Inspection on 22/04/08 for Carisbrooke Care Home

This inspection was carried out on 22nd April 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

Carisbrooke Care Home 04/10/07

Carisbrooke Care Home 04/01/07

Carisbrooke Care Home 23/02/06

Carisbrooke Care Home 25/11/05

Carisbrooke Care Home 25/02/05

Carisbrooke Care Home 17/08/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Carisbrooke Care Home 22 Carisbrooke Drive Mapperley Park Nottingham NG3 5DS Lead Inspector Lee West Unannounced Inspection 22nd April 2008 10:30 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 Carisbrooke Care Home DS0000026423.V362824.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. Carisbrooke Care Home DS0000026423.V362824.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Carisbrooke Care Home Address 22 Carisbrooke Drive Mapperley Park Nottingham NG3 5DS 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) 0115 960 5724 0115 910 6613 arksohawon@hotmail.com Mr Abdool Raouf Sohawon Mrs Bibi Sohawon Post Vacant Care Home 20 Category(ies) of Dementia (20), Dementia - over 65 years of age registration, with number (20), Old age, not falling within any other of places category (20), Physical disability (20), Physical disability over 65 years of age (20) Carisbrooke Care Home DS0000026423.V362824.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users shall not exceed 20 at any one time. Service users admitted under the category PD will be 60 years old and over. Service users admitted under the category DE will be 60 years old and over. 4th October 2007 Date of last inspection Brief Description of the Service: Carisbrooke Care Home is an older converted house set in the residential area of Mapperley Park, about two miles from the city centre. The home provides care for older people with nursing needs and is registered for up to 20 service users. It has a pleasant outlook, with safe attractive wellmaintained gardens to the front of the property, where car parking facilities are available. There are 12 single rooms and 4 double rooms, none of which have en-suite facilities. There are two lounge areas, dining room, opening into a dining area and a conservatory, where smoking is permitted. Two bathrooms and one shower room are provided and toilets are in close proximity to all individual service users rooms and communal areas. The range of fees are £294 to £328, according to level of nursing and care support required. The certificate of registration was displayed, but requires amendment with the change of manager. Carisbrooke Care Home DS0000026423.V362824.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This inspection was unannounced and involved one inspector. The main method of inspection used is “case tracking”, which involves selecting four residents and looking at the quality of the care they receive by speaking with them, observation, reading their records, and asking staff about their needs. Four members of staff, two other professionals and three visitors were also interviewed. Due to the complex needs of some of the service users, who had difficulty with communication, time was spent with them in the lounge areas observing their interactions with staff and visitors. Documents, including care plans, medication administration records and financial records were inspected to help form an opinion about the health, safety and welfare of residents at the home. Information supplied to the commission by the manager, on the Annual Quality Assessment, together with information received by the Commission about the home, since the last inspection, were also considered, and helped the decision of which areas to focus on. The quality rating for this service is 1 star. This means people who use this service experience adequate quality outcomes. Carisbrooke Care Home DS0000026423.V362824.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Care plans need to be person centred and involve input from the resident, to be able to identify and address each resident’s individuality, culture, personal preferences, leisure and recreational interests. None of the plans seen had any information about the person’s diversity or psychological needs, which could have a negative impact on their physical and mental well-being. When reviewing care plans the resident, or their representative, must be involved, to make sure their care needs are met in a way they wish, but also to Carisbrooke Care Home DS0000026423.V362824.R01.S.doc Version 5.2 Page 7 help residents feel they are valued and involved in the development of their care support. All staff must undergo induction training, to make sure they have the skills and competence to support the care needs of residents. The training must be recorded, signed and dated, to provide supporting evidence that it has been carried out. Staff must undergo training in how to care for people with dementia, to make sure they can provide the proper support for people suffering dementia. The acting manager must complete an application to be the Registered Manager, to ensure the manager is skilled and eligible to work within the service. An effective quality assurance monitoring system, consisting of planning, action and review, must be developed and implemented which also reflects aims and outcomes for residents, as well as reviewing policies and procedures to protect residents and monitor the quality of care provided by the service. 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. Carisbrooke Care Home DS0000026423.V362824.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 Carisbrooke Care Home DS0000026423.V362824.