Inspection on 27/02/06 for Chatsworth House

This inspection was carried out on 27th February 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

Chatsworth House 17/12/09

Chatsworth House 28/01/09

Chatsworth House 25/01/08

Chatsworth House 14/03/07

Chatsworth House 09/06/06

Chatsworth House 13/07/05

Chatsworth House 22/11/04

Chatsworth House 30/07/04

Chatsworth House 31/01/04

Similar services:

Fairfields Country Rest Home

Fairfax House

Claremont Nursing Home

Doveridge Care Home

Dunmore

Chatsworth

Dunraven Lodge

Eastleigh Care Homes, South Molton

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

CARE HOMES FOR OLDER PEOPLE Chatsworth House 9 Belvedere Road Redland Bristol BS6 7JG Lead Inspector Sandra Gibson Unannounced Inspection 11:00 27 February 2006 th 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 Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 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. Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Chatsworth House Address 9 Belvedere Road Redland Bristol BS6 7JG 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) 0117 9743253 0117 9743258 Mr T A Seehootoorah B&C Care Limited Helen Jane Fuller Care Home 15 Category(ies) of Dementia - over 65 years of age (15) registration, with number of places Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th July 2005 Brief Description of the Service: Chatsworth House is a privately owned Care home that is registered by The Commission for Social Care Inspection to provide accommodation and personal care for up to 15 people aged 65 years and over who have dementia. It is situated in a residential area close to Durdham Downs in Westbury Park and is located close to major bus routes. The home is a converted older property providing single room accommodation on three floors, which can be accessed via stairs or a passenger lift. There is one shared room. Five bedrooms have ensuite facilities. The home is situated in its own grounds with a courtyard to the rear. Visitors are welcome at any time and refreshments are readily available. Inhouse activities and entertainments are also provided. There is currently an application with The Commission for Social Care Inspection to extend Chatsworth House and increase the number of residents to be accomodated by six. Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on a Monday Wednesday between the hours of 11:am and 5.15pm. Evidence was gathered from: Talking to and observing residents, talking to a visitor, talking to a relative, talking to the manager and deputy manager, talking to and observing staff, observing communal lunch and evening meal, looking at the premises, examining records and policies and procedures. What the service does well: What has improved since the last inspection? Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 Page 6 Information provided to prospective residents and their representatives has improved considerably since the last inspection. Residents can now make an informed choice about whether they wish to move to Chatsworth House. Please see below 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. Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 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 Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 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): 1,3,4 Information provided to prospective residents and their representatives has improved considerably since the last inspection. Residents can now make an informed choice about whether they wish to move to Chatsworth House. People moving to Chatsworth House can be sure that their individual needs can be adequately met. EVIDENCE: The statement of purpose was examined and it was noted that it had been revised in July 2005 following the last inspection and recent variation of age range of the registration. Chatsworth House is currently registered to provide accommodation to residents who are sixty-five years and over who have dementia. This document was observed to be of a good standard. The service user’s guide in place was also revised in July 2005. The manager has used plain English and photographs of residents and staff to make it more accessible to residents and their relatives. This is good practice Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 Page 9 The inspector observed a sample of needs assessments completed prior to residents admission. It was noted that these had been completed by Social Services and Health or by the manager in the case of privately funded residents. All assessments were found to be of a good standard. The manager discussed the possibility of admitting one new resident who was aged 59 years, but in her opinion she felt that Chatsworth House could meet this resident’s specialist needs. The inspector saw the needs assessment / care plan in place that had been drawn up by Social Services and Health. During the course of the inspection the manager demonstrated how Chatsworth House could meet this younger persons needs. The manager informed the inspector that an application to vary the age range of the registration would be applied for before the prospective new resident was admitted and the amendments to the statement of purpose would be made accordingly. Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Care plans and individual risk assessments are of a good standard ensuring that residents’ needs are fully identified and met. The health care needs of residents are well met with evidence of good multidisciplinary working taking place on a regular basis. There have been improvements in the medication administration system since the last inspection . However further improvements are required to ensure safeguards are in place to protect residents and staff. EVIDENCE: A sample of care plans and risk assessments were seen and it was observed that they were very clear and well detailed. There was evidence in place to confirm that they were reviewed on a regular basis by the manager in consultation with the resident and their representative where possible. Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 Page 11 The manager explained that during the last few months she had now delegated some of this responsibility to the residents’ named workers including attending review meetings and up dating care plans on a weekly basis. The manager monitors this process very closely. The inspector noted through out the inspection how staff members treat the residents with dignity and respect. One regular visitor to the home confirmed this information. He said, “ Staff are very respectful, caring and loving in this home. They get up and dance with residents. I love coming to Chatsworth House because staff get very involved. I have never seen anything I was concerned about” There was evidence in place to confirm that General practitioners, Psychiatrists, Community Psychiatric nurses, District nurse, dentists and chiropodists are contacted at the appropriate time. Equipment was observed to be in place to prevent pressure sores in residents who were at risk. The manager informed the inspector that following the last inspection she has transferred the medication administration system to a new pharmacist. This change took place in February 2006. During the course of the inspection the manager explained that there had been a few initial problems following the change in service and requested advise from the CSCI Pharmacist. Arrangements were made for the CSCI pharmacist to conduct an inspection at the home on the 14th March 2006. The medication administration records were not examined during this inspection. It was noted that medication training is provided to all staff during the induction. The previous pharmacist with the support of the manager and deputy manager had provided this training. However, this situation must now be reviewed since the home does not currently have this arrangement with the new pharmacist. Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 The residents of Chatsworth House are given the opportunity to experience a stimulating and varied life where various informal activities and outings have been regularly made available. Visitors are made very welcome and meals are well managed and provide daily variation, good nutrition and social contact for people. EVIDENCE: There is an activities Coordinator in post who works Monday to Friday during the hours of 8.30am and 3.30pm. There was evidence in place to confirm that a variety of activities take place throughout the week with individual residents or groups of residents. On the day of the inspection several residents were helping the activities coordinator to make a frieze / collage for the home. The inspector heard how mush residents enjoyed this experience. Other residents and a visiting relative had been listening to an entertainer that morning who had been playing 40’s and 50’s music on a keyboard. The volunteer said staff and relatives get very involved with the activity and there is always a member of staff on hand if somebody needs support with personal care. One member of staff commented “one new resident who is usually very quiet had enjoyed dancing with his wife. It was lovely to see them together”. Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 Page 13 Two residents said they had enjoyed the music that morning. Written evidence confirmed that regular outings take place. It was noted in the residents meeting minutes that a trip to Horse World was planned to take place in the next few weeks. All residents observed during the inspection looked relaxed with the staff providing their care who were observed to respond to the residents in a respectful unhurried manner. The inspector noted that relatives’ social evenings continue to be held every three months to which all relatives carers and friends are invited. During the course of the inspection the inspector saw lunch and supper being served in the communal dining room. Both meals looked wholesome and nutritious and it was noted that there was a choice on both occasions. Residents were observed enjoying each meal. Information about the daily menu is made available on a board close to the dining room One relative commented, “my mother likes the food here. She never complains she is hungry and she has put on weight since she was admitted to Chatsworth House.” Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Residents and their relatives are confident that their concerns will be listened too and have been made aware of the complaints procedure. Arrangements for protecting residents from harm has improved considerably since the last inspection. However, further attention is required to ensure that there are robust systems in place to protect residents from possible risk or harm. EVIDENCE: Residents, and staff told the inspector that they were comfortable talking to the manager or one of the management team about any concerns. Residents were seen actively seeking out the members of the management team on duty that day with any concerns they had. No complaints have been received either by the manager, or The Commission for Social Care Inspection since the last inspection. One resident said, “I know the staff. I like them very much particularly the manager and deputy. I would go to them if I had a problem”. Another resident said, “I have no grumbles here.” Her relative said. “Staff are very caring. She has everything she needs. If there were a problem I would speak to the manager”. This relative confirmed that she had been given the complaints procedure when her mother was admitted to the home. Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 Page 15 No Secrets in Bristol (Local authority Adult Protection procedure) is in place in the home. Following the last inspection in July 2005 the manager and deputy manager attended training provided by Social Services and health on adult protection specifically for managers on 26th January 2006. It was also noted that all staff who work at Chatsworth House have now been enrolled on adult protection training with Social Services and Health starting at the end of February 2006. Recruitment checks were examined as can be seen in the section on staffing. It was noted that further Criminal Records Bureau / Protection of vulnerable adults checks must be made on overseas staff that are appointed before they commence working in the home. Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 There has been deterioration in the comfort and cleanliness of Chatsworth House since the last inspection. Urgent attention is required to ensure that residents live in homely comfortable, clean environment. EVIDENCE: The communal areas were inspected on the ground floor and were observed to be generally clean and smelt fresh. However it was noted that the carpet in the lounge and main hallway was very badly stained and the decoration to this area was in a very poor state. It was also noted that the partition in the lounge has made the room appear very cramped for the number of residents who access this area. Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 Page 17 A member of staff stated that these issues had been raised in the last residents’ meeting and that residents were starting to say, “the home looked grubby”. The inspector was informed by one of the management team that there were plans to remove the partition in the lounge, replace the carpet in the hallway and lounge and redecorate the area once the new extension and building work has been completed. The inspector was informed that there was still no dedicated domestic assistant in post. However she reported that night staff were now carrying out some of the cleaning tasks when residents are asleep at night. It was noted that the activities coordinator is still carrying out cleaning tasks in the afternoon (five days a week) when residents are resting or watching TV. The manager said that this situation is monitored closely and that it will be reviewed when the home’s extension is completed. The manager confirmed that a dedicated cleaner would be appointed at this point Planning permission to build the extension has been completed but there is no start date for the work to commence nor is there a planned programme of refurbishment / redecoration in place for the communal area on the ground floor of the main building. It was noted that if the registration of the extension is agreed by CSCI that although the numbers of resident who can be accommodated in the home will increase by five or six. The extension will allow more communal space for residents to access, which will be a major improvement in this care home. One resident consulted confirmed the issues raised in the last residents meeting on the 21st February 2006 when 11 residents were present. She said, “The carpets are a bit dingy especially in the hallway where people come in. The whole area including this room (lounge) is also a bit dingy. They need brightening up. Pictures could make it brighter, but look at this wallpaper it is coming off the wall”. Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 Staffing levels have remained the same since the last inspection. They continue to be monitored very closely to ensure that residents’ dependency needs are met at all times. The procedures for the recruitment of staff have improved since the last inspection. However further attention is required to ensure that the procedures are fully robust to ensure the protection of residents accommodated at Chatsworth House. There has been some improvement in staff training since the last inspection. However, further attention to specialist training must take place to ensure that all residents’ individual needs physical and mental health needs are met. EVIDENCE: During the course of the inspection a discussion took place with the manager regarding the staffing levels. The staff rota was also examined. It was noted that staffing levels have remained the same since the last inspection July 2005 following a requirement made at the previous inspection November 2004 for staffing levels to be adequate at all times. The manager said that in her opinion the current staffing levels were adequate for the dependency levels of residents in the home. Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 Page 19 Prior to the unannounced inspection a discussion had taken place with the new responsible individual about staffing levels. It was noted that he has been reviewing current staffing levels in preparation for the potential increase in number of residents following the application to CSCI extend the home. The responsible individual was advised that current staffing levels must not reduce in the home for the care provided to the current numbers of residents. This inspection took place on a Monday and it was it was observed that the staffing levels were adequate for the needs of the resident accommodated that day. It was noted that the staff rota had improved since the last inspection. It is easier to read and staff job titles are now included. The inspector examined a sample of personnel files of five members of staff who had commenced working at Chatsworth House since the last inspection. It was observed on one file that the manager and deputy manager had interviewed the employee, which is good practice. However it was noted that the interview notes had not been dated or signed by either of these staff. It was also noted that the pre- employment medical questionnaire does not ask for any information about applicant’s mental