Care Home: Baker Street (86)

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What the care home does well The staff teams including management continue to demonstrate their openness and positive response to requirements, recommendations and suggestions made by the Commission. Prospective individuals, significant others and potential placing authorities are provided with relevant information about services and encouraged to visit the care home. The assessment and admission process is robust, which ensures that the needs of new residents are identified and support is planned accordingly. Care plans are `person centred` and reviewed on a regular basis to address the changing needs of individuals who have learning disabilities. The care planning approach involves the resident and significant others, in order to ensure the needs, wishes and aspiration of the individual are at the centre of service delivery. The ethos of the organisation has a strong sense of care and compassion for people with learning disabilities giving a high profile to supporting and enabling people to learn independent living skills and participate in meaningful activities and work to reflect their wishes and needs. The environment is reasonably well maintained and a good standard of cleanliness was evident throughout those areas viewed. People using the service benefit from a well maintained garden that has easy access for wheelchairs. The systems in operation including complaint and adult protection should offer adequate protection to people using the service. In relation to equality and diversity, the home has this policy in place and staff spoken to were aware of it and ensured that people were treated equally irrespective of their age, race, disability, religious beliefs, cultural background and sexual orientation. What has improved since the last inspection? As stated in the AQAA, the home has gone through a maintenance programme with new carpets being fitted, new furniture and curtains provided. Relevant training being provided for all care staff What the care home could do better: The registered manager must ensure that: Hand written instructions on the medicine charts are signed by the person making the entries. Liquid medicines dispensed in large bottles should be stored appropriately to prevent leakage and staff should take care not to spill the medicines on the labels when dispensing. The upstairs bath and toilet seat that are badly stained must be replaced so that residents’ dignity is respected. A door handle must be fitted to the downstairs shower room so that residents can use this facility in private and that their dignity is respected. The sliding door in the main lounge was hard to shut and open. This must be repairedso that residents and staff are not put at risk. As identified in the provider`s visit report and agreed for the replacement of the kitchen, this should be carried out so as to compliment the decor and refurbishment of the rest of the home. The flooring in the downstairs shower room that is very badly stained should be replaced so that residents’ dignity is maintained. The door to the main lounge was wedged open. This door must only be held open by means approved by the Fire Safety Officer so that residents and staff are not put at risk. Key inspection report Care homes for adults (18-65 years) Name: Address: Baker Street (86) 86 Baker Street Potters Bar Hertfordshire EN6 2EP The quality rating for this care home is: Two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: B. Ramkhelawon Date: 1 4 0 8 2 0 0 9 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement They reflect the We review the quality of the service against outcomes from the National Minimum Care Homes for Adults (18-65 years) Page 2 of 25 Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for Adults (18-65) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Learning disability (6) Number of places (if applicable): Under 65 Over 65 6 Walsingham Nicholas Martin Jackson Care Home 6 Baker Street (86) 86 Baker Street, Potters Bar, Hertfordshire, EN6 2EP 01707 642542 01707 642542 bakerst@walsingham.com Additional conditions: Date of last inspection: Brief description of the care home: 3 1 0 7 2 0 0 7 Baker Street is a residential care home provided by Walsingham. It is registered to provide accommodation for six people with learning disabilities, two of whom may have physical disabilities. The building is a large detached house that is situated in a residential area in Potters Bar with easy access to local shops and amenities. The main entrance is to the side of the building, where there is a small parking space. In front of the building is a small lawn. The communal spaces include the lounge and the large conservatory that leads onto Care Homes for Adults (18-65 years) Page 4 of 25 the back patio and large garden. The garden is mainly lawn bordered by mature trees. The garden is wheelchair accessible. Opposite the lounge is the spacious kitchen. The laundry room is by the entrance. There are two bedrooms on the ground floor adapted for wheelchair users. The doors are electronically controlled. The assisted bathroom and toilet are nearby. On the first floor there is a small office that is also used as sleep in room and four other bedrooms. The bathroom and toilets are nearby. All the bedrooms are for single occupancy. The fees range from £950.17 to £1264.04 per week. A copy of the Statement of Purpose, Service Users Guide and the latest inspection report can be obtained on request from the manager of the care home. Care Homes for Adults (18-65 years) Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 2 Star good service How we did our inspection: This unannounced key inspection was carried out on the 14th August 2009 and took one day. It included talking to staff, examining care plans, staff files, staff training records, fire safety procedures, medicine records, maintenance records, all other records and documents and a tour of the premises. We looked at all the information we have asked for or received about the home, since the last inspection. This information included the Annual Quality Assurance Assessment (AQAA), sent by and returned to the Commission from the homes manager. