Inspection on 29/06/06 for Bishop`s Court

This inspection was carried out on 29th June 2006.

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

Bishop`s Court 13/07/09

Bishop`s Court 13/01/09

Bishop`s Court 17/10/08

Bishop`s Court 01/07/08

Bishop`s Court 14/04/08

Bishop`s Court 08/06/07

Bishop`s Court 12/01/06

Bishop`s Court 17/11/05

Bishop`s Court 27/07/04

Bishop`s Court 10/05/04

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

CARE HOMES FOR OLDER PEOPLE Bishop`s Court Sefton Park Care Village Sefton Park Road Liverpool Merseyside L8 3SL Lead Inspector Dave O`Connor Key Unannounced Inspection 29th June 2006 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 Bishop`s Court DS0000059340.V296207.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. Bishop`s Court DS0000059340.V296207.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bishop`s Court Address Sefton Park Care Village Sefton Park Road Liverpool Merseyside L8 3SL 01512917800 02077248686 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) European Wellcare Homes Ltd Sandra Watkins Care Home 41 Category(ies) of Dementia - over 65 years of age (41) registration, with number of places Bishop`s Court DS0000059340.V296207.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Two named people under 65 years old may be accommodated. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 12th January 2006 Date of last inspection Brief Description of the Service: Bishops Court is situated in a busy suburb of Liverpool. The home is registered for 41 residents’ who suffer from Dementia. The building is modern, purpose built and provides ground floor accommodation. The home has very nice garden areas which are secure and well maintained. The home is continuing developing its Person Centred Care approach as its main philosophy of care. All residents’ have their own private room, 22 of the rooms have an en-suite facilities. The home is close to the city centre and all local shopping and public amenities. Fees for placements are agreed with the placing authority and in general are dependant upon the assessed needs of people placed. Bishop`s Court DS0000059340.V296207.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was not told the inspector was visiting. Before the visit took place the manager provided the Commission with a pre inspection questionnaire. On the day of the visit the inspector spoke with the manager, deputy manager, staff on duty, people living at the home and a relative of a visitor. As a result of this inspection nine requirements and seven recommendations were made. What the service does well: What has improved since the last inspection? Most of the corridor areas have been redecorated in a way which assists residents to distinguish their bedrooms, shower rooms etc. The manager continues to be proactive in ensuring staff have a greater understanding of caring for people with dementia. Some development was seen in creating communication systems to suit the residents’, i.e. picture forms of notice boards. Bishop`s Court DS0000059340.V296207.R01.S.doc Version 5.2 Page 6 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. Bishop`s Court DS0000059340.V296207.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 Bishop`s Court DS0000059340.V296207.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4,5 Service user’s needs are being assessed by qualified and trained staff, although important documentation used to inform this process needs to fully support and evidence this process. Service users and their relatives are provided with good opportunities to visit the home and speak with staff prior to moving in. EVIDENCE: The manager and her deputy generally carry out assessments of people placed at the home. Both are registered general nurses and have completed the N11 care of the elderly with dementia training indicating they have the appropriate skills and qualifications to carry out these assessments. The inspector is informed prior to a person being admitted a referral form is received from the placing social worker and an initial assessment is undertaken. This information and staff visiting potential residents in hospital forms the basis of the home’s assessment of needs and whether the home is able to meet those needs. Potential residents are provided with the opportunity to visit where appropriate and similarly their relatives are also invited to spend time at the home chatting Bishop`s Court DS0000059340.V296207.R01.S.doc Version 5.2 Page 9 with staff etc. Inspection of some files did show evidence of the initial assessments being undertaken and the forms being completed. However, the forms can be better utilised for example some sections are generally not being completed such as the section clearly asking the assessor whether or not the home is able to meet the needs of the person referred. Some files did contain a copy of the social work assessment whereas others did not. Whilst the inspector is aware receiving these assessments is out of the control of the home greater effort should be made to ensure these documents are on files and used as part of the initial assessment processes. People with a learning disability/ mental impairment have been placed and staff have worked and consulted with appropriate agencies such a community learning disability nurse and the Alzheimer’s Society. The home is situated in a culturally diverse part of Liverpool. The majority of people placed are white, although there are some people placed from ethnic communities and discussions with those people and staff indicate the home is sensitive and pro active in meeting cultural and identity needs. The staff team is well balanced with both male and female staff. Staff have been recruited from diverse cultures for example Poland and ethnic communities. Whilst the mix of the staff team is a strength of the home particular care needs to be considered to ensure staff appointed have the ability to communicate well with residents particularly those of which are quite confused due to their needs. In general the inspector found on the day of the inspection staff communicated well with residents. A visitor to the home did comment most of the staff communicate well, although a staff member he found hard to understand. Bishop`s Court DS0000059340.V296207.