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Inspection on 25/07/05 for Brookes House Care Centre

Also see our care home review for Brookes House Care Centre for more information

This inspection was carried out on 25th July 2005.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

All residents are assessed prior to admission to ensure that the care home is the right place for them. The home has received a low number of complaints since the last inspection. The home`s environment is pleasant, homely and provides a safe place in which to live. Residents were very complimentary regarding their personal space.

What has improved since the last inspection?

The acting manager has attempted to improve the home`s recruitment procedures and record keeping. The acting manager is trying to address previous identified shortfalls following inspections to the home.

What the care home could do better:

The home`s care planning processes and other records need to be consistently maintained and updated. Care staff within the home need to receive appropriate care planning and risk assessment training. The deployment of care staff within the home needs to be suitable to meet the needs of residents. The registered provider needs to ensure that there are sufficient numbers of staff on duty at all times and that the home`s lounges are adequately staffed so as to ensure resident`s health and well being. A programme of meaningful and stimulating activities must be provided to all residents residing at the care home. The registered provider must ensure that the number of hours provided by staff to enable residents to receive both `in house` and community-based activities are increased and ensure that clear records are maintained. The home should ensure that all residents receive a varied choice of meals, that the meals are attractively presented and that resident`s wishes and comments are taken into account. Ensure that the food budget is adequate and that the menu is changed regularly, food is varied, appealing and wholesome. The home should also make sure that care staff receive a range of training which meets the needs of residents. The home must ensure that there is a training programme for 2005-2006, which details both mandatory and specialist training to be undertaken. They must ensure that appropriate recruitment procedures are adopted at the home and all records as required by regulation are made. They should also ensure that a supervision programme for all staff is devised for 2005-2006.

