Inspection on 08/09/05 for Birch Abbey

This inspection was carried out on 8th September 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Birch Abbey 17/07/07

Birch Abbey 09/05/06

Birch Abbey 16/03/06

Birch Abbey 03/03/05

Birch Abbey 19/10/04

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

CARE HOMES FOR OLDER PEOPLE Birch Abbey 55 Alexandra Road Southport Merseyside PR9 9HD Lead Inspector Mike Perry Unannounced 08 September 2005 th 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 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. Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Birch Abbey Address 55 Alexandra Road Southport Merseyside PR9 9HD 01704 532 788 01704 885 050 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Melton Health Care Ltd Mrs Janet Dean PC - Care Home Only 18 Category(ies) of DE(E) Dementia - over 65 - 18 Places registration, with number of places Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to a maximum of 18 DE(E). 2. The Service should, at all times, employ a suitably qualified and experienced manager who is registered with the CSCI. Date of last inspection 3rd March 2005 Brief Description of the Service: Birch Abbey is regestered to care for upto 18 elderly mentally infirm persons. The home has been in operation since 1989 but has come under new ownership over the past 18 months. The owners are Melton Health Care Ltd and the Responsible Person is Mr George Daniel Lyngard. The Registered Manager is Janet Dean. The service now conduct an assessments on behalf of Sefton Social Services with whom a bed is contracted (reserved) for respite and assessment purposes. The building is a large detached property situated reasonable close to Southport Town Centre. The home currently has no passanger lift (has a stair lift) but there are plans to install a lift ove rthe next year together with other upgrading of the building. The home has 14 single rooms and 2 double none of which have ensuite facilities. The day area is on the ground floor and includes a conservatory extention that overlooks the garden at the rear of the building. There is a small patio/garden area to the side of the building which is accessible and continues on to the rear garden which has recently been landscaped. Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and was conducted over a period of 5.5 hours on one day. All day and recreation areas were seen and most of the residents bedrooms. Care records and other records kept in the home were also viewed. In total the inspector spent time with many of the residents and spoke with 1 relative, all of the staff on duty [3 care staff and the cook]. A visiting professional and other visitor were also interviewed. A series of comment cards were also left in the home for relatives, professionals and visitors to complete. 14 of the 20 Core standards were covered on the inspection. There were many positive aspects to the inspection and the staff and deputy manager were responsive and open to comments made. The feedback from both resident [observed behaviour as verbal feed back is difficult due to the residents level of confusion] and relative interviews was very positive and supported the notion of a caring home. Birch Abbey continues to develop with strong support and input from the ownership that have spent some resources on improving the environment taking into account good practice guidance. This work continues with major building work planned. What the service does well: The manager at Birch Abbey carries out assessments prior to residents being admitted so that the home is better able to meet any needs following admission. The assessments are comprehensive and include information and assessments from community care professionals such as social workers and community nurses. Once admitted there are further assessments carried out and the home try and include the relatives in this process as much as possible. The plans of care for residents are also drawn up wit the relative’s involvement and the ‘long term’ plan is signed and a copy given to the relative. The home liaises well with community professionals in the case of any resident who requires health support. For example one resident who has some challenging needs has recently been assessed by the local Psychiatric services. There is good attention paid to the way residents dress themselves and also standards of cleanliness so that dignity is preserved. Staff interviewed were clear about why this is important in caring for somebody with dementia. There is a ‘homely’ atmosphere in the home and relatives feel that they are involved in the home to the extent that they are told about events and any Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 Page 6 changes. Staff interact positively with both residents and visitors and this was commented on; ‘ its always pleasing to come to the home’ and ‘ staff are approachable’. The meals are good and the dinnertime meal observed and sampled by the inspector was well presented and appetizing. Staff were observed to assist with feeding some residents and the meal was also a social occasion that was enjoyed. The staffing in the home is consistent with no use of agency cover for some time. What has improved since the last inspection? What they could do better: The filing of care notes could be improved so that information is easer to find. The care plans are rather hard to follow and appear disjointed with the recording of information in a lot of different areas in the care file [although they do contain good information] and there was some discussion how this could be improved. Privacy for residents is well respected generally by staff although the need for curtains to maintain privacy for the residents in one shared room now needs to be given some priority. Medication