Care Home: Charlesworth Rest Home

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What the care home does well The atmosphere in the home was comfortable, homely and relaxed and staff were seen to be kind and caring towards people living in the home. People moving into Charlesworth House are encouraged to bring in their personal possessions to personalise their bedrooms. There is an open-house policy, which welcomes visitors at all reasonable times and satisfactory arrangements are in place for dealing with complaints are ensuring that people living in the home and their relatives feel their concerns are listened to and acted upon. Meals remain good with people spoken with highly praising the quality and choice offered. What has improved since the last inspection? Risk assessments are now carried out for those people who choose to self medicate but recruitment practice still falls short of the required standard. CARE HOMES FOR OLDER PEOPLE Charlesworth Rest Home 37 Beaconsfield Villas Brighton East Sussex BN1 6HB Lead Inspector Gwyneth Bryant Key Unannounced Inspection 1st July 2008 08:00 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 Charlesworth Rest Home DS0000014190.V367380.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Charlesworth Rest Home DS0000014190.V367380.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Charlesworth Rest Home Address 37 Beaconsfield Villas Brighton East Sussex BN1 6HB 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) 01273 565561 01273 565561 barry@bhorne9.wanadoo.co.uk Mrs Eileen Margaret Horne Mrs Eileen Margaret Horne Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Charlesworth Rest Home DS0000014190.V367380.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is eighteen (18) Service users must be older people aged sixty-five (65) years or over on admission 24th August 2007 Date of last inspection Brief Description of the Service: Charlesworth is registered to care for up to eighteen older people who do not require a high level of care. The home is situated near to the Preston Park area of Brighton and consists of a large double fronted semi detached Victorian house. Accommodation comprises of fourteen single bedrooms and two double bedrooms, which are located over three floors. None of the rooms provide en suite facilities. The home has a pleasant rear garden that residents enjoy during the warmer months. A lift is available to the first floor only. The home would not be particularly suitable for wheelchair users and those with extreme mobility conditions. The home is located in a residential area of Brighton and is close to local transport, parks and other local amenities. The current fees range from £381.00 to £485 per week with additional charges for hairdressing, chiropody, toiletries and newspapers. Charlesworth Rest Home DS0000014190.V367380.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was an unannounced inspection and took place in just under seven hours. The purpose of the inspection was to check compliance with the requirements made at the last inspection and inspect key standards. There were seventeen people in residence on the day of which one was in hospital. Four people living in Charlesworth were spoken with in addition to the Registered Manager, Deputy Manager and two care staff. While the Registered Manager was available through the day the Deputy Manager was the main facilitator for the visit. A tour of the premises was carried out and a range of documentation was viewed including care plans, personnel and medication records. People spoken with on the day mentioned the care and kindness of staff and said that they felt well cared for. Prior to the site visit we asked the Registered Providers to complete an Annual Quality Assurance Assessment (AQAA) and this was returned when we asked for it. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Information from the AQAA is included in this report as necessary. The CSCI asked the Registered Provider to pass surveys to service users and their relatives but as the home had recently completed its own survey she took the decision to allow the CSCI to use the homes own surveys. Comments in those surveys included: • • • • I don’t think you can improve what you have now. Lovely and clean, well decorated and welcoming. Very caring with residents well being paramount. The standard of care given to my grandmother is excellent at all times. One staff survey was returned to the CSCI and it indicated that the person felt they were given the training they needed to do their job and that management were supportive. What the service does well: The atmosphere in the home was comfortable, homely and relaxed and staff were seen to be kind and caring towards people living in the home. People moving into Charlesworth House are encouraged to bring in their personal possessions to personalise their bedrooms. There is an open-house policy, which welcomes visitors at all reasonable times and satisfactory arrangements Charlesworth Rest Home DS0000014190.V367380.R01.S.doc Version 5.2 Page 6 are in place for dealing with complaints are ensuring that people living in the home and their relatives feel their concerns are listened to and acted upon. Meals remain good with people spoken with highly praising the quality and choice offered. 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. Charlesworth Rest Home DS0000014190.V367380.R01.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 Charlesworth Rest Home DS0000014190.V367380.R01.