Inspection on 14/06/07 for Caroline House

This inspection was carried out on 14th June 2007.

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

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

Other inspections for this house

Caroline House 02/05/06

Caroline House 20/09/05

Caroline House 19/04/05

Caroline House 07/09/04

Caroline House 04/05/04

Caroline House 30/12/03

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Caroline House 7-9 Ersham Road Hailsham East Sussex BN27 3LG Lead Inspector Nigel Thompson Key Unannounced Inspection 14th June 2007 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 Caroline House DS0000021067.V337275.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. Caroline House DS0000021067.V337275.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Caroline House Address 7-9 Ersham Road Hailsham East Sussex BN27 3LG 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) 01323 841073 Mr Thuraisamy Ravichandran Mrs Radha Ravichandran, Mr N Suganthakumaran, Mrs S Suganthakumaran Vacant Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Caroline House DS0000021067.V337275.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is twenty four (24). Service users must be older people aged sixty-five (65) years or over on admission. 2nd May 2006 Date of last inspection Brief Description of the Service: Caroline House is a large, detached three storey Victorian house situated in a quiet residential area of Hailsham, close to the town centre. It is registered to provide care and accommodation for 24 older people, not falling within any other category. Menus are varied, well balanced and nutritious. Meals are served either in the dining area or in the resident’s room. Service users’ rooms are equipped with a TV point, telephone and alarm call system. Rooms that do not have en-suite facilities are fitted with washbasins. There are two lounges and a dining area on the ground floor. A passenger lift provides access to all floors. At the rear of the house there is easy access to a large, landscaped garden, which is both safe and secure. There are ample car parking facilities at the front of the home. Information about the service, including the Statement of Purpose, Resident’s Handbook (Service User’s Guide) and CSCI reports is made available to prospective service users or their relatives, on request, as part of the admission process. The range of weekly fees, as of 2 May 2006, is £385 - £600. Additional charges, not included in the fees, include hairdressing, chiropody, toiletries and transport. Caroline House DS0000021067.V337275.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over five and a half hours in June 2007. It found that all of the National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was good. Service users spoken to during the inspection expressed satisfaction with the home, the staff and the service provided. The purpose of this inspection was to assess compliance with the requirements of the previous inspection and to generally monitor care practices at the home. On the day of the inspection there were nineteen service users living at the home. The inspection involved a tour of the premises, examination of the homes records, discussion with the acting manage, area manager and consultation with three members of staff and seven service users. The focus of the inspection was on the quality of life for people who live at the home. Responses from a CSCI service users’ survey, regarding their views on the home and quality of care provided, now form part of the inspection process and have also been included in this report. What the service does well: The relaxed, homely and welcoming environment has evolved over several years and reflects the new found stability and commitment within the staff team, the efficiency and enthusiasm of the acting manager and her open and inclusive management style. Through working closely, sensitively and consistently with service users, staff have developed a sound understanding of their individual care and support needs. Service users are encouraged and supported to make decisions about their lives. Where appropriate and practicable, they are involved and regularly consulted on many aspects of life in the home, including menu planning, colour schemes and activities. Caroline House DS0000021067.V337275.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Caroline House DS0000021067.V337275.R01.S.doc Version 5.2 Page 7 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. Caroline House DS0000021067.V337275.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 Caroline House DS0000021067.V337275.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, 2, 3, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The thorough admission policy and procedure ensures that service users are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Prospective service users have the opportunity to visit the home and know that it is able to meet their individual care and support needs. EVIDENCE: Information for prospective service users including the Statement of Purpose and the Service User Guide (Residents’ Handbook) has been thoughtfully and imaginatively produced to a high standard and both documents were found to be comprehensive and informative. Caroline House DS0000021067.V337275.R01.S.doc Version 5.2 Page 10 Since the previous inspection, as required, details contained in these documents have been reviewed and updated, so as to accurately reflect the services provided and the current situation within the home. Documentation, including comprehensive assessments relating to two