Inspection on 28/11/05 for Chesham Bois Manor

This inspection was carried out on 28th November 2005.

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

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

Other inspections for this house

Chesham Bois Manor 06/09/07

Chesham Bois Manor 15/11/06

Chesham Bois Manor 12/04/05

Chesham Bois Manor 15/09/04

Chesham Bois Manor 20/04/04

Chesham Bois Manor 25/02/04

Similar services:

St Vincents

The Cotswold Home

Winton House

Newbeech House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Chesham Bois Manor Amersham Road Chesham Bucks HP5 1NE Lead Inspector Mrs Rosemarie James Unannounced Inspection 28th November 2005 09:45 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 Chesham Bois Manor DS0000022960.V267262.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. Chesham Bois Manor DS0000022960.V267262.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Chesham Bois Manor Address Amersham Road Chesham Bucks HP5 1NE 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) 01494 783194 B & M Investments Limited (Trading as B & M Care) Mrs Elaine Ward Care Home 48 Category(ies) of Dementia (31), Old age, not falling within any registration, with number other category (48) of places Chesham Bois Manor DS0000022960.V267262.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 48 residents, 31 of whom may have dementia. Date of last inspection 12th April 2005 Brief Description of the Service: Chesham Bois Manor is situated a short distance from the town centre of Chesham, a small town which provides a variety of shops and other local amenities. Chesham is served by local bus routes and has a Metropolitan Line tube station connecting it to main line services. The home is one of several run by B&M Care Limited, and provides accommodation for up to 48 elderly Residents, 31 of whom may require additional support due to dementia type illness. All Service Users are accommodated in single bedrooms, 23 of which have en-suite facilities. Communal areas consist of various lounge, dining and quiet areas.The home consists of an older building and a modern extension. The home has extensive, and well-maintained grounds, including a secure garden area where residents with dementia type illnesses can mobilise in a safe environment. A team of carers, a deputy manager, housekeeping and catering staff, support the homes manager, and access to healthcare professionals, including community nurses, is by direct contact or through General Practitioner referral. Chesham Bois Manor DS0000022960.V267262.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit was carried out on the 28th November 2005 commencing at 9.45am. The inspector was Mrs Rosemarie James. The registered manager Mrs Elaine Ward facilitated the inspection process. During the inspection the inspector followed up on the requirements and recommendations from the last inspection and measured the homes performance against a number of key national minimum standards. The inspector met with a number of residents, spoke to the manager at length, interviewed a senior carer, observed staff as they went about their tasks, undertook a brief tour of the premises and looked at a variety of paperwork. The inspector was made to feel very welcome and would like to thank the staff for their help with the inspection process and the residents for allowing the inspector into their home. What the service does well: What has improved since the last inspection? Following the last inspection, the manager has taken down all the signs / instructions for staff that gave the home an institutional feel. A redecoration programme has continued and the results of this are very pleasing. Although not all areas of the home were inspected, those parts of the home that the inspector saw were clean and no unpleasant odours were detected. Clarification from food suppliers has been sought as to the correct storage of produce. The manager reported that it was now the homes practice to liaise with the GP and/or the Pharmacist when queries arise pertaining to medication. The homes activities programme continues to develop. Chesham Bois Manor DS0000022960.V267262.R01.S.doc Version 5.0 Page 6 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. Chesham Bois Manor DS0000022960.V267262.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 Chesham Bois Manor DS0000022960.V267262.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): 1,2 & 6 The home have a statement of purpose and service users guide which, together with a homes brochure, are made readily available to anyone interested in living in the home or placing a relative there. This enables them to make an informed choice about making Chesham Bois Manor their or their relative’s home. All residents have a contract which they or their next of kin sign agreeing the terms and conditions of residency. EVIDENCE: The homes statement of purpose and service users guide was last revised in April 2004. The manager was aware that both documents were in need of an update although the anticipated changes were minor. Never the less keeping these documents up to date is important to ensure any potential resident and/or their family have the best picture possible of the facilities the home is able to offer. A copy of each document, together with a homes brochure, (providing both corporate and service specific information), are sent out to anyone making an enquiry about the home. This in addition to introductory Chesham Bois Manor DS0000022960.V267262.R01.S.doc Version 5.0 Page 9 visits ensures all interested parties have the information they need to decide whether to make Chesham Bois Manor a home for himself or herself or a family member. B & M Care also has a web site. The organisation have two contracts one for private clients and the other for those funded by social services that detail the same terms and conditions of residency. The only difference is the detail at the end of the document where payment responsibilities are stated. The contract of the latest resident to take up residency at the home was made available for inspection purposes. It was pleasing to see that a family member backed up by the appropriate power of attorney documentation had signed the document. The home does not provide an intermediate care facility. Core Standard 3 was assessed as being met at the last inspection. Chesham Bois Manor DS0000022960.V267262.