they need available to them, which could support them in making informed choices about day-to-day life in the home. All potential residents are assessed prior to moving into the home and given assurances that their needs can be met by the home and the services offered. EVIDENCE: Updated copies of the Statement of Purpose and Service User Guide have been forwarded to the Commission. These have been reviewed and found to be comprehensive and the Statement of Purpose has been presented in pictorial format. At the inspection visit a Copy of the Service User Guide was available in the reception area but a copy of the Statement of Purpose was not accessible. WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 Page 9 All potential residents are assessed before being offered a place in the home and three pre-admission assessments were seen and examined. Examination of the information that could be gained would be sufficient to make an informed decision as to whether the home has the resources to meet the needs of potential residents. WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 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 and 11 The residents’ health, personal and social care needs were not consistently described in care plans, which could result in the oversight of care and possible harm to residents. The administration of medication is generally well managed. There is the need for improvements to ensure that residents are protected from harm by the homes policies and procedures for dealing with medicines at all times. Residents’ rights to privacy and dignity are respected resulting in an increase in self-esteem and general wellbeing. The process for supporting residents who are dying and at the time of their death ensures they are treated with respect and sensitivity resulting in appropriate support being given to the resident and their family. WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 Page 11 EVIDENCE: The organisation has developed comprehensive individual plans of care identifying the health and personal care needs of residents, which is linked to a quality assurance system. A care summary is completed following a full assessment. There were no dates recorded on the summary sheets examined to indicate when these had been completed. Staff have received training on completing the documentation and this training is ongoing. Daily entries identified changing care needs although not always reflected in care plans due to documentation not being completed. Discussions with care staff evidenced that they are aware of the care needs of residents. Three care plans were examined two of which were for residents recently admitted to the home. Care plan documentation had entries made in different coloured inks, entries were not all dated and timed and not signed with a signature information of which is important when auditing care plan profiles or if carrying out an investigation. Daily entries made by staff during the day generally made reflective statements providing details on the personal, health and social aspects of a residents’ day. Entries made by night staff were limited and only state for example ‘Good night’, ‘slept well’, ‘tea given 7 am’ and ‘his eyes done’. There are also concerns about confidentiality due to the names and room numbers of other residents being included in daily entry statements. At the time of this visit two residents had pressure sores that was being treated up to three times weekly by the district nurse. There is adequate equipment and support from specialists to support care staff to sustain good tissue viability for resident’s assessed to be at risk. Equipment available includes nursing beds, pressure relieving mattresses walking aids and hoists. The inspector reviewed the homes medication procedure, generally the receipt, storage administration and disposal is good but there were some areas, which need attention. There was the occasional omission where medication had not been signed to confirm that medicines had been taken and medication was not in the pack. Eye drops and ointments were not dated to confirm date of opening so as to ensure they were used within the stated 28 days of opening. Codes were entered over the top of signatures indicating that medicines had been signed for prior to ensuring resident had taken their medicine. Symbols were used with no indication as to the reason for the medicine not be given or taken. The manager had signed on the medication chart to say checked, which could cause confusion if staff need to initial in the area following the administration of medicines. Records examined combined with discussions with the residents, visitors and staff demonstrated that the home is pro-active in protecting the privacy and WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 Page 12 dignity of all residents. Staff spoke to residents with respect and as adults addressing residents as they wished to be addressed. The inspector spent time observing the staff undertaking their duties. Staff were noted to knock on bedroom doors before entering. Personal care such as nursing tasks, washing, dressing and using the toilet was carried out discretely and with privacy in mind. Residents were able to receive visitors to their home in the privacy of their own room or other rooms in the home. Telephone points are provided in bedrooms and some residents have their own phones or access is available to the phone in the home. Staff were able to reflect on their experience of caring for residents who were dying and required sensitive and intensive care in order to meet all their needs Care staff informed the inspector that a palliative care plan was developed with the support of the district nurses, access was available to specialised beds and the GP made frequent visits. The care plan provided details of the personal care to be delivered, pain relief and nutritional needs including fluid intake. Family input and contact was also considered and any religious wishes observed. WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 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 and 15 A good lifestyle is offered to residents related to social, cultural, religious and recreational interests resulting in a high level of well being and quality of life. Residents are encouraged and supported to maintain contact with their family, friends and local community resulting in supporting their social skills and increase in their mental well being. There home supplies three main