most recent admissions to the home was inspected and found to be generally up to date and well maintained. However in other files examined it was noted that assessment sheets had still not been fully completed and important information, including details of medication and family involvement were not recorded. As part of the admission procedure, the acting manager confirmed that prospective service users are invited to visit the home, to look around and meet with staff and existing residents. They also have the opportunity to stay overnight before moving in. A formal written contract has been developed and implemented and is routinely provided to each new service user or their representative. This contract incorporates a statement of terms and conditions of residency detailing the placement arrangements and clarifying mutual expectations around rights and responsibilities. Service users, spoken with during the inspection, spoke positively about their experiences of moving into the home: ‘I like it here. I couldn’t wish for a better place’. ‘The staff here are so kind and helpful, they can’t do enough for you’. Caroline House DS0000021067.V337275.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 good. This judgement has been made using available evidence including a visit to this service. Comprehensive care plans enable staff to meet the assessed needs of service users in a structured and consistent manner. Service users are protected by the home’s medication policies and procedures. They are treated with respect and encouraged to make decisions about their day-to-day living. EVIDENCE: Personal care plans are in place for each service user and continue to be clearly and directly linked to the individual’s assessed needs. Service users’ plans that were inspected were found to be accurate, generally well maintained, and up to date. Caroline House DS0000021067.V337275.R01.S.doc Version 5.2 Page 12 However, there is still little evidence of service users or their relatives being routinely involved or having the opportunity to be involved, as required, in developing or reviewing individual care plans. From discussion with the acting manager and care staff, it is evident that only senior carers are involved in writing up daily progress notes, ‘comment sheets’ and direct access to service users’ individual plans is currently restricted. It is therefore recommended that service users’ care plans be held in the office and all care staff (key workers) be more aware of the contents of the plans and be directly involved in updating daily records. To improve communication during handover, ensure that staff are aware of all current issues and to reduce the potential for information being missed, it is also recommended that individual ‘comment sheets’ should be contained in a single ‘communication’ folder. All service users are registered with local GPs and have access to other health care professionals, including District Nurses and physiotherapists, as required, via the surgeries. It was noted, in care plans that were examined, that all appointments with, or visits by, health care professionals are recorded. Satisfactory policies and procedures are in place for the control, storage, safe administering and recording of medication. The acting manager confirmed that all staff involved in administering medicines receive appropriate training. This was supported by documentary evidence and through discussions with care staff. The home operates a reasonably effective key-worker system. However it is noted that the current system is to be reviewed, in the near future, regarding individual roles and responsibilities. The acting manager confirmed that, as part of their induction programme, all staff receive instruction on the principles of dignity and respect. This was evident, through discussion during the inspection, and from direct observation of staff interacting sensitively and professionally with service users. Caroline House DS0000021067.V337275.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 good. This judgement has been made using available evidence including a visit to this service. Service users are enabled and supported to maintain contact with family and friends as they wish. They benefit from appropriate recreational and leisure activities and menus that are balanced and nutritious, reflecting their individual likes and preferences. EVIDENCE: Service users’ social and recreational interests and preferences are now recorded, as part of the pre admission assessment process and, since the previous inspection, there is evidence of some improvement regarding organised activities. An activities coordinator continues to work in the home three days a week and it was evident that a full monthly programme of recreational and leisure Caroline House DS0000021067.V337275.R01.S.doc Version 5.2 Page 14 activities has been developed. A copy of the programme for June was in place in the office. To ensure that activities reflect the interests and preferences of service users and meet their individual and collective needs, it was noted that the coordinator now partakes in service users’ meetings. Independence continues to be promoted and encouraged within the home and the acting manager confirmed that, wherever possible, service users are enabled and supported to make choices and take decisions affecting their life and daily routine Visiting in the home is evidently unrestricted and service users may see friends or relatives in one of the lounges or in the privacy of their own room. Service users continue to be provided with a varied, wholesome and nutritious diet. At lunchtime a choice of meals is available and special diets are catered for. A weekly menu is displayed in the main dining room, reflecting service users’ preferences and including seasonal variations. Caroline House DS0000021067.V337275.