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Medication is organised well this ensures the safety and well being of all residents. Individual and health care needs are being met with the recording systems being improved. Resident’s privacy is being respected, however due to the failure to keep the home clean within an adequate standard residents dignity is not always being promoted. EVIDENCE: Individual care plans are created for each resident and cover aspects of health, social and personal care. The home uses a pre formatted care for each aspect of individual needs which would apply for all residents, the inspector is informed that this type of pre printed care plan is used to ensure there is a consistent staff approach to meeting individual needs. The inspector did see evidence of the pre printed care plan format also allowing for individual needs to be recorded. Care plans are being reviewed each month and a brief record of any changes is being recorded. The manager is in the process of introducing a different care file format for each resident, which is intended to make sure only appropriate and up to date information is kept on files. Some care files inspected did contain relevant Bishop`s Court DS0000059340.V296207.R01.S.doc Version 5.2 Page 11 health assessments and these are being reviewed. The inspector did note one assessment on a resident’s file has not been reviewed for some time, appropriate care needs to be taken to ensure all assessments in place are being reviewed. Resident’s health care needs are being promoted with evidence the home works well with health care agencies. All health records were contained within a health file and inspection of this indicates recorded health care needs and interventions are difficult to track. The manager has recognised this aspect and has begun to introduce a health record sheet in each residents file although the recording in these sheets is minimal at the moment. Good storage and procedures are in place in relation to medication. Sample files were checked and medication stocks and record tallied. All appropriate medication records including controlled drugs are in place and these records are being regularly checked by senior staff. All medication is administered by trained staff and discussions with trained staff on duty indicate a consistent approach to the management of medication is being adopted. A medication fridge is used daily, although the inspector does recommend a digital minimum/maximum thermometer be used to check the fridge temperatures. Resident’s personal care needs are being promoted and reflected in care files. During the visit the inspector noted staff supporting residents with care and patience. When assisting residents with their mobility or with meals they kept eye contact and reassured and prompted the resident where necessary. All residents were dressed appropriately for the whether and their choice was being promoted. Residents who spoke with the inspector said they get well looked after, a visitor to the home was very complimentary about the care provided. The inspector did note that throughout the visit a number of issues were identified in relation to hygiene within the home, specifically around faeces staining around the outside of a W.C near the lounge and on the floor of a shower room. These were brought to the attention of the manager shortly after the visit began and also at the end of the visit. The staining remained during the visit and this impacts on the dignity of all residents placed including those who use these facilities. Bishop`s Court DS0000059340.V296207.R01.S.doc Version 5.2 Page 12 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): 12,13,14,15 Activities are planned in conjunction with the residents’ likes and preferences and residents dietary needs are being met. Residents are supported in making decisions and their views are listened too and acted upon. EVIDENCE: The home employs an activity organiser who works 21 hours per week over a period of five afternoons each week. The home has maintained its contact with the Alzheimer’s Society, who provide staff with training and guidance in Dementia care. The home displays the monthly activity plan on the notice board and a daily notice is displayed in both picture and word form for the residents. The home has its own mini bus which is regularly used to take residents on outings. Residents informed the inspector they go on regular outings and recently enjoyed a trip to Southport. Dependant on the availability of staff, residents are provided with opportunities to visit local shops. On the day of the visit national flags and pictures were hanging on walls etc. in various parts of the home and the inspector is informed residents had painted these with support from the activity organiser. The home operates an open visiting policy and discussions with a relative indicate staff facilitate and welcome visitors at all times, although there is a polite notice to respect residents meal times. Residents meetings are held regularly and the Bishop`s Court DS0000059340.V296207.R01.S.doc Version 5.2 Page 13 menus have changed to reflect comments made by residents indicating views are respected and acted upon. Menus and food provided on the day indicate a well balanced diet is being provided with cultural diets provided where observed. Residents are provided with an alternative meal and during the inspection staff supported residents with care and dignity if assistance with food was necessary. The manager has arranged for blended food to be provided more appropriately in blended portions rather than mixed together and a varied selection of finger food is provided to help maintain residents independence. Bishop`s Court DS0000059340.V296207.R01.S.doc Version 5.2 Page 14 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): 16,18 A clear complaints procedure is in place indicating complaints from a resident, relative or other person is taken seriously and investigated. Systems are in place to ensure residents will be protected