meals each day and residents are given a choice at each mealtime resulting in residents exercising their right to choose and ensuring their well being. EVIDENCE: The programme of activities includes regular outings, music and movement, reminiscence, quizzes, theatre visits and music recitals. Residents can take part in activities in the day care facility or can remain on their own unit where up to date information regarding activities is displayed. All residents spoken with felt there were sufficient activities offered by the home. Residents said that they could choose how they spent their day and could take part in the social activities if they wished to. Trips out are also arranged. Activities are also displayed on the homes notice board. WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 Page 14 Residents were observed watching television reading books and newspapers and communicating with each other. Two residents who are independent maintain their contact with the community and are able to leave the home as they wish. Visits are made outside of the home on their own, visiting their families, shopping and leading as normal a life as possible. Access is available to the blind association to which a resident had been a member prior to moving into the home. A visitor’s book was available in the reception area this had been regularly signed providing details of all visitors to the home. Residents were having Sunday lunch at the time of the visit, roast beef, Yorkshire pudding and mixed vegetables. An alternative of jacket potatoes with a choice of toppings was available. A choice of two sweets was also offered. The menu for the day was written on a blackboard. Residents said that they enjoyed their meal and there was very little waste. WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 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 and 17 The home has a clear and easily accessible complaints procedure, which indicates an open and positive approach to problem solving. The service ensures that resident’s legal rights are protected, increasing their independence and their quality of life in the home. EVIDENCE: The home has a complaints policy/procedure, a copy of which is displayed in the home and a copy was available in the Service User Guide. The inspector was informed that there have been no complaints received and no complaints have received by the Commission. There is a comments, suggestions and complaints the last entry was dated 07/10/03 and this could be due to the book not being easily accessible to visitors or staff. At the time of the recent general election residents were enable to vote by securing postal votes, some residents went to the polling station themselves and other residents was assisted by their relative or staff. WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 Page 16 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, 22, 23, 24 and 26 The home is very clean and comfortable. Generally the premises are well maintained resulting in a suitable living environment for residents. The environment is very well maintained however there are insufficient safeguards to ensure the safety of some residents. The environment is varied throughout the home in relation to safety, maintenance, comfort and cleanliness, which might reduce the experience of quality of life for residents. EVIDENCE: On arrival to the home the front door was open and no staff were available the inspector was able to walk around the home freely. A tour of the home was carried out with the senior carer on duty. The home provides a comfortable and safe environment, which is clean well managed and homely. The home is generally well decorated and in a good state of repair. WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 Page 17 The garden is in need of tidying but is accessible to residents’ and has a range of garden furniture available. The home is domestic in style and promotes a homely atmosphere and environment is provided. Residents spoken with told the inspector that they were happy with their bedrooms and other areas of the home to which they have access. Residents said they felt comfortable. Some bedrooms looked homely and were made personal by the presence of resident’s own possessions, other bedrooms looked quite sparse. One bedroom was in the process of being decorated and looked light and airy. The window in this room was open and the window restraint off and the door was unlocked. Inspection of the communal bathroom/toilet facilities on the ground floor noted that the underside of the bath chair had corroded, the enamel was coming off the inside and outside of the bath. Around the bath was dirty. The cover over the radiator was dirty. Toiletries noted were available for communal use. An electric shaver was in the bathroom this was dirty and is used as communal shaver. Bedrooms are situated on two floors and are accessible by lift and stairway. There are two communal lounges one on each floor. A separate dining room is available on the first floor and a combined dining lounge area on the ground floor. The lounge on the first floor presents as a dark area, residents preferred to sit in the landing area, which offers an open space with a large expanse of windows making the area light and provides a good view for residents to look out on. The kitchen was clean and well organised. A four weekly menu is available which look nutritious and diabetic meals are also prepared. Cleaning rotas were available for inspection records were not consistently maintained temperatures were not always recorded and signatures not available to confirm who had completed the records. Kitchenettes are situated in each of the dining areas these are clean and the inspector was informed that fridge temperatures are monitored but no records were available. Equipment and aids are available to support staff when caring for residents, which include a Parker bath, sitting scales and a standing and full hoist. The tables in the dining rooms were set for the next meal, the cups were left uncovered and right side up leaving them open to become dirty. WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 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 and 30 The numbers and skill mix of staff on the day of inspection were sufficient to meet the needs of residents accommodated in the home. Staff are provided with training enabling staff to competently meet the needs of residents resulting in appropriate care provision and an increase in the quality