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The open and inclusive atmosphere within the home enables service users, staff and visitors to express any concerns, confident that they will be listened to and acted upon. Service users are safeguarded from abuse through relevant staff training and robust policies and procedures. EVIDENCE: Since the previous inspection, as required, an updated, clear and accessible complaints procedure has been developed and is now in place in the entrance hall, for the benefit of service users’ friends, relatives and other visitors to the home. The acting manager continues to operate an ‘open door’ policy and is clearly considered to be very approachable and understanding. Service users and members of staff spoken to during the inspection confirmed that, should they have a concern or complaint, they would have no hesitation in speaking to the manager and each person was confident that they would be listened to. Caroline House DS0000021067.V337275.R01.S.doc Version 5.2 Page 16 Since the previous inspection there has been one complaint received by the home. Documentary evidence examined indicated that the matter was dealt with efficiently and professionally, to the satisfaction of the complainant. The home has produced detailed policies and procedures relating to adult protection and abuse, including a whistle blowing policy. In line with other policies in the home it is recommended that such policies be reviewed and updated. The manager confirmed that in April 2006 all staff received specific adult protection training, in accordance with the multi agency guidelines for the protection of vulnerable adults. Further relevant training has been organised for this coming August. This was supported through discussions with members of staff during the inspection and evidenced through individual training records. Caroline House DS0000021067.V337275.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, 20, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from accommodation that is safe, comfortable, well maintained and decorated to a satisfactory standard. EVIDENCE: As with many of the environmental standards, the situation at Caroline House regarding communal areas and service users’ accommodation remains largely unchanged, however a walk-in ground floor shower room is currently being developed and two service users’ rooms have recently been redecorated and refurbished. Caroline House DS0000021067.V337275.R01.S.doc Version 5.2 Page 18 During my ‘guided tour’ of the premises, including service user accommodation and communal areas, it was evident that the well maintained décor and adequate furniture and furnishings continue to provide a comfortable, pleasant and homely environment for service users. Service users rooms were found to be clean, comfortable and generally well maintained. It was evident that many of the rooms have been personalised, with pictures, family photographs and other small items of furniture and personal belongings, to reflect individual taste, choice and preference. It was noted and discussed with the managers that both bathrooms on the first floor are currently looking ‘tired’ and neglected and are clearly in need of redecoration and refurbishment. The area manager confirmed that this work, including new floor covering in both rooms and replacement carpet outside on the landing outside room 18, is scheduled for later this year. It was noted that, to ensure the safety of service users, following risk assessments the majority of radiators throughout the home have now been fitted with covers. At the rear of the home, leading out from the ‘quiet lounge, is a large, pleasant and easily accessible garden, where service users are able to sit and relax in the fresh air. One service user proudly showed me the flowers, cuttings and pot plants cultivated and brought inside from the garden. ‘I love being outside and am out there most days, without fail’. On the day of the inspection, it was evident that infection control procedures within the home are in place and are closely adhered to. Levels of cleanliness and hygiene remain generally high throughout. Caroline House DS0000021067.V337275.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 good. This judgement has been made using available evidence including a visit to this service. There is sufficient trained and competent staff on duty at all times to meet the assessed needs of the service users. Robust recruitment procedures and appropriate staff training ensure the safety and protection of service users. EVIDENCE: Appropriate staffing levels are evidently in place, with a minimum of three care staff, including one senior carer, being on duty at all times during the day. At night there are two staff on duty - one waking night and a sleep-in person. An improved staff rota has been developed, showing details of which staff are on duty at any time and their designation. In addition to the comprehensive induction programme undertaken by all newly appointed staff, the acting manager confirmed that appropriate core skills training is provided, including first aid, moving and handling, food hygiene and fire safety. Caroline House DS0000021067.V337275.R01.S.doc Version 5.2 Page 20 This was confirmed through discussions with staff and supported by training records examined: ‘There is always plenty of opportunity for training here’. As previously documented, it is evident, from discussions with members of staff that the manager operates an ‘open door’ policy, with staff feeling confident and able to discuss any issues at anytime. The acting manager is clearly aware of the need for thorough and robust recruitment procedures, to ensure the protection of service users. She confirmed that procedures have recently been reviewed and improved and staff files that were examined were found to be generally well maintained, containing necessary information, including proof of identity and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. Caroline House DS0000021067.V337275.