Inspection on 08/07/08 for West Street Home

This inspection was carried out on 8th July 2008.

CSCI found this care home to be providing an Adequate service.

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

West Street Home 07/07/09

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE West Street Home 198/200 West Street Dunstable Bedfordshire LU6 1NX Lead Inspector Katrina Derbyshire Unannounced Inspection 8th July 2008 12:50 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 Street Home DS0000071211.V368325.R01.S.doc Version 5.2 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 Street Home DS0000071211.V368325.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service West Street Home Address 198/200 West Street Dunstable Bedfordshire LU6 1NX 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) 01582 477794 01582 471684 audrey@benslow.co.uk Benslow Management Company Limited Audrey Cragg Care Home 36 Category(ies) of Dementia (36) registration, with number of places West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service: Care Home - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia - Code DE The maximum number of service users who can be accommodated is 36 This is the first inspection of this service. 2. Date of last inspection Brief Description of the Service: West Street home is situated on a busy road close to the centre of Dunstable within a short walk of the towns many amenities. The home provides personal care for up to thirty-six people over the age of 65 years who have dementia. The accommodation is distributed over four floors that are accessed by staircases and/or a shaft lift. Twenty-six rooms have an en-suite toilet and wash hand basin, one has en-suite shower facilities and the remaining nine rooms do not have en-suite facilities. The dining and lounge facilities are located on the ground floor together with the kitchen, laundry, bathrooms, WC’s and some bedrooms. To the rear of the property is a garden with seating areas. A copy of the homes statement of purpose and service user guide are available in the front hall. Copies are available to prospective people who may wish to move into the home. West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This unannounced inspection was carried out on 8th July 2008. This was the first inspection of the home. The home had been registered with the Commission for Social Care Inspection since February 2008. At the time of this inspection the level of provision by the home was limited and consideration, must be given on the amount of information available to assess the standards against in view of this. The home had 21 vacancies resulting in occupancy of below 40 , in turn the level of staffing ratio to each person was high. Therefore it must be taken into consideration, that the findings following this inspection are not based on a fully operational home and the effect and or differences that full occupancy may have, on the outcomes for people living at the home. The care of three people was looked at in detail. Tracking people’s care is the methodology we use to assess whether people who use social care services are receiving good quality care that meets their individual needs. Through discussion, observation and reading records, we track the experiences of a sample of people who use a service. During the visit the communal areas of the home were seen alongside twelve of the individual rooms. Time was spent with many of the people who live at the home in the sitting and dining area. Observations of care practice and communication between the people living at the home and staff was also made at the inspection. The focus of this inspection was to look at the key standards. What the service does well: When a person feels they may wish to move into the home, staff carry out an assessment of their needs. This information is then used by the manager at the home to see if staff have the skills and experience to provide care for that person. The assessment for someone who had recently moved into the home West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 Page 6 was of a good standard. The staff member had made sure that they had found out about their individual needs including what they liked to eat and what time they liked to get up in the morning. This means staff at the home have very clear information to make a decision on whether they will be able to meet that persons needs. A relative spoken with said, “we looked at several places for mum but this one gave us the information we needed and answered any questions we had”. The way that the staff look after small amounts of monies on behalf of the people living at the home is good. They make sure that they keep separate records for everyone and keep receipts for any purchase, this means that people feel that their money is safe and that staff will manage their finances in their best interests. The manager had sent out surveys to relatives and medical professionals who had visited the home, to seek their views. She was looking at the feedback received through these to look in to how improvements could be made to the standard of care. This means that management are willing to listen to comments and suggestions on how to make things better and is willing to make changes. What has improved since the last inspection? What they could do better: There are several areas that the owners and management needs to look at to make things better for the people living there. Some examples are as follows. We made an immediate requirement at this visit. This is when something is cause for concern and must be changed within days to safeguard people living at the home. This was about the way staff had been recruited. There must be two written references and a special check by the Criminal Records Bureau that must be carried out each time a person is employed in a home. We looked at three staff files and only one had two references in place. This increases the risk of someone being employed at the home, who may not be suitable to work there. People had not always received the