Inspection on 14/12/05 for Well House

This inspection was carried out on 14th December 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 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

Well House 15/06/07

Well House 06/06/06

Well House 19/01/05

Well House 10/08/04

Well House 24/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Well House Chestnut Way Brightlingsea Essex CO7 0UH Lead Inspector Kathryn Moss Unannounced Inspection 16th December 2005 09:30 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 Well House DS0000017993.V273877.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. Well House DS0000017993.V273877.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Well House Address Chestnut Way Brightlingsea Essex CO7 0UH 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) 01206 303311 01206 306130 Southend Care Limited Manager post vacant Care Home 36 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (36) of places Well House DS0000017993.V273877.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 36 persons) Five persons, aged 65 years and over, who require care by reason of dementia, whose names were supplied to the Commission in October 2002 The total number of service users accommodated in the home must not exceed 36 persons 19th July 2005 Date of last inspection Brief Description of the Service: Well House is a purpose built home for older people, situated in a residential area of Brightlingsea, close to the town centre. Accommodation is all on one level and the home is divided into four units, each unit consisting of seven single bedrooms and one double bedroom. Each unit has its own lounge and dining area and there is an additional large communal lounge with a smoking lounge attached. The home is registered to provide personal care for 36 Older People (over the age of 65), provides 24 hour personal care and support, and has appropriate equipment (e.g. mobile hoist, hand rails, etc.) to assist residents with limited mobility. There are currently some existing service users who have diagnosed dementia living at Well House, and the home’s conditions of registration reflect the fact that the home is allowed to continue caring for these named individuals, but is not registered to admit people with dementia. The home is owned by Southend Care, and the manager is Kerry Williams, who is currently undergoing registration with CSCI. Well House DS0000017993.V273877.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on the 14/12/05, lasting seven hours. The inspection process included: discussions with the manager, 5 staff, 4 residents, and 1 relative; an inspection of the premises; and inspection of a sample of staff and resident records. 15 standards were inspected, and 4 requirements and 9 recommendations have been made. The focus of this inspection was on environment and health and safety issues. Information on key standards not covered on this inspection can be found in the report of the announced inspection that took place on 19/7/05. Residents and relatives spoken to on this inspection continued to speak positively about the staff team and manager at Well House. What the service does well: What has improved since the last inspection? Action had been taken to address staffing issues identified at the last inspection, especially with regard to ensuring consistent staffing throughout the day and ensuring that staff did not work too many long days. Rotas seen showed a good improvement in relation to this. There was also better evidence of the Criminal Records Bureau/Protection of Vulnerable Adults checks being carried out as part of recruitment practices. Well House DS0000017993.V273877.R01.S.doc Version 5.0 Page 6 At the last inspection several residents had commented that they had not had any trips out for some time. It was therefore good to see on this inspection that there had been some trips arranged: a recent theatre trip had been clearly enjoyed by residents, and a trip to a pantomime was booked. 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. Well House DS0000017993.V273877.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 Well House DS0000017993.V273877.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): 3 Pre-admission assessments are carried out to enable staff to determine if the home could meet a prospective resident’s needs. EVIDENCE: Residents spoken to appeared well cared for, were positive about staff, and felt that staff met their needs. The manager was clear on the needs the home was able to meet, and stated that all prospective residents are assessed prior to admission, either by someone from Well House visiting them in their own home (usually the manager) or when the resident visits the care home. A standard assessment form was used by the home, containing a list of set statements regarding abilities or needs, which were ticked to select issues relevant to the person. This was viewed for one new resident: although this was completed, it had not been dated when the pre-admission assessment had been carried out, and there was no information recorded on the form to reflect the fact that the person was bed-bound. Care management assessments are received for residents referred through social services, but these were not viewed on this occasion. Well House DS0000017993.V273877.R01.S.doc Version 5.0 Page 9 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 and 9 Health and personal care needs were set out in individual care plans, but these did not provide sufficient details of the action required by staff. Medication practices were efficient and protected residents; however, evidence of staff medication training was not satisfactory. EVIDENCE: The care plans were viewed for a resident who had been admitted six weeks prior to the inspection, and who was bed-bound. There were appropriate assessments completed in relation to the person’s key needs (e.g. moving and handling and risk of pressure areas), but care plans did not adequately cover this person’s needs. Although there were standard care plan formats present covering medication, risk of falls, contact with family, and welfare and choice, all the person’s personal and healthcare needs had been recorded on one care plan form, with just a brief comment on each need (e.g. personal