Care Home: Heathfield House

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What the care home does well The home provides residents with a welcoming and homely place to live in. The majority of staff have worked in the home for some years and are familiar with the residents needs. Individual likes and dislikes are catered for and residents are treated with respect and dignity. What has improved since the last inspection? This is the home`s first inspection since the new Registered Provider took over the ownership of the home. Therefore previous inspection requirements have not been considered in this report. What the care home could do better: The kitchen is in need of updating, in particular the tiles, as they are in need of replacing. Recruitment checks need to be more robust to protect vulnerable residents. A training programme must be developed in order to meet the needs of staff. Health and safety procedures must be considered, such as closing fire doors, if door-releasing equipment fails to work. Regular fire drills for staff and residents need to be held. CARE HOMES FOR OLDER PEOPLE Heathfield House 10 Heath Road Hillingdon Middlesex UB10 0SL Lead Inspector Sarah Middleton Key Unannounced Inspection 8th April 2008 09:15 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 Heathfield House DS0000070414.V361436.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. Heathfield House DS0000070414.V361436.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heathfield House Address 10 Heath Road Hillingdon Middlesex UB10 0SL 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) 020 8804 1115 gurbir.heathfield@hotmail.com Vijayekoomar Kowlessur Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Heathfield House DS0000070414.V361436.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Old Age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 13 New service Date of last inspection Brief Description of the Service: Heathfield House is a care home for thirteen older people. It is situated in a quiet residential road and can be accessible via nearby public transport. There are five single rooms and four shared rooms. The home is a large double fronted detached house with a ground floor extension to the rear. There is parking to the front of the home. The accommodation is on two floors, with a third floor where a member of staff sleeps in. Four single rooms are located on the ground floor. There is a lift to the first floor and this is situated in the Managers office, residents access the different floors through this office. The fees for Heathfield House range from between £400.00 and £733.00 per week. Heathfield House DS0000070414.V361436.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 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced key inspection that took place between 9.15am6pm. Records relating to care and the running of the home were viewed during the inspection visit. Postal surveys had been sent out. Four relative and three resident surveys had been completed and returned. We spoke with two members of staff, one visitor and four residents. The home has a new Registered Provider and a new Deputy Manager. The Deputy Manager will be referred to in this report as the Acting Manager. The long-standing Registered Manager left six months earlier. The Acting Manager, who assisted with this inspection, plans to apply to become the Registered Manager. The Acting Manager had completed the Annual Quality Assurance Assessment. This provides information about the home and describes how the home cares and supports the residents. There were two resident vacancies and no staff vacancies at the time of the inspection. All of the National Minimum Standards were assessed. Five requirements were made from this inspection visit. What the service does well: What has improved since the last inspection? Heathfield House DS0000070414.V361436.R01.S.doc Version 5.2 Page 6 This is the home’s first inspection since the new Registered Provider took over the ownership of the home. Therefore previous inspection requirements have not been considered in this report. 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. Heathfield House DS0000070414.V361436.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 Heathfield House DS0000070414.V361436.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, Standard 6 is N/A Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents wanting to move into the home are assessed prior to any planned move. EVIDENCE: No new residents have moved into the home since the new Registered Provider and Acting Manager began working in the home. We were informed that all potential residents would be assessed by the home and the expectation is that the professional referring a new resident would give the home as much information about the resident’s needs and identified risks. This would enable the Acting Manager to make a decision about offering a place. Pre-admission assessments were viewed on a small sample of residents. We would encourage the home to review and, where necessary, update the pre-admission assessments to ensure sufficient details about a new resident is obtained during the assessment period. Heathfield House DS0000070414.V361436.R01.S.doc Version 5.2 Page 9 The home does not provide intermediate care. Heathfield House DS0000070414.V361436.