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): 3 and 4 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Improvements need to be made to the admission assessment to demonstrate the needs of people moving into the home can be met. EVIDENCE: The pre-admission sheets for the last three people to be admitted were viewed and while they identified needs, they did not include information as to how the home will meet those needs. There was particular concern for two people admitted for respite care as full care plans are not created for these people and one was identified as being at high risk of falls. These shortfalls are such that staff are not provided with sufficient information on meeting the needs of people newly admitted to the home. Intermediate care is not provided. Charlesworth Rest Home DS0000014190.V367380.R01.S.doc Version 5.2 Page 9 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 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. All aspects of service users health, welfare and care must be identified and planned for, in order to clearly direct staff in the delivery of appropriate care. Improvements in the administration in medication need to be made to ensure people living in the home are not at risk. EVIDENCE: Three care plans were viewed and in the main were found to include most aspects of care needs. However, the plans in their entirety are not updated although quarterly reviews are carried out and these were detailed for the most part. It is important to ensure that care plans are working documents that accurately reflect current care needs as there is a danger that staff will use the reviews as care plans and thus will not have access to significant background information. This appears to be the case as although staff members spoken with are familiar with the needs of people living in the home none asked to view the plans during the site visit. It is important that care plans are regularly viewed by staff to ensure they remain up to date with current care needs and that the plans accurately reflect current care needs. Charlesworth Rest Home DS0000014190.V367380.R01.S.doc Version 5.2 Page 10 Updating care plans were discussed with the Deputy Manager who agreed that there does need to be a change in this aspect of record keeping as one persons health and general well being has improved significantly since moving into Charlesworth but their care plan does not reflect this. Comments in the homes surveys included: • • • • Since auntie arrived she could not sing the praises fro Charlesworth high enough. The staff are caring and really enjoy looking after the residents. No criticisms at all, keep up the good work and well done. I would have no hesitation in recommending Charlesworth to anyone who was looking for a care home. The two people admitted for respite care did not have care plans as the Registered Manager explained that they were only staying for one week. It is important to ensure that if their stay is extended, detailed care plans are created to direct staff in the delivery of care. In general, daily notes were good, providing information as to how individuals spent their day and it is these notes that are used to inform the review process. One person has become quite confused and their needs must be clearly identified in their care plan and staff offered relevant training to ensure they understand the condition and how to ensure good quality life is maintained. The medication administration records (MAR) were viewed and although mostly correct it was of concern to note that some signatures were scribbled out and the daily diary indicated that one person was given paracetamol but this had not been entered on the MAR chart. It is crucial to ensure that medication records are clear, accurate and up to date to demonstrate whether or not medication has been given. It was also of concern that the carer who was administering the morning medication had to leave the drugs trolley unattended whilst she took medication to people on the second floor and whilst delivering medication to individuals bedrooms. This practice should be reviewed to ensure unauthorised people cannot access medication. One person is currently prescribed a Schedule 3 controlled drug therefore this must be stored in an approved controlled drugs cupboard and good practice is that a controlled drugs register is also maintained. Charlesworth Rest Home DS0000014190.V367380.R01.S.doc Version 5.2 Page 11 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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The lifestyle experience by people living in the home mostly match their expectations, choice or preferences. EVIDENCE: Records relating to the daily routines of individuals included preferred times for getting up and going to bed. However, leisure preferences were not identified either through the pre-admission assessment process nor the care plans and this needs to be addressed to ensure activities are based on the preferences of those living in the home. People spoken with said how much they enjoyed the musical entertainment and this was the activity on the day. It was clear that people really enjoyed this and some joined in with the singing. People spoken with also said that they very much enjoyed the hand massage and manicures that are also provided. One persons care plan indicated that they do not join in any activities but there was no evidence that attempts had been made to find out what activities they did enjoy. The two staff spoken with were both knowledgeable about the care needs of individuals in the home and the importance of ensuring their independence and autonomy is protected and promoted. Charlesworth Rest Home DS0000014190.V367380.R01.S.doc Version 5.2 Page 12 One person spoken with said she is able to go out independently and visit friends and go to the shops and another person said that they numerous visitors, all of whom are made welcome. There were a number of visitors on the day and it was clear they were comfortable in approaching staff and management with any issues. All individuals spoken with confirmed that the food was excellent and meals are varied, nutritious and wholesome. Most part people living in the home maintain an acceptable weight which indicates they have a good nutritional intake. On arrival a bowl of cereals and a plate of toast were on the kitchen worktop, shortly afterwards a carer was seen to reheat the toast in the microwave. Following the site visit the Registered Manager confirmed that the person for whom the toast was intended has requested that his toast be reheated in a microwave. Charlesworth Rest Home DS0000014190.V367380.R01.S.doc Version 5.2 Page 13 