Inspection on 09/10/07 for Barton Grange

This inspection was carried out on 9th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Barton Grange 23/04/07

Barton Grange 08/06/06

Barton Grange 08/11/05

Barton Grange 25/07/05

Barton Grange 07/03/05

Barton Grange 05/10/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Barton Grange Barton Road Barton Winscombe North Somerset BS25 1DP Lead Inspector Nicola Hill Key Unannounced Inspection 9th October 2007 10:00 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 Barton Grange DS0000049161.V348764.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. Barton Grange DS0000049161.V348764.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barton Grange Address Barton Road Barton Winscombe North Somerset BS25 1DP 01934 842827 F/P 01934 842827 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) Scosa Ltd Ms Sarah Jane Matthews Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Barton Grange DS0000049161.V348764.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd April 2007 Brief Description of the Service: Barton Grange provides personal care for up to 20 elderly residents. The home is situated on the outskirts of the village of Winscombe. Mr and Mrs Scott, trading as Scosa Ltd bought the home in June 2003. Ms Sarah Matthews is the registered home manager. Accommodation is in a Victorian country house with a modern extension. Seven of the bedrooms are on the ground floor. There is level access to these rooms. The remaining bedrooms are on the first floor. A stair lift is provided on both staircases. Additional steps to some of the rooms mean that residents with impaired mobility may not be able to access these areas. The rooms affected are clearly identified in the service user guide. One of the bedrooms has en suite facilities. There is a large garden with lawns at the front of the building and a patio area to the rear. The home can sometimes accommodate residents’ pets, subject to prior agreement. The fees range from £365 - £450 per week with additional charges being made for hairdressing, chiropody, newspapers, and toiletries. This information was provided in April 2007. Barton Grange DS0000049161.V348764.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is an overview of what the inspector found during the inspection. This was the second Key Inspection this year for this service, the inspection was carried out by Regulatory Inspector, Nicola Hill, over the course of one day. The manager for the home Sarah Matthews was available throughout the inspection. As this was the first visit to this home for this inspector, a full tour of the premises was carried out. During the inspection, the personal files and documentation of people who use this service were examined, and we spoke with five people about their experience of living at the home. Staff files were picked at random by the inspector to examine, and one member of staff spent time with the inspector discussing their role, personal goals and experience of working in the home. Documentation relating to: staff training and supervision, quality assurance, complaints and medication administration were also examined, and observation of care practices were carried out during this inspection. We also received feedback from questionnaires sent to the service prior to the site visit. Comments from the questionnaires were positive about the service, one person wrote ‘I am very happy here’, one relative commented that I am delighted at the good care my mother is receiving. At the time of the inspection there were 16 people living at the home. The individual care and support provided to the people using the service at Barton Grange is good, however, there are areas that still require improvement and overall Barton Grange provides an adequate level of service. What the service does well: What has improved since the last inspection? Barton Grange DS0000049161.V348764.R01.S.doc Version 5.2 Page 6 Since the last inspection, there have been improvements made to the physical environment of the home. For example, a new fire alarm system has been installed. The organisation have also been successful in accessing funding to improve the physical environment and plan to increase the number of ensuite facilities at the home. The retention of staff is good and the staff have received their statutory training courses. The supervision of staff has improved and documentary evidence shows a mixture of one-to-one supervision as well as supervised practice. 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. Barton Grange DS0000049161.V348764.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 Barton Grange DS0000049161.V348764.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): 1,2,3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service has developed a Statement of Purpose, which sets out the aims and objectives of the home, and includes a service user guide, which provides basic information about the service and the specialist care the home offers. EVIDENCE: The Statement of Purpose and Service User Guide would benefit from a revamp in order to present the home and its attributes positively for marketing purposes. We discussed this with Sarah Matthews, who stated that following the last inspection she had worked with the staff at the home to improve this documentation, however, it has been sent to headquarters and no action has yet been taken. We discussed the implications for the home from providing poor information to potential residents in a competitive market. We recommend that action be taken to produce the new guides. Barton Grange DS0000049161.V348764.R01.S.doc Version 5.2 Page 9 The Terms and Conditions of residency document the weekly fees to be charged and are clear, the invoices show a breakdown of each partys contribution, however the contracts and the information from the organisation should reflect the principles of the Fair Contract with Older People published by the Commission. We reviewed the preadmission documentation for the residents who had been admitted to the home in the last inspection. One resident had been admitted on a respite basis, and one resident on a permanent basis. Both of the preadmission assessments for these residents included all aspects of daily living and were comprehensively completed. From these documents the manager can clearly demonstrate that the home can meet the assessed needs. Barton Grange DS0000049161.V348764.