Inspection on 30/01/07 for Acorn Lodge

This inspection was carried out on 30th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Acorn Lodge 13/12/07

Acorn Lodge 21/10/05

Acorn Lodge 07/06/05

Acorn Lodge 25/10/04

Acorn Lodge 07/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Acorn Lodge 14 Abbotts Lane Kenley Surrey CR8 5JH Lead Inspector Michael Stapley Key Unannounced Inspection 30th January 2007 09:30 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 Acorn Lodge DS0000048034.V329172.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. Acorn Lodge DS0000048034.V329172.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Acorn Lodge Address 14 Abbotts Lane Kenley Surrey CR8 5JH 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 8660 0983 Medicrest Ltd Miss Angela Caroline Bradley Care Home 39 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (39) of places Acorn Lodge DS0000048034.V329172.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A variation has been granted to allow one specified service user under the age of 65 to be admitted. As agreed on 12/05/2006, 2 service users with Dementia between the ages of 60 - 65 years old can be accommodated within the home. 21st October 2005 Date of last inspection Brief Description of the Service: Acorn Lodge is a modern building situated in the rural area of Kenley. The only possible disadvantage of its pleasant location is that it is located some distance away from public transport. The main entrance to the home is by driving or walking up a steep lane from the nearest bus route and rail link. The Lodge adjoins a similar home (Acorn House), also managed by Medicrest Limited. The two homes share a large rear garden. The home’s stated aims and Objectives are to ‘provide a home from home, friendly atmosphere where staff is approachable and an open relationship is encouraged between residents, staff and relatives to ensure a happy home and ensure the well being of the residents’. Acorn Lodge DS0000048034.V329172.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes first statutory inspection during the year 2006/2007. The inspection was unannounced and involved consultation with the registered manager and staff on duty. The inspection took place over one day and during that time a tour of the premises was undertaken, several service users and members of staff were spoken to. Care plans of the last three service users, who had been admitted since the last inspection, were examined as well as various records required for the health and safety and wellbeing of both the service users and staff. Most of the service users suffer from dementia however several were spoken to during the course of the visit and two members of staff were spoken to on an individual basis. There have been no complaints made about the service since the last inspection although there has been suggestion made by the tissue viability nurse which has been taken on board and followed through by the home. What the service does well: This home provides a safe and comfortable environment for service users, the majority who have some form of dementia. Although communication can be difficult with them one commented that she “felt very happy here “and another that the” food was very good”. Comments from families, relatives reflect that they are always made welcome and are appreciative of the care and service that is provided. They all perceive that staff always has time to spend with the service users and respect their individuality. The daughter of one service user commented to the inspector during the course of the inspection ‘that she was very happy with the service being provided for both of her parents at the home’ The district nurse commented ‘that the home is well managed and there are no issues of concern’ Acorn Lodge DS0000048034.V329172.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: During the course of this inspection it became apparent that the manager was not receiving supervision. The registered providers must therefore make suitable arrangements for this to take place. The owner agreed to ensure such notes were available. In addition the inspector suggests that the home consider appointing an outside consultant to support the manager in her development of the home. Although the home now has a reasonable training programme there is a need to ensure link workers attend Person Centred Planning training. Service users do have the facility to participate in local outings although the home does not have any form of transport whatsoever. Consideration could therefore be given to purchasing a vehicle for the home. Acorn Lodge DS0000048034.V329172.R01.S.doc Version 5.2 Page 7 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. Acorn Lodge DS0000048034.V329172.R01.S.doc Version 5.2 Page 8 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 Acorn Lodge DS0000048034.V329172.R01.S.doc Version 5.2 Page 9 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): 2, 3 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Contracts between the home and the service users contain all the information required under standard two thus ensuring the rights of the residents who live at Acorn Lodge (Standard two) All service users admitted to the home have a full and comprehensive pre admission assessment usually undertaken by the homes registered manager. This ensures that the home is fully able to meet the needs of anyone who moves into the service. (Standard three) Prospective service users and their relatives and friends have an opportunity, wherever possible to visit the home to assess the quality of care on offer and ensure the suitability of the home. (Standard five) Standard 6 does not apply, as the home does not offer intermediate care. Acorn Lodge DS0000048034.V329172.R01.S.doc Version 5.2 Page 10 EVIDENCE: Contracts inspected contained all the information as required under standard 2.2. thus ensuring service user’s rights. The assessments of the last three service users