medical attention that they needed, as staff had not always followed safe practice following an accident. One person West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 Page 7 for example had a fall, even though there was evidence of substantial bruising a Doctor or Nurse was not called to see the person for another three days. This places people at serious risk as they have not received a medical assessment in order to identify if any treatment is needed. Although within the individual records several documents were in place to show that assessments had been undertaken including risk and a review of a persons care, there were no documents known as care plans. These need to be in place as they show the individual needs of a person and provide guidance and direction to staff on how the person should be supported, to ensure continuity of care. The communal toilets and bathrooms have no locks fitted, there is no way of ensuring your privacy when you need to use the toilet or have a bath. Three of the bedrooms have either no natural ventilation or very limited ventilation. This is not suitable as temperature control of the room is limited, if a person is unwell in bed for example and would benefit from fresh air this would not be possible. 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. The summary of this inspection report can be made available in other formats on request. West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The system in place for staff to assess the needs of prospective people is sufficient to ensure that they would have the information to know if they would be able to meet their needs. EVIDENCE: Documents seen within the records of a person recently admitted to the home, showed several assessments of their needs. Representatives of, Social Services and staff of the service had completed documents. Each representative had completed their own assessment documentation and further evidence was seen to show all had been involved in the decision for the person to move to the home. Documents described in detail the needs of the person; this included any diagnosis that had previously been made, the behaviours of the person West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 Page 10 and their individual aspirations alongside any risks. People that live in the home and entries within the daily notes confirmed that they had also had the opportunity to visit, prior to moving in. One relative spoken with confirmed that the family had been fully involved when their mother had moved into the home. The statement of purpose was seen to be displayed in the home. The document provided information on the staffing, accommodation and services available at the home. People able to indicate stated that they felt they had been given enough information, before they decided to move into the home. Intermediate care is not provided at the home. West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 & 10 People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Inconsistencies in care planning, medication systems and accessing healthcare mean some people not receive the care that they need to maintain a satisfactory level of well being, disparity in care planning does not ensure all people receive continuity of care. EVIDENCE: Files examined contained many completed documents for each person; files were set out in a logical way with an index at the front to guide the reader. Included were assessment of needs, risk assessments relating to moving and handling, tissue viability and falls. Entries were also seen to show that regular reviews had been made relating to the assessment of risks. However there were no actual documents within the care plan section even though the index indicated there should be one. On speaking to staff they demonstrated a West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 Page 12 sufficient level of understanding of the needs of the people living at the home, however the level was not consistent. A requirement is made for care plans to be in place for everyone so that staff have guidance in how to meet the needs of each person to ensure continuity of care. Through observation of the people living at the home it was noted that their clothes, hairstyle and makeup reflected their individual personalities. Guidance and support regarding personal hygiene was offered and the level offered by staff was seen to be acceptable by the people in the home as they responded positively to the staff. However there were no locks on the communal toilets or bathrooms, people had no way of ensuring that someone else would not walk in on them. Staff and records confirmed that in the majority of instances a Doctor or Nurse had been called when someone needed medical support. One example was a person had presented with increased confusion and their appetite had decreased over two days, staff called a Doctor who following their visit prescribed antibiotics, and the person’s health then improved. However another person had fallen, entries described over days that they had ‘extensive bruising to the right side of their face and had a bloodshot eye’, yet no Doctor or nurse was called for three days. The storage, receipt and administration of medication was examined. The medication administration sheets were noted to be correct in most instances, however the balance of one medication was incorrect. The system for recording balances was not sufficient to enable an audit to be carried out and this needs to be changed. Staff confirmed that they did receive regular updates in the administration of medicines and certification of training was seen in staff files and observations were made of medication and noted to be appropriate and follow safe practice guidelines. West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at this home feel that the choice of meals provided are sufficient to meet their tastes and preferences. EVIDENCE: With the exception of one person, all other people spoken to stated that they enjoyed their meals. An observation of a meal was undertaken most people had