Care Home: 1 Malling Terrace

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What the care home does well The home provides an environment in which service users can exercise independence with staff support and they are encouraged and supported to make decisions about their daily lives. Health needs are well met and the home maintains good links with health and social care professionals. The staff rota is organised to make best use of staff time in supporting activities outside of the home and some additional hours are built in. Staff have a good rapport with service users and are knowledgeable about their individual needs. What has improved since the last inspection? Staffing has been reviewed and a full time staff member replaced by two part time posts to allow for more flexibility for activities. The service users` weekly activity programmes have been reviewed and more activities are added or have been planned so that they are better spaced out throughout the week. One service user`s flat has been repainted and new flooring has been fitted in another flat. There is a new entrance hall carpet and the garden has been made tidier and more attractive. What the care home could do better: Improvements are needed to the environment to make sure that it fully meets the service users needs and is safe. The kitchen units in each flat are worn, surfaces are peeling and chipped in some cases and some drawers no longer fit. New kitchen units must be provided so that they are fit for purpose and do not pose a health risk. New hoists must be fitted as existing hoists are breaking down compromising the privacy and dignity of service users. Bathroom floors need renewing as they are looking worn and the plughole surrounds are damaged and their surfaces peeling. The wash hand basin in one service user`s bathroom needs resiting as it in inaccessible to them. CARE HOME ADULTS 18-65 1 Malling Terrace 1 Malling Terrace Maidstone Kent ME16 0JU Lead Inspector Debbie Sullivan Unannounced Inspection 20th November 2007 09:20 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 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 1 Malling Terrace DS0000024080.V353180.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 Adults 18-65. 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. 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 1 Malling Terrace Address 1 Malling Terrace Maidstone Kent ME16 0JU 01622 692152 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) malling@mcch.org.uk www.mcch.co.uk MCCH Society Ltd Mr Paul Tompsett Care Home 4 Category(ies) of Physical disability (4) registration, with number of places 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd August 2006 Brief Description of the Service: 1 Malling Terrace is one of a group of homes managed by MCCH Society Ltd in the South East of England. The home offers long-term care and support to 4 adults with a Physical Disability. The home provides 4 individual flatlets in a purpose built bungalow unit. The flats comprise of an open planned kitchen, dining room, lounge, bedroom and separate bathroom and WC. The home’s philosophy is to provide the staffing to encourage and promote the service users to be as independent as possible within their own flats, whilst realising that due to their physical disabilities 24 hour staffing support is needed with sleep in cover to the four flats in the bungalow unit. The home provides a separate staff flat / office. There is off road parking for approximately 5 cars. The home is situated in a quiet lane off the main Queens Road in Maidstone, with easy access to public transport into Maidstone town centre. There is a small local shop and public house within walking distance. Service users have opportunities to take part in a range of work, educational and social activities and each has an individual weekly activities plan. The fees for the service currently range from £910 to £1,186 per week. 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection of 1 Malling Terrace took place over six hours. Time was spent speaking with service users, staff, the manager and a visiting relative, the property was toured and a range of documentation including care plans, medication records and policies and procedures were read. Throughout the visit service users and staff were very helpful in providing information. Survey forms completed by service users, friends and relatives, staff and health and social care professionals provided additional information, as did the home’s Annual Quality Assurance Assessment document that was completed and returned by the manager within the timescale given by the Commission. The inspection process was assisted by an Expert by Experience who was present for part of the visit and whose remit was to spend time speaking with service users. The manager and service users had been informed in advance that when the inspection took place the Expert would be present for some of it and service users were offered the opportunity to meet with him. The Expert by Experience has prepared a report parts of which are incorporated in the text of this report, his input was very valuable in establishing the views of service users about the home. The Expert by Experience met with each service user individually, in one case the service user was supported in the meeting by a relative and another by the manager. An Expert by Experience is someone who has personal experience of using services and who is trained in their role as an expert by an independent organisation. What the service does well: The home provides an environment in which service users can exercise independence with staff support and they are encouraged and supported to make decisions about their daily lives. Health needs are well met and the home maintains good links with health and social care professionals. The staff rota is organised to make best use of staff time in supporting activities outside of the home and some additional hours are built in. Staff have a good rapport with service users and are knowledgeable about their individual needs. 