Inspection on 05/04/07 for Yew Trees

This inspection was carried out on 5th April 2007.

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

Yew Trees 22/05/09

Yew Trees 10/01/06

Yew Trees 15/08/05

Yew Trees 22/03/05

Yew Trees 03/07/04

Yew Trees 02/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Yew Trees Off Long Lane Chadderton Oldham OL9 8BR Lead Inspector Michelle Haller Key Inspection 09:30 05 April 2007 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 Yew Trees DS0000005548.V330404.R02.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. Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Yew Trees Address Off Long Lane Chadderton Oldham OL9 8BR 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) 01616816204 0161 6816204 Mrs Karen McCarley Susan Fitton Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 16 OP Date of last inspection 10th January 2006 Brief Description of the Service: Yew Trees Rest Home is a comfortable residential home registered to provide for 16 older people over two floors. The home is situated within walking distance of convenience stores, take-away restaurants and a video rental shop. The garden area is easily accessible and pleasantly landscaped with raised beds and planted pots. The accommodation consists of 12 single rooms, eight of which have en-suite facilities and two double rooms. Bathing and toilet facilities are adapted to meet the needs of the service users. There is a choice of two large lounges and a dining room. The home displays the previous inspection report at the main entrance. The home charges approximately £313.15 per week. Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was undertaken which included a visit to the home. The home did not know beforehand that this inspection was taking place. During this documents, reports and records concerned with the support of service users and the running of the home were examined, this included the care files for eight service users, employment files for five members of staff. A tour of the building was completed and observations of the interaction between staff and service users were undertaken. Discussions with three service users, their relatives, three care staff and the manager also took place. What the service does well: What has improved since the last inspection? Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 6 Since the last inspection a new bath chair has been installed. 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. The summary of this inspection report can be made available in other formats on request. Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 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 Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 3 (6 is not applicable) The service ensures that it can meet the needs of prospective service users, and that service users and their representatives receive information that will help them to make a decision about moving into the home. EVIDENCE: Eight care files were examined, including that of the most recent admission, each contained a pre-admission assessment that had been completed by senior staff that had conducted a home or hospital visit. Each file also contained a fuller and detailed assessment of needs, which included sensory, health, moving and handling, dietary, mental health, and social needs. The details recorded confirmed that assessments had been completed using information gained though speaking with and spending time Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 9 with the service user and their family and gathering information from health care professionals and social workers. A completed checklist confirming that, a contract had been provided, that information about the routines of the home including meals and mealtimes, activities, laundry and visiting, was on file. There was also documents and list providing confirmation that the complaints procedure had been explained, tours of the communal and bathing areas had been provided and that an allocated key worker had been introduced. Service users who were interviewed stated that a member of staff had visited them before moving into the home, and a relative confirmed that the home had provided the opportunity for short visits as a part of the admission process. Comments from service users about the admission process included: ‘I was visited in hospital by the manager.’ And ‘My daughter visited first and thought I’d like it the manager came to see me and I had a look around- at first I was staying to see if I liked it.’ Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service ensures that the health and personal care offered to service users is based on their individual needs and, is provided in a manner that respects their dignity and right to make choices. EVIDENCE: All service users files contained care plans that contained detailed information about the actions required to make sure that service users personal care, health, social and psychological needs were met. These documents were individualised and had been reviewed frequently and updated according to the changing needs of the service users. All routine health checks and care including dentist, optician, podiatrist, general health checks, flue vaccine and weight checks were up to date. Service users were observed wearing glasses and hearing aids. Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 11 Correspondence and the care plans also confirmed that specialist monitoring care and intervention was also provided through close liaison with the district nurses, physiotherapist, continence nurse, mental health team and dieticians depending on the individual needs of the service users. It was clear from nutritional intake charts, pressure area care charts, daily records and other records that the staff were competent in carrying out the instructions of health professionals and were also knowledgeable of how to respond to service users needs. The comfort and safety of service users are promoted through the development of moving and handling risk assessments, and corresponding care-plans. Staff were observed adhering to these. Discussion with staff indicated that they understood the actions and observations required to maintain and promote the continued health and independence of service users. Recent specialist training provided to staff includes diabetic foot care; infection control level 2 and providing nutritional support in nursing and residential care. The manager and one senior care assistants is completing the Trainee Assistant Practitioner course. This is a basic nursing course and participants have to achieve practical and clinical competencies and knowledge in specific health care areas concerning health and residential care. The manager has confirmed that the course is beneficial in respect of updating and improving the health care and practice provided at Yew Trees. The medication round was observed, the medication record sheets were examined and the storage of medication was checked. In the main the medication record sheets had been completed correctly and a complete recorded of medication entering and leaving was maintained. Senior carers take charge of administering medication and these have all completed NVQ level 2 and 3. This training provides an element of medication training. Supervision records confirmed that medication administration and competency was assessed and additional in-house training, observation and support was provided if the need was identified. The medication administration process would be made safer if pictures of service users, and sample initials of staff assigned to administer medication, were included in the medication administration record (MAR) file. Furthermore the home does not have a designated lockable medication fridge and so medication that must be kept cold is kept in the food fridge, this is not in keeping with best practice in this area. On the day of inspection it was noted that eye drops were not been stored at the temperature stated in the patient information leaflet. This medication also Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 12 had a reduced shelf life from the day it was opened and this had not been written on the product or on the MAR sheet. The manager stated that she took regular advice from a local pharmacist in respect of the correct storage of medication. However CSCI pharmacy guidance dictates that a designated medication fridge is used and this must be lockable and have an external temperature gauge. All personal and health care procedures that occurred during the inspection were carried out in privacy. Service users who were interviewed were aware that a plan about their support had been written. One person commented- ‘I don’t need help with anything- only to get in and out of the bath- they told me that when I came here.’ Other comments made about health care provided in the home confirmed a high level of satisfaction and included: ‘..has been well cared for.. they keep a good eye on her.’ And ‘I’ve had a dental check and I’ve been to the hospital for check-ups.’ And: ‘Staff are good they are gentle and kind.’ Yew Trees DS0000005548.V330404.R02.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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service ensures that, for the most part, social, recreational and cultural activities, including meals and mealtimes, meet with the expectations and assessed needs of service users. EVIDENCE: The record of activities, discussion with service users, their family and staff confirms that the home provides varied and frequent activities that prevent boredom and help to keep service users alert, stimulated and interested in the world about them. The activities book recorded activities that included, sing-along, reminiscence games, discussion groups using local history books or the local news paper, large format board games such as ‘Connect Four’, outings to a local restaurant that includes a game of bingo and a singer and theatre visits facilitated by care staff. In addition service users can enjoy alternative therapy sessions including aromatherapy, hand and foot message, provided by qualified therapist; arts and crafts, quizzes and games and musical shows provided by professional singers and artists who visit the home. The care staff and service users also Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 14 stated that special calendar dates such as Easter, St Georges, St David’s, birthdays and special anniversaries were also celebrated through decorating the home, provision of buffet teas, a celebration cake and additional entertainment. The reports concerning activities were written in general terms and so it was difficult to assess which service users had joined in with or enjoyed each activity, althugh this could be easily remedied through staff completing the activities section in each care file. The manager stated that the “alternative therapist” kept his own record of the treatment he provided. Service users and their relatives were keen to confirm that there was plenty going on in the home and excursions, either in groups or individually, outside of the home. Comments concerning activities included: ‘There’s plenty to do- they don’t make you join in- I like to sit in my room when my children visit.’ And ‘Yes there’s enough to do- I’m a music person and they put it on when you want. I’m not keen on outings a gentleman comes and plays games and quizzes- general knowledge questions. The staff are very good they’ll sit and talk to me and they’ll listen.’ Daily records and observations made during the course of the inspection suggested that service users could receive visitors at any time. Comments concerning visiting included: ‘I like to go upstairs and get ready for when my daughter who visits in the late evening after work.’ One gentleman stated that he visited the home twice a day every day and he was made welcome and given every hospitality during each visit. Meal times in the home are unhurried and service users who can voice an opinion can have their meals when they like. Breakfast was a choice of bacon and eggs, cereals, toast or any combination. Fresh and tinned fruit was observed in the storeroom. Hot and cold drinks, biscuits and snacks were served throughout the day, and service users also felt at ease to ask for drinks when they wanted them. The menus indicated that there is a choice of home cooked traditional meals that included: roast chicken; savoury mince, cauliflower and broccoli cheese, casseroles, liver and onions, dumplings, poached fish and chilli. On the day of Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 15 inspection the lunchtime meal was cottage pie and mixed vegetables, followed by cherry crumble and cream. Service users stated that if they didn’t like a choice on the menu then the cook would prepare something special. Comments included ‘there is plenty of food.’ ‘Food is very good’. Detailed food and drink records were maintained for a number of service users in keeping with the nutritional guidelines followed by the home, and these further demonstrated that meals offered were varied and modified to meet the dietary needs of individuals. This included fortification using cream, additional supplementary drinks, chopping food small or liquidising. Lunchtime was observed and this was a pleasant unhurried experience, and those requiring additional support were treated as individuals and, in the main, supported with dignity. Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 16 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users expressed satisfaction with the complaints procedure and felt safe and supported by the service. EVIDENCE: Examination of the complaints record and incident files confirmed that issues were dealt with fairly and openly. The home has investigated an adult protection concern and daily records, incident sheets and notes taken during meetings identified that it had been dealt with correctly. Oldham Metropolitan Borough Council (OMBC) protection of vulnerable adults team were alerted and action taken to reduce the risk of reoccurrence. This included, reassessing the service users and updating the care plans to include additional monitoring and counselling, and also stipulating the steps staff were to take if concerned; referrals were made to appropriate health care professionals and the families and service users were kept fully informed and supported in co-operating. The home also updated the adult protection procedure (POVA) and used the incident as a training opportunity for staff. Staff who were interviewed were clear about the behaviours that could be considered abuse and understood that service users, staff and family members could carry out abuse and any suspicions must be reported. Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 17 The outcome in this area could be improved if all staff were to receive POVA training from the OMBC training unit. Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 18 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 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally clean, however, the environment and in particular furnishings, have not been well maintained/replaced, however in the main Yew Trees does provide people with a comfortable and homely place to live and they are treated well. EVIDENCE: A tour of the communal and private areas of the home was completed. A significant number of bedrooms had been personalised with items chosen by the service users or brought from their homes. The rooms were warm however some areas held unpleasant odours and the carpets and flooring in a number of areas throughout the home were heavily Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 19 stained, frayed or cracked. The floor at the entrance to a downstairs shower room dipped suddenly and felt as though it were giving way. Many of the fixtures and fittings in the home are poorly maintained for example broken and chipped furniture, missing draw fronts. And a service user commented that the toilet seat was missing. A further concern in respect of the environment is that radiator covers have not been installed and so service users are at risk of scalding until this job has been completed. Some areas of the home were pleasant to use for example the dining room and the ‘quiet’ lounge and a new over the bath seat lift has been installed. Service users were observed moving around the home freely and with confidence. Service users were satisfied with their bedrooms and felt that the home was clean. Comments included ‘I’m very happy in my room.’ And, ‘I’ve been given a bigger room so that I can have my things here- spread out.’ Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 20 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Yew Trees provides staff in sufficient numbers, well trained and able to promote the safety and meet the needs of the service users. EVIDENCE: On the day of inspection there were 13 people living in the home and staff was two care assistants, a cook and housekeeper. The staff were experienced and had completed National Vocational Training level 2 (or the equivalent) and above. Discussion with staff confirmed that they understood the needs of the service users and their actions on the day also indicated they were able to arrange the support required for all aspects of the service users care- including liaising with the doctors, district nurses and relatives. It was also clear from the duty roster that new or agency staff always worked along a senior care worker. Five staff files were examined and each contained: the original application form, two reference and confirmation that a criminal record bureaux check had been carried out by the home, additional proof of identity and a picture of the worker. Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 21 The most recent recruit had completed the homes induction process and, has commenced the ‘common induction course’ recommended by the Skill for Care Council and provided by Oldham Council training unit. Certificates confirmed that recent training undertaken by care staff included the following topics: moving and handling, infection control, Parkinson’s disease, food hygiene and dietary needs. Service users and their relatives felt that staff were competent and readily available, comments included: ‘Staff are all good’ and ‘I love the staff and there’s always someone around.’ Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 22 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): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has a clear view of the service she wishes to offer to service users which is supported through the polices/procedures and staff practice in place. This offers service users a good quality of care. EVIDENCE: The manager is well motivated and keeps her skills up to date, she is currently completing a clinical course and passes on her learning to staff and this is of benefit to service users. Quality monitoring in the home consists of a questionnaire distributed to relatives each year. Questions concern:- contentment with food, access to health care, staff, activities, complaints and suggestions, whether choices Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 23 concerning bed-times, getting up, times of baths and showers are respected. These questions were read through and the general comments were positive and included ‘staff and management are easily accessible’ and ‘nothing needs to be changed- no problems.’ Residents meetings do not take place and social care and other professionals are not given the opportunity formally to comment on the running of the home. Staff meetings occur about four times each year and the notes indicate that staff are able to voice their opinions and make suggestions about improving aspects of running the home. Staff have received infection control training and aprons, gloves and hand cleaning products are provided. Posters reminding staff and visitors to the home to wash their hands were in place. Fire safety equipment had been checked and logbook records indicated that fire safety checks were carried weekly, and fire drill occurred regularly. Staff were able to describe what they had learnt during the most recent drill confirmed this. Signage was seen throughout the home directing to fire exits, equipment etc Health and safety records were checked and it was noted that recommendations were made following the maintenance of the passenger lift, food hygiene inspection, and water hygiene tests. Discussion with the manager indicated that there were no plans to comply with these recommendations although steps had been taken to reduce the risk identified by the water hygiene check. The manager needs to be confident that in not following the recommendations made in respect of the lift, food hygiene, and water hygiene she is not putting the health and safety of services users at risk. Residents are able to manage their own money and individual accounts are maintained for each person. Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 25 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 OP25 Regulation 13(4) Requirement Timescale for action 01/07/07 2 OP25 13 The registered person must ensure that all radiators are covered to prevent accidental burning. (Previous timescale 01/08/06 not achieved) The manager must have in place 15/05/07 a written risk assessment for any radiators which are not guarded. 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 OP38 Good Practice Recommendations The registered person must ensure that all parts of the home are free from hazards through responding to the recommendations and requirements of maintenance contractors and other advisory agencies. The registered person must develop a system of monitoring the quality of care in the home that takes into account the opinion of service users and other interested parties. 2 OP33 Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 26 3 4 OP9 OP19 A separate fridge should be purchased for the provision of medication which needs to kept at a certain temperature. A refurbishment plan that includes deep cleaning or replacement of heavily stained carpet, mending the flooring in front of the downstairs shower room and replacement or mending broken bedroom and kitchen furniture should be introduced. The manager could develop the current good practice of asking relatives for their views to other people who come into the home such as health and social care professionals. 5 OP33 Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North West Regional Office 11th Floor West Point 501 Chester Road Old Trafford M16 9HU 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. Extracts may not be used or reproduced without the express permission of CSCI Yew Trees DS0000005548.V330404.R02.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!