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): 11 Staff training and the homes policy on death and dying ensure that at this difficult time residents and their family are treated with care and respect. EVIDENCE: The homes death and dying policy is informative but sensitive guiding staff in how to help both resident and next of kin at this most difficult time. It was pleasing to see that reference had been made to different faiths and the manager stated that information and backup from the organisation was available in meeting the needs of differing faiths should it be necessary. Staff receives training on the homes policy at induction including what to do in the event of a sudden death. Knowledge of this was confirmed in a discussion the inspector had with a member of the staff team. ‘After death intent’ details are discussed at the pre-admission stage and again if a resident was knowingly deteriorating. This is a difficult thing to do but is considered good practice and the home are commended for it. At the last inspection Key Standards 7,9 & 10 were assessed as met and Standard 8 as nearly met. Chesham Bois Manor DS0000022960.V267262.R01.S.doc Version 5.0 Page 11 With regard to Standard 8, it was recommended in the last inspection report that the manager reviewed the use of the tissue viability tool, ensuring it detailed any necessary action by staff. After a lot of consideration the manager felt the best way forward was for the use of tissue viability tools and in particular Waterlow, to be discontinued. This action was decided upon with the best interests of the staff and residents in mind. However, assessing the tissue viability of all residents as they are admitted to the home and indeed as their stay at the home continues is a very important. It has been made a requirement of this report therefore that tissue viability assessments are reintroduced as a matter of urgency and that staff are trained in working with them. A timescale of two weeks to undertake this task has been agreed with the manager. The score for this Standard will remain at 2. It is pleasing to be able to report that the home have revised their practices with regard to checking out the accuracy of medication administration requirements of a new resident with a GP or the Pharmacist. The manager has been advised to ‘firm up’ this practice by including it as part of the homes medication policy and ensuring all staff are familiar with the new practices. Chesham Bois Manor DS0000022960.V267262.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 & 14 The home has an activities organiser who plans a variety of social events and pastimes to satisfy the diverse recreational interests and needs of the residents. The home is supported by local churches, ensuring the religious needs of the current resident group, are met. Family involvement, the key worker system and Resident Forum meetings helps ensure residents can exercise choice and have control over their lives. EVIDENCE: As part of the admission process, the home ask residents and / or their families to complete a pen picture of their life to give staff a real insight into what has made them the person they are. Often previous hobbies and interests are identified. The home employs the services of an activities organiser for 20 hours per week. At this inspection the calendar and events arranged for December was on display. The residents could look forward to the following: Hairstyling and Manicures (for the ladies); Beacon Boys School to sing carols; Tina’s clothes show; St Leonard’s Youth Group to sing carols; Christmas church service; Waterside School to sing carols; a visit from the St Columbus Youth Group and the residents Christmas party. Chesham Bois Manor DS0000022960.V267262.R01.S.doc Version 5.0 Page 13 In addition to this, a weekly programme of events is organised. During the week the inspection was held the residents had the opportunity to participate in: indoor games; reminiscence quiz; sing-a-long; general knowledge quiz; board games; bowls and skittles; bingo; a shoe sale; ball games; painting and exercises. As stated earlier, the activities organiser is employed to work 20 hours per week. She does well to organise and supervise the activities she does and has the help of the care staff to do this. Chesham Bois Manor is a large home with a high level of dementia. In the managers opinion more designated hours are needed to develop the activities programme including one to one sessions if appropriate. The inspector supports this and increasing the number of activity organiser hours has been made a recommendation in this report. Family and friends are invited to participate in some of the social event organised. The most recent of these was a bell-ringing event. Contact with family members is encouraged and as the visitor’s book shows, the majority of the residents have frequent contact with family and friends. Only the week before the inspection and for the second time this year arrangements had been made for a staff member to accompany a resident to a family wedding. Exercising choice and having control over their lives is not easy for people who suffer from dementia. The home help by involving family members in the pre admission assessments, the drawing up and review of care plans and successfully operating a key worker system. For the more able residents Resident Forums are held. The minutes of the latest meeting held on the 1.9.2005 were made available for inspection purposes. These included a request to have the lounge door closed during Communion, trifle on the menu and a suggestion of variety performances for the home. Residents are consulted about decoration changes and are encouraged to bring in personal belongings including items of furniture to help make their rooms their own. There was evidence of this seen. A quality assurance questionnaire is distributed three times a year. Core Standards 13 & 15 were assessed as met at the last inspection. Chesham Bois Manor DS0000022960.V267262.