who had been admitted since the last inspection were examined. These were comprehensive and showed that risk assessments and manual handling assessments had been duly completed. Activities of daily living had been assessed and physical and psychosocial needs examined. The home’s registered manager or other senior member of staff usually undertakes these assessments and they form the basis for subsequent care planning – see standard seven. Where possible the relatives of service users are involved in this process. In discussion with the manager is became apparent that service users did not have a ‘plan of care for daily living’ This should be generated from the care management assessment and care plan or the homes own needs assessment (see standard seven). It is therefore recommended that the registered manager draws up such a plan for all service users as outlined in standard 3.4 The importance of any service user coming to the home and ensuring a degree of compatibility with those already living at the home was clearly emphasised. Introductory visits are planned wherever possible and include service user’s families and friends. In discussion with the registered manager it was clear that although this admission process takes some time it does give every chance for the new service user to settle in to their new surroundings and thus give a solid grounding to any placement. Acorn Lodge DS0000048034.V329172.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All health care needs of potential residents are assessed prior to admission and the care plans illustrated that these needs are reviewed regularly. In this way the home ensures that it remains able to meet these needs. EVIDENCE: A sample of service users care plans were inspected and showed evidence of regular review and in some cases the involvement of relatives. Care Plans are monitored at least monthly and had been updated to reflect changing needs (standard 7.4) Care plans inspected had been signed by the service user and/or representative (standard 7.6) The home sends copies of updated care plans and complaints procedure to relatives and service users representatives every six months. Link workers complete link working forms twice a week that Acorn Lodge DS0000048034.V329172.R01.S.doc Version 5.2 Page 12 are monitored by the registered manager. Such reports were detailed, written in plain English and gave a clear overview of the service users life at Acorn Lodge. It is, however acknowledged that the advanced stages of dementia of many of the service users preclude their involvement. Since the last inspection there had been a number of falls, eight of which have required admission to hospital; all have been clearly and accurately recorded in the accident book. It is suggested that the registered manager monitor such falls to see if there are any emerging patterns such as when and where they occurred. There were no service users with pressure sores at the time of the inspection. However the home is able to access equipment necessary if any service users have pressure sores. In discussion with the registered manager it was acknowledged the importance of recording the treatment and outcomes on service user’s care plans as outlined in standard 8.4 Staff were seen interacting with service users in a positive manner and were treating them with dignity and respect. Despite care staff coming from a wide range of nationalities they were able to communicate well and effectively with the service users. The last inspection by the pharmacist for the home was on 20th October 2006 and all requirements from the visit have been complied with. The inspector checked a number of service users medication stock and all were found to be correct. All aspects of medication practise were found to be satisfactory. There were no service users on controlled drugs at the time of this inspection. The registered manager is advised that if any service user is prescribed controlled drugs they must be stored in a metal cupboard which complies with the Misuse of Drugs (Safe Custody) Regulations 1973. Of concern is that some prescribed medication was not in a locked medication cabinet. The manager explained that the cabinet was too small to hold all medication. It is acknowledged that medication not locked in the cabinet is kept in the locked medical room. However the manager advised that only senior staff have access to the medical room and the home pharmacist has not objected to this arrangement. In addition the home has drawn up a risk assessment for the medical room which was evidenced as part of the inspection process. A list of staff signatures that are trained to give medication was noted. In addition all tubes and tubs were clearly labelled with the date of opening. None of the service users at the home self administer medication and all staff who administer medication has received appropriate training. Acorn Lodge DS0000048034.V329172.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 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. It can be difficult to communicate with some of the service users in this home, and many of them appear to appreciate a quiet and peaceful life and the pleasant surroundings, which the home provides to enable them to do so. Care staff are encouraged to assist service users to maintain a degree of independence and participate in social activities if they choose. Visitors are encouraged and always made welcome. Acorn Lodge DS0000048034.V329172.R01.S.doc Version 5.2 Page 14 EVIDENCE: Comments received throughout the inspection year of 2006-07 showed that visitors are always made to feel welcome in the home and although it was only possible to meet one of the relatives during the course of the inspection evidence from comment cards showed their was positive staff interaction with service users. One comment card stated “that staff work very hard at the home to care for mum and dad’ and another stated that “my mother enjoys the outings the home