Inspection on 25/05/05 for Clanfield

This inspection was carried out on 25th May 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

Clanfield 03/03/09

Clanfield 03/08/06

Clanfield 24/11/05

Clanfield 11/01/05

Clanfield 08/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Clanfield 3 Toll Bar Road Islip Kettering Northants, NN14 3LH Lead Inspector Kathy Jones Unannounced 25 May 2005 07:15 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 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. Clanfield D C51 C08 S12743 Clanfield V223607 250505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Clanfield Address 3 Toll Bar Road Islip Kettering Northants NN14 3LH 01832 732298 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Paulette Crossley Mrs Paulette Crossley Care Home Only (PC) 30 Category(ies) of Dementia over 65 (DE(E)) 5 registration, with number Older People (OP) 20 of places Physical Disability (PD) 5 Clanfield D C51 C08 S12743 Clanfield V223607 250505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than 5 service users may fall withing the category of Physical Disability (55 years and over). Date of last inspection 11 January 2005 Brief Description of the Service: Clanfield is a care home providing personal care and accommodation for 30 service users who are over 65 years of age up to 5 whom also have dementiarelated care needs. Clanfield is privately owned by Mrs Paulette Crossley who is also the Registered Manager.The home is located in the village of Islip. The village of Islip, although quiet, is on the outskirts of the town of Thrapston. There are, therefore, numerous shops and other community facilities within a reasonably short distance, although realistically transport would be needed for this resident group to travel into the town. Clanfield is a two-storey house, with lift access to the upper floor, set in large and attractive gardens and providing a peaceful setting for the residents Clanfield D C51 C08 S12743 Clanfield V223607 250505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over the morning and early afternoon of a weekday. The inspection involved reviewing information from previous inspections and a complaint, which had been received since the last inspection. Notifications of incidents, which had occurred in the home, were also taken into account in the areas reviewed during the inspection. The preinspection information had not been received prior to the inspection however this was reviewed following the inspection with some information clarified through telephone calls. Comment cards sent out to the home had been distributed to Residents and relatives/visitors. A total of eighteen comment cards were received from Residents, these had all been forwarded by the home with the pre-inspection information and had been completed by a member of Staff and signed where possible by the Resident. Seventeen comment cards were received from relatives/visitors. During the inspection records relating to the assessment and planning of care needs, risk assessments and staff recruitment and training records were sample checked to establish the level of care and protection provided to Residents. Discussions with Residents and observations of the daily routines and care provided were made. The Inspector also met with a Staff member, the Deputy Manager and the Registered Manager to discuss progress in meeting previous requirements. What the service does well: The home provides a clean, comfortable and homely environment for Residents. The conservatory area used by some of the more independent Residents provides a very pleasant outlook onto the large gardens with opportunities for some bird watching. Meals and activities are both areas where positive comments were received from Residents. Staff responsible for both areas responding well to Residents and were seen to be knowledgeable about individual likes and dislikes. A lively and stimulating atmosphere was created for Residents during a quiz session. Care Staff though clearly under pressure particularly during the early morning period were dealing calmly and sensitively with Residents and all Staff were observed to have a caring approach to Residents. Clanfield D C51 C08 S12743 Clanfield V223607 250505 Stage 4.doc Version 1.30 Page 6 Complaints are taken seriously and there is a complaint procedure in place. What has improved since the last inspection? What they could do better: While partial compliance with previous requirements has been achieved progress will be monitored with the expectation that full compliance with requirements is met within the timescales set. Prior to admitting someone to the home more careful consideration needs to be given to the homes ability to meet his or her needs. Areas to be considered should include layout of the premises, staffing levels, levels of supervision and monitoring able to provide and staff training. Staffing levels and staff training are areas that still require further work to ensure that there are sufficient staff with the necessary skills and training to meet Residents needs. Suggestions have been made for a system for recognising Staff and their respective roles to enable relatives/visitors where necessary to easily identify senior staff. The adequacy of the management arrangements is to be discussed with the Registered Owner/Manager following receipt of written proposals, which she has confirmed have been posted to the Commission for Social Care Inspection. Clanfield D C51 C08 S12743 Clanfield V223607 250505 Stage 4.doc Version 1.30 Page 7 The extent of the shortfalls identified at the previous inspection raised concerns about the management of the home, which identified that the Manager was working on a part time basis with several different staff carrying out various management responsibilities. The proposals will be reviewed taking account of the need for strong leadership, accountability and overview of the home to ensure that regulations are fully met and Service Users are properly protected. 