Inspection on 07/05/08 for Bungay House

This inspection was carried out on 7th May 2008.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Bungay House 07/11/07

Bungay House 11/04/07

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Bungay House 8 Yarmouth Road Broome Bungay Norfolk NR35 2PE Lead Inspector Mrs Marilyn Fellingham Unannounced Inspection 7th May 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bungay House DS0000067514.V364051.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. Bungay House DS0000067514.V364051.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bungay House Address 8 Yarmouth Road Broome Bungay Norfolk NR35 2PE 01986 895270 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) Bungay House Ltd Ms Sally Ann Gravestock Care Home 12 Category(ies) of Dementia (12), Mental disorder, excluding registration, with number learning disability or dementia (12) of places Bungay House DS0000067514.V364051.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The 12 Mentally Disordered people may be admitted if 50 years of age or older. 7th November 2007 Date of last inspection Brief Description of the Service: Bungay House is situated in the village of Broome on the border of Suffolk and Norfolk. The entrance to the home is signposted from the road. The home can accommodate 12 people aged over 50 years with either mental health illness or dementia. There are 2 double and 8 single rooms on the ground and first floor; none of these rooms have en-suite facilities. There is a separate dining room, sitting room and a small area that can be used as a quiet area or for activities. There is a pleasant small courtyard garden to the front of the premises with a large covered area for those residents who wish to smoke. There is limited parking to the side of the home. The home is supported by the local GP surgery and other professional agencies. A copy of the last inspection report is available from the manager of the home. The range of fees charged for care and support services are £404 to 695 per week. Bungay House DS0000067514.V364051.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means that the people who use this service experience adequate outcomes. This was an unannounced inspection that was undertaken by two inspectors over seven hours. The key inspection for this service has been carried out using information from previous inspections, information from the Annual Quality Assurance Assessment (AQAA), some service users, and people who work in the home. The AQAA is a report that the manager has to fill in and send to us to tell us how the service is operating. We use the information provided to help us to plan our inspection visit. The main method of inspection used was “Case Tracking”. This involved selecting individual care plans and information available about people who live at the home and tracking the experience of people and speaking to them about the outcomes they experience as a result of the support provided. During our visit a tour of the premises was undertaken and service user records and staff files were looked at. A number of requirements have been made as a result of this inspection visit, these can be found at the end of this report. What the service does well: Bungay House has a homely feel that is promoted by the staff. Those service users who made comments during the inspection said they liked living at the home and gave positive comments about the home and the staff. The manager continues to offer a variety of good nutritional food: one resident said that “they loved the food, especially the fish and chips” that they were having on the day we visited. The service has a core staff group who showed that they are committed to caring for those people they look after. The staff support people who live at the home in a way that helps them maintain their dignity and treat them with respect. People commented that they were “well cared for”. Bungay House DS0000067514.V364051.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Although the care plans have improved the there are some areas that need more detail and some require updating to show any changes that have taken place. The manager needs to put a policy in place for medicines that they give as one offs, such as headache and cough medicines. The manager should also ensure that medicines that are past their shelf life must not be used and to record what date eye ointments are first used. People who are prescribed when required medicines by their doctor need to have care plans for this so that the staff can monitor their continued use. The staff could include the activities that the residents take part as part of their overall plans of care. Recruitment must be more rigorous in order to provide more protection for the residents. The process for supervision of staff needs to be improved so that there is a policy to follow to provide more support when family members are involved with each other’s supervision sessions. The manager must ensure that all staff have updates in safeguarding adults and that she herself attends a course for this. The manager must implement a policy and procedure that is specificto the home for use when dealing with adult abuse. Bungay House DS0000067514.V364051.R01.S.doc Version 5.2 Page 7 Although training has improved, training on mental health issues still needs to be encouraged. 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. Bungay House DS0000067514.V364051.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 Bungay House DS0000067514.V364051.