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): 18 The corporate Adult Protection Policy, staff training and access to the Action on Adult Abuse Help Line all help ensure the residents are protected from abuse. EVIDENCE: The home has a corporate adult protection policy. Abuse awareness training commences at induction. The deputy manager has overall responsibility for training staff on this topic and has set up an information file for staff to consult. The telephone number for the Action on Elder Abuse Helpline is on display in the home. The home also has a whistle blowing policy. The manager was able to demonstrate an awareness of POVA. Core Standard 16 was assessed as met at the last inspection. Chesham Bois Manor DS0000022960.V267262.R01.S.doc Version 5.0 Page 15 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): 22, 23 & 26 The environment has been adapted and equipment provided to maximise the independence of those residents that are less physically able. The residents are encouraged to personalise their rooms to help make them as homely as possible. Standards of cleanliness in the parts of the home the inspector saw were good with no unpleasant odours detected giving the residents a pleasant and hygienic environment in which to live. EVIDENCE: The original house and more recent extension have been adapted and designed to facilitate easy access to those residents who are less physically able. These include lift facilities to floors above ground level; grab rails and disabled bathing and toilet facilities. The home also has a number of mobile hoists, which at the time of this inspection were in good working order. Pressure relieving equipment was seen to be in place where required. Chesham Bois Manor DS0000022960.V267262.R01.S.doc Version 5.0 Page 16 Many of the rooms at this home have en suite facilities. A redecoration programme of bedrooms continues and most of those seen were in good decorative order. Residents are encouraged to bring in their own items of furniture and other personal belongings to help personalise their rooms. There was evidence in this inspection of bedrooms showing the character and interests of their occupants. At the last inspection core Standard 26 was marked down to a 2 (nearly met) because behind furniture and in corners dust was evident. Several areas had unpleasant odours. Although an inspection of the entire premises was not undertaken during this visit, all the areas inspected were clean and there was no evidence of any unpleasant odours. The recent employment of an additional member of the domestic team who works full time appears to of helped. At the last inspection the inspectors were critical of the staff notices evident around the home, which distracted from the homely environment Chesham Bois strived for. It is pleasing to be able to report that this problem was quickly resolved and there were no notices evident at this inspection. Maintaining a safe environment for residents and staff is important. At the last inspection it was noted that carpeting outside bathroom 1 had come away from its gripper presenting a trip hazard and a requirement was made to rectify this by the 2/5/2005. At the time of this inspection this work had not been done. This is disappointing and the proprietors are reminded of their obligations to protect residents from harm. A further requirement has been set and the proprietors are advised to take account of the timescale set. No further extensions will be given. The manager is reminded to ensure that no objects are used to prop open bedroom doors other than devices approved by the fire officer. It will be made a recommendation of this report that providing such a device for bedroom 10 be considered. One maintenance issue was identified and rectifying this issue has been made a requirement in this report. The heating in bedrooms 1 to 4 was not as warm as other parts of the home. Rectifying this has also been made a requirement of this report. Core Standards 19 & 26 received a score of 2 (nearly met) at the last inspection. Standards of cleanliness at this inspection now warrant a score of 3 for Standard 26. The score of Standard 19 will remain at 2 until the carpet gripper safety hazard has been rectified. Chesham Bois Manor DS0000022960.V267262.R01.S.doc Version 5.0 Page 17 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): 30 The proprietors and manager have a positive attitude to training and facilitate and encourage this thus ensuring staff are trained and competent to do their jobs. EVIDENCE: The home are fortunate in that they have a designated training room in the home where training sessions can take place and where a variety of information about care tasks and practice are held for staff to refer to. It is pleasing to be able to report that more than 50 of the staff at this home has an NVQ Level 2 qualification. Two staff are currently working towards their level 3. The manager has recently successfully completed her Registered Managers Award. She is commended for this and for the fine example she sets her staff. Recent training to take place has included: safe handling of medicines; infection control; movement and handling; fire