CARE HOMES FOR OLDER PEOPLE
Wilton House Nursing And Residential Home 73-77 London Road Shenley Hertfordshire WD7 9BW Lead Inspector
Louise Bushell Unannounced Inspection 31st October 2005 1:30 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 Wilton House Nursing And Residential Home DS0000019620.V264020.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. Wilton House Nursing And Residential Home DS0000019620.V264020.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Wilton House Nursing And Residential Home Address 73-77 London Road Shenley Hertfordshire WD7 9BW 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) 01923 858272 01923 850019 Wilton House Limited Linda Fuller Care Home 51 Category(ies) of Dementia - over 65 years of age (51), Old age, registration, with number not falling within any other category (51), of places Physical disability over 65 years of age (31) Wilton House Nursing And Residential Home DS0000019620.V264020.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 5. The home may accommodate up to 26 older people who require general nursing care or who are elderly mentally infirm and require nursing care. The home may accommodate up to 25 older people who require personal care. The home may accommodate 25 people with physical disabilities who require personal care. The home may accommodate up to 25 older people with dementia who require personal care. The home must ensure a minimum of 5 suitably qualified and experienced staff work at night within the home. 19th May 2005 Date of last inspection Brief Description of the Service: Wilton House Nursing & Residential Home opened on 3 June 1987. The home is currently registered to admit 51 older people who are physically frail and may have dementia. Following a variation application, the home may now accommodate twenty six older service users for nursing care within the overall capacity of the home. Wilton House is a purpose built home in a village location. Resident accommodation is single rooms with en-suite facilities. Assisted bathing and toilet facilities are provided. The village shops and pubs are a short distance from the home. Extensive car parking is provided to the rear of the building for visitors. The home is on a sloping site. There is pedestrian access from the main road or residents/visitors can enter the home from the rear car park via the lower ground floor taking the lift to the ground floor. Although there are extensive grounds at the back of the building there is only a very small garden accessible to service users. Wilton House Nursing And Residential Home DS0000019620.V264020.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place early afternoon through to teatime. Time was spent with the manager of the service and a number of service users individually and as part of a group. This inspection aimed to cover the standards that were not previously inspected and reflect on the outcomes for the service users. Where information has remained the same following the last inspection this has been transferred to this report. What the service does well: What has improved since the last inspection?
Following the last inspection further training has been provided to the staff with a rolling programme of courses attended. This includes customer care and medication training. The senior staff are also completing training in supervision and management. Staff have received training in positive dementia care and are currently looking at the provision of a more detailed course. The manager has also recently attended an Alzheimer’s conference and will be cascading the information to the staff team. Wilton House Nursing And Residential Home DS0000019620.V264020.R01.S.doc Version 5.0 Page 6 A new industrial washing machine is now in place, and a new fridge in the dining room on the ground floor. COSHH data sheets are now present on each floor to ensure that all emergencies can be responded to quickly and efficiently. All weight charts now have a signature column present to ensure constant weighing occurs. A new on call maintenance policy is place, which covers the needs of the building and the out of hour’s requirements. Medications audits are in pace and are competed by Inter Care, as well as the homes internal auditing system. New flooring has been laid in a number of service users bedrooms to empower and dignify individual needs. Thus recreating a homely comfortable environment. What they could do better:
There are a number of issues that became apparent from this inspection with regards to the environment for the comfort of the service users. In the main lounge the curtains were falling from the rail and in a number of bathrooms the shower hoses and heads were not sufficient and in good working order. A further service users bedroom floor covering requires replacing with an alternative resource to ensure that individual needs are met. COSHH items were observed out on display and were not appropriately locked away. The COSHH cupboard was also unlocked and the lock and hinge broken. There is a need for a risk assessment to be completed for the small kitchenettes in the dinning room areas on both floors and the access that is available to service users with advancing dementia. The activities room must remain unlocked so that access to all communal areas is not restricted for service users. The complaints procedure that it visually displayed on the first floor requires updating to reflect that any complaint can be made direct to the commission as required. The home has recently introduced new care planning paper work, however there is a need for the manager and the staff to ensure that if implemented that it fully and accurately competed. Evidence was seen that a social assessment had not been completed for a service user that had been admitted over six weeks previously and also that the assessment had not been fully completed signed and dated by the assessor. Monthly nutritional assessments for all service users take place and each month a record is maintained which identifies if a need or a change in need has arisen regarding nutritional intake and associated actions that may be required. If a need has been identified through the monthly monitoring then a care plan must be introduced to ensure that safe and sound management of the service users welfare and health. Following the Dementia Accreditation and the inspection of assessment paper work, there is a need for the home to further develop the information