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): Standards 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have good information about the home so that they are able to decide if the home is right for them. The manager’s use of a personalised needs assessment means that people’s diverse needs can be identified and planned for before they move into the home. EVIDENCE: Two assessment records were looked at for people who had moved into the home. These were found to contain lots of information about the people who wished to use the service: this information related not only to their physical needs but also to their social, emotional and mental health needs. These assessments of need were then used to create a care plan. There was also information available about people’s life history so that the carers could use this information to incorporate it into the care plans for activities and other meaningful stimulation. Bungay House DS0000067514.V364051.R01.S.doc Version 5.2 Page 10 One person who we spoke with said that they felt that they had been given enough information about the home to allow them to make a decision about living there. We also noted that a new brochure was being designed by the manager to provide more up to date information about the home to enhance the information that the home gave to prospective service users. The home does not provide intermediate care services. Bungay House DS0000067514.V364051.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): Standards 7,8,9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are care plans in place, which are created from assessments completed at the time of admission. However, variable practice relating to some areas of planning and delivery of care and the management of medicines means that the residents cannot always be confident that their health and personal care needs can be fully met. EVIDENCE: Five care plans were looked at and we saw that they had improved and were more detailed than at the last key inspection. The care plans also identified the mental health care needs of the service users as well as their physical, social and emotional needs. We also noted that the care plans had been reviewed frequently, although one plan of care we looked at had not been up dated in relation to recent care that was required and another care plan had not been fully updated to show specific needs recorded in the daily notes. Bungay House DS0000067514.V364051.R01.S.doc Version 5.2 Page 12 One resident had needed specific personal care support in the past, however the care plan did not refer to how the support needed was being managed now or if the specific support was no longer needed. This was discussed with the manager during our visit and she confirmed she would take action to fully check and update all the care plans. The care plans that we looked at had no evidence of the involvement of the residents in the care planning activity. The manager said she would ensure that people are involved in their reviews and that their involvement is recorded. Those staff we spoke with knew how to use the plans of care in order to provide support for people. Those service users we spoke with felt that their privacy was respected and said that they were well cared for and that “ the staff were kind”. The administration and recording of medication had improved since the last key inspection. We found no gaps in the record charts and the amount of medication in stock tallied with those numbers on the charts recorded as given. However, people who had when required medicines prescribed for their use did not have care plans in place to justify their continued use. We also noted that there were too many paracetamol and co codamol held in stock. One resident had been prescribed ointment for an eye problem; this ointment did not have a date of opening on it so it was difficult to ascertain if it had been used passed its shelf life. We also found a resident’s prescribed skin ointment in a communal bathroom and it was noted that it was past its usage date. We looked at the policies and procedures for giving medicines and noted that a policy for homely remedies had not been completed. The manager said that she would attend to this. Bungay House DS0000067514.V364051.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): Standards 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The activities arranged by the care team through discussions with the people who live there mean that people can choose to take part in individual or group activities of their choice. EVIDENCE: We spoke to two staff members who both said that there had been improvements since the last inspection in terms of activities for the residents. They felt that the residents were getting out more. They were now part of the ‘pat a dog’ scheme and took the dog for walks as well as some residents going to the pub once a week. One resident told us that they had been out shopping and had been to the pub the day before our visit. The staff also told us that they were doing more craft with the residents, held quizzes and had arranged a visit to Banham Zoo for those who wished to go; arrangements for this were seen in the minutes of the resident’s meetings. One resident told us that they liked to stay in but that “there was plenty going on, like quizzes”. The two staff members we spoke with could describe the needs of the residents they were the key worker for and how they gave them Bungay House DS0000067514.V364051.R01.S.doc Version 5.2 Page 14 special attention. A staff member described how one resident was learning to be more independent in household chores so that he could be more independent. Staff were seen were encouraging residents to go for walks on their own. One resident told us he goes for Walks on his own but does not want to do very much. On the day of inspection it was a sunny day and residents were observed enjoying the good weather in the garden and staff serving lunch out there. One resident told us that thy liked being in the garden in the summer and in the winter they played snakes and ladders, they went on to say, “if the staff have time we have bingo and quizzes”. The manager told us that one resident who went to woodwork classes had made a lovely windmill. The manager also told us that some residents maintained contact with family and friends but in some cases it had been their choice not too. A programme and record of the activities that the residents had taken part in was also seen. The menus we looked at were nutritious showing choices available and on the day of inspection the residents were enjoying bought in fish and chips that had been delivered to the home. People told us this happens once a week and the residents said that they enjoyed Tuesdays because of this. Bungay House DS0000067514.V364051.