care, skin care, incontinence, feeding, communication, sight/hearing). Although this contained some good information, it did not contain sufficient detail of the action required by staff to meet each need. A ‘lack of leisure activities’ care plan form was present, but not completed. Evidence of care plan reviews was Well House DS0000017993.V273877.R01.S.doc Version 5.0 Page 10 not inspected on this occasion, and as this was a requirement from the last inspection this will be carried over for review on the next inspection. Medication was kept on each unit, and was inspected on just one of the units. There were secure storage facilities, and the medication cabinet was clean and well ordered. Medication received by the home was recorded on the Medication Administration Record (MAR); it was noted that where no new medication had been delivered because of remaining supplies in the home, medication carried over from the previous month was not being recorded on the MAR. Records of medication administered were well completed, with no gaps evident; records of medication returned to the pharmacist were not reviewed on this occasion. Eye drops and some bottles of liquid medication were seen to be dated on opening; other bottles were not dated, but the senior carer stated that these were medicines that were always used up over the monthly cycle. Controlled drugs were being appropriately stored in a controlled drugs cabinet, and recorded in a controlled drugs book; a sample was audited, and records and tablets balanced. Training records viewed showed only five staff (two seniors and three carers) as having completed medication training (either internal training or training provided by the pharmacist); the manager felt that these records did not reflect all training completed by staff (see also standard 30). Well House DS0000017993.V273877.R01.S.doc Version 5.0 Page 11 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 and 14 The home offers opportunity for social and recreational activities; residents are encouraged to exercise choice and control over their daily lives. EVIDENCE: Activities care plans or records were not inspected on this occasion, but it was noted that the home continued to have a weekly activities programme, with a ‘What’s On’ programme for the week of the inspection seen clearly displayed on the notice board in one unit. Residents were very positive about a recent evening trip out to the local theatre, which they had clearly enjoyed (eleven of them went), and the home had also arranged to take residents to a local pantomime. Two residents spoken to said that they were able to attend the day centre when there was space, and one resident was pleased that staff had helped them to start knitting again, and were pleased with their achievement. Routines in the home appeared flexible, with residents able to chose where and how to spend their day, when to get up, etc. Menus were displayed on the notice board in each unit, and showed that a choice of food was available to residents. Many of the rooms viewed on the inspection were well personalised, showing that people could bring their own possessions into the home with them. The manager stated that residents could see their own records, and it Well House DS0000017993.V273877.R01.S.doc Version 5.0 Page 12 had been noted on previous inspections that Access to Records was covered in the Resident’s Handbook. The manager confirmed that information on advocacy services is available in the home (not inspected on this occasion). Residents were able to keep money or belongings secure if they wish (through lockable storage or being able to lock their rooms), and the home also had systems available for the safe keeping of residents’ money on their behalf. Meals were not specifically inspected on this occasion, but at the last inspection it had been highlighted that some residents had not been happy with the variety of food served at tea times. The manager stated that subsequent to this the cook had talked with residents, and was making more changes to the Southend Care standard menus, although evidence of this was not available on the inspection. On the day of the inspection, tea-time was observed on one unit: the meal being served was bacon and tinned tomatoes, and it was brought to the manager’s attention that the bacon was overcooked and was very tough to cut or chew; two residents spoken to said that they did not feel tea-time meals had improved. The manager was advised to monitor teatime meals, and it was recommended that residents’ feedback be regularly sought. Well House DS0000017993.V273877.R01.S.doc Version 5.0 Page 13 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): None EVIDENCE: None of these standards were specifically inspected on this occasion. No concerns or complaints about the home have been received by the CSCI since the last inspection. Well House DS0000017993.V273877.R01.S.doc Version 5.0 Page 14 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, 24, 25, 26 The home provides a safe environment, with systems in place for repairs and maintenance. The home provides service users with sufficient personal and communal space, suitably furnished and maintained. The home provides toilet and bathroom facilities that meet residents’ needs. There was suitable heating and lighting to keep residents safe and comfortable, and on the day of the inspection the home was clean and hygienic, with infection control practices in place. EVIDENCE: The manager stated that there is no programme of routine renewal of the fabric and decoration of the premises at present, but she had identified areas of the home needing decorating and said that this would be part of the coming year’s annual business and development plan. Urgent maintenance needs are dealt with as they arise, and the home has a part-time maintenance person; staff record any work identified, and the maintenance person then dates and signs this record on completion, providing an ongoing record of work carried out. The manager was advised of the need to also maintain a record of Well House DS0000017993.V273877.R01.S.doc Version 5.0 Page 15 decoration and refurbishment carried out. The environmental health officer had carried out a food safety inspection earlier in the year. Well House has