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans and risk assessments provide current information about a resident’s needs. Residents’ health needs are identified and were being met. Robust medication procedures protect the welfare of the residents. Residents are treated with respect and dignity. EVIDENCE: The Acting Manager is in the process of updating all the eleven residents’ care plans and risk assessments. She has introduced new documentation that will clearly show the residents’ needs and how these needs are to be met. The practice had been that the previous Registered Manager had completed all of the residents care plans. Heathfield House DS0000070414.V361436.R01.S.doc Version 5.2 Page 11 Future aims of the home would be that members of staff will be trained and supported to take over this role. As frontline care staff they are often more aware of the residents needs and can make changes and updates as and when they recognise needs have altered. The small sample of care plans viewed were detailed outlining the resident’s health, social and personal care needs. These care plans would be reviewed on a monthly basis and the whole care plan would be thoroughly reviewed, along with the resident and relatives every six months. Where possible residents will be involved in the development of their care plan and can make contributions. The Acting Manager has also introduced a keyworker system. This is where specific care workers are given named residents to monitor and to support in particular areas. The risk assessments viewed were also detailed and covered a wide range of areas, such as risk of falling, moving and handling risks and challenging behaviour. Daily records were seen and these are written three times a day after each shift to inform the staff team about how the resident has been that day. Health needs were clearly recorded and forms are used to note when a resident has seen a health professional. This enables the staff team to monitor any health changes or needs. The home has recently purchased a weighing scale whereby residents can sit on the chair and be weighed on a monthly basis. This will also be recorded and monitored. Other risks relating to health are assessed, such as nutritional needs and risk of developing pressure sores. The Acting Manager stated there have been difficulties in some GP’s coming out to the home to see a resident. We advised that this would need to be monitored, as resident’s health needs need to be assessed by the appropriate health professional. Residents confirmed that they see Optician’s, Dentists and Chiropodists. There are currently no residents with pressure sores. As some residents have lived in the home for sometime, some of their needs have changed. Where the Acting Manager suspects a resident might have developed dementia, this would need to be fully assessed by a relevant professional. A sample of medication was viewed. The home does not currently have controlled drugs. The home will need to purchase a separate metal lockable container to store controlled drugs, should the need arise. The Acting Manager confirmed there is a controlled drugs register. All medication is locked in a suitable trolley. Evidence was seen that medication is checked, counted and recorded each month and this is seen as good practice and a way to spot any medication errors. In addition, the local Pharmacist also carries out an audit. Medication Administration Records were viewed, with one staff signature missing. The Acting Manager was aware of this error and will investigate this mistake. All other medication seen and counted was correct at the time of the inspection. One member of staff administers medication and where possible this would be the most senior member of staff working on the shift. The staff team will be receiving medication training at the end of the month. Heathfield House DS0000070414.V361436.R01.S.doc Version 5.2 Page 12 Residents spoken with confirmed they were supported with personal care in private. Shared bedrooms have a curtain between beds to provide some form of privacy. Residents also stated that staff knock before entering their bedrooms. Residents have access to a payphone, although this is in the lounge. The Acting Manager said that residents could receive calls in the office. Heathfield House DS0000070414.V361436.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall residents have opportunities to engage in activities and interact with others. Social contact and relationships are encouraged and promoted within the home. Residents are supported to express their decisions and choices. The meal provision offers residents choice and meets individual likes and dislikes. EVIDENCE: The home seeks to provide some activities, usually held in the afternoon. There is no designated member of staff in charge of activities. Some residents said they play bingo or read. Each month a person comes to sing songs and one resident goes weekly to the local Salvation Army. Relatives also take residents out of the home. Heathfield House DS0000070414.V361436.R01.S.doc Version 5.2 Page 14 One resident said they were sometimes bored and a survey completed by a relative commented that there could be more activities on offer. This was discussed with the Acting Manager and it is recommended over the forthcoming months that this is an area looked at and improved upon. Where needed additional staff might prove beneficial to ensure more outings and social activities take place. Visitors are encouraged and some were seen during the inspection visit. Residents can see visitors in private and as mentioned earlier, visitors take residents out for appointments or social trips. Where they are able, residents are supported to manage their own finances. We viewed several residents’ bedrooms and saw that many had brought personal possessions into the home. The Acting Manager is keen to hold regular resident meetings to ensure the views of the residents are heard and acted on. The senior member of staff is also the cook. A sample of menus were seen and indicated that choices are provided. Feedback from residents was that they liked the food and that staff would ask them what they wanted to eat. This was evidenced when we saw a resident being asked what they wanted for their evening meal. Fresh produce is used where possible. The home has a delivery of food every two weeks, to ensure fresh vegetables are usually available. It was suggested that this could be increased to once a week to ensure fresh produce is available for the majority of meals. Fridge temperatures are taken on a daily basis. Staff attend food hygiene training as the majority of staff handle and prepare