Wilton House Nursing And Residential Home DS0000019620.V264020.R01.S.doc Version 5.0 Page 7 regarding the wishes of the service user in the later stages of their lives. This information should then be transferred to a care plan. Currently there is no activities coordinator as this post is vacant. The home has been advertising and attempting to recruit but to no avail. Following discussions with the service users it was determined that there has been a decrease in the provision of activities and that this has been noted by the service users. There is a need for the home to ensure that a protocol is implemented to ensure that the activities are still provided and are structured on a daily basis. It was discussed with the manager about possibly transferring one of the care staff to the activities coordinator and covering the lost care hours with bank staff. The manager stated that she would look at the possibility of this occurring. Supervision of staff is occurring, however this is rather sporadically. The manager stated that the senior staff have and are currently receiving training in supervision and management tasks. Suggestions and ideas were discussed with the manager about how best to display and evidence that supervisions have occurred in the home. There is a need for the home to also consider the current paper work in place, it is recommended that the supervision process is a two way process for the benefit of the employer and of the employee. The paper work in use appears not to reflect this entirely. Consideration to review this document should be considered. 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. Wilton House Nursing And Residential Home DS0000019620.V264020.R01.S.doc Version 5.0 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 Wilton House Nursing And Residential Home DS0000019620.V264020.R01.S.doc Version 5.0 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Service users have contracts detailing the terms and conditions of tenancy whilst residing at the home, thus ensuring that individual rights are supported and protected in the interest of the service user and of the company. EVIDENCE: Samples of contracts were seen to ensure that the individual needs and rights of the service users were being maintained and protected. The service user is also provided with a copy of the contract on admission. If the service user is supported by a friend, relative or other this is also provided to them as required. Also held on the contracts are the assessments and ASG notification of assessment from social services, which outlines the funding element of the placement. The CAR 510 document is also held and reviewed periodically to ensure that the needs of the service users are accurate and that the terms and conditions of residency are current and reflect the needs of the service user. The contract outlines the rights of the service users with regard to terminating the contract at any time. If any of the terms and conditions of residency change the manager stated that the contracts would also be reviewed, updated, and reissued. The contract is signed by the manager. The contract outlines the room to be occupied, the services that are included in the fee’s,
Wilton House Nursing And Residential Home DS0000019620.V264020.R01.S.doc Version 5.0 Page 10 whether fee’s are payable and by whom and additional services to be paid over and above those included in the cost. Wilton House Nursing And Residential Home DS0000019620.V264020.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 11 Service users health needs are set out in an individual plan, however where specific need has been identified through monthly monitoring a specific short term care plan must be introduced, thus ensuring that any changing needs of the service user are being monitored reviewed, actioned and addressed. Service users are assured that at their time of death staff will treat them and their family with care, sensitivity and respect. However, there is a need for the home to further develop the individual plans for all service users to ensure that all specific needs and wish’s are met and obliged. EVIDENCE: A number of care plans were tracked in detail to ensure that the needs of the service user were being identified, met, reviewed and actioned. All service users care plans were generated from the pre admission assessment and provides the basis of care to be offered to the individual. One newly admitted service user had all relevant care plans in place to ensure that immediate need could be met. However, the service user had been resident for over six weeks and the social assessment had not been completed. All care plans detail specific actions to be taken by the staff to ensure all aspects of the service users health, personal and social care needs are met. Care plans in place appeared to be user friendly for all staff and gave direct and specific guidance of the process of the care to be delivered meeting individual needs, choices
Wilton House Nursing And Residential Home DS0000019620.V264020.R01.S.doc Version 5.0 Page 12 and preferences. It was identified that a number of care plans were in need of being further developed following assessments identifying a specialist need. Area’s highlighted were around nutrition. The plan is drawn up with the involvement of the service user as much as possible, some care plans had been signed by the service user and or representative. Where a service user is unable to sign or has refused to sign, representation is advised however suitable documentation detailing the choices, wish’s or reasons for not signing are sufficient. All service users spoken with appeared well cared for clean. Self-care is promoted within the home where ever possible. One service users stated that “the staff help care for me”, another service user stated that “ the staff are very supportive and respectful, I like the staff they are great and very kind”. Appropriate risk assessments and monitoring charts are in place to ensure an appropriate level of support is offered. All necessary equipment is provided within the home to meet service users needs. Following discussions with service users is was confirmed that the staff are very caring and supportive, encouraging them to make decisions about their lives with appropriate assistance provided. Monthly weights are recorded and monitored, the home now ensures that each entry made is signed by the respective member of staff. Wilton House Nursing And Residential Home DS0000019620.V264020.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 The current provision of activities for the service users in the home does not satisfy their social and recreational needs, thus the activities provided do not meet their expectations, preferences and capacities. EVIDENCE: Evidence was seen of the activities that were being provided in the home as they were displayed on the notice board. Outside entertainers are bought into the home approximately monthly. Feedback from service users regarding the outside entertainment was positive. However, many of the service users spoken with stated that there are currently not enough activities available. Following discussions with the manager it became clear that the previous activities coordinator has left and the post is now vacant. Efforts have been made to recruit but to no avail. In the best interest of the service users it was discussed with the manager the possibility of the post being covered temporarily by a carer and the carers hours being filed through overtime and bank staff. The manager stated that he would look into this. Provision of activities within the home support service users with specific need is vital and this needs to be structured and organised in order to provide a consistent level of stimulation, variety and support to service users. The home should also explore and give further consideration to the provision of activities for people with dementia and other cognitive impairments.