four units, each with its own lounge/dining room, kitchenette, assisted bathroom and level access shower room, separate sluice room, seven single bedrooms and one double bedroom. No bedrooms had ensuite toilets, but there were several toilets on each unit, close to bedrooms and communal areas. The home also has a large communal lounge, with a small adjacent smoking area. This meets the requirements of the standards for communal space and for assisted bathrooms and toilets. Communal areas were clean and tidy, in a reasonable state of repair, and all were well decorated for Christmas. Bedrooms were similarly clean and tidy, and contained appropriate furniture and fittings, including sufficient electric sockets, lockable storage and keys to their doors (which one resident was noted to use on the day of the inspection), and emergency call systems. Double rooms were fitted with privacy curtains. Some bedrooms were fitted with lino floors: the registered person is advised that if current residents do not require lino flooring for a specific reason, they should be offered the opportunity to have carpet in their room. The home was appropriately lit and ventilated, with evidence of emergency lighting throughout the home. Bedrooms had overhead lighting, and many of those viewed also had table lighting. Rooms were centrally heated, with radiators controllable in individual rooms, and covered to prevent risk from scalding. Hot tap water temperatures were regularly tested to ensure that they remained close to 43°C to prevent risk of scalding, and to ensure central hot water storage temperatures were above 60° to prevent risk of Legionella. The home’s water system also had an annual chlorination treatment for protection against Legionella. The home had appropriate laundry facilities, located away from areas where food was stored or prepared, and with an adjacent area with a sluice sink. The laundry had three washing machines, and one had the capacity to carry out a sluice wash and wash cycles at appropriate temperatures for infection control purposes (i.e. 65°C/71°C). The laundry person showed a good awareness of infection control practices in relation to dealing with soiled laundry. The other two machines had a ‘sanitary’ wash cycle, confirmed to be a hot wash cycle of 95°C: whilst meeting infection control purposes, this would not be appropriate for items of soiled clothing. The washing machine with the sluice wash cycle had been out of use for over two weeks: although an engineer had visited, the manager was still awaiting information from the home’s head office about the action to be taken. Well House DS0000017993.V273877.R01.S.doc Version 5.0 Page 16 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 and 28 At the time of this inspection, staffing levels and skills met the needs of service users. Staff appeared competent, but records did not satisfactory demonstrate that staff had attended the training and achieved the qualifications necessary for their role. EVIDENCE: The rota for the week of the inspection was viewed, and showed that the agreed staffing levels were being maintained (i.e. seven care staff throughout the day, and three at night). The manager stated that issues identified at the last inspection had been addressed: staff were no longer working split shifts resulting in periods of the day being understaffed; staff were working fewer long days; and an additional cook was employed to cover the regular cook’s days off. This was reflected in the rota, and there was a satisfactory level of domestic staffing on duty to meet the needs of the home. Training was not specifically inspected on this occasion, other than the health and safety training referred to in the next section. No concerns about staff competence were raised during the inspection, but individual staff training records inspected showed quite a low attendance by staff at core training (health and safety, POVA, medication, etc.). This was discussed with the manager, who felt that training records were not up-to-date, and stated that she intended to do an audit of carers’ files to check on training completed. NVQ training was discussed and the manager advised the inspector that three staff had completed NVQ level2, another had almost finished this, and one had Well House DS0000017993.V273877.R01.S.doc Version 5.0 Page 17 just started. As noted at the last inspection, this would not currently meet the standard for the proportion of staff to be qualified at NVQ level 2 or above. Recruitment was not fully inspected on this occasion, but a previous requirement regarding evidence of CRB/POVA checks was reviewed. Appropriate action had been taken by the manager: the files of two newly appointed carers were inspected and in both cases there was evidence of a POVAfirst check obtained before the person started work, although there was no evidence of the full CRB check having been received back yet. The need to demonstrate that any person who starts work on the basis of just a POVAfirst check is closely supervised until receipt of a full CRB check was discussed with the manager (reference Department of Health POVA Scheme: A Practical Guide, section 38 and Annex C). For other staff, the manager was providing evidence of CRBs in the form of copies of the CRB the carer had received: as Southend Care is making CRB checks that are held centrally available to the CSCI for inspection, the manager was advised that it would be sufficient to have evidence on file from Southend Care showing that a satisfactory CRB check had been obtained by them (e.g. evidence of disclosure number and date), in order to demonstrate that regulatory requirements had been met. Well House DS0000017993.V273877.