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also provides some statistical information about the service. The information provided in the AQAA was also checked against the findings as set out in the last inspection report. What the care home does well: Care Homes for Adults (18-65 years) Page 6 of 25 The staff teams including management continue to demonstrate their openness and positive response to requirements, recommendations and suggestions made by the Commission. Prospective individuals, significant others and potential placing authorities are provided with relevant information about services and encouraged to visit the care home. The assessment and admission process is robust, which ensures that the needs of new residents are identified and support is planned accordingly. Care plans are person centred and reviewed on a regular basis to address the changing needs of individuals who have learning disabilities. The care planning approach involves the resident and significant others, in order to ensure the needs, wishes and aspiration of the individual are at the centre of service delivery. The ethos of the organisation has a strong sense of care and compassion for people with learning disabilities giving a high profile to supporting and enabling people to learn independent living skills and participate in meaningful activities and work to reflect their wishes and needs. The environment is reasonably well maintained and a good standard of cleanliness was evident throughout those areas viewed. People using the service benefit from a well maintained garden that has easy access for wheelchairs. The systems in operation including complaint and adult protection should offer adequate protection to people using the service. In relation to equality and diversity, the home has this policy in place and staff spoken to were aware of it and ensured that people were treated equally irrespective of their age, race, disability, religious beliefs, cultural background and sexual orientation. What has improved since the last inspection? What they could do better: The registered manager must ensure that: Hand written instructions on the medicine charts are signed by the person making the entries. Liquid medicines dispensed in large bottles should be stored appropriately to prevent leakage and staff should take care not to spill the medicines on the labels when dispensing. The upstairs bath and toilet seat that are badly stained must be replaced so that residents’ dignity is respected. A door handle must be fitted to the downstairs shower room so that residents can use this facility in private and that their dignity is respected. The sliding door in the main lounge was hard to shut and open. This must be repaired Care Homes for Adults (18-65 years) Page 7 of 25 so that residents and staff are not put at risk. As identified in the providers visit report and agreed for the replacement of the kitchen, this should be carried out so as to compliment the decor and refurbishment of the rest of the home. The flooring in the downstairs shower room that is very badly stained should be replaced so that residents’ dignity is maintained. The door to the main lounge was wedged open. This door must only be held open by means approved by the Fire Safety Officer so that residents and staff are not put at risk. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our websitewww.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 25 Details of our findings Contents Choice of home (standards 1 – 5)........................................................................ 10 Individual needs and choices (standards 6 – 10) ................................................... 11 Lifestyle (standards 11 – 17) .............................................................................. 12 Personal and healthcare support (standards 18 – 21) ............................................. 14 Concerns, complaints and protection (standards 22 – 23) ....................................... 16 Environment (standards 24 – 30) ........................................................................ 17 Staffing (standards 31 – 36)............................................................................... 19 Conduct and management of the home (standards 37 – 43) ................................... 20 Outstanding statutory requirements..................................................................... 22 Requirements and recommendations from this inspection ....................................... 23 Care Homes for Adults (18-65 years) Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents can be assured that information about the home would be available so that they can make an informed decision and that their needs would be assessed prior to admission. Evidence: A copy of the Statement of Purpose and the Service Users Guide is available to current and prospective residents. Two residents were admitted at the end of last year from another care home managed by the same organisation. An assessment of needs for each resident was carried out and a trial period for introductory visits was planned to test drive the home. The care plans examined indicated that a comprehensive assessment of needs was carried out prior to the admission. Care Homes for Adults (18-65 years) Page 10 of 25 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents know that their identified needs would be met and that they would be enabled to live the lifestyle they choose. Evidence: Residents are given the opportunity to make everyday choices and they are encouraged to achieve independent lifestyles. Their preferences and requests are respected. The care plans examined were detailed and