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. Clanfield D C51 C08 S12743 Clanfield V223607 250505 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Clanfield D C51 C08 S12743 Clanfield V223607 250505 Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, Standard 6 is not applicable as the home does not provide intermediate care. The admissions process provides insufficient assurances that Service Users needs can be fully and safely met. EVIDENCE: Records for two recently admitted residents were sample checked. This confirmed that assessments of care needs had been carried out by the home prior to admission and that copies of care management assessments had been obtained where applicable. The assessment information in both cases identified episodes of wandering prior to moving into the home. Due to some recent incidents and a complaint about two vulnerable Residents leaving the home unsupervised the Registered Provider is seeking advice and reviewing the measures in place to protect Residents while trying to maintain their independence and rights. The incidents indicate the need to consider more carefully the homes ability to meet specific identified needs prior to admission. Clanfield D C51 C08 S12743 Clanfield V223607 250505 Stage 4.doc Version 1.30 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 standard(s) 7, 10 The improvements being made in the care planning and risk assessment systems provide Staff with better information to meet Residents needs and manage risks. EVIDENCE: Care plans and individual risk assessments are in place for Residents to guide the care provided. There is a good level of detail regarding individual needs and improvements have been made since the last inspection particularly in the area of risk assessments. Two members of Staff have received some risk assessment training with one of them tasked with putting into place individual risk assessments for all Residents. Discussion with the Staff member doing the risk assessments confirmed that the individual risks to each Resident were being considered and that care was being taken to also consider their rights, choices and independence. Advice was given to confine the risk assessments on individual files to those that are specific to that Resident to avoid unnecessary paperwork and the risk that Staff may miss important information. For example there would only be a need to introduce a risk assessment for a Resident not taking medication if this Clanfield D C51 C08 S12743 Clanfield V223607 250505 Stage 4.doc Version 1.30 Page 11 had been identified as a risk prior to admission or if they refused medication at any time. However it may be helpful for Staff to have some written guidance as to the immediate actions they should take in such an event and risks relating to the individual that should be considered and reviewed. Some advice was given regarding the type of detailed information, which should be included to ensure specific needs can be safely met. There is evidence that Care plans and movement and handling assessments are being reviewed however one of the files looked at showed some discrepancies in information where needs had changed and not been updated on the movement and handling plan. Eighteen comment cards were received from Residents and of these sixteen said they felt well cared for, one said sometimes and one didn’t. All of the comment cards received had been completed with the help of a Staff member, discussion regarding the Resident who didn’t feel well cared for indicated the reason for this related more to a preference to be in their own home which was supported by other comments made. The Inspector spoke to several Residents during the inspection none of who had concerns about the way they are cared for. Seventeen comment cards were received from relatives/visitors and of these fifteen were satisfied with the overall care provided and two indicated they were generally satisfied but that there is room for improvement. Sixteen comment cards from Residents stated that their privacy and dignity is respected while two felt it is sometimes. During the inspection Staff were observed to speak to Residents in a respectful manner and personal care was provided in the privacy of Residents rooms. Clanfield D C51 C08 S12743 Clanfield V223607 250505 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 15 The routines of the home provide Residents with some choices, flexibility and stimulation. EVIDENCE: Comments received from relatives/visitors indicate that there is a flexible visiting policy and visitors were observed to come and go freely during the inspection. The majority said that they are welcomed into the home by Staff/Owners; one felt this wasn’t the case and another that only Staff were welcoming. All felt that they were kept informed of important matters affecting their relative/friend and in cases where this was applicable consulted about the care where Residents were not able to make decisions. Observations during breakfast confirmed that catering Staff are very aware of individual Residents likes and dislikes and were encouraging and offering alternatives where appropriate. Breakfast including drinks and toast were freshly prepared for each Resident as they came to the dining room for breakfast. Some Residents needed assistance with their meals, Catering Staff helped where possible and night Staff stayed for a while to help. Residents were not rushed and received appropriate help with their meals, which in some cases was just prompting. Clanfield D C51 C08 S12743 Clanfield V223607 250505 Stage 4.doc Version 1.30 Page 13 Comment cards received from Residents stated that sixteen liked the food and two did sometimes. Residents spoken to during