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 and 38 The home has quality assurance processes in place to monitor whether it is being run in the best interests if residents. Practices in the home promote the health and safety of staff and service users; however, evidence of staff training in health and safety issues was not satisfactory. EVIDENCE: Quality assurance processes were discussed with the manager. It had been noted at last year’s inspections that Southend Care had carried out a survey of residents’ views, from which a report had been produced, and that the home also had an annual development plan. The current manager has only been in post since April, and had not yet carried out any formal processes for seeking feedback from service users this year. However, she was able to provide evidence of a quality assurance questionnaire that she intended sending out to relatives and using with residents, had thought about who could assist residents in completing these, and intended to summarise the outcomes in a Well House DS0000017993.V273877.R01.S.doc Version 5.0 Page 19 report. It was recommended that the questionnaire be reviewed to minimise the use of ‘jargon’ that may not be familiar to people. The manager stated that the home did not have an annual development plan for this year, but that she was in the process of developing one for next year. She was advised to ensure that this includes outcomes that are resident focused and which staff can be involved in achieving. Aspects of practice are monitored within the home (e.g. medication, accidents, etc.), although no formal records of this are kept at present. The manager spends time around the home, observing practice and talking to residents. A representative of Southend Care carries out regular monthly monitoring visits, and these are clearly recorded. This standard was scored on the basis that the manager was able to provide evidence that quality assurance processes were being developed (i.e. resident survey and annual development plan), and the outcomes of this will be reviewed on the next inspection. The home’s policies and procedures on health and safety were not inspected on this occasion. The manager maintained a well-organised record of the external checks and servicing carried out on equipment and utilities, which provided evidence that the equipment and premises were regularly maintained. There were records of regular internal checks on hot water temperatures (re risk of scalding and to prevent risk of Legionella), and also evidence of regular fire drills, and of regular checks on fire alarms, emergency lighting, and fire equipment (although these had not been consistently maintained each month during the year). Accident records were maintained, and it was recommended that these be regularly audited to monitor any trends. The home had a risk assessment relating to safe working practices, which briefly addressed most core areas of the home. It was recommended that this include a risk assessment in relation to the use and storage of chemicals within the home, and also assessed any risk to residents from the quite high hot water temperatures in the kitchenette sinks on each unit. Individual staff training records showed some gaps in relation to health and safety training. According to records, of the 29 care staff shown on the rota: 18 had current moving and handling training, 11 had fire safety training, 5 had first aid training, and 5 had food hygiene training. Of 11 housekeeping and catering staff, records showed that only 6 had current fire safety and moving and handling training. The manager was aware of other training completed this year that did not appear to have been recorded, and felt that training levels were higher than records indicated (see also previous section). A new carer spoken to said they had not yet attended moving and handling training, and the manager confirmed that this training was planned, and that the carer was not carry out any moving and handling tasks at present. Well House DS0000017993.V273877.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 3 3 X X 3 3 3 STAFFING Standard No Score 27 3 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X 2 Well House DS0000017993.V273877.R01.S.doc Version 5.0 Page 21 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 Requirement Care plans require further development to ensure that they contain sufficient details of the action required by staff to meet each need. Care plans must be reviewed regularly. This is a repeat requirement, which is carried over because it was not inspected on this occasion. The registered person must ensure that all staff that administer medication are suitably trained and competent to do so. The registered person must ensure that individual staff training profiles (records) are kept up-to-date and reflect all training attended. The registered person must ensure that all staff have attended current training in relevant health and safety issues (including moving and handling and fire safety). Timescale for action 31/01/06 2 OP9 13 and 18 28/02/06 3 OP30 18 31/03/06 4 OP38OP30 13 and 18 31/03/06 Well House DS0000017993.V273877.R01.S.doc Version 5.0 Page 22 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 4 5 6 Refer to Standard OP3 OP9 OP15 OP26 OP28 OP29 Good Practice Recommendations It is recommended that the registered person ensure that pre-admission assessments clearly describe all of a prospective resident’s needs. Stocks of medication carried over from a previous month should be clearly recorded on the medication administration record. It is recommended that the manager seeks regular feedback from residents about the tea-time meals provided, and monitors the range of meals provided. It is recommended that the washing machine that provides a sluice wash cycle is repaired as soon as possible. It is recommended that the registered person ensures that training is provided to ensure that at least 50 of care staff have achieved NVQ level 2. Where copies of CRB checks obtained by the registered person are held at the provider’s head office, it is recommended that the head office notify the home of the disclosure number and date, and the date it was received, as evidence that regulatory requirements have been met. It is recommended that there is at least one person on each shift who is trained in emergency first aid. The registered person should ensure that fire alarms and emergency lighting are regularly tested. It is recommended that the home’s risk assessments of safe working practices include use and storage of chemicals in the home, and hot tap water in kitchenette areas. 7 8 9 OP38 OP38 OP38 Well House DS0000017993.V273877.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Well House DS0000017993.V273877.R01.S.doc Version 5.0 Page 24 - 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!