of life of individual residents. EVIDENCE: The staff duty rotas for the period of one month were reviewed these demonstrate that staffing numbers and skill mix are sufficient to meet the needs of residents. There are four care staff on duty during the day, the night shift is covered by two waking care staff. At the time of inspection there were three care staff with NVQ level 2 or above and the one carer hoped to start the course later this year. Sufficient domestic, laundry and kitchen staff are employed in the home. Care staff said that they had received training. Mandatory sessions attended include moving and handling, fire awareness, infection control, first aid and food hygiene. Other training attended includes medication and training related to completing the new care plan documentation. This was an unannounced visit carried out on a Sunday staff files were not available to further confirm and evidence this information and whether any other training had been provided. A new member of staff on duty was able to confirm receiving an induction, which includes moving and handling, tour of the home and fire. The induction period lasted for one week. WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 38 Practices observed and the absence of safety checks does not ensure that the health, safety and welfare of resident’s is promoted at all times. EVIDENCE: On arrival to the home the front door was open and no staff were available the inspector was able to walk around the home freely. A voice was heard in the kitchen, and later a carer was found attending to a resident. This level of open access to the home at the weekend when other staff are not available presents a potential risk to residents and staff. The room designated as a hairdressing room contained two upright hairdryers, for which it was not clear when these had been inspected. The registered manager contacted the Commission to confirm that both hairdryers had been inspected in May 2004 and will confirm how often electrical appliances used in the home are checked. WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 Page 20 The fuse cupboard was used as a storeroom storing a television, Zimmer frame and bedrails, which could present a risk if the fuses are not easily accessible. Records were not available to confirm that the temperatures of fridge’s and freezers throughout the home are consistently recorded. WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 X 2 3 2 3 3 3 X 2 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 2 WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 Page 22 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 OP1 Regulation 4 Requirement Timescale for action 31/12/05 2 OP7 15 3 OP7 15 4 OP7OP8 15 A copy of the Statement of Purpose must be available in the home and accessible to residents and visitors. Care plans must be reviewed and 31/12/05 updated monthly or more frequent if necessary to ensure residents individual current needs are identified. Where there is a change in needs a new care plan is written and implemented. Daily statements made about the 31/12/05 residents day must be dated, timed and signed to ensure information is available provides an audit trial. More information must be 31/12/05 included in care plans with regard to resident’s health, personal and social care needs and interventions. Written information must allow for methodical monitoring and provide evidence that all health care needs are identified, professional and specialist services are accessed and health care needs are continuously DS0000004268.V253735.R01.S.doc Version 5.0 WCS - Limes, The Page 23 5 OP9 13(2) 6 OP19 23 reviewed. Statements must provide details, which reflect on a residents’ care during each 24 hour period. The registered manager must 31/12/05 make arrangements for ensuring that the safe administration of medication is adhered to at all times. The issues highlighted in this report. A safe environment must be 31/12/05 provided for residents at all times: • The vacant bedroom, which is being decorated, must be locked when work is not being carried out. • All windows must have their restraints in use. The registered manager must review the level of security maintained in the home at weekends when there are less staff available. The review must include a risk assessment to determine whether it is safe to leave the front door to the home open. The registered provider must ensure that the communal bathroom/toilet on the ground floor is suitable and safe for use by residents. The registered manager must ensure that effective measures are in place to control the risk of infection. The following must be addressed: • • • Communal toiletries must not be used. The use of the electrical razor as a communal shaver must stop. Cleaning rotas in the kitchens and kitchenettes must be consistently maintained. Version 5.0 Page 24 7 OP19OP38 23 31/12/05 8 OP21 23 31/01/06 9 OP26 13(3)(4), 16 31/12/05 WCS - Limes, The DS0000004268.V253735.R01.S.doc • 10 OP30 17 11 OP38 23 12 OP38 23 13 OP38 23 If dining tables are to be laid with crockery in preparation for the next meal, this must be done just prior to the meal or covered to prevent the crockery attracting dust or insects. The registered manager must ensure that all staff training records are kept up to date. This requirement was not assessed at this inspection. The Registered Manager must confirm the arrangements for PAT testing electrical appliances used in the home. A risk assessment must be carried out to ensure that using the fuse cupboard for storage does not present a risk. The temperatures of fridge’s and freezers throughout the home must be consistently recorded. 31/12/05 31/01/06 31/12/05 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP7 OP16 OP37 Good Practice Recommendations The completion of care plan documentation in different coloured inks should be discouraged. The ‘Comments, Suggestions and Complaints ‘ book available should be easily accessible to residents and visitors. The registered person should review the policies and procedures to ensure that they contain reference to notifications to be made to the Commission for Social Care Inspection under Regulation 37 of the Care Homes Regulations 2001. This requirement was not assessed at this inspection. WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 WCS - Limes, The DS0000004268.V253735.R01.S.doc Version 5.0 Page 26 - 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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