person-centred. These included information in relation to personal safety, mobility, communication, dressing, personal hygiene, sleeping, behaviour, health care plans, risk assessments and pen pictures. Each resident is allocated a key worker who is responsible for ensuring the needs of the residents are met. Appropriate risk assessments are carried out when necessary. Any change in care needs is reflected in the care plans. The residents care needs are reviewed on a regular basis. Information about the residents is handled by staff in accordance with the Data Protection Act 1998. All written documents are kept in the office. Care Homes for Adults (18-65 years) Page 11 of 25 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to engage in appropriate activities, accessing local community amenities and that their rights are respected. Evidence: The social and leisure activities are varied and are arranged to suit individual and group preferences. Residents are consulted on all aspects of activities, outings and holidays. Residents have regular meeting with staff and individual preferences are taken into consideration. Each resident has an advocate either a member of the family or an advocate from Pohwer or they have elected a friend. Each resident has a key to the front door and their individual bedrooms. All residents have a comprehensive daily activity planner and are involved in their choice of social contact and interests. They have outside interests, are also involved in the local community clubs or churches and attend day care activities. Care Homes for Adults (18-65 years) Page 12 of 25 The menu varies and choices are given. A member of staff prepares the meal. Residents are encouraged to assist in the kitchen. Care Homes for Adults (18-65 years) Page 13 of 25 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience Judgement: People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to express their individual personalities through the choices they make regarding personal care, food, clothing and accessories. They are able to access local community health services to maintain and promote a healthy lifestyle. Evidence: Each resident has a My Health plan that showed how residents identified needs were being met and all residents are registered with a G.P. Individuals receive personal and healthcare support using the My Health plan that are reviewed and kept up to date at each health appointment attended. Staff spoken to said that the support provided for residents was based upon identified needs including the rights of dignity, privacy, choices and respect. Overall, there are good systems in place for ordering, storing and administering the medication that the each resident requires. However, staff should ensure that hand written instructions on the medicine charts are signed by the person making the entries. Medicines in liquid form dispensed in large bottles should be stored appropriately to prevent leakage and staff should take care not to spill the medicines on the labels when dispensing. There is no one on controlled drugs. The storage and administration of medication are in accordance with the homes policy and procedures. Proper records are kept in the Medication Administration Recording charts. Care Homes for Adults (18-65 years) Page 14 of 25 As stated in the AQAA, the registered manager will within the next twelve months discuss with staff in their Team Day new ways of working as a team to support the residents in meeting their identified needs. Care Homes for Adults (18-65 years) Page 15 of 25 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes staff recruitment policies and procedures, training, supervision should protect residents from harm. Evidence: The home has a complaints procedure and information on complaints is also included in the Service Users Guide with pictures. Residents meetings are held and a simplified version of the complaint process is discussed on a regular basis to remind residents of their rights. Residents spoken to said they knew who to speak to if they were not happy about something. Individuals also have contact with advocacy workers, family members and individuals outside the home, who they meet as part of their daytime activities or professional reviews. No complaints have been received in the last twelve months and 8 compliments were received during the same period. The home has a copy of the Hertfordshire procedures on Safeguarding Adults. Staff spoken to confirmed that they are familiar with the procedures and staff records showed that they have received training on the safeguarding adults. An element of adult protection is also covered in the induction programme for all new staff members and those people undertaking the NVQ assessment. Staff are aware of the Whistle Blowing Policy. Care Homes for Adults (18-65 years) Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported in an environment that is homely and comfortable but there are areas that need to be refurbished so that residents dignity is respected and to compliment the decor of the rest of the home. Evidence: The home was reasonably well maintained and furnished in a domestic style to provide a homely, comfortable and safe environment. All bedrooms viewed were personalised to reflect individuals interest and sensory needs. A good standard of cleanliness was evident throughout the home that was also bright and airy. A rolling programme of maintenance and redecoration has been ongoing. New carpets and flooring have been replaced, new furniture purchased, curtains replaced and other new equipment bought. However, there are areas that need to be redecorated and renewed. The upstairs bath, toilet seat and the flooring in the downstairs shower room were very badly stained. The door to the shower room did not have a handle. These must be replaced so that residents’ dignity is respected. In one of the residents bedroom, wall paper was peeling off and in need of redecoration. The sliding door