safety and Yesterday Today and Tomorrow a course run by the Alzheimer’s Society. Core Standards 27 & 29 were assessed as met at the last inspection. Chesham Bois Manor DS0000022960.V267262.R01.S.doc Version 5.0 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): 33, 35 & 36 The homes ethos ensures it is run in the best interests of residents. The home do not handle the finances of any resident believing the residents financial interests are best served if this responsibility remains with the resident or their next of kin. The home does not have a system of staff supervision, which has the potential to hinder improving practice and identifying training needs. EVIDENCE: The philosophy of care adopted by B & M and Chesham Bois is that the residents needs come first. This is demonstrated in the competence of the staff team and how they interact and work with residents on a daily basis. It can be difficult to have a meaningful conversation with individuals who have dementia. Those residents the inspector met with were very complimentary Chesham Bois Manor DS0000022960.V267262.R01.S.doc Version 5.0 Page 19 and no concerns were raised. Routines are kept to a minimum as evidenced by the staggered breakfast times. The home chooses not to have any responsibility for the management of resident’s finances. Any extra expenditures incurred e.g. hairdressing are invoiced monthly. The home do not have a formal system of staff supervision in place and this includes the fact that the manager herself does not get support via supervision from her line manager. This was discussed at this inspection. It will be made a requirement that the manager sets up supervision for her to take place monthly with effect from January 06. By the end of January the manager will be supervising her deputy and by the end of March the deputy and the manager will be supervising all their seniors. Cascading the supervision process further will depend on how soon senior staff members can access training in supervision skills. However, the Commission will expect the entire framework to be in place and regular supervision sessions for all staff to of commenced by the 30th June 06. Problems were identified at the last inspection regarding the storage of potentially harmful items. It is pleasing to be able to report that no evidence of this was found at this inspection. During a tour of the home it was observed that a trolley of hot beverages had been left unattended in a lounge of confused residents. It was also observed that one resident who did not appear able to help herself with her cup of coffee, spilt the contents of the cup over her thigh. Fortunately she did not suffer any harm. Staff are advised to be more vigilant when carrying out this task and not leave residents unattended. It is acknowledged that the manager was not pleased by what she saw indicating this was not normal practice in this home. Chesham Bois Manor DS0000022960.V267262.R01.S.doc Version 5.0 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 3 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X 3 3 X X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X N/A 1 X X Chesham Bois Manor DS0000022960.V267262.R01.S.doc Version 5.0 Page 21 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 OP38 Regulation 13(4a&c) 23(4ci) Requirement The staff room must be fitted with a self closing fire door. (Previous timescale of 02/05/05 not met) The carpet at the doorway to bathroom 1 must be repaired or replaced. (Previous timescale of 02/05/05 not met) The Statement of Purpose and Service Users Guide are to be reviewed and thereafter on an annual basis. The manager is to introduce the practice of tissue viability assessments for all current residents and incorporate this as part of the initial assessments carried out on new residents. Repair the ceiling outside bedroom 7. Take all necessary action to ensure bedrooms 1 to 4 are adequately heated. Care staff as appropriate to be trained in the drawing up and working with tissue viability assessment tools. Manager to receive formal supervision on a regular basis. DS0000022960.V267262.R01.S.doc Timescale for action 31/12/05 2. OP38 13(4a&c) 14/12/05 3 OP1 4&5 31/01/06 4 OP7 12 14/12/05 5 6 7 OP19 OP25 OP30 23 23 12 & 18 31/12/05 30/11/05 14/12/05 8 OP36 18 31/01/06 Chesham Bois Manor Version 5.0 Page 22 9 10 11 12 13 OP36 OP36 OP36 OP38 OP38 18 18 18 23 13 Manager to commence the supervision of her deputy. All senior care assistants to receive formal supervision. All staff to receive formal staff supervision. Bedroom doors must not be held open unless a device approved by the fire officer is in place. Staff must be more vigilant when serving hot drinks to residents in the lounge areas. 31/01/06 31/03/06 30/06/06 30/11/05 30/11/05 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 OP9 Good Practice Recommendations It is recommended that the manager firms up the homes new practice of liaising with GP’s and Pharmacists for clarification of prescribed medication for new residents by including a clause to this effect in the homes medication policy. It is recommended that the number of hours currently made available to an activities organiser is increased by 50 . Provide lockable bathroom cabinets throughout the home for the appropriate storage of toiletries, creams and other items. It is strongly recommended that a hold open device approved by the fire safety officer be fitted to bedroom door 10 as the resident in this room who has to spend time there, likes to have the door open. 2. 3. 4. OP27 OP38 OP38 Chesham Bois Manor DS0000022960.V267262.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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 Chesham Bois Manor DS0000022960.V267262.R01.S.doc Version 5.0 Page 24 - 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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