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are able to access information about the home and spend time there before deciding to move in. Needs are fully assessed prior to admission. EVIDENCE: There has been no change in the service user group since the last inspection and there are no current plans for any moves. The process for admission followed remains that needs are fully assessed before a place is offered and prospective service users are able to visit the home and spend time there before they decide to move in. Relatives, care managers and if appropriate other professionals are involved in the assessment process. A service user stated on a survey form that, “I stayed at Malling Terrace for a night so I could see what it was like to live here”. The home has a statement of purpose and service users guide that are available pictorially. 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 9 Care plans include tenancy agreements, again these are can be provided in a pictorial format. 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ care plans are well maintained and reflect their needs and goals. Service users are supported to make choices about their daily lives and independence is promoted. EVIDENCE: Each service user has a main care plan that includes details of their personal and healthcare needs, preferences and personal goals. A smaller folder is kept for daily recording and weekly or daily planning so that it is easier for staff to use. Service users are able to access their care plans and the information is well maintained, in house strengths and needs reviews take place regularly and the 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 11 care plans read included care management review records for meetings held this year. Risk assessments are in place and are reviewed and each service user has a weekly activities planner. Service users are supported to make choices about their daily lives, during the visit service users were getting up when they wished, were offered choice to go out and of where to go and they choose what to eat every day. One service user accesses an advocacy service and this could be available for others. Service users are involved in the running of the home in terms of being responsible for domestic tasks in their own flats and are involved in house meetings. Due to the layout of the building service users tend to gravitate to the staff office to seek staff or have a chat, this offers opportunities for plenty of involvement. A service user who has most communication difficulties communicates their wishes via a picture board and gestures, the Expert by Experience identified that it was possible that the service user was not always able to express their views as fully as they would like. 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. 11,12,13,14,15,16 and 17 This judgement has been made using available evidence including a visit to this service. Service users have opportunities to take part in a range of activities to suit their interests; their contact with friends and families is well supported. Service users are supported to eat healthily and plan their meals. EVIDENCE: Each service user has a weekly activity planner and a planner for staff to refer to is held in the office. The manager said that recently activities have been reviewed so that in some cases they are better spaced out throughout the day and some new ones have been added. Overall it was planned that more activities would be offered and a change in the staffing hours allowed for this. 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 13 One service user attends supported employment in a social services setting, another has started attending college and a range of social a recreational activities are available. For example service users can go shopping, out for meals, to the cinema and to the pub. One service user goes out independently and a risk assessment is in place for this. The home has two vehicles and as far as possible choice of individual or shared trips out are respected. Service users have chosen to all go together to see the Christmas lights in London and other group trips take place such as to the coast. Events at other MCCH house are attended as well. Evening activities include groups and clubs one service user regularly goes to see a friend play in a band. Most service users were satisfied with the activities provided; a suitable volunteer is being sought for one who would like more options for individual support and activities. At home service users are involved in meal planning, regular one to one time is scheduled in and they socialise with each other if they wish. Survey forms and the Expert by Experience commented that the provision of a communal room would allow for more opportunity to socialise. Contact with friends and relatives is supported, a relative was visiting during the inspection and another due the next day. Flats have space to accommodate visitors overnight. Service users budget for their shopping and go shopping with staff. They plan and cook their own meals with support from staff if required. Staff check that diets are nutritious and healthy and respect that one service user chooses to miss meals sometimes but is overall eating enough. Dining areas in flats allow sufficient space for wheelchairs to be accommodated. 