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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure with evidence that those living in the home feel that their views are listened to and acted upon. People living in the home are further protected by satisfactory adult protection systems. EVIDENCE: Information in the AQAA indicated that there are detailed policies and procedures on both complaints and Safeguarding Adults. The complaints log was viewed and neither the home nor the CSCI have received any complaints since the last inspection. However, the Deputy Manager confirmed that all complaints are dealt with in accordance with the homes policies and procedures. People spoken with felt they could talk to anyone if they had any concerns about the care given. Staff are expected to be familiar with the homes policies and procedures on adult protection and there is an on-going staff training programme to ensure all staff are trained in the procedures required for Safeguarding Adults. A Safeguarding Adult alert was made in February 2008 in respect of rough handling of service users and the matter was investigated by Brighton and Hove Social Services. The recommendations were that the home needs to ensure staff have up to date training for manual handling and are aware of how being manually handled can impact on an individual. Charlesworth Rest Home DS0000014190.V367380.R01.S.doc Version 5.2 Page 14 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 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Most parts of the home are maintained providing a homely and comfortable environment for people living in the home however a number of improvements need to be made to ensure all parts of the home are safe. EVIDENCE: A tour of the premises was carried out and a number of randomly selected bedrooms inspected. Most parts of the home are adequately maintained and it is clear that individuals are able to bring in their own items to personalise their bedrooms. Individual bedrooms were nicely decorated and generally clean and tidy with just one room visited being malodorous. The newly purchased dining room tables and chairs were smart, modern and of good quality and the redecoration of the first floor has been completed. Where rooms were shared, screens were easily accessible for staff use. The home continues to undergo a gradual upgrade and refurbishment and where redecoration has been undertaken this has been completed to a good standard. Currently work is on going to improve the frontage of the building. Charlesworth Rest Home DS0000014190.V367380.R01.S.doc Version 5.2 Page 15 The garden is not well maintained as some parts are overgrown with weeds and brambles and there were 3 zimmer frames left on the lawn. This was discussed with the Registered Manager who said she was advised by the wildlife society not to improve the garden, as it is a haven for wildlife. There is decking outside the conservatory so people are able to sit outside when the weather is good. Some decking boards were in need of renovation as two appeared to be rotting. This was discussed with the Deputy Manager who agreed to arrange for this area to be refurbished. A number of doors were wedged open and guards had not been fitted to radiators in bedrooms, toilets and bathrooms. These shortfalls need to be addressed to ensure people living in Charlesworth are not at risk. Since the last inspection safety checks are now carried out on hot water outlets to ensure water temperatures are safe, however the water temperature in two bathrooms was in excess of 500 which puts people at risk of scalding. This was discussed with the Deputy Manager who said that he does not test these outlets as only the basement bathroom is used. He agreed to check in future. A number of radiators in bedrooms, bathrooms and communal toilets have not had guards fitted and this needs to be addressed to ensure people are not at risk. It is of concern that only one bathroom is used as the home is registered for 18 people It is important that there is sufficient bathing facilities to meet peoples’ needs, therefore action needs to be taken to ensure that bathing facilities are made accessible on the first and second floors. As the only bathroom currently used is situated next to the kitchen and dining/lounge areas the dignity and privacy of individuals is compromised, as they need to walk through a busy part of the home in their nightwear. Generally the home is clean and tidy and laundry facilities are satisfactory, however staff did not follow good practice in respect of infection control. Staff were seen to be handling used laundry and providing personal care without wearing disposable aprons. Although staff used gloves they did not dispose of them in the room where they were used. Ordinary hand towels are provided in communal toilets and bathrooms but current good practice guidance is that paper towels should be used in these areas. These practices put people living in the home, staff and visitors at risk of cross infection and needs to be addressed. Charlesworth Rest Home DS0000014190.V367380.R01.S.doc Version 5.2 Page 16 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): People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are sufficient staff deployed who have the skills to meet the needs of those people living in the home but improvements need to be made to recruitment practice to safeguard those living in the home. EVIDENCE: The Registered Manager confirmed that there are two carers on duty for each daytime shift and one night waking staff. In addition to care staff the Registered Manager is on-site most days and the Deputy Manager also works for 25 hours a week. Cooks, cleaners and a maintenance person are also employed. Given that one person has become confused and others appear to be more dependent night staffing levels need to be held under review to ensure care needs can be met both during the day and at night. Of the nine care staff seven either have or are working towards gaining National Vocational Qualification 2 in care therefore the home exceeds the required 50 of care staff with this qualification. Recruitment records for the last two