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): Standards 16 and 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People know how to raise concerns and felt that any concerns would be listened to and dealt with. However Lack of recording procedures and systems regarding complaints, safeguarding and update training relating to safeguarding adults means that people are not fully protected. EVIDENCE: During our visit the people told us they had no concerns and the manager told us that they had not received any complaints or concerns from people about the service provided. The manager said she would keep a record of any complaints made but did not currently have a formal log for recording them. She said she would set one up. The manager also confirmed that she had not needed to take any specific action to protect people from abuse. Staff members said they had received some training and knew what to do in order to make sure people are protected. The staff members we spoke to said they would report any concerns to the manager or home owner immediately. The manager showed she had the social services policy and procedure for safeguarding adults, which was comprehensive and described the actions required of social services. However the manager told us she knew how to raise an alert but currently doesn’t have a procedure for the home to follow Bungay House DS0000067514.V364051.R01.S.doc Version 5.2 Page 16 that is written down and hadn’t completed any individual specific training in safeguarding adults herself. We discussed the need for additional training and for the service to have its own policy outlining the steps it will take about allegations of abuse, where they will be referred, what staff have to do and any implications re staff employment. The manager said she would make sure this was completed. Bungay House DS0000067514.V364051.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): Standards 19 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People live in a comfortable environment. However, The maintenance of some areas and storage of redundant equipment could be improved in order to protect the health and safety of people who live at the home. EVIDENCE: The home was found to be generally clean and tidy. Those individuals we spoke with liked their rooms; one resident commented that they “had everything they needed”. Three singles and one double bedroom upstairs were viewed. All were homely and individual and well equipped with a call bell, covered radiator and a lock on the door. Bungay House DS0000067514.V364051.R01.S.doc Version 5.2 Page 18 There is a bathroom and a separate toilet upstairs, both with locks for privacy and a call bell. However, The toilet area did not have a wash hand basin, the manager said that they are planning to add a wash basin to the toilet area in the near future. There is a stair lift in the home, though the manager said that no one uses it at the moment. The manager said she recognised that should the lift be needed it needs to have a switch at the top of the stairs as well as at the bottom so that residents can operate it independently. We could see that the downstairs corridor has been painted and some rooms had been re carpeted. Outside, the area by the car park has two old washing machines and an old bed. We discussed this with the manager who told us that they would be removed, as this could be unsafe for people using the area and also looks unsightly for people approaching the home. The front part of the garden is well kept and plenty of seated areas for the residents to use. Bungay House DS0000067514.V364051.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): Standards 27,28,29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is showing improvement and the manager is aware of further training needs for the staff. This capacity to improve should result in better outcomes for people using the service. EVIDENCE: Four weeks rotas were examined to see how many staff were on duty to care for the residents. The usual rota showed there were two staff on duty between 7am and 9pm, with the manager in addition on three days a week from 9am to 4pm. A cook is on duty on 6 days, four days from 9am to 1pm and at the weekends from 10 am to 1pm. There is no cook on duty on a Wednesday as they have bought in fish and chips. On the day of inspection (a Wednesday), the staffing corresponded to the rota. However the rotas showed that on the current week the manager was only extra to the care home hours on two days a week and in the following two weeks she was extra on one day only and had to help with care duties on the other days. The rota for the fourth week showed staffing was back to normal with the manager doing management duties on three days a week. Discussions were held with the manager and provider about the gaps in the rota and explanations were given. The home owner recognised the need to have relief cover so that the manager can have time for her extra duties. Bungay House DS0000067514.V364051.R01.S.doc Version 5.2 Page 20 Two staff members interviewed confirmed that there were always two staff on duty and this did provide sufficient time to attend to the needs of the residents. They did say that covering holidays meant that they sometimes had to work a lot of hours. The domestic hours were low with only three hours provided a fortnight. The manager said that the waking night staff were able to do the domestic work providing approximately three hours a night because their duties of care during the night were not onerous. They are introducing a system where staff assist some residents to maintain their own rooms as part of their rehabilitation. This was accepted as good practice though the manager said she would need to monitor the impact of reduced domestic hours on the cleanliness of the home. The staff training records were looked at during our visit; they showed that there had been several training courses recently covering dementia, bereavement, moving and handling and some related to safeguarding adults. Two staff members confirmed that they were