food. See Standard 19 with regards to the kitchen environment. Heathfield House DS0000070414.V361436.R01.S.doc Version 5.2 Page 15 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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are aware of how to make a complaint. Systems are in place to safeguard residents from abuse. EVIDENCE: The home had one complaint in the last twelve months. The Acting Manager will develop a complaints folder to ensure issues are recorded in one central place, with confidential information locked away. A visitor spoken with described how they had complained in writing twice regarding concerns. The Registered Provider had telephoned this visitor to discuss the issue. However, the visitor was not happy that their letters had not been acknowledged and that they had not received a written response. We advised the Registered Provider to follow the home’s complaints procedure, and that all written correspondence be responded to in writing. Those residents who completed postal surveys and those residents asked during the inspection visit, said they would speak with the Acting Manager if they were unhappy about something. Heathfield House DS0000070414.V361436.R01.S.doc Version 5.2 Page 16 The home has not had any adult abuse concerns. Those staff asked said they would report any abuse concerns to either the Acting Manager or the Commission. It was advised for the home to ensure copies of the Local Authority’s adult abuse policies and procedures be obtained and made available for staff. Staff will also need training and information on this important subject. Heathfield House DS0000070414.V361436.R01.S.doc Version 5.2 Page 17 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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents would benefit from an updated kitchen. Overall the home is clean and welcoming for residents to live in. EVIDENCE: We carried out a tour of the home. The first floor bathroom had been completely refurbished, with a walk in shower and assisted equipment for the residents. New carpet had been fitted through communal areas. The Registered Provider explained that the home would be updated as and where needed. Heathfield House DS0000070414.V361436.R01.S.doc Version 5.2 Page 18 It was noted that the kitchen had areas needing attention. A tile was missing by the window, a tap head was missing from the small sink and in general the tiling was in need of replacing. A requirement was made for this to be addressed. We spoke with the domestic worker who works alone in the home ensuring the home is kept clean. She confirmed she had received health and safety and infection control training, but had not had moving and handling training (See Standard 30 regarding training). Protective clothing is also available and used for cleaning and providing personal care. Cleaning products are kept locked away. The laundry room is located in a small separate room. The Acting Manager said the home was looking to replace the washing equipment for more suitable machines. Overall the home was clean, tidy and free from unpleasant odours. Heathfield House DS0000070414.V361436.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are supported by suitable numbers of staff. Recruitment procedures need to be more robust in order to safeguard the residents. An ongoing and detailed training programme needs to be implemented to ensure an informed and skilled staff team supports the residents. EVIDENCE: The rota was viewed and showed that that two members of staff work on each shift, with a person sleeping in most nights and a waking night member of staff. The home has two senior members of staff, one senior is the main cook in the home. This was discussed with the Registered Provider and Acting Manager, as on many shifts there is not a senior member of staff working. Currently, whilst the Acting Manager is getting to know the home and how it is run, she is working some shifts and weekends. The Acting Manager is aware of the need to look at the staffing structure and will consider having more senior workers in the home. Currently there are no staff vacancies. Heathfield House DS0000070414.V361436.R01.S.doc Version 5.2 Page 20 If the two resident vacancies were filled then the home would need to consider having additional staff working on a shift to ensure activities, appointments and any other tasks are carried out appropriately and safely. It is seen as good practice that the home does not use external agency members of staff to work in the home. Existing permanent staff cover any additional shifts. The Registered Provider and Acting Manager are looking to possibly recruit casual staff who would work to cover additional hours as and when needed. 50 of the staff team have obtained an NVQ. The aim is for all staff to be encouraged and supported to achieve this or a relevant qualification. Two staff employment files were viewed. These were regarding the newest members of staff to join the staff team. Findings on both files were similar. There was a lack of detail on the application form regarding current employer and references. Medical declaration forms, photographs and Criminal Record Bureau Checks were missing from these two files. This was discussed with the Acting Manager. We stressed the need for clear information on any applicant applying for a job in the home. The Registered Provider provided evidence later in the inspection that POVA first checks had been completed and that the Criminal Record Bureau Checks had been applied for. These two new members of staff had received an induction but had then worked unsupervised at night on approximately three shifts. This is not acceptable and until current Criminal Record Bureau Checks have come through these two members of staff must work alongside another permanent member of staff. Subsequent to the inspection visit, the Acting Manager forwarded on copies of amended rota’s showing that these new staff were not working a waking night shift unsupervised. In addition, we