Inspection on 26/07/06 for Brook House Care Centre

This inspection was carried out on 26th July 2006.

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

Brook House Care Centre 09/01/08

Brook House Care Centre 18/11/05

Brook House Care Centre 16/05/05

Brook House Care Centre 02/11/04

Brook House Care Centre 27/05/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Brook House Care Centre 20 Meadowford Close Off Thamesmere Drive Thamesmead London SE28 8GA Lead Inspector Ms Pauline Lambe Key Unannounced Inspection 26th July 2006 09:15 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 Brook House Care Centre DS0000006776.V296483.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. Brook House Care Centre DS0000006776.V296483.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brook House Care Centre Address 20 Meadowford Close Off Thamesmere Drive Thamesmead London SE28 8GA 020 8320 5600 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) brookhouse@lifestylecare.co.uk Life Style Care Plc Mrs Jan Crozier Care Home 74 Category(ies) of Old age, not falling within any other category registration, with number (60), Physical disability (14) of places Brook House Care Centre DS0000006776.V296483.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 14 beds for the physically disabled 60 beds for the nursing care of people aged 60 Date of last inspection 18th November 2005 Brief Description of the Service: Brook House Care Centre is registered with the Commission for Social Care Inspection to provide nursing care for 60 older people and 14 young adults with a physical disability. The three-storey building is located close to Thamesmead town centre, shops and local bus routes and was purpose built. The home consists of a kitchen, laundry, administration facilities, a fourteen bed unit for young disabled people on the ground floor and two thirty bed units for older people requiring nursing care on the first and second floors. Each unit has its own lounge, dining area and kitchenette. All bedrooms are for single occupancy with en suite toilet and hand washbasins. There is a car park in front of the home and a garden to the rear with a patio and garden seating. Current weekly fees on the older person units’ range from £550 - £700 and on the younger adult unit are £850. Residents pay privately for personal items such as hairdressing, newspapers and toiletries. Brook House Care Centre DS0000006776.V296483.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors from the Commission completed the site visit for this unannounced inspection on 26th July 2006 over 9 hours. The manager and staff assisted with the inspection. The service was last inspected on the 18th November 2005 and an additional visit was made on 9th March 2006 to review compliance with requirements and recommendations. A report for the additional visit was sent to the registered person. This inspection included a review of information held on the service file, a tour of the premises, time was spent and talking to residents, staff and the manager, inspection of records and reviewing compliance with previous requirements. On this occasion the inspection focused on the first and second floors of the home, Peacock and Ladybird Units. The manager said that she planned to ‘re-launch’ the Admiral Unit, the unit for adults. Plans were in place to do some redecoration work and to swap rooms to give the unit a larger and more suitable lounge. At the time of writing this report this unit had only four residents. Positive feedback was obtained from a number of relatives about the service. What the service does well: What has improved since the last inspection? Risk assessments were completed and up to date in relation to resident care. Care plans had improved and reflected how resident needs were to be met. Records were kept for disposed of medicines and no out of date medicines were seen. Activity records showed residents had opportunities to enjoy time outside of the home. A number of bedrooms and bathrooms had been redecorated and work had started to make the bathrooms more homely. Shelving had been provided in bathrooms to store continence products. Brook House Care Centre DS0000006776.V296483.R01.S.doc Version 5.2 Page 6 Residents were involved in choosing the paint colour for their bedrooms. A system was in place to provide formal supervision for staff. 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. Brook House Care Centre DS0000006776.V296483.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 Brook House Care Centre DS0000006776.V296483.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. Standard 6 did not apply to the service. Quality in this outcome area was adequate. This judgement has been made using available evidence including a visit to the service. Residents had their needs assessed prior to admission but there was no evidence to show that residents received written confirmation that the home could meet their assessed needs. EVIDENCE: Five resident care plans were viewed. These included pre-admission assessments completed by staff from the home and copies of care manager assessments. Although a letter was prepared to send to residents saying the home could meet assessed needs copies of this were not seen in the files viewed. Requirement 1. Brook House Care Centre DS0000006776.V296483.R01.S.doc Version 5.2 Page 9 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 – 10. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Care plans were prepared for residents, were kept under review and indicated discussion with residents. Residents had access to health care services and medicines were safely managed. From the evidence available residents were treated with respect. EVIDENCE: The care records for five residents’ were viewed and showed that preadmission and risk assessments had been completed. Care plans were prepared to show how assessed needs would be met. Care plans were reviewed regularly and indicated that where possible these were discussed with the resident. In view of the very hot weather at the time of this inspection it was reassuring to see ‘heat wave guidance’ included in resident’s care records. Daily records indicated the implementation of care plans. Residents who spoke to inspectors were satisfied with the quality of care provided and feedback sent to the Commission from relatives supported this. Staff ensured residents health care needs were met by arranging regular visits to the home by a GP, dentist, optician and chiropodist. There was information on the resident’s notice board about the GP visits. Specialist medical advice Brook House Care Centre DS0000006776.V296483.R01.S.doc Version 5.2 Page 10 was obtained through GP referral. Residents spoken with confirmed they had access to medical services. To ensure staff kept themselves up to date with practice a system was in place to have ‘link nurses’ who attended meetings with staff from the PCT in relation to care issues such as continence management, tissue viability, nutrition and diabetes. Information obtained from these meetings was then cascaded to staff in the home. Accident records seen were well maintained and accidents monitored by management monthly with evidence to show that action was taken to follow up unexplained injuries. None of the residents managed their own medicines. Medicines were assessed on Peacock and Ladybird Units. Systems were in place to safely store, receipt, administer and dispose of medicines. Medicine records checked for five residents were checked and found to be correct. On Ladybird unit a concern was noted in relation to the storage of medicines waiting disposal. The manager addressed the matter immediately to ensure safe procedures were practiced. Also on Ladybird the sharps container was overfilled and undated and this was brought to the attention of the manager. All bedrooms in the home were for single occupancy with en-suite toilet and washbasin facilities, which provided privacy for residents. Staff were observed knocking on doors before entering bedrooms and closing doors when giving care to residents. Residents spoken with said staff were kind and helpful and some residents referred to care staff by name. Staff were observed responding appropriately to resident’s request for help or assistance. Some residents had private phone lines in their bedrooms and others could use the hands free phone to receive or make personal calls. Feedback received from relatives did not indicate they had concerns about how resident’s privacy and dignity was respected. Requirement 2. Brook House Care Centre DS0000006776.V296483.R01.S.doc Version 5.2 Page 11 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 – 15. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Activities were well organised and residents were satisfied with these. Relatives and friends were welcome to visit the home. Residents indicated they could make choices about their lives. Although residents did not raise concerns about meals it was felt there was room for improvement in relation to menus, presentation and serving meals. EVIDENCE: The activity organiser prepared social care plans. Residents spoken with said they were satisfied with the activities provided and the programme was displayed on the resident notice board. One full and one part time activity organisers were employed and records seen showed residents were provided with a wide range of activities in-house, entertainment bought in, social evenings and outings to the local shops and area. Plans were in place to take resident’s on an outing to the Zoo this August. The activity organiser presented as very committed to her role and was very knowledgeable about the residents interests and needs. Visitors were welcome to the home at any time and residents spoken with said they enjoyed seeing family and friends. Feedback received from relatives on Brook House Care Centre DS0000006776.V296483.R01.S.doc Version 5.2 Page 12 the day and on comment cards indicated they were made feel welcome when visiting the home. Care plans seen indicated that staff discussed how care would be delivered with residents. Some care plans seen indicate the resident’s preferred time for going to bed. Residents spoken with said staff involved them in decision about their care and lives. Menus seen showed a varied diet was provided. However the meal on the day was not really suited to the weather. A choice of meal was provided and residents confirmed this. A number of residents said the food was good. Residents were encouraged to drink fluids throughout the day and fans were in use to help cool the environment. Lunch was observed on Peacock and Ladybird Units. A number of meal choices were provided, staff offered assistance where needed and tables were nicely prepared. On Peacock Unit staff served the pudding to some residents before they had finished their main meal also some meals were taken to residents in their bedrooms uncovered. The pureed meal on the day looked unappealing as the vegetables and meat had been pureed together and served with mashed potato. One resident’s care plan stated they should have a plate guard provided but they did not have this during lunch. The manager said she was implementing a quality assurance system and the first area planned to address was meals. This should assist staff to adjust menus and ensure resident choice and seasons are considered when planning menus. The kitchen was not inspected as an environment health inspection had been done in May 2006 and records seen showed the kitchen had been deep cleaned in January 2006. Requirement 3. Brook House Care Centre DS0000006776.V296483.R01.S.doc Version 5.2 Page 13 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. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Adequate procedures were in place to manage complaints and allegations or suspicions of abuse to residents. EVIDENCE: A policy and procedure was provided in relation to complaint management. A copy of this was included in the resident information pack. Residents spoken with and five relative feedback cards indicated they were aware of the procedure and knew how to make a complaint. A system was in place to record complaints. Two complaints had been made to management since the last inspection. Investigations into these had not been completed at the time of the inspection. Adequate policies and procedures were provided in relation to adult protections. Staff spoken with displayed a good understanding of adult protections and how to mange such a situation. Some staff were not aware of the ‘whistle blowing’ policy and the manager said she would address this at the planned adult protection training session. Since the last inspection one allegation of abuse involving staff had been investigated by social services. The findings of the investigation were inconclusive but some recommendations were made to management in relation to the issue. Brook House Care Centre DS0000006776.V296483.R01.S.doc Version 5.2 Page 14 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, 21, 23 and 26. Quality in this outcome area was adequate. This judgement has been made using available evidence including a visit to the service. A rolling programme of redecoration was in place. Residents were satisfied with the private and communal space provided. The home was generally clean and tidy. Issues were identified in relation to the quality of bed linen and pillows provided and the inappropriate disposal of soiled pads on one unit. EVIDENCE: The premises were satisfactorily maintained with attention given to providing a safe environment. The premises benefited from the on-going redecoration programme. Communal areas, some bathrooms and bedrooms had been redecorated since the last inspection. The maintenance technician recorded day-to-day repairs and records of safety checks on specific areas, for example fire exits, fire doors, window restrictors, hoist slings, bed rails, hot water temperatures and wheelchairs. Maintenance records were well kept and up to date. Brook House Care Centre DS0000006776.V296483.R01.S.doc Version 5.2 Page 15 Since the last inspection work had commenced on making the bathrooms more homely. On Peacock unit one bathroom was completed and provided a pleasant environment for the residents. However on Peacock Unit two assisted baths were out of order. The shower unit was working and the maintenance technician provided evidence that the bathrooms were being repaired and new parts had been ordered. As the repairs were being addressed an immediate requirement was not left but the manager must inform the Commission in writing when the work is completed. All bedrooms were for single occupancy with en-suite toilets and washbasins. Residents spoken with said they were satisfied with their bedrooms. Residents were able to bring in items to personalise their rooms. One resident said their bed was uncomfortable so the inspector looked at this and five other beds. This showed that beds had not been properly made up, bottom sheets not straightened, some pillows were very lumpy and some linen was quite worn. The home was clean and free of offensive odours. A number of residents said there bedrooms were kept clean. A housekeeper was employed and worked with the domestic team to ensure the home was kept clean and a satisfactory laundry service maintained. Staff had access to adequate supplies of protective clothing and hand-washing facilities were provided in areas where waste was handled. On Ladybird Unit the inspector noted that soiled pads had been left on top of the bin in the sluice area rather than being placed inside. Requirements 4, 5 and 6. Brook House Care Centre DS0000006776.V296483.R01.S.doc Version 5.2 Page 16 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 – 30. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. The home maintained staffing levels in line with its staffing notice and was working towards having 50 of care staff with NVQ2 qualification. Some improvements were needed to ensure all information required by regulation was obtained for employees. Staff received training appropriate to their work. EVIDENCE: The staff team comprised of a full time manager, two full time deputy managers, trained nurses, care assistants, domestic and ancillary staff. Staffing rotas seen showed the home complied with the current staffing notice. Staff continued to work long days and many care assistants worked three or four long days together. Rotas showed that on occasions some staff worked up to 60 hours a week. Staff said they preferred to work long days but management should monitor the number of hours worked by some staff in a week. Residents gave positive feedback about the staff and many knew the staff by name. Comments residents made included ‘staff are lovely’ and ‘staff are very good’. The home had 41 care assistants employed and seven had completed NVQ 2. Thirteen care assistants were currently completing the training. Once this group has achieved the qualification almost 50 of care staff will have this NVQ 2. Brook House Care Centre DS0000006776.V296483.R01.S.doc Version 5.2 Page 17 Three employee files were viewed and a fourth file requested could not be found. The three files seen contained most but not all the information required by regulation. For example two files did not have a health statement for the employee and some of the references seen had not been checked for authenticity. The missing file could not be found and the following day the manager was advised to suspend the employee until the appropriate documentation was available. Staff spoken with said they received the training needed to help them fulfil their roles. Training records seen showed that staff received training in manual handling, food hygiene and fire safety. The majority of staff employed had received training on prevention of pressure sores and injury and falls. Future training sessions were planned and staff training needs identified through supervision. Requirement 7 and recommendation 1. Brook House Care Centre DS0000006776.V296483.R01.S.doc Version 5.2 Page 18 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, 36 and 38. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. The home was well managed, the quality of care was monitored and reviewed and staff received supervision. Safe systems were in place to manage resident personal finances and attention was given to ensuring safety for residents and others. EVIDENCE: The manager has been registered with the Commission and has many years experience working with older people and was supported in her role by a regional manager. The manager held monthly meetings with heads of departments, deputy managers and link nurses. Senior staff held unit meetings with the staff teams. The manager monitored areas of the service such as admissions, discharges, deaths, complaints, use of bedrails, resident dependency levels and pressure sores monthly. An annual stakeholders satisfaction survey was completed. Brook House Care Centre DS0000006776.V296483.R01.S.doc Version 5.2 Page 19 This included getting views of the service from residents and relatives. The last survey was completed in June 2006 but had not been collated at the time of this inspection. The manager agreed to send a copy of the survey findings with the supporting action plan to the Commission. The manager had introduced a ‘suggestion box’ and felt this had been a useful way to get anonymous feedback from residents, relatives and others. The manager held a relatives meeting in January 2006 but the attendance was poor. No resident meetings had been held but the manager said she planned to try again to hold these meetings. Regulation 26 reports were sent to the Commission regularly. Adequate procedures were in place to manager resident’s personal allowances. This money was kept in a resident bank account. Records for two residents were viewed and found to be correct. Receipts were kept for money received and spent. Since the last inspection a system had been implemented to ensure all staff received supervision. Records of supervision were kept but these were not viewed as they were seen as confidential to the employee. Staff spoken with confirmed they received formal supervision and said they felt this was a benefit to them both in relation to their work and professional development. A selection of safety records were viewed which included fire safety, gas, lift service, hoist service, and legionella. Records were well maintained and up to date. Fire drills had been held at times to include both day and night staff. During the inspection the fire alarm was activated and staff reacted appropriately and calmly to this. Seven staff in the home were trained to provide first aid. Brook House Care Centre DS0000006776.V296483.R01.S.doc Version 5.2 Page 20 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 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 2 X 2 X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Brook House Care Centre DS0000006776.V296483.R01.S.doc Version 5.2 Page 21 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 The Registered Person must confirm in writing to residents that based on assessment the home can meet their needs in respect of health and welfare. (Timescale of 30/12/06 was not met.) The registered person must ensure the sharps containers are not overfilled and are dated when first used. The registered person must ensure: • Seasonal menus are prepared. • Meals taken to bedrooms are covered. • Foods are pureed separately to ensure they look appetising. • Plate guards must be provided for residents who require these. • Residents must be allowed time to finish their first course before the second one is served. The registered person must ensure the Commission are DS0000006776.V296483.R01.S.doc Timescale for action 04/09/06 2. OP9 13 04/09/06 3. OP15 16 04/09/06 4. OP21 23 21/08/06 Brook House Care Centre Version 5.2 Page 22 5. OP23 23 6. OP26 13 7. OP29 19 informed in writing when the assisted baths on Peacock Unit have been repaired. The registered person must ensure bedding provided is of a satisfactory standard. An audit must be completed of the pillows and linen provided and new supplies purchased as needed. The registered person must ensure staff on Ladybird Unit dispose of soiled pads appropriately. The registered person must ensure all the information required by regulation and schedule 2 is obtained for employees and available for inspection. Efforts must be made to check the authenticity of references. 04/09/06 21/08/06 04/09/06 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 OP27 Good Practice Recommendations The Registered Person should review the number of long days staff work together and the long hours worked by some staff as this may affect the quality of care provided to residents. Brook House Care Centre DS0000006776.V296483.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Brook House Care Centre DS0000006776.V296483.R01.S.doc Version 5.2 Page 24 - 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!