Inspection on 07/11/05 for West Heath House

This inspection was carried out on 7th November 2005.

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

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

Other inspections for this house

West Heath House 09/07/07

West Heath House 04/09/06

West Heath House 15/03/06

West Heath House 23/03/05

West Heath House 18/08/04

West Heath House 19/02/04

West Heath House 03/09/03

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Maple Lodge

Heathlands

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Ravenhurst

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Inspirations

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

CARE HOMES FOR OLDER PEOPLE West Heath House 90 Alvechurch Road West Heath Birmingham B31 3QW Lead Inspector Monica Heaselgrave Unannounced Inspection 09:30 7 November 2005 th 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 West Heath House DS0000033605.V254829.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. West Heath House DS0000033605.V254829.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service West Heath House Address 90 Alvechurch Road West Heath Birmingham B31 3QW 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) 0121 475 3614 0121 478 0130 Birmingham City Council (S) Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places West Heath House DS0000033605.V254829.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. That home is registered to accommodate 26 people over 65 years who are in need of care for reasons of old age which may include mild dementia. Registration category will be 26 (OP) That minimum staffing levels are maintained at 3 care staff throughout the waking day of 14.5 hours. That additional to above minimum staffing levels there must be two waking night care staff. That an application for registration of a manager is submitted by end July 2004. All toilets must be partitioned from floor to ceiling by 30th April 2005. Date of last inspection 23rd March 2005 Brief Description of the Service: West Heath House is a large purpose built two-storey building, located on the Alvechurch Road in West Heath. It is situated at the top of the road overlooking the main road with views all around the immediate area. The building is approached via a drive to the front with some off road parking. West Heath House offers accommodation to twenty-six older adults. All bedrooms are single with a wash hand basin facility, and emergency call system. Bedrooms are located on the ground and first floor, with access via a passenger lift. There are two lounges, one smoking and one non-smoking, a dining room, main kitchen and office and medical room. The laundry is situated on the first floor. Toilets and bathrooms are situated on both floors, although six out of the eight do not offer good disability access. There is an enclosed garden with a patio to the rear of the house, and open lawn areas to the front and sides. The home is opposite a church and parade of shops; a number of bus routes to the city and surrounding area are within walking distance. West Heath House DS0000033605.V254829.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on a Monday, between 9.30 am and 2.00 pm. The inspector met with the manager, and some of her staff team. A number of service users were spoken to individually. Observation of the daily routine was made, to include the morning care routine, social activities and the lunch time period. A tour of the premises was undertaken. A number of records were inspected to include information for service users, assessments, care plans and risk assessments. Some maintenance and inspection documents for safety of the building were sampled to include, fire equipment tests, gas safety, storage of hazardous substances, hot water testing, and infection control procedures. Records and procedures for the recruitment, training and supervision of staff, and staff rotas were also inspected. What the service does well: What has improved since the last inspection? Information for service users has been improved, which means they have a better understanding of the service the home provides, and whether this is the right home for them. Recruitment procedures have been improved to ensure all previous work history is known for staff that wish to work in the home. This will provide safeguards for service users. West Heath House DS0000033605.V254829.R01.S.doc Version 5.0 Page 6 An assessment of equipment and aids has been undertaken, which has lead to the replacement of chairs, beds and walking aids. This equipment is safe and suitable for the needs of older people. 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. West Heath House DS0000033605.V254829.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 West Heath House DS0000033605.V254829.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, 2, 3, 4, 5 There is information available to help service users make a choice about moving into the home. The well-established assessment and admission procedures ensure that the needs of service users are known, planned for, and service users know what to expect from the home. There are good systems in place that ensure the home has the capacity to meet the assessed needs of service users, ensuring their safety and wellbeing. EVIDENCE: The manager has provided the Commission with the Statement Of Purpose, prior to this inspection. This has been amended to include details of those bedrooms, which do not accommodate furniture as listed in standard 24. Service users are provided with the Statement Of Purpose, Service User Guide and an updated complaints procedure. These now accurately inform potential service users of the facilities provided, which enables them to make an informed choice. The manager and staff team have a good system in place for welcoming and informing prospective service users. This includes giving them copies of these West Heath House DS0000033605.V254829.R01.S.doc Version 5.0 Page 9 documents for them to read at leisure, and verbally explaining the process and procedures to them, should they decide to live in the home. Some service users