Inspection on 18/12/06 for Cedar Court Nursing Home (Dementia Unit)

This inspection was carried out on 18th December 2006.

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

The inspector 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

Cedar Court Nursing Home... 29/11/07

Cedar Court Nursing Home... 22/11/05

Cedar Court Nursing Home... 07/07/05

Cedar Court Nursing Home... 09/03/05

Cedar Court Nursing Home... 16/06/04

Cedar Court Nursing Home... 22/12/03

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

CARE HOMES FOR OLDER PEOPLE Cedar Court Nursing Home (Demenita Unit) Cedar Court Nursing Home Bretby Park Bretby Derbyshire DE15 0QX Lead Inspector Angela Kennedy Key Unannounced Inspection 18 December 2006 09:00 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 Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 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. Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Cedar Court Nursing Home (Demenita Unit) Address Cedar Court Nursing Home Bretby Park Bretby Derbyshire DE15 0QX 01283 211412 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) 01283 552220 Your Health Ltd Mrs Joy Theaker Care Home 50 Category(ies) of Dementia (50) registration, with number of places Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Option of admitting up to 10 persons aged 50 years and over within the total number registered 21st November 2005 Date of last inspection Brief Description of the Service: Cedar Court Care Home has two units. The larger unit provides nursing and personal care for up to fifty persons aged 65 years and over with dementia, including up to ten places for persons aged 50 years and over. Cedar Court is situated in a rural location near to the village of Bretby, South Derbyshire. Your Health Limited owns the home. Cedar Court is a two-storey building, adapted for use as a care home. The unit has 34 single and 8 double bedrooms. 30 bedrooms have en-suite facilities. Access to the first floor is by a stairs and a passenger lift. The unit has three lounges and dining areas on the ground floor and the first floor, and has a large enclosed garden area that is accessible to the residents. Although the ground floor is for both male and female residents, there is a specific area on the first floor for male residents. The fees for residency at Cedar Court are as per social service rates. Further information regarding the fees can be obtained by contacting the registered manager at Cedar Court. Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced key inspection, which means that the service was assessed against all of the key national minimum standards. The inspection took place over a five-hour period although other information regarding the service was obtained prior to the inspection, such as information regarding the meals provided, the number of complaints received by the service in the last twelve months, maintenance records, policies and procedures in place, the activities provided to residents and training undertaken by staff. During the inspection several documents relating to the above areas was assessed. Medication practices were looked at and the practice in place for resident’s finances was also looked at. Five residents personal files were read, looking at the care plans, risk assessment and other relevant documents that related to the care and support provided to them. Three of these residents were able to express their views of the service provided, although the information they provided was somewhat limited due to their health care needs. However residents were observed throughout the inspection, undertaking their daily activities and routines, which allowed an opinion to be formed of their general well being. Some relatives were available to speak with and expressed their views on the quality of the care and support provided to the residents. Two staff files were seen, looking at the recruitment practices in place and the training provided. These two members of staff were spoken with to gather their opinion on the support and training provided. The registered manager was available at the beginning and end of the inspection to provide any required documents and information. The inspector was assisted by a member of the nursing team in providing any additional information and gave a tour of the building, where some of the bathrooms, private accommodation and communal areas were seen. What the service does well: Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 Page 6 Assessments were undertaken before admission to ensure the needs of each individual could be met by the service, the information in place clearly informed the staff team of the care and support required to meet the needs of the residents. A range of activities was provided that met the needs of individuals. Staff interactions with residents appeared to be relaxed and friendly and both residents and relatives spoke highly of the care and support provided by the staff team. A good variety of meals was available with alternative choices offered at each mealtime. Cooked breakfasts were available each day and vegetarian options provided. Good staffing levels ensured that the needs of the residents were met and staff interaction with the residents demonstrated this. 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. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using the available evidence, including a visit to the service. Assessments were undertaken prior to admission to ensure the needs of each individual could be met by the service. EVIDENCE: Five residents care files were seen and all included a detailed needs assessment that had been undertaken prior to admission to Cedar Court. This information included each residents personal information, including next of kin and the professionals involved in their care, past medical history, their current prescribed medication, all healthcare needs, communication methods, personal care needs, mobility, hobbies and recreational interests and needs, and their personal safety needs. This demonstrates that the needs of each resident were thoroughly assessed prior to admission; to ensure that the care and support provided at Cedar Court was suitable to meet each individual’s assessed needs. Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using the available evidence, including a visit to the service. Resident’s health, personal and social care needs were set out within their plan of care and health care needs were met as required. The medication practices in place ensured that resident’s welfare was maintained. Staff practice ensures that residents were treated respectfully and their dignity maintained. EVIDENCE: Of the five residents care files seen all had care plans and risk assessments in place that clearly informed the staff team of the care and support required to met the needs of each individual. The care plans in place identified healthcare, personal, social, cultural and religious care needs. These care plans had been developed from the needs assessment undertaken. All of the care plans seen had been reviewed monthly or sooner if needs changed. Risk assessments had been developed for each individual that clearly identified any areas of risk, such as falls assessments, pressure area risk assessments, moving and handling assessments, nutritional Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 Page 10 assessments including weight monitoring, continence assessments and assessments that were specific to individuals health care needs. Copies of care reviews from the local authority were also in place within the residents files seen. Evidence was in place within the five residents care files seen to demonstrate that healthcare professionals were consulted and involved in residents care, this included, consultant psychiatrists, general practitioners, district nurses and tissue viability nurses. Records of general health checks were in place within the residents files seen; these were undertaken every three months and included resident’s weight, blood pressure, temperature, pulse and respirations. Consent forms for the flu vaccine were in place within residents files seen these had been signed by relatives. The medication practices were looked at and found to be satisfactory. Medication administration records had been completed accurately and the medication was stored securely and in line with pharmacy guidelines. Controlled medication was correctly stored and the records of stock and administration were accurately recorded. All medication received and returned was recorded. Staff were observed in their interactions with residents and this appeared to be relaxed and friendly. Staff addressed residents by their preferred name and residents appeared comfortable and relaxed when interacting with staff. Residents had access to the cordless telephone that was carried by the staff team, this could be used to receive or make telephone calls for residents who were able. Three of the residents whose files were seen were able to express their views of the service provided, although the information provided by two of these residents was somewhat limited due to their health care needs. However both residents said that the staff team were very nice. The third resident spoken with stated that the staff were very kind and he said that he was very happy with the care and support provided by the staff and confirmed that the staff treated him with respect. Relatives spoken with were very complimentary regarding the support and care provided by the staff team. One relative said that her mother always seemed content and always appeared clean and nicely dressed and stated that the staff seemed very caring towards all of the residents. This relative stated that she had no concerns regarding the care and support given to her mother. Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The activity programme in place ensured that resident’s social, recreational and religious needs were met and the staff team ensured that contact with family and friends was promoted and maintained. Staff practice encouraged residents to exercise choice and control over their lives. Dietary needs of residents were well catered for with a choice and variety of meals available that met residents’ tastes and choices. EVIDENCE: The activities co-ordinator was spoken with regarding the different activities that were provided to the residents, and she demonstrated a good understanding of the needs of people with dementia. She confirmed that she tried to plan activities that were suitable for the individual or specific groups as due to the residents health care needs a more specific activity that related to individuals earlier lifestyle and social or employment history was more likely to engage and interest them. An example of this was that several of the male residents enjoyed sanding down wood, as within their earlier years this was a hobby, task or profession that they had undertaken. Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 Page 12 It was stated by the activities co-ordinator that the majority of residents enjoyed singing and dancing and this was a popular activity within Cedar Court as residents were always able to remember the words to songs and participate fully. The activities co-ordinator stated that activities such as arts and crafts were offered to residents such as sewing or knitting, making Christmas cards for family and friends. A greenhouse was also available through the summer months and residents had assisted the activities co-ordinator in growing tomatoes and flowers. Outside entertainment was provided at the home on a monthly basis and residents were able to visit the local town on a one to one basis with staff. The activities co-ordinator confirmed that taxis were used on these occasions. Two of the residents were celebrating their 65th wedding anniversary on the week of the inspection and the registered manager was busy preparing for the party that was due to take place. Reporters from two local newspapers were visiting Cedar Court on the day of inspection to take photographs of the married couple. Cedar Court employs a hairstylist therefore there were no additional charges for any residents who wished to use this service. Holy Communion was provided by the local priest at Cedar Court on a weekly basis for any residents who wished to participate and every three months the local vicar held a service within Cedar Court for residents who wish to attend. On the day of inspection many residents had visitors and the atmosphere within Cedar Court was noted to be relaxed and friendly. Visiting at Cedar Court was open and relatives spoken with stated that they were always made to feel welcome by staff when they visited and were always offered a drink by the staff. None of the residents were able to manage their own finances and these were managed by either relatives or Cedar Court. Residents were able to personalise their own private accommodation with their personal possessions and records were maintained of resident’s personal possessions. The menus were seen and demonstrated that a good variety of meals were available with alternative choices offered at each mealtime. Cooked breakfasts were available each day and vegetarian options provided. Special diets were catered for although it was stated that none of the residents required special diets to meet any cultural requirements at the time of inspection. Residents that were spoken with all confirmed that the meals were very good, and several visitors also commented on the good quality and choices available at mealtimes. Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Relatives felt confident that complaints would be listened to and acted upon and the practices in place protected residents from abuse. EVIDENCE: The healthcare needs of the residents made it difficult to discuss with them their understanding of the complaints procedure at Cedar Court. However relatives spoken to stated that they were confident that if they had any concerns the registered manager would address them. One complaint had been received by Cedar Court in the last twelve months this had been addressed within the 28 day timescale and the outcome of this complaint had been recorded. No safeguarding adult referrals or investigations had been undertaken at Cedar Court. A requirement from the last inspection was that staff must attend training on Safe guarding Adults. A corporate training manager is now available who ensures that staff training is maintained and kept up to date and this included training in safeguarding adults. Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents live in a safe, comfortable environment with ongoing maintenance provided. EVIDENCE: A tour of the unit was undertaken. At the time of inspection redecoration was taking place of all corridors. Some of the resident’s private accommodation was seen and these rooms had been personalised to reflect each resident’s preference and individuality. Some of the bathrooms and toilet areas were seen and provided sufficient space and moving and handling equipment to allow staff to support residents in personal care needs. Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 Page 15 The communal areas were seen and provided a safe and comfortable area for residents. The laundry area was looked at, and provided sufficient equipment to ensure disinfection standards were maintained. Laundry staff were employed to manage the laundering of residents clothing and it was confirmed that a member of the laundry team was available within Cedar Court every day, including weekends. On the day of inspection it was noted that residents clothing appeared well laundered. One relative said that her mother always appeared to be well groomed and nicely dressed. Comments seen on questionnaires from relatives that were completed in November this year included “ clothes are always clean and ironed well”. Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents needs were met by the numbers and skill mix of staff on duty who had the appropriate qualifications and training required to support and care for the residents. The homes recruitment procedures require further development to ensure the resident’s welfare is safeguarded. EVIDENCE: The duty rotas were looked at and demonstrated that nine staff were on shift throughout the day, one of these being a registered nurse and three staff were on duty throughout the night again one being a registered nurse. Visitors spoken with felt that the numbers of staff on duty were sufficient to meet the needs of the residents. Sufficient staff were seen interacting and supporting residents on the day of inspection. Nine care staff had achieved a National Vocational Qualification at level 2 in care, this equates to 50 of the care staff team. Two staff files were looked and both contained satisfactory criminal records bureau checks, medical health questionnaires and two forms of proof of Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 Page 17 identity including photo identity. One member of staff had two references in place and the other only had one reference in place. There was evidence to demonstrate that efforts had been made to obtain a second reference although this had not been achieved. This was discussed with the administrator and registered manager and it was agreed that this member of staff would be asked to provide a second referee in order for a reference to be obtained. Both staff had employment application forms in place. However neither of these had requested a full employment history. The registered manager stated that new application forms now requested a full employment history and a written explanation for any gaps in employment. It was noted that one application form did not provide dates of previous employment stated or reasons for leaving employment, and as one previous post included working with vulnerable adults this should have been explored. This was discussed with the registered manager. The training undertaken during the last twelve months by these two members of staff was also looked at and included; control of infection and contamination, manual handling of people, safeguarding adults, basic food hygiene, nutrition and fire training. A training manager was employed who was responsible for ensuring staff training was kept up to date. These two members of staff were spoken and both confirmed that the training opportunities provided were very good. Both members of staff demonstrated a good understanding of the needs of the residents and stated that the staff at Cedar Court worked well together as a team. Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Residents lived in a home that was well managed and run in their best interests. Residents financial interests were safeguarded and the health, safety and welfare of residents and staff was promoted and protected. EVIDENCE: The registered manager had been in post at Cedar Court for the last three and a half years, and had 11 years experience in a management position. The registered manager held a first level nursing qualification in mental health and had achieved the Registered Managers Award. Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 Page 19 Both staff and relatives were very complimentary regarding the manager’s ability to manage the service and one member of staff stated, “ she’s the best manager I’ve ever had, she’s always there when you need her and will always try and help out with any problems you have.” The quality assurance systems were looked at it was confirmed that the company send out questionnaires to relatives and any residents that are able to answer them. Questionnaires had been sent out to relatives in October and November 06. The feed back received was very positive and included comments such as “I always find staff very attentive and caring” and “ I have not met one member of staff that wasn’t caring towards residents. I think they do an outstanding job”. Resident’s finances were securely stored and records were maintained. The monies held for five residents was counted and corresponded with the records kept. It was noted that not all financial transactions had two signatures in place, this was discussed with the administrator and registered manager and recommended that this been done as a good practice measure. Discussions also took place regarding the amounts of monies in place for some residents. The administrator agreed to look into this matter. Some of the safe working practices at Cedar Court were assessed and found to be satisfactory, and included: Monthly safety audits and monthly maintenance checks which were carried out by the qualified health and safety person. Fire alarms, which were checked each week and staff fire training which was kept up to date. Hoist and adaptations were serviced in September 2006. Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 Page 21 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 OP29 Regulation 19 4 (b) Schedule 2 Requirement Employment application forms must provide dates of all previous employment and state the reasons for leaving employment, especially when that work involves working with vulnerable adults. Two satisfactory written references must be obtained for all staff employed. Timescale for action 01/03/07 1 OP29 19 4 (b) Schedule 2 01/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP35 Good Practice Recommendations Two signatures should be obtained on resident’s financial transactions records. Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cedar Court Nursing Home (Demenita Unit) DS0000002160.V293227.R01.S.doc Version 5.1 Page 23 - 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!