from abuse. EVIDENCE: The homes complaint procedure is displayed in the entrance area providing residents and others with clear information around what to do if they have any concerns or complaints. Information on how to contact the Commission for Social Care Inspection is also displayed. Since the last inspection there has been one complaint received by the Commission. This complaint is currently being investigated by the home. A record of any complaints received by the home is maintained and these records indicate a clear audit trail with complaints being appropriately investigated. No complaints were made to the inspector on the day of the visit. Generally residents said they were happy with the care being provided. A visitor to the home was very complimentary about the staff and the care provided to his relative. New staff are provided with adult protection training as part of their induction and ongoing updated training is provided to staff in the form of an educational video. Staff complete a questionnaire following the training to how establish their competence around the procedures and practices. Any adult protection issues are reported to the appropriate bodies where necessary. Bishop`s Court DS0000059340.V296207.R01.S.doc Version 5.2 Page 15 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): 19,20,21,22,23,24,25,26 The home is generally well maintained providing residents with pleasant accommodation. The current practices in relation to cross infection put service users at risk. Appropriate equipment is being provided to keep residents safe from harm. Improvements can be made in relation to the monitoring and testing of fire equipment to fully ensure residents safety. EVIDENCE: Generally the environment is maintained to a good standard. There are plans for stained carpets to be replaced with contractors having recently measured for more suitable replacement flooring. The corridor areas have been redecorated with different parts of the home painted bright different colours to assist residents in locating their rooms. There are plans for bedroom doors to be repainted. Shower rooms and W.Cs have a pictorial sign to again help residents more easily locate these facilities. There have been previous issues of the home being odorous and as discussed earlier in this report there is an inadequate response to ensuring faeces staining is adequately cleaned. The W.C near the lounge which is used regularly did not have hand towels in the Bishop`s Court DS0000059340.V296207.R01.S.doc Version 5.2 Page 16 dispenser, the W.C seat was missing and the nurse call bell cord was snapped. The home provides suitable wheelchair access throughout and appropriate hoist and lifting equipment is provided which is regularly serviced. During the visit rooms where found to be nicely decorated and personalised. Communal furniture is generally in good order although the dining room table and chairs are marked and would benefit from re staining or replacement. The outside parts of the home are very nicely maintained with water features and plants adding to the appeal of these areas. The inspector did note there are some trip hazards for residents with mobility problems and an adequate risk assessment should be undertaken in relation to this risk. All service certificates are in place where necessary and staff receive regular fire drills and fire safety training. A comprehensive environmental health and safety check book is in place although since the beginning of the year there has been a significant reduction in the frequency of these tests. The manager explained this is due to the maintenance persons not visiting the home as frequently. The testing of the fire alarm and emergency lighting systems has become infrequent and this aspect needs improving to ensure residents health and safety is being promoted. Bishop`s Court DS0000059340.V296207.R01.S.doc Version 5.2 Page 17 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): 27,28,29,30 The numbers of domestic staff being deployed is sometimes insufficient to ensure the residents live in a clean and odour free home. Trained staff are qualified and experienced and all staff receive good induction training, although ongoing vocational training needs to improve for care staff to ensure residents are being looked after by a consistently well trained care staff team. EVIDENCE: Observations on the day of the visit indicate not enough domestic staff are being deployed. During the visit there was one domestic on duty, although the inspector was informed the second domestic was on leave. The home was generally clean however as discussed within this report there are cross infection issues with a failure of staff to clean faeces. On the day of the visit there were both trained staff and care staff on duty. Trained staff on duty are well trained, experienced and there is a good staff skill mix. Trained staff have qualifications in relation to general nursing, with some having undertaken additional training in relation to dementia care. A number of trained staff are undertaking training around supporting people who have a mental health diagnosis and learning disability. Since the last inspection a number of staff have been recruited and records provided indicate appropriate reference, POVA first and criminal record checks have been undertaken. Staff files contain evidence of staff experience and qualifications, although not all staff have a photograph for the home records. Additional staff Bishop`s Court DS0000059340.V296207.R01.S.doc Version 5.2 Page 18 records are held at the home’s head office and there are plans for all these files to be stored securely within the home. A staff training programme is in place, although there are plans to review and change the training provider. New staff complete a well-organised corporate induction that includes core training to carry out their role. An induction to the home’s policies, procedures and practices is also undertaken. A number of staff have yet to be enrolled on or achieve national vocational training and this remains an area of improvement. Bishop`s Court DS0000059340.V296207.R01.S.doc Version 5.2 Page 19 