in the main lounge was very hard to shut. This must be repaired so that residents and staff are not put at risk as this is a fire safety requirement. The kitchen flooring was very badly marked and some of the cabinet doors were broken. The other kitchen cupboards also looked worn and tired. These must be repaired or replaced so as to complement the rest of the home that has been redecorated. The upstairs bathroom and the kitchen have been identified in the providers monthly visit report for replacement but no dates have been confirmed for this work to be carried out. The manager said that finance has been agreed for the bathroom to be done. The manager also said that plan to renovate the outbuilding has been agreed and will start next week. This building will be used as a quiet room for residents, visitors and Care Homes for Adults (18-65 years) Page 17 of 25 meetings. The small office remains the sleep-in room for staff at night. Care Homes for Adults (18-65 years) Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported and protected by an effective staff team. Evidence: Information gained from duty rotas and staff members provides evidence that the day and evening staffing levels remain adequate to meet the needs of the residents. One staff sleeps in during the night. Staff members have the necessary skills and they receive appropriate training to meet the varying needs of the residents. Staff spoken with indicated that they have opportunities for relevant training and this gives them greater confidence to do their jobs. Staff were aware of the needs of residents. Currently, there are 8 care staff employed, 4 of whom have completed the NVQ Level 2, 2 have an equivalent qualification and one staff have completed the NVQ Level 3. Three staff files were examined that only contained supervision notes, training records and application forms. The manager said that all other recruitment documents and files are kept at the head office. Staff spoken to confirmed that they received one to one formal supervision on a regular basis. Supervision records were maintained. Staff also confirmed that they received support from the management team and that senior members of staff were approachable and available for advice as and when needed. There is a rolling training programme for all the staff. Care Homes for Adults (18-65 years) Page 19 of 25 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be assured that their health and welfare are protected by policies and procedures but may be at risk if fire safety regulations are not adhered to. Evidence: The implementation of a number of systems including assessment and admission process, care planning and review, consultation and communication, recruitment, induction, training, supervision and appraisal of staff ensures that the home operates in a manner that benefits people using the service and the staff team. The home has a quality assurance system and seeks the views of people using the service, relatives, staff and other interested parties. All statutory records were available for inspection and maintained in accordance with legislation. Records inspected were up-to-date and accurate and were held securely. Staff spoken to were aware that people using the service can access their records and information held about them in accordance with the Data Protection Act 1998. There were policies and procedures in place to ensure that the health, safety and welfare of people using the service and staff are promoted and protected. These records were accessible to all staff. All accidents and injuries are recorded in the accident book and RIDDOR forms have been completed where applicable. The Commission has been kept informed of all accidents and admissions to hospital. Regular checks on hot water temperatures (weekly) and moving and handling equipment were recorded. Fire alarm test and fire drills were carried out on a regular Care Homes for Adults (18-65 years) Page 20 of 25 basis. However, it was noted that the door to the lounge was wedged open. This door must only be held open by means approved by the Fire Safety Officer so that residents and staff are not put at risk. A valid Employers Liability insurance certificate was displayed and expires on the 31st March 2010. Care Homes for Adults (18-65 years) Page 21 of 25 Are there any outstanding requirements from the last inspection? Yes No x Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 22 of 25 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 43 23 The door of the main lounge was wedged open. This door must only be held open by means approved by the Fire Safety Officer so that residents and staff are not put at risk. 25/09/2009 2 24 23 The upstairs bath and toilet seat that are badly stained must be replaced. So that residents dignity is respected and maintained. 30/10/09 3 24 23 A door handle must be fitted 25/09/09 to the downstairs shower room. So that residents are able to open to the room with ease and to maintain their privacy and dignity. 4 24 23 The sliding door in the main 25/09/09 lounge was hard to shut and open. Page 23 of 25 Care Homes for Adults (18-65 years) This door must be repaired so that it is easy to close and shut and conform to fire safety regulations. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 20 Medicines in liquid form dispensed in large bottles should be stored appropriately to prevent leakage and staff should take care not to spill the medicines on the labels when dispensing. Staff should ensure that hand written instructions on the medicine charts are signed by the person making the entries. As identified and agreed for the replacement of the kitchen, this should be carried out so as to compliment the good decor and refurbishment of the rest of the home. The flooring in the downstairs shower room should be replaced as this is badly stained. 2 20 3 24 4 24 Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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