Wilton House Nursing And Residential Home DS0000019620.V264020.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, 17 & 18 The home has a comprehensive complaints procedure in place, which ensures that the rights of all service users are maintained. There is a need for the home to make a minor amendment to the procedure, which is on display, thus ensuring that service users, visitors, professionals and family have the correct information to make a complaint. Robust polices, procedures and training for staff is in place regarding abuse, to ensure all service users are protected. EVIDENCE: The home holds a comprehensive complaints procedure, which is on display throughout the home. There is a need for the home to make a minor amendment to the procedure, which is on display, thus ensuring that service users, visitors, professionals and family have the correct information to make a complaint. The ethos of good practice within the home promotes that all complaints are taken seriously and acted upon. The open management of the home encourages and empowers staff and service users to make complaints with effective resolution. The procedure includes clear time scales and is accessible to all. A record of all complaints is maintained within the home. Service users and visitors spoken with stated that they were aware of the complaints procedure and would not hesitate in making their complaints known to the management of the home. They stated that they felt confident that their complaint would be dealt with effectively. There has recently been a complaint in which the home was requested to initially investigate, following the findings of the complaint the Commission also completed further investigation. The complaint made was regarding the health and welfare of a service user following a fall. Issues surrounding the
Wilton House Nursing And Residential Home DS0000019620.V264020.R01.S.doc Version 5.0 Page 15 maintenance protocol of the home and accurate recording of records. Following the Commissions inspection and number of requirements were made. On inspection it was clear that the home had actioned all of the issues identified and the commission remains satisfied that the complaint is now fully resolved. There were four main elements t the complaint and three out of the four areas were either upheld or partially upheld. One remained not upheld. The home has its own Whistleblowing procedure, which is displayed in various locations in the home and has adopted the Hertfordshire Adult Protection Procedure. Staff members spoken had a clear understanding of the policy following further briefing in staff and team meetings. The home has been proactive in the provision of training for all staff and has arranged external training, this is currently occurring on a rolling programme for all staff. Wilton House Nursing And Residential Home DS0000019620.V264020.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): 20, 21 & 26 Service users have access to comfortable communal space. Areas that are designated as communal space must not be locked and thus not restrict movement of the service users. Service users have sufficient bathing and toileting facilities available to them, however the showering hoses and heads require replacing in all bathrooms to ensure service users choices and preferences over bathing or showering are supported. The home is clean and hygienic promoting a homely comfortable atmosphere. EVIDENCE: Following renewal and redecoration works within the home, its environment presents as practical, clean and tidy. There is a planned renewal and redecoration plan in place, with all minor emergency work being completed promptly. Some areas of the home have recently been redecorated and this includes the activity room and a main lounge. Some bedrooms are still in need of redecoration but have been identified in the renewal and redecoration plan. An internal system has been developed within the home that further promotes and enables service users to become familiar with their surroundings, through
Wilton House Nursing And Residential Home DS0000019620.V264020.R01.S.doc Version 5.0 Page 17 the painting of all surrounding wood work on all toilet facilities and the use of symbols on the doors. The home is a self-contained unit, promoting an accessible safe space for all service users. Service users spoken to confirmed that they like the decoration of the home. Communal indoor space provides lighting of a domestic style and a friendly homely atmosphere suitable for the needs of the service users. Service users have access to comfortable communal space, areas that are communal space, for example the activities room, must not be locked and thus not restrict movement of the service users. Bathrooms and toilet facilities are in abundance throughout the home, ensuring that they all suitably located for all service use, staff and visitors. the showering hoses and heads require replacing in all bathrooms to ensure service users choices and preferences over bathing or showering are supported. Service users spoken to state that there are ample toilet facilities available at all times. Specialist equipment is also provided in throughout the home, ensuring all identified needs can be met. Suitable grab rails and other aids are available throughout the home. The home has a passenger lift to enable service users to have access to the 1st floor or ground floor. All rooms are single and provide adequate and suitable en-suite facilities. Rooms are personalised and many have been redecorated. All service users are encouraged to personalise their rooms to individual tastes. Laundry facilities are sited so that solid articles are not carried through where food is prepared. Hand washing facilities are provided throughout the building and staff are actively encouraged to maintain good hygiene practices. Policies and procedures are in place for the control of infection through out the home. Wilton House Nursing And Residential Home DS0000019620.V264020.