people to be employed were viewed and although both had POVA first checks and a criminal records bureau check, one person did not have a reference from her last employer and this same person did not provide a full employment history. It is important to ensure that these checks are carried out to ensure people living in Charlesworth are not at risk. Comments from people spoken with and from surveys included: Charlesworth Rest Home DS0000014190.V367380.R01.S.doc Version 5.2 Page 17 • • • • • all the staff are lovely, very polite and kind. Nothing is too much trouble. Never a raised voice and always happy to help Everyone is so helpful and welcoming. The staff are super, I couldn’t fault them, helpful and friendly and efficient and kind. All new staff undergo an induction training programme and although the records were all signed for on the same date the Deputy Manager explained that he does the induction over a number of weeks and signs them off when finished. Staff training records showed that all staff except one has had mandatory training in fire safety and manual handling. The one carer who has not had up to date training is a night carer so it is important to ensure this person receives this training without delay. Charlesworth Rest Home DS0000014190.V367380.R01.S.doc Version 5.2 Page 18 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 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Improvements need to be made to ensure all aspects of peoples health; safety and welfare are protected and promoted. EVIDENCE: The Registered Manager has managed the home for a number of years and is therefore very experienced. Although she does not possess the required care and management qualifications the Deputy Manager does have the Registered Managers award and a National Vocational Qualification in care at level 4, so is knowledgeable on current good practice guidance. It was of concern that fire doors were still wedged open and a notice was pinned to the laundry door requesting that staff use the wedge and not the iron to hold the door open. It is important to ensure that current fire safety Charlesworth Rest Home DS0000014190.V367380.R01.S.doc Version 5.2 Page 19 guidance is followed and self-closing devices fitted as required. Some bedroom doors did not close fully and this needs to be addressed, as it is important to ensure people are protected in the event of fire. There is a range of quality monitoring systems in place including surveys, staff and resident meetings each of which enable people to be consulted on how the home is run. This is in addition to reviews of policies and procedures and other documentation relevant to the running of the home. The survey carried out in March 2008 indicated that respondents rated all aspects of the home as good or excellent. The home does not handle any money on behalf of people living in the home. Individuals either handle their own money or solicitors and families do so on their behalf. One person said that they go to the post office each week to collect their pension which indicates that people are encouraged to remain independent. Information in the AQAA indicated that all safety checks are carried out regularly and that all policies and procedures are reviewed annually. There were records to show that a fire risk assessment has been carried out and that staff (except one) has been trained in fire safety. These measures are in addition to regular fire drills, which ensure both people living in the home, and staff are clear on what action to take in the event of fire. The last part of the external fire escape is the wooden decking in the garden and this was discussed with both the Registered Manager and Deputy Manager as it was not mentioned in the fire safety risk assessment. It was agreed that the fire service would be contacted following the site visit to assess the fire escape. Charlesworth Rest Home DS0000014190.V367380.R01.S.doc Version 5.2 Page 20 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 2 X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Charlesworth Rest Home DS0000014190.V367380.R01.S.doc Version 5.2 Page 21 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 OP4 Regulation 14 (1) (d) Requirement That the pre-admission document be expanded to include information as to how the home will meet assessed needs. That care plans are updated to reflect current care needs. That all medication administration records are clear accurate and up to date and that a controlled drugs cupboard is provided. That water delivery temperatures are at a level that does not put service users at risk and guards fitted to radiators unless a risk assessment suggests otherwise. That staff wear gloves and disposable aprons whilst giving personal care in line with latest infection control guidance. That a robust recruitment procedure is in place. This includes ensuring that two written references have been received prior to staff working in the home to protect service users. (timescale of 24/08/07 DS0000014190.V367380.R01.S.doc Timescale for action 01/08/08 2 3 OP7 OP9 15 (1) 13 (2) 01/09/08 01/09/08 4 OP19 13 (4) (b) (c) 01/09/08 5 OP26 13 (3) 01/09/08 6 OP29 19(1)(b) 01/09/08 Charlesworth Rest Home Version 5.2 Page 22 7 OP38 23(4)(ae) 18 (1) © (i) 8 OP38 not met). That the propping open of fire doors ceases and self closing devices fitted as required and that all fire doors close fully. That all staff have up to date training in manual handling and fire safety. 01/09/08 01/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP9 OP10 OP26 OP30 Good Practice Recommendations That the practice of leaving the drugs trolley unattended be reviewed and consideration be given to the provision of a controlled drugs register. That the use of bathrooms be reviewed to ensure service users dignity is not compromised. That consideration be given to providing paper hand towels in all bathrooms and toilets. That staff are trained in dementia care. Charlesworth Rest Home DS0000014190.V367380.R01.S.doc Version 5.2 Page 23 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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