health. This was discussed with the manager. All other checks were in place including an up to date Criminal Record Bureau /Protection of Vulnerable Adults checks completed by Chatsworth House prior to the person being employed. It was noted that the other four members of staff were employed on working visas from Bulgaria. It was noted that they all held health professional qualifications from their own country but were employed as care assistants. All members of staff are attending English language course. Criminal Records bureau checks had been completed in Bulgaria prior to entering the United Kingdom. These were dated February 2005. However, it was noted that no CRB/POVA checks had been completed by Chatsworth House since employment. The manager stated that this was because these new members of staff had only just arrived in the country. The manager was advised that this check must now take place as soon as possible and that all members of staff employed from overseas must be treated like British applicants. A risk assessment must be in place for these members of staff who must shadow work until POVA First and then CRB is completed. There is a programme of internal distance learning on statutory subjects, which includes basic food hygiene, first aid, and manual handling. It was noted that the manager, and deputy manager have completed training for trainers in these subjects, which enables them to provide training to all the care staff in the home. Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 Page 20 The staff also complete distance learning in specialist subjects such as dementia care and coping with aggression. The inspector advised the manager about the benefits of seeking external training as well as distance learning. As stated previously this has started to take place with protection of vulnerable adults training. The manager was advised about seeking medication training and information was provided about the Mental Health In reach team based in Bristol who also provide training to staff about working with people with dementia and mental health needs. The manager informed the inspector that the staff team are progressing well with NVQ training. Evidence confirmed that the staff from Bulgaria have attended a two weeks TOPPS induction course specifically designed for overseas staff. It was pleasing to hear that the Deputy manager has completed NVQ 3 and has recently obtained The Registered Managers Award. She is currently working towards NVQ4 in care management. Communication between residents and staff was noted to be very good and all staff observed were very sensitive to residents’ needs and spoke to residents with respect and an awareness of their dignity. A relative commented, “staff are very caring. There is no language problem with new staff whose first language is not English. The staff at Chatsworth House are consistent, which is nice” Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32, 37 There have been changes to the ownership of the home. However the residents continue to benefit from an experienced manager who ensures that residents’ rights and best interests are protected EVIDENCE: The manager has several years experience of managing Chatsworth House. She also has an NVQ4 in Management of Care Services and is considering studying for NVQ 5. She also holds a diploma in management of care services. Written records to confirm that she regularly updates her knowledge and skills. The manager is an NVQ Assessor. Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 Page 22 The Company that owns Chatsworth House has changed since the last inspection. It now consists of a sole owner who is also the registered responsible individual who conducts monthly visits to the home as required to by the legislation. This person has also recently attended training courses to up date his knowledge and skills. This training has included dementia care training. The majority of records, policies and procedures examined were up to date except those already discussed in the report. All staff consulted felt well supported and confirmed that they had regular team meetings and supervision. An external financial auditor visits the home on regular basis. There are arrangements in place to hold secure any finances held for residents. It was noted following the last inspection that environmental security arrangements have improved. Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 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 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X X STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X X 3 X Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 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 2 Standard OP9 OP19 Regulation 13 23(2)(d) Requirement Medication training must be organised externally to the home A programme of re carpeting and re decoration of the communal area must be sent to the CSCI Staff interview notes must be signed for and dated immediately after an interview All staff including overseas staff musty have CRB/POVA check completed before they start working in the home Timescale for action 31/08/06 31/05/06 3 OP29 19 15/04/06 4 OP29 19 30/04/06 Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 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 Refer to Standard OP30 Good Practice Recommendations Specialist training should be sought from sources such as Social Services and Health, “In reach” mental health team, Community psychiatric nurses, and District nurses to compliment the distance learning in place The pre-medical assessment for prospective staff should request information about applicants’ mental health 2 OP29 Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Chatsworth House DS0000026651.V263537.R01.S.doc Version 5.0 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!