studying for the NVQ 2 qualification and were expecting to finish by the end of the month. We discussed the improvements made to the training plan since our last inspection visit with the manager. Care plans did identify peoples mental health needs and staff had some understanding about how to provide individual support for people, particularly in relation to dementia needs. However the manager also recognised that there should be more specific training made available for staff in order to support people who may have specific mental health needs. Four staff files were looked at to see what recruitment process was used by the service. Two showed that staff had been working in the home for several years and had up to date criminal record checks. Another file showed recruitment had been carried out by an agency and showed that references and checks were in place. One file for a more recently recruited staff showed that a criminal record check had been carried out, work permits were in place and two references. One of these references was “to whom it may concern” letter brought by the applicant and not checked by the home, the other had no address on it, and it was very short and did not provide any details about who had completed it. The home’s application form does not ask for references, though does have a section for previous employment. The manager said they use this information to request references. Bungay House DS0000067514.V364051.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): Standards 31,33,35 ad 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are management arrangements in place, which need to be supported with specific policies and procedures relating to supervision to ensure that the needs of the residents and the quality of the service is not compromised. EVIDENCE: During our visit we talked to two staff members. Both confirmed they had one to one sessions with their manager on a regular basis, often six weekly. They felt that they had good support from their manager and that she was approachable. One staff member told us that she supervised the cleaning staff. Staff files also showed that supervision was being provided giving staff an opportunity to discuss their work and training needs. Bungay House DS0000067514.V364051.R01.S.doc Version 5.2 Page 22 In addition the records we saw about staff meetings showed they were held regularly. It was clear that there were arrangements in place so that staff members could receive supervision and support. However, we did see that the provider had organised for one new staff member to carry out supervision of another staff member after only two weeks in the home. The supervisee was a member of the supervisor’s family. We asked why the staff member had been given the responsibility after so short a time and why they should be asked to supervise a family member when there was a manager in place to do that work more objectively. This was discussed at length and we asked the manager and homeowner to review the arrangements in place and to confirm their policy and procedures for family members who work together. Records and certificates relating to electrical and gas appliances were looked at to see how the home was ensuring the health and safety of its residents. These showed that appliances had been checked in the last twelve months and bath and lift hoists had been serviced. The fire record showed weekly alarm testing and up to date training on fire evacuation. The fire system had been serviced in January 2008. The manager showed us how she had started to monitor the quality of the service it offers and the results of surveys that had been given to people who live at the home; staff members and relatives were seen. The manager said these are now being reviewed so that the both she and the home owner can address any issues raised and further demonstrate how the service run in the best interests of the people who live there. Bungay House DS0000067514.V364051.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 2 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 2 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 X X 3 Bungay House DS0000067514.V364051.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO. 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 OP16 Regulation Requirement Timescale for action 09/07/08 2. OP30 3. OP9 8. OP29 9. OP36 17 (2) All incidents of complaints must &Schedule be recorded and action taken, 4 this will ensure that service users and others feel that they are listened to. 18 (1) The manager and all staff must be appropriately trained in the work that they perform. This will ensure people are safe and protected whilst helping to reduce the risks related to their care. 13 (2) People who use the service must have medicines prescribed on a prn (as required) basis given to them by staff only when clinically justified and this can be demonstrated by record keeping practices. 19 4 (b) All staff must be recruited to the (ii paras standards required by the 1-7 of regulations; shortfalls in the schedule system for recruitment can place 2) service users at risk. 18 (2) The manager must ensure that all staff are appropriately supervised with policies and procedures in place, which ensure that residents have DS0000067514.V364051.R01.S.doc 09/08/08 09/07/08 09/07/08 09/07/08 Bungay House Version 5.2 Page 25 sufficient protection. 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 OP27 OP21 OP9 Good Practice Recommendations Consideration needs to be given to obtaining relief staff who can be used to cover holidays and sickness. Consideration needs to be given for the provision of a wash hand basin in the upstairs toilet, this is recommended for hygiene reasons. It is recommended that a policy for homely remedies be implemented to ensure safe administration of one off medications that the service is allowed to give. Bungay House DS0000067514.V364051.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Eastern Regional Contact Team CPC1 Capital Park Fulbourn Cambridge, CB21 5XE 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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