Inspection on 17/10/05 for Birchlands

This inspection was carried out on 17th October 2005.

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

Birchlands 18/02/09

Birchlands 01/11/06

Birchlands 11/05/06

Birchlands 21/04/05

Birchlands 26/11/04

Birchlands 11/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Birchlands Birchlands Barley Mow Road Englefield Green Surrey TW20 0NP Lead Inspector Sandra Holland Announced Inspection 17th October 2005 10:30 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 Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 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. Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Birchlands Address Birchlands Barley Mow Road Englefield Green Surrey TW20 0NP 01784 435153 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) margaretwood@anchor.org.uk Anchor Trust Ms Linda Ann Grout Care Home 51 Category(ies) of Dementia - over 65 years of age (14), Old age, registration, with number not falling within any other category (51), of places Physical disability over 65 years of age (12) Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Of the 51 service users up to 14 may fall within the category DE(E) and up to 12 may fall within the category PD(E). The age/age range of the persons to be accommodated will be: OVER 65 YEARS OF AGE 12/09/05 Date of last inspection Brief Description of the Service: Birchlands is a residential care home in a substantial detached property that has been purpose built to provide accommodation for fifty one service users. The home is owned by the Anchor Trust Group and is located in Englefield Green, near Egham. A selection of facilities and services including shops, church, public transport and G.P. surgeries are available locally. The home is a two storey building served by a passenger lift to both floors. A wheelchair lift provides access from the first floor to one of the seven residential units which the home is divided into. Each unit serves between 6 and 8 service users and has its own communal lounge and dining room with a kitchenette. Units on the ground floor have access to the garden via french doors from the lounge. All bedrooms are for single occupancy and have wash basins. Toilets and bathrooms, most with easy access baths or with a hoist facility are provided on each of the units. There is a large communal lounge, equipped with a television, music centre, piano and selection of books. This room is used for activities and has access to an enclosed garden area. A further area with comfortable seating and a music centre is situated centrally on the first floor. Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was the third to be carried out in the Commission for Social Care Inspection (CSCI) year April 2005 to March 2006 and took place over six and a half hours. Mrs. S. Holland, Lead Inspector for the service and Mr. G. Cheney, Regulation Inspector, carried out the inspection. A number of Anchor Trust management staff were present representing the service, including Ms. Christine Conroy, Area Home Support Manager and Mrs. Maureen Burns, newly appointed manager of Birchlands. Ms. Linda Grout and Ms. Alex Strong were also present, as they have been providing management support at Birchlands. Mr. Jon Stanley, Anchor Trust Business Manager was present for part of the period of the inspection. Areas of the home were seen and 13 residents, one visitor and 7 members of staff were spoken to. A number of records were examined including those held under Regulation 26, residents’ monies held for safekeeping and the home’s petty cash. As this was an announced inspection, a pre-inspection questionnaire was sent to the home and was returned when completed to CSCI. Information from the questionnaire has contributed to the inspection and to this report. An additional, unannounced inspection was carried out on 12th September 2005 by the inspectors named above, to look into issues that had been raised by events in the home. A full report was not completed at this inspection, but the additional inspection response, which is not published, is available from CSCI on request. Anchor Trust had carried out a two-day care review at Birchlands during September, to look at all aspects of the service provided. This was arranged as a result of the previously mentioned events in the home. The results of the review were given to the inspectors, along with details as to how the home would be addressing the issues raised and the priority of each area. The people living at the home prefer to be known as residents and that is the term that will be used throughout the report. What the service does well: Residents spoke appreciatively of the care and support they receive in the home. Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 Page 6 Staff spoken to welcomed the changes being made in the home and were positive about them. A management team has been allocated to the home to address the outstanding issues. What has improved since the last inspection? What they could do better: An assessment of prospective residents must take place before they are admitted to the home. Resident’s plans of care and risk assessments must be completed, kept up to date and regularly reviewed. Appropriately trained staff must carry out medication administration and they must follow the policy and procedure. A programme of activities must be drawn up, in consultation with residents and resources and facilities must be provided for activities to be carried out. Any complaint must be fully investigated and staff must be trained, so that they know what to do if a complaint is made. Staff must be trained in the protection of vulnerable adults. Staff cover for essential posts, including an activities co-ordinator and maintenance worker, must be arranged. Persons must not be employed unless the required records and documents have been obtained. The manager must apply for registration with CSCI. A system for reviewing the quality of the service provided must be developed. Monthly, unannounced visits under the requirements of Regulation 26 must be carried out. Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 Page 7 Residents’ monies must be held in an account in their own name and not be held in a communal account. Records regarding residents’ monies must be checked regularly and must be accurate. 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. Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 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 Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 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 the following standard(s): 3 and 6. Pre-admission assessments have not taken place. EVIDENCE: A previous requirement that pre-admission assessments are carried out has not been met. The care review stated there was no evidence that these had been carried out for recently admitted residents. A pre-admission assessment form is available in the home but needs to be revised to meet the requirements of the National Minimum Standards (NMS). The manager stated that she is aware that staff need to be appropriately trained in order to carry out pre-admission assessments. Until other staff have been trained, the manager advised that she or the deputy manager would carry out all pre-admission assessments. The care review indicated that intermediate care is not provided and the management team confirmed this. Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 Page 10 The timescale for a requirement has extended. The timescales for some requirements have been extended by a short period following this inspection, to enable the new management team to meet them. Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 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 the following standard(s): 7 and 9. Individual plans of care are being reviewed. A detailed review of the medication administration system has been carried out. EVIDENCE: A previous requirement that individual plans of care and associated risk assessments are kept up to date has not yet been met. The care review indicates that individual plans had not been fully completed, had not been drawn up with the involvement of the residents and did not reflect residents’ individual needs. The individual plans were being reviewed and updated by nominated staff, the management team stated. The storage of the care plans is also being reviewed and consideration is being given to keeping the plans in each resident’s bedroom, in order that it is available to all those involved in the care or support of the resident. A support manager stated that residents are now signing the plans, and where this has not been possible, by the resident’s representative. In the event that a resident is not able to sign, the reasons for this will be recorded. Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 Page 12 The management team stated that following a number of incidents of poor practice regarding medication administration, one of the support managers had carried out a detailed review of all aspects of medication. This had highlighted a number of shortfalls including medications to be used within 28 days not dated on opening, larger than necessary stocks of “as required” medication, medication in stock for residents who had left the home and the receipt of medications not recorded. The manager stated that a meeting is to be arranged with the company who are contracted to supply medication to the home to discuss issues arising. The pharmacist from the company will be requested to carry out a review of medication administration and storage. Further training for staff is also to be organised, to cover the use of the medication system and the more detailed, Care of Medicines. Other improvements are to be made, including the storage of Medication Administration Record (MAR) sheets, ensuring all personal details on MAR sheets are correct and the making of amendments on MAR sheets. The timescale for a requirement has been extended. Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 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 the following standard(s): 12 and 15. An activities plan has been drawn up, but is not put into action. Residents enjoy their meals. EVIDENCE: Although an activities plan has been drawn up, there is no activities coordinator in post to carry it out. In the absence of a specific member of staff, no other staff have been allocated to take a lead with activities. The care review has identified that there has been a general lack of interaction between residents and staff, even in day-to-day activities. The management team stated that they plan to discuss with staff, the everyday opportunities for residents to be involved in the life of the home, such as laying tables, choosing colour schemes and going for a walk. The team advised they would be planning more events in the community and promoting the involvement of resident’s families. Two residents were observed playing dominos with a member of staff during the inspection and another group of residents were observed to be sitting in the upstairs hall area, chatting and listening to music. Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 Page 14 Meals are taken in the individual dining rooms/lounge on each unit and the food is delivered to the units in hot trolleys, the management team advised. It was noted that resident’s chosen food is placed onto the plates in the main kitchen. This limits residents’ choices and does not allow for portion sizes to be selected according to the resident’s appetite at the time of the meal. The area support manager stated that this would be changed immediately. Menus are displayed on the notice board in the entrance hall and are changed seasonally. The menus were also supplied to CSCI with the pre-inspection questionnaire. These were varied, offered a choice and were well balanced. The dining areas on each unit are equipped with two or three small tables with chairs, each for up to four people. Colourful tablemats and flowers provide an attractive environment in which to eat. A small kitchenette is fitted next to the dining areas, enabling easy access to refreshments and snacks. A requirement has been made. Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 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 the following standard(s): 16 and 18. The complaints procedure has not been fully carried out. Residents have not been fully protected by the systems in place in the home. EVIDENCE: The management team stated that they are aware that a recent complaint had not been handled as thoroughly as required by their complaints procedure and appropriate action had now been taken to correct this. A full investigation is to be carried out regarding the complaint Additionally, staff will be trained in the correct procedure so that they know what to do if a complaint is made. Recent events in the home have shown that staff were not fully aware of the procedure to be carried out if concerns are raised or a situation arises, which could have indicated abuse. The manager stated that training for staff in the protection of vulnerable adults was being arranged as matter of urgency. It is of concern that the actual amounts of residents’ monies held for safekeeping did not match the record held, as detailed at Standard 34. The lack of safeguards in this respect, leave residents open to financial abuse. The shortfalls noted at Standard 29, in relation to the recruitment of staff, have also placed residents at risk. Requirements have been made. Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 Page 16 Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 26. The areas of the home that were seen were clean and freshly aired. EVIDENCE: The management team stated that the premises of the home have been reviewed and it has been agreed that decoration needs to take place in many areas. It was stated that a number of carpets in the home have already been cleaned or replaced. Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 29. A team of staff are employed to meet the needs of residents. There is concern about the standard of the home’s recruitment procedures. EVIDENCE: The pre-inspection questionnaire showed that in addition to members of care staff, a gardener, an administrator, housekeepers, laundry and kitchen staff are also employed to carry out the roles required to meet residents’ needs. A number of these staff were spoken to during the inspection. Vacancies in the staff team include those for an activities co-ordinator and maintenance worker. Both of these have an impact on the daily lives of residents and it is required that provision is made for these posts to be covered. The management team stated that two members of the senior staff team have recently been suspended whilst investigations are carried out. Senior staff cover has been provided from other local homes on a temporary basis and recruitment of further senior team members is being arranged. The management team are aware that morale amongst the staff team has been low during the recent changes and are hopeful that a fresh start in the home will improve this. Staff spoken to said they felt the changes were positive and that they welcomed them. Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 Page 19 From the care review, it was noted that there have been a number of serious shortfalls in the documentation relating to recruitment of staff. It stated that a member of staff who has a conviction has been employed, but no reference had been made as to how this decision was reached. In the event that a conviction is declared or is revealed on a Criminal Record Bureau (CRB) disclosure, it is required that a risk assessment be carried out and a record made of who made the decision and why. The timescale of a previous requirement has been extended and another requirement has been made. Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33 and 35. Changes in the management of the home have taken place. Assessments of the quality of the service provided are not being carried out. The procedures for the handling of residents’ monies held for safekeeping do not fully safeguard residents. EVIDENCE: The home’s manager has recently left and another manager has been appointed, the day of inspection, being the new manager’s first full day in post. To support the new manager, an area home support manager has been allocated to work alongside her. Additionally two managers from other homes in the organisation have been providing management assistance. This level of management cover has been required to enable the home to meet the requirements made at previous inspections and to address a number of issues that have arisen in the home. The care review that was carried out has Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 Page 21 enabled the management to prioritise the areas requiring attention. It is clear that the home has not had a sense of direction and has lacked effective leadership. The newly appointed manager is required to apply for registration with CSCI as soon as possible. The care review document states that there is no effective quality assurance or quality monitoring system in place at the home. It was observed that manuals relating to quality assurance were available in the office, but it is clear that these are not being used. It is required that a system for reviewing the quality of