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): 1, 3, 4, 6, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Information is freely available, together with a pre-admission assessment, for prospective residents and their families, to help them make a choice about the suitability of the home to meet their needs. EVIDENCE: A service user guide, with a statement of purpose, was available for prospective residents. This set out clearly what the service provided, the facilities available and how to make a complaint. Thorough pre-admission assessments were seen in the records of residents case tracked. These had been completed by the contracting councils and formed the basis of the care plans. Carisbrooke Care Home DS0000026423.V362824.R01.S.doc Version 5.2 Page 10 Prospective residents were given the opportunity to spend time in the home and relatives visiting to view the home today were shown around the home by the manager, who explained aspects of care and then left them to look around the home on their own. When asked, the relatives said, “Staff were very helpful and answered all our questions. They even provided more copies of the handbook so all the family can have a copy, to help us make a decision.” The service does not offer intermediate care. Carisbrooke Care Home DS0000026423.V362824.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Health needs are identified and actions taken to meet physical needs, but more attention is needed to changes in these. Care plans are not person centred, and do not address each resident’s individual diversity. EVIDENCE: Pre-admission assessments were used to form the basis of the care plans for residents, which set out the actions staff need to take to meet physical needs, but there was no evidence of any monitoring of psychological health, to help support care which could restore this, or prevent deterioration, and reduce a negative impact on the person’s mental capacity. When asked about care plans residents said they did not know about care plans. One said, “I don’t know what that is, I just leave everything to the staff,” which could lead to care needs not being identified and met. Carisbrooke Care Home DS0000026423.V362824.R01.S.doc Version 5.2 Page 12 Evidence of review of the plans was contained in the records seen, but there was no evidence of any involvement of the resident in this process, possibly leading to care needs not being fully met. Medicines are now supplied in a Measured Dosage system; these were stored correctly, which helped protect residents from the risk of errors in administration. Medication Administration Records were inspected and were accurately completed, with no gaps. Administration of medication was observed at lunchtime, and this was carried out by the Registered Nurse and followed the proper procedures to safely administer medicines to residents. Oxygen cylinders, stored in one corner of the medicines room were clearly identified with warning signs and with safety measures in place to protect people from risk of harm. At present there were no residents who administer their own medication, but policies were in place to enable this to happen if a resident wished, and was able to do so. Residents said, staff treat them with respect and dignity. One said, “staff are lovely, they always treat me with respect. I like the way they look after me.” Staff were observed in the lounge and dining areas interacting with residents. All interactions were positive and respectful, in a quiet manner. Some residents were assisted to eat their meal at lunchtime and this was carried out in a dignified manner, with staff sitting quietly with one resident and providing the assistance needed. Carisbrooke Care Home DS0000026423.V362824.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents are enabled and encouraged to maintain contacts with their family and friends, but because their social, cultural, religious and recreational interests are not identified, or addressed, their ability to exercise choice is limited. EVIDENCE: The Annual Quality Assurance Assessment report sent to the Commission by the manager prior to this visit said, “All service users have the right to exercise their choices,” and “Religious and cultural needs are catered for as requested.” However, the care plans did not contain any information about the person’s individuality, personal preferences or cultural diversity, leading to a reduction in control and ability to exercise choice. Residents spoken with said they were not given opportunities to make real choices, one said, “I get up when they want me to get up,” and “I leave it to staff to tell me when I can have a shower.” Carisbrooke Care Home DS0000026423.V362824.R01.S.doc Version 5.2 Page 14 Another said, “I get up when they feel like getting me up, and they take me to bed far too early for me.” Indicating the lack of choice residents have in their preferred lifestyle. Staff spoken with said they had been short of staff and this had made things difficult, but that they tried to get people up when they want, and not take them to bed too early. The staff working assisted residents with dignity, but there was little interaction between them unless carrying out a care task. Two members of staff were observed standing behind residents’ chairs for some time, but made no attempt to interact with the residents. There was a resident who did not speak English at the home and the service had taken the opportunity to employ a care worker who spoke the same language. This positive step would enhance this resident’s lifestyle, reducing isolation. The carer assisted this resident to the table and conversed in their mutual language, but there was no other contact between them, during