were also informed that one of the Criminal Record Bureau Checks had come through and we were sent the disclosure number. A requirement was made for the recruitment procedures to be followed at all times. Training was discussed with the Acting Manager. There were no individual training records and no overall training plan for the staff team. It is seen as good practice and a way to identify individual staff’s training needs if these are developed and implemented. The home’s current induction programme was viewed. This is a checklist and would benefit new staff if this were provided in more detail. The Registered Provider acknowledged this and will introduce a more detailed induction plan for future staff. It was not clear if staff had received the core-training subjects last year, such as moving and handling, health and safety and fire awareness. Medication had been booked for all care staff to attend later in the month. A requirement was made for this shortfall to be addressed. Heathfield House DS0000070414.V361436.R01.S.doc Version 5.2 Page 21 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 & 38 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 managed with the interests of the residents considered. Systems are in place to protect resident’s personal finances. Robust health and safety procedures need to be adhered to in order to protect those living and working in the home. EVIDENCE: The previous Registered Manager left the home approximately six months ago. For a few months there was not a day-to-day Manager in the home. However feedback from staff is that the home coped without a Manager. Heathfield House DS0000070414.V361436.R01.S.doc Version 5.2 Page 22 The Acting Manager does not have direct managerial experience but has several years experience in working with older people and is in the process of studying for the Registered Managers Award and NVQ level 4. She has made some positive changes in the home and is aware of the shortfalls. The aim is for her to apply to become the Registered Manager and to continue to make changes where she feels it will benefit the residents. The Acting Manager is aware that previous surveys were given to residents and relatives but completed ones could not be located during the inspection. Reviewing the care offered in the home was discussed. The Acting Manager is keen to obtain views of the residents, relatives and others and will be sending out surveys later in the year. Resident meetings will also be held on an ongoing basis. It is recommended that the home each year develops a quality review report that is then made available to the Commission and to residents. This report should summarise all the work the home has been doing over the past year along with future aims and objectives. Any relevant feedback from surveys or complaints should also be included. The quality assurance policy was viewed and is more of an assessment of the home rather than a policy. The Acting Manager agreed to review this policy and the necessary amendments will be made. The Registered Provider is currently in charge of two resident’s personal finances. Records are kept of the money given to the resident and where relevant any expenditure is also recorded. The majority of residents have the Local Authority or their relatives managing their finances. Samples of some records were viewed and there was evidence that both the Acting Manager and a relative had signed when there had been a financial transaction. The fire risk assessment is in place and was viewed. This covered all the areas in the home and identified ways to minimise the risk of fire. There was evidence that a fire drill had been held in 2007 but not since then. This is a requirement and subsequent to the inspection the Acting Manager confirmed that she had carried out and recorded that a fire drill had taken place. Other maintenance records were viewed, such as Portable Appliance Testing, Gas safety check and testing for Legionella. All were up to date. It was noted that three fire doors, the kitchen, the lounge and a bedroom were being propped open as the door releasing equipment was not working. The Registered Provider confirmed that he had been trying to resolve this problem but so far no work had been carried out. A requirement was made for these doors to be closed until the equipment is fixed. Heathfield House DS0000070414.V361436.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 2 Heathfield House DS0000070414.V361436.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A 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 OP19 Regulation 23(2)(b) (d) Schedule 2 Requirement To ensure residents live in a pleasant home, the kitchen needs to be updated and the tiles replaced. To protect residents, recruitment procedures must be followed. Medical declarations, fully completed application forms and current Criminal Record Bureau Checks must be available for inspection. To meet the needs of the residents, an ongoing training programme must be implemented. To protect residents and staff, regular fire drills must be held and recorded. In order to safeguard residents and staff, fire doors must either be closed or fitted with suitable door releasing equipment. Timescale for action 31/07/08 2. OP29 09/04/08 3. OP30 18(1)(a) (c)(i) 23(4)(e) 23(4)(c) 14/07/08 4. 5. OP38 OP38 11/04/08 30/04/08 Heathfield House DS0000070414.V361436.R01.S.doc Version 5.2 Page 25 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. Refer to Standard OP12 OP33 Good Practice Recommendations It is recommended that more regular activities and outings be organised to meet the interests and needs of the residents. It is recommended that an overall quality review report is developed and available for residents and the Commission on a yearly basis. Heathfield House DS0000070414.V361436.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Heathfield House DS0000070414.V361436.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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