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 and 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health and personal care needs are well met. Medication procedures are in place and service users can choose to self medicate. EVIDENCE: The health needs of service users are recorded on care plans as are preferences for the provision of personal care. Care plans show that contact with health professionals is supported and the home makes referrals when necessary to health colleagues such as OT’s. One service user was awaiting an assessment from an Occupational Therapist for toileting equipment, another has input from a speech and language therapist. 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 15 The manager spoke of involvement from a CPN throughout the summer for one service user, this was valuable input and the service user has returned to most of their usual activities and is feeling able to try new ones. Service users attend therapeutic activities such as hydrotherapy, fitness classes and physiotherapy. Regular routine health checks are kept up; one service user went to the dentist during the visit. Service users have individual medication cabinets, one service user partially self medicates, medication records were in order and there is a medication procedure in place. Each service user has equipment in their rooms to aid their personal needs and mobility, they receive varying amounts of support with personal care depending upon needs and care is delivered as flexibly as possible. There have been some problems with the ceiling track hoists, a mobile hoist is available as well although when a hoist does not work the dignity of service users could be compromised. Staff observed during the visit attended to the needs of service users discreetly and respected privacy. Service users can choose to have their wishes in the event of death recorded on their care plan. 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users can feel confident that any concerns will be listened to and taken seriously. Procedures are in place to protect service users from abuse or harm. EVIDENCE: The home has a complaints procedure that is available to service users pictorially, it is displayed in the home and service users are aware of how to complain. One service user stated on their survey form “I know that I could speak to the manager, senior or my keyworker about any problems that I have” and they added they were aware of the procedure. The Commission had received one formal complaint about the service since the last inspection that has been addressed by the service and a senior manager. One service user is accessing an advocacy service and this could be available for others if necessary. Staff receive adult protection training and an adult protection procedure is in place. All staff working at the home are properly vetted. 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users live in a warm clean and comfortable environment. Some equipment, furnishings and fittings require replacement due to wear and tear. EVIDENCE: Each service user lives in a self contained flat within the building and there is also a staff office/sleep in room, staff toilet and small staff kitchen. The flats are all open plan and spacious and comprise of living, dining, cooking and sleeping space with bathrooms/toilets easily accessible from the main area. The flats and other areas were all cleaned to a good standard, staff support service users with housework in their flats and are responsible for cleaning 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 18 other areas. Two flats were inspected and the Expert by Experience visited three flats to speak with service users. Flats reflect the individual interests and tastes of service users, one has recently been completely repainted and a new floor has been laid in another flat. Service users said they liked their flats although the kitchen units in all of them are damaged, the laminate on the doors is chipped in places and drawers no longer fit. There is damage to some work surfaces and wheelchair damage to the cupboard doors. The Expert by Experience wrote in their report that “In one of the residents’ flats it was noted that there was some damage to the washing machine, and that the resident felt that the paintwork in his flat could do with “touching up a bit”. The corridors between the rooms were in need of re-painting due to damage caused by what looked like constant contact with wheelchairs.” The flooring in bathrooms is looking rather worn and in need of replacing. The drain hole surrounds are rusting and damaged and could be an infection risk. One service user who spoke with the Expert by Experience in the company of a relative expressed concerns about the siting of their hand basin, the Expert by Experiences’ report states, “It was mentioned to me by one of the residents that there was a problem with the sink in the bathroom area being to low for wheelchair use. Saying that “in order to brush my teeth, I have to do this in the bath so that I can rinse my mouth, as I cannot get under the sink in the bathroom”. There is no communal space for service users, although during the visit two of them visited the staff office on several occasions and this area serves as a place where staff and service users can chat, staff make it clear if they need private time. The Expert by Experiences’ report noted that residents would “benefit from some form of communal area where they could meet each other and/or guests out of the environment of their own personal accommodation.” Service user each have the personal equipment necessary to help them to be as independent as possible, however the hoists throughout the building need replacing as they are prone to breaking down. A hoist technician visited during the inspection, as there had been recent problems. 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. 