Inspection on 20/06/07 for Brenalwood Care Home

This inspection was carried out on 20th June 2007.

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

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

Other inspections for this house

Brenalwood Care Home 11/06/08

Brenalwood Care Home 24/08/06

Brenalwood Care Home 14/12/05

Brenalwood Care Home 21/09/05

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

CARE HOMES FOR OLDER PEOPLE Brenalwood Care Home Hall Lane Walton On Naze Essex CO14 8HN Lead Inspector Ray Burwood Key Unannounced Inspection 20th June 2007 10:27 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 Brenalwood Care Home DS0000062892.V343817.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. Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brenalwood Care Home Address Hall Lane Walton On Naze Essex CO14 8HN 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) 01255 675632 01255 850356 Brenalwood@btconnect.com R.W. Care Homes Ltd Mrs Tracy June Nelson Care Home 38 Category(ies) of Dementia - over 65 years of age (38) registration, with number of places Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 38 persons) 24th August 2006 Date of last inspection Brief Description of the Service: Brenalwood is a home providing care and accommodation for 38 individuals over the age of 65 who have dementia. The premises consist of a large detached property, offering accommodation on two floors, with a passenger lift to the first floor. There are three double rooms and thirty-two single rooms, all rooms offer en-suite facilities. The home provides a range of communal areas available for the use of all service users and a quiet room for visitors. The home is situated within walking distance of all the local amenities of Walton-on-the-Naze. Adequate parking spaces are provided to the side of the property. Current fees charged range from £374:00 to £600:00. Information about the service is made available through leaflets, a Statement of Purpose, and a Service User’s Guide stating the services provided by the home. Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on the 20th June 2007 with the assistance of the Registered Manager, people who live at the home, staff, and visitors, my thanks to them all. The site visit was conducted between the hours of 10:00am and 3:30pm. The inspection involved a tour of the premises, looking at records, documents, and talking to staff, including the cook and visitors to the home. Feedback and interviews with residents, relatives and staff were positive about the standard of care, support, and the commitment of the management team. A total of 22 standards were inspected with eighteen of the standards being met. The remaining four standards were partially met and requirements set for the home to address. At the end of the site visit, the findings were discussed with the Registered Manager, and advice and guidance given. What the service does well: The home provides good accommodation that is well furnished, decorated and comfortable. The home offers a good standard of care by experienced and qualified staff in sufficient numbers to meet the assessed personal and health care needs of people who use the service. Relatives and visitors spoken with said people who live at the home are respected and their dignity preserved by a caring team of staff. Observations made during the site visit confirmed this. Comments received from residents and visitors indicated that they were always consulted about proposed changes, have access to meetings and their opinions sought in all aspects of the running of the home. Relatives and friends are made welcome and are encouraged to join in the daily routines if they wish. Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Provide staff with the appropriate training to enable them to recognise and protect people using the service from abuse. Arrangements for people who need to take their medication with food should be reviewed to allow those who choose not to get up early in the morning, to do so. Sufficient numbers of baths/showers fitted with a regulated supply of hot water should be available, are accessible and safe for residents use. The pre-assessment process should include the social and recreational needs of prospective residents and subsequent care plans reflect these needs. Continue to address the recommendations made by the Fire Service. Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. The home’s assessment process is well managed and ensures that prospective residents needs are comprehensively detailed before moving into the home. EVIDENCE: The home’s pre-assessment procedures and records were examined and provided the evidence that all areas of need were covered and prospective residents and their families/professionals were involved in the process. The assessment process had recently been updated to include additional mental health assessment. The manager had recently introduced a dependency assessment form in a different format that provided a numbered rating for each section of the assessment. Also, the manager provided evidence that there is an additional assessment of needs carried out during the trial period to ensure that they can be met and the placement is appropriate to the needs and safety of other people living at the home. Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 10 Two relatives spoken with during the inspection visit confirmed that they had both been involved in the pre-assessment process, one relative went on to say no assessment had been carried out initially regarding social activities and interests. It was only when the person moved into the home that the activities co-ordinator assessed their needs. New residents or their representatives are provided with statement of terms and conditions/contracts; setting out in detail what is included in the fee, the role and responsibility of the provider, and the rights and obligations of the individual. Relatives spoken with confirmed that they had seen a copy of the contract. The home does not offer intermediate care. Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. Residents are looked after well in respect of their health and personal care. Further attention needs to be given to the revision and review of care plans and medication practices. EVIDENCE: New care planning documents had been introduced by the home that included a daily personal hygiene check for all resident with some life history information entered on to individual residents’ files. Care plans examined during this inspection visit were generally well presented, included records of healthcare professionals visits and information to enable staff to carry out their duties, however not all care plans were up to date. The manager said keyworkers were updating the new care planning documents and she was monitoring care plan reviews as they were being completed. Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 12 Comments within the surveys returned to the Commission stated that the care at Brenalwood has always been very good, others said the personal care support is carried out in dignified manner that recognises peoples’ privacy and independence. Visitors spoken to on the day of the inspection also confirmed this. The Falls Assessment Team visits the home to assess people who the home has referred following mobility concerns. From these reports risk assessments are generated and mobility aids provided where appropriate. Medication practices were discussed with the manager following concerns raised about residents who were being got up early in the morning to ensure that they took their medication with food. The manager was advised that this practice should be reviewed and appropriate action taken to instruct staff about alternative arrangements. Since the home’s last inspection the medication system has been changed to ensure that those who did not wish to administer medication did not have to. All senior staff are responsible for the ordering, storage, administration and disposal of medicines. The manager has taken on the responsibility of quality monitoring medication practices. At the last inspection it was noted that the recording of controlled drugs was not correct. This has since been addressed through the purchase of a drugs register. The storage of controlled drugs was also inspected and found to be correct. Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. People living at the home are supported to experience a varied life with visitors encouraged, various informal activities made available, and good meals. EVIDENCE: The residents of Brenalwood find it difficult to concentrate and communicate with people due to their different stages of dementia. Observations made throughout the inspection visit provided examples of how the care staff and the activities co-ordinator had tried to involve people in activities. One group observed was discussing and listening to their favourite music, another activity observed was a resident being shown a book and read to by a member of staff. Activities are generally undertaken locally with visits to the pier, promenade and garden centres. A programme of activities was displayed in the home Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 14 One relative said the person she was visiting had not had her interests recorded onto her care plan and they would enjoy being involved in things they used to do before moving into the home. This was discussed with the Activities Co-ordinator who reassured the relative that she was in the process of assessing individuals new to the home and would make sure the information was typed out and their life history entered into their care plan. The activities co-ordinator divides her time between care duties, organising activities and recording information. During the site visit people living at the home had many visitors and the inspector was able to talk to them and find out how they felt about the home and the care the home provided. One relative was happy with the support and care offered by the manager and her staff and how well the person they were visiting had settled into the home. Another visitor said they were always made welcome and were provided with refreshments. Since the last site inspection the manager had formed the ‘‘Brenalwood Committee’’ to encourage residents, their relatives and friends to meet on a quarterly basis to discuss any changes at the home and how they could support issues and ideas that residents may benefit from. However, records of meetings were not seen during this visit. During the lunchtime meal people living at the home were spoken with regarding the meals and the choices they had. Most of the people said the food was good, plentiful and there was always a choice of meals. Staff were observed during lunch period and found to support residents who found it difficult to manage on their own. Menus and the general running of the kitchen was discussed with the cook who said she plans a twelve week menu and tries to involve residents in choosing the food they like to eat. The cook said she was aware of some residents’ special diets and made the appropriate arrangements to ensure these were met. Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. The home has an open culture where individuals feel safe and supported to share any concerns in relation to their protection and safety. The home does not provide all staff with training around Safeguarding Adults which leads to inconsistent knowledge and practice within the service. EVIDENCE: The home has a detailed complaints policy and procedure that is made available to individuals wishing to register a complaint. Information for residents is contained in the Service Users Guide, with the addresses and telephone numbers of other agencies, including the Commission for Social Care Inspection (CSCI), that people living at the home and others may wish to contact. Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 16 The home had received one complaint since the last site inspection and dealt with it positively, the outcome being acceptable by the complainant. The homes complaint register was examined and found to be correct. Surveys received from the relatives indicated that they were aware of the complaints procedures and would know how to make a complaint and to whom. The manager provided the evidence through letters of compliments from relatives thanking the home for the care and supported they gave, one in particular coming from the family of someone who had recently passed away at the home. Policies and procedures relating to Adult Protection and Whistle Blowing were in place together with local policies and guidelines provided by Essex Vulnerable Adult Committee. Staff spoken with had a good understanding of how to protect and prevent abuse situations but had not received Adult Protection training. The manager said training courses were booked for existing and new staff. There are no current adult protection alerts relating to this home. Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21 and 26. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. The home provides a well-maintained environment that has good facilities, is comfortable and is safe place for those living there. EVIDENCE: A tour of the building was undertaken with the manager and all areas found to be well maintained and suited the needs of people living there. The home was decorated and furnished to help residents recognise areas and get about the home safely. Bedrooms were decorated and furnished to a good standard, had en-suite facilities and contained items of audio equipment and furniture brought in by residents and relatives. One bedroom had recently had the carpet replaced with a material that was easily cleaned following an Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 18 incontinence problem with a previous occupier. The home employs a house keeper/cleaner who is responsible for all communal areas and bedrooms. Toilet, washing and bathing facilities were found to be adequate and were provided in close proximity of bedrooms and communal areas. Two bathrooms served the first floor and had disability aids and adaptations to meet the needs of people using the service. One