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. The service involves individuals in the planning of care that affects their lifestyle and quality of life. Staff understand the importance of residents being supported to take control of their own lives. Individuals are encouraged to make their own decisions and choices. EVIDENCE: Individual records are kept for each of the residents, which include a social history. Nine care plans were reviewed, all reflected current health and social care needs. We saw evidence of regular visits by the chiropodist and optician; the people who spoke to us confirmed that they were supported to attend appointments locally or at the hospital. Clear actions to meet identified needs were recorded and regular evaluation noted. Some care plans did not indicate any resident or relative involvement Barton Grange DS0000049161.V348764.R01.S.doc Version 5.2 Page 11 although it was stated by the head of care that it was usual practise to invite relatives to review meetings. All care plans contained well-formulated risk assessments for falls and any environmental risks e.g. use of the stair lift. Risk assessments were carried out on an individual basis and this was supported by general environmental risk assessments. Daily records are not made but entries are made of significant events and these were objective and provided relevant information to support the well-being of people who use the service. We observed that there were caring interactions and good communication skills between staff and the people using the service. Choices and preferences were discussed and offered. We observed one member of staff helping a resident to use the stair lift. The staff member was very considerate and gave a clear direction and reassurance throughout the process. The staff member then met the resident at the bottom of the stairs and assisted them into the lounge. The support given to the resident was not intrusive and promoted the resident’s independence in use of the stair lift. We observed that there was an electric bed and a pressure mattress in situ for one of the residents. We discussed this with the manager who stated that the resident had recently been ill, and she had sought the support of the PCT to provide the equipment to enable them to continue to care for the resident at Barton Grange. Subsequently the health of the resident has improved, and the PCT has agreed to the equipment remaining in place. We saw this as an example of the person centred approach of the manager to support residents in her care. Medication storage, receipt and disposal are well managed and an audit trail of medicines entering and leaving the home provides safeguards for residents. Medication administration records were appropriately completed. The home does not have a policy for the administration of homely remedies, however a shortlist of recommended remedies is held at the home. The manager understood the need for a policy and is planning to access the North Somerset PCT policy and discuss and agree it with the local GP’s. All residents spoken with felt that kind and caring staff respected their dignity and privacy. None of the residents who spoke to us expressed any concerns about the care and support they received from the staff team. One person commented that ‘ the staff are very good and jolly us along’. We discussed with the head of care the quality of the personal support provided to the residents. We were shown documentary evidence that individual preferences are recorded and shared with all care staff about how residents like to be treated. Barton Grange DS0000049161.V348764.R01.S.doc Version 5.2 Page 12 Barton Grange DS0000049161.V348764.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. People who use services are involved in meaningful daytime activities of their own choice and according to their individual interests and capability. EVIDENCE: All of the residents have an allocated key worker, the people who spoke with us knew who their key worker was, and the specific tasks they undertook for them. All of the residents felt that having a key worker was a good idea as it provided some continuity and contact for them. There is an extensive activity programme in place that includes a wide variety of activities including; games, video afternoons, quizzes, family events, hand and nail care, visiting entertainers, and church services. People who live in this home are encouraged to participate in activities, however the choice is always up to the individual. The home try and meet the recreational needs of all the residents, consequently some residents find some of the activities childish. However, the residents confirmed that they exercised individual choice about joining groups and that individual interactions and conversation was available to them. Barton Grange DS0000049161.V348764.R01.S.doc Version 5.2 Page 14 During the visit to the home we were aware that during the morning a harpist visited and entertained residents, and during the afternoon staff organised competitive activities in the lounge. There is information available to residents about activities as well as this staff were observed verbally informing residents of the events. The manager is planning to introduce a weekly mobile shop service for residents. Residents told us that visitors are welcomed into the home ‘a tray of tea is always offered‘ and the day to day routine can be flexible. The dining room is very homely and comfortably furnished; effort is made to make the tables appear attractive and residents stated that they often stayed chatting after the meals, and this made it a very social occasion. We asked residents their opinion of the food at the home. There was a mixed response possibly because the regular cook had recently left the home and the manager or other staff were cooking the meals. Some people stated that the meals were fine and they had no complaints whilst others would like to be offered more choice. Barton Grange DS0000049161.V348764.