chosen salad; bowls were placed on the table so people could select the items that they wanted to eat. Menu cards were being placed on the table at this inspection, in addition the food on offer for the day was written onto an orientation board in the main communal area. The most recent environmental health inspection found that there were sufficient standards in this area being maintained. In addition nutritional risk assessments were seen to have been undertaken for the people living at the home West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 Page 14 Policies examined and activities advertised suggested that there were no fixed rules or regulations on how people occupied their day. The individual interests for most people were recorded in their personal files. People spoken with confirmed that activities available. The home had access to a mini bus to assist in outings, however there were no funds at the time of the visit to pay for this, so outings had been limited. Staff were fundraising to pay for this. Several people were seen to visit people living at the home during this inspection. People living at the home, relatives and staff confirmed that the home has an open visiting policy. People are able to choose whom they see and do not see and are able to receive visitors in private. On speaking to two relatives, they said that they were not aware of any restrictions on visiting. West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The training of staff is sufficent to ensure they have a satisfactory level of understanding of the safeguarding protocols to protect the people living at the home, but follow up has not always been undertaken in this area. Systems in place for receiving, investigating and responding to complaints is not clear so not all people are assured that their concerns will be listened to and acted upon. EVIDENCE: The homes complaints procedure was examined. It advised the reader on how they could complain and information on how to complain was also detailed within the homes service user guide. Two complaints had been received by the service at the time of this visit. The documents seen did not show clearly the investigation of the concerns or the outcome, in addition the company’s own form had not been completed. The manager did explain that the complainants had received a response, however evidence of how the service responded to the concerns must be in place. Following this visit a further complaint was received by the home, which the Commission for Social Care Inspection was copied into. At the time of writing this report a response from the manager had not yet been given. One relative spoken with confirmed that they had verbally West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 Page 16 raised concerns, and that they had been satisfied with the action taken and that they felt comfortable raising issues. As detailed within the health and personal care section entries within the care records for one person described over days that they had ‘extensive bruising to the right side of their face and had a bloodshot eye’, yet no Doctor or nurse was called for three days. At the time of this inspection no action had been taken by management to address this with the staff involved in accordance with the homes disciplinary procedures. The home had a copy of the local protocols and reporting procedure in safeguarding. Staff when interviewed demonstrated that they were aware of what they should do in the event of an alleged/suspicion of abuse. Training records and staff also confirmed that staff had received training in this area. West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The general standard of the environment is good however unsuitable ventilation in some individual rooms and absence of locks on toilets and bathrooms is not sufficient to provide an appropriate environment for everyone living at the home. EVIDENCE: The furnishings, fittings and décor in the communal areas of the home were of a good standard. Individual rooms contained personal items of the person to West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 Page 18 assist in creating a homely atmosphere. All areas visited on this day were tidy and free of odours. The rear garden accessed from the large lounge contained seating, flowerbeds and ornaments. Feedback from people living at and visiting the home was generally positive. The lighting however in the lounge/dining area is not domestic; it is a strip light and does not assist in creating a homely environment. In addition three of the bedrooms have either no natural ventilation or very limited ventilation. For two of the rooms you need to open the en-suite toilet door and open the window in this area for fresh air. The other room had no window that could open. This is not suitable as temperature control of the room is limited, if a person is unwell in bed for example and would benefit from fresh air this would not be possible. The matter of locks on toilet and bathroom doors has been addressed within the health and personal care section of this report. Staff were observed to wear suitable protective clothing when carrying out certain activities. Cleaning schedules were in place and clinical waste was disposed of in an appropriate manner and clinical waste contracts are in place. West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The initial training arrangements for staff have been sufficient for staff to be able to demonstrate a clear understanding of their role. However inconsistencies in the recruitment of staff does not protect the people living at the home. EVIDENCE: On examination of staff records to inspect the recruitment practices at the home, three staff files were chosen. It was noted that two of the three staff had information missing relating to the checks required before they had been allowed to work with people who use your service. One person had commenced employment when only one reference was in place; the first reference stated in their application form was not in place. The second person, employed had no