care is set up and maintained. The reviewing system must give residents and their representatives the opportunity to state their views and the results should be made available to residents and a copy sent to CSCI. The carrying out of monthly visits to the home by a representative of the registered provider under Regulation 26 is required and is an effective monitoring tool. Regulation 26 requires the registered provider of the service, to organise an unannounced visit to the service on a monthly basis to check on the quality of the service provided. This must involve speaking to residents, their families or friends and staff, and looking at the premises and the complaints record. A written report must be made and a copy retained in the home. The management staff advised that the holding of residents’ monies for safekeeping was not encouraged and that wherever possible, residents or their representatives are encouraged to manage their own finances. Where it is required that money is held for residents, this is held in a communal bank account, with individual records maintained and the accruing of large amounts is discouraged. Where a large amount does accrue, residents would be advised to open their own bank account, managers stated. When the residents’ financial records were examined, it was noted that a large amount of money was being held for each of eleven residents and that the total being held for all residents was substantial. The account in which this is held is not interest bearing the administrator stated. The administrator manages the monies on a day-to-day basis and is overseen in this by the manager. The administrator explained that to enable residents to manage day-to-day expenses, cash could be supplied from the monies held for safekeeping. Alternatively, the home will pay for expenses such as hairdressing and chiropody and recoup the costs from each resident’s account. Paper records of these transactions are maintained, as well as a computerised record keeping system. The amount of money held in the petty cash tins was checked with the administrator. It is of concern that the amount present did not accurately Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 Page 22 match the record held. The administrator stated that a check of the amounts and records had not taken place with the manager for two months. Requirements have been made. Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 1 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 1 x x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 1 x 1 x x x Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14 Requirement Accommodation must not be provided to a resident unless a suitably qualified or suitably trained person has assessed the needs of the resident. UNMET FROM 21/04/05 & 12/09/05 The resident’s individual plan must be kept under review and kept up to date. UNMET FROM 26/11/05 & 21/04/05. Timescale for action 18/11/05 2 OP7 15 18/11/05 3 OP9 13 4 OP12 16 (2) (n) 5 OP16 22 The registered person must 18/11/05 make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. The registered person must 20/01/06 consult residents about the programme of activities arranged on their behalf and provide facilities for recreation. The registered person must 18/11/05 ensure that the complaints procedure is appropriate to the needs of the residents and that DS0000013569.V250208.R01.S.doc Version 5.0 Page 25 Birchlands 6 OP18 13 (6) 7 OP27 18 (1) (a) 8 OP29 19 (1) (ac) 9 OP31 12 (1) (a) 10 OP33 24 and 26 any complaint made under the complaints procedure is fully investigated. The registered person must make arrangements, by training staff or other measures, to prevent residents being harmed or suffering abuse or being placed at risk of abuse. The registered person must ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of residents. Specifically, the posts of activities co-ordinator and maintenance worker must be covered. The registered person must not employ persons to work at the care home unless (a) the person is fit to work at the care home; (b) that the information and documents specified in Schedule 2 have been obtained in respect of that person and (c) he is satisfied on reasonable grounds as to the authenticity of the references referred to in paragraph 5 of Schedule 2, in respect of that person. The registered person must ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of residents. Specifically, the manager must apply for registration with CSCI. An effective system for reviewing the quality of the service provided must be established and maintained. This system must make provision for consultation with residents and their representatives and a copy of the outcome of the review DS0000013569.V250208.R01.S.doc 18/11/05 20/01/06 17/10/05 18/11/05 20/01/06 Birchlands Version 5.0 Page 26 11 OP35 must be made available to residents and supplied to CSCI. Monthly, unannounced visits to the home by the registered provider or their representative must be carried out. 20(1)&17 The registered person must not (2)&(3)(a) pay money belonging to any resident into a bank account unless (a) the account is in the name of the resident, or any of the residents, to which the money belongs and (b) the account is not used by the registered person in connection with the carrying on or management of the care home. The registered person must maintain in the care home the records specified in Schedule 4 and must ensure that the records are kept up to date. Specifically, the record of monies or valuables held for safekeeping on behalf of residents must be accurately maintained. 18/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Birchlands DS0000013569.V250208.R01.S.doc Version 5.0 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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