prescribed and given to residents on a ‘when needed’ [PRN] basis needs to be entered on the care plan so that clear guidance is available for Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 Page 7 staff about when to give such medicine as well as providing the basis for ongoing review. This was discussed on the previous inspection. The upgrading of the home including the laundry area still needs to be completed. An estimated time for this work should be included in the homes action plan to the Commission. The filing of CRB records for staff needs to be improved for ease of reference. Training has improved generally for staff although there was some discussion around the need to include reference to dementia care on the staff induction programme so that some awareness can be raised at quiet an early stage. Staff also need to be involved on a regular [at least 6 times yearly] basis with a formal supervision programme so that they are support by the management. There is a more immediate need to organise fire safety training for all staff as the last recorded date of this is over a year ago. 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. Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3 The homes Statement of Purpose and Service User Guide was unavailable and therefore prospective residents do not have information in order to make an informed choice. The assessments carried out by the home are good and help ensure that the home can meet the needs of residents admitted. EVIDENCE: A copy of the information given to prospective and current residents in the form of the ‘Service Users Guide’ and ‘Statement of Purpose’ was requested. Both were unavailable and are being updated following requirements on the last inspection report. It is important that these documents are now given some priority so that prospective residents and their relatives have the information they need to make an informed choice about where to live. Likewise the information around the provision of contracts was unavailable [unannounced visit and both the Manager and Responsible Person [owner] were not present on the day]. It was agreed that this requirement would remain on the report and be reviewed at the next inspection. Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 Page 10 Three residents files were seen. All residents had been assessed prior to admission and there was reference to community assessments from professionals [social workers and hospital and community nurses]. A new preadmission assessment tool has recently been drawn up. The homes assessments cover all aspects of the care standards including history of falls. Assessments also include mental state, risk and nutrition. The assessments provide information so that the home can make a decision as to whether they can meet the care needs adequately. They also form the base from which a care plan can be drawn up. There is also a regular [new] dependency assessment, which is completed monthly and can be used to identify new needs or as a comparison of dependency over a time period. Relatives are involved in some of the assessments and signatures were seen on risk assessments for example. The relative interviewed felt generally included in the ongoing assessment process and care in the home generally. The assessments were rather hard to find in the care notes and would be easier accessed if filed more carefully and chronologically. Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 Individual care plans are drawn up with the relative’s involvement and reflect changing needs so that both personal and health care needs are met. Relatives and visitors canvassed felt that staff were supportative and appropriate in their care so that respect and dignity is maintained although the issue of privacy for residents in one shared room needs addressing. The management of the medicines in the home is satisfactory so that residents are protected by a safe policy. EVIDENCE: The care plans are divided into a long term plan of more ongoing personal care needs and shorter term plans of care for more acute needs. The long-term plans are written in a narrative form and paint a general picture of the residents personal care needs and the basic interventions by care staff. These are situated at the front of the care file and are signed by relatives who also have a copy. One resident has been displaying particularly challenging behaviour at present and the short-term care plan reflects this. It includes reference to professional input and liaison with the community psychiatric service and reviews of medication. There are some references to staff interventions although these Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 Page 12 are less clearly defined [i.e. the diversional interventions, triggers to the behaviour and staff response to incidents of aggression]. These short-term care plans are also backed up by ‘action plans’ for specific acute episodes. Daily entries are also made by care staff in ‘activity’ files and varies other information recording formats such as GP’s visits etc. There was some discussion around the care planning system. The information that residents are receiving ongoing care and review is apparent but is difficult to follow as the care files contain many different areas for recording and are rather disjointed. There is also no clear idea of the objective of the care or what goals are to be achieved, as these are not recorded. Perhaps this could be considered. The deputy manager stated that a new system is being considered and these comments should be taken into account. The requirement from the previous inspection for the medication recording [MARR] sheets to include the recording of medicines received into the home has been carried out. Medicine procedures are