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): 29 Robust recruitment procedures are now in place in the home thus ensuring that the service users are supported and protected by the policy and the procedures. EVIDENCE: The homes recruitment procedure is based on equal opportunities thus ensuring the protection of the service users. Detailed policies and procedures are in place that outline procedures and steps that the home takes whilst and during recruiting. Samples of files were inspected to ensure that the systems in place had been adhered to. The files contained all of the required information, including two or three written employer references, CRB disclosure and/or appropriate authority clearance to work. The home has a particularly good system in place ensuring that suitable and thorough checks are made on individuals that may require working permits and or visa’s. All staff have read and have received the General Social Care Code of Conduct, and all receive a written statement of their terms and conditions of employment. Wilton House Nursing And Residential Home DS0000019620.V264020.R01.S.doc Version 5.0 Page 19 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 36 & 38 Staff are supervised, however there is a need for this to be provided at least six times a yearly formally to each member of the care team. Health and safety issues require further attention to ensure that at all times the safety and the welfare of the service users is maintained. EVIDENCE: The staff at the home have been receiving a form of supervision through staff and small group meetings, however there is a need for the senior staff and the manager of the home to provide a minimum of six formal and individual supervision sessions to each member of staff. The manager stated that the senior staff have been and are currently receiving training in supervision and management tasks. Suggestions and ideas were discussed with the manager about how best to display and evidence that supervisions have taken place in the home. There is a need for the manager to also consider the current paper work in place, it is recommended that the supervision process is a two way
Wilton House Nursing And Residential Home DS0000019620.V264020.R01.S.doc Version 5.0 Page 20 process for the benefit of the employer and of the employee. The paper work in use appears not to reflect this entirely. Consideration to review this document should be considered. COSHH items were seen to be left unattended in the kitchenette areas of the home. Each kitchenette has a locked COSHH cupboard, however in one of the kitchens this was unlocked and the hinge broken. An immediate requirement was made for the home to rectify this issue. The manager must also complete a detailed risk assessment regarding the access to the Kitchen by the service users to determine their safety and access to equipment that may cause injury. Wilton House Nursing And Residential Home DS0000019620.V264020.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 X 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 3 18 3 X 2 2 X X X X 3 STAFFING Standard No Score 27 X 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 2 X 2 Wilton House Nursing And Residential Home DS0000019620.V264020.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 (1) Requirement All identified needs must be supported with detailed care plans. Timescale for action 20/12/05 2. OP8 17 (1)(a) Sch3 3 OP12 16 (2) & 12 4 OP16 22 This requirement has been carried forward from the last inspection. Non-compliance may result in enforcement action being taken. All records regarding service 20/12/05 users must be maintained, promoting service users health, ensuring records are accurate so identified needs can be met. This requirement has been carried forward from the last inspection. Non-compliance may result in enforcement action being taken. The provision of activities must 01/01/06 be structured. Activities must be suitable for people with dementia and other cognitive impairments. (See Regulation 16 (2) (m & n) & 12 (2) & (3)) The complaints procedure 15/12/05 requires amending to reflect that complaints can be made direct to the commission at any time.
DS0000019620.V264020.R01.S.doc Version 5.0 Page 23 Wilton House Nursing And Residential Home 5 6 7 8 OP20 OP21 OP36 OP38 23 (2) (h) 23 (2) (c) 18 (2) 13 (3) & (4) 9 OP38 12 (3) & (4) Communal space in the home must be made available to the service users. Shower hoses and head not working require replacing. Staff must be appropriately supervised. All COSHH items must be locked away. This requirement has been carried forward from the last inspection. Non-compliance may result in enforcement action being taken. COSHH cupboards must be suitable and meet the needs of the regulations and compliance. A risk assessment must be completed with regards to service users accessing the kitchenette areas. 01/12/05 15/12/05 22/12/05 31/10/05 15/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP24 Good Practice Recommendations Consideration should be given to the increase of the maintenance hours provided within the home. This recommendation has been carried forward from the last inspection. Not inspected on this occasion. Care plans should record all service users needs, preferences and wishes in the event of death. Consideration should be given to covering the activity coordinators hours with a permanent member of staff until successful recruitment has occurred. 2 3 OP11 OP12 Wilton House Nursing And Residential Home DS0000019620.V264020.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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