references in place. Evidence of identification and Criminal Records Bureau checks were in place for all staff. An immediate requirement was made. West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 Page 20 Staff training information submitted by the home to the Commission for Social Care Inspection and seen at this visit was also examined and showed that staff had attended a variety of courses and workshops including health and safety, food hygiene and safeguarding adults. The induction and training of staff was recorded in the individual records of all employees. Staff through interviewing confirmed that they had undertaken a variety of courses these included health and safety, moving and handling and national vocational qualifications in care. A manager, Deputy manager care assistants, catering and housekeeping staff are employed at the home. The rotas supplied by the home show that there are sufficient numbers of staff on duty throughout the day and night to meet the needs of the residents at this time. People living at the home confirmed that staff were available to help and assist them when they need help. Staff were questioned on the individual needs of some of the people who live at the home, through this they demonstrated a good level of understanding of the needs of the person. West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35 & 38 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Health and safety systems are sufficent to reduce the risks associated with this area for the people living at the home. EVIDENCE: Health and safety policies were noted to be clear in its guidance to staff and comprehensive. Records were seen that evidenced that required safety checks had been carried out relating to fire, gas and electrical equipment. Approved contractors had undertaken servicing of equipment. Staff carried out the regular checks relating to water temperature checks for example and recorded West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 Page 22 the temperature on charts. Random water temperature checks were carried out at this visit; all were to the required level. Stocks of aprons and gloves were noted to be available for staff to use, in relation to infection control. No staff at this visit were seen to use these items inappropriately, their use was only seen to be made in the area where they were needed, for example at the evening meal to reduce the risk of cross infection. Small amounts of money are held on behalf of people living at the home to help assist them in paying for additional services such as hairdressing. A sample check of the records confirmed that receipts are kept which confirm the transactions made on behalf of people helping to protect them. All balances checked were noted to be correct. There are quality assurance systems in place, which include sending questionnaires to relatives and visiting professionals to ascertain their views on the quality of care provided. Surveys were viewed that had been returned to the manager, at the time of this visit the results of the surveys had not yet been published but the manager advised that this was to be done. In view of the home only being open for six months, this is acceptable at this time. West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Timescale for action 31/08/08 2. OP8 12 (1)(b) & 13(1)(b) Schedule 3 (j) 3. OP9 13(2) A care plan containing sufficient information that is clear must be in place for each assessed need and kept up to date when changes occur, to ensure people receive the care and support that they require. Action and reporting of injuries 31/07/08 and falls and incidences must be made in accordance with the homes policy, monitoring and follow up must be made by staff and medical attention sought when an injury has occurred. This is to maintain the safety and well being of the people living at the home. 31/07/08 Medication systems must be changed to allow for medication audits to be carried out. This will enable incorrect balances to be identified so action can be taken to ensure all people receive their medication as prescribed. Communal bathrooms and toilets must have a suitable locking mechanism in place to ensure people can ensure they can have DS0000071211.V368325.R01.S.doc 4. OP10 16 & 12(4)(a) 31/07/08 West Street Home Version 5.2 Page 25 5. OP16 22(3) &(4) 6. OP18 13(6) 7. OP19 23(1)(b),( 2)(a)(p) 8. OP29 19(1) privacy when using them. All complaints received must be responded to in accordance with the homes own policy and evidence of the investigation and action taken must be in place. This is to ensure people and their relatives are listened to and their concerns are acted upon. Appropriate action must be taken by management when neglect of a persons needs has occurred. This is to safeguard the people living at the home. There must be adequate ventilation in the individual rooms so that people have access to fresh air and increased ability for temperature control. No staff must be allowed to commence work prior to the receipt of at least two references. This is to safeguard the people using the service by having information on their past employment history and character so that you can make a decision on their suitability to work in a care home. (An immediate requirement was issued at this inspection) 31/08/08 31/07/08 30/09/08 08/07/08 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. Refer to Standard OP12 Good Practice Recommendations Systems should be in place to ensure people consistently have a varied selection of activities including those outside of the home. This is so people can continue to be part of the local community through accessing public events and facilities. DS0000071211.V368325.R01.S.doc Version 5.2 Page 26 West Street Home 2. OP19 Consideration should be given to change the lighting in the communal sitting area to domestic style fittings to assist in creating a homely environment for people to live in. West Street Home DS0000071211.V368325.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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