spoken with, confirmed that this experience has been positive, and that they are happy with the information provided for them, which has enabled them to make an informed choice. In several files examined, the assessment undertaken by the Social Worker at the point of referral provides only basic details, in one it stated ‘as appropriate’, to each element. This does not determine the need in specifics, or how they should be responded to. It was positive to see therefore, that the manager has ensured their own assessment of needs, is explored more fully. There is a well-established, admission process. This includes the service user, their family, and any relevant professionals involved with the care of the service user. Records seen confirm that an assessment of needs is undertaken primarily within in the first few days of admission. Staff sit with the service user and explore their needs, preferences and requests. This is then developed into a Care Plan. The Care Plans viewed covered most aspects of the person’s needs, to include mobility, health, risk of falls, continence, weight, manual handling needs, and the use of aids or adaptations. However the detail was not comprehensive, and some aspects were not explored fully, such as social needs. There is currently a high ratio of service users who are identified as at risk of falling. The manager has monitored this closely via good auditing of the accident records. This information has been instrumental in determining whether the home could adequately and safely meet the needs of any new referrals with the same level of need. It’s also acknowledged that a number of preliminary visits might need to take place at a pace dictated by the service user, and his or her needs. West Heath House DS0000033605.V254829.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, 10 There are very good systems in place, which ensure service users health and social care needs are met. Service users are cared for in a manner that both promotes and protects their dignity and privacy, however toilet facilities compromise this. EVIDENCE: Care Plans are current, and contain good health care details, and how these will be managed. This ensures needs are met in a consistent and planned way. A review takes place on a six monthly cycle. Each service user has an allocated Key Worker who liaises with family and other professionals to co-ordinate how needs will be met, and ensure that any significant change in care needs, is identified and acted upon promptly. The involvement of the service users in this process is recorded. Daily records viewed confirmed that any change in a person’s health, is recorded, and acted upon. On the day of inspection staff reported someone feeling unwell, this was recorded, and the G.P was called out. Service users falling resulted in an updated risk assessment and preventative measures being put in place. Concerns relating to weight loss, diet, and pressure sore care were well managed, and detailed in Care Plans. West Heath House DS0000033605.V254829.R01.S.doc Version 5.0 Page 11 Staff had good knowledge of service users’ needs, characters or idiosyncrasies, and observation of their interaction with service users, showed they used this well in supporting them with their care and preferred routines. Several services users commented favourably on how staff supported them. One said ‘Staff are lovely, always prepared to help me, and if I’m not well they always get the doctor in.’ Records confirmed that service users have access to health care services, to include; a G.P of their choice, dental, chiropody, hearing and optical services. It was also evident that advice is currently being sought for one individual regarding psychological needs to include confusion, and Dementia. The arrangements for personal care ensure that the privacy and dignity of service users is protected. However the toilet facilities within the home compromise this. Toilets are in a very poor state of repair, and only two out of eight provide enough space for service users who require assistance. Toilets are not fully partitioned from floor to ceiling, and are accessed off communal corridors. Consequently, trying to maintain a degree of privacy is difficult. The manager has submitted plans for toilets to be up-graded to provide assisted facilities, which are capable of meeting the assessed needs of service users. This was a requirement from the previous inspection. Service users confirmed that they have access to a phone in private, and handle their own mail and private affairs. Where this was not possible, arrangements were seen to be in place for these to be handled independently from the home. West Heath House DS0000033605.V254829.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 Social activities are varied, and stimulating for service users. There are good opportunities for service users to maintain contact with their family and local community. Meals provided are wholesome, pleasing to service users, and there is good monitoring of food intake where concerns are evident. EVIDENCE: There is a well-established and varied level of social activities available to and utilised by the majority of service users. Service users’ meetings are used to explore what pursuits service users prefer. There are activity workers and an entertainment committee who organise a range of events. From anecdotal comments, there are some established social events within the home, Bingo, board games, and ‘ring and ride’ for community amenities. There is a visiting library. Service user meetings take place, and minutes of these show that the service users would like the movement and mobility sessions to be re-instated, and the bar to be up and running. Christmas events were also being planned to include a pantomime. The notice board informed service users of the next visit from the priest. From sampling individual I.S.S’s and activity records, it is not evident how choices are arrived at, or how staff, ensure that the service users routines or West Heath House DS0000033605.V254829.R01.S.doc Version 5.0 Page 13 preferences are arrived at. The inspector found that the ‘goals’ are not specific, for example one entry stated, ‘inform him of activities ’, another ‘I have no special dietary needs’. There needs to be further detail of what the service user previously enjoyed in the way of activities, and what will be presented to them. Individual Service Statements were cross-referenced with daily notes. Entries in these such as ’resting in the lounge’ or ‘all care given’, do not adequately describe the care, how it was received or whether it suited the person. Further more, these comments do little to further inform the I.S.S or care plan. Daily records must focus on how the person responded to the activity, or whether they enjoyed it or not. In the same way, dietary needs could state what the service user enjoys, where they prefer to eat and whom they like to sit with. Service users continue to enjoy contact with their family, and this is well documented in care notes. Via a variety of social events in the home, family, friends and the local community maintain good links with service users. There is also a Compliments Log, which has very favourable comments concerning the care provided. Some service users stated they maintain a good degree of control over their lives, to include their religious observance, leisure time, personal relationships, finances and daily routines. Reviews showed that service users contributions are recorded in these areas. From discussions with some service users, it is evident that the quality of food is good. The inspector observed the lunchtime meal, staff were asking service users comments upon their meals. Service users meetings are also utilised to explore menu choices. One service user said, ‘menus have improved there are lots of different dishes now’. Service users enjoy wine with their Sunday dinner. Menus were viewed by the inspector, and showed a varied choice, were appealing and enjoyed by the service users. There are numerous examples of good care, but the daily records do not accurately reflect this. West Heath House DS0000033605.V254829.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Complaints are handled properly and provide service users with confidence that their concerns will be listened to, and acted upon. There are robust procedures for safe guarding service users from the risk of abuse. EVIDENCE: There is a detailed complaints procedure, which is given to service users upon admission to the home. This describes how complaints can be made, and who will deal with them. Since the last inspection these have been amended and now include the arrangements for Contacting CSCI. A record of complaints, is maintained, this was viewed. The entry made included feedback to the service user. One service user confirmed that they had a copy of this procedure, and knew how to make a complaint. Service users were confident that any concern or complaint would be dealt with quickly. Service users also said that there are lots of other platforms available to them to air their views, and so there rarely was a need to complain. These included service user meetings. These were sampled and showed that comments made were followed up. There is a Compliments Log for people to comment on all aspects of the care and service they received. These were very complimentary of the service provided. West Heath House DS0000033605.V254829.R01.S.doc Version 5.0 Page 15 Adult Protection Policy and Procedures is available for staff who have also received training in Adult Protection. These developments will ensure that a proper response to any allegation or suspicion of abuse is quick. West Heath House DS0000033605.V254829.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, 21, 22, 24, 25, 26 Service users have clean surroundings in which to live. Lack of appropriate toilet facilities compromises their privacy. The provider has not complied with previous requirements, which would greatly enhance the comfort of service users. EVIDENCE: There were several requirements made at the last inspection of March 2005, which included outstanding maintenance works identified at previous inspections. A report for Strategic Commissioner Special Projects, shown to the inspector, lists all these as a priority, and is waiting budgets. The main areas of concern are: - At least eight bedrooms are in need of redecoration. - Doorframes and skirting require painting for peeling paint and general wear and tear. - Flooring in five of the W.Cs is extremely poor. - Cracked ceilings and peeling plaster in toilets. - Replacement of two toilets. Exposed concrete around toilet base. West Heath House DS0000033605.V254829.R01.S.doc Version 5.0 Page 17 - Not all bedrooms have an automatic door closure. An audit of all bedrooms is needed to identify the shortfall. - Replacement of guttering. - Repainting of outside of building. - Redecoration of the main kitchen. - Unsafe garden wall caused by tree roots. - Floor covering to the upstairs is badly worn and requires replacement. The inspector was informed that a quote and budget is being sought, but there is no confirmation as to replacement. - Toilet areas require floor to ceiling partitioning. There is a significant amount of work needed to ensure that service users live in a safe and well maintained environment, with suitable toilet facilities to meet their assessed needs. The Registered Person will need to provide the Commission with a plan outlining how and when these works are to be undertaken, to ensure the comfort of the people both living and working in the home. There have been some developments in ensuring that service users have access to equipment that will maximise their independence and meet their assessed needs. Some service users have a physical disability. The Occupational Therapist has assessed and replaced chairs, zimmer frames and beds. This has provided them with a degree of comfort and independence. Since the last inspection a programme for replacing the fluorescent lighting to a more suitable domestic fitting has commenced, this will enhance the comfort of service users. The location of the laundry on the first floor was at the last inspection identified as infringing on the comfort and privacy of service users. The re-siting of the laundry remains outstanding. There is now a policy which staff follow regarding the times that laundry can be undertaken. A storage area for laundry has been identified. This appears to be working well, and enables service users to enjoy their bedrooms. Infection Control procedures have been implemented and all areas were seen to be clean, and free from offensive odours. Hot water outlets are tested to ensure service users are protected from the risk of scalding. A test certificate for Legionella was available to confirm service users were not placed at risk from water not stored or distributed at safe temperatures. West Heath House DS0000033605.V254829.