satisfactory and the audit by the supplying pharmacist confirmed this. One resident was discussed who is prescribed medicine on a PRN [given as needed] basis. Care plans did not give clear guidelines to staff as to when and what circumstances this should be administered. Residents were observed to be appropriately dressed and attention to maintaining personal hygiene was good. Some residents are resistive to personal care and it was observed that in one instance a resident was being given some extra 1:1 attention in terms of social interaction. Relative interviewed stated that residents are ‘always clean and tidy’ and that the standard was consistent. Staff interviewed displayed an understanding of the need to maintain dignity for residents and gave examples of how people with dementia, for example, had to be closely monitored if they displayed behaviour that compromised their dignity. Relatives/visitors spoke positively about the staff and the interactions between staff and residents were observed to be warm and supportative. There are two shared rooms and whilst one room has been upgraded to provide curtains between beds to ensure privacy the other has not as yet. Personal care in this room cannot be carried out with privacy. This room is planned to be upgraded in the near future. Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13,15 Activities are provided and continue to be developed in the home and assist in providing some quality of life for all residents. Arrangements to involve relatives in the home and in the care of residents are good so that relatives feel supported and in contact with events. Daily choices of meals are always available and nutritious meals and special diets are provided, to ensure residents received a wholesome balanced diet. EVIDENCE: There has been some work completed since the last inspection in the way that activities are provided in the home. Some staff have attended a training day and there are more planned. Social profiles on resident’s are good and staff were aware of individual preferences regarding daily activity. There is a programme of events organised and the relative interviewed commented that there ‘was always something going on’. An example of this was a recent barbeques which was enjoyed by all concerned. There are also musical events and staff talked about encouraging residents to carry out daily living skills such as baking and cleaning so that a sense of participation is encouraged. The interactions between staff and residents is positive and supportative and the principal of creating a homely and relaxed environment continues with the dayroom being bright and attractive. Bedrooms evidenced many personal ornaments and photographs, which chronicle and gave reference points for Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 Page 14 residents lives. On the day of the inspection the hairdresser was in the home and this was the focus of good interaction and socialisation. The relative and visitors to the home felt that staff were warm and friendly and one comment that it was ‘always pleasing to come to the home’. The dinnertime meal was observed and residents clearly enjoyed the food. Tables were arranged so that residents could interact. The quality of the food is good [sampled by the inspector] and the visiting relative said that the quality of the food was consistent. Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The home has a complaints procedure and complaints are listened to and investigated so that residents and relatives feel that their concerns are dealt with. EVIDENCE: The home has a complaints procedure and this is displayed in the corridor outside the office. It is unclear as to whether this is include in the homes information guides as these were not available. The relative interviewed felt that staff were available to listen to concerns and these would be acted on. Any formal complaints are recorded [there have been no complaints over recent inspections]. There is a complaints book available for this purpose. Residents and relatives spoken to felt that the homes staff were approachable and would listen to any concerns. Staff interviewed could explain the complaints process. Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,26 The environment at Birch Abbey has been improved greatly over the past year and there are clear maintenance and upgrading plans to improve this further so that residents live in a safe, well maintained environment that is also homely. EVIDENCE: There have been considerable improvements made to the environment at birch Abbey since he new owners have taken over the home. All current day areas and bedrooms have been improved and the general environment is now bright and clean and homely. Particular attention has been paid to ensuring that bedrooms are personalised so that residents can feel more relaxed and at home. Both décor and furnishings have been improved so that there are new chairs in the day area and new dining furniture. Externally there is a new ramp so that the rear garden is now accessible and the garden itself has been improved by the addition of a patio area and garden furniture. There is still much to do before the upgrading of the home is complete and a major building project has recently met planning approval which will provide Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 Page 17 more day space and new bedrooms and also a lift. Smaller upgrades such as the provision of locks for all doors and curtains in shared rooms are also to be completed. Over all the home is bright and homely and this was commented on by the visitors spoken to. The laundry was seen and the provision of new washing machines and dryers completes the first part of the upgrade although work to walls and floors still needs to be actioned [planned imminently]. The home was clean and hygienic and the requirement from the previous inspection for weekend cleaning staff has been met. Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 There are appropriately trained and experienced nurses and care staff employed so that residents feel supported and that their needs are understood and met. EVIDENCE: On the day of the inspection there were 17 residents in the home and the staffing consisted of the deputy manager and 2 care staff. The duty rota confirmed that the usual staffing is 3 care staff supported by the Manager who works supernummery for most of the time. In addition to this there are domestic staff daily and a cook. The relative spoken to felt that there was always enough staff around to attend to care needs and offer support where necessary. Staff interviewed also felt that they had enough time to generally meet the needs of the residents. During the inspection it was observed that the day area was regularly staffed and monitored. Visitors felt that staff were competent and supportative and always kept them in formed of any changes in the care. It was also felt that staff were caring and supported the residents appropriately. 4 of the staff files were seen and the recruitment of staff covers good practice in that information necessary for employment is sought. References for staff and information for identification purposes were evident in all the files Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 Page 19 including those of staff from overseas. Criminal records Bureau [CRB] checks were completed on all but one file checked. The deputy manager would recheck this, as the homes policy is that staff are not employed with out this check being satisfactory. The filing of the CRB checks was confusing so that they were difficult to locate. Staff training has been improved over the past year. All new staff have a basic induction package and this is recorded in staff files. Staff interviews confirmed this process but specific awareness of dementia care is not formally broached at this stage. Ongoing foundation training consists of NVQ training in direct care. 5 out of the 13 care staff already have NVQ awards and all staff are involved in training. Some staff are now undergoing the Alzheimer’s training package around care of dementia. Three staff have attended a specific dementia care course. Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 Page 20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36,38 [ with respect ot fire saftey only] Staff do not receive formal supervision sessions to ensure and enhance their feeling of being supported in their role caring for residents. Fire safety training for staff needs to be addressed so that resident’s safety is maximised. EVIDENCE: Staff interviewed felt that the management of the home were supportative and easy to approach about any issues they were concerned about. They felt support with respect to appropriate training. None were able to identify regular planned supervision sessions however and staff files contain no records of these. Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 Page 21 Health and Safety in the home was not assessed in any depth on this inspection but it was noted that training in fire safety for staff was over a year ago and this must now be attended so that residents safety is promoted. All routine safety checks are recorded. Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 Page 22 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 1 2 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x 2 x 2 Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 Page 23 yes Are there any outstanding requirements from the last inspection? 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 OP1 Regulation 5 Requirement The of Purpose and Service User Guide must be updated as previosly required and made available in the home. [ Last requirment date 1.8.05 not met]. Updated copies of contracts of terms and conditions of residency must be made available. The provision of curtains in the shared room discussed must be actioned so that privacy can be maintained when carrying out personal care. The inspector would require a newly updated plan of works to be completed with estimated completion dates as part of the action plan for the home. The upgrading of the laundry must continue to the floor and walls so that they are both impermeable and easy to clean. All staff must undergo formal supervision sessions. All staff must recieve training updates in fire saftey. Timescale for action 1.11.05 2. OP2 5 1.2.06 3. OP10 12 1.11.05 4. OP19 23 include in returned action plan. 1.11.05 5. OP26 13 6. 7. OP36 Op38 18 23 1.2.06 1.11.05 Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard OP7 OP9 OP28 OP29 Good Practice Recommendations The review of the care planning system in the home should take account of the discussion at the inspection and the comments in this report. Any prescription for PRN medication should be monitored through the care plan and subject to evaluation. The home should aim to achieve 50 of care staff to be NVQ trained by the end of 2005 CRB records for staff should be filed appropiatle so that they are easily tracable for checking purposes. [they should be disposed of after an appropiate time and a record retained in the staff file]. Awarness of dementia should be addressed in the induction programme as discussed. 5. OP30 Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Burlington House, 2nd Floor, South Wing Crsoby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 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 Birch Abbey F53 F03 Birch Abbey S60016 V248398 08.09.05 Stage 4.doc Version 1.40 Page 26 - 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!