arranges for her’ On the day of the inspection, various activities were the order of the day and care staff at the home were actively encouraging service users to participate. The homes registered manager sees activities as pivotal in the development of service users at the home and seven service users recently went to a local circus which proved an enjoyable experience. The advanced stages of dementia of the service user’s means that they appreciate a degree of routine in their daily lives however staff were seen encouraging them to exercise as much choice as they are able. Lunch was not observed at this visit although comments about the food have always been positive. There is a wide range of choice and menus are changed on a regular basis. The present cook, who has a food hygiene certificate, works very hard to offer all service users a balanced, healthy diet and is very popular with the service users. One relative stated “That the variety and choice of food is excellent” S Staff offer service users assistance to eat their meals in a dignified and sensitive manner. The amount of food actually eaten is duly recorded if there are concerns regarding appetite. In addition the weight of service users is monitored and the registered manager advised the inspector that any adverse concerns are referred to relatives and/or GP. The home had an inspection from the Environmental Health regarding food safety on 110107. All requirements and recommendations from that report have been complied with. Temperatures of fridge/freezer and cooked foods were available for inspection. Acorn Lodge DS0000048034.V329172.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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents in the home and their relatives are confident that complaints would always be treated seriously and acted upon promptly. The staff within the home are aware of and work within the Local Authority guidelines for the protection of vulnerable adults and refers any allegations of abuse under the London Borough of Croydon’s Vulnerable Adults Procedure. EVIDENCE: The complaints record was checked and there had been no entries since the last inspection. The complaints book and associated procedure is available on request and it is included in the homes statement of purpose. Service user’s Families and Relatives are aware of the procedure to be followed should they wish to make a complaint. Given that the home has regular meetings with service users that both Families and Relatives are able to attend it is not surprising that there have been no complaints since the last inspection. In addition as stated earlier the complaints procedure is sent to all Acorn Lodge DS0000048034.V329172.R01.S.doc Version 5.2 Page 16 relatives and service users’ representatives every six months so they are clearly aware of the process to flow if wishing to make a complaint. The culture of the home and the transparent manner in which all the staff work lead to a confident approach when managing concerns or complaints. All of the staff members that were spoken to displayed knowledge of adult abuse procedures and all felt confident that they could approach the homes management team with any concerns. All of the staff has now completed Adult Abuse Awareness training. The manager has drawn up a flow chart for ease of reference for all staff to ensure the correct procedures are followed when reporting any allegation of adult abuse. The inspector spoke to the daughter of one of service users at the home who had previously had concerns which were discussed at the last inspection. She advised that all her concerns had been addressed and that she was very happy with the care both of her parents were now receiving. There have been no referrals to the local authority regarding the protection of vulnerable adults since the last inspection. The registered manager reviews the homes Adult Abuse policies and procedures on an annual basis. It is suggested that following the next review they are sent to the London Borough of Croydon’s Adult Abuse Advisor for comment and to ensure they dovetail the local authority’s procedures. Acorn Lodge DS0000048034.V329172.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, 22, 24 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is reasonably well maintained with due regard to the health and safety of both staff and service users. It is clean and provides a pleasant place to live with a homely and cheerful atmosphere. EVIDENCE: The home is in a pleasant residential area and offers reasonable accommodation for service users. The décor of the home is reasonable and new furniture has recently been purchased for the lounge. Acorn Lodge DS0000048034.V329172.R01.S.doc Version 5.2 Page 18 The registered manager advised the inspector that the home has a programme of planned decoration and maintenance. In general the home is decorated to a reasonable standard and reference is made to decoration in the homes Quality Assurance. Bedrooms and communal areas are decorated as and when necessary. The inspector drew the manager’s attention to the external patio area which on two recent visits to the home had looked dirty and unhygienic. Cigarette ends and dirty cups were noted in this area. In addition weeds and grass were growing from part of the guttering in an adjoining building. The manager advised that she would ensure the patio area was cleaned and that the guttering was cleared. The home has not had an assessment of the premises for adaptations and equipment as outlined in standard twenty-two. The manager advised that as this was a requirement at the last inspection she had contacted an Occupational Therapist who informed her that such an assessment was not required as the client group had not changed residential to nursing. The inspector has had an opportunity of discussing this matter with the occupational therapist and she advised it was about the changing needs of the service users not the category of registration. Given