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, 29 Service users needs are met by a skilled well deployed, and organised staff team. Recruitment procedures have improved and provide further safeguards for service users. Staff are trained and competent in carrying out their role as carers, this ensures they can meet the needs of people accommodated. EVIDENCE: Rotas sampled indicated that staffing levels are maintained at a level that complies with the conditions of registration. Training records showed that approximately 50 of staff are trained to NVQ level 2, with some having level 3, and 4. There are currently ninety-three care hours vacant, which amounts to 1 post at 30 hours, 1 post at 35 hours and 1 post at 28 hours. These vacancies are currently covered via the use of casuals, permanent staff and one temporary staff member. The manager said that despite these difficulties, staff are managing to maintain a degree of consistency for service users. Service users themselves had no complaints, they commented upon the kindness of staff, and said ‘they are always willing to help’. Another said, ‘they know what I like, and when I want to do things, and when I don’t. They are always chatting to us and treat us very well’. The current dependency level of some service users is high. Several are assessed as at risk of falling and some have physical and mobility needs, staff were observed to be well deployed and observant to these risks. West Heath House DS0000033605.V254829.R01.S.doc Version 5.0 Page 19 Staff files were maintained in good order. Recruitment records showed that all the necessary checks are taken to ensure the safety of service users. Since the last inspection, a system has been implemented to explore gaps in employment history; this will further enhance the safety of service users. West Heath House DS0000033605.V254829.R01.S.doc Version 5.0 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 37, 38 The management of the home is good, with clear leadership and guidance to staff. This ensures service users receive consistently high standards of care. The health and safety of service users and staff is promoted. EVIDENCE: The manager has NVQ level 4 in care and management. She is waiting completion of her Registered Managers Award. She has a wide range of experience, training and expertise in meeting the needs of older people. Observations made of the care practices, systems, routines and record keeping; clearly demonstrate that the home is well run, by a capable manager. Service users and staff spoke positively of the ethos of the home. There are good initiatives which demonstrate that the interests of service users are actively promoted. This included service user meetings, activity workers and an entertainment committee. West Heath House DS0000033605.V254829.R01.S.doc Version 5.0 Page 21 Staff meetings and formal supervision are well established and provide a good sense of direction for staff in undertaking their role and responsibilities. Statutory records were well organised, and well maintained. The management of safe working practices is good, there are systems in place for the monitoring and review of all practice areas, this ensures the well being of service users and staff. West Heath House DS0000033605.V254829.R01.S.doc Version 5.0 Page 22 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 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 3 X 2 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X 3 3 West Heath House DS0000033605.V254829.R01.S.doc Version 5.0 Page 23 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 OP21OP10 Regulation 12(4) Requirement Toilets require partitioning from floor to ceiling in order to protect service users privacy and dignity. This is an outstanding requirement. The Registered Person must provide an action plan specifying works and timescales, to the Commission by 1st February 2005. Daily records and Individual Service Statements must clearly specify the choices made by service users, and state how these are to be managed. The Registered Person must provide a programme of redecoration and repairs, with timescales, in relation to the list of works specified in standard 19. Timescale for action 01/02/06 2 OP12 15(1) 01/02/06 3 OP19 23(2)(b) (d) 01/02/06 West Heath House DS0000033605.V254829.R01.S.doc Version 5.0 Page 24 4 OP21 23(1)(n) 5 OP24 23(2)(d) 6 OP26 23(2)(a) 7 OP27 18(1)(a) Toilet facilities must be accessible to service users who require assistance or use wheelchairs or other aids. Plans for upgrading these facilities must consider the assessed needs of the service users. An action plan specifying works with timescales must be submitted to the Commission. An action plan with timescales must be submitted to the Commission for the redecoration of service users bedrooms. Plans for the re-siting of the laundry should be submitted. Current policy on the use of the laundry adequately meets the needs of service users. The Registered Person should recruit to current care staff vacancies. An update on the use of casual and temporary staff should be forwarded to the Commission. 01/02/06 01/02/06 01/02/06 01/02/06 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 West Heath House DS0000033605.V254829.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 West Heath House DS0000033605.V254829.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. 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