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): 31,33,35,38 There is a clear management structure in place, although residents would benefit greater if there was a clear and focused supervision structure in place ensuring staff are given appropriate direction and effective leadership. Management monitoring of the home takes place and generally residents best interest are being promoted by the home’s records and written policies and procedures. EVIDENCE: The home has a manager is in place and she plans to submit her registered managers application to the Commission. Discussions with the manager and deputy indicate they are trying to implement change in relation to policies and practices and have a clear plan of what they want the home to achieve in relation to improved outcomes for residents. However, due to the deputy not having supernumerary hours and the manager having only 18.5 Bishop`s Court DS0000059340.V296207.R01.S.doc Version 5.2 Page 20 supernumerary per week this process will be impeded. Consideration should be given to increasing the supernumerary management hours of both the manager and deputy manager. There is some evidence of staff supervision and appraisals but the frequency of these for all staff needs significant improvement. On the day of the visit despite the manager being made aware of cross infection issues there was a failure to ensure staff received appropriate direction and supervision to ensure the task was undertaken. The operation of the home is being monitored and reports are forwarded to the Commission. Service users monies are kept secure and since the last inspection there has been an improvement in the recording of both the petty cash and residents personal monies. The head office keeps information and details in relation to appointee ships and the arrangements for the paying of fees and receipt of benefits. A receipt is maintained of any transactions for example if clothing is purchased. Consideration should be given to providing residents with copies of these receipts in accordance with their wishes and understanding. Bishop`s Court DS0000059340.V296207.R01.S.doc Version 5.2 Page 21 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 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 1 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 3 3 2 3 3 3 1 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 2 X 3 Bishop`s Court DS0000059340.V296207.R01.S.doc Version 5.2 Page 22 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 OP26 Regulation 16(2)(K) Requirement The registered person shall keep the home free from offensive odours. This relates to the uncleaned faeces staining in the identified W.C and shower room. This requirement remains unmet timescale 31/03/06 The registered person must ensure resident’s dignity is being maintained at all times. This specifically relates to failure to appropriately clean faeces staining throughout the duration of an inspection visit. The registered person must ensure the emergency lighting and fire alarm systems are tested regularly with a record of the test being maintained. The registered person must ensure there are adequate systems in place to ensure the health and welfare of services users in relation to cross infection. This specifically relates to the failure to adequate clean faeces staining in a W.C and shower room, ensuring a missing W.C seat is replaced and DS0000059340.V296207.R01.S.doc Timescale for action 29/06/06 2 OP10 12 29/06/06 3 OP19 23 29/07/06 4 OP26 13 29/06/06 Bishop`s Court Version 5.2 Page 23 5 OP22 13 6 OP19 23 7 OP27 18 8 OP36 18 9 OP36 18 ensuring a W.C has adequate hand towels. The registered person must ensure the identified W.C has a working nurse call bell in place. This relates to the detached nurse call bell cord. The registered person must undertake a risk assessment in relation to the rear garden area with appropriate action taken as a result of the risk assessment. This specifically relates to the identified trip hazards in the enclosed garden area. The registered person must ensure adequate numbers of domestic staff are deployed at all times including cover for annual or sick leave. The registered person must ensure all staff be provided with adequate supervision. Care staff should receive supervision at least six times per year. The registered person must ensure there is an adequate staff training programme in relation to national Vocational Training for care staff. A plan must be submitted to the Commission within the timescale stated indicating when and how this is to be achieved. 29/07/06 29/08/06 29/07/06 29/07/06 29/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP3 Good Practice Recommendations Arrangements should be in place to ensure a copy of the care management plan is obtained prior to a resident DS0000059340.V296207.R01.S.doc Version 5.2 Page 24 Bishop`s Court 2 OP3 3 4 5 6 OP9 OP7 OP19 OP31 7 OP35 being placed to help inform the initial assessment process. Staff should ensure the initial assessment document is completed in full with as much detail to aid the initial assessment and care planning process. The section stating whether or not the home is able to meet a persons needs should be routinely completed. It is recommended a minimum/maximum digital thermometer be used for monitoring of the medication fridge temperatures. Arrangements should be in pace to ensure all care related risk assessments be kept under review. The marked dining room chairs and tables should be restained or replaced. In order to improve the effectiveness of the current management arrangements and support the planned changes around some of the homes policies and procedures consideration should be given to increasing the supernumerary management hours of both the manager and deputy manager. In relation to the management of residents personal monies consideration should be given to providing residents with copies of receipts of any transactions in accordance with their wishes and understanding. Bishop`s Court DS0000059340.V296207.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Bishop`s Court DS0000059340.V296207.R01.S.doc Version 5.2 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!