this time. On speaking to the member of staff, she said that she had other people to care for, and had not been assigned this resident’s care regularly, but she tried to speak to her at some time every day. The care plan also did not identify any issues around language, or actions put into place to reduce isolation, due to language barriers, creating a negative outcome for this person’s mental well being. The resident’s relative was spoken with at some length. This relative spent a great deal of time at the home and carried out a number of care interventions for the resident, again communicating in the native tongue, which helped reduce isolation. The home has a part-time activities co-ordinator, but no activities were taking place during this visit, until one of the nurses put on a CD of “old time music” during the afternoon. Most residents were observed to be enjoying the music, but one resident said, “I would have preferred Elvis, or Bill Hayley.” Care plan records though did not identify any interests or recreational hobbies for this, or any other, resident. Another resident was pleased as they had the daily newspaper delivered and enjoyed doing the crosswords and was quite happy to be alone in their own private space. There were social activity plans within the care plan records, but these were not accurately kept, three had dated entries completed for three or four days in advance of today’s date. One activity plan stated, “refused to do puzzles,” Carisbrooke Care Home DS0000026423.V362824.R01.S.doc Version 5.2 Page 15 but on checking the care plan, there was no evidence whether or not this resident liked doing puzzles, or had any physical, or cognitive reasons why puzzles couldn’t be completed, reflecting the lack of assessment of individual diversity, leading to a negative outcome for this resident.” All residents spoken with said they were satisfied with the food and one, a vegetarian, was very happy with the menu provided. The lunchtime meal was served in a pleasant dining area and people were assisted in a dignified manner to eat. The food looked appetising and nourishing. Carisbrooke Care Home DS0000026423.V362824.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There is a complaints procedure that is easy to understand and is available to help anyone to express their views, concerns, or make a complaint, which will be dealt with. EVIDENCE: The service had a complaints procedure available within the service user guide, displayed in the main entrance area, and complaints were recorded, and included details of investigations and action taken. During the visit the manager dealt with a complaint from a relative. This was carried out in a supportive manner, and the relative, spoken with later, said the manager had dealt with the situation in a very satisfactory way. Staff, when asked, were aware of their role in safeguarding adults, and had received training in safeguarding adults, to support protection of residents from harm. Carisbrooke Care Home DS0000026423.V362824.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23, 24, 26, Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The environment is homely and comfortable. Hygiene practices have improved, however, some current practices still place residents at risk from cross infection. EVIDENCE: There was now a specific person working as cleaner, although the same person does work some care shifts as well, and the environment was satisfactorily maintained, generally clean and pleasant. Following an audit by the Infection Control Support Nurse in July 2007, recommendations for improvement set out in the audit had been undertaken. However, there was a problem with disposal of continence materials, which could have caused cross infection, as well as creating an odour within the Carisbrooke Care Home DS0000026423.V362824.R01.S.doc Version 5.2 Page 18 home itself. This was dealt with though, as soon as the manager was made aware of the situation, reducing the risks. Bathrooms and toilets were seen to be clean and have soap and alcohol gel in place to reduce cross infection risks. Bedrooms were clean and personalised, each with a lockable drawer for personal possessions. Residents said they were happy with their rooms and had their personal possessions around them. One resident, who preferred to stay in their own room, said, “I have everything I need in here and I am quite comfortable.” Carisbrooke Care Home DS0000026423.V362824.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. There are generally sufficient staff working to meet the physical needs of residents, and the service recognises the importance of training, although there are some gaps in the training programme. Recruitment procedures meet statutory requirements. EVIDENCE: One relative said, there was insufficient staff on duty at times, but generally the care was of a reasonable standard. During this visit there was 1 registered nurse and 3 carers working, and they were observed carrying out their role of caring in a quiet, dignified manner. Staff files examined contained all the recruitment information, particularly Criminal Records Bureau checks, application forms and two written, professional references, as well as proof of identity, to ensure their eligibility to work with vulnerable people. There were no records of any induction training having been undertaken. Carisbrooke Care Home DS0000026423.V362824.R01.S.doc Version 5.2 Page 20 The manager though, stated she carried out induction, verbally, for the carer who spoke very little English, as she spoke the same language. There were no records kept of this however. I spoke to the assessors who were working with two of the