CARE HOMES FOR OLDER PEOPLE Brookes House Care Centre 79-81 Western Road Brentwood Essex CM14 4ST Lead Inspector Michelle Love Unannounced 25th July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Brookes House Care Centre Address 79-81 Western Road Brentwood Essex CM14 4ST 01277 212709 01277 200706 info@ashbourne.co.uk Asbourne (Eton) Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Vacant Post CRH 70 Category(ies) of Old Age (OP) 70 registration, with number of places Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Personal care to be provided to no more than 70 service users over 65 years of age. (Total number not to exceed seventy). Total number of service users for whom personal care is to be provided shall not exceed 70. Date of last inspection 2nd March 2005 Brief Description of the Service: Brooks House Care Centre provides 24 hour accommodation and personal care for up to seventy older people. The home is not registered to care for people with dementia. It is a three storey building with residents accommodation on the first two floors and staff accommodation is provided on the top floor. It is situated a short distance from Brentwood Town Centre with its shopping areas and public transport. The home provides mostly single bedrooms and some double bedrooms. All bedrooms have en-suite facilities. There are lounges and dining rooms on both floors, which are accessible to residents by way of a passenger lift or ramp. A smoking room and hairdressing facility is available. Parking facilities are available at the front of the premises. There is a garden to the rear which has a small patio area that is accessible to residents. Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out by Michelle Love and Carolyn Delaney, inspectors, over sixteen hours. At this visit a tour of the premises took place and some care records and staff employment files were inspected. At the time of the visit the inspectors were assisted by the home’s acting manager, and several residents were spoken with. What the service does well: What has improved since the last inspection? The acting manager has attempted to improve the home’s recruitment procedures and record keeping. The acting manager is trying to address previous identified shortfalls following inspections to the home. Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 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 standard(s) 2, 3, 4 and 5 Arrangements have been made to ensure that residents are assessed prior to admission. It is unclear as to whether prospective residents are given information and have the opportunity to visit the home prior to admission so as to make an informed choice as to whether or not Brooks House Care Centre is a care home they wish to live in. EVIDENCE: Pre Admission Assessments were completed for the newest residents to be admitted and also included information from the resident’s Placing Authority and or hospital placement team. No formal `dependency tool` to determine whether or not the home was able to meet the residents needs was available. Residents spoken with were unsure as to whether or not they had received a copy of the homes Service Users Guide prior to admission. A copy of the homes Service Users Guide is available for all residents and located within each bedroom. A completed Statement of Terms and Conditions was available for one out of three residents. No evidence was available to indicate that prospective residents and/or their representatives had been given the opportunity to visit the care home prior to admission. Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 Page 9 Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 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 standard(s) 7, 8, 9, 10 and 11 The care planning process remains inconsistent in some cases within the home. The systems for resident consultation are poor with little evidence to indicate that resident’s views are sought and acted upon. Medication procedures within the home remain appropriate and satisfactory. EVIDENCE: On inspection of five individual care plans and associated documentation, some elements were not completed or were incomplete i.e. pressure sore risk factors not completed for one resident. Another care plan did not include information pertaining to the resident being diabetic. In addition information from one resident’s placing authority was not transferred to the individuals care plan highlighting that they had a poor appetite. Documented evidence indicated that some residents and/or their representatives wished to be consulted and involved within the care planning processes. However, little evidence was available to indicate that this had occurred except for individual’s life histories. Out of seven residents, six were unable to identify their named key worker. Information related to healthcare issues, visits and professionals involved were clearly recorded. Currently one resident has a pressure sore. Interaction between some members of staff and residents remains poor and inadequate Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 Page 11 and some lounges were left unattended for periods of up to 10-15 minutes. One resident was observed to be pushed in their wheelchair without any particular regard to their dignity i.e. the residents dress was up above their knees and their bare legs/thighs were showing. Risk assessments were not devised for all areas of identified risk. Information pertaining to funeral arrangements for residents were clearly detailed within the care plan. The home’s medication records and storage facilities were appropriate at the time of the inspection. PRN (“as and when required” medication) protocols were not devised for residents. The home’s accident records from April 2005 were inspected. In general terms records were satisfactory but some entries require additional information detailing injuries sustained to residents and treatment/interventions provided by care staff. The home has a new accident audit format devised and implemented. Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 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 standard(s) 12, 13, 14 and 15 Activities within the home and local community are fairly limited and activities for those residents with complex needs have not been devised or implemented. Comments relating to the home’s food were mixed. EVIDENCE: The home has 35 hours per week allocated so as to provide activities to all residents residing at Brooks House Care Centre. Currently only 24 hours are being utilised, as there is only one activities co-ordinator employed at the care home. The number of hours provided for activities remains inadequate for the numbers and needs of residents. Recording of activities for individual residents is poor. There is a communal activity book and this detailed such activities as sing along, quiz, art and crafts and karaoke. On the day of inspection some residents were seen to enjoy a sing along session on the patio. No formal activities programme was displayed within the home. Resident’s personal preferences are not adequately recorded. One resident commented “nothing to do except to just sit here”. The home has an `open visiting policy` whereby residents are free to receive their visitors at any reasonable time in the privacy of their own room or within the visitor’s room. Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 Page 13 The home operates a four week rotational menu, however at the time of the inspection no menus were displayed. The home’s chef advised that this was due to one of the home’s freezers not working and having to use up the stock first and amend the menus on a daily basis. Five residents said that they did not know what was available for lunch and one resident was able to indicate the choices available. Food provided to residents looked plentiful and was attractively presented, however one choice at lunchtime was observed to be dry and there was no additional gravy available. A choice of orange and lemon squash was evident at lunchtime. No jugs of squash/water were evident within the home’s lounge areas at other times, despite the weather being very hot and humid. Comments from residents regarding the choices of food/menu provided and quality of food served was mixed with positive and negative comments i.e. “the food is alright”, “not enough choice”, “same old fillings in sandwiches”, “I used to like sandwiches not any more” and “all residents unsatisfied as sandwiches had the same filling as they were given at lunchthey also had the same dessert and the soup was too thick and salty” (13.7.2005) and “Pork Belly-…….said it is the toughest meat he has ever encountered”. Some residents also commented that they would like clearer distinction between the summer and winter menu’s and more varied choices at teatime i.e. a ploughman’s platter or cheese and biscuits/baguette. A cooked breakfast is available to residents only once a month. Both the chef and the acting manager were asked to disclose the monthly food budget allowance to the Commission. Both Ashbourne representatives stated that they had been requested to withhold this information. Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 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 standard(s) 16 and 18 The home has a complaint and adult protection policy and procedure in place, however this does not protect residents from harm or abuse. Some members of staff have a limited knowledge and understanding of adult protection issues which protect residents from abuse. EVIDENCE: The home’s complaints procedure is displayed within the main reception area. Since the last inspection the home has received one complaint pertaining to poor quality/availability of food within the home and laundry issues for one resident. Documentation was evident relating to the nature of the complaint, details of the investigation and action taken by the home to address the issues. Following a request from the complainant for a breakdown of food costs/cost to produce each meal on a daily basis evidence indicated, this was denied by the registered provider. On inspection of staff training records for all members of night staff and the newest recruited members of staff employed at Brooks House Care Centre, evidence detailed that not all members of staff had received Resident Welfare training and no members of staff had received training to deal with residents aggression/inappropriate behaviours. At the time of the inspection the home, Social Services and the Commission were dealing with one Protection of Vulnerable Adults issue relating to a resident being locked in his bedroom by night staff for a period of a period of approximately four hours. Following the inspection a strategy meeting was planned with all concerned parties including the resident’s relatives and next of kin. One member of staff’s employment files made reference to them having a disciplinary hearing in 2004 and one Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 Page 15 informal warning and one written warning also in 2004. Records were not clear identifying the specific nature of the incidents or the action taken by the registered provider. Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 24 The standard of the environment within the home is good, providing residents with an attractive and homely place to live. EVIDENCE: The home is well maintained and decorated for residents needs. All bedrooms were personalised and individualised and had en-suite facilities. Resident’s comments relating to their private space were positive. The home has sufficient communal space for residents (lounges/dining areas). Residents have sufficient toilet, washing and bathing facilities. A random sample of hot water temperatures were tested from residents wash hand basins and baths and these were appropriate. Residents have access to a range of specialist equipment such as walking frames, wheelchairs, bedrails and protective covers, hoists and slings. One member of staff was observed pushing a resident in their wheelchair, with one foot on the footplate and the other foot trailing on the floor. This is seen as a possible health and safety risk to the resident. The home has a maintenance programme to ensure that equipment is serviced and maintained to a safe standard. A maintenance person is employed for 35 hours per week Monday to Friday. At the time of the Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 Page 17 inspection one minor health and safety issue was observed and the acting manager notified. During the inspection some lounges were left unattended for up to 10-15 minutes without staff support for residents. Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 Since the last inspection the standard of vetting and recruitment practices has improved only marginally. Staffing levels within the home remain inadequate for the numbers of residents. Staff training both mandatory and specialist remains poor for some staff. EVIDENCE: Staff rosters showed that some members of staff are working long days/double shifts and do not always have appropriate planned days off duty i.e. one senior member of staff and two members of care staff have been working in excess of 50, 57.75 and 60 plus hours per week. The staff roster was muddled and disorganised and on some days indicated insufficient numbers of staff on duty and not in line with those levels agreed by the previous registration authority. In addition the staff roster did not specify the specific hours worked by staff or detail the full names of staff working at the care home. One resident stated that “staff are good but can be very short staffed” and sometimes residents have to wait a long time to be toileted. Recruitment practices within the home have improved slightly, however not all records as required by regulation have been sought for staff (both newly appointed and those appointed post January 2005) i.e. gaps include only one written reference in some cases, no photograph and no record of training and qualifications/experience. Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 Page 19 Evidence indicates that the majority of staff had received mandatory training/updates i.e. Basic Food and Hygiene, Health and Safety, Manual Handling, Fire Awareness and Basic First Aid training, but little specialist training which meets the specific needs of residents and those illnesses and ailments associated with older people/old age. The majority of the induction training is provided on one or two days. The induction format does not cater for those newly appointed members of staff who have little or no previous care experience. It was not clear from staff records pertaining to NVQ training, as to how far into the programme members of staff are. Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 and 36 The management arrangements at Brooks House Care Centre are of concern. Staff do not receive regular supervision. EVIDENCE: Since the last inspection no management changes have been made at the care home. The acting manager has applied to the Commission to be the homes registered manager and this is currently being processed. It is of concern that issues pertaining to the homes care planning processes, staff recruitment, staff training, staffing levels, staff supervision and induction and food/meals for residents have not progressed significantly. Additionally it is concerning that protection of vulnerable adults issues/staff disciplinary action has not always been dealt with efficiently and prompt action taken and recorded i.e. one member of staff who failed to attend a disciplinary hearing for alleged theft of a residents belongings was not referred to the protection of vulnerable adults register. Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 Page 21 Formal supervision for care staff is infrequent and there are limited records available. Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 2 3 2 2 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 1 14 2 15 2 COMPLAINTS AND PROTECTION 3 x x x x 3 x x STAFFING Standard No Score 27 2 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 2 x x x x 2 x x Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 Page 23 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard OP2 OP4 Regulation 5 18(1)(a) and (c)(i) Requirement Timescale for action 01.11.05 Each resident must be provided with a completed Statement of Terms and Conditions. All staff at the care home must 01.01.06 undertake appropriate training to the work they perform and have the necessary skills and expertise to meet the specialist needs of residents. Previous timescale of 01.12.02 not met Ensure that comprehensive and detailed care plans are devised for all residents. 3. OP7 15(1) 01.11.05 4. OP7 13(4) Previous timescale of 01.12.02 not met Ensure that risks to residents are 01.11.05 identified and as far as possible eliminated. Risk assessments must be detailed, comprehensive and reviewed regularly to reflect changes. Previous timescale of 01.12.02 not met The registered person must make suitable arrangements for the safe recording of medication. This refers specifically to the 5. OP9 13(2) 01.09.05 Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 Page 24 devising of PRN (as and when required medication) protocols. Previous timescale of 24.02.04 not met Ensure that residents privacy and dignity is respected at all times. The registered person must ensure that all staff within the care home receive appropriate practical training in dealing with residents inappropriate and aggressive behaviours and have a good understanding of this topic. Previous timescale of 01.12.02 not met. Ensure that all staff are familiar with the homes adult protection policies and procedures and that they have a good understanding of how to prevent residents being harmed or suffering abuse. Ensure that proper provision is made for residents health and welfare. This refers specifically to residents being moved around the home in their wheelchair and the appropriate use of footplates. Ensure that residents are consulted about their social interests and appropriate arrangements are made to enable residents to engage in local, social and community activities. The registered person must ensure that at all times suitably qulaified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of residents. This refers specifically to adequate numbers of staff 6. 7. OP10 OP18 12(4)(A) 13(6) 21.08.05 01.01.06 8. OP18 13(6) 01.10.05 9. OP19 12(1)(a) 21.08.05 10. OP12 and 13 16(2)(m) and (n) 01.10.05 11. OP27 18(1)(a) 01.10.05 Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 Page 25 being on duty and some members of staff working long days/double shifts. Previous timescale of 01.12.02 not met Ensure that all residents receive a varied diet and food that is properly prepared and well presented. Ensure that robust recruitment procedures are adhered to in line with regulatory requirements. Previous timescale of 01.12.02 not met Ensure that a quality assurance system is devised which takes into account residents, their representatives and professionals views. Not inspected on this occasion Ensure that all staff receive appropriate supervision on a regular basis. Previous timescale of 01.12.02 not met 12. OP15 16(2)(i) 01.09.05 13. OP29 17(2), schedule 4 and 19, schedule 2 24 01.09.05 14. OP33 Carried forward to next inspection 15. OP36 18(2) 01.09.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP8 OP28 OP35 Good Practice Recommendations Accident records should include details of staff interventions and outcomes. A minimum of 50 of care staff should be trained to NVQ Level 2 in Care by 2005. Ensure that residents have access to their personal monies at all times. Not inspected on this occasion. Brookes House Care Centre I56-I06 S18120 Brookes House V225303 240505 Stage 4.doc Version 1.20 Page 26 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend On Sea Essex SS2 6BG 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. 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