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, 32, 33, 35, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from effective management and thorough quality assurance systems. Satisfactory health and safety policies and procedures, within the home, help to ensure the protection of service users and staff. EVIDENCE: The experienced acting manager has been in her current post at Caroline House since October 2006. An application for her to be registered with the CSCI is currently being processed. She is evidently competent and qualified to run the home, having completed both the Registered Manager’s Award (RMA) and NVQ level 4 in Management and Care. Caroline House DS0000021067.V337275.R01.S.doc Version 5.2 Page 22 The acting manager is clearly motivated, positive and approachable and has successfully developed an open and inclusive atmosphere within the home. From direct observation and through discussions with service users and members of staff, it is evident that she demonstrates a clear sense of leadership and direction: ‘She is a brilliant manager and the improvements here are mainly down to her’. Effective quality monitoring and consultation with service users, including residents’ meetings, is ongoing. Feedback from service users, regarding the care they receive, is sought by the use of satisfaction questionnaires. Since the previous inspection, the format of the questionnaires has been amended and improved. Following discussion with the acting manager, it is recommended that the satisfaction survey be extended to obtain feedback from service users’ relatives and possibly other visitors to the home. In addition to their regular weekly visits to Caroline House, it is evident that since the previous inspection, as required, the proprietors now visit the home at least once a month, unannounced, inspect the premises, speak with service users and staff and prepare a written report on the conduct of the home. A copy of this report is to kept in the home and made available for inspection by the CSCI. However on the day of the inspection, no such reports were made available. Of some concern is the fact that, despite previous requirements, formal staff supervision is still not currently being provided. However it is evident that the new acting manager fully understands the concept and potential benefits of formal supervision. In her previous position she had responsibility for providing staff supervision and, following consultation with staff, she is keen to introduce it at Caroline House. It was noted during a tour of the premises that fire extinguishers have been serviced recently and fire safety systems are now regularly checked and outcomes recorded. Since the last inspection, as required for fire safety, doors into service users’ rooms and throughout the premises have now been fitted with automatic closers. The manager confirmed that the health, safety and welfare of service users and staff remains of paramount importance within the home. Staff training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. All staff training is recorded. Caroline House DS0000021067.V337275.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 3 2 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 2 X 3 Caroline House DS0000021067.V337275.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 (1) Requirement It is required that each individual care plan, generated from a comprehensive assessment, be drawn up with the involvement of the service user, or relative where appropriate, and provides the basis for the care to be delivered. (Previous timescale of 30.09.2005, 30.06.2006 & 31.12.06 not met). It is required that that the service users’ care plans, including risk assessments, be regularly reviewed with the involvement of the service user, or relative where appropriate, and updated to reflect changing needs. (Previous timescales of 30.06.2005, 30.09.2005, 30.06.2006 & 31.12.2006 not met). It is required that all care staff receive formal, recorded supervision at least six times a year. (Previous timescales of 30.06.2005, 31.10.2005, 31.07.2006 & 31.12.2006 not met). Timescale for action 31/08/07 2. OP7 15 (2) 31/08/07 3. OP36 18 (2) 31/08/07 Caroline House DS0000021067.V337275.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP3 OP7 Good Practice Recommendations It is recommended that all parts of the pre admission assessment be completed in full. It is recommended that service users’ care plans be held in the office and all care staff (key workers) be more aware of the contents of the plans and be directly involved in updating daily records. It is recommended that individual ‘comment sheets’ be contained in a single ‘communication’ folder, to improve communication including staff handovers. 3. OP7 Caroline House DS0000021067.V337275.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Caroline House DS0000021067.V337275.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. 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