the inspection confirmed that the standard of the meals was very good. An Activities Organiser has been appointed for five sessions a week and was running a quiz on the day of the inspection, which a lot of Residents were participating in and appeared to be enjoying. Comment cards received from Residents confirmed that the majority are happy that the home provides suitable activities with one requesting more quizzes. Some external entertainers are used to supplement the activities programme and some exercise sessions are arranged fortnightly. The Activities Organiser advised that she is developing the activities programme to meet the varying needs and abilities of Residents and recognises that for some Residents one to one conversation is appreciated. A comment from a relative/visitor indicates that there is a need to consider how Residents can become involved in some simple chores and short walks to enable them to remain engaged and physically active. Clanfield D C51 C08 S12743 Clanfield V223607 250505 Stage 4.doc Version 1.30 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 standard(s) 16 Complaints appear to be taken seriously with the findings of investigations being acted on. EVIDENCE: There is a copy of the homes complaints procedure in the hall of the home, which was revised following the last inspection. Comments cards from relatives/visitors stated that twelve are aware of the complaints procedure and five are not. The Deputy Manager advised that a copy of the complaint procedure is now given out to all new Residents and their families. The Commission for Social Care Inspection has received one complaint about the home since the last inspection. This complaint related to a Resident who was found to have wandered towards the centre of the town. An initial review of the homes procedures was carried out and the Registered Owner/Manager has said that further advice is being sought regarding the policies and procedures. Other similar incidents have occurred since and the Registered Owner/Manager confirmed that she is in the process of getting quotes for work to make the premises more secure to reduce the risk. In the meantime risk assessments have been carried out and Staff confirmed that they are checking more regularly the whereabouts of Residents who are confused and at risk of wandering. Clanfield D C51 C08 S12743 Clanfield V223607 250505 Stage 4.doc Version 1.30 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 standard(s) 19, 26 The standard of the environment is good providing Residents with a clean, comfortable and homely place to live. EVIDENCE: The home is set within its own grounds and has large mature gardens to the rear. A conservatory/lounge looks directly onto the gardens and some Residents were enjoying watching the different birds, one, which the Inspector was told, is quite rare. The communal areas of the home were clean, looked homely and comfortably furnished. The temperature in the home at the time of the inspection was comfortably warm. A free standing radiator that had been in the conservatory at the time of the last inspection and identified as a risk had been removed and Staff advised that it was no longer necessary since the central heating system has been rebalanced. Clanfield D C51 C08 S12743 Clanfield V223607 250505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 30 The improvements in the recruitment procedures provide better protection for Residents however staffing levels and Staff training need to be improved to adequately meet Residents needs. EVIDENCE: Of the comment cards received from relatives/visitors nine said that in their opinion there were sufficient staff on duty while six felt this was not always the case with one identifying evenings as a particular time when staff are very rushed. One comment made was that there are too many chiefs and not enough Indians. The pre-inspection questionnaire states that staffing levels are going to be increased. The Deputy Manager confirmed that staffing levels are being reviewed in accordance with Residents needs. On the morning of the inspection there was a shortage of care staff due to sickness, however the Inspector noted that Staff were working together to minimise the impact on Residents for example night staff stayed on later to assist some Residents with breakfast and catering staff were also assisting and monitoring Residents with breakfast. Observations and staff rotas identified that various support staff are employed in the home including a housekeeper, catering staff, cleaners, laundry staff and staff who assist with serving teas. A comment received from a relative/visitor suggests that it would be helpful to have a board in the home with photographs of staff and there positions so that Clanfield D C51 C08 S12743 Clanfield V223607 250505 Stage 4.doc Version 1.30 Page 17 relatives and visitors can easily identify senior staff. This comment links with part of the complaint received since the last inspection, which said it, was difficult to identify staff members, as they don’t wear uniform. The reason given for not having uniforms was that they wanted to preserve a homely atmosphere however in the light of the comments and suggestions other options such as the photographs may be helpful to Residents and Relatives/visitors. The Inspector experienced similar difficulties at the start of the inspection in identifying staff roles and a recommendation has been made to give consideration to the suggestion. Concerns were raised at the inspection carried out in January regarding the homes recruitment practices, which did not adequately protect Residents. A sample check of staff files, information received in the pre-inspection questionnaire and discussion with the Registered Owner/Manager and the Deputy Manager confirmed that action has been taken to address these issues. More thorough