carers on their National Vocational Qualification, and they informed me that they were working with six candidates. Three were within days of completing their qualification, and three others within the next few weeks. Staff said they had training and Wednesdays were their days for National Vocational Qualification training, and the manager encouraged this. Staff also confirmed they had been trained in safeguarding adults and that other training had been offered. However, there was no evidence within the staff files to support this. Evidence was seen of training in a separate file, which showed current training certificates for carers. There was no evidence seen of any induction or training in dementia care, to help carers develop their skills in this area of their work to competently support residents with this problem. Carisbrooke Care Home DS0000026423.V362824.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37, 38, Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The acting manager has yet to apply to become the registered manager. The home is run in a way which creates a homely atmosphere, with health and safety protected by relevant servicing and testing of equipment carried out as recommended, but record keeping requires improvement to support residents’ rights and best interests. EVIDENCE: The acting manager has been in post since May 2007. She has achieved the National Vocational Qualification Level 4 in Care and also the Registered Managers Award, but has still not completed an application for Registration as manager, contrary to Regulation 9 of the Care Home Regulations 2002. Carisbrooke Care Home DS0000026423.V362824.R01.S.doc Version 5.2 Page 22 Evidence was seen of questionnaires completed by residents, to obtain their views about the service, but there was no evidence of any other form of quality auditing, for example, to show the service is developing to meet the diversity needs of residents. This has a negative impact on service users when their needs are not identified, or met. Residents’ financial records were checked and, receipted, signed transactions were accurately recorded. Staff said they had regular appraisal sessions and records of these were seen, although they were kept separate from the individual staff member’s personal file. They also said their training needs were discussed at these supervision sessions, and one said she had been offered training at the home, but had had the training in her other role at a local hospital. Staff and residents said the manager was very approachable, listened to them and tried to sort out any difficulties they may have swiftly. Evidence was seen in the Annual Quality Assurance Assessment report of the dates when servicing of equipment, including fire detection equipment, hoists, portable electrical equipment, lifts and emergency call equipment were carried out, and records seen within the home confirmed the accuracy of these dates. The Annual Quality Assurance Assessment report was received before this inspection visit, and contained some statistical information. However, the responses to information requested about each of the outcome areas, only described “plans for improvement in the next 12 months,” but failed to describe what the service does well, what be done better and what could be improved to support care needs of residents and maintain their well being. Residents and relatives spoken with said they felt the manager and staff worked hard to help them feel safe and secure and one resident said, “Since coming into this home I have felt much more secure, and staff are always kind and helpful.” Carisbrooke Care Home DS0000026423.V362824.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 3 x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x 3 3 x 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 3 3 2 2 Carisbrooke Care Home DS0000026423.V362824.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 OP7 Regulation 15(1) Requirement Timescale for action 27/06/08 2. OP7 15(2)c 3. OP30 18(1)c 4 OP31 9(1) Care plans must be developed to include the individual’s diversity, culture, personal preferences, leisure and recreational interests, to enable carers to provide person centred care for each resident which would improve their health and welfare. Residents, or their 27/06/08 representatives must be involved in the review of their care plans to make sure their care needs are met in a way they prefer and to help them feel valued as a person. All new care staff must undergo 27/06/08 training, including caring for people with dementia, first aid and induction training, which is recorded and signed to help develop the skills and competence necessary to support the care needs of the residents. The acting manager must submit 30/05/08 an application to become registered with the Commission, to ensure the manager is a fit and competent person to DS0000026423.V362824.R01.S.doc Version 5.2 Carisbrooke Care Home Page 25 5. OP33 24(1) manage the service. You must establish and maintain a system for reviewing and improving the quality of care provided at the home, including the quality of nursing, which also reflects outcomes for the residents to protect them and monitor, and improve the quality of care provided. 25/07/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Carisbrooke Care Home DS0000026423.V362824.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection 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. Extracts may not be used or reproduced without the express permission of CSCI Carisbrooke Care Home DS0000026423.V362824.R01.S.doc Version 5.2 Page 27 - 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!