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. The complaints procedure is supplied to everyone living at the home and is displayed in a number of areas within the service. Residents and others involved with the home understand how to make a complaint and are clear about what will happen if a complaint is made. EVIDENCE: The home has a comprehensive complaints procedure and all residents have a copy of it. There have been no complaints since the last inspection. Residents stated that if they were not happy about anything they would speak to the manager. The residents who spoke with us stated that they had no real complaints and ‘couldn’t say a bad word about the place’. The system for dealing with complaints is very clear; no complaints have been recorded at the home since the last inspection. The local safeguarding adults procedures were available in the office of the home; no referrals have been received from Barton Grange. Staff attend the safeguarding adults training through North Somerset Council and develop their knowledge when completing NVQ in care. Barton Grange DS0000049161.V348764.R01.S.doc Version 5.2 Page 16 Barton Grange DS0000049161.V348764.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 adequate. This judgement has been made using available evidence including a visit to this service. The home is comfortable, and has a programme to improve the decoration, fixtures and fittings. Maintenance tends to be reactive rather than proactive. People who use services can personalise their rooms. They also say they the home is clean and warm. EVIDENCE: Following the last inspection a development plan for the premises has been drawn up and the manager told us that the provider is currently looking at the work needed to provide a safer environment. Work has been undertaken to replace the fire safety system, both staff and people who use the service confirmed that they were aware that there was a new system in place; one Barton Grange DS0000049161.V348764.R01.S.doc Version 5.2 Page 18 person was able to recount their involvement in a practise fire drill and evacuation of the home. We raised with the manager the visible impact of the home on prospective residents, in particular there are corridors with unshaded lights; wallpaper coming off the wall and an area of rising damp. The outside communal area is not fully accessible; the rear patio will be relaid during the winter. The front garden is uneven and floods; the soak away from the septic tank is insufficient to cope with the rain water coming off the hills. The manager stated that the organisation were fully aware of the problems and that a handyman had been allocated to the home for one day a month. We discussed how the amount of work that was needed was going to be achieved, and will request further information from the providers. We observed during the tour of the building that there was signage relating to fire escapes and fire equipment visible in all the corridors. The hot water temperature is controlled from the main boiler and outlets do not exceed recommended temperatures. The portable appliance testing (PAT) had been completed. All of the bedrooms have a telephone point and the new call bell system. There is a lock on bedroom doors which residents can choose to use if they wish. The manager informed us that the stair lift which has been regularly serviced, will be replaced in the general refurbishment of the home. The bathrooms which are regularly used and accessible to the residents have been refurbished; all hoists have been tested. We observed that there are pets kept in the garden. The home was clean and free from offensive odours throughout. The laundry facilities were well organised. We observed Infection Control procedures and practices in place. Barton Grange DS0000049161.V348764.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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service report that staff working with them are very skilled in their role, and are consistently able to meet their needs. There are consistently enough staff available to meet the needs of the people using the service. EVIDENCE: At the time of a site visit the home had 16 residents (one resident for respite care). The staff rota indicated that there were two care staff on duty supported by the head of care. The manager was also in duty although covering the cooks hours until the new cook started the following week. In the afternoon we observed that there were two care staff on duty supported by a junior assistant. The junior assistants work in the evening to prepare snacks and to serve the evening drinks allowing the care staff to concentrate on their role. We observed that the level of staffing was sufficient for the number and dependency of the residents. The manager stated that the layout of the home was difficult however the new call bell system allows people to summon help if needed. There have been no new staff recruited to the home since the last inspection, and there are two overseas staff employed at Barton Grange. Barton Grange DS0000049161.V348764.R01.S.doc Version 5.2 Page 20 We discussed staff recruitment with the manager, because of where the home is and the lack of public transport, recruitment to Barton Grange is difficult. Currently staff and the manager cover any shortfalls in the rota. The home has met the requirements from the