that the homes last assessment is nearly five years old and given due regard to the number of falls and ages of service users this requirement has been repeated. The grounds of the home have also been reasonably well maintained and are easily accessible to all service users who enjoy it particularly during the summer months. Service user’s bedrooms are pleasant and they have been personalised by their occupants. Most of the bedrooms contain all of the furniture and fittings as per standard 24. Where a service user has made a decision not to have a particular item of furniture or if the space is inadequate this has been recorded. The home has central heating and windows have been fitted with restrictors. Laundry facilities are well set out and the home is generally odour free. Appropriate floor covering has been provided in bedrooms for those service users who are incontinent. There is one sluice in the home, which is kept locked. Acorn Lodge DS0000048034.V329172.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): 27, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is sufficient staff on duty that collectively has the skills and experience to provide a good level of care for the service users in this home. Robust recruitment procedures and staff training ensure that service users are well cared for. EVIDENCE: Staff turnover in the home is relatively low; many of the staff has been with the home for some years. There is now a good balance of staff. The manager is supported by an experienced deputy manager and senior staff while there are an enthusiastic team of carers. Many of them have gained an NVQ level 2 qualification and six staff have just enrolled on an NVQ level 3 in caring for the elderly. The deputy manager is completing her registered manager’s award while one of the senior care workers is completing her NVQ level 3. Acorn Lodge DS0000048034.V329172.R01.S.doc Version 5.2 Page 20 A number of staff files were inspected at random during the course of the inspection cycle 2006-067 and all those inspected complied with the standard. Copies of their induction programme were seen. No new member of staff is employed until POVA and CRB checks are complete. The training programme within the home consists mainly of the core elements although there were some minor gaps noted with regard to these elements. The manager advised the inspector that all staff now has access to an effective ongoing training programme that meets their developmental needs. In addition while the care plans that the home has developed are excellent none of the staff have attended person centred planning training. It was also noted that none of the management staff at the home had undertaken risk assessment training. Acorn Lodge DS0000048034.V329172.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, 34, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home benefits from a strong staff team with good leadership, which ensures a reasonably high standard of care. Attention to health and safety procedures means that the wellbeing of service users is maintained. Acorn Lodge DS0000048034.V329172.R01.S.doc Version 5.2 Page 22 EVIDENCE: Meetings are held for service users every two months and relatives/friends are always welcome to attend. Staff meetings are held every month and minutes of the last three meetings were evidenced. It is suggested that staff sign them to ensure they have read them. The home has begun to ‘fine tune’ its quality assurance system and an annual development plan for 2006-07 will be completed shortly. The manager advised that she is in the process of seeking stakeholder’s/staff/care management views by means of surveys. In addition she will be undertaking an annual audit in line with standard 33. Records of Supervision were available for inspection and take place in line with the standard, although there was no evidence of the manager herself having had any formal supervision. The manager advised that annual appraisals should be completed by the end of March 2007. The home does not take responsibility for the financial affairs of any of the current service users. The home has not provided the commission with a business and financial plan for the year 2006-07. A requirement has therefore been made that the managing company send this to the commission within laid down time scales. Maintenance records were seen and were all in good order. Fire safety requirements had all been complied with. The home has the appropriate insurance policies in place and the certificate of public liability certificate was in place. Kitchen practices were reasonable and all staff has received appropriate health and safety training. Acorn Lodge DS0000048034.V329172.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 3 3 X 3 X 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 3 X X 2 X 3 X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 2 3 2 X 3 Acorn Lodge DS0000048034.V329172.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO. 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 OP22 Regulation 12 Requirement The registered person must make suitable arrangements for an assessment of the home by an occupational therapist to ensure suitable aids and adaptations are provided for service users. The responsible individual must send to the commission the homes business and financial plan for 2006-07. Timescale for action 31/03/07 2. OP34 25 31/03/07 3. OP36 18 The responsible individual must 31/03/07 ensure that the manager receives supervision as laid down in Standard 36. Acorn Lodge DS0000048034.V329172.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 Refer to Standard OP3 Good Practice Recommendations It is strongly recommended that the registered manager draw up a ‘plan of care for daily living’ for all service user as outlined in standard 3.4 Acorn Lodge DS0000048034.V329172.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Acorn Lodge DS0000048034.V329172.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!