procedures are in place, which includes obtaining references and criminal record bureau clearances prior to staff starting work in the home providing better protection for Residents. A requirement was made at the previous inspection regarding the need for staff to receive induction and foundation training which meets the expectations of the National Training Organisation. Two staff have attended training to enable them to provide the relevant training however this training now needs to be provided for staff to ensure that all staff providing care have at least some recognised basic training. Clanfield D C51 C08 S12743 Clanfield V223607 250505 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 36, 38 Management arrangements need to be agreed and formalised to ensure that there is strong leadership, accountability and overview of the home to ensure that regulations are fully met and Service Users are properly protected. EVIDENCE: Clanfield D C51 C08 S12743 Clanfield V223607 250505 Stage 4.doc Version 1.30 Page 19 It was identified at the previous inspection that the Registered Manager had been working part time in the home with the day to day running of the home being carried out by the Deputy Manager and Senior Staff. The Commission for Social Care Inspection had not been informed of the changes to the management arrangements. A requirement was made for a proposal to be submitted in order that the adequacy of the management arrangements could be discussed and agreed. This requirement remained unmet at the time of this inspection however prior to completion of this report the Inspector has been informed that the proposal has been posted. The proposal will be reviewed at the earliest opportunity and discussed with the Registered Owner/Manager taking account of the need for strong leadership and management able to take responsibility and control over the delivery of care. It was evident that following the last inspection a lot of work has been carried out with progress being made in meeting the requirements made which were all based on the minimum expectations for the provision of care in care homes as set out in the legislation. A requirement was made at the previous inspection for arrangements to be made for staff to receive supervision. Formal staff supervision sessions are important in that they provide regular opportunities for discussion about individual strengths and areas where staff need more training or extra support in providing care or meeting Residents specific needs. The Deputy Manager confirmed that the process has started but that is still in the very early stages. Records have been established which provide a good overview of training including various training relating to safe working practices carried out by staff and the dates on which they received it. This record has clearly identified areas where training is required which the Deputy Manager advised is being arranged. This is an area, which requires progressing as a matter of urgency to ensure that Residents are properly safeguarded. As discussed under a previous section two members of Staff have received some training and guidance in risk assessment. In addition to the individual risk assessments for Residents, risk assessments relating to the premises are being undertaken. The Pre-inspection questionnaire confirms that relevant safety checks are carried out which include checks on fire safety equipment, central heating system and the lift and that action has been taken to address any requirements or recommendations. Clanfield D C51 C08 S12743 Clanfield V223607 250505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 2 x x x x 2 x 2 Clanfield D C51 C08 S12743 Clanfield V223607 250505 Stage 4.doc Version 1.30 Page 21 Yes Are there any outstanding requirements from the last inspection? 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 3 Regulation 12 (1) (a & b), 14 (1) (d) Requirement All information received during the assessment process must be taken into account when assessing the homes ability to meet a prospective residents needs. Staffing levels in relation to dependency levels must be kept under review and increased where necessary based on assessment of Residents needs throughout the twenty four hour period. Staff must receive induction and foundation training which complies with National training Organisation specifications..( Similar requirement with timescale of 30.03.05 partially met) All Staff must be receiving regular supervision sessions.( Similar requirement with timescale of 15.03.05 partially met) Staff must receive up to date training in safe working practices including first aid, movement and handling, fire safety, food hygiene and infection control.(Previous timescale of Timescale for action 30.06.05 2. 27 12 (1) (a & b), 18 (1) (a) 30.06.05 3. 30 12 (1) (a & b), 18 (1) (c ) ( i) 30.08.05 4. 36 18 (2) 30.08.05 5. 38 12 (1) (a & b), 18 (1) (c) (i), 13 (4) (c) 30.07.05 Clanfield D C51 C08 S12743 Clanfield V223607 250505 Stage 4.doc Version 1.30 Page 22 30.03.05 partially met) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 7 16 27 Good Practice Recommendations Work on improving care plans and risk assessment based on the advice given should be completed as soon as possible and then reviewed regularly. Consideration should be given to providing existing residents and relatives with copies of the complaints procedure if not already received. Consideration should be given to methods of ensuring relatives/visitors are able to easily identify staff and their responsibilities particularly senior staff. Clanfield D C51 C08 S12743 Clanfield V223607 250505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Northamptonshire Area Office Newland House, First Floor Campbell Square Northants, NN1 3EB 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. 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