31,32,33,35 and 36. This judgement has been made using available evidence including a visit to this service. A well trained and competent staff group supports service users. Staff are knowledgeable about the individual needs of service users. EVIDENCE: Standard 34 was not inspected as staff recruitment files are inspected centrally at least once a year, the last inspection did not raise any major concerns about the organisations’ recruitment processes. The home is staffed by the manager and support staff. Staffing kevels are flexible to accommodate the activities that take place each day and the home is allocated some extra staff hours if they are needed. Recently two part time posts had replaced a full time post to give more flexibility for activities especially those outside of the home. At least two staff are on duty at all times, during the visit three staff and the manager were on duty in the morning and afternoon, this included a new staff 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 20 member who was in their induction period and who was able to spend some extra time on their induction due to staffing levels that day. Staff were spoken with thought the day either individually or together as part of general discussions, staff were knowledgeable about the needs of service users and confident with them, there is a keyworker system in place. A survey form from a service user commented, “All the staff treat me well and I get on with everybody” and “The staff listen to my opinions and act accordingly” The Expert by Experience wrote in their report “Those residents spoken with seemed to be happy with all of the staff (including bank staff) who are there to help and support them in living a full and worthwhile life”. The organisation provides a wide range of training and statutory training is updated. Staff commented very positively about training provided in person and on survey forms. Currently over 50 of the staff group have NVQ level 2 or above in care. Team meetings are held and staff receive recorded supervision. The staff team had been awarded the Top Team Award for 2007 for work on a project that included service users and was aimed at improving access to and facilities in country parks. During the visit staff were seen to be confident with the service users and had a good rapport with them. 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 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. The home is well run and service users have opportunities to contribute their views. The health safety and welfare of service users and staff are protected by the policies and procedures in place. EVIDENCE: The registered manager is well established at the home, the manager and the senior support worker are well qualified to undertake their roles. 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 22 The home is run in the best interests of service users, recent changes to the arrangement of staffing hours is helping to meet needs more fully. There is a friendly atmosphere and service users are not reticent in accessing the office to spend time with staff or to ask them anything. The views of service users are formally sought via surveys and at house meetings. The Expert by Experiences’ report stated “Those residents spoken with seemed to be happy with the services on offer to them with regard to their general day to day lives and needs”. The policies and procedures in use are mainly organisational and they are reviewed at appropriate intervals. Equipment is maintained in good order, bearing in mind the hoists need replacing but they are being attended to when there is a need. Fire checks are undertaken regularly and full fire evacuations take place, the last was held in August 2007. Safe working practices are observed and the temperatures are checked in the service users and staff fridges daily. The views of service users are sought via survey forms, at house meetings and individually. Some investment has been made in the service with recarpeting, refloring and redecoration since the last key inspection and it is a now a priority that kitchens are upgraded in the flats. Confidential records are securely stored whilst service users can access their personal information. 1 Malling Terrace DS0000024080.V353180.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 Adults 18-65 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 2 28 2 29 2 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLE Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 3 3 3 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? 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 YA24 Regulation 23(2)(b) Requirement “The registered person shall ensure that the premises are of sound construction and kept in a good state of repair externally and internally” In that kitchen units and damaged work surfaces in each flat must be replaced so that they are fit for purpose. 2 YA27 23(2)(n) “The registered person shall ensure that suitable adaptations are made, and such support equipment and facilities as may be required are provided for service users who are physically disabled.” In that wash hand basin in a bathroom that is not easily accessible for a service user must be made accessible and ceiling track hoists must be replaced as they are unreliable and compromise dignity when not working. “The registered person shall make suitable arrangements to prevent infection, toxic DS0000024080.V353180.R01.S.doc Timescale for action 29/02/08 29/02/08 3 YA30 13(3) 29/02/08 1 Malling Terrace Version 5.2 Page 25 conditions and the spread of infection at the care home.” In that bathroom floors must be replaced. 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 YA39 Good Practice Recommendations It is recommended that the home seek the views of relatives and others such as health and social care professionals via quality assurance forms. 1 Malling Terrace DS0000024080.V353180.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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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