last inspection relating to statutory training. We discussed with the manager the requirements from Environmental Health relating to staff having a Food Hygiene certificate. The Environmental Health officer who visited the home stated that those people who are preparing cooked meals from raw food need to have the Food Hygiene Certificate. Those staff that prepare snacks do not need to have achieved this qualification. The record of food temperature of reheated food i.e. evening snacks, was maintained to the satisfaction of the Environmental Health Officer. We agreed that all of the staff who take responsibility for cooking meals will have the Food Hygiene Certificate, and that the others, including the junior assistants do not need it. Access to further vocational training for care staff remains an issue, as there is limited funding for National Vocational Qualifications. Consequently amongst the current staff group only one person has NVQ 2 in care, and three staff are working towards NVQ qualifications. The residents have a high opinion of the people who care for them, and are on first name basis with all staff and the manager. We observed that the manager is open and receptive to both staff and residents. Barton Grange DS0000049161.V348764.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, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager is qualified and has the necessary experience to run the home. The service is user focused, and works in partnership with families of people who use the service and professionals. EVIDENCE: The manager gives clear leadership, guidance and direction to staff. Residents feel she is approachable, available and seeks to ensure all their needs are met. She is very committed to improving services in this home and is focused on individualised care and promoting independence for the people who live there. The manager is undertaking further training to enhance her knowledge and skills of caring for older people. Barton Grange DS0000049161.V348764.R01.S.doc Version 5.2 Page 22 We discussed the situation at the time of the inspection whereby she was working in the kitchen covering the cook vacancy. This was obviously not the best use of her time and meant that her own work was not being completed in the normal work day. The Manager stated that the organisation was aware of the situation but that use of agency staff to cover the vacancy had not been agreed. We also discussed the positive feedback from residents about their quality of life at the home. The quality assurance in place at the home currently include use of residents questionnaire, however, no action appear to be taken from the results of the questionnaire. The residents also have their own charter, and the manager organises resident/relatives meetings on a regular basis. The organisation needs to develop a comprehensive quality monitoring system and link this into the development plan for the home. The manager was aware that initially the organisation had intended to refurbish the home and extend the number of rooms available, however, the physical environment requires substantial financial investment and low occupancy has impacted on these plans. We will be requesting evidence of financial viability for Barton Grange from the service providers. The staff supervision records were available to us, and show that staff receive one-to-one supervision as well as work based supervision of specific tasks. Generally all staff have received supervision of their work practice and have identified training needs. The implementation of health and safety at the home has improved since the last inspection; further improvements have been identified on the development plan received by the Commission from the providers. The home’s policies and procedures reflect the current guidance for equality and diversity. The people who live at the home are of the same ethnic group and gender. The home undertakes individual assessments to ensure that any religious beliefs are identified and support people to attend worship. Barton Grange DS0000049161.V348764.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 2 2 3 X X 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 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 2 X X X 2 Barton Grange DS0000049161.V348764.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 OP19 Regulation 23.2 (d) Requirement To ensure that all parts of the home are reasonably decorated and in good repair so that the people who live there have access to safe and comfortable facilities. Timescale for action 31/12/07 2. OP33 24 To develop and implement a formalised quality assurance process that shows how the results are fed back to residents and their families, and the information used to inform the development of the home in the best interests of the people who live there. The registered provider must provide the Commission with evidence of the continued viability of the home. The organisation must ensure that the home promotes the well being of the people who live there by maintaining a safe environment that is fit for purpose. DS0000049161.V348764.R01.S.doc 31/12/07 3. OP34 25(2) 24/11/07 4. OP38 13(4)(a) 31/12/07 Barton Grange 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 OP1 Good Practice Recommendations Review and update the Statement of Purpose and Service User Guide to ensure information is a current reflection of the home. To amend the Terms and Conditions of residency document to show the way in which the fees are made up and who is contributing what amount. The development and implementation of a Homely Remedies policy. Staff should be supported with training to achieve relevant qualifications in care. 2. OP2 3. 4. OP9 OP28 Barton Grange DS0000049161.V348764.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Barton Grange DS0000049161.V348764.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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