bathroom and one shower room were located on the ground floor. The manager said the ground floor bathroom was to be converted into a walk in shower with appropriate aids for residents’ comfort and ease during showering. The ratio of one bath/shower per eight residents is an outstanding requirement under Regulation 21 of the Care Home Regulations. The home provides a hairdressing salon for residents to book appointments with a hairdresser who regularly visits the home. The home also provides a visitors room that would benefit from some reorganisation and decoration if it were not possible to relocate to another part of the building or extend. Records relating to the routine maintenance, renewal of the fabric, and the decoration of both buildings were in place, together with safety checks undertaken. All areas visited smelled pleasant and were cleaned to a high standard. Laundry and sluicing facilities provided complied with regulations associated with infection control. Staff spoken with confirmed that they were aware of the importance of wearing protective clothing and had undertaken infection control training. The home provided attractive gardens and patio areas that were safe and easily accessed by residents. Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support and meet the needs of people who use the service. EVIDENCE: Staff rotas seen covered the period June and July 2007 and provided sufficient hours to meet the needs of people living at the home with the flexibility of additional staff hours to cover busy periods, appointments and activities. Domestic staffs are employed in sufficient numbers throughout the week to ensure that the home is kept clean and tidy. The Department of Health guidance for calculating dependency levels, ‘Residential Forum’ was used to assess the required staffing levels. Staff spoken with confirmed that they work some additional hours to cover holidays and sickness. The manager was advised to monitor overtime working to ensure that people have regular time off duty. The homes continues to support staff who are undertaking NVQ Level 2 and 3 qualifications and provide above the required 50 of care staff who are qualified. Seven members of staff have achieved their NVQ Level 2 and two Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 20 members of staff have achieved their NVQ Level 3. Four members of staff are currently undertaking their NVQ Level 2 training. The homes catering and cleaning staff are also undertaking their NVQ Level 2 training. The registered manager is a qualified trainer, NVQ Assessor and has completed the NVQ Level 4 in Management (Registered Managers Award). Dementia training has been completed by most of the staff team with some refresher courses also completed. Staff spoken with confirmed that they had undertaken the relevant training to meet the diverse needs of people using the service. The homes induction process is linked to the guidance provided by “Skills for Care” and completed by all new staff. The recruitment files of staff were sampled, inspected and found to contain the required information before staff start to work at the home. These included two references, proof of identity and POVA/CRB clearance. Staff files also included relevant qualifications, job descriptions and contracts. Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. There is leadership, guidance and direction to staff to ensure that people who use the service receive a good quality of care and are safe. EVIDENCE: Since the last site inspection the manager of the home has been registered with the Commission for Social Care Inspection (CSCI). She is experienced in social care, qualified in management and a National Vocational Qualification (NVQ) Assessor and Internal Verifier. The manager also carries out Manual Handling instruction to staff working at the home. Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 22 Discussions with staff and relatives during the site inspection about the management of the service were positive, with support and good communication always being at hand. Staff also commented on the managers’ commitment to working towards improving services with a strong focus on equality and diversity. The manager confirmed that she undertakes training to update her knowledge and skills. The home’s quality assurance system has been further developed with feedback received from various people both within the home and outside. Information from the surveys had been studied and an action plan and report has been completed. The registered manager provided a copy of the report to the Commission. The report comments on four sections relating to areas surveyed, these were: • Catering. 72 felt the home achieved a very high standard. Requests for a wider range of meats has been acknowledged and is in place following surveys completed by the people who live at the home. • Information. 67 felt the home achieved a very high standard, one relative said ‘ I know that mum is safe and surrounded by people who care for her. If there are any problems, the home always contacts me’. • Personal care, privacy and dignity. 74 felt the home achieved a very high standard. One relative said ‘I think that all the staff work well as a team and treat residents with loving care and respect. Senior staff will now contact relatives when reviewing care plans. • Environment. 68 felt the home achieved a very good standard. One relative commented on the improvements carried out and how much better it is now. New staff has been employed to ensure the home is clean. Plans have been submitted to improve both the ground floor bathroom and shower rooms. Residents’ allowances are kept safe in the office with appropriate records of expenditure in place. Lockable cabinets are provided in bedrooms for those residents who are able to use the facility. Health and safety issues within the home are generally well managed with the home responding to recommendations made by the Fire Service. All relevant checks, servicing of equipment and insurance cover is in place, with appropriate records kept up to date. Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X 2 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 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 OP7 Regulation 15 (1) Requirement Residents’ care plans must contain all of their assessed needs, in particular social and recreational needs. Arrangements for the training of staff to help prevent residents being harmed or suffering abuse must be provided. There are sufficient numbers of baths/showers fitted with a regulated supply of hot water that are accessible and safe to residents. (Previous timescale of 30/11/06 not met). Timescale for action 30/08/07 2 OP18 13 (6) 30/08/07 3. OP21 23 (j) 31/10/07 Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP9 Good Practice Recommendations People living at the home who are required to take their prescribed medication with food are not woken early to enable this to happen. Brenalwood Care Home DS0000062892.V343817.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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